Modern Slavery Regulations

Andrew Stephenson Excerpts

Thursday 14th March 2024 Written Statements

[The Minister for Health and Secondary Care (Andrew Stephenson)]

Today, I am pleased to announce that we will be continuing the Government’s goal of introducing robust regulations to ensure the eradication of modern slavery in NHS supply chains in England. This is in line with our Government’s world-leading ambition to tackle modern slavery. These regulations will support continued efforts to build an ethical and reliable UK health system.

The Department of Health and Social Care has pledged to put an end to modern slavery in NHS supply chains. As is set out in the National Health Service Act 2006, we will create regulations to eradicate the use in the health service of goods and services which are tainted by slavery and human trafficking. These regulations will place legal duties on public bodies to assess modern slavery risk in procurement and contract activities and take reasonable steps to address and, where possible, eliminate that risk.

My hon. Friend Lord Kamall committed to introducing these regulations within 12 to 18 months of the enactment of the Health and Care Act 2022. Since that commitment was made, a large amount of work has happened on both modern slavery and procurement policy both within the DHSC and the NHS, and across Government. The introduction of these regulations has therefore been delayed so that we can ensure they are fit for purpose and interact with the current legislation and updated policies.

The DHSC, supported by NHS England, delivered a review in December 2023 into the risk of modern slavery within NHS supply chains. The review showed a significant amount of commitment from our suppliers to tackling modern slavery in their supply chains, and made a recommendation to lay the regulations.

Other work has been ongoing to reform procurement rules in the UK. The Procurement Act 2023 will be enacted on 1 October 2024 and will set out the new laws the public sector is required to follow when a procurement is within the duties prescribed. The Procurement Act 2023 created specific means for debarment, including “professional misconduct” where a serious breach of ethical standards is found; our regulations will operate compatibly with this requirement. Further, in January 2024, the provider selection regime also came into force, which sets out procurement rules for the procurement of clinical services; the NHS is now implementing these new procurement regulations.

The developments to understand modern slavery risk in NHS supply chains and the introduction of new procurement laws are relevant to our modern slavery regulations. The regulations will introduce legal duties to assess modern slavery risk in supply chains and to take reasonable steps in a proportionate and relevant way when buying goods and services for the NHS. They will include duties requiring public bodies to first assess the extent of the modern slavery risk in relation to that procurement and then take reasonable steps to address and, where possible, eliminate that risk. Reasonable steps include:

ensure robust selection and award criteria is built into their tenders to respond to identified risks;

include specific contract terms to monitor and require mitigation where instances of modern slavery are discovered.

This spring, the Department will launch a public consultation to further support the development of the modern slavery regulations. It is with this consultation that we will publish our draft regulations for the first time. We will welcome the views and contributions of a wide range of stakeholders, including public bodies, suppliers, trade associations, interest groups and the public. Subject to the outcome of the consultation we intend to lay draft regulations before Parliament in due course.

Modern slavery has no place in our society, and the DHSC has a duty to eradicate the use of goods and services tainted by modern slavery in NHS supply chains. This is also a global effort—that is why we will be working collaboratively across Government to ensure that our work reflects these priorities and the duties of public bodies within our regulatory framework.

[HCWS343]

Health and Wellbeing Services: Essex

Andrew Stephenson Excerpts

Tuesday 12th March 2024 Westminster Hall

[The Minister for Health and Secondary Care (Andrew Stephenson)]

It is a pleasure to see you in the Chair, Mr Henderson—I think this is the first time I have responded to a debate while you have been in the Chair. It is a pleasure to respond to the debate, and I congratulate my right hon. Friend the Member for Witham (Priti Patel) on securing a debate on such an important subject. My further thanks go to my esteemed predecessor, my hon. Friend the Member for Colchester (Will Quince), not only for his work supporting his own constituency, but for his tireless efforts as a Health Minister and as my immediate predecessor in the Department. I also thank my right hon. Friend the Member for Maldon (Sir John Whittingdale) for his thoughtful contribution and the powerful advocacy that he always conducts on behalf of his constituents.

We all know that much of the continued recovery of the NHS following the pandemic is entirely dependent on the people who work in our NHS. I commend my hon. and right hon. Friends for the tributes they have paid to NHS staff. Our long-term workforce plan, which was raised by my hon. Friend the Member for Colchester, sets out the Government’s vision and commitment to ensuring that we have an NHS that can deliver for the future. Our plan commits to improving retention by improving culture and leadership to ensure that up to 130,000 fewer staff will leave the NHS over the next 15 years. It also sets out an aim to double the number of medical school places in England to 15,000 by 2031-32. That is our commitment to the future of the NHS moving forward, and there is cause for optimism now too. In recent months, the rate of staff leaving active service in the NHS has returned to pre-pandemic levels. In the east of England, the rate of staff leaving active service in the NHS has followed a similar pattern and is now below pre-pandemic levels. We know there is more to be done, but the plan is working.

The number of doctors and nurses is also on the rise. There are almost 6,800 more doctors and more than 21,500 more nurses in the NHS than last year. In the east of England, there are almost 740 more doctors and almost 1,700 more nurses in the NHS than last year. My hon. and right hon. Friends mentioned Anglia Ruskin University. I had the huge privilege of visiting the university on 4 March to meet some of the medical students. If there is anything that gives a person optimism about the future of the NHS, it is sitting down and having a roundtable with some of the medical students in a university such as Anglia Ruskin, which has gone from strength to strength over recent years thanks to the campaigning of local MPs who have championed investment in that university.

Medical training at our best medical institutions is an essential part of delivering the long-term workforce plan. I therefore welcome Anglia Ruskin University’s commitment to the medical degree apprenticeship and recognise that it is a trailblazer. The university can bid for additional Government-funded places, in common with all existing medical schools across England, and I look forward to continuing to work with it and local MPs to secure more investment in the university.

We know that the NHS faces pressures all over the country, including in Essex and the east of England more broadly. As a Government, we are committed to working every day to improve the outcomes and experiences of patients. A huge part of that is making sure that patients get to talk to a GP. I am glad to say that since 2019 we have recruited more than 36,000 additional staff into general practice, covering a range of roles including pharmacists. We fulfilled our commitment to recruit 26,000 additional staff a year ahead of the March 2024 target, and we have also delivered on our manifesto commitment of 50 million more general practice appointments a year, with 367.7 million booked appointments across the past 12 months.

Looking more closely at the constituency of my right hon. Friend the Member for Witham, I am pleased to say that there are now approximately 105 full-time equivalent members of the clinical general practice workforce. That is an increase of 62% since September 2019, when there were about 65 full-time equivalent staff in the clinical workforce. In the east of England, there are now approximately 3,909 full-time equivalent GPs and an estimated 3.7 million general practice appointments took place in January 2024, with 72% of those face to face. In Witham specifically, 76% of appointments in January 2024 were face to face, up from 68.5% in January 2023. All the same, I commend my right hon. Friend for her tenacious advocacy of a new health hub for Witham. Her constituents are fortunate to have such a doughty champion, with a deep and genuine care for their access to the health service.

