Oral Answers to Questions

Andy McDonald Excerpts

Tuesday 19th November 2024 Commons Chamber

[Andrew Gwynne]

NICE is reviewing its guidelines for the diagnosis, monitoring and management of chronic asthma, and an updated version is due to be published in late November 2024. I am happy to meet the hon. Lady to discuss it further.

[Andy McDonald (Middlesbrough and Thornaby East) (Lab)]

Women with spinal cord injuries face significant challenges in accessing core health services, including breast screening, cervical screening and gynaecological care. Research shows that women with disabilities, including spinal cord issues, are 30% less likely to attend routine breast screening appointments, in significant part due to the physical inaccessibility of the screening equipment. Will the Minister meet me and representatives of the all-party parliamentary group on spinal cord injury to discuss these unacceptable disparities and ensure that women receive the equitable and accessible care they deserve?

[Karin Smyth]

My hon. Friend highlights a shocking example of inaccessibility in these important services. I will make sure that the Department responds to him and that either me or a ministerial colleague meets him.

Hospice Services: Support

Andy McDonald Excerpts

Wednesday 14th June 2023 Westminster Hall

[Paul Holmes]

I agree with the right hon. Lady; we do. In my experience, the uplift that has been given to local NHS commissioning groups is simply not making it through to those end of life services. I hope we will see some recognition of that from the Minister, and I am sure she will enforce this, to ensure that the funding to local commissioning groups gets through to these services.

[Andy McDonald (Middlesbrough) (Lab)]

Will the hon. Member give way?

[Several hon. Members rose—]

--- Later in debate ---

[Paul Holmes]

The hon. Gentleman is absolutely correct. I only have to see Mountbatten local networks of fundraising and charity supporters, whether in charity shops or in fundraising roles. I am honoured that I may become part of that community—if I land on the ground safety, alongside Miles—but it will not end there. I will carry on fundraising for a fantastic cause.

When Mountbatten hospice wrote to me in January to outline those extraordinary energy costs, I was happy to write on its behalf to the Secretary of State. Unfortunately, the energy bill relief scheme and the later energy bills discount scheme did not ease the pressures, as the hospice was not eligible. Mountbatten still faces unsustainable pressure, as do hospices across the United Kingdom.

Of course, there are some people who ask whether a charity should not take the majority of its funding from its local community—from donations and contributions, rather than from Government funding. That is a fair question, but unfortunately it does not provide a solution, especially considering that community donations already support 70% of Mountbatten’s funding, which it has calculated to be the limit of what it can ask from people.

[Andy McDonald]

The hon. Gentleman is making an excellent speech. He is right about donations, but my local hospice, Teesside Hospice, is really struggling. I congratulate the hon. Member for Darlington (Peter Gibson) on his work in that respect. Is the hon. Member for Eastleigh (Paul Holmes) not describing a perfect storm? There is a statutory obligation on the NHS to fund hospices for medical care, but the NHS is entirely strapped. Can I divert him away from the solution of asking members of staff to tighten their belts even further? That is not an option. When we cannot recruit and retain, that is not the solution. We need a fundamental reset of the economic settlement.

[Paul Holmes]

I hope the hon. Gentleman has not taken from my speech that I am suggesting that staff tighten their belts. In fact, I am advocating that hospices be allowed to follow the NHS pay settlement model, and be funded properly to so do. I would say to the hon. Gentleman that the Government have put their hand in their pocket through the £1.5 billion uplift, although that is simply not getting through from the Department of Health and Social Care and local commissioning boards to the hospices. That is where the Government need to step in to a greater extent. Therefore, I ask the Government to take the issue seriously and to continue to treat the charity care sector with the priority it deserves.

Hospices do incredible work, and they represent spectacular value owing to the services they provide. We cannot allow that vital link in the care chain to be broken, or even weakened, particularly at this time. Evidence submitted to the all-party parliamentary group on hospice and end of life care’s report detailed how the covid-19 pandemic made fundraising even more challenging for hospices. Hospices experienced a massive decrease in income while facing unprecedented demand for their services. One hospice’s overnight sitting service had to end due to lack of funding to sustain it, which highlights how dependent those services are on charitable donations.

It is important to highlight the fact that the sustainability of the hospice sector continues to be tested due to the cost of living crisis. Some sort of long-term funding settlement for hospices would be in the interests of all concerned because 160,000 more people each year are expected to require palliative care by the end of 2040. Having sufficient staff and volunteer resourcing in the specialist palliative care field is essential. An ideal outcome would be the Government and the NHS working with the hospice sector to provide an ongoing financial settlement, with regular contractual reviews to ensure that the support that hospices receive is at least the minimum they require to keep services running. That should be directed to cover both staffing and energy cost rises.

