Oral Answers to Questions

Thelma Walker Excerpts

Tuesday 23rd July 2019 Commons Chamber

[Matt Hancock]

We have. Through Public Health England, which is the responsible agency, we have absolutely put out communications, which I heard this morning. The communications that the hon. Lady asks for are out there. Of course air pollution is a significant risk to public health. I am delighted that it is falling to its lowest levels since the industrial revolution, but there is clearly much more that we need to do.

[Thelma Walker (Colne Valley) (Lab)]

Can the Secretary of State confirm that the Care Quality Commission has recently inspected Calderdale and Huddersfield NHS Foundation Trust, and that patient safety was raised as an issue during that inspection? If that is the case, what action is he taking?

[Caroline Dinenage]

Clearly, patient safety is a massive priority for the Government. I do not know the exact details of the site that the hon. Lady is talking about, but if she would like to drop me a line, I will definitely find out and get back to her.

Cystic Fibrosis Drugs: Orkambi

Thelma Walker Excerpts

Monday 10th June 2019 Westminster Hall

[Thelma Walker (Colne Valley) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Bailey.

It is just two years ago last week that I was elected Member of Parliament for Colne Valley. Over the past two years, it has been a real privilege to serve and speak up for my constituents. One day, however, will stand out more than most for me, among many amazing and challenging days. It was Friday 31 May, when two children visited me in my constituency office. One was nine-year-old Tristan with his grandpa John, and the other was one-year-old toddler Charlie with his Mum and Dad. I had had a busy advice surgery that afternoon, but went straight to meet Charlie in one room, while Tristan waited patiently in another. They were in different rooms to avoid cross infection as they both suffer from cystic fibrosis.

They had come to see me to each hand me a letter in which they described their daily challenges living with cystic fibrosis. The letter also described how access to just one particular drug might make their daily battle with the disease a bit easier, and might result in both children living longer lives. One-year-old Charlie, along with his parents, would benefit if he could access the necessary drug from such an early age. Charlie handed over his letter to me, which I must admit was a bit soggy and chewed by the time I got it. It was a joy to be with him and his parents.

Tristan also handed me a letter. Following the death of Tristan’s father in 2016, Tristan’s grandpa and granny, John and Frances, look after Tristan as his guardians. The family have experienced more than their fair share of loss. Like Tristan, his uncle Adam suffered from cystic fibrosis, and died aged 25 in 1999. I can only imagine the immense pain and grief and incredible frustration of losing a son, yet still, nearly 20 years later, being unable to access the drugs that already exist and that would improve the life of their grandchild. I cannot express how much admiration I have for Tristan and his family, and for Charlie and his; they have campaigned with the Cystic Fibrosis Trust to improve the lives of others.

What is this drug? It is called Orkambi; it already exists and it would improve the lives of children such as Tristan and Charlie. It is made by the pharmaceutical company Vertex, and the fact that it is not already available to those who need it is shameful. There are at least 2,834 people currently dealing with cystic fibrosis in England who could benefit from Orkambi.

Why has Orkambi not been made available? The current situation is that Vertex, NHS England and the National Institute for Health and Care Excellence cannot agree a price. We know that Vertex declined a £500 million offer from NHS England, and we know that the NHS has made a new offer, which currently remains confidential. Vertex did not consider £500 million an adequate sum, but it did, allegedly, consider it okay to destroy 8,000 packs, or a 600-year supply of Orkambi, as the deadlock continued. The lives of children such as Tristan and Charlie seem to be deemed acceptable collateral damage in this boardroom-style version of healthcare provision.

I urge Vertex to consider the NHS’s current offer with the lives of children such as Charlie and Tristan at the forefront of its mind. This seems to me to be a straightforward ethical decision for Vertex, which should be willing to compromise on its profit margin in circumstances where the lives of children are at stake. Let us be clear: Vertex is not struggling to make ends meet. It is a $43 billion company. That is about the same as the GDP of Bolivia or Tunisia. Vertex’s chief executive officer received a total salary of around $19 million in 2018, making him one of the best paid CEOs in the pharmaceutical industry. As ever, the problem is not that there is not enough money, but that big business is not willing to spend it.

