Covid-19
Andrew Lewer Excerpts(3 years, 7 months ago)
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Andrew Lewer (Northampton South) (Con)
I supported the Government in the decisions they took in March, at the start of the covid-19 outbreak, when scientific understanding of this virus was not at the point that it is today. Tough decisions had to be made as to how to protect human life, because we were still learning how the virus could be transmitted and who was most vulnerable to becoming critically ill if they were infected. I commend Ministers for acting as they did and when they did, as well as everyone who has gone the extra mile during this terrible time, in Northampton and elsewhere.
The steps the Government took in the spring stopped the NHS being overwhelmed and saved lives. However, no Member of this House could be in any doubt that they also had a significant impact on our country in terms of the economy, society, the policing of our civil liberties and the devastating effect on people’s mental health. As data published by NHS England on a daily basis outlines, the number of people testing positive for covid-19 is rising, yet the death rate is staying low. “Yes, at the moment,” will be the response, and I acknowledge that, but I urge that that remain the key statistic either for further steps or for reeling back.
It is therefore imperative at this time that all areas of our lives affected by current restrictions be taken into account. Changing the Government’s response in line with the rates of infections if there are significantly lower death rates should not be viewed, as some might like to shout from the rooftops, as a U-turn. Changing tack in response to the statistics is rather a response to the reality of the situation we currently find ourselves in or may come to find ourselves in. That is not a humiliation or a repudiation, but adapting to circumstances.
I am concerned about the impact on the economy, not only in terms of people’s livelihoods—I thank the Chancellor for the unprecedented support he has given there—but in terms of the economy being able to provide for public services, particularly in non-covid health, notably cancer and mental health services. In addition, I am concerned about the impact there has already been on people attending vital appointments at their local hospitals and receiving urgent medical treatment. Earlier today, a constituent sent me an interesting link to an open letter by 394 medical doctors and over 1,300 healthcare professionals in Belgium, touching on this exact point: a cure must not be worse than the disease.
In essence, the dystopian nature of some of these restrictions has already caused a considerable deal of damage in society. I recognise the difficult balance and approach the Government had to take, but if we look at some other countries—Sweden, yes, but others too—it becomes evident that there are alternative approaches to controlling the virus without as significant an impact on civil liberties or as damaging an effect on the economy, with shielding the elderly and vulnerable more specifically than via general lockdowns being the approach.
I turn from the current challenges and dilemmas, the current agonising choices, blizzard of statistics and analysis of infection rates versus death rates, to a time—we hope and pray it will be soon—when we emerge from this, hopefully with a vaccine, I want to be very clear that any temptation on the part of the Government to attempt to keep any aspect of the restrictions, even if they have been determined to have been beneficial in some way, must be totally rejected. Any restrictive measure that has been implemented to fight coronavirus must go when a vaccine has been developed and distributed among much of the population.
At that point, a bonfire of restrictions must be metaphorically set alight. My inbox has seen a huge increase in people who now share that position with me. That goes back to my point on the damage—necessary though it may have been felt to be, and not to denigrate that—that these restrictions have done to society as a whole. This has been a national trauma, and it has eroded our nation’s civil liberties to a level that we have not seen in this country during peacetime. It is therefore crucial that every opportunity for public and parliamentary scrutiny is availed of.
NHS Funding Bill
Andrew Lewer ExcerptsMonday 27th January 2020
(4 years, 3 months ago)
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Andrew Lewer (Northampton South) (Con)
This Government have now committed £33.9 billion, the largest cash increase in the history of the NHS, and I am hopeful that the funding will go where it is needed most and that, when combined with the NHS long-term plan, it will help to provide direction and certainty. During the last Parliament, I sat on a Joint Committee of the Housing, Communities and Local Government Committee and the Health and Social Care Committee, which commissioned a report on adult social care that recommended various ways in which the funding of adult social care could be reformed.
