Oral Answers to Questions

Alistair Burt Excerpts

Tuesday 9th February 2016 Commons Chamber

[Ian Lavery (Wansbeck) (Lab)]

3. What estimate he has made of the number of patients who went to A&E after having been unable to make an appointment with their GP in the most recent period for which figures are available.

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

The results of the last GP patient survey show that 91.9% of all patients get convenient appointments. Of the 8% who are unable to get an appointment or a convenient appointment, 4.2% indicated that they went to A&E.

[Ian Lavery]

The same survey indicates that one in four people are now waiting more than a week to see their GP, and a staggering 1 million people are heading off to A&E because they cannot get an appointment with their GP. It is a total meltdown. What is the Minister doing about it?

[Alistair Burt]

There are 40 million more appointments available for GPs than in the past. The Government have made a commitment to transform GP access, and £175 million has been invested to test improved and innovative access to GP services. There are 57 schemes involving 2,500 practices, and by March next year more than 18 million patients—a third of the population—will have benefited from improved access and transformed service at local level. That is what we are doing about it.[Official Report, 22 February 2016, Vol. 606, c. 2MC.]

[Mr John Baron (Basildon and Billericay) (Con)]

The Minister will be aware that, despite great improvements in cancer care under this Government and the previous Government, one in five cancer patients—more than 20%—are first diagnosed as late as when they go to A&E. The Government rightly focus on one-year survival rates as a means of driving forward earlier diagnosis. Can he give me an assurance that that will remain a key focus?

[Alistair Burt]

My hon. Friend raises a serious issue. Pursuing the earliest diagnosis of cancer is very important to the Government; it is obviously also important to all patients. We are going to publish the statistics on early detection through the clinical commissioning groups to improve transparency still further, because as this Government have shown, transparency often drives improvement in performance.

[Kate Osamor (Edmonton) (Lab/Co-op)]

24. Can the Minister tell me how the Government are urgently going to tackle safety of care at the North Middlesex hospital A&E department, following revelations last week that a patient died at the hospital in December 2015 after being forced to wait an unacceptable time in A&E? The department has also received a notification of risk.

[Alistair Burt]

The hon. Lady gives an example of why it is so important to continue to seek to improve the quality of care in A&E and why it is so important to keep transparency going. This is one of the reasons that we have a new inspection regime, which has been designed to highlight these things, but the introduction of 1,250 new doctors in accident and emergency departments over the past five years will also make a difference to the improvement in quality of care. However, she is right to highlight this matter. The NHS does not do everything right, but what is important is that we value what is done with the vast majority of stuff and that, when things do go wrong, we say so, we examine them and we learn lessons.

[David Tredinnick (Bosworth) (Con)]

According to information that I have received, 16 of the 25 ambulances on duty in Leicestershire one evening before Christmas were queueing outside Leicester royal infirmary to discharge patients. I have written to my right hon. Friend the Secretary of State about this issue. Please will the Minister update me and the House on the steps he thinks we should be taking?

[Alistair Burt]

The issue with ambulances and with quality of care elsewhere is the variation in quality. It is so important to ensure that local leadership addresses those local problems, because they are handled very differently in different places. It is right for my hon. Friend to raise this matter, and I am sure he has raised it with his local ambulance trust, as well as the hospital, to see how there can be better facilitation of patients going in and being discharged so that ambulances need not queue.

[Dr Philippa Whitford (Central Ayrshire) (SNP)]

The Health and Social Care Information Centre has shown that last year 124,000 patients waited more than 12 hours after arrival at accident and emergency, which compares with a figure of 1,700 in Scotland, and the number has doubled since 2013. The Royal College of Emergency Medicine has explained that these tend to be the sickest patients and that this delay is associated with increased mortality, so how do the Minister and the Secretary of State plan to improve that performance?

[Alistair Burt]

I have to tell the hon. Lady that patient satisfaction with A&E was rather lower in Scotland than it is in England, which indicates that we all have problems to deal with in this area. It is correct that we continue our progress both to increase resources throughout the health service and to A&E, and to improve transparency and people’s ability to see what is going on. Unacceptable waits are not part of what we all want to see from the NHS, which is why we are determined to drive them down. Patients in England will have the best information anywhere in the world about what is happening in their NHS, as we continue to drive efficiency and improvement.

[Dr Whitford]

Patients will not have the information about the four-hour waits, as that has not been published since November. The doctors required to look after these people are A&E specialists. There is already a major problem in retaining A&E trainees because they work a higher proportion of unsocial hours. These are exactly the hours that will be less rewarded in the new contract, so how does the Secretary of State plan to recruit and retain doctors in emergency medicine in the future?