Mid and South Essex ICB has confirmed that GP practices in Witham are working together to help meet the health needs of local residents by sharing staff, teams and services. However, as my right hon. Friend acknowledged in her speech, the financial complexities of bringing GP estates together can be multifaceted and challenging. Mid and South Essex ICB has confirmed that transitioning to a new building would involve complex considerations surrounding property ownership, leasing arrangements and financial investments. The ICB is also concerned that while section 106 monies serve as a valuable contribution to local NHS healthcare provision, the money available may fall short in sustaining the entire development of a new healthcare centre. I hope my right hon. Friend and the ICB can continue to work together to think carefully through those challenges and find the best solution that meaningfully responds to the needs of Witham’s patients.

I also thank my right hon. Friend for her comments about the future of St Peter’s Hospital, which I know is a subject dear to her heart and to the heart of my right hon. Friend the Member for Maldon. As she said, it is generating an unprecedented reaction from her constituents. I will keep my comments on this issue brief, knowing that another debate on it will take place on Thursday. That will provide a longer opportunity for my right hon. Friends, particularly my right hon. Friend the Member for Maldon, to build and expand on the concerns that my right hon. Friend the Member for Witham has set out today.

Let me be clear that no decision has yet been made about the future of St Peter’s. Any decision regarding the future configuration of NHS services in Mid and South Essex should be made locally, following engagement with local communities. I am sure that local views are being listened to and, as my right hon. Friend the Member for Witham said, an NHS consultation is currently live. I urge both her and my right hon. Friend the Member for Maldon, and their constituents, to participate in it actively.

I expect any subsequent decision taken by the local NHS to demonstrate improved outcomes for patients, having taken into account all of the many issues that my right hon. Friend the Member for Witham has outlined today, which I am sure will be further expanded upon on Thursday.

I want to reassure both my right hon. Friends. In my constituency, an unpopular reorganisation of local health services in east Lancashire under the last Labour Government in 2007 removed a significant number of health services in my constituency and transferred them to Blackburn, so I am very conscious of the potential impacts of hospital reorganisations and I always look at these matters very closely and pay close attention to the views of local Members of Parliament.

I turn to the subject of urgent and emergency care. We absolutely recognise the pressures that these services are facing and we are working to ensure that people receive the care they need when they need it. Although we recognise that there is more to do, we have seen performance improve this year.

For example, at the Mid and South Essex NHS Foundation Trust 67.3% of accident and emergency patients were seen within four hours in January 2024, which was better than the trust’s performance in January 2023. At the East Suffolk and North Essex NHS Foundation Trust, 72.2% of A&E patients were seen within four hours in January 2024—performance above the national average. Ambulance handover delays, which have a big impact on response times, have reduced significantly this winter compared with last year. At the Mid and South Essex NHS Foundation Trust, delays of over 60 minutes have fallen by 48%. Nationally, we have seen progress on ambulance response times, with the average ambulance waits for category 2 incidents down by over a third this winter.

We have heard today about the continuing difficulties that patients have in accessing a dentist. That is deeply unfortunate and it is essential that we give patients access to the dental care that they deserve. That is why, on 7 February, we published our plan to recover and reform dentistry, to make dental services faster, simpler and fairer for patients. The plan will fund around 2.5 million additional appointments; our plan to recover and reform NHS dentistry is backed by £200 million.

Hon. Members also mentioned the important role of community pharmacy. Community pharmacy is delivering healthcare, which makes an extremely valuable contribution to patients’ lives. That is why we are continuing to support the sector financially, and we are providing over £2.6 billion every year to support community pharmacy. To go further, we are now investing up to £645 million across this financial year and the next in Pharmacy First, which will allow for more blood pressure checks and more contraception consultations in pharmacy.

I will now address some of the concerns expressed regarding the Lampard inquiry, which is an issue of the utmost importance and sensitivity. I completely recognise the desire of families and other stakeholders that the terms of reference of the inquiry be finalised as soon as possible, so that the inquiry can make progress with its investigations. Let me update my hon. and right hon. Friends on the most recent discussions.

Following consultation with families and other stakeholders, the chair of the Lampard inquiry has shared her initial views on potential changes to the terms of reference. On 5 December, my right hon. Friend the Secretary of State for Health and Social Care agreed to meet families and local MPs in Essex to discuss the terms of reference. On 6 March, as referred to by both my right hon. Friends today, the local MPs and I met to discuss the inquiry. We agreed that my right hon. and hon. Friends across Essex would put forward names of family members to attend a meeting with the Secretary of State, so that she could hear directly from the families herself.

We have now identified a potential date for that meeting, and that will be communicated very shortly to local MPs, if it has not been already; the date will be emailed out by my office. I hope that the meeting can take place on that date, and that we can make the swift progress that we all want to see. Families have been waiting far too long. Again, I commend my hon. and right hon. Friends for their work to shine a light on what has gone on and to ensure that the inquiry was established, and I hope that it can finally get on with its work and deliver the outcomes and justice that the families all want to see.

I will wrap up by addressing one of the most important elements in the future of healthcare: prevention. I reiterate the Government’s commitment to our levelling-up mission to narrow the gap in healthy life expectancy by 2030 and to increase healthy life expectancy by five years by 2035. To do that, we are tackling health inequalities through programmes such as the NHS’s Core20PLUS5, which focuses on improving health outcomes for the poorest 20% of the population as well as other groups.

Furthermore, we will publish our major conditions strategy this year, a direction-setting document aiming to pave the way for further action towards integrated care, co-ordinated around the needs of people. It aims to improve healthy life expectancy, reduce pressures on the NHS and reduce ill health-related labour market inactivity. Together, those programmes will help us shift the dial, both nationally and in Essex, on NHS pressures.

I thank my hon. and right hon. Friends for their contributions, and once again thank my right hon. Friend the Member for Witham for securing the debate. I hope my answers have helped to assure all those who have attended that we are firmly committed to delivering for the health and wellbeing needs of people in Essex and across the country.

Hereditary Tyrosinemia Type 1

Andrew Stephenson Excerpts

Monday 11th March 2024 Written Statements

[The Minister for Health and Secondary Care (Andrew Stephenson)]

I would like to inform the House that I have accepted the UK National Screening Committee’s recommendation to introduce a new condition, tyrosinemia type 1, to the newborn blood spot screening programme in England.

