Budget for Community Pharmacies

Bill Esterson Excerpts

Tuesday 24th May 2016 Commons Chamber

[Michael Dugher]

My right hon. Friend is absolutely right. Given the success of community pharmacies, we should be doing far more with them, not cutting them. I shall come to some of the arguments for that during my remarks.

In the course of this campaign, I have been lucky enough to visit some excellent community pharmacies in almost every part of my constituency, campaigning with local councillors, listening to residents who rely greatly on the services these pharmacies provide and meeting staff who are among the very best healthcare professionals in the country.

[Bill Esterson (Sefton Central) (Lab)]

I congratulate my hon. Friend on securing this debate. Like him, I have visited several pharmacies in my constituency. They make the point that we are short of GPs and that, in that environment, it makes no sense to cut a service that can provide the support necessary to make up for the challenging circumstances that GPs face. Pharmacists can often provide advice and support to those who otherwise would go to their GP. In the absence of those GPs, pharmacies are essential.

[Michael Dugher]

My hon. Friend is of course absolutely right. One of the successful community pharmacy operators in my own constituency, Lo’s pharmacy, which has 20 community pharmacies across Yorkshire, was set up by a fantastic individual, Mr Steve Lo, who was brought up in Hoyland Common in my constituency and remains the firm’s managing director. Of the Government’s proposals, he told me:

“There is a real and present danger that these cuts will make many pharmacies unviable. That can only mean a longer trip, not just for your prescription, but for free advice on minor ailments or medicines as well as a number of other NHS led services, and is only going to put more pressure”,

as my hon. Friend just said,

“on GP surgeries and Accident and Emergency departments.”

I wholeheartedly endorse his comments.

Conception to Age 2: The First 1001 Days

Bill Esterson Excerpts

Thursday 17th December 2015 Commons Chamber

[Bill Esterson (Sefton Central) (Lab)]

I am grateful to the hon. Member for Congleton (Fiona Bruce), who has been an excellent vice-chair of the all-party group on foetal alcohol spectrum disorder. I congratulate hon. Members on bringing the debate to the House because it gives us a timely opportunity to talk about the initial findings of our inquiry, of which the hon. Member for East Worthing and Shoreham (Tim Loughton) was another valued member.

I want to repeat as forcefully as I can the point that the hon. Lady made about the need for a prevalence study. I have asked the Minister about it previously in questions, and I put it to him that such a study is essential. The evidence we took in our inquiry is backed up by evidence that has come from around the world over many years—the hon. Lady identified a number of those countries. The time has long since passed for us getting that evidence base in this country so that we can understand as well as possible exactly how great a problem it is and what solutions are needed. The Minister can intervene now, but perhaps he will address that point later.

The hon. Member for East Worthing and Shoreham and my hon. Friend the Member for Nottingham North (Mr Allen) mentioned brain development and the damage done by alcohol during pregnancy when a mother and baby are susceptible to that damage. They are frightening results.

[Dr Philippa Whitford (Central Ayrshire) (SNP)]

One other area we need to consider is malnutrition and micro-malnutrition. Regardless of obesity or weight, we are seeing a more malnourished diet in this country from poor quality food and reliance on food bank food. Work done has shown low levels of iodine, which increases cretinism, and low levels of folate, in girls in their late teens, which means that, as they enter the child-bearing age, they are at high risk of having children who have major disabilities.

[Bill Esterson]

I am glad the hon. Lady managed to get that point on the record. That is an incredibly important part of the picture of the damage done to brain development. I want to concentrate my remarks on the damage from alcohol and the inquiry report that the all-party group has just published, but I am grateful to her. Her point is very complementary to my remarks.

My hon. Friend the Member for Nottingham North made a powerful point on the potential of early intervention—he said it could be the biggest deficit reduction scheme of all and mentioned the figure of £17 billion. That is an important point when it comes to foetal alcohol spectrum disorders. In Canada and the US, they use the term “million dollar baby”. It refers to the lifetime costs of the damage done by alcohol during pregnancy. The hon. Member for Congleton and others have mentioned many of those costs, whether it is the inability to engage socially or hold down a job. Many end up in the criminal justice system and many of us care for children and young adults who were damaged by alcohol during pregnancy. All of these things have huge economic and social costs. It is incredibly important that we take those points on board, whether on alcohol harm or other forms of damage and deprivation caused during pregnancy and in the early years.