This situation, in which children’s lives are held to ransom, must not continue. Vertex and NHS England must agree a deal soon, or an interim solution must be found, as happened in Scotland. Children’s lives must not continue to be held hostage. Tristan’s grandpa has already lost a son to this condition. There is simply no excuse for not prolonging and improving Tristan’s life. I will continue to campaign with Tristan and his grandpa, and Charlie and his parents, until this drug is made available to them and they are able to get on with their lives.

I will finish with a direct plea from Tristan’s grandpa, John Binns:

“We don’t have time – please don’t waste it. It’s costing lives and there are too many cystic fibrosis angels already.”

NICE Appraisals: Rare Diseases Treatments

Thelma Walker Excerpts

Thursday 21st March 2019 Commons Chamber

[Liz Twist]

Like the hon. Gentleman, I took part in the PKU diet for a day challenge. It was indeed very restrictive, even though I knew it was only for one day.

Archie is one of those who responds well to Kuvan, and last year, his parents took the difficult decision to pay to buy him the drug. That took a great deal of soul searching on their behalf, and it cost them dear—£25,000 a year, even though Archie is currently on just half a dose. They know that for many people with PKU, or for parents with more than one child who has PKU, it is simply not possible to self-fund, and they are acutely conscious of the unfairness of that. The difference that Kuvan has made to Archie is real and significant: increased concentration and energy, so that he can make the best of his education; no recurring mouth ulcers, which were a real problem; and a chance substantially to increase the number of exchanges he can have, and eat a more normal diet. For Archie, Kuvan has made a real difference.

Archie’s case, and those of many others in other constituencies, prompted us to form the all-party group on phenylketonuria, and to consider how Kuvan could be made available to those who would benefit from it. Nearly 10 years after Kuvan was approved, that treatment does not seem to have been an appraised, and in England it is still not available on the NHS. Since we set up the group, there has been a move for Kuvan to be appraised by NICE, and discussions have been held with NHS England about a managed access agreement. We were disappointed to learn just before Christmas that no agreement had been reached on that managed access agreement, and that the NICE appraisal was to be via the single technology appraisal route, and not the highly specialised technologies programme. I understand that following a legal challenge, the Department of Health and Social Care is again considering the appropriate appraisal route, and the all-party group has made representations on that point.

When talking about the NICE appraisal system it is easy to get lost in technical details—QALYs, and everything else, that means nothing to people on the street—but what really concerns people is whether or not there is a fair chance that the drugs they need will be fairly assessed and made available on the NHS.

[Thelma Walker (Colne Valley) (Lab)]

I thank my hon. Friend for securing this debate. One of my constituents suffers from Batten disease and is receiving cerliponase alfa on compassionate grounds. However, NICE will not now recommend that treatment, which in part is due to cost. Does my hon. Friend share my view that allowing patients on to clinical trials when there is no funding to deliver the treatment, places them and their families in an incredibly difficult and uncertain position regarding their future?

[Liz Twist]

I certainly agree, and such things happen too often. We need a system that properly evaluates those drugs.

Integrated Care Regulations

Thelma Walker Excerpts

Monday 18th March 2019 Commons Chamber

[The Minister for Health (Stephen Hammond)]

Although we oppose the motion, I welcome the opportunity to debate the regulations. The NHS long-term plan, which was published in January, set out a clear blueprint for fully integrated community health in the NHS for the first time in its history. The plan highlighted the intention to dissolve the historical distinction between primary and community health services and to break down the traditional barriers between care institutions, teams and funding streams, so as to support the increasing number of people with long-term health conditions, rather than viewing each encounter with the health service as a single unconnected episode of care.

NHS organisations will increasingly focus on population health by delivering the so-called triple integration of primary and specialist care, physical and mental health services, and health with social care, which is consistent with what doctors have consistently reported they need. I obviously welcome the commitment from the shadow Secretary of State, the hon. Member for Leicester South (Jonathan Ashworth), to integration. Today, the integration of services can take place through collaboration and co-operation, including some local alliance arrangements. However, in some areas, people working on the ground have told us that it would be better to have a lead provider to take responsibility for the integration of services for a population through an integrated care provider contract.

It is worth making the distinction between integrated care providers, which we are discussing tonight, and integrated care systems. An integrated care system growing out of the current network of sustainability and transformation partnerships will provide a platform on which commissioners can make shared decisions with providers about how to use resources, design services and improve population health. The long-term plan has set out an ambition for all STPs to evolve into ICSs. Integrated care providers, or ICPs, will be a new way of integrating health and care services so that people’s care is co-ordinated around them.

