Government PPE Contracts

Alan Campbell Excerpts

Tuesday 6th December 2022 Commons Chamber

[Neil O’Brien]

What did the hon. Member for Brent Central say there? [Interruption.] No, she does not want to repeat it.

Let me be clear, Madam Deputy Speaker: at every point in the procurement process, the process is rightly run by our brilliant commercial professionals. Ministers are not involved in the procurement process; Ministers are not involved in the value of contracts. Ministers are not involved in the scope of contracts, and Ministers are not involved in the length of contracts. That is something echoed by the National Audit Office, whose report concluded that the Ministers had properly declared their interests and that there was

“no evidence of their involvement in procurement decisions or contract management”.

The role of Ministers was exactly what we would expect. Approaches from suppliers were passed on to civil servants for an independent assessment. Let us again look at the scale of the effort: 19,000 companies made offers, around 430 were processed through the high-priority group, and only 12% of those resulted in a contract for 51 firms. That group was primarily about managing the many, many requests that were coming in to Ministers from people across the House and from people across the country who were desperate to help with that national challenge of getting more PPE, and there had to be a way of dealing with them. To be clear, due diligence was carried out on every single company, financial accountability sat with a senior civil servant, all procurement decisions were taken by civil servants, and a team of more than 400 civil servants processed referrals and undertook due diligence checks. It was a huge operation run by the civil service, and I thank them for their work in getting our NHS the PPE that it needed.

Let me be clear, I will not stand here and say that there are not any lessons to be learned; of course there are. But we should be clear about what those lessons are. Despite the global race to get PPE, only 3% of the materials sourced were fit for purpose, but we have built more resilient supply chains. We are implementing the recommendations of the Boardman review of pandemic procurement in full. I have mentioned the growth of UK procurement of face masks and of vaccines.

In closing, I wish to thank all of those who have been involved in this important conversation. We should be rightly proud of what was achieved during those dark and difficult days at the start of the pandemic, operating in conditions of considerable uncertainty. We were in a situation where, literally, there was gazumping going on. If people did not turn up with the cash, things were removed that they had bought from the warehouses. That was the global race that we were in to source these things. The 400-strong team of civil servants who led this process did a remarkable job from a standing start of sourcing the goods that we needed.

During this debate, we have heard a number of deliberate obfuscations of the different things that Ministers and officials do. To be clear, all of these decisions went through an eight-stage forensic process that was run entirely by officials and it did not get anyone a contract to go into this high-priority group. It was simply about managing the sheer number of bids for contracts that were coming in to people across this House. At the time, although memories are very short and the barracking on this continued—

[Sir Alan Campbell (Tynemouth) (Lab)]

claimed to move the closure (Standing Order No. 36).

Question put forthwith, That the Question be now put.

Question agreed to.

Main Question accordingly put and agreed to.

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. It is inadvisable for people to shout other things if I am listening for the Ayes having it.

Resolved,

That this House –

(a) notes that the Department for Health and Social Care purchased more than £12 billion of Personal Protective Equipment (PPE) in 2020-21;

(b) regrets that the Government has now written £8.7 billion off the value of this £12 billion, including £4 billion that was spent on PPE which did not meet NHS standards and was unusable;

(c) is extremely concerned that the Government’s high priority lane for procurement during the pandemic appears to have resulted in contracts being awarded without due diligence and wasted taxpayer money;

(d) considers there should be examination of the process by which contracts were awarded through the high priority lane; and

(e) accordingly resolves that an Humble Address be presented to His Majesty, that he will be graciously pleased to give direction that all papers, advice and correspondence involving Ministers and Special Advisers, including submissions and electronic communications, relating to the Government contracts for garments for biological or chemical protection, awarded to PPE Medpro by the Department for Health and Social Care, references CF-0029900D0O000000rwimUAA1 and 547578, be provided to the Committee of Public Accounts.

Children’s Mental Health

Alan Campbell Excerpts

Tuesday 8th February 2022 Commons Chamber

[Will Quince]

My hon. Friend is absolutely right: acute services, which are of course a Department of Health and Social Care lead, are very important. In the Department for Education, we have a role to play in doing as much prevention as we can and getting early identification and support in place for people so that they do not need to attend the acute unit, which then frees up space for those who desperately do need it.

Let me turn to some specific points made by hon. Members from across the House. Time is relatively short, but I will cover as many as I can. I remind the House that my door is always open; Members can come to see me if I do not address any of these points and I will be happy to meet them to discuss them in person.

The hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron)—I have probably pronounced her constituency wrongly, so I apologise for that—and my hon. Friend the Member for Burnley (Antony Higginbotham) made positive and constructive comments about how it is so important that we remove the stigma and break the taboo about mental health, and put children and young people at the heart of our recovery. My hon. Friend mentioned Burnley FC and its work through football in the community. It does hugely important work and I echo his comments about it. Those Members, along with my hon. Friends the Members for Sevenoaks (Laura Trott) and for Penistone and Stocksbridge (Miriam Cates), raised the issue of online harmful content, particularly about self-harm and suicide. They rightly said that the Online Safety Bill must tackle this issue, and I can certainly give the House the commitment and confirmation that the strongest protections in the Bill are on the safeguarding and protection of children.

My hon. Friend the Member for Aylesbury (Rob Butler) raised the issue of the Youth Concern charity in his constituency, rightly praising its work, and I echo his comments. He also rightly raised the issue of waiting times, which are too long in too many cases. We need to address them, and we are doing that in part with the NHS long-term plan. His experience of the Youth Custody Service is hugely welcome, and we will certainly be calling on him to discuss that further.

The hon. Members for Batley and Spen (Kim Leadbeater) and for Brighton, Kemptown (Lloyd Russell-Moyle) rightly referenced the serious point about suicide. Of course every suicide is a tragedy, especially so when it involves a child or young person. DHSC has a suicide prevention plan, and we are investing £57 million in suicide prevention by 2023-24, as part of the NHS long-term plan. I know that the Minister for Care and Mental Health, my hon. Friend the Member for Chichester (Gillian Keegan) will be happy to meet both of them to discuss that issue further.