The all-party group took evidence from a great many experts: Martin Clarke of the Adolescent and Children’s Trust; the consultant psychiatrist and nationally renowned expert on FASD, Dr Raja Mukherjee; Sir Al Ainsley Green, now President of the British Medical Association; SABMiller from the drinks industry; the British Pregnancy Advisory Service; Public Health Research; a midwife; and parents and carers, as well as young adults living with foetal alcohol spectrum disorders. We heard heartrending examples of damage done, difficulties faced and the life-limiting effects of alcohol during pregnancy.

I want to pay tribute to and thank the Foetal Alcohol Spectrum Disorder Trust for the secretariat support, and other organisations such as the National Organisation for Foetal Alcohol Syndrome, which has for many years attempted to improve the education of professionals in health, education and other sectors on what is needed to prevent the disorder and to support people who care for children and young adults; and Mencap, which advises GPs.

There have been some puzzling changes over the past 20 or 30 years, something the hon. Lady touched on. In the 1970s, alcohol consumption in the UK was one of the lowest in the western world. From that low base, however, there has been a steady increase. There is a remarkably strong correlation between the increase in alcohol consumption and the increase in the incidence of mental health problems, attention deficit hyperactivity disorder, autism, Asperger’s, and many different kinds of learning and physical disabilities. The remarkably close correlation suggests causality. Brain damage is not reversible and is clearly significant. As the hon. Lady said, the World Health Organisation estimates that 1% of people born today are affected by FASD. Even at 1%, that is 7,000 children born every year. That is 7,000 too many.

For anyone new to this subject, there is a widely shared video of the effect of a small drop of alcohol on an embryo, which is compared with an embryo that does not experience the ingestion of a small drop of alcohol. The difference is stark. For two hours, the embryo stops moving altogether. We can only wonder at the damage done at that very early stage of pregnancy. International evidence suggests that the damage is done in the early days and weeks in particular.

As the hon. Lady said, the advice is far from clear. On the one hand, people are told not to drink. That seems clear. From the evidence heard by the all-party group, that is the right advice. However, the advice also says that if a woman chooses to drink, she should drink only one or two units. The advice appears inconsistent and contradictory. We took evidence from health professionals, the vast majority of whom do not appear to be aware of the real level of risk and danger. They do not appear to be passing on advice to women planning to conceive or who are pregnant. That is why our inquiry recommended it be made clear that the best thing for mother and baby is for the mother not to drink at all.

I hope that the Minister—I am sure he will—and all who are interested will read the report and carefully consider its recommendations. It is only an initial report—we plan to continue our work—and I hope that he or one of his colleagues will come to one of our meetings to discuss this matter in greater detail. As my hon. Friend the Member for Nottingham North said, early intervention gives us a fantastic opportunity not only to improve the life chances of many people but to save a lot of money. When it comes to the damage done by alcohol during pregnancy, the 7,000 figure, which, from the evidence we received, might well be on the low side, suggests that there is a huge opportunity. I hope that, as a result of the work we have done and the fine work of those Members responsible for today’s report, progress can be made and that the Minister will agree to commission the prevalence study, so that we can start to reduce the number of children damaged every year in this country.

--- Later in debate ---

[The Minister for Community and Social Care (Alistair Burt)]

I thank all colleagues who have taken part in what is a most important debate, despite being the last of this parliamentary term. It was handled in an exemplary way by a number of colleagues who know a great deal about the subject. I commend them for the breadth of interest and knowledge they demonstrated. I thank my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton) and the hon. Member for Dwyfor Meirionnydd (Liz Saville Roberts) for securing the debate through the Backbench Business Committee.

I also pay tribute, as others have done, to my hon. Friend the Member for South Northamptonshire (Andrea Leadsom). The debate has been graced by a number of colleagues who have taken a huge interest in these matters over a lengthy period, often in quiet rooms, talking to people about the issues, and raising them on the Floor of the House. That often unsung work has been vital in giving us the information we need, and a number of hon. Friends deserve real credit for it, not least my hon. Friend the Member for South Northamptonshire.

