NHS Funding Bill

Alex Cunningham Excerpts

Legislative Grand Committee & 3rd reading: House of Commons & Legislative Grand Committee: House of Commons & Programme motion: House of Commons & 3rd reading & Programme motion
Tuesday 4th February 2020 Commons Chamber

[Justin Madders]

My hon. Friend sets out very clearly the challenge that the Government face from the debt situation in the NHS. Both in-year deficits and total debt to Government have not been addressed adequately or taken into account in the Bill and that is clearly of huge concern.

Amendment 5 deals with patient safety, which should be front and centre in the NHS. When things go wrong, as they sadly do from time to time, it can have tragic consequences for patients and their loved ones. When three in four baby deaths and injuries are preventable with different care, it seems particularly tragic when things go wrong during birth, leaving families devastated by the loss of a child or having to cope with the long-term impact. There have been many things over the years that I have disagreed with the previous Secretary of State—the right hon. Member for South West Surrey (Jeremy Hunt)—about, but on Second Reading he raised the important issue of maternity safety training, calling on the current Health Secretary to reinstate the maternity safety fund. We absolutely agree with him on that, which is why we have tabled amendment 5.

Improved maternal health is one of four priority areas in the long-term plan for care quality and improved outcomes, and it includes action to achieve 50% reductions in stillbirth, maternal mortality, neonatal mortality and serious brain injury by the middle of the decade. As a party, we have pledged to legislate for safe staffing and to increase funding for NHS staff training, including reinstating the maternity training fund to help to improve maternity safety in our hospitals. The leaked interim report of the Ockenden review last year exposed widespread failures in maternity care at Shrewsbury and Telford hospital trusts and demonstrated, sadly, that Morecambe Bay was not a one-off.

An evaluation of maternity safety training from 2016 found that it had made a difference and improved patient safety, yet it was still axed. Just two years later, the “Mind the Gap” report found that fewer than 8% of trusts were providing all training elements and care needs in the “Saving Babies’ Lives” bundle and called for the maternity safety training fund to be immediately reinstated to address, as it said, the

“clear…inadequate funding for training”.

Given the clear evidence of the need for the training fund’s reinstatement, I very much regret that it is not within the scope of the Bill for us to submit an amendment to include its reinstatement. However, with the amendment we seek to put a greater spotlight on the issue, and hopefully, that will require the Government to set out how much they are spending on improving maternity safety and care for mothers and babies each year in order for them to demonstrate their commitment to improving maternity and foetal safety. I believe that that will enable us to judge and evaluate their commitment to those aims.

[Alex Cunningham (Stockton North) (Lab)]

It is not within the Bill’s scope to press the Government on the need to have funding restored to smoking cessation services so that they can have multimedia campaigns to reduce smoking in pregnancy and smoking generally. Does my hon. Friend agree that it is a shame that the Government cannot address that at this time?

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[Justin Madders]

My hon. Friend is again showing what an assiduous and determined constituency MP he is. He might want to look at the NHS providers’ report today, which sets out some of the challenges from the lack of a long-term capital investment programme. As we have heard, including from him and in relation to other various examples around the country, this is not just about a lick of paint, but about really vital work that impacts on patient care.

[Alex Cunningham]

When my hon. Friend talks about capital, I think of the hospital that was cancelled for my constituency by the Tory-Lib Dem Government 10 years ago. Does he share my opinion that when it comes to the capital programme and NHS funding, the Government should consider the life expectancy in different areas? In my constituency, it is 14 years lower than in the Prime Minister’s constituency, so I desperately need a new hospital for my area.

[Justin Madders]

I am sure that if my hon. Friend continues with his determined campaign, he will see that hospital appear. His point about health inequalities is really important. It is absolutely scandalous that we see such disparity in this country, and we want to see further and more determined action from the Government on that.

Patients ultimately pay for the increasing backlog. Between 2017-18 and 2018-19, there was a 25% increase in clinical service incidents. These incidents are caused by estate and infrastructure failure that leads to clinical services being delayed, cancelled or otherwise interfered with.

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[Jeremy Hunt]

I do, because this Bill about the NHS in England. It would be nice if we occasionally had a word of thanks, because the Bill will result in a lot more money being made available for the NHS in Scotland. The hon. Gentleman should, if I may say so, welcome that, because I think that will be as welcomed among the Scots as it will be welcomed by the English.