My hon. Friends the Members for Milton Keynes North (Ben Everitt) and for Truro and Falmouth (Cherilyn Mackrory) discussed the importance of green open spaces—I am amazed at the number of people in Cornwall who have not had access to the sea, so we certainly need to look at that. They also mentioned the importance of being in school wherever possible, and I have to say that there are no greater champions for the people of Milton Keynes, and Truro and Falmouth than my hon. Friends. The hon. Member for Ealing North (James Murray) raised the issue of mental health professionals in schools. We are rolling out mental health support leads and mental health support teams up and down the country, and I welcome his interest in this area.

My hon. Friend the Member for Stoke-on-Trent South (Jack Brereton), a passionate advocate for children and young people in Stoke-on-Trent, has made a compelling case for family hubs and the family hub model and investment in Stoke-on-Trent, and we will no doubt discuss that further down the line. The hon. Member for Blaydon (Liz Twist) raised the issue of the importance of early intervention, and I totally agree on that; we are doing this in schools and colleges, and she was right to praise two schools in her constituency, in Whickham and Kingsmeadow.

My hon. Friend the Member for Ipswich (Tom Hunt) is a passionate advocate for children and young people with SEN and disabilities, and I am happy to discuss this issue with him later at greater length. I agree with him on the importance of early diagnosis. My hon. Friends the Members for Devizes (Danny Kruger) and for Sevenoaks, and the hon. Members for Bath (Wera Hobhouse)—I wish her a happy birthday—and for Sheffield, Hallam (Olivia Blake) rightly raised the issue of eating disorders. We have put additional investment in, and there is a new waiting time standard, but I know we need to do more in this area, and I would be happy to work with the hon. Lady.

I am proud of our record in supporting children and young people, and I am grateful for the ongoing support that hon. Members have given to this agenda. Can we do more? Yes. Can we always do more? Yes. We must do more and we will do more. I welcome the spotlight on this issue. Let me assure the House that good mental health and wellbeing for our children and young people remains a priority for me and this Government, and it will continue to be a priority as we recover and build back better from this pandemic, improving children’s futures and the future of our country.

[Sir Alan Campbell (Tynemouth) (Lab)]

claimed to move the closure (Standing Order No. 36).

Question put forthwith, That the Question be now put.

Question agreed to.

Main Question accordingly put.

Question agreed to.

Resolved,

That this House recognises the importance of Children’s Mental Health Week; is concerned about the impact of the coronavirus pandemic on the mental health of young people and that there has been a 77% rise in the number of children needing treatment for severe mental health issues since 2019; calls on the Government to guarantee mental health treatment within a month for all who need it and to provide specialist mental health support in every school, including a full-time mental health professional in every secondary school and a part-time professional in every primary school; and further calls for the Government to establish open access mental health hubs for children and young people in every community to ensure the best start to life for future generations.

Mental Health Units (Use of Force) Bill

Alan Campbell Excerpts

2nd reading: House of Commons
Friday 3rd November 2017 Commons Chamber

[Jackie Doyle-Price]

I agree with that point very ably made by my hon. Friend. The Bill brings real accountability and transparency, which will protect everyone in the system.

I welcome the opportunity to debate the Bill, and to highlight some of the progress we have already made on some of the provisions that the Bill seeks to introduce and strengthen. First, we should examine the issue of restrictive restraint. It is not a great picture, to be frank. Information from NHS Digital shows that more than 6,000 people who spent time in hospital in 2013-14 were subject to at least one incident of restraint. Collectively, these people experienced more than 23,000 incidents of restraint, with 960 people having been restrained five or more times in a year. As colleagues across the House have said, that can cause real trauma and should be avoided at all costs. The group who experienced the highest proportion of restraint per 1,000 inpatients was the category labelled “mixed ethnic group”, with 101 incidents of restraint per 1,000 in-patients. We need to get to the bottom of why that is the case. There is a link between the use of restraint and particular points in the patient pathway. For example, in 2015, the survey of restraint commissioned by the Government found that 23.6% of restraint incidents occurred in the first week of admission. We have discussed gender, and I can confirm that 54.7% of people who were restrained were men, compared with 42.5% being women. That clearly does not reflect the gender balance of people in detention.

Members have referred to the fact that on Monday the House welcomed the publication of Dame Elish Angiolini’s independent review of deaths and serious incidents in police custody, and the Government response. The report is thorough and identifies room for improvement at every stage in procedures and processes surrounding deaths in police custody. It makes 110 recommendations on the use of restraint, on training for officers and on making it easier for families facing an inquest into a death in police custody to access legal aid. The hon. Member for Croydon North is concerned about that issue.

The extent to which restraint techniques contribute to a death in custody and whether current training is fit for purpose is a crucial aspect of Dame Elish’s report. Police training and practice emphasise that under certain circumstances any form of restraint can potentially lead to death, so the National Police Chiefs Council and the College of Policing continue to ensure that legal, medical and tactical advice are embedded in the national personal safety manual, especially in relation to the challenges of prone restraint and mental health issues.

Members have expressed views on the use of restraint, particularly prone restraint, with some of them suggesting that that type of restraint should be banned altogether. I was at Broadmoor yesterday, and I was told about a man who had experienced a head injury and needed stitches. Because of the challenges of his behaviour and mental health condition, prone restraint was used. I am not condoning the use of prone restraint in that situation or in any other, but I will say some words of caution. We need to understand restraint and define it clearly before introducing an outright ban. The guidance says that prone restraint should be used only as a last resort, and we must be careful not to put staff at risk by introducing a blanket ban without understanding more about the circumstances in which that type of restraint might be necessary.