I congratulate the all-party group for conception to age two—the first 1001 days on relaunching its manifesto, “The 1001 Critical Days”. I popped into the relaunch for a short time, but a few weeks earlier I was grilled by the group’s members on my interest in the subject. I am not the Minister responsible for children’s health, but one of the issues is that a number of different agencies are involved, and I understand very well that one of the requirements of the manifesto is to ensure that they work more closely together. I also have a particular interest in perinatal mental health, which I will spend a bit of time speaking about today. I certainly take the manifesto’s point about the range of different actors that need to be involved, and the fact that we need to work together more effectively. I will be glad to take that message back to colleagues. I thank the all-party group for its work.

I note that the manifesto includes a foreword by Dame Sally Davies, the chief medical officer. I must say that that is probably at least three quarters of the work done. I do not know how many Members have met Sally Davies, but they should know that anything she gets behind tends to happen. I therefore congratulate the all-party group on securing her support, which will be vital.

At the manifesto’s core is a clear and simple message: the first 1001 days of a child’s life are a critical window of opportunity. Prevention and early intervention at that stage can improve outcomes and transform life chances. There is no dispute about that across the House; there is perhaps sadness and regret that more was not done in the past, but we must all start from where we are and make progress. Much work has been done in recent years, and colleagues have been generous in their praise of it, but clearly there is more to do, and the manifesto sets out some of the challenges.

I will make a few general remarks about the speeches we have heard, and then I will refer to others as I go through my speech. The hon. Member for Nottingham North (Mr Allen), who has spent a great deal of time working on early intervention, spoke about the philosophy that was needed to understand this, and he is absolutely right—few could have done more than he has to bring that forward. Some of these issues are cultural; they are about taking people out of silos. He was generous in his praise of my right hon. Friend the Member for Chingford and Woodford Green (Mr Duncan Smith). My right hon. Friend, and I suspect a number of other Members, was much inspired by the work of a chap called Bob Holman—a family worker and an academic who chose to live in Easterhouse in the centre of Glasgow—on social justice. Bob is unfortunately quite ill at present. I would like to send good wishes to him for the remarkable work he has done. He is well known for his work in Scotland, and in the United Kingdom. We are sorry that he is ill and send our best wishes to him and to Annette.

The hon. Members for Foyle (Mark Durkan) and for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) —thank you, John Ronald, who follows on me on Twitter, for helping me with the pronunciation—pointed out the importance of all of us in the British Isles looking to what work is done by one another. I will certainly inform ministerial colleagues of the work being done by the unit at Queen’s University Belfast, and that being done in Scotland, and we can follow that up. I said to the hon. Member for East Kilbride, Strathaven and Lesmahagow after her intervention on mental health that I am keen to see what is being done in other places, and I will follow that up as well. We do have parenting skills classes in England. That provision has been much boosted by the health visitor programme, and it is as vital to us as it is in Scotland. I am sure that others will be interested in looking further at that.

The manifesto highlights the importance of high-quality universal services from conception to age two, which have rightly been described as a “lynchpin”. For the vast majority of women and babies in England, NHS maternity services provide a positive experience and good-quality care. We also have a good, strong, evidence-based universal public health programme—the healthy child programme from pregnancy to age five—which is delivered by health visitors. To strengthen the delivery of the programme, we have increased the number of health visitors by almost 50% in the past four years—one of the most rapid workforce expansions in NHS history. At the same time, the landscape for delivering services to under-fives is changing. On 1 October, responsibility for commissioning nought-to-five public health services transferred to local authorities. This change is of course a challenge for services, but it also presents an opportunity for local leaders to commission and provide more joined-up services for young children and families, across health, education and social care, based on their understanding of local need.

The manifesto contains a number of recommendations, including one mentioned by my hon. Friend the Member for East Worthing and Shoreham about the attachment needs of families:

“Childminders, nurseries and childcare settings caring for under 2s must focus on the attachment needs of babies and infants, with OFSTED providing specific guidance on how this can be measured effectively.”

The Government absolutely agree. Personal, social and emotional development is one of the three prime areas of the early years foundation stage curriculum, and forming positive relationships, including with adults, is key to this. I will ensure that my colleagues in the Department look particularly closely at that recommendation, for attachment is absolutely crucial.

My hon. Friend the Member for Congleton (Fiona Bruce) and the hon. Member for Sefton Central (Bill Esterson) raised foetal alcohol issues. I commend them for the report that has, I think, come out today, following the inquiry by the all-party group on foetal alcohol spectrum disorder.

