Oral Answers to Questions

Alex Chalk Excerpts

Tuesday 22nd March 2016 Commons Chamber

[George Freeman]

I pay tribute to my hon. Friend, who had a distinguished career in the life science sector, including through setting up her own business. She is right to highlight the work at Nottingham University which, along with Leicester and Birmingham, represents something of an east midlands powerhouse. The Nottingham University Hospitals NHS Trust is part of the East of England NHS Genomic Medicine Centre, recruiting patients and becoming one of our hubs for NHS genomics medicine. In addition, we are actively supporting research into Alzheimer’s through our £1 billion a year National Institute for Health Research budget, the £150 million Dementia Research Institute and our dementia plan. I continue to lead conversations with dementia charities.

[Alex Chalk (Cheltenham) (Con)]

7. What progress the Government have made on achieving parity of esteem for physical and mental health services.

[The Minister for Community and Social Care (Alistair Burt)]

We remain committed to achieving parity of esteem between mental and physical health, and we are investing more than ever in mental health. We welcomed the publication of the Mental Health Taskforce report last month and will work to embed its recommendations in our policies.

[Alex Chalk]

Steph Cater, a 17-year-old at Pate’s Grammar School in my constituency, is concerned that mental health in-patient services are distributed unevenly, meaning that those needing treatment can end up being cared for hundreds of miles away from their families. What more can be done to ensure that those in crisis are treated closer to home?

[Alistair Burt]

A review of beds in 2014 partly redressed that uneven distribution. In my hon. Friend’s area, an analysis of the impact of the new beds shows that the average distance travelled to child and adolescent mental health services units in the south-west has improved from 114 miles in 2014 to 39.9 miles in 2016. It is not enough simply to provide more beds, however. We have to provide more community-based support and treatment—that is at the heart of “Future in mind”. The number of out-of-area treatments also has to be reduced.

Diabetes Care

Alex Chalk Excerpts

Thursday 3rd March 2016 Commons Chamber

[Jane Ellison]

I will certainly take that issue away and reflect on it, and we will speak about it again.

For people under 40, only 27% with type 1 diabetes and 41% with type 2 received all care processes, compared with 58% and 65% respectively for those aged between 65 and 79. I have some sense of why that is, but it does highlight the challenge we face. Encouragingly, 77% of those newly diagnosed with type 2 diabetes were offered structured education, but again the percentage was lower for type 1. That is clearly unacceptable, because everyone with diabetes should receive the best possible care regardless of age, postcode or the type they have been diagnosed with. That is why, in our 2016-17 refresh of the mandate to NHS England, we have made tackling variation in the management and care of people with diabetes a key priority over the lifetime of this Parliament.

[Alex Chalk (Cheltenham) (Con)]

Does the Minister agree that we need consistently early diagnosis? Early intervention is particularly important in diabetes care, as it saves the NHS from unnecessary expenditure in the long run, and, just as importantly, saves patients from unnecessary suffering.

[Jane Ellison]

That is absolutely right. I am going to talk about the national diabetes prevention programme, which goes to the heart of the problem. When I spoke to the all-party group, I mentioned the conveyer belt that can start with weight in childhood developing into type 2 and go through to the serious complications that have been alluded to. At all points along that continuum, there are things we can do, and must be doing, to make life better for people with diabetes.

Because of the mandate, diabetes is now right at the heart of NHS England’s agenda. We want it to lead a step change in preventing ill health and supporting people to live healthier lives. Our 2020 goal is for a measurable reduction in variation in the management and care of people with diabetes. However, there is some way to go, so this debate is an opportunity to update the House on some of the areas where we are going to make progress.

We have increased transparency through the creation of the Healthier Lives website, which is a major online tool from Public Health England. I encourage Members who have not looked at it to do so. It highlights variation in the prevalence and treatment of diabetes, allowing clinical commissioning groups and GP practices to compare how well they deliver diabetes care and so drive improvements and iron out variation. I will come on to the support that we are offering them as well.

The CCG outcomes indicator set provides clear comparative information. As was said, it will soon be replaced by the improvement and assessment framework, which will have two diabetes indicators aimed at reducing variation in the achievement of the NICE treatment targets and the referral and take-up of structured education. Consultation on the framework has just closed, and we expect it be published in the summer. It goes to the heart of tackling variation and the cohesive approach that was spoken about.