As a former county council leader and as a vice-president of the Local Government Association, this matter has been of interest to me for a long time, and as an MP in Northamptonshire, that interest is even more acute. There is no point pretending that the weight of adult social care costs has not had a large part to play in the crises that that authority has experienced. In recent years, increases to adult social care funding have come, and they have been welcome, but they have been piecemeal, which can affect a local council’s ability to plan for anything beyond the short term. This is why I am encouraged by the confirmed funding and the long-term plan covered in this Bill. Social care and public health funding need the same long-term certainty as NHS funding.
A joined-up approach between local authorities and NHS staff where both are working in tandem with each other is vital to delivering adult social care, especially in constituencies such as mine. This is an approach that I will continue to push for across Northampton South and Northamptonshire, and I have had several meetings with colleagues, council leaders and healthcare professionals to discuss an integrated joined-up approach to adult social care across the county. This could be a radical and exciting pilot—a blueprint, if you prefer—if handled with ambition and vision.
I am fortunate in having been able to go on numerous visits to Northampton General Hospital in my constituency, both publicly and for private meetings with staff. I have a very good relationship with Doctor Sonia Swart, the chief executive of NGH, and I am immensely proud when I meet the dedicated and hard-working NHS staff on my visits there. There is one thing I would like to see a commitment to, or have further discussions with Ministers about, and that is the £6.5 million funding for a new children’s A&E facility in Northampton General Hospital. I have seen at first hand the brilliant work carried out by the staff there, but some of the facilities are in desperate need of updating, and this is something I am keen to help deliver. I believe that this Bill will help to deliver the funding and the commitments we made in our manifesto to transform patient care and to support those who use the NHS and those who provide first-rate care free at the point of delivery.
Health and Social Care (Kettering)
Andrew Lewer Excerpts(4 years, 6 months ago)
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Mr Philip Hollobone (Kettering) (Con)
I beg to move,
That this House has considered health and social care in Kettering constituency.
I welcome you to the Chair, Mr Wilson, and I thank Mr Speaker for granting this debate. I also welcome Northamptonshire colleagues who are here: my hon. Friends the Members for Wellingborough (Mr Bone) and for Northampton South (Andrew Lewer). If he is released from his important role in the Government Whips Office, my hon. Friend the Member for Corby (Tom Pursglove) hopes to be able to attend. Others with a local interest are also here, including my right hon. Friend the Member for Rutland and Melton (Sir Alan Duncan), who I welcome to his place.
I also welcome our excellent Minister for Health, my hon. Friend the Member for Charnwood (Edward Argar). He is not only excellent in his own right, but he is super excellent because within just a few weeks of being appointed as hospitals Minister, he made a visit to Kettering General Hospital one of his very highest priorities. He did that on 7 October and met: the superb chairman of Kettering General Hospital, Alan Burns; our wonderful chief executive, Simon Weldon; the medical director, Andrew Chilton; the chief nurse, Leanne Hackshall; the chief operating officer, Joanna Fawcus; the director of strategy and transformation, Polly Grimmett; the director of finance, Nicola Briggs; the director of estates, Ian Allen; the clinical director of urgent care, Adrian Ierina; and the head of nursing in urgent care, Ali Gamby. All those magnificent people were there to meet the Minister because the hospital is absolutely determined to get the necessary funding for a new urgent care hub at the Kettering General Hospital site.
Kettering General Hospital is a much-loved local hospital. It has been on its present site for 122 years, and there cannot be many hospitals that have such a record. The problem at Kettering General Hospital is that the A&E department is full. It was constructed in 1994 to cope with 45,000 attendances each year. This year, we could well go through the 100,000 attendances mark, which is well over 150% of the department’s capacity. By 2045, 170,000 attendances are expected at the same site. The solution to that pressure is for an urgent care hub facility costing £46 million to be constructed on the site. It would be a two-storey, one-stop shop with GP services, out-of-hours care, an on-site pharmacy, a minor injuries unit, facilities for social services and mental health care, access to community care services for the frail elderly and a replacement for our A&E department. All the NHS organisations in Northamptonshire, as well as NHS Improvement regionally, agree that that is the No. 1 clinical priority for Northamptonshire. They are all saying the same thing to the Government, and I am delighted to support their campaign.