NHS England has developed the ICP contract to enable local areas to commission local health and care services, including primary medical services through a single contract. The intention is to establish the right organisational and financial incentives for providers to collaborate in order to deliver preventive, proactive and co-ordinated care. It is important to underline that ICPs are not new types of legal entity, but provider organisations that have been awarded ICP contracts. In the long-term plan, NHS England underlined that, when the contract is made available for use, it expects ICP contracts to be held by public statutory providers, and I want to discuss that a bit more in my remarks later.

Turning to the particular statutory instrument we are discussing tonight, we have identified a number of regulations that need to be amended to allow the first ICP contract to be awarded.

[Thelma Walker (Colne Valley) (Lab)]

In the last year, I have been on numerous Delegated Legislation Committees, and I have been shocked by the complex and far-reaching changes the Government have forced through without appropriate scrutiny. Can the Minister justify why substantive change to existing regulations should not be part of a Bill and subject to parliamentary scrutiny?

[Stephen Hammond]

As the hon. Lady knows, this has been subject to considerable scrutiny. It has been scrutinised by the Health and Social Care Committee, as she has already heard from its Chairman. She will also have heard that it has been subject to a number of other scrutiny processes, including judicial reviews.

Hospice Funding and the NHS Pay Award

Thelma Walker Excerpts

Wednesday 31st October 2018 Westminster Hall

[Liz McInnes]

Of course I agree with the hon. Gentleman, and I will go on to talk about recruitment and retention and the problems that this issue is causing to our hospices in Bolton, in Rochdale and, I am sure, up and down the country.

The chief executive raised three issues with me; I have outlined the first, but the second was whether the effect of the pay increase on voluntary sector hospices had been calculated. The third point was whether voluntary hospices would be able to access additional Government funding to be able to afford the NHS pay increase.

[Thelma Walker (Colne Valley) (Lab)]

Does my hon. Friend share my concern that these changes will only reinforce existing recruitment and retention pressures, and agree that the Government should ensure that they take steps to address staffing issues as well as pay changes?

[Liz McInnes]

There is a theme developing on recruitment and retention. We have shortages of particular groups of staff, and a two-tier pay arrangement for different NHS providers will only exacerbate those problems.

--- Later in debate ---

[Caroline Dinenage]

I can only applaud the hon. Lady’s tenacity in continuing to make that case, and we will certainly look into the matter. As I say, I have no knowledge of that individual case, but I share the desire of my right hon. Friend the Member for New Forest West to ensure that hospices such as Naomi House and Jacksplace have the funding that is necessary to do their incredible work. My mum got the whole family involved in all manner of quite humiliating fundraising exercises back in the 1990s to build Naomi House children’s hospice, and I was delighted that my role as Minister took me back to Naomi House and, indeed, Jacksplace, which caters for young adults. I went there over the summer, and Mark Smith, its director of care, was kind enough to give me a tour of the facilities. We discussed some of the issues that have been raised today, as well as others, and my team has been looking carefully at what more we can do about some of those issues.

Since I was appointed Minister for Care in January, I have met with a range of charitable stakeholders from the end of life and palliative care sector, as well as the national clinical director for end of life care, Professor Bee Wee, who is quite incredible. Having met both system representatives and representatives of charities, I have been impressed by not only their incredible passion and commitment to see Government aims for end of life care delivered, but the shared consensus on what changes are needed to drive through the improvements that we would all like to see. Hospices are an incredibly important feature of end of life care provision, but we have to see them in the wider context of our ambitions in that area. In 2016, the Government published our end of life care choice commitment, which encompasses the whole system approach to transforming end of life care, placing patients and their choices, needs and preferences at the heart of planning. The NHS gets it right when choice is meaningful, personalised, and matched by healthcare services that can respond in an effective way that places patients, families and carers at the centre of the decision-making process. I know that parts of the country are delivering excellent palliative and end of life care for both adults and children.

[Thelma Walker]

The Minister’s reference to “parts of the country” is of concern to me. Does she agree that the amount of funding, and the capacity for particular communities to raise that funding, is still a postcode lottery? In more deprived areas, accessing the knowledge, skills and ability to raise that funding is more of a challenge. How would the Minister suggest that we create more equity and parity?

