Oral Answers to Questions

Debate between Daisy Cooper and Steve Barclay

Tuesday 17th October 2023 Commons Chamber

[Steve Barclay]

I am happy to join my hon. Friend; indeed, I am sure the whole House is happy to pay tribute to the exemplary public service Mr Warrender has provided, both in the Royal Navy and with the ambulance trust, and to wish him a very happy retirement.

[Daisy Cooper (St Albans) (LD)]

Immunocompromised patients are facing their fourth winter without adequate protection from covid, despite a new study showing that they now comprise approximately 25% of all covid hospitalisations, intensive care unit admissions and deaths. In the last few days, some hospitals have been giving guidance to their staff that they should not even test for covid unless they are working on specific wards. After three and a half years, what are the Government going to do to put an end to this appalling situation, where some of the most clinically vulnerable patients are scared of accessing the healthcare they need for fear it could literally be a death sentence?

[Steve Barclay]

During the pandemic, as the hon. Lady knows, the Government prioritised the clinically extremely vulnerable and significant investment went in there. We follow the guidance from the UK Health Security Agency about the right level of infection control. More widely, we need to look at what medicine is effective. If it relates to immunosuppressants, there was a big debate in summer 2022 about that issue and we keep the science under active review.

Oral Answers to Questions

Debate between Daisy Cooper and Steve Barclay

Tuesday 11th July 2023 Commons Chamber

[Steve Barclay]

Again, I agree that disposable vapes are a particular concern: in our view, the growth in youth vaping is largely due to the growth in the use of disposable vapes. That is why we have particularly focused on that issue in our call for evidence, and that is what we are considering.

[Daisy Cooper (St Albans) (LD)]

6. What assessment he has made of the potential impact of guidance issued by District Valuer Services on the availability of city-centre GP premises.

NHS Long-term Workforce Plan

Debate between Daisy Cooper and Steve Barclay

Monday 3rd July 2023 Commons Chamber

[Steve Barclay]

My right hon. Friend makes a valid point about the integration between health and social care, and that was a flagship part of the reforms in 2022, which brought the NHS and social care together through the integrated care system. I join him in welcoming the news about William Harvey Hospital, which is extremely important to the local area. On social care more widely, we must also be cognisant of the differences. The NHS and social care employ roughly similar numbers at around 1.5 million people, but one is one employer and the other is 15,000 employers, so the dynamics between the two are different. The prioritisation of that integration is exactly right. That is why my right hon. Friend the Chancellor announced up to £7.5 billion for social care in the autumn statement, recognising that what happens in social care has a big impact on discharge in hospitals and hospital flow, which in turn impacts on ambulance handovers.

[Daisy Cooper (St Albans) (LD)]

After promises of new hospitals that have not got off the ground and 6,000 more GPs that never came to pass, it is fair to say that the British public will judge the Government on their actions not their words. Let me press the Secretary of State further on social care. He will remember that at the start of this year, people were dying in the back of ambulances and in hospital corridors, in part because people could not be discharged from hospitals into social care. If the Government believe, as I do, that we cannot fix the NHS if we do not fix social care, will he also bring forward a workforce plan for our social care sector?

[Steve Barclay]

That repeats the previous question, so I will not repeat the answer. It is slightly ironic to call for a plan for a new hospital programme and for a long-term workforce plan, and then criticise us when we deliver on both of those, as we have done with more than £20 billion of investment in the new hospitals programme, which we announced last month, £2.4 billion in the first ever long-term workforce plan and the biggest ever expansion of workforce training in the history of the NHS. Of course we need to take action in the short term to deal with the consequences of the pandemic. That is what our recovery plan does. The urgent emergency care plan that I announced in January takes specific action on demand management in the community. There are measures upstream on boosting capacity in emergency departments and downstream on things such as virtual wards. A huge amount of work is going on. We are putting more than £1 billion into 5,000 more permanent beds to get more bed capacity into hospitals. On social care, in the autumn statement the Chancellor committed up to £7.5 billion of further investment over two years, and it was part of our reforms to better integrate health and social care.