The A&E department at Kettering General Hospital was visited in 2016 by Dr Kevin Reynard of the national NHS emergency care improvement programme. He said:
“The current emergency department is the most cramped and limiting emergency department I have ever come across in the UK, USA, Australia or India. I cannot see how the team, irrespective of crowding, can deliver a safe, modern emergency medicine service within the current footprint.”
Despite some temporary modifications over recent years, including moving other patient services off the hospital site, detailed surveys show that no further opportunities remain to extend the department and that a brand-new building is required on the site. The hospital has developed a superb business case for a fit-for-purpose emergency care facility that will meet local population growth for the next 30 years. It has been developed with all the health and social care partners across the county so that patients can get a local urgent care service that meets all the Government guidance on good practice, ensuring that they get the care they need to keep them safely outside of hospital if necessary, and ensuring that if they come into hospital, they are seen by the right clinician at the right time, first time. The bid has been submitted to the Government. We have been pressing the case for the facility since 2012. It is about time that the Government listened to the concerns and responded by promising the funding.
The pressure on Kettering General Hospital is primarily being driven by very fast population growth locally. The Office for National Statistics shows that we are one of the fastest growing areas in the whole country, at almost double the national average. The borough of Corby is the fastest growing borough outside of London. The population served by the trust has grown by almost 45% since the A&E opened in 1994. The area is committed to at least 35,000 new houses over the next 10 years. That means a population rise of some 84,000, to almost 400,000 people locally. The A&E department now sees approximately 300 patients every single day in a department that is safely sized to see just 110. Every day, 87 patients are admitted into the inpatient wards from A&E, and over the next 10 years, the hospital expects the number of A&E attendances to increase by 30,000, equivalent to almost 80 extra patients every day. Bluntly, a solution is required immediately if the hospital is to have time to prepare and build for that.
Andrew Lewer (Northampton South) (Con)
I thank my hon. Friend for giving way. I recently visited A&E at Northampton General Hospital, which also has a space and crowding problem, particularly in paediatrics. Does he agree that investment there would assist Kettering with the problems it has and would lead to a whole Northamptonshire approach to solving some of these problems?
Mr Hollobone
I am delighted to take that intervention from my hon. Friend, who is a superb representative for his constituents in Northampton and is very much in touch with the importance of local healthcare issues to our constituents. He is absolutely right.
I am delighted to welcome the Government’s commitment to include Kettering General Hospital on the list of hospitals that will be considered for health infrastructure plan 2—or HIP2—funding from 2025. That is important for Kettering, because the hospital has been there for 122 years, 70% of the buildings on the main hospital site are more than 30 years old and there is a maintenance backlog of £42 million. We need the reconstruction of many wards at the hospital. I welcome the Government’s commitment to investment in the hospital site from 2025 onwards, which could transform the whole of Kettering General Hospital. The point about the urgent care hub is that we need the money now to address the pressure on the A&E department.
The second part of the debate is about the need for us to use the opportunity of local government reorganisation in Northamptonshire to create in the county a combined health and social care pilot that will put responsibility for healthcare and social care under one organisation. Northamptonshire County Council has faced tremendous financial difficulties. The Government appointed an inspector, who concluded that it was not possible to turn around the organisation. The Government’s solution is to create two unitary councils in the county: a “north” council and a “west” council that will take over all the responsibilities of the eight different councils in the county from May 2021. We can use that once-in-a-generation opportunity to create a new organisation on a pilot basis to combine health and social care in Northamptonshire.
That is important for Kettering General Hospital because it has 531 beds; at any one time 110 of those beds—21%—are occupied by patients who should not be in hospital at all, but in a social care or other setting. In Government jargon, they are defined as super-stranded patients who have been in hospital for more than 21 days. If the hospital discharges 87 patients a day from the A&E department to the hospital, and 110 of the beds are occupied by patients who should be in a different setting, it creates huge problems for the A&E department, so finding a solution to the social care issue is also important for the A&E department.