[Caroline Dinenage]

The hon. Lady makes an excellent point. She is right: there are services up and down the country delivering first-class care, but there are also areas where we know we need to do more. NHS England is firmly focused on providing both the support and the challenge to achieve that, and the hon. Lady is right to mention the incredible efforts of the imaginative and resourceful volunteers who do incredible work to raise much-needed funds for those vital hospices.

A key objective in delivering our commitment to strengthening the provision of end of life services out of hospital and in the community is that people should have that level of choice, and a quality choice, up and down the country. Work is ongoing nationally to provide sustainability and transformation partnerships with tailored information to assess and enhance end of life care services in their areas. We talked earlier about commissioning; NHS England has commissioned Hospice UK to undertake an evaluation of the cost-effectiveness of hospice-led interventions in the community. Historically, hospices have struggled to demonstrate strong evidence of the services they provide and the fabulous care that we all know they offer.

The hon. Member for Burnley (Julie Cooper) mentioned currency. NHS England is working to support local use of the specialist palliative care currency, which can help local areas to plan and deliver services, including hospice services. The currency can help local services better understand the complexity of palliative care and the investment needed to deliver it properly. It is also essential that we can assess how effectively commissioners are working to improve end of life care services. My hon. Friend the Member for St Ives hit the nail on the head when he spoke about that. This year we have a new indicator in place designed to help measure how well patients needing end of life care are supported in the community. Going forward, we are planning to do more work to develop indicators that will enable NHS England to further scrutinise the effectiveness of local health economies in delivering choice in end of life care and securing the progress we all want to see.

Social Care Funding

Thelma Walker Excerpts

Wednesday 17th October 2018 Commons Chamber

[Barbara Keeley]

I am constantly astonished when Conservative Members talk about a cross-party approach. It is up to their party to come up with some proposals. When it has some proposals, there will be something to talk about. All that we have seen the Conservatives do is to abandon all the proposals that they have previously had. We legislated, in the Care Act 2014, for a cap on care costs and a lifting of the ceiling—the asset threshold—but the Conservatives have abandoned that now. They had a set of policies at the time of the election last year, but they have abandoned that. The hon. Lady needs to speak to her own Secretary of State, and I hope that she can have a constructive conversation with the Chancellor as well.

The Government’s cuts have not just reduced access to care in the ways that I have outlined; they have reduced care quality. Cuts mean that there is less good-quality care, which causes great indignity to both older and younger adults. The Care Quality Commission tells us that one in five care services—about 4,000 facilities—requires improvement or is inadequate. In too many care facilities quality is hanging by a thread largely because of the good will and dedication of care staff, but there are times when even their efforts cannot prevent standards falling. In a recent case in Tameside a care home rated inadequate was eventually forced to close for financial reasons. Care home staff were not only not being paid themselves, but they had paid out £5,000 for the food for care home residents, and an agency was owed £37,000 to pay care staff. An earlier CQC report had noted that that care provider had been made bankrupt. During the time before this home was closed, care quality was scandalously low. In 2017 the CQC found that one resident had been left in bed for five months without a bath or shower. It beggars belief that the Government think that care home managers in such situations should be given responsibility in the process for assessing a cared-for person’s mental capacity under the proposed mental capacity legislation currently in the other place, but that is what the Bill currently says—even care home managers in that failing home would be given a part in the process of assessing mental capacity—and it seems that the Government will not shift from that. I join others in the other place and urge the Secretary of State to pause the passage of the Mental Capacity (Amendment) Bill and listen to the concerns being raised about his proposals, because that is not a role that should be dumped on care home managers in the way the Bill is trying to do.

[Thelma Walker (Colne Valley) (Lab)]

The Kirklees Solidarity Economy Network in my constituency is working to establish a community-based care co-operative. The model it is developing seeks to demonstrate that a better way is possible by putting people before profit, valuing, rewarding and respecting careworkers, and ensuring that the people receiving care and the workers providing that care have a real say in how the service is run. Does my hon. Friend agree that we could all look to that model in the future?

[Barbara Keeley]

I very much do and thank my hon. Friend for making that point. There is a great place for co-operatives and mutuals and other such organisations. Organisations like Shared Lives are producing outstanding care in some parts of the country, and we must look at all those models.