Hereditary tyrosinemia type 1 is a rare genetic condition that affects approximately seven babies in the UK per year. Left untreated, this condition can lead to severe complications such as liver, kidneys and nervous system damage, and in some cases requires liver transplant. Without treatment, children with tyrosinemia type 1 often do not survive past the age of 10. There is no cure for this condition but treatment can help prolong life.

There is currently an inequitable situation whereby families with a known history of this condition can seek early screening and access treatment before their child shows symptoms, when treatment is most effective, while parents without a known history will only discover their child’s condition when symptoms become evident and when treatment is less effective. Introducing tyrosinemia type 1 to the newborn blood spot screening programme will create a fairer, faster, and simpler route to diagnosis and treatment. NHS England have started the work needed to ensure this programme can be implemented next year.

I would like to take this opportunity to thank the UK National Screening Committee for continuing to provide invaluable expert advice on screening programmes. I would also like to pay tribute to all those who work in delivering high-quality screening across the country. The addition of this new condition will maintain the Government’s commitment to improving equity of access to effective treatments for rare diseases.

[HCWS328]

Equity in Medical Devices

Andrew Stephenson Excerpts

Monday 11th March 2024 Written Statements

[The Minister for Health and Secondary Care (Andrew Stephenson)]

The NHS is committed to upholding high standards in medical device safety. In response to emerging evidence of potential ethnic and other unfair biases in the design and use of some medical devices commonly used in the NHS, an independent review was commissioned by former Secretary of State for Health and Social Care, my right hon. Friend the Member for Bromsgrove (Sajid Javid).

Today, I am pleased to publish the final report of the independent review into equity in medical devices, alongside the Government’s response.

I would like to place on record my gratitude to the review chair, Dame Margaret Whitehead, and the panel who conducted this review. They embraced a comprehensive approach, involving stakeholders, fostering collaboration with clinical experts, NHS planners and policy advisors, engaging with health professionals on the frontline, educators and crucially, patients and the public. This deliberate approach underscores the importance and impact of the panel’s findings, and their recommendations are integral to our commitment to fostering a fair and healthy future for all.

The panel made 18 recommendations, taking these recommendations in turn:

Recommendations 1 to 3 focus specifically on pulse oximeters and cover immediate mitigation measures to ensure existing devices can perform to a high standard and improvements in international standards for approval of new device models.

Recommendations 4 to 7 focus on prevention of potential for harm through improved detection of bias in optical devices, including better research and testing, more robust monitoring and auditing and refreshed education for health professionals.

Recommendations 8 to 14 focus on enabling the development of safe and equitable artificial intelligence (AI) medical devices.

Recommendation 15 underscores the urgency of preparing for the transformative impact of large language and foundation models on healthcare and regulatory systems.

Recommendations 16 to 18 address equity concerns and societal challenges related to polygenic risk scores (PRS) in genomics. They emphasise the need for regulation in response to the influx of commercial PRS tests in the UK.

The Government’s response has been published alongside the final report. The Government welcome and acknowledge the importance of the outlined recommendations, endorsing its main argument that, unless appropriate actions are taken, biases can occur throughout the entire medical device life cycle.

We are dedicated to ensuring equitable medical device practices, spanning from design through to use. The Government have already initiated substantial efforts addressing many of the essential elements of the report’s recommendations, as detailed in the Government response. As we continue to drive progress, we welcome ongoing collaboration with industry partners, which is paramount to embedding best practices and supporting the NHS in delivering optimal and equitable care for all.

Both the final report from the independent review into equity in medical devices and the Government’s response will be deposited in the Libraries of both Houses, and published on www.gov.uk.

[HCWS329]

Breast Cancer Screening

Andrew Stephenson Excerpts

Tuesday 5th March 2024 Written Statements

[The Minister for Health and Secondary Care (Andrew Stephenson)]

I would like to inform the House that on Monday 4 March, NHS England wrote to a group of women who are at very high risk of breast cancer who have been eligible for annual MRI checks, but who may not have been routinely referred to the annual tests recommended in NHS guidance.

This is an historic cohort of women who from 1962 to 2003 received radiotherapy treatment above the waist to treat Hodgkin lymphoma. Because of their treatment, this group were at an increased risk of breast cancer, so in 2003 clinicians were asked to contact both previous and current patients to refer them for annual checks. Women do not start annual MRI testing immediately following treatment—but between eight and 15 years after treatment depending on their age at the time they were treated.

A number of women who were eligible for more regular annual testing did not receive it. This was due to variable referral processes. To rectify this, specialists set up a database to identify how people were referred on to the very high-risk pathway for breast screening. Details of the missed group were shared with NHS England in late September 2023, and they have since analysed data to triangulate information about clinical history, current status and residency in order to identify the individuals in the affected cohorts. Ministers were notified in February 2024.

We have overseen a system that has resulted in the identification of these very high-risk women, and we are now taking the appropriate action. This week, NHS England has written to 1,487 women whom they have identified as not currently on the correct very high-risk pathway to receive annual MRI testing. This cohort will now be urgently offered an MRI follow up and inclusion in the very high-risk pathway. We expect all women to be offered a scan within the next three months.

The specialist team have also identified a much smaller historical group whose details are currently being verified, and they will be written to in the coming weeks.

NHS England has set up a helpline for affected women, the details of which will be included in letters sent to them. More widely, NHS England will undertake a review of the process that refers these women into the most appropriate service for their risk to mitigate any future impact of this issue.

Further details of this issue can be found in a letter from NHSE to the Secretary of State for Health and Social Care, the right hon. Member for Louth and Horncastle (Victoria Atkins), which will be deposited in the Library.

Attachments can be view online at:

http://www.parliament.uk/business/publications/written-questions-answers-statements/written-statement/Commons/2024-03-05/HCWS312

[HCWS312]

Oral Answers to Questions

Andrew Stephenson Excerpts

Tuesday 5th March 2024 Commons Chamber

[The Minister for Health and Secondary Care (Andrew Stephenson)]

At Buckinghamshire Healthcare NHS Trust, the number of gynaecology patients waiting more than 52 weeks reduced by over 30% between August and December, but I sympathise with the many women who are still waiting too long. NHS England has been doing targeted work to help trusts with the most long waiters to support gynaecology patients in the community where appropriate, and to find specialist services that can treat them as quickly as possible.

[Sarah Green]

My local NHS trust recently stated that the average wait for a gynaecology appointment is 18 weeks, with patients starting treatment within 24 weeks, but that does not include those on cancer pathways. One of my constituents who had been identified as having abnormal cells in her cervix waited more than 60 weeks for a diagnostic assessment. She is one of many contacting me with tales of long delays for gynaecology appointments and paying to go private out of desperation. What steps is the Department taking to reduce waiting times for gynaecology assessments and treatment for those on cancer pathways?

