Hospice Funding

Clive Efford Excerpts

Thursday 19th December 2024 Commons Chamber

[Karin Smyth]

To govern is, indeed, to choose. The Conservative party chose neither this sector nor any other health sector and it refused to govern. Within five months, we have not only increased the funding to the health sector to stabilise it but made today’s announcement.

Beneath all that, there might have been a welcome for the announcement—I am not entirely sure—whereas the sector is pleased to have the money. The chief executive of Hospice UK said:

“This funding will allow hospices to continue to reach hundreds of thousands of people every year with high-quality, compassionate care. We look forward to working with the government to make sure everyone approaching the end of life gets the care and support they need”.

The chief executive of Haven House children’s hospice said that it is

“very positive to hear about the government’s plan to invest significantly in the wider hospice sector; we hope that there will be as much flexibility as possible to determine locally how this new money is spent.”

This is an important issue for many hon. Members, and we look forward to working with the sector in the new year on the specifics of the announcement.

[Clive Efford (Eltham and Chislehurst) (Lab)]

This is a very welcome announcement and I am sure the hospices are breathing a sigh of relief after the level of funding they endured for 14 years under the Tories. If we are to move palliative care out of hospitals and into care situations or people’s homes, the money needs to be passported to the hospice sector for it to play its part. Integrated care boards have been charged under the Health and Care Act 2022 to provide that funding. Will the money go through ICBs or will it be passported straight to the hospice sector?

[Karin Smyth]

My hon. Friend makes an important point about the need for more people to be treated at home. That is absolutely the direction of travel that we want to see. This money will help, for example, with technology to support more people to be treated at home. ICBs are responsible for commissioning and allocating funding, so that will be done in the normal way.

Musculoskeletal Conditions

Clive Efford Excerpts

Tuesday 17th December 2024 Westminster Hall

[Clive Efford (in the Chair)]

I understand that Sonia Kumar has agreed that another hon. Member can make a contribution. I will then go straight to the Minister. As is the convention with half-hour debates, there will be no opportunity for the mover to sum up at the end.

[Sonia Kumar (Dudley) (Lab)]

I beg to move,

That this House has considered the diagnosis and management of musculoskeletal conditions.

I am grateful for the opportunity to have this debate. As chair of the all-party parliamentary group on osteoporosis and bone health, and as an advanced practice physiotherapist and first-contact practitioner, musculoskeletal health is my speciality. I am here to discuss the provisions needed to improve the diagnosis and management of MSK conditions.

My experience as an advanced practice physiotherapist is very much autonomous. I do not think many people know that physiotherapists work from paediatrics all the way to elderly care—from nursery all the way to palliative care. Most people do not know the work of a first-contact practitioner, which is a new service in which physiotherapists work with GPs to diagnose, assess and refer to secondary care, if needed. I was part of that vital service at Dudley Group hospitals, so I declare my interest as working on the bank there.

MSK physiotherapists work not only across hospitals and primary care but also in tertiary care. They work in fracture clinics, rheumatology, pain management and A&E. Not many people realise what we do. MSK physiotherapists are the specialists and experts in musculoskeletal diagnosis. That could include referring people for X-rays to look for suspicion of fractures or for MRI scans to look for sinister pathology, a differential diagnosis, masqueraders that look like Pancoast tumours, metastases or spinal or multi-joint cysts. Along with ultrasounds, guiding injections and prescribing, the scope of physiotherapists has expanded year on year, to a point where they are now specialising and moving their practice on to do simple surgeries, such as carpal tunnel releases.

I look not only from a diagnostic point of view but at the importance of managing MSK conditions, including in respect of rehabilitation.

--- Later in debate ---

[Sonia Kumar]

Of course. One of the things MSK physiotherapists look at is spinal fractures, 70% of which happen in the thoracic spine, generally in older women who have had poor bone health. It is essential to look after bone health from a really early age, while women are in their 40s, so that when they are older, in their 50s, 60s, 70s and 80s, they are on the right medication and doing bone health exercises to help for the future. For MSK conditions and osteoporosis, physiotherapists are essential. Spinal fractures are very often undiagnosed, and those who suffer spinal fractures as they get older are more likely then to have a hip fracture, after which the mortality rate becomes really high. My hon. Friend makes a very good point.

