SELECT COMMITTEE ON HEALTH

Ben Bradshaw Excerpts

Thursday 3rd November 2016 Commons Chamber

Dr Wollaston

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Of course I welcome the increase in staff in our accident and emergency departments. As the Minister will recognise, there is further to go in this regard.

Mr Ben Bradshaw (Exeter) (Lab)

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Does the hon. Lady agree that the four-hour A&E target is absolutely vital, because it, more than any other target, shows the overall performance of a hospital, and that the figures are extremely worrying? Does she also share my concern that last winter was very mild, and we were relatively lucky, with the absence of a big winter flu outbreak? If this winter is as cold as this Chamber, the NHS could face a very serious crisis indeed.

Dr Wollaston

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Certainly, the evidence we heard in our inquiry was that there is grave concern about the level of existing pressure. As the right hon. Gentleman says, if we see a very cold winter, and the flu vaccine does not work as well as it did last winter, we are in serious difficulties. But I stress again that the Committee was very clear that we want to see the four-hour waiting time standard continued, because it is a good measure of whole-system pressure, and if people are facing very long waits that leads to a deterioration in patient safety. So it is a quality issue, as well as an issue about patient experience.

A&E Departments: Winter Pressure

Ben Bradshaw Excerpts

Thursday 3rd November 2016 Commons Chamber

[Dr Wollaston]

Of course I welcome the increase in staff in our accident and emergency departments. As the Minister will recognise, there is further to go in this regard.

[Mr Ben Bradshaw (Exeter) (Lab)]

Does the hon. Lady agree that the four-hour A&E target is absolutely vital, because it, more than any other target, shows the overall performance of a hospital, and that the figures are extremely worrying? Does she also share my concern that last winter was very mild, and we were relatively lucky, with the absence of a big winter flu outbreak? If this winter is as cold as this Chamber, the NHS could face a very serious crisis indeed.

[Dr Wollaston]

Certainly, the evidence we heard in our inquiry was that there is grave concern about the level of existing pressure. As the right hon. Gentleman says, if we see a very cold winter, and the flu vaccine does not work as well as it did last winter, we are in serious difficulties. But I stress again that the Committee was very clear that we want to see the four-hour waiting time standard continued, because it is a good measure of whole-system pressure, and if people are facing very long waits that leads to a deterioration in patient safety. So it is a quality issue, as well as an issue about patient experience.

Community Pharmacies

Ben Bradshaw Excerpts

Wednesday 2nd November 2016 Commons Chamber

[Dr Murrison]

rose—

[Mr Ben Bradshaw (Exeter) (Lab)]

rose—

[Jonathan Ashworth]

I will give way to my right hon. Friend the Member for Exeter, but then I really must make some progress.

[Mr Bradshaw]

Although the Government say that they want to devote a greater proportion of overall health spending to primary care, our Health Committee’s report on primary care, published in the summer, showed that a smaller proportion was being devoted to the primary care sector, which, of course, includes pharmacies. Is that not the ultimate false economy? If we do not invest more in primary care, all the pressure goes into the acute sector.

[Jonathan Ashworth]

My right hon. Friend is another experienced former Health Minister, and he is right. As we learned this week, the Health Committee has completely blown apart the Government’s figures on the financing of the NHS.

NHS Funding

Ben Bradshaw Excerpts

Monday 31st October 2016 Commons Chamber

[Mr Hunt]

It absolutely does. I much enjoyed visiting with my hon. Friend some health facilities in his constituency during the general election campaign. The difference between Conservative Members and Labour Members is that we recognise that every penny of the NHS budget has to come from a strong economy. We know that if we take that for granted, we end up having to cut the NHS budget, which is what has happened in Spain, Italy, Greece, Portugal and many other countries that have lost control of their national finances. That is something that Labour Members would do well to remember.

[Mr Ben Bradshaw (Exeter) (Lab)]

The Government have been well and truly found out on this issue. Rather than quote selectively from Simon Stevens, the head of the NHS, will the Secretary of State confirm that among the conditions that Mr Stevens put down to the Government as part of the five-year review was an increase in public health spending, not a 20% cut, and a policy of maintaining spending on social care? Will he also confirm—he was there in Simon Stevens’ presence before the Select Committee—that Mr Stevens made it quite clear that those conditions and others had not been met?

[Mr Hunt]

Actually, what Mr Stevens said—I was there—was that social care and, indeed, public health provision needed to be maintained. We are increasing the social care budget by £3.5 billion over this Parliament. Although I accept that difficult cuts are being made to the public health budget, we are doing other things that do not cost money to make sure that we continue to improve this country’s excellent record on public health.