The NHS Right Care programme is a very practical approach to tackling variation that uses the “Atlas of Variation”. In the case of diabetes, NHS experts help CCGs and other local health system partners to make the step change they need in some areas to improve care, because transparency alone is not enough if we do not offer people support and hands-on advice. In Slough, for example, huge improvements have been made through a clinical mentorship programme that has upskilled healthcare professionals in general practices. That has resulted in an increase in patients who have had their blood glucose, blood pressure and cholesterol controlled. The Right Care programme will be rolled out across CCGs nationally by 2018.

I urge the all-party group on diabetes and the right hon. Member for Leicester East to continue to engage colleagues. It is absolutely right that Ministers are brought to the House and scrutinised about what we can do, but the very nature of our health system and the variation under discussion are also highly susceptible to pressure at local level from well-informed Members and senior councillors. I encourage him to continue to engage Members in asking the right questions at a local level.

Community Pharmacies

Alex Chalk Excerpts

Tuesday 23rd February 2016 Westminster Hall

[Derek Thomas]

I think we all share those concerns. I am pleased to have secured this debate, so as to give people an opportunity to share their experiences in their own constituencies.

Reform of community pharmacies is not something that we can afford to get wrong. Many of the community pharmacies in my constituency are independent businesses that have been established for decades. A wrong move by the Government now might make those community resources unviable. We all know that community pharmacists provide important services, including the safe dispensing of medicines. They are often the first port of call for people with minor ailments and health concerns, and are a key support for elderly and vulnerable patients in the community.

[Alex Chalk (Cheltenham) (Con)]

General practitioners in my constituency are under significant strain. Although no one is against sensible savings, does my hon. Friend agree that nothing should be done to undermine the excellent job done by community pharmacists in diverting patients from primary care, or to add to the burden on hard-pressed GPs?

[Derek Thomas]

That is absolutely superb—my next line is: “Community pharmacies have a vital role in giving advice and in diverting patients from GPs and emergency departments,” exactly as my hon. Friend said. In tourist areas such as Cornwall, they take their share of the extra demand during the height of the season. Most recently, my local community pharmacists administered flu jabs to increase uptake. Pharmacies regularly get prescriptions to patients out of hours when no alternative is otherwise available, and Cornwall has led the way, with ground-breaking work in enhanced services. That is an example of how community pharmacists are very much part of the solution to integrated community health provision.

Healthwatch Cornwall recently surveyed Cornish residents about access to community pharmacies. Some 69% of participants said that they regularly visit their pharmacy, and 74% of those felt comfortable talking to the pharmacist about their health, while 78% felt well informed by their pharmacists when taking new drugs and 93% said that the pharmacist was polite and helpful.

One constituent of mine, a retired doctor, Professor Dancy, wrote to me as follows:

“I am a warm supporter of Nigel, our local pharmacist, and proud to be so. He is always ready to help when I forget (as one does at the age of 95) to re-order a medicament, and when my doctor is unavailable, or just pushed for time, I do not hesitate to ask Nigel for advice, which I follow with a confidence that is always rewarded.”

Community pharmacists are highly trained and trusted healthcare professionals, qualified to masters level and beyond. Their knowledge base covers far more than just drugs, making them the ideal healthcare professionals to relieve pressure on GPs and other areas of the NHS. Equally importantly—perhaps even more importantly—community pharmacists are welcoming change and embracing new clinical opportunities.

However, the proposed funding cut will not sustain the transition from a supply-based service to the more clinically focused service that the Government desire and our patients deserve. Cuts will discourage progress and can only result in small, independent and much-loved businesses failing, at the expense of patients, the public and the wider NHS.

Junior Doctors’ Contract Negotiations

Alex Chalk Excerpts

Monday 8th February 2016 Commons Chamber

[Ben Gummer]

The hon. Lady says the junior doctors in her constituency had legitimate concerns. They did. Every single one has now been answered in the negotiations between Sir David Dalton and his predecessors apart from one, and that is the one the BMA refuses to open negotiations on, despite having promised to do so in November last year. Yes, our door remains open, but the BMA has first to agree to talk to us, which it is again refusing to do.