Let me explain why MSK physiotherapists and MSK care are so important. By 2035, two thirds of the population are expected to have two or more long-term conditions, which include MSK conditions. Versus Arthritis reports:

“Arthritis and related musculoskeletal conditions affect 20.3 million people in the UK.”

That means that one in six people has arthritis, which is a staggering amount. MSK conditions cost the NHS £5 billion a year, accounting for one in five GP appointments, 1.6 million hospital admissions and 30 million prescriptions a year. People with low confidence who feel that they cannot manage their conditions are more likely to attend hospital, while those who are most confident with long-term conditions have 38% fewer hospital admissions.

That is what we can do for the economy, but this issue is also about first-contact practitioners, as I mentioned at the beginning. With first-contact practitioners, we can save so many GP appointments. It is part of the long-term plan, which has been created to improve the impact on GP care and allied health professions that work in general practice. Working adults with MSK conditions are twice as likely to be economically inactive compared with those with long-term conditions. Of the people who are economically inactive due to ill health, 21% report having MSK conditions. It is about not just health but the economy and the wellbeing of the society that we are hopefully building together now that we are in government.

It is really important that we look at this issue in a holistic way. MSK conditions affect not just affect somebody’s mental health but their relationships and how they build them. They affect whether they can get into bed and sleep well, as well as their sleep hygiene. Perhaps a person eats poorly because they cannot get out, so they put on lots of weight. A person’s emotions, self-esteem and ability to work can be affected. I do not believe there is a silver bullet or that if we manage MSK conditions it will just fix one part. It has to be effective in respect of all the facets of somebody’s general wellbeing. We cannot tackle waiting lists and return people to work without that, and we need a strong workforce to plough back into the economy. It is incredibly important for people to understand that it is about holistic management and how we can improve health literacy and self-efficacy for people with MSK conditions.

I came to this debate to talk about solutions, as I am a solution-led person. We need to recognise the allied health professions in the NHS and build a workforce for MSK physios. That includes not just MSK physios but paramedics, podiatrists and every single person in the 14 allied health professions, all of which help to build resilience in the NHS, reduce waiting lists and build a healthier society.

MSK assessments need to happen from day one in nursery. We cannot expect paediatrics or care to be delivered well if we wait until the future, look back and say, “We should have done a better job when that person was younger.” If we looked at MSK conditions from day one—early in a child’s development and in their early years of support—there would not be a massive impact on society later in that person’s life because of having to do delayed diagnosis with multiple appointments and to look after their general wellbeing.

We also need to embed into society notions of what good health looks like from day one. That includes keeping active, going to classes and going to rehabilitation. We need a bigger awareness campaign about what being well looks like. It should not just be that the person leaves school and that is it; it needs to be lifelong. In the same way that people do continuous professional development, they should learn what looking after their body entails, and that should be translated into health policy.

We also need to increase the scope of physiotherapists’ practice. At the moment, they do not do DEXA scans, but they look at bone health in every other way. We look at X-rays, and work in fracture clinics, rehabilitation and trauma orthopaedics, but we do not look at the full picture of bone health. Will the Minister consider inputting that in future?

We need to increase the roll-out of community appointment days. We must provide same-day services for patients, including assessments, advice, health promotion and rehabilitation, and the community and volunteer sectors should provide support in a non-medicalised environment. If somebody has shoulder, knee or back pain, there should be a one-stop shop where they can be assessed appropriately, and they can then move on and get the right care at the right time.

We also need to put community care services on high streets and in places of worship. There are people who are not getting access, and there are massive health inequalities, so how do we promote care and health in difficult-to-reach communities? I would love to see care being put into places of worship and other locations people do not normally think of. I very much welcome the fact that the Government are already moving away from hospital care.

We also need to increase the number of first-contact practitioner places. A consultation with an FCP physio is £30 cheaper than the traditional GP-led pathway. MSK issues are one of the most common reasons to visit GPs, accounting for about 20% to 30% of appointments. Will the Minister meet me to discuss more of the solutions that I think need to be put forward to manage MSK issues? Would he be happy to visit my constituency to look at our fracture liaison service? I hope we will continue to fund that and that the service will be rolled out nationally.

[Clive Efford (in the Chair)]

I call Lizzi Collinge.

[Lizzi Collinge (Morecambe and Lunesdale) (Lab)]

I was told that I would not be able to speak today, and that I could merely intervene, but I am happy to speak if you allow it, Mr Efford.