I want to talk about hard-pressed family carers, because the situation of less care and lower quality care means that family carers are under pressure as never before to step in and provide care. The strain of caring has seen almost three quarters of carers suffer mental ill health and nearly two thirds suffer physical health problems, according to Carers UK. But too few carers can access respite from caring; they are at breaking point.

Problems with poor care quality and a lack of support were highlighted earlier this year in a report by Age UK entitled, “Why call it care when nobody cares?” At the launch of that report, both I and the Care Minister heard from carers like Joyce. At 73, Joyce cares full-time for her husband David who has had a stroke and a massive brain haemorrhage. Joyce has to do everything for David to make sure he is

“clean and comfortable at all times”.

That involves regularly lifting him in and out of his bed or chair to wash him, or take him to the toilet, throughout the day and night. She said:

“It is extremely hard to get good respite care where we live in Cheshire. Our local care home is no longer an option due to being cut as a provider by the local council. I had to fight tooth and nail for the care David currently gets in a day centre—but it just isn’t enough.

I don’t know how I’ll continue to cope without more support and regular respite breaks. Our care was cut in March, the third time that we have had respite care pulled. I am so angry and frustrated, I am so worried at what is facing us at the moment I hardly dare think about it.”

What carers like Joyce need is comprehensive support and carers breaks to allow them to look after themselves as well as the person they care for. What they have received from the Government is the damp squib of a “carers action plan” in place of a proper national strategy.

Labour has already pledged to deliver a national carers strategy as we did with our second national strategy in 2009. That national carers strategy pledged £150 million of funding for respite care breaks for carers. That funding has now disappeared into a black hole in the better care fund, leaving carers like Joyce to fight “tooth and nail” to get any respite at all.

Oral Answers to Questions

Thelma Walker Excerpts

Tuesday 8th May 2018 Commons Chamber

[Mr Speaker]

Patience rewarded. I call Thelma Walker.

[Thelma Walker (Colne Valley) (Lab)]

Does the Minister agree that eating a nutritionally balanced meal can reduce snacking between meals and therefore help to reduce childhood obesity? If so, will he speak to his colleagues in the Department for Education and ask them to ensure that the 6,400 children in Kirklees who are set to lose out on a well balance nutritious free school meal do not?

[Steve Brine]

I talk to colleagues across Government all the time. The first round of the child obesity plan—it was maligned earlier—contained many good things, such as the sugary drinks tax. A couple of months ago we launched, with Public Health England, changes in relation to the nutrient profiling of foods marketed to children. That is positive for the hon. Lady’s constituents and for mine.

Social Care

Thelma Walker Excerpts

Wednesday 25th April 2018 Commons Chamber

[Barbara Keeley]

It is reported, in fact, that the total back-pay bill across the social care providers that provide sleep-in cover will be about £400 million, so it is not surprising that a care provider such as Lifeways would say that. The Government have to come up with answers for this, because there has been a dragging of heels, the guidance has been very confusing, and it is a serious matter. I understand, too, that the Government have completed two reports, but they have not been made public. Hon. Members and I would certainly welcome having those reports placed in the Library so that we can get that information.

We have seen warnings from the Competition and Markets Authority that care homes would find themselves having to close or move away from local authority-funded care because the funding is now only just covering day-to-day running costs. It is quite clear from all this that there is a growing funding gap in social care that must be filled. The Local Government Association has said that our social care system needs an immediate injection of £1.3 billion to fill that gap, and this is projected to rise to £2.5 billion by 2020, according to the King’s Fund.

In our last Opposition day debate on social care, in October, the strain social care was under—from the weight of growing demand, reducing supply and the lack of funds from Government—was plain to see, but since then the system has cracked still further under the pressure of Government funding cuts.

[Thelma Walker (Colne Valley) (Lab)]

When elderly people fall, they often have a stay in hospital, putting additional pressures on the NHS, and when they are ready to be discharged, hospitals sometimes cannot discharge them, because local social care provision is not available. Two thirds of admissions to hospitals for falls could have been averted by early intervention in the home. Does my hon. Friend agree that we need more money for our adult social services?