Community Pharmacy in 2016-17 and Beyond

Ben Bradshaw Excerpts

1st reading: House of Commons
Thursday 20th October 2016 Commons Chamber

[David Mowat]

I do recognise that. My right hon. Friend made the point that the network is well spaced and that rural areas are protected. I would also make the point that, as I said in my statement, we are recruiting a further 1,500 pharmacists into the GP network. They will also play a big part in that integration.

[Mr Ben Bradshaw (Exeter) (Lab)]

Are not these cuts the latest evidence of the unprecedented financial pressure the national health service is under? Is it not the case that cutting community pharmacy services is the very last place we should begin, as they take pressure off GP surgeries and hospitals and offer an excellent service? The Government should be investing more in them, not cutting them.

[David Mowat]

This year we invested a further £5 billion in the NHS, three times the rate of inflation. In June the OECD noted we are now above average in terms of NHS and social care spend in the OECD. However much we spend, it is right we look to do it as efficiently and effectively as possible, to modernise this service and make it better for patients, and that is what we are doing.

Oral Answers to Questions

Ben Bradshaw Excerpts

Tuesday 11th October 2016 Commons Chamber

[David Mowat]

My hon. Friend refers to the time lag that can exist between target and actual funding. When I visit, I will be delighted to meet stakeholders not only to understand the allocation issues to which he refers but to congratulate the health and social care leadership on the progress they have made with their fund and on the above-average satisfaction ratings that have been achieved in Plymouth.

[Mr Ben Bradshaw (Exeter) (Lab)]

12. When the Minister is in Devon, will he meet patients’ groups and NHS staff, who are very worried about the proposals under the Government’s Orwellian Success regime, which include the closure of scores of community hospital beds, including the only community hospital beds in Exeter at Whipton hospital? Although it may make sense to integrate, and it certainly makes sense to move money from beds and buildings to better care for people in their homes, does he accept that it is simply not deliverable against a backdrop of massive cuts in social care budgets?

[David Mowat]

Yes, I am happy to meet in that context. The right hon. Gentleman is right that the Success regime is about a transfer of resources from the community hospitals to care at home and domiciliary care. That is not necessarily the wrong thing to do, but it must be done right, and I am happy to meet.

NHS Commissioning (Pre-Exposure Prophylaxis)

Ben Bradshaw Excerpts

Tuesday 7th June 2016 Commons Chamber

[Jane Ellison]

My hon. Friend is quite correct on his latter point about the impact of PrEP. Whether it was commissioned or not, and whoever it was commissioned by, we would still have the significant challenge that he describes around STIs. Drug-resistant gonorrhoea, for example, is a problem that we are increasingly aware of.

There are international comparisons that we can look at, as my hon. Friend mentions. I have looked at the matter in some detail, and the picture across the world is that many countries are in broadly the same position as the UK. They are trying to understand, leaving aside the question of clinical effectiveness, more about how PrEP can be used as part of an HIV prevention programme in broader cost-effectiveness terms, and how it compares in cost-effectiveness terms with other available interventions. My hon. Friend is right that there is work to do, and we are not resting easy on this. We are moving forward, and we are working on and planning these pilots now.

[Mr Ben Bradshaw (Exeter) (Lab)]

When does the Minister expect the damaging buck-passing between NHS England and local authorities, which is one of the disastrous results of the Health and Social Care Act 2012, to be resolved? Does she agree that it would be far more appropriate for NHS England to be the commissioner of something like PrEP than for local government to commission it? Finally, will she be very cognisant of the danger that we are going back to the bad old days when certain groups were stigmatised? Stigma is disastrous for public health policy, and it will result in an explosion of sexual disease in this country if we do not always bear in mind the danger that decisions by NHS England—not just on this, but on drug treatment for hepatitis C —may have a disastrous impact on public health.

[Jane Ellison]

The NHS England position is based on a legal argument, and as the matter is likely to go before the courts, it is not really appropriate for me to comment further. There was a little discussion this morning on this subject in the Health Committee, for which some Members were present. I have laid out a process by which we will work out how and where this is commissioned. Clearly, we need to identify the commissioner.

I do not accept the right hon. Gentleman’s challenge about fragmentation, simply because if we look around the world at a series of very different health systems, we see that they are all going through broadly the same process of understanding where PrEP sits. There are a number of options, but first we need to go through this work. On his latter point about stigma, he is right to identify that it is a significant concern, but I do not accept that that is what this represents. He knows my personal commitment to tackling stigma, and we could not have made it clearer that addressing rising HIV rates, addressing STIs in the MSM community and looking at the challenges surrounding things such as chemsex are all very much front of mind, and we have given considerable time and thought to them. We must challenge stigma wherever it rears its head.