[Andrew Stephenson]

Significant investment is going in to reduce both general wait times and cancer wait times. More patients on the cancer pathway have been seen than ever before; nearly 220,000 patients were seen last December following an urgent GP referral for suspected cancer, representing 117% of December 2019 levels. We continue to keep this under review and continue to strive to make the system go faster and reduce the elective backlog.

[Mr Speaker]

I call the shadow Minister.

[Abena Oppong-Asare (Erith and Thamesmead) (Lab)]

NHS figures from December show that the number of women waiting for gynaecological treatment reached another record high of nearly 600,000. That number has tripled since 2012. A Labour Government will cut NHS waiting lists in England by funding 2 million more appointments a year. What can the Minister say to the women waiting urgently for treatment?

[Andrew Stephenson]

I would say that we are sticking to our plan to back the NHS to cut waiting lists and make our NHS fairer, simpler and faster. When there is no strike action, that plan is working. We already eliminated the longest waits, and, in November, we saw the biggest fall in waiting lists outside of the pandemic in more than a decade, alongside record investment in things like women’s health hubs. We are prioritising women’s health.

[Julie Marson (Hertford and Stortford) (Con)]

7. What steps her Department is taking to improve access to primary care.

--- Later in debate ---

[Neale Hanvey (Kirkcaldy and Cowdenbeath) (Alba)]

12. What steps she plans to take to improve the recruitment and retention of community and district nurses.

[The Minister for Health and Secondary Care (Andrew Stephenson)]

We have delivered our manifesto commitment of 50,000 more nurses six months early. There are now almost 361,000 nurses working across the NHS. As part of that, community nursing has grown by over 9% since 2019.

[Neale Hanvey]

There has been a crisis brewing in community-facing nursing over the past decade, with the number of district nurses down by 40% and health visitor numbers in England and Wales falling by almost a third. What guarantees will the Minister provide that this vital workforce will be supported, when health budgets in all the nations of the UK are under increasing strain and NHS funding faces a £2 billion black hole, and cuts to spending in England have a consequential impact on budgets in Scotland?

[Andrew Stephenson]

Record funding is going into our NHS. In addition to the 9% increase in community nursing since 2019, we are investing over £2.4 billion in education and training through the NHS long term workforce plan, which commits to increasing training places for district nurses by 41% by the end of the decade. Since 2010, we have delivered over 63,300 more nurses and midwives into our NHS.

--- Later in debate ---

[Vicky Ford (Chelmsford) (Con)]

T8. I thank the Health and Secondary Care Minister for visiting the new medical school in Chelmsford yesterday. This is the first time that students have ever been able to train as doctors in Essex in its history, and the results are phenomenal. This is living proof of the Government’s commitment to train the NHS staff of the future. What progress is he making to increase work placements for students so that we can train even more doctors, nurses and people for important roles such as physician associates?

[The Minister for Health and Secondary Care (Andrew Stephenson)]

I thank my right hon. Friend for her question and her kind invite to visit her constituency. I pay tribute to all the work she has done to secure investment in Anglia Ruskin University. She is right to highlight the importance of delivering clinical placements as part of the long-term workforce plan. I assure her that we are working closely with NHS England and partners in health and education to ensure that happens.

[Alan Brown (Kilmarnock and Loudoun) (SNP)]

Medicine shortages have doubled in the UK in the last two years. There might be some global pressures, but two issues have particularly affected the UK: first, the post-Brexit regulatory framework; and secondly, the fact that the pound has tanked, making it more expensive to buy medicines. What are the Government doing to undo that Brexit dividend?

[Andrew Stephenson]

The hon. Gentleman sounds like a broken record, as usual. The Department has no evidence to suggest that EU exit is leading to sustained medicine shortages. Shortages occur for a wide range of reasons and are affecting countries all over the world.

[George Freeman (Mid Norfolk) (Con)]

Rural Norfolk is experiencing a dental crisis and a generation of children are in danger of going without dental care. I welcome the dental recovery plan, but I notice that it will be four or five years before we get more dentists. Last week, NHS Norfolk and Waveney integrated care board announced a £17 million underspend on dentistry. Will the Minister agree to meet with me and the ICB to work out how we get more money out now to help dentistry in Norfolk today?

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[Sir Jacob Rees-Mogg (North East Somerset) (Con)]

Will my right hon. Friend explain an anomaly in the “Agenda for Change” pay deal as it affects non-NHS providers? People working in the NHS for non-NHS providers may be eligible for extra money if the organisation they work for is in financial difficulties, but not if it is not. So badly run organisations are being rewarded and well-run organisations are being penalised, which seems to me to be perverse.

[Andrew Stephenson]

I am happy to meet my right hon. Friend to discuss the matter. We have reached pay settlements with the “Agenda for Change” unions, and we continue to reach pay deals with other unions. We are also supporting non-NHS providers whose contracts are dynamically aligned. It is a complex area, so I am more than happy to meet my right hon. Friend to discuss his concerns.

[Florence Eshalomi (Vauxhall) (Lab/Co-op)]

The Secretary of State will know that NHS England is expected to announce the decision about the primary children’s centre for cancer treatment in south London and south-east London. Evelina London Children’s Hospital in my constituency is one of the only specialist centres in south London. Does she agree that the final decision should be made as soon as possible in order to benefit staff, patients and families? Will she join me in visiting Evelina London?

--- Later in debate ---

[Paul Bristow (Peterborough) (Con)]

I remind Members of my entry in the Register of Members’ Financial Interests. The Medicines and Healthcare products Regulatory Agency’s international recognition procedure will ensure faster access to innovative treatments, but it will realise its full potential only if it is matched by the National Institute for Health and Care Excellence’s evaluation process. What is my right hon. Friend the Minister doing to ensure that the two processes are aligned?

[Andrew Stephenson]

My hon. Friend will be aware that there have been delays with approvals by the MHRA and NICE. We are keen to ensure that those delays are reduced, and I am delighted to tell the House that significant progress has been made in both organisations. I am happy to work with my hon. Friend and both organisations to ensure that progress continues to be made.

[Sarah Dyke (Somerton and Frome) (LD)]

Figures obtained by the British Dental Association project that £8 million of the NHS budget in Somerset is going unspent. Will the Minister explain to my constituent, who is suffering in dental agony, why that is happening?

--- Later in debate ---

[Sir Chris Bryant (Rhondda) (Lab)]

How many people were treated for acquired brain injury last year?

[Andrew Stephenson]

The hon. Gentleman has caught me off guard—I will write to him. I am keen to continue working with him on that issue. As he knows, we have already shared draft details of the acquired brain injury strategy with him and members of the all-party parliamentary group, and I am very keen to continue working collaboratively on that issue with him.