Mental Health In-patient Services: Improving Safety

Debate between Daisy Cooper and Steve Barclay

Wednesday 28th June 2023 Commons Chamber

[Steve Barclay]

Having discussed that harrowing evidence with my right hon. Friend, I do not think any Minister could either forget it or not be moved. I found it an extremely moving experience to hear her talk about the experiences of a number of her constituents. She is right to praise those who come forward, and to recognise that it is often a difficult ask to relive the most awful circumstances, but it is important that families come forward so that we learn lessons and ensure this is not repeated.

My right hon. Friend is also right to highlight the two broad elements of learning the lessons of what happened in the past and maintaining services for the future. I am therefore happy to give her an assurance that we will work closely with her on support for Essex as lessons are learned through the statutory inquiry and as services continue to be delivered. We are working closely on that with the chief executive.

[Daisy Cooper (St Albans) (LD)]

My thoughts are, first and foremost, with the bereaved families and all those involved, because this process must be utter agony for them. It is right that the inquiry is put on a statutory footing.

In his statement, the Secretary of State quoted from a letter he received from Dr Strathdee, in which she said:

“I am very concerned that there are serious, ongoing risks to patient safety.”

The Secretary of State did not expand on that, and I do not know whether he is able to do so. If I may extrapolate, we know that, more broadly, there are risks to patient safety when there is not enough workforce and when there are not enough beds. Hertfordshire is the most under-bedded area of the country. When we see the workforce plan, potentially this week, will it include estimates of the number of qualified mental health staff we need in in-patient settings, NHS community settings and schools? Will he meet me and my local mental health trust to discuss the number of beds we have in the county and our plan to expand them?

[Steve Barclay]

Dr Strathdee did not particularly focus on staffing numbers, as far as I recall; she focused on some of the issues with care from staff. That was the nature of the concerns. On the ongoing risk, part of the reason why we commissioned the rapid review was to look, in particular, at the quality of data. There was a quantity of data that was not effective, and that often distracted staff from spending time with patients. There were also gaps in the quality of data that needed to be filled, and the document that will be placed in the Libraries of both Houses speaks to that point. That is why we are so keen to move at pace on learning lessons.

Oral Answers to Questions

Debate between Daisy Cooper and Steve Barclay

Tuesday 6th June 2023 Commons Chamber

[Daisy Cooper (St Albans) (LD)]

I recently learned that my local integrated care board is not allowed to spend the money it wants to spend on securing the best location for a new GP practice and health centre. The reason is that Treasury rules, which are used by the District Valuer Services, are not keeping up with market rents. Will the Secretary of State speak to his colleagues in the Treasury to fix that, before we face an epidemic of health centres and GPs leaving town and city centres, and moving to ring-road locations away from the populations they serve?

[Steve Barclay]

I am very happy to look at that specific issue and raise it with Treasury colleagues.

New Hospitals

Debate between Daisy Cooper and Steve Barclay

Thursday 25th May 2023 Commons Chamber

[Steve Barclay]

It is not just the Eden Project North on which my hon. Friend has been a vigorous campaigner: he has raised this assiduously as well. As he knows, the trust is at a very early stage in its consideration of what public consultation will be needed around the reconfiguration of services across Lancaster. We are not letting that stop our work to open a new surgical hub at the Royal Preston Hospital, for example. As he knows, I know the geography very well in terms of the interaction with Lancaster. There are a number of options on consolidation and expanding to two sites. I look forward to discussions with him as we take that forward.

[Daisy Cooper (St Albans) (LD)]

Having asked the Government 14 times to release funding to West Hertfordshire Hospitals NHS Trust and other hospital trusts, I am relieved that they now have approval to proceed, but the Secretary of State will know, as the rest of us do, that the construction industry thinks that the 2030 date is pie in the sky. The Government have not been looking after our hospitals, so we have lost huge parts of the workforce and of our supply chains. Building magazine says that the contract notice for a delivery partner will not even be published until September. Of course, as I understand it, none of the major construction companies has even started to put together project teams to bid for the work. For all the talk of 2030, could the Secretary of State tell us how much progress he is prepared to promise before the next general election?