[Clive Efford (in the Chair)]

I was told that it had been arranged for you to speak.

[Lizzi Collinge]

Excellent news. It is a pleasure to serve under your chairship, Mr Efford. I apologise for the confusion.

Musculoskeletal conditions are very serious, particularly when looked at through the lens of the health and social care workforce. In Morecambe and Lunesdale, 27% of the sickness rate in the health and social care workforce is caused by musculoskeletal conditions. It is clear that if we want to fix our health and social care workforce, we must fix the prevention, diagnosis and treatment of musculoskeletal conditions.

As my hon. Friend the Member for Dudley (Sonia Kumar) pointed out, the conditions do not just have a physical impact, affecting mobility and the ability to work, but can have a particularly serious effect on people’s mental health, relationships and ability to live their life to the full. I believe that health and social care and public health should be framed around allowing people to live their absolute best lives. They need to focus on enabling individuals, whether or not they have long-term health conditions, to work, socialise and have a good family life.

I am passionate about preventing ill health as much as possible. We must prevent musculoskeletal conditions, which can cause a lot of pain and discomfort. I welcome the proposals set out by my hon. Friend, and I look forward to hearing from the Minister about the Government’s plans.

Infected Blood Inquiry

Clive Efford Excerpts

Tuesday 19th November 2024 Commons Chamber

[The Paymaster General and Minister for the Cabinet Office (Nick Thomas-Symonds)]

I beg to move,

That this House has considered the Infected Blood Inquiry.

I am grateful for this opportunity to come before the House to update it on this vital issue and discuss the findings of the infected blood inquiry’s final report. We are now almost six months on from the publication of that report. I am pleased to have the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Gorton and Denton (Andrew Gwynne) with me on the Government Front Bench today. He will lead on the elements of the inquiry report that are matters for the Department of Health and Social Care. We are as one in our determination to drive forward this vital work and deliver action on the findings of the infected blood inquiry’s report. That is the very least that the infected and affected victims of this appalling injustice deserve.

As right hon. and hon. Members will be aware, I have made a number of statements to this House regarding the progress the Government have made on the compensation scheme. Today is an opportunity to go beyond that and cover the wider issues raised in Sir Brian Langstaff’s report. I am grateful to colleagues across the House for their engagement on this matter. I know that we are united as a House in seeking to deliver justice, in so far as it is possible, for this terrible scandal. We will not shy away from the appalling findings of the inquiry’s report and the horrors that have been inflicted on the infected blood community. I reiterate my thanks today to Sir Brian Langstaff and his team for that comprehensive report. Crucially, I thank the community themselves. I recognise the anger and the mistrust that many, quite understandably, hold towards public institutions that have let so many people down so badly.

When the infected blood inquiry reported in May, the now Prime Minister and I were clear that an apology is meaningful only if it is accompanied by action. It is action that we are taking. That is why I was so determined to move quickly to establish the infected blood compensation scheme and why I expect to see payments begin by the end of this year. The Prime Minister committed to delivering the Hillsborough law to help address the institutional defensiveness so powerfully exposed by Sir Brian’s report.

Today, I want to update the House on the work we are driving forward across the other key findings of the report to do everything possible to ensure that an injustice such as this is never allowed to happen again. I welcome the fact that my right hon. Friend the Chancellor provided, for the very first time, specific funding for the compensation fund: £11.8 billion in the Budget. That makes clear the scale of this Government’s commitment to justice, and I am proud that we are driving that work forward. Compensation delayed for generations will be delivered.

[Clive Efford (Eltham and Chislehurst) (Lab)]

My right hon. Friend rightly pays tribute to Sir Brian Langstaff. Everyone should be grateful to him for what he has done. In recommendation 14 of his second interim report, he was quite clear that the compensation body should be at arm’s length from Government and chaired by a completely independent judge with sole decision-making powers. Do the Government accept the core of that recommendation?

[Nick Thomas-Symonds]

The Infected Blood Compensation Authority has operational independence. The Government have stewardship over the amount of money allocated. As my hon. Friend will appreciate, the £11.8 billion is a huge and substantial commitment. I do not pretend for a moment that any amount of money can actually provide recompense for the scale of the injustice, but at the same time it is an indication of the commitment—from the Prime Minister, the Chancellor and across the Government—to deliver justice.