My point about capital to revenue transfers is that it is a big deal to get a hospital building project off the ground. So many get delayed because hospital management teams are very busy. They may have struggling A&E departments and are trying to meet other targets and to deal with safety issues—whatever it is—and they do not have the management resource to invest in putting together the case that, quite rightly, the Treasury and the Department of Health and Social Care demand is extremely rigorous and thorough. That is why things get delayed. If we want to ensure that these 40 hospitals get built, the Government should consider a central team at the Department of Health and Social Care to put at the disposal of hospitals that we want to build extensions or new buildings, so that they can actually navigate those hurdles—[Interruption.] I am getting nods from the very capable Minister for Health, my hon. Friend the Member for Charnwood (Edward Argar), so that might be under consideration.

[Alex Cunningham]

I am grateful to the former Secretary of State for giving way. I admire his admitting his role in converting capital to revenue, and I am sure he regrets that he was unable to build the hospital we need in Stockton to close the health inequality gaps in our society. If he has any influence left in Government, perhaps he will have a word in some ears and say, “They really do need a new hospital in Stockton-on-Tees.”

[Jeremy Hunt]

I can be honest with the hon. Gentleman and say that I regret not being able to build lots of hospitals around the country in that period, because funding was short. Now, however, we are in a different situation. It is important that we build these extra hospitals, but there will be some big challenges in ensuring that we do so.

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To conclude, I reiterate what a pleasure it is to take part in a debate where everybody is trying to get the best outcome for their constituents, the country and the NHS in terms of the service it delivers to all our constituents.

[Alex Cunningham]

You, Dame Eleanor, were not in the Chamber when the hon. Member for Glasgow North (Patrick Grady) indicated that SNP Members might pass through the Lobby, although of course they will not be counted. I seek your help. I want to make sure that the Government Whips do not get confused by my accent and count my vote on behalf of the people of Stockton North when I support the amendment.

[The Chairman of Ways and Means (Dame Eleanor Laing)]

The hon. Gentleman asks for clarification and raises a point that I have many times had cause to raise myself, so I am in total sympathy with him, and I am quite sure that his plea has been heard.

[Alex Cunningham]

I am very grateful, Madam Deputy Speaker.

Amendment 2 concerns spending on mental health services and the Secretary of State’s plans to achieve parity of esteem. Mental illness is often not viewed as a risk to human life, but it is exactly that. In 2018, according to the Samaritans, 6,507 deaths in the United Kingdom were registered as suicides—an increase of 10.9% on the previous year. That means that nearly 7,000 people did not believe that there was help, or another way out of what they were going through.

It can be hard for adults to talk about the feelings that come from being mentally unwell. The words are in their vocabulary, and it may be simple enough to string them together into a sentence, but it is incredibly difficult to say them out loud. I can only imagine how hard it must be for children to express how they are feeling when something is not right. Perhaps they do say the words that are in their heads, but they are not taken seriously. It is a scandal that there are suicidal children as young as 12 who are having to wait more than two weeks for a mental health bed. By not viewing mental illness as life-threatening, we are letting generations down.

There is much debate about what causes mental illness and what is the best form of treatment, but it can take several visits to a GP for people to be taken seriously about not being OK—although many GPs, of course, respond immediately. When parents are fighting for their unwell children to be taken seriously and receive the urgent care and treatment they need, it is horrifying for that to be delayed.

At this stage I should pay tribute to my former colleague Paul Williams, who was the Member of Parliament for Stockton South. He is a GP, and as a member of the Health Committee he spoke extensively about health matters, but locally he took on the child and adolescent mental health services. He knew, as I did because we shared the same area, that it was taking well over two years for young people to be seen by CAMHS. As a direct result of his work, that ended, up to a point, because some children who were due to be seen quickly were actually seen when they should have been. However, those long waits still exist in our area. As we heard earlier from the right hon. Member for South West Surrey (Jeremy Hunt), the former Health Secretary, sometimes children are just not taken seriously.

It is right for the Secretary of State to answer to the House on exactly what the Department is doing, because this is a matter of life and death. Not only the House but the country needs assurance and answers. The state of mental health services will only get worse unless we take action to deliver what is required. The additional money is more than welcome, but I see the amendment as the first, necessary step to provide the funds that are so desperately needed. Equally important is the ability to monitor what those funds are being spent on, and how.