[Bill Esterson]

It is on its way to you.

[Alistair Burt]

Thank you very much.

It is too early to respond to the report, but I can say that it is really important. It is not like a Select Committee report, in that the Government do not have a duty to respond to it, but I would be extremely surprised if colleagues did not want to do so in due course, because it is so important. The official advice given is this:

“Our advice remains that women who are trying to conceive or are pregnant should avoid alcohol…If women choose to drink, to minimise the risk to the baby, they should not drink more than one to two units of alcohol once or twice a week and should not get drunk.”

We will shortly publish a consultation on the UK chief medical officer’s alcohol guidelines review. This will offer an opportunity to work with clinicians and other professionals to ensure that they are fully informed about the content of the guidelines and able to explain them to the women they care for and help them make informed choices on alcohol consumption. I would imagine that the substance of the inquiry ought to form part of that consultation and discussion. I think that the most important part of the advice is:

“Our advice remains that women who are trying to conceive or are pregnant should avoid alcohol”.

[Bill Esterson]

I am grateful to the Minister for those comments. The international examples given by his colleague the hon. Member for Congleton (Fiona Bruce) are very clear. The advice is not in two parts; it is a simple, single piece of advice: the best advice for mum and baby is to not drink at all. That is what happens around the world. The Minister has mentioned Dame Sally Davies. I hope she will agree with that and that that is what we will end up with, because it would make a massive difference.

[Alistair Burt]

I absolutely understand the hon. Gentleman’s point and hope that comes to pass. The Government will respond in due course.

I am the Minister with responsibility for mental health, which was raised by the right hon. Member for North Norfolk (Norman Lamb) in particular and the hon. Member for Ellesmere Port and Neston (Justin Madders).

Oral Answers to Questions

Bill Esterson Excerpts

Tuesday 17th November 2015 Commons Chamber

[Alistair Burt]

I thank my hon. Friend for the question. Autism is certainly a growing area of identified special educational need across the country that requires an increasing range of provision to meet the diverse needs of the population. Although it would be inappropriate for me to comment on a particular free school application, where it is needed, a special free school can add to the local continuum of provision, by providing specialist places and specialist expertise that can be shared more widely.

[Bill Esterson (Sefton Central) (Lab)]

The all-party group on foetal alcohol spectrum disorders took evidence last week about the link between alcohol consumed by mothers during pregnancy and the growing incidence of learning disability and autism. In Canada, this has been widely known for many years, and the Canadian Government at national and federal levels have invested heavily in raising awareness. When can we expect the same in this country?

Oral Answers to Questions

Bill Esterson Excerpts

Tuesday 13th October 2015 Commons Chamber

[Rushanara Ali (Bethnal Green and Bow) (Lab)]

5. How much additional investment there will be in children and young people’s mental health services in 2015-16.

[Bill Esterson (Sefton Central) (Lab)]

7. How much additional investment there will be in children and young people’s mental health services in 2015-16.

[The Minister for Community and Social Care (Alistair Burt)]

We are investing an additional £173 million this year, which includes £30 million specifically for eating disorders. We are taking a targeted and phased approach to the additional investment to develop capacity and capability across health, education and children’s services, from prevention and resilience building to supporting the most vulnerable.

--- Later in debate ---

[Alistair Burt]

The hon. Lady makes a fair point. While we invest money nationally in services, people complain that locally clinical commissioning groups have not been funnelling the money down. Two things should help: first, for the first time the national access and working time targets, which the Government have introduced, will provide a means of monitoring what CCGs are doing; and, secondly, the new scorecard for CCGs will look explicitly to ensure that a proportion of the increase to a CCG goes into mental health services. The hon. Lady will also be pleased to know that in her own CCG area there will be an extra £521,000 for children’s mental health services.

[Bill Esterson]

Some 23% of the adult prison population were in care as children and many of them have poor mental health. Will the Minister ensure that mental health services are in place for children in care to make the greatest contribution possible to improving their life chances, and not least to ensure we reduce the numbers ending up in prison?

[Alistair Burt]

Yes, the hon. Gentleman makes a point made by successive Governments: care outcomes are terrible and the earlier the intervention the better. We are encouraging the engagement of early prevention therapies, including for those in care, and for the first time the Government have appointed a dedicated mental health Minister, in the Department for Education, further to promote resilience and work more closely with young children, including those in care.