[Steve Barclay]

The announcement and the manifesto commitment were to build by 2030. The hon. Lady touches on the engagement with industry; Lord Markham has been engaging with industry. We have had a significant team, both within the Department and in NHS England, working on the standardised designs. The whole point is that we have seen in other sectors how standardisation allows us to construct much more quickly. It will also allow internal processes in government to be much quicker because we are not looking at each scheme in a bespoke way; we will have much more standardisation. That is how we will move at a much quicker pace. It has required us to take a little more time over recent months as we have finalised the plan, but now that we have that plan and clarity about the RAAC hospitals in particular, we will be able to move with much more pace.

Patient Choice

Debate between Daisy Cooper and Steve Barclay

Thursday 25th May 2023 Commons Chamber

[Steve Barclay]

Yes, I can. Part of this is allowing patients to choose according to a number of factors. Some may have had treatment previously and want to go back to a particular consultant-led team. Some may want to look at CQC ratings and other performance metrics. Some may want the convenience of not travelling—relatively small numbers say they are not willing to travel; far more are willing to do so. Patients will look at a range of factors when shaping their decision. The key is to have transparency and the technology that enables patients to take control.

[Daisy Cooper (St Albans) (LD)]

Of course we all want to see real patient choice, but for millions of people who are waiting in pain, a choice between travelling miles away or paying to go private is no choice at all. We all know that the key to unlocking millions of people from the NHS backlog is tackling the crisis in the workforce. Why on earth are we spending precious parliamentary time talking about the NHS app instead of the NHS workforce?

[Steve Barclay]

We are talking about the wider workforce. The hon. Lady mentions private capacity. This patient choice will enable people to make much better use of the independent sector and to do so free at the point of access. Given the size of the challenge of pandemic backlogs, the question is: how can we make full use of capacity across the NHS and in the independent sector?

Recovering Access to Primary Care

Debate between Daisy Cooper and Steve Barclay

Tuesday 9th May 2023 Commons Chamber

[Steve Barclay]

My hon. Friend raises a great point. I am extremely keen on how we can improve diagnostic testing and make it more accessible. As she knows from her time in the Department, early treatment is more effective and more cost-effective. Looking at more home testing, more testing at pharmacies and more work with employers to accelerate early detection is a win for patient outcomes and for delivering care in a more affordable way.

[Daisy Cooper (St Albans) (LD)]

Liberal Democrats and many others in this House have called for a pharmacy first approach for a long time, but there appear to be two major problems with today’s announcement. The first is that the Government’s own plan says that the money will be re-targeted; I would be grateful to know from the Secretary of State which other service will miss out.

In my constituency two pharmacies have already closed, and across England 16% of pharmacies have said that they do not think they will survive another year. How does the Secretary of State expect people to access a pharmacy first if their pharmacies continue to close?

[Steve Barclay]

As I said, there are more pharmacists than in 2010 and more people working in the pharmacy sector—the numbers have gone up by 24,000 since 2010—so to address the hon. Lady’s second question, there are more. On funding, as I said in my statement, this is new funding for primary care. That is the commitment that we made, and it should be welcomed in the primary care sector.

NHS Strikes

Debate between Daisy Cooper and Steve Barclay

Monday 17th April 2023 Commons Chamber

[Steve Barclay]

I agree with my hon. Friend. The fact that even the Labour party does not support 35%—the Leader of the Opposition himself says that is not affordable —indicates how out of step the junior doctors committee co-chairs are on what is realistic to get the balance right in bringing down inflation and on the wider economic pressures we face. We stand ready to engage constructively with the junior doctors committee but, as my hon. Friend says, that has to be on the basis of a meaningful opening position.

[Daisy Cooper (St Albans) (LD)]

On 5 July, the British public will want to celebrate 75 years of our amazing NHS, but if they are still feeling the brunt of NHS strikes at that time, does the Secretary of State think it would still be right for him to be at the Dispatch Box?

[Steve Barclay]

We have agreed an offer with the Agenda for Change staff council. That is something that the staff council and the majority of trade unions have recommended to their own members, and that the largest health union has voted in favour of. I think we should allow that ballot to take place; it reflects meaningful and constructive engagement. That was reflected in the fact that trade union leaders themselves recommended the deal to their members. I hope that, when we come to the 75th anniversary, we can celebrate that.