Oral Answers to Questions

Ben Bradshaw Excerpts

Tuesday 10th May 2016 Commons Chamber

[Jane Ellison]

The Government take extremely seriously the issue of making sure that only those who should have access to NHS services do access them. Let me make an important point about the figures that I have just given. Some 80% of that imbalanced statistic represents our pensioners who choose to retire to Europe, typically for sunnier weather. The figure is 80% because many more UK pensioners retire to Europe than European pensioners retire here, and there will always be an imbalance. I am sure that even the keenest Brexiteer would not claim that Britain would be sunnier outside the EU.

[Mr Ben Bradshaw (Exeter) (Lab)]

Will the Minister encourage her Back Benchers to study the expert evidence that was given recently to the Select Committee on Health on the issue that the hon. Member for Kettering (Mr Hollobone) has just raised, our access to free healthcare in Europe, and the economic shock that our leaving the European Union would cause to the NHS finances and to major public health measures such as clean air and clean water that benefit us immensely? Every single one of them told our Committee that leaving the European Union would be disastrous for the NHS, disastrous for health and disastrous for public health.

[Jane Ellison]

On this, I am happy to say that I very much agree with the right hon. Gentleman. I encourage all colleagues to look at the evidence deposited with the Committee. Just last year, UK European health insurance card holders—5.5 million people—were able to travel to any other EEA country or Switzerland safe in the knowledge that they would be able to receive free healthcare or reduced costs arising from healthcare if they needed it. That offers great peace of mind and shows that Britain is safer in a reformed EU.

Junior Doctors Contracts

Ben Bradshaw Excerpts

Monday 25th April 2016 Commons Chamber

[Mr Hunt]

I am afraid that junior doctors, who work incredibly hard and are the backbone of the NHS, have not been well represented by their union. The BMA is currently telling junior doctors not to co-operate with trusts in any discussions about the implementation of the new contract. The kinds of issues mentioned by my hon. Friend are exactly those that we want to sit down and talk to the BMA about. I wrote to Mark Porter, the chair of the BMA’s council—in fact, I talked to him earlier this afternoon—about the possibility of talks to go through all those extra-contractual issues and the contract itself to ensure that we implement it in the best possible way. That is the kind of dialogue that the Government are willing to have and that we would welcome, but we need another party to come to the table if we are to succeed in doing so.

[Mr Ben Bradshaw (Exeter) (Lab)]

The Health Secretary knows well that seven-day working has absolutely nothing to do with his proposed new contract. The Health Committee recently visited Salford Royal hospital, to which he referred earlier and which is already running a seven-day service on the existing contract. His petulant rejection of the all-party proposals to pilot the contract shows that tomorrow will be his responsibility and his alone.

[Mr Hunt]

Let us be absolutely clear. The people who are responsible for the strike tomorrow are those who choose to do the BMA’s urging and withdraw emergency care for patients. That is where the responsibility lies.

Let me deal with the right hon. Gentleman’s point directly. There are a couple of trusts in the country that have been good at introducing seven-day standards in urgent and emergency care, but my judgment, and that of the Government, is that it would not be possible under the current contractual structures to roll that out across the whole NHS. Those trusts happen to have some of the NHS’s most outstanding leaders, and we need to learn from what they have done, but we also need to make it possible for those same things to happen at all hospitals, including the right hon. Gentleman’s own.

Oral Answers to Questions

Ben Bradshaw Excerpts

Tuesday 22nd March 2016 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

It is worth saying that the National Institute for Health and Care Excellence does not recommend homeopathy to treat any health condition. My hon. Friend mentioned antimicrobial resistance, and an increasing number of studies from around the world show that resistance to common treatments is growing, which serves to underline the importance of the responsible stewardship of all drugs and medicines and why the international efforts on AMR, in which the UK is at the forefront, are so important.

[Mr Ben Bradshaw (Exeter) (Lab)]

Given the latest, very worrying reports about goings on at the office of the Parliamentary and Health Service Ombudsman, does the Secretary of State still have confidence in the leadership of this vital regulator?

[Mr Jeremy Hunt]

I have expressed my concerns on the behalf of patients about some of the things that have been happening, but I respect the fact that it is a matter for this House and its relevant Committee, not for the Government, to deal with. I do have concerns, and it is important that patients have confidence in the ombudsman, because it is a vital, independent avenue to challenge NHS trusts when things go wrong.