Doing that would be in the best interests not only of hospices, because hospices play a vital role in reducing pressure on NHS services by providing bed space and crucial care capacity. The NHS can scarce afford to lose such space and capacity, particularly in the light of the current waiting lists, but lose them it may if action is not taken.

Mental Health Treatment and Support

Andy McDonald Excerpts

Wednesday 7th June 2023 Commons Chamber

[Neil O’Brien]

I will come to the point about waiting lists in a moment.

Let me complete my thoughts on prevention, which I think we all agree is important. There are 3.4 million pupils covered by mental health support teams in 2022-23, which equates to about 35% coverage of pupils in schools and learners in further education in England. We expect around 500 teams to be up and running by 2024, covering around 44% of pupils and learners, so it will be up from 35% to 44%. Over 10,000 schools and colleges now have a trained senior mental health lead, including more than six in 10 state-funded secondary schools in England. On prevention, the Government are also providing £150 million of capital investment in NHS mental health urgent and emergency care infrastructure over the next two years.

[Andy McDonald (Middlesbrough) (Lab)]

While the Minister is addressing the issue of young people, can I say that I have yet to hear any news from the Department as to whether there will be a public inquiry into the deaths of the three young women who died under the care of the Tees, Esk and Wear Valleys Foundation NHS Trust. Can he enlighten me on that?

[Neil O’Brien]

This is an extremely important issue that the hon. Gentleman is quite right to raise. We will be producing the results of the rapid review in the coming weeks, so he will not have to wait very long.

NHS Strikes

Andy McDonald Excerpts

Monday 6th February 2023 Commons Chamber

[Will Quince]

We do not, as yet, have the details of today’s and tomorrow’s industrial action, but we will certainly be able to publish that information in due course. I can tell the right hon. Gentleman, as I mentioned in my opening response to the urgent question, that over 88,000 appointments have been rescheduled so far and over 58,000 shifts have been missed. Of course I deeply regret that and wish that there was no strike action. [Interruption.] Of course I do.

If we had not accepted in full the independent pay review body’s recommendations, the right hon. Gentleman and others would have an argument to make to say that we had not, but we did accept them in full. We accepted them in full last year, too, despite them being over and above the evidence submitted by the Government in respect of affordability. That is why I look forward to the next independent pay review body process, and why it is so important that the unions and others engage with that process so that we get it right.

[Andy McDonald (Middlesbrough) (Lab)]

I have more than enough cause to thank my local NHS for the lifesaving treatment it has given me, but so has every single family in this country. Why do the Government not get it, as the public clearly do, that our health workers, like all public sector workers, are at the end of their tether? Get round the table to resolve these disputes and give them the proper wage rise they so desperately need and deserve.

Cancer Outcomes: Tees Valley

Andy McDonald Excerpts

Monday 16th January 2023 Commons Chamber

[Andy McDonald (Middlesbrough) (Lab)]

May I share in the warm words of tribute to Professor Bonner from the right hon. Gentleman, my constituency neighbour? Like me, he is very much aware of the superb, world-class work that goes on at the James Cook University Hospital’s oncology department. It has six linear accelerators with a lifespan of about 10 years, but half of them are now reaching the end of their natural life, and as they break down they are becoming less efficient. Does he share my plea to the Department of Health and Social Care and the Treasury to ensure that the necessary funding is made available to the James Cook University Hospital and the trust to carry on their vital, life-saving work for our constituents across Teesside and beyond?

[Mr Clarke]

I echo what the hon. Gentleman says about the importance of ensuring that our equipment is absolutely the best it can be. I had the privilege of seeing the new equipment at the James Cook’s interventional radiology department before Christmas, which was incredibly impressive. The hon. Gentleman is absolutely right that such investment is vital to ensuring that once treatment commences, people can get the best possible care.

NHS: Long-term Strategy

Andy McDonald Excerpts

Wednesday 11th January 2023 Commons Chamber

[Andy McDonald (Middlesbrough) (Lab)]

I do not know whether my hon. Friend is as horrified as I am by the juvenile and facile comments from the Conservative Benches, or whether he heard today on Radio 4 about the 600,000 people who every single month are waiting for four hours or more to get into A&E and be treated. As a direct result, horrifyingly, each and every month, hundreds and hundreds of people are dying needlessly in our country. That is on this Government’s watch. Should they not be hanging their heads in shame?

[Wes Streeting]

I wholeheartedly agree with my hon. Friend—avoidable and preventable. The Chancellor wrote an entire book about getting the number of preventable deaths down to zero, because that is where the figure should be, so to have 50,000 preventable, avoidable deaths reported is a badge of shame for the Government.