In saying that, I should say that I am grateful for the work and co-operation of hon. Members across the House. In particular, I once again thank my predecessor as Paymaster General, the right hon. Member for Salisbury (John Glen), for his efforts in government. As I indicated in the debate last week, I look forward to continuing to work in that spirit with the new shadow Paymaster General, the right hon. Member for Basildon and Billericay (Mr Holden), on this hugely important issue. I also thank my ministerial colleague, my right hon. Friend the Member for Kingston upon Hull North and Cottingham (Dame Diana Johnson), and the former Member for Worthing West. Their tireless campaigning and representation of the community’s interests over so many years has been invaluable.

Much progress has been made in responding to Sir Brian’s report, but much more remains to be done. I will set out the Government’s fuller response to the recommendations to the House in line with the timetable Sir Brian set out, but I hope in the course of this debate to assure right hon. and hon. Members, and most importantly those in the community, that we have listened, we have learned and we are taking long overdue action.

The inquiry’s report is persistent in uncovering the truth, unshakeable in its honesty and damning, frankly, in its criticisms. It is absolutely clear that fundamental responsibilities of patient safety in healthcare were repeatedly ignored, and that

“what happened would not have happened if safety of the patient had been paramount throughout.”

The culture of wilful ignorance runs through the report, and continued to proliferate as the scandal developed. It speaks to Governments across decades and a state more focused on discharging its functions, whatever the risk and whatever the cost. The report chronicles suffering of almost unimaginable scale: thousands of people died prematurely and continue to die every week; lives completely shattered; evidence destroyed; victims undermined; families devastated; and children used as objects of research.

It is a truly horrifying injustice.

However, Sir Brian’s report goes much further. He lays bare the institutional defensiveness that existed within the Government, and indeed the civil service, which led to the truth being hidden for so long, compounding the pain and the injustice. Sir Brian highlights

“the consequences of civil servants and ministers adopting lines to take without sufficient reflection, when they were inaccurate, partial when they should have been qualified, had no proper evidential foundation…or made unrealistic claims that treatment had been the best it could be.”

These actions are the very antithesis of public service, and that is why I know there is such collective determination to learn the right lessons and to act on them.

There is so much that can be said about the volumes of evidence that Sir Brian has uncovered, and I know that during this debate many Members will raise vital issues, but let me be absolutely clear: the report details utterly unacceptable failings on a chilling scale, and this Government will do everything in their power to address them. Through acting on these lessons, we must ensure that all those who have suffered, and those who have campaigned, have not done so in vain.

Let me now turn to the 12 recommendations that the inquiry made in its report. First, I will touch briefly on the progress that has already been made. I know that Members on both sides of the House are keen to hear the details of what the Government intend to do in response. The recommendations are wide-ranging, and are being given full consideration. As I have said, I will provide an update to Parliament by the end of the year against each and every one of those recommendations.

I will begin with compensation. I have already updated the House on a number of occasions on the progress that is being made. I am grateful to Members on both sides of the House for their contributions to the debate on the regulations that we have made to establish the Infected Blood Compensation Authority and the core route for compensation for infected people, but I am also grateful, crucially, for the support there has been throughout the House to ensure that the delivery of compensation is not delayed in any way by Parliament.

--- Later in debate ---

[Clive Efford (Eltham and Chislehurst) (Lab)]

I pay tribute to my hon. Friend the Member for Gedling (Michael Payne) for his maiden speech. It is clearly special for him to represent the area in which he grew up. He has so much personal experience and memories, and he spoke passionately about his family. I am sure they are very proud of him today, and that he will be an excellent representative for Gedling. I remember his Labour predecessor well. We were both elected on the same day, and perhaps I can challenge my hon. Friend a little and say that he has big boots to fill as his predecessor was an excellent Member of Parliament.

It is worth reminding ourselves of how we got to this stage. In spite of everything we have heard about the excellent progress being made in response to Sir Brian Langstaff’s report, there is still an enormous amount of frustration out there among victims and their families. In the 1970s and 1980s, as many as 6,000 people with haemophilia and other bleeding disorders were treated with factor concentrates contaminated with HIV and hepatitis viruses. Almost all of them were infected with hepatitis C, and around 1,250 people, including 380 children, were also infected with HIV. Some of those unintentionally infected their partners or other family members. More than three quarters of those infected with HIV have since died, as have around one third of those infected with hepatitis C. Of those still alive, many are in poor health due to liver damage, or from living with long-term HIV. Additionally, around 26,800 people were given blood transfusions that were infected with hepatitis C. All that was avoidable.