Oral Answers to Questions

Bill Esterson Excerpts

Tuesday 7th July 2015 Commons Chamber

[Mr Hunt]

We will of course publish how we are going to make these efficiency savings. We have already started with a crackdown on agency spend and a crackdown on consultancy spend, and with the work that Lord Carter, a Labour peer, has done to improve hospital procurement and rostering.

Let me gently say to the hon. Gentleman, however, that he went into the election promising £2.5 billion more for the NHS—£5.5 billion less than we did—and most of that was from the mansion tax that Labour now says was a bad idea. So there would have been nearly £8 billion more of efficiency savings under Labour’s plans than under this Government’s plans, and he should recognise the progress we are making.

[Bill Esterson (Sefton Central) (Lab)]

13. What recent assessment he has made of the implications for his policies of guidance from the chief medical officer on the consumption of alcohol by pregnant women.

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

We know that too many women may be unaware of the health risks from drinking during pregnancy. The chief medical officer’s review of the alcohol guidelines—the hon. Gentleman knows, because we have spoken about it—includes consideration of the Government’s advice on drinking during pregnancy. The UK chief medical officers are meeting to discuss this in September, and we expect to consult on the new guidance in the autumn.

[Bill Esterson]

I thank the Minister for her answer and remind Members that 7,000 children are damaged every year from irreversible brain damage as a result of alcohol consumed by their mothers during pregnancy. I urge the Minister please to clear up the confusion in the advice available to pregnant women at the moment, which on the one hand says, “Do not drink at all”; and on the other hand says, “If you do drink, have only one or two units”.

[Jane Ellison]

The message is actually very clear, as we have labelling on over 90% of bottles. As the hon. Gentleman knows from the debates we have had on the subject, it is a difficult area and there is no consistent evidence of adverse effects from low to moderate pre-natal alcohol consumption. I have talked this through with the chief medical officer: we have to get the balance right between warning women and responding to the important stats the hon. Gentleman has mentioned, without causing unnecessary worry for the around 50% of women who do not plan their pregnancy and might have drunk alcohol before they realised they were pregnant.

NHS Success Regime

Bill Esterson Excerpts

Thursday 4th June 2015 Commons Chamber

[Ben Gummer]

Every single aspect that is troubling local health economies, including recruitment, I understand, will be within the scope of success regimes.

[Bill Esterson (Sefton Central) (Lab)]

Having listened to the Minister’s answers, it seems to me that patients have every right to be worried about whether care is safe in the NHS. Does he not realise that, unless the Government reverse the cuts in social care, the problems in patient care will not be resolved anywhere in the NHS—not just in the areas covered by the so-called success regimes?

[Ben Gummer]

May I gently remind the hon. Gentleman that this Government and their predecessor changed the culture of trying to suppress bad news, whether on care or money, and instead tried to understand what was best for patients, even when that meant facing up to difficult decisions? That is precisely what NHS England is doing with the success regime, and that is why we are addressing seriously challenged local health economies, rather than pretending that there is not a problem, which I am afraid was the attitude of the Labour Front-Bench spokesman when he was in power.

Health and Social Care

Bill Esterson Excerpts

Tuesday 2nd June 2015 Commons Chamber

[Mr Hunt]

I understand that geographical isolation is a particular issue and may have led to some of the problems at the trust that the hon. Gentleman and I have discussed on many occasions. We need to be sensitive to that in helping the standard of services to improve going forward.

[Bill Esterson (Sefton Central) (Lab)]

Will the Secretary of State give way?

[Mr Hunt]

I will just make some progress.

Prevention also means transforming mental health services. I paid tribute earlier to my former colleague the right hon. Member for North Norfolk (Norman Lamb), who did a terrific job. I welcome in his place my right hon. Friend the Member for North East Bedfordshire (Alistair Burt), the Minister for Community and Social Care, who I know will build on his legacy. It also means a big focus on public health, especially tackling obesity and diabetes. It remains a scandal that so many children are obese. I know that the Under-Secretary of State for Health, my hon. Friend the Member for Battersea (Jane Ellison), is working hard on a plan to tackle those issues.