In August this year, the CQC published its report, “The state of care in mental health services 2014-2017”, which identified variations in the frequency with which staff used restrictive practices to manage people with challenging behaviour. It is looking at the issue more closely, and it has committed to reviewing how it assesses the use of restrictive interventions, including developing and regularly updating tools for inspection teams to ensure consistency of assessment and reporting. We believe that the variations are as much due to the principles behind the making of reports as differences in behaviour.

As part of its annual report, “Monitoring the Mental Health Act”, the CQC is developing a publication to highlight areas of good practice in reducing the need for restrictive interventions. Colleagues at the CQC have indicated that they support the principles of better reporting, improved training and accountability, and greater transparency under the Bill, and it is vital that we engage with that as we take this forward.

Turning to the measures in the Bill, there is provision for front-line staff to receive training in equality and non-discrimination, as well as awareness of conduct prohibited under the Equality Act 2010; a trauma-informed approach to care; and, critically, techniques to avoid and reduce the use of force. Individual providers are expected to ensure that all their staff are appropriately trained in the use of force, and there are many training programmes available to health service providers The Bill will help us to address the variation across the system in the training received by staff. Healthcare providers are encouraged to focus training on de-escalation and on understanding the causes of challenging behaviour, and to reflect on incidents of restraint to see how they can be reduced or avoided for both the individual concerned and for all service users.

Treating and caring for people in a safe, compassionate environment both for patients and staff is a priority for this Government. We know that restrictive physical interventions are risky for all individuals involved and that they have a negative impact on patients’ dignity and their trust in services. We have made progress since the publication of “Positive and proactive care: reducing the need for restrictive interventions” in April 2014. This guidance focuses on the use of preventive approaches and de-escalation for managing behaviour that services may find challenging. It also recommends that all restrictive interventions should be for the shortest time possible and use the least restrictive means to meet the immediate need. The guidance introduced an expectation that services develop restrictive intervention reduction plans. These plans, along with organisations’ relative use of restraint in comparison with other organisations, form a key focus of the CQC inspections. We expect the CQC to use its regulatory powers to ensure that services minimise the use of force and other restrictive interventions, including face-down restraint.

Our colleagues in the police are training officers on how to respond to calls that relate to those with mental health conditions and people with learning difficulties. The revised national police guidance on authorised professional practice on mental health was published by the College of Policing in October last year. It aims to give officers the knowledge they need to resolve situations and ensure that the public get the most appropriate service. While the police are not, and are not expected to be, mental health professionals, they are often first on the scene at incidents involving those experiencing a mental health crisis. The aim is therefore to ensure that officers can respond appropriately.

On data collection, the Bill seeks to gain more detailed information in relation to incidents of force used in mental health settings. From January 2016, NHS Digital has collected information about the use of face-down restraint as part of the mental health services dataset. There is still a lot of work to be done on the quality of the data, as the hon. Member for Croydon North said, as they do not currently go into the amount of detail that the Bill would require. However, we are confident that we can make changes to improve the transparency of the information that we collect.

[Mr Alan Campbell (Tynemouth) (Lab)]

claimed to move the closure (Standing Order No. 36).

Question put forthwith, That the Question be now put.

Question agreed to.

Question put accordingly, That the Bill be now read a Second time.

Question agreed to.

Bill read a Second time; to stand committed to a Public Bill Committee (Standing Order No. 63).

NHS Bursaries

Alan Campbell Excerpts

Wednesday 4th May 2016 Commons Chamber

[Alistair Burt]

I say in all honesty to the hon. Lady, who is knowledgeable about health matters and has been to see both me and the Under-Secretary of State for Health, my hon. Friend the Member for Ipswich, that the proposals help. At the moment, the problem with nurse training in this country is that it is limited. The universities cannot take all the people who want to be nurses; they have to turn them away—37,000 of them. This scheme opens up the opportunity for more people to train, and for more people to come into nursing through the nursing associates route. If the hon. Member for Dewsbury (Paula Sherriff) is looking for a straight answer on whether this will provide more nurses and help her local hospital, I can say: yes, it will. That is why these proposals are being made.

I wish to set out briefly the details of the basis for the reforms, just for those who were not able to attend the whole debate, and then answer one or two questions that were raised. To deliver more nurses, midwives and allied health professionals for the NHS, a better funding system for health students in England and a sustainable model for universities, we need to move nursing, midwifery and allied health students from grants and bursaries on to the standard student loans system. Putting more funding into the existing system was not a sensible or viable option for the Government, if we are also to increase the number of student places, live within our budget, and ensure that the NHS can use the extra £10 billion-worth of additional investment for front-line care by the end of the Parliament.

The subjects that we are talking about are extremely popular with students. In 2014, nursing registered as the fifth most popular subject on UCAS, and in that year there were 57,000 applicants for 20,000 nursing places. Rather than denying thousands of applicants a place to study health subjects at university, surely it is better that the new proposals ensure enough health professionals for the NHS, while cutting the current reliance on expensive agency and overseas staff, and giving more applicants the chance to become a health professional. Part of the reason why we need to modernise the funding system is that student nurses, midwives and allied health students currently have access to less money through the NHS bursary than students using the student loan system do. Under a move to the loan system, these health students will receive an increase of about 25% in the financial resources available to them for living costs during the time they are at university.

It is not possible to pick out all the speeches made today, but I would like to make reference to some. The hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) discussed issues affecting postgraduate students, which are important. The majority of healthcare students undertaking these courses will be able to access a BIS postgraduate masters loan, although we acknowledge in the consultation that some courses currently fall outside the BIS postgraduate loan package. We are working with BIS and the Treasury on their higher education and lifelong learning review, and we will address these matters in the Government’s response to the consultation, so she is right to raise that issue.

My hon. Friend the Member for Totnes (Dr Wollaston), the Chair of the Health Committee, said straightforwardly that we need to train more nurses. That is our bottom line; it is what we are trying to do. On transition, she said that it was important to listen to needs, and she spoke about getting more professionals away from the acute sector and into primary care. As she knows, that is a major interest of this Government, and these proposals will help in that regard.