Eating Disorders Awareness Week

Andrew Stephenson Excerpts

Thursday 29th February 2024 Westminster Hall

[The Minister for Health and Secondary Care (Andrew Stephenson)]

It is a pleasure to see you in the Chair, Mr Hollobone. I start by paying tribute to the hon. Member for Bath (Wera Hobhouse) for securing an important debate on an important topic. I know that both as an MP and as the chair of the all-party parliamentary group she has long been a champion for those living with eating disorders. She has worked with the hon. Member for Sheffield, Hallam (Olivia Blake) and others on the APPG to ensure that eating disorders are kept high on the political agenda.

I share the passion for this issue expressed by all the hon. and right hon. Members who have spoken in this debate. As the right hon. Member for Hayes and Harlington (John McDonnell) said, one thing that unites everybody in the Chamber today is that we have all tried to help a constituent, or the family of a constituent, who is suffering from an eating disorder. I have certainly done so in my 13 years as the MP for Pendle, and those cases that I have dealt with are some of the most difficult and emotional to have come across my desk in my surgery.

Improving eating disorder services is a key priority for the Government and a vital part of our work to improve mental health services. As we have heard, this week is national Eating Disorders Awareness Week, and raising awareness is essential to making progress on this important issue. I am grateful for the work of Beat and other charities across the whole sector; they have shone a light on eating disorders and they support people who are struggling.

We know that having an eating disorder can so often be utterly devastating for those with the condition, as well as for those around them. As I think has been said by pretty much every hon. Member who spoke today, we know that eating disorders can affect people of any age, gender, ethnicity or background. However, we do know that recovery is possible, and that access to the right treatment and support can be life changing. Early intervention is vital, and we want to ensure that children and young people with eating disorders get swift access to support.

Since 2016, investment in children and young people’s eating disorder community services has risen every year; £53 million was invested per year in 2021-22, and that figure rose to £54 million in 2023-24. As part of the £500 million covid-19 mental health recovery action plan, we invested an extra £79 million to significantly expand young people’s mental health services—enabling 2,000 more children and young people to access eating disorder services. We have also introduced a waiting time standard for children and young people with eating disorders. Our aim is for 95% of children to receive treatment within one week for urgent cases, and within four weeks for routine cases.

[Abena Oppong-Asare]

On the Minister’s point about getting waiting time targets down to one week, those targets were implemented in 2015, and they are yet to be met. Could the Minister explain what work is being done to address that, because he just mentioned those same targets again?

[Andrew Stephenson]

I completely recognise the shadow Minister’s challenge on that point and the concern that she has—I will set out what we are doing to address it. She also mentioned the Royal College of Psychiatrists, which published a report on this today. It is worth putting on record that we very much welcome that and that we look forward to working with it and other stakeholders. Waits are not as short as we would like, and the Government are determined to meet our waiting-time standards for children and young people with eating disorders. Extra investment is going into the services to meet increased demands and reduce waits, so hopefully we will start to see progress made towards meeting those targets. However, we acknowledge that, while there has been record investment and progress in improving access to eating disorder services and improving quality, there has also been a significant increase in demand for those services over the past few years. That was especially true during the pandemic, with increased demand outstripping the planned growth in capacity.

Children and young people’s eating disorder services are treating 47% more children and young people than before the pandemic, with almost 12,000 children and young people starting routine or urgent treatment in 2022-23, compared with just over 8,000 in 2019-20. That surge in demand has made meeting our waiting-time targets more challenging, and waits are not as short as we would like them to be. However, I am proud that our services and clinicians, backed by new funding, are supporting more children and young people than ever before. Those services are changing and saving lives.

We also know that even earlier intervention is critical to prevent eating disorders from developing. Community-based early mental health and wellbeing support hubs for children and young people aged 11 to 25 can play a key role in providing that support. In October 2023, we announced that £4.92 million from the Treasury’s shared outcomes fund would be available to support hubs, and an evaluation to build the evidence base underpinning those services.

[Wera Hobhouse]

Can the Minister perhaps comment on what I said about intensive out-patient units, in that we really do not have any information on how widely spread they are and where they are being provided? They are a very good alternative way of treatment, and we really need more information about where they are available.

[Andrew Stephenson]

We do need more information on that, and I will come to that point. The next point that I wanted to make was on an announcement that I know the hon. Lady will already be aware of, but other hon. Members may not be. Following the evaluation of some excellent commercial tenders from hubs across the country, the Government announced just this week that we are now providing an additional £3 million, which means that total of 24 hubs will receive a share of almost £8 million in 2024-25. That is more than double our original target of funding 10 hubs, and organisations across England—from Gateshead to Truro—will now benefit.

I appreciate that there is still a bit of a postcode lottery around the country, but we are looking to strengthen services, working with different partners across England, to ensure that we are improving services—enhancing existing services—or developing new services where they have not been provided in the past.

[Abena Oppong-Asare]

I just want to add to the point made by the hon. Member for Bath (Wera Hobhouse) about hubs. What work will be done to ensure that the data is captured to see how the growing problem of eating disorders can be addressed and what effective treatments could slow the increase?

[Andrew Stephenson]

We are working very closely with NHS England and partners to ensure that that data is captured. We are also working with the charities involved in this sector and with others.

I know that the Minister with responsibility for mental health, my hon. Friend the Member for Lewes (Maria Caulfield), has been doing a lot of work on this and has met with various stakeholders. I perhaps should have said at the start of the debate that the reason my hon. Friend is not here and hon. Members have me instead is, of course, that the International Women’s Day debate in the Chamber was still going when this debate started —so, unfortunately, there was an unavoidable clash.

However, I know that this is a topic very close to my hon. Friend’s heart, and getting the data right is really important for us to ensure that the gaps that currently exist in services are being addressed. I will certainly ensure that the shadow Minister’s issue is raised with my hon. Friend; if I may, I will ask her to write to the hon. Lady on that.

We know that eating disorders can have devastating effects on adults too. Under the NHS long term plan, by 2023-24 we are investing almost £1 billion extra in community mental health care for adults with severe mental illness, including eating disorders. That extra funding will help to enhance the capacity of new or improved community eating disorder teams covering the whole of the country. As part of funding provided in 2021-22 in response to pressures created by the pandemic, we also provided £58 million to support the expansion of community mental health services for adults, including those relating to eating disorders.

Many hon. Members in their contributions raised avoidant/restrictive food intake disorder, or ARFID. I share their ambition to improve support for people living with this under-recognised condition. In 2019-20, NHS England funded seven community eating disorder teams for children and young people, one in each region of England, in a pilot programme to improve access, assessment and treatment for children presenting with ARFID. The pilots ran from September 2019 to March 2020 and included training to support the adaption of each service’s existing care pathways, assessments and treatment interventions for children and young people with ARFID. The training from those pilots is now available for local areas to commission for their community children and young people’s eating disorders services. In 2021, NHS England also commissioned ARFID training for staff delivering treatment in inpatient children and young people’s mental health services.