[Alex Chalk (Cheltenham) (Con)]

Junior doctors in Cheltenham are some of the most dedicated and hard-working people anywhere in our local community. It is therefore a concern to me that some have cited information from the BMA suggesting that the Government are proposing a pay cut. Will the Minister make the position crystal clear? Is that right?

[Ben Gummer]

No, it is not.

Post Office Horizon System

Alex Chalk Excerpts

Monday 29th June 2015 Commons Chamber

[George Freeman]

I absolutely accept that the Post Office must be accountable for any miscarriages and I will make a suggestion at the end about how we might address that.

My hon. Friend the Member for North West Leicestershire raised the case of his constituent Mr Rudkin. As he will understand, I cannot comment on that or any other individual case, because their details are rightly confidential, but I reiterate an offer that has been made to all hon. Members who have a constituent in the scheme: Post Office Ltd has offered to meet to discuss individual cases in detail, provided the applicant gives their consent. I am aware that Post Office Ltd has repeated that offer to my hon. Friend in the last fortnight, and I hope that he and others will take up that offer. I would be delighted to convene the meeting in my office in the Department if that helps.

I will move on to the points that my hon. Friend made about whether there may have been miscarriages of justice where sub-postmasters have been prosecuted and convicted. The Post Office handles large amounts of public money every day and operates a trusted role in communities, so it is vital that it has processes in place to protect that money and guard against fraud or theft. The Post Office can bring prosecutions against an individual, but it is down to the courts to determine whether they are guilty.

If an individual has been convicted and feels that their conviction is unsafe, they should explore the legal avenues open to them. They should seek advice on whether they can appeal their conviction, or raise their case with the Criminal Cases Review Commission. That is the correct way to deal with these issues if people believe there have been miscarriages of justice. The House cannot overturn a court ruling; nor, indeed, can mediation.

[Alex Chalk (Cheltenham) (Con)]

It is of course for individuals to decide whether they plead guilty and there is of course an avenue of appeal. Is it not important to note, however, that for many of these people the time for an appeal will be long past, so they remain the victims of a grave injustice?

[George Freeman]

As I say, if any individuals feel that their conviction is unsafe, they can always explore the legal avenues open to them. Where large numbers feel that that is the case, as is alleged, it is perfectly possible for them to bring a class action together. I do not accept that there is a fundamental injustice in the process that prevents people from bringing claims. I accept, however, that it is absolutely vital, where there is a legitimate claim against the Post Office about how it has treated its sub-postmasters, that those claims must be looked at properly.

In the limited time available, I want to move on to the Post Office’s approach. Both tonight and elsewhere, my hon. Friend the Member for North West Leicestershire and others have raised the very serious dissatisfaction felt about the way in which the Post Office has handled relations with its sub-postmasters. When this debate was called, I spoke to the Post Office to understand the situation. I have received a letter from its chief executive, Paula Vennells, which I shall send to my hon. Friend and others who have spoken and place in the Library. The letter sets out just how seriously the Post Office has taken this matter. Ms Vennells says:

“We have gone to great lengths...because I was determined that, if there were problems with the Horizon system, these had to be identified and resolved.”

I will happily pick up any issues that my hon. Friend or others feel are not addressed in the letter.

As I have already said, the mediation scheme is rightly independent of the Government. It was established jointly by the Post Office and the Justice for Subpostmasters Alliance, working with Second Sight, and it is overseen by an independent chair, a former Court of Appeal judge. It is right that the details of individual cases should be confidential and that the Post Office respects that.

Health and Social Care

Alex Chalk Excerpts

Tuesday 2nd June 2015 Commons Chamber

[Alex Chalk (Cheltenham) (Con)]

Thank you, Mr Speaker, for calling me to make my maiden speech. I am conscious that I am following a great many distinguished debuts. I confess that there were moments in the past two years of campaigning when I wondered for a moment whether I would indeed be standing before you as the Member of Parliament for Cheltenham. A difficult moment came early on in the campaign when I knocked on a door in Charlton Kings. It was opened by a lady who was immediately and clearly unimpressed. “I know who you are,” she said. “You might be better than your brother, but we don’t want David Miliband either.”