My hon. Friend the Member for Morecambe and Lunesdale (David Morris) was straightforward. He talked about his trust recruiting from abroad, but said that it would like to recruit more at home. It will be able to do so under these proposals.

My right hon. Friend the Member for Hitchin and Harpenden (Mr Lilley) talked about what he discovered when he spoke to his local university and trust. He discussed the morality of taking more nurses, and student nurses, from overseas. It is important to recognise that our proposal will ease that situation to some degree. He also spoke about the important issue of the Ministers’ dilemma: of whether to put money into training now, knowing that the benefit will come some years later. It is important for any Government to recognise that more money must go into the training of doctors and of the people about whom we are talking today. There will be a return later.

I am conscious of time, and I am sorry that I cannot cover more speeches. Let me say this: the NHS never sleeps or stays still. As our country changes, so does the NHS; it must. It is always comforting to resist change, even when the status quo is not good enough; however, the need for innovation, which will be challenging and resisted, is imperative. This Government have given the NHS that commitment, and we will promote the finance, planning and innovation that were denied by the Opposition. We will not allow so many people to be denied the opportunity of becoming a nurse. We will not allow those on hardship funds and bursaries to fail to get access to more finance. We will not allow them to be—

[Mr Alan Campbell (Tynemouth) (Lab)]

claimed to move the closure (Standing Order No. 36).

Question put forthwith, That the Question be now put.

Question agreed to.

Question put.

National Health Service

Alan Campbell Excerpts

Wednesday 21st January 2015 Commons Chamber

[Norman Lamb]

Let me make this point.

I acknowledge that several Members, including the hon. Members for Penistone and Stocksbridge (Angela Smith) and for Barrow and Furness (John Woodcock), raised distressing cases. I offer my personal sympathies to everyone who has been let down by the system. Such cases should motivate us all to strive to do everything that we can to improve how our NHS operates and to address the areas where it falls short.

The Opposition claim that the move from NHS Direct to NHS 111 has increased the demand faced by accident and emergency departments. There is no evidence to support that claim. Only 8% of calls result in a recommendation to go to A and E, and 30% of callers say that they would have gone to A and E if NHS 111 had not been available.

An accusation has been made about the impact of local authority cuts on social care. I remind the Labour party that the Government were faced with a £160 billion black hole in the public finances and had to act to sort that out. There is still no proposal from the Labour party to increase the funding for social care. The claims that it makes are hollow, without the money to go with them.

Let us look at one of the key indicators: delayed discharges from hospital. From August 2010 to November 2014, delayed days attributable solely to social care decreased from 38,324 to 37,000. The position is not as simple as some people suggest. Social care is performing incredibly well under difficult circumstances. In Cambridgeshire, there is the brilliant development of a service for older people to address their needs in innovative ways.

It has been claimed that the closure of walk-in centres has led to the current pressures on A and E. Again, we need to look at the evidence. A report by Monitor found that the reasons why local commissioners decided to close walk-in centres included that they were replacing them with urgent care centres co-located with A and E departments or other models of integrating primary care staff in A and E departments. The situation is not as simple as is suggested by the claim that walk-in centres have been closed and A and E has been left to pick up the burden.

The Opposition have said that the ambulance service is failing. In fact, ambulance services nationally are delivering nearly 2,000 more emergency journeys every day than in 2010. Ambulances respond to the majority of life-threatening cases in less than eight minutes. The Government have provided an additional £50 million to support ambulance services through this winter. It is right to take clinical advice to ensure that target response times are clinically based to avoid the unintended consequences of ambulance crews being driven crazy in the pursuit of targets, when it is patient safety that should be prioritised.

I come to the solution. In the short term, the Government have made an additional £700 million available to the NHS to cope with the pressures this winter. The right hon. Member for Tottenham (Mr Lammy) did at least acknowledge that. In the longer term, we need to focus on stopping the crises from occurring in the first place. We need a much greater focus on prevention, better integration of health and social care, and the implementation of Simon Stevens’s forward view.

I thank NHS staff for the amazing work that they do, often under great pressure, and the tremendous commitment that they make. We owe it to them and to the public to ensure that our NHS is protected and enhanced. Most people who use urgent and emergency care services receive effective, timely treatment. That is as it should be. Patients and their families should get the right advice and should get a response when they need it. We set the toughest standards in the world, and rightly so. We all know that those standards are under pressure across the UK, so let us be open and honest about that.

[Mr Alan Campbell (Tynemouth) (Lab)]

claimed to move the closure (Standing Order No. 36).

Question put forthwith, That the Question be now put.

Question agreed to.

Main Question accordingly put.

Type 1 Diabetes (Young People)

Alan Campbell Excerpts

Wednesday 30th April 2014 Westminster Hall

[Mr Alan Campbell (Tynemouth) (Lab)]

As ever, Mr Havard, it is a pleasure to serve under your chairmanship. I am grateful to my right hon. Friend the Member for Knowsley (Mr Howarth) for securing this important debate and for the way in which he opened it. He knows better than almost anyone else the terrible price that this condition sometimes forces sufferers to pay and its impact not only on individuals, but on their families. If the Government need a champion for the matter, they could not find a better one than my right hon. Friend.

My short contribution will support many of my right hon. Friend’s points, but first I want to thank the health care professionals involved in the management and treatment of this condition, particularly those at my North Tyneside General hospital. As we have heard, diabetes affects around 35,000 people aged under 19, 90% having type 1 with a peak age of diagnosis between 10 and 14. We are making good progress in the treatment and management of type 1 diabetes, including among young people, but we have a long way to go. I am no scientist, but my fervent wish is that we find a cure not just in my lifetime but much sooner. Important work is being done in this country and elsewhere on stem cell research, which is a possible route to finding that cure.

I welcome the Prime Minister’s interest in promoting the work of the UK-Israeli partnership. It is important when Prime Ministers take an interest in a particular issue, but I echo the points made by my right hon. Friend that we must look at where the funding is coming from, where it is being directed, and the overall amount.