[Barbara Keeley]

I do absolutely—and that is the point I was making. It was only when the number of delayed transfers of care hit a record high that the Government started to pay much attention to this issue. The other worry is that, as the British Red Cross has reported, in attempting to reduce the number of delayed transfers of care, hospitals often eject people before they are ready. One can see a vicious cycle of admission and readmission.

As I was saying, the system is beginning to crack. Hard-pressed councils and their associations are pleading for more funding to deal with the ever-increasing demand for social care. In December, the former president of ADASS, Margaret Willcox, said:

“The crisis facing us is so acute that we fear social care could pass the point of no return in 2018 while we wait for decisions to be made.”

The National Audit Office has warned that councils could face insolvency after using their reserves just to meet those increasing costs of social care. As well as Northamptonshire County Council being technically insolvent, we recently learned that Worcestershire County Council has a massive budgetary disparity. A report from the Chartered Institute of Public Finance and Accountancy has warned the council that it faces a £26 million hole in its finances this year and that that would rise to £60 million in 2020, owing mainly to an increase in demand. The council chief executive, Paul Robinson, has said that

“there comes a point where cost-cutting can’t go any further – there has to be a solution, and I think it has to be a national solution.”

Lord Porter, the Conservative chair of the LGA, has said to councils that:

“you can’t keep dipping into your savings; sooner or later the money will run out.”

Let us think about what these cuts to social care mean for the quality of care that people receive. In the recent words of the Secretary of State himself, there is unacceptable variation in the quality of services. One in five care facilities receives the lowest quality rating from the Care Quality Commission, and Labour’s own research has revealed that over 3,000 care facilities that already have the lowest quality rating continue to receive the lowest rating even after being re-inspected. Cuts mean providers have less money to pay staff or to invest in training or building renovations, which can obviously lead to their getting trapped in a cycle of poor-quality care provision, and that poor-quality care has a serious impact on the lives of people who need care.

--- Later in debate ---

[Caroline Dinenage]

I can honestly say with my hand on my heart that the Labour party does not have a monopoly on care or kindness.

I mentioned earlier that local authorities will receive a real-terms, above-inflation increase in their funding profile. We have announced significant dedicated funding for social care. The Opposition regularly seem to forget that we allocated an additional £2 billion to social care only a year ago, with a further £150 million this year. That means councils have access to £9.4 billion of dedicated funding.

[Thelma Walker]

Kirklees Council has had its funding cut by central Government by nearly £200 million. This year, it has raised its council tax by 5.9% to help pay for services. The three percentage points for social care come to £4.8 million, but there is a shortfall of £12 million a year. Can the Minister tell councillors where the rest of the money for social care should come from?

[Caroline Dinenage]

We are looking at the long-term sustainability of adult social care funding, and there will be more news in the Green Paper later this year. The last Labour Government had 13 years without dealing with the here and now, so I will take no lessons from them.

Privatisation of NHS Services

Thelma Walker Excerpts

Monday 23rd April 2018 Westminster Hall

[Mike Hill (Hartlepool) (Lab)]

I beg to move,

That this House has considered e-petition 205106 relating to the privatisation of NHS services.

It is an honour to serve under your chairmanship, Sir Graham. I pay tribute to a young constituent of mine, Connor McDade, whose father, John, is a friend and a former work colleague. Connor was run over in Newcastle last weekend, but despite the most excellent care provided by NHS staff in the critical care unit at the Royal Victoria Infirmary in Newcastle, his life support was switched off yesterday. On 14 May, he would have been 22. He passed in the early hours of this morning. The standard of care delivered by staff at the RVI was second to none, so it is fitting that I pay tribute to them and all hard-working NHS staff at the beginning of my speech.

Privatisation in the NHS is not new. When the NHS was founded in 1948, agreements had to be thrashed out with GPs, doctors and consultants to allow private practice to continue and sit alongside the new national health service. Private healthcare insurance has been around for longer than the NHS. The British United Provident Association—BUPA—was founded in 1947, and it currently has about 15.5 million health insurance customers and 14.5 million people in its private clinics and hospitals.

The NHS itself has always had a private treatment offer, although between 1974 and 1976, Barbara Castle, the Labour Secretary of State for Social Services, campaigned to abolish pay beds in the NHS. That was achieved after her tenure in 1977, but the Tories repealed it three years later in the Health Services Act 1980. On abolishing pay beds and separating out private and NHS facilities, Mrs Castle said:

“The existence of pay beds, with the opportunity it gives to a few senior doctors to make private gain and the opportunity it gives to patients with money to jump the queue, is seen as a bitter affront to those thousands of other staff who are dedicated to the principle of a free Health Service.”—[Official Report, 21 November 1975; Vol. 901, c. 355.]