[Alistair Burt]

There have been 500 more consultants in A&E medicine since 2010. The new contract is under negotiation at the moment and the majority of it has been agreed with junior doctors. It is designed to replace the failures in the old contract, which everyone knew needed to be corrected, and it provides the basis for the profession for the future to deal with some of the issues the hon. Lady mentions. All of us are concerned to ensure that the negotiations continue and that there should be no strike tomorrow, so that this pattern for the future, which is wanted by doctors and patients alike, as well as by the Government, gets a chance to work.

[Andy Slaughter (Hammersmith) (Lab)]

4. What assessment he has made of the implications for his policies of the findings of the Independent Healthcare Commission on the NHS in north-west London.

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[Daniel Zeichner (Cambridge) (Lab)]

10. What progress his Department has made on reviews investigating the end of the contract between Cambridgeshire and Peterborough clinical commissioning group and UnitingCare Partnership.

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

The CCG expects to publish its internal review by the end of February, and NHS England’s independent review is expected to be completed by the middle of the month. Monitor is assessing the project from the providers’ perspective and will share its findings with NHS England in due course.

[Daniel Zeichner]

The UnitingCare contract in Cambridgeshire was an attempt to join up unintegrated services. We now appear to be having a series of unintegrated reviews. What is actually needed is a single overarching review that looks at the roles of NHS England, Monitor, the strategic projects team, and, of course, Ministers. When are we going to get that review?

[Alistair Burt]

As I said, there are ongoing reviews concerning the precise responsibilities of each individual part. There is no doubt that this is a very serious matter—a serious failure—that raises series concerns. We want to know what went on as much as the hon. Gentleman does, so once the reviews have been completed and we have been briefed, I will be very happy to talk to him about their consequences.

[Mr Speaker]

I call the victorious team leader, Mr Stephen Pound.

[Stephen Pound (Ealing North) (Lab)]

11. What assessment he has made of the potential effects on public health of his Department’s proposals on the future of community pharmacies.

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

It is my considerable honour, Mr Speaker, to respond to the hon. Gentleman in his victorious mode.

Community pharmacy is a vital part of the NHS and it plays a pivotal role in improving the public’s health in the community. We want a high-quality community pharmacy service that is properly integrated into primary care and public health. The proposed changes will help us, in conjunction with the pharmacy profession, to do just that.

[Stephen Pound]

I am very grateful to the Minister for that answer. There is always a place for him in our team next year, although we are running trials in the next few weeks.

Despite the generosity of the Minister’s response, does he not accept that community pharmacies are of great and growing importance to our constituents and provide an ever-increasing range of healthcare and advice in accessible high street locations? What message does he have for these dedicated professionals, who, frankly, now fear for the future due to the uncertainty arising from the announcement of a 6% cut in funding for the NHS pharmacy service?

[Alistair Burt]

I am grateful to the hon. Gentleman not only for his question but for the way he put it. The message is that community pharmacy does, and is doing, an extraordinary and important job, but it will change. In 2013, the Royal Pharmaceutical Society said in its publication, “Now or Never: Shaping pharmacy for the future”:

“The traditional model of community pharmacy will be challenged”

due to

“economic austerity in the NHS , a crowded market of local pharmacies, increasing use of technicians and automated technology to undertake dispensing, and the use of online and e-prescribing”.

It pointed to the massive potential of community pharmacists to do more and sees pharmacy as ideally placed

“to play a crucial role in new models of…care.”

All that is to come. We are negotiating with the pharmaceutical profession. A consultation is going on. There is a great future for pharmacy, but, like so much else, it will be different.

[Kevin Hollinrake (Thirsk and Malton) (Con)]

13. What progress his Department has made on making the UK a world leader in tackling antimicrobial resistance.

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[Sir Simon Burns (Chelmsford) (Con)]

14. What assessment he has made of the adequacy of provision of GP practices in Chelmsford constituency.

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

NHS England advises that in Chelmsford there is a GP to patient ratio of 1,927 patients per whole-time equivalent GP, which is slightly lower than that for the Mid Essex clinical commissioning group area. The Care Quality Commission has inspected eight of the 13 Chelmsford GP practices—seven were rated “good” overall and one, Sutherland Lodge, was rated “outstanding”.

[Sir Simon Burns]

Does the Minister think it would be possible for the NHS review of the personal medical services scheme to ensure that the good and innovative work promoted by PMS, as exemplified by Sutherland Lodge surgery, can be sustained?

[Alistair Burt]

I hope so. I appreciate my right hon. Friend’s visit to my office yesterday with members of that surgery and NHS representatives. The £1.4 million released from PMS in Essex will be reinvested in the CCG area, but it is important that there is an opportunity for all practices to bid for that money so that some of the work already done under PMS gets the chance, if it is vital and still needed, to continue, which certainly includes services that are rated “outstanding”.

[Rosie Cooper (West Lancashire) (Lab)]

T1. If he will make a statement on his departmental responsibilities.