Worst of all, the height of the Prime Minister’s ambition is to stop making things worse. If we have 7.1 million people waiting for treatment, rather than 7.2 million people, apparently that is a job well done in the Prime Minister’s book. Our NHS needs to be rebuilt and renewed, but all he offers is managed decline. His five pledges have the bar set so low that even his predecessor could meet those promises.

If hon. Members want to know what real ambition and action look like, it is this: 89,000 more nurses; 44,000 more doctors; waiting times cut from 18 months to 18 weeks; 3 million more operations carried out each year; banning smoking in pubs; the largest hospital building programme in history promised and delivered; 100 new walk-in centres; GP appointments guaranteed within two days; free prescriptions for cancer patients; appointments with a cancer specialist within two weeks of referral; waiting lists cut to their lowest point in history; and patient satisfaction at its highest levels in history. That is the difference that a Labour Government make.

NHS Workforce

Andy McDonald Excerpts

Tuesday 6th December 2022 Commons Chamber

[Wes Streeting]

I thank my hon. Friend for raising that heartbreaking case. It is every family’s worst nightmare. All of us now know someone who is waiting for treatment. Many of us know someone who has called for an ambulance and waited for hours and hours—and, in some cases, given up on it and gone to hospital. I have spoken to ambulance service staff who, like many other staff across the NHS, feel a real sense of deep personal moral injury because they know that, despite their best efforts and busting a gut at work every single day, their best simply is not good enough because the system has collapsed. Ambulance turnaround times are not fast enough because A&E waiting times are too high. That is because people cannot see a doctor and the social care is not available, so the beds are full of people who are well enough to go home and would be better off at home. This is the problem in the NHS: the whole system is broken. I am afraid to say that political decisions made in this place by the Conservative party have led us to this tragic situation.

[Andy McDonald (Middlesbrough) (Lab)]

My hon. Friend is making an excellent case. At the James Cook University Hospital in Middlesbrough, the number of people still in hospital who could be discharged into social care amounts to three full wards. That is the situation that we have got to. It is a perfect storm, with ambulances queueing outside and people turning up at A&E because they cannot get to a GP. That will only ever be addressed if we also address staffing in our GP services to ensure that they can attract people who are offered Agenda for Change terms and conditions to alleviate the backlog. Does he agree that we need to invest in all the elements along that supply chain?

[Wes Streeting]

My hon. Friend is absolutely right. This is the tragedy of where we have got to on social care in particular. The Government have allocated half a billion pounds to alleviate pressure this winter, but not a penny of it has reached social care providers. Not a penny of it is currently being worked in action to try to deal with delayed discharges. I have no doubt whatsoever that one reason why it has taken so long from that commitment to getting money to the frontline is the constant churn of Ministers that we saw over the summer. The absolute circus that we saw in the Conservative party has had a direct impact on the competence of effective Government in this country. We now have ineffective Government, so even when the Government seek to do the right thing and allocate the resources, they cannot get the money out the door far enough because Ministers seem to change week in and week out.

Government PPE Contracts

Andy McDonald Excerpts

Tuesday 6th December 2022 Commons Chamber

[Angela Rayner]

I think it absolutely stinks, and my hon. Friend is absolutely right, in that the public can see through it, as can those businesses, who are pretty angry. They knew that Britain faced a situation with a global pandemic that it had not faced before and they wanted to do the right thing by doing their bit. The frustration—my hon. Friend is right to quote her business—is that there is no question that the specifications should have been known. Therefore, why was all this PPE bought knowing full well it could not be used?

[Andy McDonald (Middlesbrough) (Lab)]

Does my right hon. Friend agree that the mood in her constituency, as in mine, apposite these dealings is one of faith being completely shaken in the good governance and process of this nation? At the very least, people are saying that moneys obtained and goods not properly utilised have to be returned and, if circumstances so dictate, there should be criminal prosecutions long before an inquiry can progress.

[Angela Rayner]

My hon. Friend is right to capture the mood of the public on this. At a time when the public are told that we have to show restraint, at a time when they can see the finances—not least because the Government’s former Prime Minister and former Chancellor crashed the economy—it absolutely galls them to think that Ministers were not doing the due diligence that was required with the funds we needed. Now we have a situation where we are spending billions of pounds on wasted PPE and we also have thousands of pounds every single day being wasted on storage for PPE.