My first brief point is about timing. Type 1 diabetes in young people often occurs at a difficult time in young people’s lives when they are struggling to cope with the physical changes that come with being a teenager. After an acute episode they often find themselves managing a chronic condition. They may be struggling to come to terms with a new health regime and may suddenly find themselves being treated in the NHS as an adult. That difficult transition may lead to a break in service, and add to complications further down the line with damaging consequences.

The statistics for young women with type 1 diabetes are startling. Young women between the ages of 15 and 34 have a mortality rate seven times higher than the general population. I welcome the introduction of the best- practice tariff up to the age of 19, but ask the Government to consider extending it to 25. That would allow greater continuity of care and a more flexible transition, which should be based on clinical need and not age.

Type 1 diabetes is more than simply a physical condition, although it is that, and health care has improved in many ways with advice on diet, the massive impact of accessing eye tests and checking feet regularly, but there is a psychological impact. Anyone with a serious chronic condition that will last the whole of their lifetime will think about that and may become depressed at some point. I do not know enough about anorexia or bulimia to comment, but I do know that type 1 diabetics must at some point in their lives not only think about it but become depressed as a result. Therefore, access to psychological services should be part of the offer that is made. That should, when necessary, involve family members as well, because it is not just about the individual, but about their family.

I very much welcome the professional pathway that has been created for paediatric diabetes as a specialism, but, as my right hon. Friend and the hon. Member for Cities of London and Westminster (Mark Field) mentioned, we need to ensure that health care professionals are also aware of the condition and are supported by clear national standards. I would like that to be extended to teachers and other staff in schools as well. It is as important that the person looking after the dinner queue knows about diabetes in young people as it is that the person at the front of the class teaching them knows. That is why I support very much Diabetes UK’s “Make the Grade” campaign. I want every young person with type 1 diabetes to get the health care that they need, but I want them to get the educational opportunities as well. I want them to do well and go on to further and higher education. I want them to be able to take part in school sport and school visits without being worried and without the member of staff with them being worried.

The Government have produced figures—we have heard them today—about the cost to the NHS of diabetes. We have heard that the figure is £1.9 billion and rising, but, as ever, behind those statistics are thousands of young people with type 1 diabetes. Frankly, we could do more, and Government could do more, to make their lives not only better, but longer.

Health Inequalities (North-East)

Alan Campbell Excerpts

Tuesday 24th January 2012 Westminster Hall

[Mr Alan Campbell (Tynemouth) (Lab)]

It is a pleasure to serve under your chairmanship, Mrs Riordan. I promise not to mention Leeds, which is nearer to your constituency than it is to the north-east.

I congratulate my hon. Friend the Member for Newcastle upon Tyne Central (Chi Onwurah) on securing this important debate. She set out very well the challenges facing our constituents in addressing health inequalities, which still exist in the north-east, despite the progress made over the 13 years of the Labour Government. I have to say I found the hon. Member for Redcar (Ian Swales) somewhat confusing and confused about the nature of those inequalities—I suppose confusion is one result of trying to face both ways.

I want to make three broad points, and I will be interested in the Minister’s response to them. The first is about health spending in the north-east. The Government’s view is that NHS spending will continue to grow overall in the next few years, and figures from the House of Commons Library certainly confirm that planned spending is set to grow in cash terms. For 2010-11, the cash figure is £102 billion; by 2014-15—at the end of the spending round—it is set to be £114.4 billion. If we look at the issue in real terms, however, and we take 2010-11 as a base figure, the broad trend is essentially flat.

I do not, however, want to argue that point. Instead, I want to ask how that spending affects the north-east and institutions in my constituency. The Government will no doubt tell us that there is a 3% increase for PCTs this year. They will say that is evidence of their commitment to growing budgets; in fact, that is, effectively, what the Secretary of State said on this morning’s “Today” programme. However, the tariff that funds hospital treatment has been reduced. Next year, the budget of Northumbria Healthcare NHS Foundation Trust, which serves my constituency and those of a number of Members here, will be reduced by 1.9%. Hospitals have a key role to play in not only treating patients, but addressing health inequalities, and I want to place on record the excellent work done at my local hospital—North Tyneside general hospital—particularly in treating diabetes and stroke, where we have made huge advances in the past few years, although we are still running to catch up.

My first question to the Minister, therefore, is this: if PCT budgets are rising, why are hospital budgets, which are already under pressure, being cut? Where is the money going? Is it to pay for reorganisation? Will the Minister confirm the fear that PCTs are required to put the extra money into contingency funds to pay not only for reorganisation, but for other things that might arise? Will she confirm that if those things do not arise, that money will be clawed back by the Department of Health and ultimately, one fears, by the Treasury? That helps to explain the difference between the planned expenditure that the Government announced and the actual expenditure in the past 12 months.

The second issue I want to turn to is alcohol-related harm. The north-east has a reputation for heavy drinking, which in some ways reflects our heavy industrial past. The region does significantly worse than the English average on alcohol-related hospital admissions. In February 2009, Balance, the north-east alcohol office, was launched, based on the excellent work of Fresh, which works for a smoke-free north-east. For the first time, we had a strategy that covered the whole region on this issue. One of Balance’s concerns—I remain to be convinced on this issue—relates to the introduction of a minimum unit price for alcohol. There was no consensus in the previous Government on the issue. The Home Office, of which I was proud to be a member, was sceptical about minimum unit pricing, because it was most concerned about addressing alcohol-related crime and disorder. However, the Department of Health, which was more concerned about individuals’ health, was more positive.

Just before Christmas, the Prime Minister entered the debate in The Daily Telegraph, saying that he was in favour of minimum unit pricing and will overrule any Department or Minister who stands in his way. As my hon. Friend the Member for Newcastle upon Tyne Central asked, will the Minister confirm that the Government will introduce proposals for minimum unit pricing and, if so, when? Will she confirm that the Department of Health supports the policy? Is she personally committed to it? Is the Secretary of State a supporter of it?