By the 1970s, blood and blood products were already known to transfer viruses. It was known that the use of pooled blood products significantly increased the risk of infections. Those risks were ignored by leading clinicians, Ministers and civil servants, and they failed to take appropriate action to end the use of those products and ensure the use of safer products. Pharmaceutical companies and leading clinicians did not share appropriate information about risks with patients and patient groups. They failed in their duty of candour. It is no wonder that the victims of those crimes mistrust the state—the state that should be there for them, to protect them and be on their side.

We are here because, despite many dying along the way, and with one victim dying every four days, the surviving victims refused to give up. They refused to be defeated. They won their battle, and over and above that they won the right to be included in the decisions, as Sir Brian Langstaff made clear in his report. All along, the victims have been lied to, refused access to information, their records have mysteriously gone missing, and more recently they have found themselves repeatedly let down by the Government, it has to be said, in the form of the Cabinet Office.

The Cabinet Office controls the decisions of the Infected Blood Compensation Authority. I hear what the Paymaster General and Minister for the Cabinet Office said to me earlier about operational independence, but ultimately the Cabinet Office is making the decisions and victims are not included in the way that Sir Brian recommended. Victims feel that decisions are being made without their involvement. Those suffering with hepatitis C feel particularly excluded and do not feel that their suffering has been fully recognised in the compensation scheme.

In his interim report, Sir Brian Langstaff said that there should be an arm’s length body. I will not read the whole recommendation, but he said:

“I recommend that an Arms Length Body…should be set up to administer the compensation scheme, with guaranteed independence of judgement, chaired by a judge of High Court or Court of Session status as sole decision maker”.

The report goes on to state that the body should

“involve potentially eligible persons and their representatives amongst those in a small advisory panel, and in the review and improvement of the scheme; and…permit the hearing of applicants in person.”

None of that is part of the compensation process, yet it is clearly there in the report, and it was Sir Brian Langstaff’s intention that the victims should be involved much more.

[Nick Thomas-Symonds]

In terms of listening to the victims, there was an extensive consultation exercise during the general election campaign. My predecessor set that up, and it continued under the aegis of civil servants in that period. Afterwards, 74 recommendations were made, having listened to the community about changing the scheme. The Government accepted the implementation of 69 of those 74 recommendations. I suggest to my hon. Friend that that shows listening to the concerns about the scheme’s original formation. In respect of the Infected Blood Compensation Authority, I strongly recommend that he, as chair of the APPG, meets Sir Robert Francis and David Foley. He can speak to them about precisely the involvement of the infected blood community, which is hugely important.

[Clive Efford]

I am fully aware of the consultation that took place, but what Sir Brian Langstaff describes is the ongoing involvement of the victims in the process, by their being part of an advisory panel and continuing to advise the compensation board.

I know that David Foley was at the conference at the weekend for the organisation that represents people with hepatitis. That organisation was pleased with the discussions it had with him, but none the less and in spite of that, people who were at that conference have since made clear to me that they feel frustrated and that, ultimately, the Cabinet Office is in control of the decision-making process. My right hon. Friend may take issue with that, but he should take note of the fact that that belief is out there, and we need to deal with it.

[Pete Wishart (Perth and Kinross-shire) (SNP)]

The hon. Gentleman is right to labour the point. All that we are hearing from the representative groups—those who make sure that they represent all those in the infected or affected communities—is that they want consultation with Government. They just want to be listened to and properly consulted as all these regulations are designed going forward. The hon. Gentleman is absolutely right. I do not understand the Minister’s sensitivity around all this. He has to be aware—I am pretty certain that he is—that there is this sensitivity when it comes to the community.

[Clive Efford]

I could not agree more with the hon. Gentleman. I am trying to make my right hon. Friend the Paymaster General aware of the strength of feeling out there that needs to be addressed. We will not satisfy people about the process unless we address those concerns.