North East Ambulance Service

Andy McDonald Excerpts

Monday 23rd May 2022 Commons Chamber

[Maria Caulfield]

I can reassure my hon. Friend that I have already had an initial meeting with the CQC and the trust this morning and that I will instigate further meetings after today. On NDAs, a previous Health Secretary made a move to outlaw them, and I will speak to the Secretary of State about whether we need to go further, because I am concerned that we cannot have a culture of learning and disclosure while NDAs may be in place.

[Andy McDonald (Middlesbrough) (Lab)]

This cover-up totally stinks. It will stink to the family of a gentleman who tragically died while waiting for an ambulance which, unbeknown to the family, had been dispatched to Middlesbrough from Bishop Auckland, around 25 miles and 40 minutes away. If the family had been allowed to know how long the ambulance would take to get there, they would indeed have tried to save his life by driving him to the hospital less than 3 miles away. The people of Middlesbrough and the north-east are entitled to the security of knowing that an ambulance will get to them promptly in the event of an emergency. Will the Minister guarantee that?

[Maria Caulfield]

I would like to hear more from the hon. Gentleman about his constituent’s case. I have concerns about what was reported in The Sunday Times. I am concerned that the process followed in investigating those concerns has not got to the bottom of some of the fundamental problems, so if he would like to meet me afterwards I would be very happy to take it further.

Future of the NHS

Andy McDonald Excerpts

Monday 31st January 2022 Westminster Hall

[Matt Vickers]

I am sure we are going to hear about the ways in which these structural reforms will take place with that very aim in mind. I am going to try to get through my speech, because I am sure that Members would prefer for everybody to get in and to hear from the Minister, who is wiser on this issue than I am.

In my view, the Health and Care Bill does not represent an attempt to create a “pay for play” system—quite the opposite. While I am sure the Minister will go into detail about this point in his response, my understanding is that the Bill is largely the work of the NHS itself, inspired by NHS England’s own desire to restructure its organisational system to be more efficient and effective. It builds on the NHS’s own long-term plan, as set out in 2019, and the NHS people plan, which was published in 2020. Many of my conversations with leaders from my local NHS trust suggest that the answers to improving health outcomes require multi-agency working and empowerment of local health agencies, and my understanding is that the reforms and structural changes in the Bill set out to do exactly that.

One point on which I strongly agree with the petitioners is the need to drive value for money within our NHS, reducing management costs and excessive use of consultants, so that the huge increases in funding for the NHS can actually reach the frontline, not just fund more fruitless layers of bureaucracy. I am hopeful that the Minister will update us on what is being done to drive efficiency in that regard. Another point that I fundamentally agree with is the petitioners’ view that private finance initiative contracts have no place in our NHS. I know all too well the debilitating effect they have on the ability of the NHS to administer care across our country. Nationally, PFI contracts cost our NHS £1 billion a year and restrict numerous hospitals across the breadth of Great Britain.

I have seen at first hand how PFIs have damaged our local services in the Tees Valley. South Tees Hospitals NHS Foundation Trust, in particular, has been plagued by a dodgy new Labour PFI contract. The James Cook University Hospital was completed in 2003, but its PFI contract does not run out until 2034, and will cost over £1.5 billion. The trust currently has to meet annual payments of £57 million a year—more than £1 million every week. Of course, hospital upgrades and rebuilds are expensive, but that trust is paying £17.5 million over and above what an equivalent Treasury-funded hospital would cost annually. Shockingly, that is enough to pay for more than 530 nurses. It is ludicrous.

Even if there were not an extra 530 nurses at South Tees, there is so much the hospital could do with this money, such as investing in its building, equipment and staff to help improve health outcomes and inequalities. Excessive costs from historic PFI contracts are listed as the largest single contributory factor to the hospital’s troublesome financial position. At time when retention is a huge issue for our NHS, this money would be crucial to making a substantial difference to the working lives of our NHS heroes. I am glad that in 2018 a Conservative Government decided that PFI contracts would be phased out. However, hospitals up and down the country are now stuck dealing with a Labour legacy that has damaged our NHS, our people and our ability to tackle health inequalities across this country.

[Andy McDonald (Middlesbrough) (Lab)]

Will the hon. Member give way?

[Matt Vickers]

I will carry on; I am sure that there will be a chance for the hon. Member to contribute. I look forward to hearing the rest of the debate and to listening to the input of Members from across the House.

--- Later in debate ---

[Ian Byrne (Liverpool, West Derby) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Gray. The privatisation of the NHS has been a lengthy and well-documented process that started during Thatcher’s Conservative Government in the 1980s. It has shifted the responsibility for the long-term care of the elderly and the vulnerable from the NHS to local authorities, and allowed hotel-type charges for long-term care. This violated a key NHS principle that patients should not pay health charges. Charges became means tested, and homes had to be sold to pay for the bills. Local authorities were forced to pass on their responsibility for healthcare to outsourced private companies. That created a for-profit industry worth £6 billion a year.