Thirdly, I want to acknowledge the points that have been made about health inequalities being addressed only if we go beyond NHS professionals and make sure that individuals make the right choices about issues such as smoking, how much alcohol they consume and whether they eat healthily. The Government have a role to play—if they had not played a role, we would not have made the progress that has been made in recent years.

In my constituency, there is a clear link between health inequality and deprivation. Life expectancy in the borough of North Tyneside is 76.8 years for a man and 81 years for a woman, which is about 18 months lower than the English average. However, in parts of my constituency, such as Chirton ward, Valley ward, Collingwood ward, central Whitley Bay and central North Shields, life expectancy can be about 11.5 years less for a man and over nine years less for a woman than it is in the least deprived areas of our country.

As we have been told, the Marmot review recommended that the focus should be on the social causes of health inequality, and it highlighted the need for an effective integrated approach. In my constituency, however, health inequality is worst among those groups and those areas that are most likely to be hit by cuts elsewhere. My hon. Friend the Member for Strangford (Jim Shannon) mentioned Northern Ireland. I recall, as he will, that the Prime Minister—then the Leader of the Opposition—was interviewed by Jeremy Paxman days before the general election. They talked about the scale of public spending cuts, and the Prime Minister was asked to name the regions that would be hit worst. The first one off the tip of his tongue was the north-east and the second was Northern Ireland, so my hon. Friend and I, as well as my other hon. Friends, are here to raise these issues because our regions face the most cuts overall.

Let me give an example of what that means. North Tyneside council has to make £48 million of cuts over the next four years. Next year and in subsequent years, it proposes to charge bowling clubs more to use bowling greens. It also proposes to close more bowling greens in my constituency than in any other part of the borough. The outcome will be that fewer people will be involved in the sport. Many of them will be pensioners, and my constituency has one of the highest numbers of pensioners of any in the country. The proposal could have an adverse impact on their physical and mental health.

I am concerned about getting a joined-up, integrated approach—which just is not happening. The region has a better than average record of reducing child poverty and premature winter deaths, but what effect will the proposed benefit changes have, and what about increasing energy prices, which the Government appear powerless to do anything about? What about the impact of cutting Warm Front? That will affect not just the bills of people who are trying to keep warm, but their health.

Do the Minister and the Government believe that central Government still have a role to play in reducing health inequality? Will the Minister confirm that she is raising the issue of health inequality across Government, wherever Departments want to take action? I tell her this: in our region alarm bells are ringing about the effects on health and a range of other matters. Or has her Department, as the report of the Select Committee on Health suggests today, put its focus and energy on a costly NHS reform Bill, which no one asked for and for which there is decreasing support?

Hinchingbrooke Hospital

Alan Campbell Excerpts

Thursday 10th November 2011 Commons Chamber

[Mr Burns]

I am rarely speechless, but I am left speechless by the sheer effrontery of the hon. Lady. I have to remind hon. Members that this process stems from the previous Labour Government’s legislation in 2001, which was consolidated in 2006. This process started in 2007 at strategic health authority level, when she was a special adviser in the Department of Health. It continued, and the decision to move forward from a Department of Health level was taken in 2009 by the then Secretary of State for Health, who is now the shadow Secretary of State. It is often thought that shadowing a Department that one ran is helpful because one knows where the bodies are buried. The problem for the shadow Secretary of State is that not only does he know where the bodies are buried, but he was the one who buried them in the first place.

The hon. Lady asks how many bidders there were. As she will appreciate, a number of processes have taken place. There were 11 bidders at the start, the vast majority of which were private sector bidders, although there were some NHS ones—this was in 2009, under a Labour Government. The number reduced to six in December 2009, again under a Labour Government. Of those six bids, one was from an NHS body and one was from an NHS body in conjunction with the private sector. In February 2010, when I believe the right hon. Member for Leigh (Andy Burnham) was the Secretary of State, the number reduced again, this time to five. All these bids were from the private sector, except one, which was made in conjunction with an NHS trust. In March 2010, again under a Labour Government, the number reduced to three, with one bid associated with an NHS body, and then it reduced to two, with both bidders in the private sector.

[Mr Alan Campbell (Tynemouth) (Lab)]

When did that happen?

[Mr Burns]

In July last year, as part of the ongoing process started by the previous Government.

The hon. Lady also asked whether the contract and the business case would be put into the public domain. They will be published in due course although, as she will appreciate, certain commercially sensitive information will be redacted, which is only reasonable. She also asked about staffing and whether there would be redundancies. May I tell her that there will not be redundancies as a result of the operating franchise? Circle has said that it might need to redeploy and retrain some staff within the hospital, but it does not expect job losses. I reassure the hon. Lady—I think she would like this reassurance—that, as I am sure she understands, Hinchingbrooke will remain an NHS hospital, the staff will remain as NHS staff, and the services will continue, as I said in my statement, within the format of all other services provided in every other NHS hospital, which is within the format of reconfigurations, if and when. [Interruption.] The hon. Lady says I cannot guarantee that they will stay over. I can give the greatest and most honest guarantee as of now because nobody—listen carefully so that it is not got wrong—can guarantee what services a hospital will be providing in 10 or 15 years, due to different and changing circumstances.

The hon. Lady also mentioned, as a hare that she wanted to start running to frighten people, the question of the 20 hospitals within the NHS that are having financial and other problems. The fact is that in the past month or so all those hospitals have published their tripartite formal agreements with regard to the foundation trust pipeline, and I can tell her that all those are options by which to move forward, either as stand-alone bodies or possibly mergers and acquisitions with other foundation trusts within the NHS.