Tens of thousands of health workers, citizens and patients would echo that opinion today. It is also the opinion of the British Medical Association, which believes that the NHS should always be free at the point of use and has campaigned for many years to halt the spread of privatisation. Its focus is not just on private practice, but on private provision—the privatisation of services, commissioning and procurement.

It is worth noting that, on private practice or healthcare provision, an update to the BMA’s 2016 report entitled “Privatisation and independent sector provision in the NHS” shows that in recent years, the number of NHS patients treated in private hospitals has increased substantially. In 2015-16 alone there were 557,200 admissions—an increase of 8%—and in the same period 5% of NHS-funded elective surgical admissions were to independent sector facilities.

[Thelma Walker (Colne Valley) (Lab)]

We are witnessing the fundamental dismantling of the NHS and creeping privatisation, which is undermining its dedicated, hard-working staff. Does my hon. Friend agree that we need to halt all privatisation and legislate against the selling-off of our world-renowned health service?

[Mike Hill]

As a member of the Petitions Committee, I am independent; as a Labour MP, I agree. I will come to that point later.

Private practice is only one aspect of the worrying trend towards the increased privatisation of NHS services. As the BMA points out, the recent legal action that Virgin Care brought against several clinical commissioning groups should serve as a stark reminder of what can happen when the relationship between the NHS and the private sector sours.

GP Recruitment and Retention

Thelma Walker Excerpts

Wednesday 28th March 2018 Westminster Hall

[Bridget Phillipson (Houghton and Sunderland South) (Lab)]

I beg to move,

That this House has considered recruitment and retention of GPs.

It is a pleasure to serve under your chairmanship, Mrs Moon—for the first time, I believe. I am grateful for the opportunity to hold this debate on an issue of critical importance to all our constituents.

General practitioners are the cornerstone of the health service in this country. The work they do on a daily basis is vital to the nation’s wellbeing. As the first point of contact for people with physical or mental health problems, they have a unique duty of care within the NHS. From newborn babies to our elderly citizens, the continuity of care that they provide from cradle to grave puts them at the heart of communities up and down the country, and the lifelong relationship they build with their patients as a result is unique. We in this House must do our best to protect and promote that relationship in any way we can. That is one reason why I am holding today’s debate.

I also sought this debate out of increasing concern for the state of general practice in my constituency and the wider north-east. Since entering the House in 2010 I have noticed a marked increase in the number of constituents getting in touch to raise concerns about the amount of time it has taken them to see their family doctor. It was on the back of those concerns that I began to survey my constituents on waiting times at their local GP practice. That survey is ongoing, but the results that have come in over the last year are concerning. When asked how long they had to wait for an appointment to see their GP regarding a routine matter, over 30% of those who responded to my survey said it took more than two weeks, and 15% said it took even longer. Waiting times for urgent care were equally concerning, with over 30% waiting more than 24 hours for an appointment. The growing difficulty in accessing GP services is clearly having a knock-on effect on the rest of the health service in my area.

[Thelma Walker (Colne Valley) (Lab)]

Due to staff shortages in a local GP surgery, one of my constituents in the Colne Valley was referred to our local hospital for a blood test. They had a 30-minute drive each way and a two-hour wait for the test to take place. Does my hon. Friend agree that that is a warning sign that general practice is struggling to cope with extra pressures and less money?

[Bridget Phillipson]

I am sure the experience of my hon. Friend’s constituent is happening up and down the country. We want to ensure that people can access quality healthcare close to home. It is neither cost-effective nor in the best interest of patients to have to travel further to hospital for things that could be dealt with more readily within a GP’s practice.

More and more local people are telling me that they have to attend accident and emergency to get the treatment they need, because they cannot get an appointment with their GP or their local practice is closed when they need it. We saw record numbers at Sunderland Royal Hospital A&E this winter, when the entire NHS was stretched to breaking point. It is extremely worrying in that context that so many people are turning to emergency services simply to access the care that family doctors might ordinarily provide.