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[Ben Howlett (Bath) (Con)]

T4. I am sure Ministers will join me in congratulating Number 18 surgery in Bath on being ranked in the top 10 GP practices in the country. Do they agree that patients having a choice of where they are treated will increase patient satisfaction in the NHS?

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

Yes, it certainly will. That is another reason why we hope to have 5,000 more doctors and 5,000 more allied health professionals working in general practice, to expand the primary care service by 2020.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

Today’s The Independent reports that a potential deal on the junior doctor contract was put to the Government that would have resolved junior doctors’ concerns without costing any more money and potentially avoided tomorrow’s industrial action. A source close to the negotiations told the newspaper:

“The one person who would not agree was Jeremy Hunt. Even though the NHS Employers and DH teams thought this was a solution he said no”.

So let me ask the Health Secretary a very direct question: have the Government at any point rejected a cost-neutral proposal from the BMA on the junior doctor contract—yes or no?

[Oliver Colvile (Plymouth, Sutton and Devonport) (Con)]

T6. Will my right hon. Friend update us on the progress in decriminalising dispensing errors for pharmacists?

[Alistair Burt]

I am aware of my hon. Friend’s keen interest in the rebalancing programme of work, and particularly the work on dispensing errors. We are fully committed to making that change. There are a number of stages to amending primary legislation through a section 60 order. Given the timetable, it is likely that the order will be laid before the Westminster and Scottish Parliaments in the autumn.

[Tommy Sheppard (Edinburgh East) (SNP)]

T2. The Secretary of State will be aware that Maximus is recruiting junior doctors to perform work capability assessments in the Department for Work and Pensions. The company is offering £72,000 a year, which is up to twice the salary that junior doctors would get in the health service. Is he concerned that that will result in inexperienced medical staff making judgments that relate to people’s livelihoods? Is he not also concerned that it will result in a drain of staff resources out of the NHS and out of providing general healthcare for the public?

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[Henry Smith (Crawley) (Con)]

I am pleased to support the National Society for the Prevention of Cruelty to Children’s “It’s Time” campaign, which is an initiative to ensure that children who have been the victims of abuse receive ongoing support. May I seek assurances from the Government that they will actively help with this initiative?

[Alistair Burt]

Yes, indeed. We strongly support the initiative. Our work to look after children who need extra care, particularly in relation to their health and emotional needs, has been helped by the transforming care package, which is going through local authorities at the moment. Their vulnerabilities are certainly a matter of great concern, and that will be followed up by the Government.

[Mrs Emma Lewell-Buck (South Shields) (Lab)]

Over 1 million elderly people are able to maintain independence and remain in their own homes due to the attendance allowance. What discussions has the Minister had with his colleagues about ensuring, when the fund is transferred from the Department for Work and Pensions to the Department for Communities and Local Government, that the allowance will remain at the same level?

[Alistair Burt]

The consultation is ongoing between Departments. A unit has been set up by the Department of Health and the DWP to look at a range of issues that concern us both. The actual detail of the future attendance allowance has not been finalised yet, but it is a matter of concern and discussion between Departments.

[Dr Sarah Wollaston (Totnes) (Con)]

In asking a question about mental health, may I remind the House that I am married to an NHS forensic psychiatrist, who is also registrar of the Royal College of Psychiatrists? Have the Government looked carefully at today’s report from the independent commission on improving mental health services, particularly its finding that provision nationally for the most severely ill acute patients is inadequate? Will the Government set out what measures they will take to make sure we really see progress on parity of esteem and on improving access to such severely ill patients?

[Alistair Burt]

I thank my hon. Friend for her question, and the Royal College of Psychiatrists for its work on Lord Nigel Crisp’s commission, which we have supported. The report and recommendations have only just come to us, but they certainly travel in the direction in which the Government are already going. We want to reduce out-of-area placements. The NHS is already committed to that, and is working on moving to a definitive target to reduce the number of them and, I hope, eventually to scrap them. I was up in Hull last week to look at problems in that particular area. The recommendations on waiting times are very important. As we all know, this area has been undervalued in the past. It is under greater scrutiny, and more investment and support are going in through the Government. Today’s report will help us in relation to that.

[Greg Mulholland (Leeds North West) (LD)]

rose—

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[Kevin Barron (Rother Valley) (Lab)]

The 6% cut in the pharmacy budget will come in in October—halfway through the next financial year. Will the Minister tell us what the percentage cut will be in a full financial year?

[Alistair Burt]

Negotiations are ongoing with the Pharmaceutical Services Negotiating Committee. The amounts that have been set out cover this financial year and the settlements are moved on from year to year, so the discussion is ongoing. The future for pharmacy is very good, although it will be different, as the profession has wanted for some time. Not only is there a great future for high-street shops in areas where we need them, but there will be an improvement in and enlargement of pharmacy services in healthcare settings, primary care settings and care homes around the country.

[Several hon. Members rose—]