Future of the NHS

Alan Campbell Excerpts

Monday 9th May 2011 Commons Chamber

[The Minister of State, Department of Health (Mr Simon Burns)]

At the instigation of the Opposition, we have spent the past three hours debating the future of the national health service, and yet in not one single speech from their Members did we hear any mention of what they would do for the future of the NHS. We heard from the right hon. Member for Holborn and St Pancras (Frank Dobson), who is always a joy to listen to. He objected to the Blair/Brown health service reforms and to our proposals to improve the NHS, apparently without fully understanding them. We heard speeches from the hon. Members for Pontypridd (Owen Smith) and for Easington (Grahame M. Morris) that were simply a continuation of what we had to listen to for eight long weeks in the Bill Committee.

We had a sensible and reasonable speech by my right hon. Friend the Member for Charnwood (Mr Dorrell). My hon. Friend the Member for Totnes (Dr Wollaston) made an interesting speech and was right—absolutely right—to encourage the greater integration and seamless provision of social care and health care, because that is so important.

We had an excellent speech from my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter), which was based on his experiences of having worked in the national health service, and we had a good speech by my hon. Friend the Member for Stafford (Jeremy Lefroy), who raised a number of questions. Time does not permit me to answer them all, but I remind him that, because of my right hon. Friend the Secretary of State, the Care Quality Commission started an unannounced investigation of nursing in hospitals to look specifically at dignity, respect and safety.

During this debate there have been times when the facts seem to have been obscured, so it is time that we had a reality check: our population is ageing—in 20 years’ time 2.5 million people will be over the age of 85; the cost of new medicines has almost doubled in the past 10 years, from £6.7 billion to £11.9 billion, rising last year alone by £600 million; and new surgical procedures are breathtakingly effective but expensive.

Those are the pressures facing the NHS at a time of economic turmoil inflicted on this country by the previous Labour Government. As a result, there are real challenges that the NHS must meet, so it does no one any good to scream “privatisation” as soon as we start exploring the best ways to safeguard the health of our children and of our children’s children. It is scaremongering of the lowest order, because this Government will never privatise the NHS. We have been, and we always will be, committed to an NHS free at the point of use for all eligible to use it.

In fact, when the Labour party was in government, it introduced private companies into the NHS on a scale that would have produced howls of outrage if we had done the same, but it was not privatisation then and it is not privatisation now. The previous Labour Government gave £4.7 billion to private companies in 2009-10 alone, and, unbelievably, to add insult to injury, £250 million of that money was given to private providers as payment for operations that never even happened.

We want to see a much fairer relationship, one that does not undermine the NHS but means increased choice for patients and better outcomes. That means saving thousands of lives every single year from conditions such as heart disease, respiratory disease and cancer. It means people with long-term conditions having their quality of life revolutionised with the seamless provision of care; the care that people receive being as good it possibly can be, based not on percentages or pie charts but on people’s real experiences; and the relationship between patients and doctors being humanised rather than seen as a means to an end—a relationship of equals based on trust, transparency and the best available treatment from the best available provider.

Every sensible-thinking person in the House knows that patient care can be improved if the NHS becomes more efficient. Efficient treatment is faster, cheaper and more effective. The previous Government knew that as well. We are carrying on their plans for £20 billion of efficiencies, plans that the right hon. Member for Kingston upon Hull West and Hessle (Alan Johnson) brought in, whereby every penny saved will be reinvested in patient care.

To those who say that the plans are happening too fast, let me remind them that this coalition Government are giving the NHS an extra year to find those efficiencies, over and above what the Opposition would have allowed. On top of that, we are protecting front-line spending and, in fact, increasing the NHS budget overall in real terms.

We also want to see the quality of our clinical care improve so that a patient’s care will be among the best in the world, whatever they are being treated for. But these are not just pretty words and noble intentions; we are making real changes and patients can already see a real difference.

We are removing layers of unnecessary management so that clinicians have the freedom to look after in-patients rather than inboxes, and there are examples of improvements in care throughout the country. To look at just one, Oxford’s John Radcliffe hospital has invested in an electronic blood transfusion system that cuts the time taken by staff to deliver blood and reduces transfusion errors to improve services for patients. That saves the NHS £1 million every year to reinvest in patient care, because it is more efficient. That is the reality of efficiency, and it goes hand-in-hand with innovative, forward-thinking care.

Underpinning all our plans is the philosophy that a more integrated NHS is a better NHS—ending stop-start care and making sure that, from the point of diagnosis, every patient has seamless care that spans health care, social care, mental health care and, of course, a reliable support network afterwards so that patients can just concentrate on getting better.

We want GPs and other health care professionals, social care providers and local councils to come together to provide seamless services, whereby, for the patient, the lines drawn between those organisations fade to nothing. Giving autonomy to clinicians, in the form of consortia, will allow that to happen, and I hope that that reassures my hon. Friend the Member for Totnes.

Let us ask Dr Howard Stoate, who some Members might remember was Labour MP for Dartford until last May. [Interruption.] I know that the hon. Member for Islington South and Finsbury (Emily Thornberry) does not like this, but she will have to listen to it once again, because he is leading pathfinder consortia in Bexley. GPs such as Dr Stoate take a broader, more responsible view of care, working with others throughout the country and across primary, community and secondary care to manage, treat and refer their patients.

They are all in an ideal position to design services in collaboration with all the different strands of the NHS and, of course, with those beyond the NHS as well. Patients, who will have their own personal care budgets to spend how they like, will be involved every step of the way.

As I have said before, everyone knows that the NHS has to change. The noble Lord Warner, a Labour Health Minister for more than three years under the previous Government understands that point. [Interruption.] I am disappointed that the hon. Member for Leicester West (Liz Kendall) laughs, because at the time she thought that he was a valued Minister in the Department of Health. That point about change is in his book—a thoroughly good book, by the way, which I suggest she reads if she has not already done so. He says that reform is essential, because failure cannot be allowed to carry on taking taxpayers’ money and providing a sub-standard service to the public.

Reforming an organisation the size of the NHS is a big challenge, but it is also a big opportunity. What we propose is not simply to tread water or to be satisfied with the NHS just scraping by; we want to see it improve for the benefit of patients in every way.