One thing driving that concern is that the current process is not what was described in Sir Brian’s report, and it is not what was expected at the time he published his reports. The victims and their representatives feel excluded. On top of that, they feel enfeebled because of the lack of resources for advice and advocacy. There is further to go, if the victims are to have complete faith in the process. There is frustration that the people they have been battling against have been put in charge of the reparations. Surely my right hon. Friend can see their concerns. The death rate is now one every three days, and the increase in the rate is largely due to the fact that those with hepatitis have been suffering with long-term chronic liver disease. The Red Book for the Budget sets out that compensation will be paid over five years. At that rate, another 600 people will die without getting justice. The Treasury must not become another reason for justice for victims being delayed. Will my right hon. Friend guarantee that that will not be the case?

I am aware that Sir Brian Langstaff has written to my right hon. Friend about the rule on siblings of 18 years of age at the time the sibling passed away. Will he explain to the House—or write to me on this—exactly where that ruling came from? It does not seem to appear in any of the recommendations or in Sir Brian’s report.

I have spoken before about the £15,000 offered to former pupils of Treloar school, which they consider derisory. It is another example of what happens when victims are excluded from the process.

I also draw my right hon. Friend’s attention to the report of the Secondary Legislation Scrutiny Committee, which is an excoriating criticism of the Cabinet Office. It exposes what it describes as a lack of clear and understandable information in the explanatory memorandum and a lack of preparedness for delivering the compensation scheme. The Committee doubts that the Cabinet Office will be able to pay compensation by the end of the year. Is he confident that the Committee is wrong and that payments will be made by the end of the year?

Lastly, large amounts of money were made by pharmaceutical companies and others while victims were being exploited and, in some cases, even being experimented on. That did not come about because of mistakes; they were deliberate actions, which in many instances were criminal. The British taxpayer must not pay the full cost alone. Those who made money from this appalling scandal should be required to make a significant contribution. In spite of what my right hon. Friend may consider a negative speech, I welcome the progress that we have made, but there is much further to go to deliver the justice that Sir Brian Langstaff set out in his report.

--- Later in debate ---

[Andrew Gwynne]

I can assure the hon. Gentleman that the Minister for the Cabinet Office is carefully considering this matter. If the hon. Gentleman would like, the Minister for the Cabinet Office will write to him, but he is considering it.

We expect the Infected Blood Compensation Authority to begin making payments to people who are infected under the infected blood compensation scheme by the end of this year. Payments to the affected are expected to begin in 2025, following a second set of regulations.

Turning to a question raised by the hon. Member for Perth and Kinross-shire about the independence of IBCA, it is rightly operationally independent. Parliament would clearly expect the Government to have oversight of a scheme of this size and for there to be proper management, given the amount of public money going into the scheme. It is true that there are only two non-departmental public bodies that are independent of the Government: one is IBCA and the other is the National Audit Office. It is absolutely right for IBCA to have that independence.

[Clive Efford]

On that point, the National Audit Office is directly accountable to Parliament through the Public Accounts Commission. Is the intention to create a similar sort of arrangement, as envisaged by Sir Brian Langstaff, in which there is direct accountability to Parliament, rather than to the Department?

NHS: Independent Investigation

Clive Efford Excerpts

Thursday 12th September 2024 Commons Chamber

[Mr Speaker]

This statement will run for an hour, so please help each other. Let us try Clive Efford as a good example.

[Clive Efford (Eltham and Chislehurst) (Lab)]

Thank you, Mr Speaker. I will rise to the challenge.

I welcome the Secretary of State’s statement. In 2008, the previous Labour Government commissioned a report from Sir Michael Marmot on the state of society and health, and he found that there was health inequality, particularly in deprived areas. Ten years on, his second report found that health inequality had become even worse against the backdrop of an underfunded NHS. Does that not demonstrate the urgency of the need to invest in those communities under this Government? What can my right hon. Friend do to direct resources into the most deprived communities in order to turn around those health inequalities?

[Wes Streeting]

My hon. Friend is absolutely right that our country has stark health inequalities. It is not right that people who live in different parts of the country have such different chances of living well. A girl born in Blackpool can expect to live healthily until she is 54, whereas a girl born in Winchester can expect to live healthily until she is 66. That is why, with the Prime Minister’s mission-driven approach, we will not just get our NHS back on its feet and make sure it is fit for the future; we will also reduce the cost and burden of demand on our national health service by attacking the social determinants of ill health.