Ninety per cent. of nursing home beds are now operated on a for-profit basis. Almost 400,000 elderly patients are now a source of income in an increasingly privatised sector. The staff in those nursing homes are an increasingly casualised and deskilled workforce. The privatisation of care for the elderly created such a mess that we are still trying to sort it out 40 years later. That is the shameful legacy of privatisation in one sector of healthcare. We can see clearly that the process of privatising the NHS itself will follow the same pattern. It will be run by private contractors who will de-professionalise and casualise a temporary workforce.

There has been a creeping privatisation of the NHS. In 2012, an Act was passed that, among other things, required all NHS contracts to be tendered to any qualified provider. Now we have ambulance services run by taxi firms, private companies that have taken over GP practices covering half a million patients in London, and a private company taking over an NHS hospital and cancelling the contract when there was no more money to be made. I have seen first hand, working for Unite and organising outsourced workers in the health sector, the damage that privatisation does to our essential care services.

If that tale of incompetence was not enough, the Government are now pushing through a new reorganisation, this time to establish what they call “integrated care”. It does the complete opposite, instead butchering our NHS into 42 separate areas. It should not be called integrated care but “disintegrated care”. Each area has a fixed budget that cannot be overspent. This will create a postcode lottery and force each area not to co-operate with each other to save cash. Each area board will allow private healthcare companies—another play on words: they are mostly private health insurance companies—to make decisions about the provision of healthcare.

Here we go again: the Government’s answer to underfunding our NHS is to let private companies run it. History has taught us that this is not the solution. NHS staff employed by 42 different organisations face a most uncertain future of casualisation, deskilling and the introduction of poorer terms and conditions. The people of England face a regional, not a national, health system, which will have different terms and conditions for its workforce and different provision of treatment. It is chaotic and irresponsible.

Every Government of the day have been entrusted to preserve and protect one of the country’s greatest achievements—to cherish, not cherry-pick and hive off to the private sector. I urge the Minister to listen to the calls of my constituents, campaigners and the trade unions and scrap the catastrophic Health and Care Bill, which destabilises, fractures and imperils our NHS.

[Andy McDonald]

rose—

[James Gray (in the Chair)]

I apologise to the hon. Member for Middlesbrough; I fear we have no time.

--- Later in debate ---

[Andy McDonald (Middlesbrough) (Lab)]

Thank you, Mr Gray; I am grateful to you for accommodating me. I declare an interest as a private member of Unite the union.

The level of involvement of private interests that has built up in our NHS over decades is deeply troublesome. That concern has been expressed forcefully in the demands set out in the petition that we are debating. That petition has garnered more than 135,000 signatures.

In our manifesto at the last election, Labour stated:

“Our urgent priority is to end NHS privatisation”,

because

“Every penny spent on privatisation and outsourcing is a penny less spent on patient care.”

We committed to repealing the Health and Social Care Act 2012 and reinstating the responsibilities of the Secretary of State to provide a comprehensive and universal healthcare system. We also committed to ending the requirement on health authorities to put services out to competitive tender, to ensure that services are delivered in-house and that subsidiary companies are brought back in-house.

In the moments remaining to me, I will address the issue of the private finance initiative. The hon. Member for Stockton South (Matt Vickers) set out a lot of the detail very accurately. He told us about a hospital in my constituency, the James Cook University Hospital, and I pay tribute to the work of all its team, ably led by Sue Page, the chief executive. That hospital has performed marvels during this period, and offered services to other hospitals across the entire north of England.

I am appealing to the Minister for some help for my hospital, because the burden of PFI has been absolutely colossal: the hospital has cost £1.5 billion to build and maintain since it opened in 2003. The amounts paid by the trust increase every year until the final payment in 2034. I do not want to get into debate about how rotten the PFI deal was, quite frankly. All PFI deals were rotten. They were started in 1992 under John Major’s Government—please, let us not have any of that nonsense. The PFI deal costs an absolute fortune: £20 million more than an equivalent hospital would have to pay for maintenance.

What was missing is what we are going to do about it. As an initial solution, we could look at the decisive action of the Department of Health in 2012 to make £1.5 billion available in grants—not loans—to seven hospitals in England with some of the heaviest PFI debts through a stability fund. The seven trusts were able to use that money, rather than their usual budgets, to meet their PFI payments. It has been done elsewhere. I appeal to the Minister to look very carefully at providing assistance to get this PFI albatross from around our neck and let my hospital thrive and continue to do the wonderful work it has done for many years.