The National Health Service
Andrew Lewer Excerpts(4 years, 6 months ago)
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Andrew Lewer (Northampton South) (Con)
I am pleased to follow the hon. Member for North Tyneside (Mary Glindon) and my hon. Friend the Member for Dudley South (Mike Wood), who gave very personal examples of how this debate touches us all, and our families, in the most intimate and moving way possible. I am glad to be in the Chamber to speak on a subject that I have long believed needed more focus, and I am pleased that it has been given the attention it deserves in the Queen’s Speech.
Demand is steadily growing and pressure will continue to rise in our health services. In particular, we must focus on addressing the issues that social care brings up, in respect of both adult social care and children’s social care, which I shall touch on shortly. That is why I am glad that the Government have committed an extra £1 billion, in addition to the existing £2.5 billion that they have ring-fenced for adult and children’s social care. Why is that so important? Because adult social care and support enables people of all ages to live the lives that they want and deserve to lead. It helps people to maintain their own health, wellbeing and independence and, importantly, it reduces pressure on the NHS and the need for NHS services.
The Government launched the better care fund, which aims to join up the NHS and social care at local level, with almost £6.5 billion in 2019-20 and £2 billion pooled voluntarily last year to make sure that services are more joined up for patients. That joined-up approach at a local level is something I really believe in. If it is carried out in the right way, it can help to take some pressure away from the NHS and help to deliver a better service to local communities.
Although welcome, more money like that in the short term is not the ultimate answer. I have spoken many times in the House, including at Prime Minister questions, about the adult care Green Paper, so I welcome the pledges to get on with that and perhaps even move directly to a White Paper, informed by the work done in the joint report by the Housing, Communities and Local Government Committee and the Health and Social Care Committee. I was involved in that report and many of its recommendations are very worth while.
In line with my speaking about adult care and the importance of local government working with the NHS on overall outcomes for health, I have a recent example from my constituency that demonstrates the importance of the whole public sector taking a holistic approach to health. The left hand needs to know what the right hand is doing. Earlier this month in Northampton South, I met some truly inspirational parents, Jamie Shellard, Susan Underwood and Olivia Anderson, along with Councillor Julie Davenport. They had been fighting to secure local school transport for their children with special educational needs and health issues and disabilities. The scheme proposed by the county council wanted a pick-up and drop-off point for their children, but that would have meant that children who currently get picked up by many buses or taxis from their homes might instead have had to walk up to a mile to be picked up from unknown bus stops instead. That does not make any sense. It is an example of a disjointed approach when, as I say, it is more important for the left hand and the right hand to know what they are doing.
In addition to paying tribute to those inspirational parents and the tireless work that they have championed, let me explain why I have mentioned them. Their case underlines how, even in a single local authority with significant health responsibilities, there can be an inability to see the bigger picture. It is good news that Northamptonshire County Council has now postponed that plan. I hope it will not come back at all. That case demonstrates how even highways and transport policies can have a direct impact on health and health services, which is why an integrated health and social care approach is important, and why we need all parts of local government and NHS services to work together in greater harmony, so that we can have the result we want for all our constituents who rely on those services.
Oral Answers to Questions
Andrew Lewer Excerpts(5 years, 1 month ago)
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Matt Hancock
I am afraid that I profoundly disagree with the hon. Gentleman, who used to be so sensible. Antimicrobial resistance is a global problem and we contribute to global funds, because only by coming together as a whole world will we be able to tackle it— and that is what we are going to do.
Andrew Lewer (Northampton South) (Con)
The Minister for Health (Stephen Hammond)
Health Education England is leading a national nursing associate expansion plan to train 7,500 apprentice associates in 2019, building on the 5,000 who were trained in 2018.
Andrew Lewer
The University of Northampton successfully carried out its partnership with Northampton General Hospital in training the first wave of nursing associates in the United Kingdom, as the Secretary of State saw when he visited the hospital recently. What can he and his team do to encourage other universities and local hospitals to form partnerships to deliver similar results?
Stephen Hammond
I know that the Secretary of State enjoyed his visit and was very impressed by what he saw. Health Education England has led the establishment of test site partnerships across England. There were 11 test sites in the first wave and a further 24 in April 2017, and the programme is now being rolled out all over the country.