We must continue to make progress on cancer. We have discussed some of the measures that we need to take, but independent cancer charities say that we are saving about 1,000 more lives every month as a result of the measures that have already been taken. We want to build on that.

We have also talked about technology a number of times today. It will remain a vital priority to achieving the ends that I have described. In the last Parliament, I said that I wanted the NHS to be paperless by 2018. In this Parliament, I would like us to go further and be the first major health economy to have a single electronic health record shared across primary, secondary and social care for every patient. Alongside that, our plans to be the first country to decode 100,000 genomes will keep us at the forefront of scientific endeavour, ably championed by the Minister for Life Sciences, my hon. Friend the Member for Mid Norfolk (George Freeman).

--- Later in debate ---

[Mr Hunt]

The hon. Gentleman is right to raise that issue. The previous Minister with responsibility for mental health set up the crisis care concordat, which he got all parts of the country to sign up to, to provide better care. There is a big issue with the quality of child and adolescent mental heath services provision. We want to cut waiting times for people in urgent need of an appointment, so I recognise the problem and I hope that the hon. Gentleman will give us some time to bring solutions to the House.

[Bill Esterson]

rose—

[Mr Hunt]

I said that I would not give way again, but I will take one final intervention.

[Bill Esterson]

The Secretary of State has spoken of the importance of people’s ability to secure hospital appointments. The same applies to GP services, but when I wrote to him about my constituents’ difficulties in securing appointments with their GPs, he told me that that was the responsibility of NHS England, not his Department. Will he now recognise that he must take responsibility for dealing with the problems of GP surgeries, so that my constituents, and those of every other Member, can make appointments with their family doctors when they need them?

[Mr Hunt]

I absolutely do recognise that. One of my key priorities is to deal with the issues of GP recruitment and the GP contract, and to make general practice an attractive profession again. If we are to deal with prevention rather than cure, vulnerable older people in particular will need more continuity of care from their GPs, and we must help GPs to provide it.

None of those big ambitions will be achieved, however, if we do not get the culture right for the people who work in the NHS. One of the reasons that Mid Staffs—and, indeed, so many other hospitals—was in special measures was the legacy which, for too long, put targets ahead of patients. We should never forget that Mid Staffs was hitting its A&E targets for most of the time during which patients in the hospital were experiencing appalling care. In that context, Sir David Nicholson used the phrase “hitting the target and missing the point”.

Through the toughest inspection regime in the world, we are slowly changing the culture to one in which staff are listened to and patients are always put first. However, although we identify hospitals that are in need of improvement much more quickly, we are still too slow in turning them around. I know that the new hospitals Minister, my hon. Friend the Member for Ipswich (Ben Gummer), will be looking closely at that, and I warmly welcome him to my team. Like me, he believes it is wrong that we have up to 1,000 avoidable deaths every month in the NHS, that twice a week we operate on the wrong part of someone’s body, that twice a week we leave foreign objects in people’s bodies, that almost once a week we put on the wrong prosthesis, and that people die because they are admitted on a Friday rather than a Wednesday.

We will leave no stone unturned in our quest to make a seven-day NHS the safest healthcare system in the world. Nye Bevan’s vision was not simply universal access or healthcare for all. The words that he used at this Dispatch Box nearly 70 years ago, in 1946, were “universalising the best”, which meant ensuring that the high standards of care that were available for some people in some hospitals were available to every patient in every hospital. Our NHS can be proud of going further and faster than anywhere in the world to universalise access, but we need to do much more if we are to complete Bevan’s vision and universalise quality as well. The safest, highest-quality care in the world, available seven days a week to each and every one of our citizens: that must be the defining mission of our NHS, and this Conservative Government will do what it takes to deliver it.

National Health Service

Bill Esterson Excerpts

Wednesday 21st January 2015 Commons Chamber

[Andy Burnham]

My hon. Friend makes his point very well. This is what we must challenge as we move forward. Before the general election, people need the facts about what is happening to the NHS. There has been a big drop in the number of nurses working in the community, as my hon. Friend mentioned, and these are the facts that we need to bring home to people.