Oral Answers to Questions

Debate between Daisy Cooper and Steve Barclay

Tuesday 7th March 2023 Commons Chamber

[Steve Barclay]

It is for schemes such as those that my hon. Friend highlights that we are investing a further £2.3 billion a year in mental health services, and that in turn is facilitating an extra 2 million patients accessing NHS-funded mental health support.

[Daisy Cooper (St Albans) (LD)]

More than £300 million of the NHS dentistry budget is set to be clawed back by NHS England at the end of this month. That is not because of a lack of demand; it is because the Government’s NHS dental contract is broken and dentists are walking away from NHS work. Will the Government ringfence these funds, rolled over to next year, so that people who desperately need dental treatment can get those appointments?

Urgent and Emergency Care Recovery Plan

Debate between Daisy Cooper and Steve Barclay

Monday 30th January 2023 Commons Chamber

[Steve Barclay]

Within my right hon. Friend’s question is, I think, how we get more flow into hospital: once bed occupancy goes above a certain threshold, lack of flow is the key interaction that drives inefficiency within hospitals. That is why we are putting in the extra capacity. It is also a question of reducing the numbers going to hospital in the first place and speeding up the discharge of those who are fit to leave. Whereas at the moment someone might sit on a ward for three days because they have to have antibiotics every day, if one continuous dose of antibiotics can be administered through new kit at home, not only is that a much better patient experience but it relieves pressure on the wards.

[Daisy Cooper (St Albans) (LD)]

I welcome the additional transparency on data for 12-hour wait times, because it is only by shining a light on the problem that we can see just how bad it is, but the targets set out in the plan today are utterly woeful. The Royal College of Emergency Medicine says that we need 13,000 beds; the Government are offering 5,000. The percentage of patients who are seen within four hours should be 95%; the Government are aiming for 76%. Heart-attack and stroke victims should be seen within 18 minutes; the Government are aiming for only 30 minutes. Surely the truth is that this woeful lack of ambition means that our emergency care services are themselves on life support and that patients will continue to die needlessly for a very long time to come.

[Steve Barclay]

First, I thank the hon. Lady for recognising the steps that we have taken on transparency. That has been an area of challenge and it is part of my wider commitment to transparency.

The ambition of the targets has to be realistic, and targets are not a ceiling but a floor. It is about saying, “How do we set a target that is realistic?” Of course, we will aim to do better than that, but it is about setting something that the system feels is achievable, because that in turn gets much more buy-in.

On beds, we are increasing capacity, as my right hon. Friend the Member for Wokingham (John Redwood) alluded to. What it is really about is freeing up patients who are fit for discharge from hospital, who should not be there and would actually prefer to be getting care at home. It is about looking at the end-to-end bed capacity, not simply at beds within the acute sites.

NHS: Long-term Strategy

Debate between Daisy Cooper and Steve Barclay

Wednesday 11th January 2023 Commons Chamber

[Steve Barclay]

My hon. Friend highlights an extremely important area of innovation that speaks to the point about how to adopt that at scale. I will come on to the issue of virtual wards. At Watford, they told me that it was saving the equivalent of another ward of the hospital by enabling people to be discharged to recover in their homes where it was more comfortable. Patient satisfaction was extremely high—over 90% in the programme in Watford. Not only that; the clinical wraparound support means that if they need to return to hospital, they are able to do so.

[Daisy Cooper (St Albans) (LD)]

I, too, have seen the virtual ward at Watford General Hospital, which serves my constituents. We are very proud in west Hertfordshire that we were the first hospital trust to have that virtual ward, but he will know from his visit that the No. 1 priority of every member of clinical staff in that hospital is to have funding from the new hospitals programme to improve our hospitals in Watford, Hemel and St Albans. Could the Secretary of State please pledge to write to me within the next seven days to report on his meeting with the hospital trust and tell us whether and when we will finally get some funding, after being overlooked for decades?