Oral Answers to Questions
Andrew Lewer Excerpts(5 years, 4 months ago)
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Andrew Lewer (Northampton South) (Con)
Stephen Hammond
Departmental officials have worked alongside the council to engage with Shaw Healthcare to identify the causes and explore the solutions to minimise the number of empty beds under the PFI. Through improved contract management and regular meetings with Shaw, significant improvements are being made, and contract changes are under discussion to further improve performance. This aligns with the Department’s best practice centre for PFI contracts, as the Chancellor announced in the Budget—
Social Care Funding
Andrew Lewer Excerpts(5 years, 7 months ago)
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Matt Hancock
That need not necessarily be the case. It was slightly disappointing that the hon. Lady, who is normally a great champion of cross-party working, did not welcome the £780,000 extra for Grimsby, but you can’t win them all. The people of Grimsby need to know that we are there to support them and to support their local NHS.
I now turn to the long-term funding pressures. The lifetime care costs of a 65-year-old today are about £45,000 on average, but those total average costs that people face are not distributed evenly. Some people face no care costs at all, whereas the care costs for someone with dementia who lives into their 90s can run into hundreds of thousands of pounds. As a society, that is the challenge we face, yet right now there is no way to predict or insure this potential financial burden. We are committed to ensuring that everyone has access to the care and support they need. However, as has always been the case, that must be based on the principle of shared responsibility. With sensible planning, people should not have to fear the risk of losing everything. The adult social care Green Paper, which will be published later this year, will bring forward a range of ideas to address the long-term challenge. We want to learn from what has been proven to work, with one example being the auto-enrolment pension reforms, which have been taken forward on a cross-party basis over a decade. The rate of opting out has been remarkably low, and this has put in place the foundations for the strengthening of our pensions system over time. The Green Paper will propose a range of options and ideas, learning from both the UK and from around the world.
Andrew Lewer (Northampton South) (Con)
The Secretary of State has said that he wants this debate to be based on fact, not partial fact, so may I have his assurance that research behind the Green Paper has taken full account of overseas options, which provide insurance models and choice, taking us well beyond these simplistic more tax solutions to address this complex problem?
Department of Health and Social Care and Ministry of Housing, Communities and Local Government
Andrew Lewer Excerpts(5 years, 10 months ago)
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Andrew Lewer (Northampton South) (Con)
I draw Members’ attention to my entry in the Register of Members’ Financial Interests; I am a vice-president of the Local Government Association. I am pleased to take this opportunity created by the estimates to discuss adult care funding, given that a large percentage of the funding that local government administers relates to it.
I have been part of the joint Select Committee inquiry on the future of adult care. Before that, I led a county council with responsibility for adult care that had an adult care budget alone of around a quarter of a billion pounds. I then arrived as an MP just in time for Northamptonshire County Council to fall over financially, due in no small measure to adult care costs; addressing local versus national responsibilities for that are perhaps for a different time.
Adult care funding is a very important issue, and the solution to it requires bold thinking. Although the better care fund and the general funding in the estimates are welcome, they do not represent a solution; rather, they represent a temporary patch. When I was deputy chairman of the LGA, we had a presentation from the King’s Fund in which it showed us reports that it had produced every year since 1999—this is very much a cross-party issue—saying, “This year must be the year that there is a solution to adult care funding.” That was in the last century. Integration is not the same as the NHS taking over. There will always be lines. With adult care, the next line would be housing, and I do not think anyone is suggesting that the NHS take over housing.
Colleagues have mentioned parity of esteem. Parity of esteem for employees is important institutionally. We speak a lot about the NHS. We are proud of it, and we are talking about its birthday, but often the NHS workers shade out the esteem that we need to give to social care workers and people who work in local authorities providing essential local services, particularly to the elderly.
Mr Clive Betts (Sheffield South East) (Lab)
I thank the hon. Gentleman for the part he played in the joint Select Committee report. He is absolutely right about that. Figures in the inquiry showed that for the same work, social care workers were paid about 29% less on average than workers in the NHS.
