Business of the House
Debate between Baroness Winterton of Doncaster and Maria Caulfield(4 months, 3 weeks ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)
On a point of order, Madam Deputy Speaker. I am very grateful to you for allowing me to raise a point of order from the Front Bench. It relates to comments that the shadow Leader of the House, the hon. Member for Manchester Central (Lucy Powell), made at the start of business questions. She did notify me that she was going to make those comments, but after business questions had started. However, this point of order is more about the content of the comments, which I personally found very difficult.
I did write to my constituents over a year ago about a consultation that is being run by my local council on 15 to 20-minute communities. In that letter, I pointed to some of the rumours about 15-minute cities, because that is something that constituents have raised with me. That consultation is still live on the council’s website—it is on page 45 of its planning and appraisals document—so this is very much a constituency-based issue.
However, I find it very difficult to be accused of being a conspiracy theorist on the back of that, especially as the vaccines Minister. Whenever there is a debate in this place on that subject, the number of death threats and the amount of abuse that I get is overwhelming at times. I realise that colleagues sometimes have valid points to raise, but there is a backlash whenever those debates are held.
More importantly, being linked to antisemitism when my family in London are actually Jewish, and have had a very difficult time over the past few months, was devastating. I kindly ask the shadow Leader of the House to either withdraw those statements, or just to reflect that while we all play politics in this space, sometimes things are very personal.
Madam Deputy Speaker (Dame Rosie Winterton)
Does the shadow Leader of the House wish to make a further point of order?
Business of the House
Debate between Baroness Winterton of Doncaster and Maria Caulfield(2 years ago)
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Maria Caulfield (Lewes) (Con)
On page 31 of the Conservative party manifesto, the Government pledge to protect greenfield sites and prioritise brownfield sites for development, yet in practice planning inspectors are overturning local democratic planning authorities’ decisions to refuse building on greenfield sites—most recently at South Road in Wivelsfield in my constituency, while Nolands Farm in Plumpton and Mornings Mill in Polegate are facing a similar fate. Can we have a debate in Government time about the Government’s commitment to their pledge in the manifesto, the promise made by the Prime Minister to the Father of the House recently, and the role of planning inspectors in overturning these democratic decisions?
Madam Deputy Speaker (Dame Rosie Winterton)
Order. Before I call the Leader of the House, let me say that I want to get everybody in, so it is quite important that questions are brief.
NHS and Social Care Funding
Debate between Baroness Winterton of Doncaster and Maria Caulfield(7 years, 8 months ago)
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Dame Rosie Winterton
I do not agree with the hon. Gentleman. The four-hour target led to much better diagnoses and much improved provision of the type of treatment that people needed, as well as better interaction with communities. And I want to come on to that point because the Secretary of State has been trying—perhaps the hon. Gentleman is guilty of this as well—to separate the target for A&E departments from what happens outside, whereas I see the importance of putting the two together. Providing alternative treatment, which is perhaps part of what the hon. Gentleman was getting at, means having proper support in the community. It was bringing those two things together that made it possible to achieve the target, so it was a driver.
Dame Rosie Winterton
I give way to the hon. Lady, who I know has some experience of this.
Maria Caulfield
In my experience of trying to meet the four-hour target, it is often—or was in the past—prioritised over everything else, including patient care and clinical need. It was sometimes abused, with huge pressure put on staff to meet the target, and as a result patient care suffered. I saw that myself.
Dame Rosie Winterton
It is always important to look at the feedback from clinicians, and I did that as a Health Minister. It started during my time as a Minister, and I remember that we had constantly to consider whether there was a clinical reason for reducing the 95% target. It became clear that some patients needed longer to be assessed owing to their particular condition. In such cases, I could see why the target might need to be reduced, but that was based on clinical need. By contrast, the impression given last week was, “My goodness! We’re going to have to cope with some winter pressures. Let’s reduce the target in order to meet it,” rather than there being an assessment of clinical need. That sent completely the wrong message to the NHS. I think it was the wrong thing to do.
I want briefly to set out some areas in which we can bring the community input together with what is happening in emergency departments to reduce some of the pressures. The first point was that made by my hon. Friend the Member for Leicester South (Jonathan Ashworth), who spoke from the Front Bench. Good social care is vital to ensuring that people do not end up in A&E. I have previously raised problems with the Government’s current proposition to, in a sense, move responsibility for raising money to local councils. That is particularly unfair in areas such as mine, which simply cannot raise the same amount of money through a council precept as better-off areas can. It simply does not work. We need it probably more than any other area, but we will be less able to raise the money.
On shortages, I have been talking to senior NHS staff in Doncaster, and there are real problems with emergency care staffing. They tell me that although more doctors are being trained—I accept that—it will take years for them to come through. The single most effective step we can take to ease pressure on A&E departments is immediately to increase funding for social care, because it would keep people out of A&E departments, and it could be done straightaway. The personnel are out there; the Government just need to increase the funding, as my hon. Friend said from the Front Bench.
We also have to look seriously at the problem of GP shortages. As others have said, if patients are waiting three weeks to get an appointment with a GP, they are bound to end up in A&E. This needs to be addressed very quickly, with proper forward looks at exactly where the gaps are in GP services. I have said before that PCTs—now clinical commissioning groups—or NHS England should be able to take over practices and employ salaried GPs. That would make a huge difference.
Furthermore, on community pharmacies, if people are confident that going to a pharmacy will save them a visit to A&E, again that will relieve pressure on the system. I hope, therefore, that the Minister will assure us that he is looking seriously at the community pharmacy forward view, which sets out how pharmacies can be integrated into the NHS and social care.
Briefly on mental health, the Prime Minister answered a question today about mental health and the crises that people can get into, which mean that they end up in A&E. She talked, in particular, about young people. I urge the Minister to consider the role that educational psychologists can play in children’s mental health and in keeping them out of A&E.
It was my experience as a Health Minister that we needed people on the ground locally to help organisations across the spectrum—local government through to social care, pharmacies, GPs and ambulances—to work with A&E departments, yet the £2 billion reorganisation that removed PCTs and strategic health authorities has made it much more difficult to drive through the necessary changes. I hope, therefore, that the Minister will look very seriously at what has happened, because local knowledge can be vital.
On the basis of the Secretary of State’s contributions, it seemed that he was trying to use every excuse not to face up to the reality of what is happening. I think that sends a terrible message to NHS staff. I hope that, as a result of today’s debate, the concerns raised will be taken on board by Ministers and the Secretary of State and that they will come back to us with a proper plan that recognises the problems and offers real solutions.