Another dicey moment came during the mayoral visit of my hon. Friend the Member for Uxbridge and South Ruislip (Boris Johnson). Initially it seemed to go well, but then came that forensic and dastardly question from the local BBC reporter—“Mayor, who exactly have you come to support?” I have to tell you now, Mr Speaker, that the name that came back was not mine. Instead it was the name of a prominent local estate agent. In mitigation, it was an agent who had been advertising heavily on the roads leading into Cheltenham, and I have been asked by my hon. Friend to make that clear.

But by far the biggest obstacle to winning back Cheltenham for the Conservatives after 23 long years was the sheer calibre of my opponent. Martin Horwood came into politics for all the right reasons. Talented and principled, he served for 10 years as Cheltenham’s MP. He did so with conviction, speaking powerfully on issues that he believed strongly in—the merits of the European Union and Britain’s place in it, international aid, the conditions of the world’s tribal peoples and, perhaps most important of all, the fate of our global environment. Locally, he was a committed campaigner on issues ranging from protecting green spaces to tackling illegal pavement parking. I have great respect for his contribution and will continue to learn from his example.

If it was no surprise to see Martin Horwood rise to chair his party’s parliamentary committee on international affairs, I am bound to say that no such advancement traditionally awaits Conservative representatives for Cheltenham. James Agg-Gardner served for 39 years in the 19th and 20th centuries. In that time he made just two speeches and finished his career as a member of the Commons Kitchen Committee. More recently, the last Conservative Member for Cheltenham—the late, great Sir Charles Irving, whose name continues to inspire great affection and respect 23 years since he stood down—went one stage further. He left Parliament as Chairman of the House of Commons Catering Committee.

But if it was a hard road to get here, I am immensely proud to now represent Cheltenham. Having grown up locally, I can tell you, Mr Speaker, that truly it is the greatest town in Britain. I know that Members traditionally make that claim, but on this occasion I am right and they are wrong. Ranked by The Daily Telegraph last year as the best place in the UK to raise a family, there is so much to celebrate. Cheltenham is architecturally magnificent, the most complete regency town in Britain. It is also home to GCHQ, where some of our most brilliant, dedicated and conscientious public servants work tirelessly to keep our country safe. We host famous world-class festivals, including the science festival recently described by Professor Brian Cox as

“without doubt, the premier science festival in the country”.

Similar praise is due for jazz, literature, music, food and other festivals—and who could forget the horseracing, even if the racecourse does, technically, fall within the Tewkesbury constituency?

Culture is very important to our town, and if you need confirmation of that, Mr Speaker, I can tell you that one of the 15 hustings that we participated in—yes, 15—during the election campaign was a poetry hustings. Each candidate had to recite their two favourite poems, to be judged by the audience. I did not win, but mercifully the people of Cheltenham are forgiving.

Our town’s motto is “Salubritas et Eruditio”, which translates as “Health and Education”, and we have formidable traditions in both. As well as our excellent acute emergency hospital, we have some of the finest schools in the country. I will stand up for both. A first-class Cheltenham general hospital is essential for our town, and education is the key to the social mobility that many in the House, I know, wish to see, but none more than I. I will continue my campaign to secure a fair funding settlement for Gloucestershire’s schools. Historically, we have received a raw deal, and work has been done by the coalition to redress that, but it is time to put that right once and for all.

In his speech in Downing Street on the morning after the general election, my right hon. Friend the Prime Minister spoke powerfully about the need to govern as one nation and to ensure that our national economic recovery reaches all parts of our country. He was absolutely right to do so, and so it must be in Cheltenham. Cheltenham, like Britain, has come a long way since 2010: 1,600 fewer people in Cheltenham are claiming unemployment benefit and 2,900 more people are on apprenticeships, but we should not forget that poverty and deprivation remain. It is not often appreciated that Cheltenham is home to some of the most deprived neighbourhoods in Britain, and that is something I am determined to tackle. It is what underpins my plans to promote my constituency as a town of opportunity, where prosperity and life chances reach into every part of the town. It is central to my passion for improving our road and rail infrastructure and promoting Cheltenham as a regional tech hub. So “one nation”, yes, but “one town” too.

There is much to say, but time is short. I will end by saying that it was a son of Cheltenham, Gustav Holst, who wrote the music for that great patriotic hymn, “I vow to thee, my country”, and it is to my country and to my town that I here pledge my service.