Andrew Lewer
I thank the hon. Gentleman for that comment. It is about pay, but it is also about conditions and remembering that the health economy is much more than the NHS.
I believe, however, that more tax is not the solution, even if hypothecated and ring-fenced as road fund licence and national insurance were in their time. It is not wholly in tune with Conservative philosophy to suggest that higher tax rates equal higher tax revenue, and there is economic theory to back that up. The Laffer curve, for which the British economy in the 1970s was in many respects the laboratory, indicates that when a certain tax rate is reached, revenue goes down, not up. We are high on the Laffer curve already: 41% of GDP is Government spending in the last recorded figures, compared with 38% in 1988-89 and 34.5% in 2000-01. This is not about whether we need more—we do—but how to get it.
In general economic terms, productivity gains, as my hon. Friend the Member for Mid Worcestershire (Nigel Huddleston) said, and GDP growth per head are key to more funding going into adult care. In specific terms, an insurance approach with some elements of the German model has a great deal to commend it. I was very pleased to see that option retained in the recommendations of the joint Select Committee report.
Oral Answers to Questions
Andrew Lewer Excerpts(5 years, 11 months ago)
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Sir Henry Bellingham (North West Norfolk) (Con)
Andrew Lewer (Northampton South) (Con)
The Secretary of State for Health and Social Care (Mr Jeremy Hunt)
I know that the thoughts of the whole House are with the families affected by the terrible atrocity a year ago.
Personal health budgets have a transformative effect on people with very complex health needs, and we plan for 50,000 to 100,000 more people to benefit from them by 2021.
Mr Hunt
Absolutely, and not just to North West Norfolk, but to the whole country. We are currently consulting on giving a right to personal health budgets to people with the most complex health needs. That would be about 350,000 people and would include anyone with a continuing NHS need combined with a mental health need, a learning disability, autism or PTSD. Obviously, it would be hugely significant if we were able to proceed with that.
Andrew Lewer
Will the Minister ensure that the long-term NHS plan puts a major emphasis on empowering patients through the wider availability of personal budgets? May I also join my hon. Friend the Member for North West Norfolk (Sir Henry Bellingham) and make a pitch for my local area of Northampton for one of the next wave of pilots?
Mr Hunt
Absolutely, and technology will have a big role, because this year we intend all NHS patients to be able to access their health records through an app. That will be extremely empowering, but my hon. Friend is right that giving people with long-term conditions control over their health and care destiny is a potentially huge leap forward.
Oral Answers to Questions
Andrew Lewer Excerpts(6 years, 1 month ago)
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Steve Brine
I will look at Hightown surgery, and if the hon. Gentleman wants to talk to me about it, he is welcome to do so. Of course it is the responsibility of his clinical commissioning group and NHS England in his area to provide primary care services for the patients who are his constituents, but if wants to talk to me further, I am very happy to do so.
Andrew Lewer (Northampton South) (Con)
The Secretary of State for Health and Social Care (Mr Jeremy Hunt)
Following the Government’s commitment to expand medical school places by 25%—one of the biggest expansions in the history of the NHS—I am pleased to announce to the House the results of the competition to set up five new medical schools. They were chosen following a rigorous and independent bidding process, which prioritised attracting doctors to harder-to-recruit areas and increasing the number of GPs and psychiatrists. Many congratulations to the winners, which are: the University of Sunderland; Edge Hill University in Lancashire; Anglia Ruskin University in Chelmsford; the University of Lincoln working in collaboration with Nottingham University; and Canterbury Christ Church University.
Andrew Lewer
With the death of Professor Stephen Hawking in all of our thoughts, can the Minister tell us what steps his Department will take to support research to develop a cure for motor neurone disease?
Mr Hunt
Professor Hawking was an inspiration not just because of his scientific thinking, but because, to many people with motor neurone disease, he was an absolute exemplar: he was given two years to live at the age of 21 and ended up living until he was 76. This disease is a big area of priority for us. In the last year for which we have full-year figures, £52 million was invested into it, and we are currently recruiting for 24 clinical trials.