Healthcare: Hampshire

Andrew Gwynne Excerpts

Wednesday 20th November 2024 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)]

I congratulate the hon. Member for Winchester (Dr Chambers) on securing the debate, and echo his thanks to all health and social care staff who do incredible work in very difficult circumstances. We know that our NHS is broken. Whenever MPs from across the House come to me with issues affecting their constituencies, I repeat the same mantra: this Government will be honest about the issues facing our NHS, and serious about tackling them. Lord Darzi has already completed his review of the current state of the NHS, and his report laid bare the true scale of the challenges facing our health service.

We will not sugarcoat the problems faced by the health service in each and every part of the country, because colleagues from across the House are right to raise issues with me, and we will fix them together. We have already launched our national conversation on the future of the NHS, and we want patients, families and staff to join that conversation and make their voices heard. If Members have not already been to the website, the address is change.nhs.uk. Please let us have some sensible suggestions—not firing the Secretary of State out of a cannon.

In her spring Budget, the Chancellor of the Exchequer announced an extra £22.6 billion to protect NHS day-to-day spending. Every penny of that investment will come alongside vital health reforms; they are two sides of the same coin.

As the Secretary of State outlined last week, this Government intend to publish a league table of providers, allocating the best talent to the most challenging areas and ensuring that there are no rewards for failure. Where necessary, we will remove failing managers, and we will reward senior leaders who successfully improve performance.

[Paul Holmes]

On failing organisations, just before the general election a cross-party group of MPs, including Labour MPs, had a meeting with the then Secretary of State, my right hon. Friend the Member for Louth and Horncastle (Victoria Atkins), about the performance and management of Hampshire and Isle of Wight ICB. Members of Parliament from across the political divide have serious concerns about its leadership, communications and funding—not Government funding, and I welcome the increased funding, but the way that it is distributed to services in Hampshire. Frankly, I do not think the leadership is up to running that ICB. Will the Minister agree to meet me and other Members from across the House to discuss the urgency of the situation? Will he find out from his civil servants where the request for a two-week action plan went and come back to Hampshire MPs?

[Andrew Gwynne]

I am sure the officials in the Box will have noted the concerns the hon. Gentleman rightly raised about his ICB. I will ensure that that is communicated back to the Minister for Secondary Care, my hon. Friend the Member for Bristol South (Karin Smyth), so she can look in more detail at those concerns and communicate with the Hampshire MPs. If a meeting is necessary at the end of that, I am sure she will be more than willing to meet him and his colleagues.

We want to ensure that every part of our NHS is working as well as it can and, as I say, good performance will be rewarded as part of our reforms. Alongside a college of executive and clinical leadership, that will ensure the NHS continues to develop and attract the best talent to top positions, bringing the best outcomes for patients and taxpayers alike.

Let me turn to some of the specific issues that the hon. Member for Winchester raised. On local hospital provision, patients deserve to have safe, compassionate and personalised care in a fit-for-purpose environment. That is why this Government have committed to building and refurbishing hospitals across the country. The new hospital programme includes a new hospital for north and mid Hampshire and a major refurbishment at Winchester to provide specialist and emergency care. As part of the proposal, I am aware that the local trust explored changes to the current obstetrician-led maternity services at the Winchester site. I know the hon. Member has been a strong champion of that, having raised it with the Prime Minister in October.

As announced in the Chancellor’s autumn Budget, my right hon. Friend the Secretary of State will set out further details of the review of the new hospital programme in the coming months, alongside a new and realistic schedule for delivery. The Hampshire hospitals scheme is in scope of the review, and I acknowledge the local concern over the proposal and the impact on the Winchester site and on maternity services.

[Damian Hinds (East Hampshire) (Con)]

My constituents use both Winchester hospital and Basingstoke hospital, as well as others, such as Frimley Park, the Queen Alexandra and Guildford. I understand that a clinical assessment was made about urgent treatment and services at Winchester, but there is a need for a new hospital in or near Basingstoke. In what the Minister said about a review of the new hospital programme, I accept he says a statement is coming soon, but will he confirm that it is about timing and that he or a colleague will come forward to the House soon with the certainty that people in Hampshire need?