We recognise that more needs to be done. We know that the earlier treatment is provided, the greater the chance of recovery. NHS England continues to work with eating disorders services and local commissioners to improve access to treatment for all children and young people with a suspected eating disorder, including those presenting with ARFID.

Several hon. and right hon. Members raised the issue of BMI and the Dump the Scales campaign. NHS England continues to emphasise to systems and services that BMI should not be used as a single measure to determine access to treatment within either adult or children and young people’s eating disorders services. That is in line with NICE recommendations and is included in the national published guidance, as well as in the recent community mental health framework. NHS England is also in the process of updating the children and young person’s guidance, which will also state that BMI should not be used as a single measure.

The hon. Member for Bath asked whether we would consider appointing an eating disorder champion who could help to galvanise action and support for people living with those conditions. As she may know, the Government do not currently have plans to appoint a specific champion role, but I can assure her that the Department of Health and Social Care and NHS England already work closely with stakeholders advocating for better care, such as Beat. We are also very grateful for the work of Dr Alex George in his role as the Government’s ambassador for children and young people’s mental health, which includes championing the needs of those with eating disorders.

The right hon. Member for Hayes and Harlington raised the issue of palliative care pathways. I want to assure him and other hon. Members that people with eating disorders should not be routinely placed on palliative care pathways, including those with severe, complex or enduring eating disorders. The NHS is clear that all those with severe, complex or enduring eating disorders should have access to evidence-based treatments focused on helping people recover, including hospital-based care if appropriate. Staff involved in the care of people with complex and severe eating disorders must adhere to the legal frameworks that safeguard their best interests, and NHS England will work with patient groups and stakeholders to develop further guidance on that.

The hon. Members for Bath and for North Ayrshire and Arran (Patricia Gibson) raised the issue of suicide. It is critical that we all do all we can for those affected by eating disorders before they reach that point. That is why the Government published a suicide prevention strategy in September of last year, which aims to reduce suicide over the next five years. I want to reassure right hon. and hon. Members that people in contact with mental health services, including those with eating disorders, are a priority group for the strategy.

In closing, I extend my thanks once again to the hon. Member for Bath for securing the debate, and to all the hon. and right hon. Members here today for their thoughtful contributions and questions.

England Rare Diseases Action Plan 2024

Andrew Stephenson Excerpts

Thursday 29th February 2024 Written Statements

[The Minister for Health and Secondary Care (Andrew Stephenson)]

The Government have published England’s third rare diseases action plan on www.gov.uk today, on international Rare Disease Day.

Rare diseases are those affecting less than 1 in 2,000 in the population. Although rare diseases are individually rare, they are collectively common with one in 17 people being affected by a rare disease at some point in their lifetime. Approximately 3.5 million people in the UK are living with one of over 7,000 rare diseases, such as muscular dystrophies or Huntington’s disease. People living with rare diseases often face challenges with the health and care system. The National Conversation on Rare Diseases received nearly 6,300 responses and helped us to identify the four priorities of the 2021 UK rare diseases framework: faster diagnosis; increased awareness of rare diseases among healthcare professionals; better quality of care; and improved access to specialist care, treatment and drugs.

This 2024 England rare diseases action plan is part of the Government’s continued commitment to improve the lives of those living with rare conditions. This year’s action plan provides an update of the progress made against actions outlined in the 2023 and 2022 action plans, and sets out seven new actions to continue to address the priorities highlighted in the UK rare diseases framework.

The Government have shown strong leadership in addressing the concerns faced by the rare diseases community over the past year. Key achievements include:

Designing and securing funding for a pilot of two syndromes without a name clinics in England to deliver care and diagnosis for people with rare undiagnosed conditions.

Updating the National Institute for Health and Care Excellence quality standard on transition from children to adults’ services to ensure that it is relevant to the rare diseases community.

Publishing the UK rare diseases research landscape report, illustrating the strengths of UK research, with over £1.1 billion of rare disease research funded by the Government and charities, and over 250 research projects supported by industry over a five-year period.

A £14 million investment to fund the UK rare disease research platform, which is made up of 11 UK-wide research nodes and a co-ordinating hub facilitating greater collaboration between academic, clinical and industry research, and people living with rare diseases, research charities and other stakeholders, to accelerate the understanding, diagnosis and therapy of rare diseases.

Announcement of over 200 rare genetic conditions that will be screened in the Generation Study. This is the biggest study of its kind in the world, screening over 100,000 newborns with the aim to understand whether sequencing babies’ genomes can help to discover rare genetic conditions earlier.

The 2024 action plan also includes significant new commitments against the framework priorities, developed collaboratively with our delivery partners across the health landscape, and in close consultation with members of the rare disease community. These include:

Developing a genomics communication skills resource to ensure healthcare providers are equipped to have sensitive conversations relating to the gathering of genomic information, consent for diagnostic genomic testing and feedback of results.

Developing the specialist genomics workforce through the Genomics Training Academy.

Developing networked models of care for rare diseases, ensuring that specialist expertise is always available while allowing patients to be treated and cared for as close to home as possible, starting with networked models for inherited metabolic disorders and amyloidosis.

Improving access to whole body scans to increase survival rates and outcomes for people who have rare conditions that result in an inherited predisposition to cancer.

Addressing health inequalities for people with rare conditions through publishing a toolkit for highly specialised services and by mapping and measuring the geographic spread of patients accessing these services.

Under the action plan, the millions of people with rare diseases in England will see more efficient and equitable access to care and new treatments introduced. Over the coming year, we will closely monitor the progress of these actions, seeking input from those living with rare diseases to ensure we are measuring the outcomes that matter most. Progress will be reported in 2025, as part of England’s commitments to report annually over the five-year lifetime of the UK rare diseases framework.

Through this third action plan, we will continue to take steps towards achieving our overarching vision—delivering improvements in diagnosis, awareness, treatment and care, and creating lasting positive change for those living with rare diseases.

[HCWS298]

Leighton Hospital Rebuild

Andrew Stephenson Excerpts

Wednesday 28th February 2024 Westminster Hall

[The Minister for Health and Secondary Care (Andrew Stephenson)]

It is a pleasure to serve under your chairmanship, Mrs Harris. I congratulate my hon. Friend the Member for Crewe and Nantwich (Dr Mullan) on securing this important debate on the rebuild of Leighton Hospital. He is a tireless campaigner for improving healthcare in his constituency and across our country. I commend him for the frontline service that he gave in our NHS as an A&E doctor before entering the House, and for returning to work on the NHS frontline during the pandemic.