There is no reason why we have to put up with care that is anything less than world-class, and our plans revolve around that happening: cutting down inefficiency; empowering clinicians; giving them—

[Mr Alan Campbell (Tynemouth) (Lab)]

claimed to move the closure (Standing Order No. 36).

Question put forthwith, That the Question be now put.

Question agreed to.

Main Question accordingly put.

Diabetes (Young People)

Alan Campbell Excerpts

Wednesday 15th September 2010 Westminster Hall

[Mr Burstow]

Again, I do not recognise that characterisation, in that coterminosity does not exist in many parts of the country under the current model. As the hon. Lady has rightly said, integrated models of care, and collaborative approaches and behaviours are not present in many places. The desire and intent behind the White Paper is to make them the norm.

I want to do justice to this debate. We could have a debate about the White Paper, and I am sure that at some point the Opposition will choose to do so. If they do that, we would be only too happy to meet them point by point, but I want to talk about some of the key developments that will bear down on this problem and really help to transform lives.

The coalition Government want to make a significant move in respect of their commitment to introducing a much stronger payment system for children’s diabetes services, which will help to bring them out of the shadow of other NHS services. As a start to the process, a new mandatory tariff, which we plan to introduce in stages from April 2011, will recognise paediatric diabetes care as a clear and discrete specialism within the NHS, and will provide a clear funding stream to support such services over the long term.

At present there is a non-mandatory tariff, which was rushed in for April 2010, but it is wholly inadequate because it fails to take into account the complex nature of paediatric care, which this debate has articulated. As a result, under the current system, many paediatric diabetes services either continue to be under-resourced—we have heard about that today—or are funded through other budgets. Hence, they can sometimes be relegated to a second-class status in the NHS. The new tariff, as part of a more patient-focused funding model, will help to put us on the right track.

[Mr Alan Campbell (Tynemouth) (Lab)]

Will the Minister give way?

[Mr Burstow]

I will. The hon. Gentleman has listened to the whole debate, and I appreciate the fact that he has done that.

[Mr Campbell]

We have reached the point about money, and I can assure the Minister that the first concern of a parent of a child diagnosed with type 1 diabetes is the health of the child, not money. My hon. Friend the Member for Mitcham and Morden (Siobhain McDonagh) discussed support for families. May I ask what representation the Minister has made to the Department for Work and Pensions on disability living allowance, which is available to many families of young people with type 1 diabetes?

[Mr Burstow]

I obviously have many conversations with colleagues in the DWP, but as that is the first occasion on which that matter has been raised in this debate, and as I want to do justice to other speakers, I shall move on to ensure that I answer their questions.

Let us deal with family support more generally. The hon. Member for Mitcham and Morden took us through some of the statistics; the impacts on families’ lives are truly disturbing. We need to ensure that appropriate and tailored support services are in place, including the right support for carers.

I am concerned that where peer support services are provided, they are not given priority. However, not all peer support services need funding; they need willingness and support to ensure that they carry on. I would certainly commend peer support as one of the ways in which people can cope with self-care and the ongoing management of the conditions that have been discussed in this debate.

Let me deal briefly with emotional support for children in particular, and the children’s charter, which has been mentioned several times. My hon. Friend the Member for Torbay spoke about the impact of a diagnosis at a young age. Part of that comes back to providing proper emotional support in formal settings—schools and other settings. We must ensure better alignment in the way that we develop our thinking around public mental health strategies, and we will be saying more about that in a cross-Government strategy on mental health later this year. I am sure we will want to pick up, at least in thematic terms, on the public health issues in the White Paper that we will publish, also later this year.

I very much welcome Diabetes UK’s children’s charter, which will help to establish the kind of support that children and young people need to help them cope. Also, a guide has been developed to help commissioners ensure that children with diabetes receive the emotional and psychological care that they need.

In the last four minutes, I want to speak about insulin pumps. The right hon. Member for Knowsley rightly raised that key issue in the debate and in an article that he published today. The National Institute for Health and Clinical Excellence has clearly recommended pump therapy for children and young people if daily injections are not working. Frankly, I am disappointed and shamed that many primary care trusts are dragging their feet on making pumps available. That should have been sorted out; I should not have to come to this Chamber to explain why that has not been done, given how long the recommendations have been there. It is a pity that the delay was not challenged more in the past, and that the previous Government did not get around to sorting it out. I expect to see real improvement in this area as a result of the new funding arrangements that have been discussed in the debate.

My hon. Friend the Member for Torbay raised some important points about obstacles, and I want to ensure that, through the all-party group on diabetes, we have further conversations about what we can do to kick down those obstacles, and to ensure that the important research on artificial pancreases that is being done in this country is not undermined by the treatment not being available because there is not a route through the pumps. That point has been powerfully made in the debate, and I want to ensure that we follow through on it.

Research has been touched on in broader terms, and I want to mention a couple of examples of work that is being done at present. We are looking at how to provide better psychological support for children with diabetes, and how we can improve education and training in diabetes for children and families. We are also funding a major trial on the effectiveness of insulin infusion treatments versus standard injections. Alongside that, there is a vibrant third sector investing in research.

We have heard about work at Cambridge university to develop an artificial pancreas to reduce the risk of hypoglycaemia in children and adolescents. The link to telehealth that my hon. Friend the Member for Torbay referred to is important, and I want to ensure that the message is clearly understood and that we build it into some of the work that the Department is doing. I am about to run out of time, so I will have to write to my hon. Friend about international research.

Hon. Members raised points about schools. I shall elaborate in more detail by writing to all those who have taken part in the debate, but it is key that schools understand their responsibilities in respect of well-being and safety, and that they provide appropriate support for children who need to take medication at school.

The Government are determined to improve care for type 1 and type 2 diabetes. This is not something that we will put on the back burner. We have inherited a legacy but intend to build on and really improve those services.