[Andrew Gwynne]

Absolutely. I will try to be as unpartisan as I can, but the hospital programme that we inherited from the right hon. Member’s Government did not have anything like the money it needed to back it up. Conservative Members can shake their heads, but it is true. It had nothing like the money needed to bring forward those hospitals. As I have said, we will review that. Our intention is to bring forward those schemes, but that has to be done in an achievable programme, with the finances to back it up. When we announce to the House how we will schedule the hospital programme, I expect that all the answers he wants will be there. We intend to introduce the hospital building programme, but it must be done with money—we cannot build them with fresh air.

[Dr Chambers]

any potential new hospital is decades away, while the hospital we have needs to be maintained and improved. The quickest way forward is to provide 160 new social care packages for Winchester hospital. Will the Minister meet me and the chief executive officer of Winchester hospital to work out how we can deliver those packages as quickly as possible, and provide good A&E, hospital and social care services for everyone in and around Winchester?

[Andrew Gwynne]

It is crucial that we have the best possible health and care services in place for today’s needs while we plan for the future. I understand the hon. Gentleman’s concerns, and I will ensure that they are communicated back to the Minister for Secondary Care, so that she can consider them. I will ask her to report back to him on that. Ultimately, all decisions are best made locally, so that they can cater to local interests, and are clinically led. This is no exception. I know that the hon. Gentleman’s trust will consider all feedback from the public consultation held earlier this year, including from those who will access the new facilities, as well as wider bodies of evidence. The result of the public consultation on location and services will be put to the local integrated care board, and we look forward to hearing the outcome of that.

[Dr Chambers]

I apologise for intervening again so soon. One of my main concerns about the public consultation is that the NHS had assessed sites in Winchester as suitable, but they were not then included in the consultation. The people of Winchester want to know why those suitable sites were not included in the consultation. Can the Minister assure me that that will be addressed by the ICB, and anyone else publishing the consultation?

[Andrew Gwynne]

As I said before the hon. Gentleman’s intervention, ultimately these are local decisions, and they must be clinically led. If the trust has decided that certain outcomes that he would like to see are out of scope of the consultation, we must take it as read that there are sound clinical reasons for that. If he thinks otherwise, I am sure that he can bring that up with my hon. Friend the Minister for Secondary Care, but ultimately we must be guided by the clinicians. They know, more than we Ministers in Whitehall will ever know, what the better outcomes for their areas are.

The hon. Gentleman mentioned primary and community care. We know that patients nationally and in Hampshire find it increasingly difficult to see a GP. We are committed as a Government to fixing the front door to the NHS, to ensure that patients receive the care that they deserve. If patients cannot get a GP appointment, they end up at accident and emergency, which is worse for them and more expensive for the taxpayer. That is why we will shift the focus of the NHS out of hospitals and into community. One of our three big shifts is from hospital to community; the others are from analogue to digital, and from sickness to prevention. Those three things, taken as a whole, could be quite transformative in how we deliver primary care.

[Gregory Stafford]

I agree entirely with the Minister on the shift from hospital to community. I do not want to labour the point that I made when I intervened on the hon. Member for Winchester (Dr Chambers), but in the Hampshire part of my seat, we have a debate about whether we will still have Chase community hospital or a new health hub there. They are both essentially local services. The ICB is dragging its feet and will not make a decision on which it will be. Local people do not know what will happen, and decisions are being kicked down the road by the ICB. As my hon. Friend the Member for Hamble Valley (Paul Holmes) said, the leadership of the Hampshire and Isle of Wight ICB is not fit for purpose. Will the Minister meet us and them to ensure that we can get this moving?

[Andrew Gwynne]

I hear loud and clear what Conservative Members say about the leadership of their ICB. I hope that the ICB management will obtain a copy of today’s Hansard and read not only those comments, but the Minister’s reply. I expect them to make decisions in a timely fashion, so that there is some certainty for the local population about the new make-up of health and care services in that area—not just for the sake of patients and the local population, but staff. As we redesign services and change towards more preventive, community-focused care, some parts may become obsolete, and it is absolutely crucial that we take the workforce, as well as the population, on that journey of change in services. I very much hope that the hon. Gentleman’s ICB leadership will have heard the message from the Minister at the Dispatch Box, which is that they really need to crack on, make a decision, communicate it and work with Members of Parliament, the public and staff on whichever changes they propose.