Government Policy on Health

Clive Efford Excerpts

Monday 9th September 2024 Commons Chamber

[Madam Deputy Speaker (Ms Nusrat Ghani)]

The urgent question has just started, so there will be ample opportunity to continue to hold to account the Secretary of State, who no doubt believes that his answers are responding to the UQ. We have some time to go, so if Members bob, I will endeavour to ensure that they are called to do so.

[Clive Efford (Eltham and Chislehurst) (Lab)]

The sheer brass neck of the Conservatives to turn up on the very day that Transparency International UK published its report showing that £15 billion of contracts were red-flagged during the covid epidemic—[Interruption.] I am not reading. Those contracts have been red-flagged and are worthy of further investigation, and £500 million of them were given to companies that had not even lasted 100 days. Should the Conservatives not have taken that into consideration before coming here with this urgent question?

[Wes Streeting]

I wholeheartedly agree with my hon. Friend. Frankly, every single contribution from the Opposition Dispatch Box should begin with a grovelling apology for the way they conducted themselves in government, but they will not apologise: they have learnt nothing and they show no humility. To my hon. Friend’s point, when it comes to covid corruption and crony contracts, the message from the Chancellor is clear. We want our money back and the covid commissioner is coming to get it.

NHS Dentistry: Recovery and Reform

Clive Efford Excerpts

Wednesday 7th February 2024 Commons Chamber

[Victoria Atkins]

I understand my hon. Friend’s point, and I commend him for his work to ensure that his constituents receive the care and help that they deserve. On training, I hope he has drawn out from the plan the emphasis that we are putting on long-term ambitions. We understand that we need to train more dentists and get internationally trained dentists registered in our system. We recognise the critical role that dental hygienists and therapists can play as well.

[Clive Efford (Eltham) (Lab)]

If the Tories cared about the NHS, we would not have 7.6 million people on the NHS waiting list and dentistry in crisis. The answer that the Secretary of State gave to my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) demonstrates why we are in this situation. It is not about people turning up at A&E; the inability to access NHS dentistry services leads to people being in a crisis situation and needing emergency care. After 14 years of the Tory Government, why do we need a recovery plan for dentistry?

[Victoria Atkins]

The hon. Gentleman was obviously asleep at the beginning of my statement, because I set out what I hope is a fact agreed across the House about the pandemic—the real problem. People who had a relationship with a dentist before the pandemic do not face quite the same pressures as people who may have moved home or whose dentist may have moved practice. That is the cohort of people who we are trying to help. It really would help if Labour Members focused their arguments a little more on the facts, rather than on the scripts that their Whips have given out.

Pharmacy First

Clive Efford Excerpts

Wednesday 31st January 2024 Commons Chamber

[Dame Andrea Leadsom]

I can assure my hon. Friend that pharmacists are highly skilled and better trained than ever before in this country. They are fully equipped to meet the demands of their new prescribing role.

[Clive Efford (Eltham) (Lab)]

I welcome the Pharmacy First initiative—its roll-out is long overdue—but what expectations are we creating in the minds of patients attending pharmacies? Will pharmacists be trained in denying medication to people who turn up expecting to be given a prescription of some sort? Clearly, the initiative will encourage more people to present in order to get medication when it may not be necessary.

[Dame Andrea Leadsom]

The hon. Gentleman raises a good point. Of course, pharmacists will be prescribing for seven common conditions. Plenty of referrals will be made to GPs, and from GPs to pharmacists, to give patients the accessibility and the appropriate level of assessment for their needs.

Oral Answers to Questions

Clive Efford Excerpts

Tuesday 23rd January 2024 Commons Chamber

[Maria Caulfield]

I thank my hon. Friend for raising this issue. We were holding regular meetings with Norfolk and Suffolk MPs, the trust, the Care Quality Commission and NHS England, and with the new management team, that trust did appear to finally be turning things around. However, I am concerned to hear the points that my hon. Friend has raised. I am very happy to restart those meetings and will ask my office to arrange them as quickly as possible.

[Clive Efford (Eltham) (Lab)]

8. What steps she is taking to increase staff recruitment and retention in the adult social care sector.

[The Minister for Social Care (Helen Whately)]

Care is a skilled profession, and I want care workers to get the support and recognition they deserve. This month, we took the next step in our ambitious care workforce reforms, publishing the first ever national career structure for the care workforce alongside our new nationally recognised care qualification.