Securing the rebuild of the hospital was a long-term team effort. My hon. Friend worked hard alongside the local hospital leadership, my hon. and learned Friend the Member for Eddisbury (Edward Timpson), my hon. Friend the Member for Congleton (Fiona Bruce) and thousands of their constituents who signed a petition to show their support. I myself have spoken to Aphra Brandreth, the Conservative parliamentary candidate for Chester South and Eddisbury, who has told me of the huge benefits that the rebuild will have for local residents.

The Government announced the rebuild of Leighton Hospital in May 2023 as part of the new hospital programme. Like Leighton, six other hospitals that we are rebuilding were initially constructed using reinforced autoclave aerated concrete, more commonly known as RAAC. We took the decision to rebuild those hospitals by 2030 not only to protect the safety of patients and staff but to give them access to the best facilities and the newest technology, which is progress that will allow our NHS to improve patient outcomes, cut waiting lists and deliver for another 75 years.

I was particularly delighted by that announcement because, as the MP for Pendle, I was campaigning, like my hon. Friend the Member for Crewe and Nantwich, for the full rebuild of my own local hospital—Airedale General Hospital, which is just “over the border” in the Keighley constituency—so I was incredibly pleased that its rebuild was also approved by the Government on the same day. For the sake of clarity, I was not a Health Minister at the time when I was campaigning for that rebuild, so all propriety and ethical rules were followed.

I know that my hon. Friend and his constituents are eager to hear about how the rebuild of Leighton Hospital is progressing and I hope to provide a comprehensive update today. I am pleased to say that the local trust is working in lockstep with the new hospital programme to develop designs for its new hospital, following the standardised designs that we have developed to accelerate construction and get patients better care faster. The trust is also working with the programme to prepare its strategic outline case, which will be submitted to my Department this year.

By providing more than £2 million of funding, we have already supported the trust to develop the business case for critical early works, which will prepare the site for main construction, including more than £350,000 to support upgrades to the new hospital’s electricity capacity and over £250,000 to support geothermal and solar enablers. The support that we are giving to Mid Cheshire Hospitals NHS Foundation Trust signals this Government’s commitment to rebuilding Leighton Hospital as quickly as possible; I will keep my hon. Friend updated as further funding is released and the strategic outline case progresses.

The rebuild of Leighton Hospital is just one part of this Government’s commitment to improve healthcare in Crewe and Nantwich, and across Cheshire. We have provided Mid Cheshire Hospitals NHS Foundation Trust with over £50 million to address RAAC at the existing hospital, £15 million to upgrade its accident and emergency department, and £19 million to build a new surgical hub at the Victoria Infirmary in Northwich.

I know that my hon. Friend is championing cross-Government work to utilise geothermal energy, which he referred to in his speech, and I also know that he has already engaged with the Mid Cheshire Hospitals NHS Foundation Trust’s chief executive officer and with my ministerial colleague, Lord Markham, on how geothermal energy could be used at Leighton Hospital and across our NHS. This is incredibly exciting technology and the Government are exploring how it could be used throughout our economy. The Department for Energy Security and Net Zero is working on proposals to do that and my ministerial colleagues will keep the House updated on progress.

If I may, I will provide the House with a broader update on the new hospital programme. We are engaging with the market to build awareness of the programme among businesses, particularly main works contractors and those operating in the mechanical, electrical and plumbing markets. In all, we have held over 100 engagement events and spoken directly to over 1,500 businesses. What is more, later this year we will launch the full version of Hospital 2.0, which is our national approach to standardisation. That will be a major milestone for the programme and we will continue to develop our designs over time, in order to deliver better care for patients and better value for taxpayers.

I am also very pleased that four of our new hospitals are already open to patients: the Northern Centre for Cancer Care in Newcastle; the Royal Liverpool University Hospital; and Northgate Hospital and Ferndene Hospital, which are both in Northumberland. In addition, there is stage one of the Louisa Martindale building, which is also known as the “3Ts hospital”, in Brighton.

By the end of the next financial year, we expect to open another four hospitals: Salford Royal Hospital’s major trauma centre; the Dyson Cancer Centre in Bath; the National Rehabilitation Centre near Loughborough; and the Midland Metropolitan University Hospital. I am delighted that at another 18 hospitals, either construction is already taking place or early work has started—or been completed—to get the sites ready for construction.

I again thank my hon. Friend the Member for Crewe and Nantwich for securing this debate on the rebuild of Leighton Hospital. He is right to hold our feet to the fire on this issue and he is also right to demand that patients and staff, both in his constituency and throughout the country, have access to world-class facilities and world-class care. This is what the new hospital programme will deliver. The Government remain absolutely committed to delivering every scheme that has been announced as part of this programme and we are also absolutely committed to delivering the rebuild of Leighton Hospital by 2030.

Question put and agreed to.

North Tees and Hartlepool NHS Foundation Trust

Andrew Stephenson Excerpts

Tuesday 27th February 2024 Westminster Hall

[The Minister for Health and Secondary Care (Andrew Stephenson)]

It is a pleasure to see you in the Chair, Sir Charles. I congratulate the hon. Member for Stockton North (Alex Cunningham) on securing this important debate. He has used it to raise important questions that are vital to NHS governance—localism, transparency and accountability. He is right that patients in his constituency and the wider region should be at the forefront of decision making about their healthcare. NHS England has found that shared leadership and group working arrangements between trusts can stabilise governance and align approaches to help improvement.

[Matt Vickers (Stockton South) (Con)]

I thought that those were very legitimate questions and concerns about the way forward with mergers—joint working—but one of the issues in our part of the world is that South Tees Hospitals NHS Foundation Trust was burdened by the last Labour Government with a huge PFI deal at James Cook Hospital that cost £1 million a week. That is what makes this contentious. That is what makes it so difficult to see joint working in our part of the world.

[Andrew Stephenson]

I thank my hon. Friend for making that point. I recognise that they are two trusts with very different characteristics. He is right about the eye-watering legacy in one trust—I think it is £57 million a year of PFI debt—which can make joint working controversial. However, as I will come on to say, I have been assured that the two trusts want to work together with joint arrangements, but not merge. I hope we can set the record clearly: in doing the research behind this speech, I have heard that this is not the prelude to a merger through the back door; rather, it is about trusts wanting to work together to address the healthcare needs in the area.

It is right that any decisions about shared leadership arrangements are made in Stockton, not Westminster. However, where an NHS trust is facing performance challenges, the Government back targeted interventions by NHS England, bringing the trusts together to properly diagnose the problem and develop an improvement plan, which could include shared leadership. Any leadership changes should be kept under constant review to ensure that they are effectively delivering for patients and the local area. The point is to help challenged trusts to improve and take ownership of local issues. External evaluations of NHS England’s leadership interventions have found them to be effective.