I return to primary and community care. As I said, our manifesto commits to moving towards a neighbourhood health service, with more care delivered in local communities, so that problems are spotted earlier. We will bring back the family doctor by incentivising GPs to see the same patient, so that ongoing or complex conditions are dealt with effectively. In doing so, we will improve continuity of care, which is associated with better health outcomes for patients, and our plan will guarantee a face-to-face appointment for all those who want one; we will deliver a modern booking system that will end the 8 am scramble. That is crucial in improving access to general practice.

The hon. Member for Winchester rightly raised the huge problems with dentistry in his area, which are not that uncommon across the whole country. I do not believe that the previous Government’s dentistry recovery plan went far enough; too many people were still struggling to find an NHS appointment. We are working to ensure that patients can start to access additional urgent dental appointments as soon as possible, and we will target the areas that need the most—the so-called dental deserts. Integrated care boards have started to advertise posts through the golden hello scheme. This recruitment incentive will see up to 240 dentists receive payments of £20,000 to work in the areas that need them most for three years. The common reason why children aged five to nine are admitted to hospital—this is absolutely shocking in the year 2024—is tooth decay. We will work with local authorities to introduce supervised toothbrushing for three to five-year-olds in the most deprived communities. These programmes are proven to reduce tooth decay and boost good practice at home.

To rebuild dentistry in the long term, we will reform the dental contract with the sector, with a shift to focusing on prevention and the retention of NHS dentists. To be fair, this has been an issue for all Governments, going back to the Labour Government who introduced the dental contract. They did so for the right reasons, but in 2010, we recognised that the dental contract was not working in the way we envisaged, and that it had to change. It is shocking that 14 years have passed since then with no real action having been taken—we are determined to fix that. At the same time, we will not wait to make improvements to the system to increase access and incentivise the workforce to deliver more NHS care. We are continuing to meet the British Dental Association and other representatives of the dental sector to discuss how we can best deliver our shared ambition of improving access for NHS dental patients.

I have to say that the statistics for Hampshire and Isle of Wight integrated care board make sorry reading. Only 36% of adults were seen by an NHS dentist in the 24 months to June 2024, compared with 40.3% across England, and 54% of children were seen by an NHS dentist in the 12 months to June 2024, compared with 56% across England. In 2023-24, there were 46 dentists for every 100,000 people in the hon. Gentleman’s trust, whereas the national average across all ICBs in the same year was just under 50 dentists, and in 2024, the general practice patient survey success rate for getting an NHS dental appointment in the past two years in the Hampshire and Isle of Wight ICB area was 72%, compared with 76% nationally. They are not great statistics nationwide, but they are certainly not brilliant in the ICB of hon. Members present, and we look for real improvements there.

Turning to the pharmacy sector, we want to take pressure off GPs by increasing the services offered in community pharmacies. There is so much more that our pharmacists could and should be doing to deliver basic healthcare services on the high street and in the community, as part of the shift from hospital to community. That would free up thousands of GP appointments in cases where people do not really need to see a general practitioner for their condition. We are committed to looking at how we can further expand the role of pharmacies and better use the clinical skills of pharmacists as more become independent prescribers—that is where the potential gets really exciting. Now that the budget for Government has been set, we will resume our consultation with Community Pharmacy England shortly. I hope Members will understand that I am unable to say more until that consultation has concluded. Suffice it to say that Pharmacy First and community pharmacies have a huge role to play in improving health outcomes in the community.

[Jim Shannon]

In my former role as an Assembly Member back home, we had a very close relationship with pharmacies. The consultation process that the Minister is outlining for England would be very much welcomed in Northern Ireland, so can I ask the Minister a favour? When that consultation concludes, will he share his findings with the Northern Ireland Assembly, and particularly with the Minister in Northern Ireland? What the Minister is hoping to achieve is what we would also like to achieve.