[Clive Efford]

Ambitious care workforce reforms—it is all blah, isn’t it? We have had 14 years of Conservative Government, and we have a crisis in every area of the NHS. Job insecurity, poor working conditions and low pay—one in five care workers is living in poverty—are all reasons why we have a recruitment and retention crisis in social care. Is not the truth that that is a damning indictment of 14 years of Conservative Government, and the only thing that is going to sort out social care and the crisis in recruitment and retention is a general election?

[Helen Whately]

I am actually really shocked by the way the hon. Member referred to the care workforce, with terms like “It is all blah”—very shocking. I am determined that care workers should get the recognition they deserve. We have a 10-year plan for social care, and it is working: the care workforce grew by over 20,000 last year, vacancies in social care are down, and retention is up. We are reforming social care so that it works as a career. That is why, as I said a moment ago—I wish the hon. Member had been listening—we have introduced the first ever career pathway for social care workers and a new national care qualification.

NHS Winter Update

Clive Efford Excerpts

Monday 8th January 2024 Commons Chamber

[Victoria Atkins]

I thank my hon. Friend for all his work in making that happen. He worked very hard on virtual wards when he was a Health Minister, and they represent a real step change in how we treat people with long-term conditions who can be monitored safely at home. They mean that people do not have to spend time in hospital, with all the pressures that can mean for us as individuals. Importantly, that also frees up beds for other patients who need them. I am keen to roll the scheme out further. Indeed, we have not just met but exceeded our initial ambition, which is why I can confirm that we have delivered 11,000 places in the virtual bed ward category.

[Clive Efford (Eltham) (Lab)]

The BMA says that junior doctors’ pay has been cut in real terms by 26% through consistent below-inflation increases. If the Tories really cared about this strike and about the NHS, would they not have avoided creating the circumstances that made junior doctors so angry that they felt the need to go on strike? Does that not just show that you cannot trust the Tories with the NHS?

[Victoria Atkins]

The figure that the BMA relies on is in fact from 2008, when the Labour party was in government for the first two years. The BMA cites a 35% pay rise. Just to clarify, independent organisations such as Full Fact and the Institute for Government rely on the consumer prices index measure, which shows a difference of 11% to 16%. I am sure that the hon. Gentleman will take into account the fact that we have already given graduate doctors, in their first year out of medical school, a rise of 10.3%, and I was willing to negotiate further and consider additional settlements that are fair and reasonable to the taxpayer.

NHS Long-term Workforce Plan

Clive Efford Excerpts

Monday 3rd July 2023 Commons Chamber

[Steve Barclay]

My hon. Friend is absolutely right. As we boost our domestic workforce training, there will be scope to reduce the number recruited internationally. From 1948 onwards, international recruitment has always played an important role in the NHS, and we are hugely grateful for the service offered by those recruited internationally, but we also recognise that as demography changes in other countries, there will be increasing competition for healthcare workers around the world, so it is right that we boost our domestic supply. That is what this plan does, and it is why this is a historic moment for the NHS in making that long-term commitment that will in turn reduce the demand on the international workforce.

[Clive Efford (Eltham) (Lab)]

I, too, add my condolences to the family of Bob Kerslake, who did excellent work in my borough tackling poverty. I would congratulate the Secretary of State on this announcement if it did not come 13 years into a Conservative Government. It is a bit like Bobby Ewing coming out of the shower, the way the Secretary of State is saying, “I’ve just realised there’s a crisis in the NHS.” We went into covid with 2.4 million people on waiting lists, which was a record. It is now up to 7.4 million. The report itself says that we have 154,000 fewer staff than we need today in the NHS. After 13 years in government, if the Tories really cared about the NHS, it would not be in the state it is in, would it?

[Steve Barclay]

The hon. Gentleman ignores the fact that since 2010, there has been a 25% increase in the NHS workforce. More than a quarter of a million more people now work in the NHS than was the case in 2010. There is a 50% increase in the number of consultants working in the NHS today compared with 2010, but the reality is that demand has increased as a result of an older population, advances in medicine and in particular the demands of the pandemic, and that is what we are responding to. We are also taking measures in parallel. We are on track to deliver our manifesto commitment for 50,000 more nurses, with 44,000 now in place. We also have beaten our manifesto target on primary care, with 29,000 additional roles in place. That means that people can get to the specialist they need, which in turn frees up GPs for those things that only GPs can do and ensures that patients can access care much more quickly.