I will address the current leadership arrangements of the North and South Tees trusts. Up and down the country, trust governance fits a variety of different frameworks. As the hon. Member for Stockton North knows, putting a round peg in a square hole is pointless. However, although we support a diversity of models, I am crystal clear that every arrangement should be geared towards building a faster, simpler and fairer NHS that works for both patients and staff. I am happy to assure him that, in this instance, I have been assured that the shared leadership and joint working arrangements are not in any way a precursor to trust mergers or acquisitions. In other words, both trusts intend to remain statutory organisations in their own right.

NHS England promotes those models of working to maintain consistency within trusts and to ensure that everyone is on the same page when lessons are being learned. However, for over 10 years now, North and South Tees trusts have been discussing how to work together to provide a better offer for the people of Stockton.

[Alex Cunningham]

The Minister may like to acknowledge that the North Tees and Hartlepool trust and the South Tees trust have worked together for many years. It is not a case of how they can do it in the future; they have been doing it for many years.

[Andrew Stephenson]

They have been doing it for many years. There are shared challenges in the area that they need to work on together, and this model of operation has worked in many parts of the country. I hope that what the hon. Gentleman describes is very much a bump in the road rather than something that characterises the past 10 years of joint work, most of which seems to have been constructive and conducted through local consensus.

In September 2021, the trusts appointed a joint chair. Just over a year later, they announced plans to form a group model to strengthen health services in the local area. That model was intended to improve recruitment and retention of specialist doctors and nurses, ensure join-up with local communities and partners, and secure capital investment to rebuild and upgrade hospital facilities. To deliver that new way of working, I understand that North Tees and South Tees foundation trusts engaged extensively with partners in the local area.

There is now strong collaborative work taking place across the Tees Valley, in the long-term interest of patients. The North Tees foundation trust is one of the best performing providers across the country for urgent and emergency care. The area’s NHS urgent care services will now be run by an alliance of four health organisations, including the North Tees and South Tees foundation trusts. Together, the partnership will oversee minor injuries and illnesses across the Tees Valley, including urgent care centres at the University Hospital of Hartlepool, the University Hospital of North Tees, and Redcar Primary Care Hospital.

I am delighted that the new urgent treatment centre at the James Cook University Hospital opened in March. We are backing the centre with a £9 million investment in urgent care services on Teesside, which will integrate services, provide patients with care close to home, and ease pressures on A&E. We should also celebrate the new Government-funded Tees Valley community diagnostic centre, which will open in Stockton town centre later this year. The centre will offer rapid scans, tests and checks for a number of major conditions. It will help thousands of people to access simpler services, with easily accessible life-saving tests and faster treatment.

I turn now to the investigation that the hon. Member for Stockton North raised. I understand that NHS England looked into the proposed appointment of a joint chief exec, as well as the actions and behaviours of the board. It aimed to find out whether these concerns amounted to breach of the trust licence. The investigation determined that the trust board had not acted consistently in relation to moving to a single chief executive appointment for South Tees. This constituted evidence suggesting a breach of a provider licence by the North Tees and Hartlepool Trust, which would normally lead to formal regulatory action being taken. After careful consideration, however, NHS England decided that the trust should implement the recommendations on a voluntary basis.

[Alex Cunningham]

Does the Minister recognise that the non-executive directors had moved on by then? They had actually resigned from their posts in protest at the lack of due process. Does the Minister, or maybe even the region, accept that this matter could have been handled a lot better?

[Andrew Stephenson]

I hope the hon. Gentleman recognises that there are local government arrangements, and also that these are very much operational matters for NHS England and for the region. Certainly, given the concerns that he has outlined, it is quite clear that things could have been done better to take people with them, rather than alienating people. I also echo the tributes he paid to people who serve as non-exec directors on trust boards across the length and breadth of the country. They play a vital role in local NHS governance, and it is therefore regrettable to see a large number of non-execs resign for any reason.

I think that looking at the reasons behind this and investigating the best way forward is something best delivered by the NHS, and not dictated centrally by Ministers. The recommendations arising from the report were that a summary of it should be presented at the next board meeting and that an action plan for the next steps should be agreed, which has now been completed. It was also recommended that proper consultation between board members of both organisations should take place in future, so that they can reach the best collective decision for better services for Stockton. I hope that the trusts are now able to move forward with these new arrangements, especially with a new joint partnership board, establishing a clear chain of accountability going forward to address their challenges during this troubled period.

In wrapping up, I would like to thank the hon. Gentleman for bringing this debate forward.

[Alex Cunningham]

The Minister has just indicated that he is wrapping up, but the central question here is whether or not that report will be published. I have a heavily redacted report, which has more black ink than white paper. Does he accept that those people have the right to understand what judgments were made on the accusations against them? They should see the full report, not a version from the person who ordered it and then refused to publish it.

[Andrew Stephenson]

I hope the hon. Gentleman will appreciate that the NHS commissions a large number of reports on a whole range of services. When those reports are published internally, we expect all participants to be frank and open with investigations. They do so on the basis that they are internal reports to improve the governance of the organisation. It is not expected, and it is not the normal course, for such a report to be published. My understanding is that, following the hon. Gentleman’s freedom of information request, the report will be published in a heavily redacted fashion, as he said. The redactions were made by NHS England, in accordance with its policies. It is not a report that I am privy to and, to the best of my knowledge, it has not even been shared with the Department. It is an NHS England report that, as I say, has been published in accordance with its usual practices.

[Alex Cunningham]

Frankly, I find it amazing that a Minister cannot even get access to a report that questioned the integrity of five long-standing non-executive directors, who then resigned because of the lack of due process in the appointment system. I remind the Minister that, as I said in my speech, Mr Barker sat in my office and told me, face to face, that he would publish the report and that I would get to see it. He has reneged on that promise. Does the Minister think he should fulfil that promise?

[Andrew Stephenson]

Unfortunately, I will just reiterate the point that a summary of the recommendations emerging from this investigation were published; they were shared with the board. They are accessible by anyone who wishes to see them. Through his own endeavours, the hon. Gentleman has been able to secure a copy of the redacted full version of the report. As far as I can see from the investigations that I have made, the report has been published fully in accordance with NHS England’s normal practices.

Clearly, this is something that has led to a rocky period for the trust, but I believe that the recommendations that have been shared with the board are now being implemented and that the group model of working, as I have said today, is not a merger by the back door. I know that, in securing this debate, the hon. Gentleman wanted to give greater impetus to the trust to get its act together and resolve these issues. I am absolutely sure that the issues he has mentioned today will have been heard by members of the trust’s board—I am absolutely sure they have been listening. I urge them to work with him and other local MPs to ensure that any other concerns that he has raised, and any other concerns that other hon. Members may have, are addressed in due course.

[Alex Cunningham]

Can I wind up, Sir Charles?