[Andrew Gwynne]

The hon. Gentleman raises an important point. No part of the United Kingdom holds a monopoly on wisdom, and if we are doing something good or if there is innovation in one part of the United Kingdom, it is incumbent on Health Ministers across the devolved Administrations and here in Whitehall to share best practice—to work together and, where possible, take a four-nation approach. I hope I can reassure the hon. Gentleman that since this new Labour Government came into power, we have really tried to reset our relationships with the devolved Administrations and with the various Ministers. I have had several meetings with Mike Nesbitt on a range of health issues that appertain to the whole United Kingdom on which we want to ensure there is consistency of approach. I am more than happy to communicate further with Mike Nesbitt and colleagues in the Northern Ireland Executive on how we reform our health and social care services in England to see whether things can be taken by them in Northern Ireland. Vice versa, if there are good ideas from Northern Ireland, I am more than happy to consider them in how we transform NHS services in England.

The hon. Member for Winchester mentioned social care, and he is right to raise winter resilience. I have spoken about fixing the front door to the NHS through primary care reforms. We also have a serious job to do to fix the back door and ensure that patient flows through the system are not held up because of a lack of social care. On winter resilience, I hope he will understand that we are working to ensure that there are no crises and that we tackle the issues of social care. Getting beds in appropriate places is a key part of our plan.

In the long term, there are no quick fixes. The Dilnot reforms were announced by the previous Government, but it is fair to say that, when we came into office, we found that the money apparently set aside for the Dilnot reforms had already been spent on other NHS pressures. Laudable though it may have been to spend that money to try to get waiting times and waiting lists down and to fix some of the problems that that Government had created, it left us with a bit of a social care issue, given that the reform money had gone, had disappeared and was no longer there to be spent.

Over the next decade, this Government are committed to building consensus on the long-term reform needed to create a national care service based on consistent national standards, including engaging across the parties. It is good to see the shadow Secretary of State, the right hon. Member for Melton and Syston (Edward Argar), in his place, and I am sure he will be very willing to work with us, as indeed will the Liberal Democrats. We genuinely want to make sure that we get cross-party consensus on the future of our adult social care, so that we can finally grasp this nettle once and for all, and to fix it without it becoming such a contentious issue, as it became, sadly, in 2010 and 2017. Neither of the two main parties has a good story to tell on this, because we have both shamefully used it as a political football from time to time. It is now appropriate that we set aside those politics and get on with fixing social care. I hope that, in due course, we will be able to move forward on that agenda.

I assure the hon. Member for Winchester that we are acutely aware of the problems with mental health services. We both agree that waiting lists are unacceptably high. Indeed, the people of Hampshire and most of England are not getting the mental health care they deserve. He has spoken previously about Lord Darzi’s report, which has shone a searing spotlight on the waiting lists that young people face, in particular. I am immensely proud that this Government are intent on tackling the issue head on, with specialist mental health professionals in every school in England. That is our aim. These NHS-funded mental health support teams in schools and colleges will work with young people and parents to manage mental health difficulties and to develop a whole-school approach to positive mental health and wellbeing.

[Damian Hinds]

Can I just check whether I heard the Minister correctly? Did he say there would be a mental health specialist in every school in England?

--- Later in debate ---

[Andrew Gwynne]

Yes, that is our manifesto commitment. There will be mental health specialists for every school in England. In Hampshire, there are mental health support teams assigned across the area, including schools in Winchester, Eastleigh, Andover and Havant. In addition, we will introduce young futures hubs in every community and recruit an additional 8,500 mental health workers across children and adult services. We have also set aside £26 million in capital investment for new mental health crisis centres, and we are expanding NHS talking therapies, alongside individual placement and support schemes.

This Government are committed to fixing the NHS so that patients, including those in Hampshire, can access excellent care when they need it. It is true to say that every Labour Government have inherited an NHS in a far poorer state than that which they bequeathed to their successors. It turns to this Labour Government to fix our NHS once more.

Question put and agreed to.