[Steve Barclay]

It was extremely helpful to discuss the priorities for the new hospital build with the clinical team and the leadership team at Watford. I could see that for myself, and we are committed to it. This is an issue that my hon. Friend the Member for Watford (Dean Russell) champions assiduously on behalf of the people of Watford, but I know that it matters to a wider cohort there and I am happy to write further to the hon. Lady as she requests.

The virtual ward at Watford—it is great to have cross-party support for that innovation—is further facilitated by the funding we announced in the autumn statement: the further £500 million this year, £600 million next year and £1 billion the year after. The Opposition say we are “failing to recognise” the scale of the current challenges in the NHS, yet when I set out in the statement the additional actions that we are taking, it was both to respond to the pressures from flu—the sevenfold increase we have seen, with 100 times the number of patients in hospital with flu compared with last year—and to facilitate the innovation that they highlight in programmes such as virtual wards.

NHS Winter Pressures

Debate between Daisy Cooper and Steve Barclay

Monday 9th January 2023 Commons Chamber

[Steve Barclay]

First, I am very happy to write to my right hon. Friend with further details. For the benefit of the House, in relation to the £500 million announced in the autumn statement, local authorities gave the Department and NHS England their data returns on Friday. We will have that data, which I will be able to share more specifically in relation to the £500 million. The £250 million for NHS England announced today is for very urgent delivery into systems and that will be going out extremely quickly.

[Daisy Cooper (St Albans) (LD)]

NHS leaders have today told the Health Services Journal that the Government have just seven to 10 days to get the additional funding to discharge hospital patients to the frontline for it to make any difference whatever. The NHS Confederation has said that the next three months in the NHS will likely be defined by critical incidents being declared. Will the Secretary of State promise that the extra funding will reach the frontline in the next seven to 10 days? Will he please finally declare a national critical incident, so that we can mobilise every single bit of our NHS to save lives and save the NHS?

[Steve Barclay]

The very purpose of today’s announcement—I have made it on the first day that Parliament is back—is to give that urgent uplift in funding to local authorities and ICBs so that they can act now, knowing that that funding is available. They have the additional £500 million, which is ramping up as well. That is part of a wider package of measures—NHS England putting in community support with 7,000 more beds—but the purpose is to recognise the very real immediate pressure the frontline has been under. It also needs to be viewed as something that other healthcare systems across the globe have faced: a very sudden and very significant spike in flu seven times higher than last month and 100 times what it was last year.

Ambulance Pressures

Debate between Daisy Cooper and Steve Barclay

Monday 18th July 2022 Commons Chamber

[Steve Barclay]

My hon. Friend is absolutely right on mental health and where a patient is violent, as I saw for myself on my visit to Bedford, for example, that can be unsettling for A&E. I am happy to have further conversations with him on what measures can be taken. The fact is there is no single intervention in this space; it is a question of looking at the integrated approach. That is what the call for evidence is about. Also key is understanding the data and seeing where it can better target action on areas such as mental health that can have a disproportionate impact.

[Daisy Cooper (St Albans) (LD)]

It is absolutely right that we limit the amount of time that patients must spend in the back of ambulances, and I welcome that measure, but it is putting intolerable pressure on hospitals. This morning, health leaders told me that they simply do not have the space or the staff, and the one thing they need in the next few hours is more staff. Can the Secretary of State commit himself to ensure that in the next few hours there are no financial or other barriers to the NHS being able to access more NHS bank staff, paramedics and ambulance drivers from the fire service, and, if necessary, from the military?

[Steve Barclay]

The principle of subsidiarity is that, as part of the extreme heat plans, local trusts make decisions locally on targeting resource, whether that has an impact on outpatients or other services, to meet the increased pressure. The hon. Lady is absolutely right that there is significant increased pressure, as we see in the call volumes coming in to 999 and 111. Part of the contingency plans that are in place is to surge resource, but it is also partly about being clear where risk best sits. At the heart of the letter from NHS medical director Stephen Powis on Friday was the importance of not pushing risk out into the community where it is an unmet need, or into the ambulance, where it is best that patients are, but having that risk more on the ward, where a patient is known and can receive care. Local contingency plans are in place to allocate resource to meet that.