It is not just the fact that the GP headcount has gone down. One of the present Government’s first acts was to scrap the guarantee of an appointment within 48 hours and incentives to open GP surgeries in the evenings and at weekends. That, combined with cuts to the GP budget, means that it has got harder and harder to get a GP appointment in recent years. The constituents of all the Members present say, “I am ringing the surgery at 8 or 9 every morning and being told that nothing is available for days.” In 2010, the vast majority—80%–of people said they could get an appointment within 48 hours; now, according to the GP survey, one in four people say they must wait a week or more to see a GP.

[Bill Esterson (Sefton Central) (Lab)]

One of the problems in my constituency is that GP surgeries are relying on locums because it is not possible to find GPs to recruit on a full-time basis. Those locums provide a very erratic service; sometimes there is not even a locum available. That is adding to the problem, because as a result, all that is left to people is to go to A and E. I am sure that my right hon. Friend agrees that that is one of the contributory factors, and it proves his point that a chronic shortage of GPs has come about under this Government.

[Andy Burnham]

That is an absolutely vital point. It is not just about GP locums; there are also A and E locums. The Government have, throughout, cut training places, which were another victim of the reorganisation. Ever since then, the number of places commissioned for doctors—and nurses, I might say—has gone down. That leaves us with a bill for agency staff that is literally out of control—it has gone through the roof—and that means that money is now being siphoned out of the NHS at an alarming rate. That is mismanagement; that is what has happened. How must staff working in the NHS feel when they see the bill for agency staff spiralling in this way and know that they will not even get a 1% increase from this Government? They will draw their own conclusions about how this Government value them.

Oral Answers to Questions

Bill Esterson Excerpts

Tuesday 13th January 2015 Commons Chamber

[Mr Hunt]

But we are taking measures. That is why we have 2,000 more doctors and 5,000 more nurses compared with a year ago. Frankly, the last thing those doctors and nurses on the front line want is scaremongering by the right hon. Gentleman—posters saying that the NHS might cease to exist under this Government; and leaflets like the one I have here from Lancaster saying that the local hospital might close. We are backing the NHS with more doctors, more nurses, more resources and a long-term plan. Will he now back the NHS by disowning this kind of scaremongering and stop trying to weaponise the NHS?

[Bill Esterson (Sefton Central) (Lab)]

3. What the average waiting time was for a GP appointment in the most recent period for which figures are available.

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

The latest GP survey results suggest that the majority of patients can get GP appointments at a time convenient to them, but we want to do more. We are offering 7.5 million more people evening and weekend appointments through the Prime Minister’s £100 million challenge fund. NHS England does not directly collect data for GP waiting times.

[Bill Esterson]

I think many people up and down the country will be surprised by the Minister’s answer, including my constituent Lynne Taylor who had a chest infection but was sent to A and E by a locum because of a lack of appointments at her GP surgery. That was done on the phone without seeing her. The A and E doctors told her that she certainly should not have been sent to A and E. Will the guarantee of a GP appointment within 48 hours help patients like Ms Taylor who need to see their own doctor? Would that not also be a big step in reducing the huge pressure on A and Es?

[Dr Poulter]

I hope the hon. Gentleman will be reassured to hear that, according to the latest GP survey, 87% of patients in Southport and Formby clinical commissioning group were able to get an appointment or to see somebody they wanted to see at an appropriate and convenient time. It is important to note that Labour’s 48-hour target did not work. From 2007 to 2010, the percentage of patients who were able to get an appointment within the 48-hour target actually fell.

A and E (Major Incidents)

Bill Esterson Excerpts

Wednesday 7th January 2015 Commons Chamber

[Mr Hunt]

I am sorry to hear the news about the chief executive at Watford. I am aware of the pressures there and I agree with my hon. Friend about the need for stability in management as much as possible over the next few months.

[Bill Esterson (Sefton Central) (Lab)]

One of my constituents wrote to me about her elderly mother who faced a wait of many hours for an ambulance to A and E. My constituent told me that at A and E she saw patients on trolleys backed up through the corridor to ambulances waiting in the car park. Meanwhile, patients were waiting at home, unable to get those same ambulances. She described the scene as “a war zone”. Is it not the case that A and E is unable to cope, the ambulance service is unable to cope, and patients who need to go to A and E are suffering?

[Mr Hunt]

I agree that there are real pressures in A and E across the system, but it is important to remind the public that even under that pressure, nine out of 10 people continue to be seen, treated and sent home within four hours. That is an extremely impressive record for the people working very hard in our A and E departments.