There are many other services on which people depend heavily, including some that we may take for granted, such as smoking cessation services. There is widespread concern about existing funding for services to help people stop smoking. Nearly a third of local authorities no longer provide specialist “stop smoking” services. Stopping smoking is not just a matter of nicotine patches or vaping; people need behavioural support as well, particularly pregnant women, children, and people who are already unwell. One ward in my constituency has some of the highest incidences of smoking in families—whole families smoking—but we also have some of the highest incidences of smoking during pregnancy, and that is not good for the unborn child.

We cannot afford to lose the progress that we have made. We have made tremendous progress over the years, but we need local services that are effective and properly funded. The Government also need to return to funding the multi-media approach to smoking cessation services. I was particularly pleased to learn last week that research has shown that the ban on smoking in cars when a child is present has produced a 75% drop in children being exposed to cigarette smoke in a car. I led on that issue during my first few years as an MP, through private Members’ Bills and a ten-minute rule Bill. The Bills were unsuccessful, but I was delighted when the Government adopted my clause a few years later. We still need to be ambitious and bold about helping people to quit smoking, but services need the resources. I hope the Minister will commit to ensuring that such services are provided, whether for mental health or for smoking cessation, and that they are fully funded so that we can continue to make real progress in that area.

Finally, I shall turn to the matter of capital. The Minister has already heard me talk about the needs in my own constituency. In one ward—the same one I referred to earlier: the Town Centre ward in Stockton—men live 14 years less than those in the Prime Minister’s constituency. His constituency is getting a new hospital, but there are no plans yet for us. However, I have good news for the Minister, because the plan for our hospital is still sitting there. I met the chief executive of North Tees and Hartlepool NHS Foundation Trust just two weeks ago, and she told me that they were ready to dust off the plans again and see how we could provide a hospital. At the time we asked for £100 million from the Government as a guarantor in order to make the project work. The numbers do work, and the health inequalities need to be addressed.

We need to be able to attract the best doctors and clinicians that we can to address the problems in our society. The heart problems are higher on average than anywhere else in the country. We have smoking problems, as I have mentioned, with their related lung and respiratory problems. We also have the legacy of our heavy industry on Teesside, where men who have now retired are in extremely ill health but sometimes cannot get the support they need because we do not have the experts locally to provide it.

In my final sentences, I appeal to the Minister to meet me and the trust members so that we can sit down and talk about this project.

[The Minister for Health (Edward Argar)]

indicated assent.

[Alex Cunningham]

I am glad that he is nodding his head. Ten years ago, the Tory-Lib Dem Government cancelled the project, despite the fact that it was a priority for the country and for the national health service, so I hope that we can now have a meeting and actually start to motor on this. I am pleased to see the Minister smiling, and I hope that he can leave me smiling as well.

[Suella Braverman (Fareham) (Con)]

I rise to speak in favour of the clauses in the Bill and against the amendments. I do not think that the latter add anything material, and they ignore the vast improvements in mental health under this Government in recent years. One in four adults will experience mental health illness in their lifetime, and that is obviously a high incidence of mental health illness. It shows the growing concern around this issue as well as a growing awareness, and, I have to add, a growing commitment by today’s Government, but we cannot ignore the fact that there are many challenges in the system and many areas for improvement.

I want to talk briefly about the Government’s record. I fully support their commitment to providing funding for mental health services, which will mean that those services’ funding will increase faster than in other areas of the NHS. I hope that much of that funding will go towards the frontline in teaching and education. Perhaps the Minister will address this in his closing remarks.

I meet many education professionals in Fareham who report an increase in the incidence of mental illness among their young people and finding the cost of providing counselling and support an additional burden on their budgets.

It is important to note that by 2023-24, under the proposals in the Bill, at least an additional 345,000 children and young people under 25 will be able to access support via NHS-funded mental health services. That is a welcome aim, and I am confident that we will meet that target under this landmark funding commitment. That progress is hugely welcome, and I am glad that the Government have made children and young people’s mental health a top priority within the NHS, which is halfway through a major programme to improve access to specialist services, supported by £1.4 billion of funding. I congratulate the Front-Bench team and the Government on that work.