Oral Answers to Questions

Dan Poulter Excerpts

Tuesday 11th June 2013 Commons Chamber

[Mr David Amess (Southend West) (Con)]

2. What steps his Department is taking to ensure consistent and continuous provision of pre-natal and post-natal care.

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

The Government are committed to improving continuity of care during pregnancy and the post-natal period. To give women the personalised care that they deserve, we have increased the number of midwives by nearly 1,400 and the number of health visitors by more than 1,000 since May 2010. In addition, there are a record 5,000 midwives in training.

[Mr Amess]

Will my hon. Friend visit Southend university hospital, and tell residents at first hand what steps the Government are taking to ensure that post-natal care meets clinical guidance and the Government’s aspirations to ensure that the maternity experience is continuous, with patients having one dedicated midwife?

[Dr Poulter]

I would be delighted to visit my hon. Friend’s constituency. He has been a tremendous advocate for maternity services, both nationally and in his constituency, in his time in the House. As I am sure that he has realised, if we want a genuinely personalised maternity service, we need to ask women about their experiences of care. That is why the Government are introducing a friends and family test in maternity from October this year.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

The Minister knows full well that post-natal depression is the thing that is most likely to kill a healthy young woman, and we know how to deal with it, but in many areas across the country we are cutting the number of visits from midwives after births, and the support given. We know how to tackle post-natal depression. Why should it be that in some parts of the country the support is wonderful, and in others, it is non-existent?

[Dr Poulter]

The hon. Gentleman is absolutely right to highlight that there has, in the past, sometimes been unacceptable variation in the quality of post-natal care. That is why we are increasing the number of midwives and have done so by nearly 1,400, and why we are putting money and effort into increasing the number of health visitors, who play a vital role in supporting mums, babies and families in securing that important bond, and in supporting mums so that they get the right help when they suffer from post-natal depression.

[Stuart Andrew (Pudsey) (Con)]

3. What plans he has for the future of children’s heart surgery provision in Yorkshire and the Humber.

--- Later in debate ---

[Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)]

5. What estimate he has made of the optimal level of bed occupancy in NHS hospitals.

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

Average annual bed occupancy rates for all NHS beds open overnight have remained stable between 84% and 87% since 2000. The Government do not set optimal bed occupancy rates for the NHS. NHS hospitals need to manage their beds effectively in order to cope with peaks in both routine and emergency clinical demand.

[Luciana Berger]

I listened carefully to what the Minister said, but the Royal College of Physicians has warned that this winter there were more black alerts—when a hospital has no beds available—than there were over the previous 10 years combined. What urgent action are the Government taking to reduce bed occupancy levels and prevent next winter being even worse?

[Dr Poulter]

We had this debate last week. The long-term pressures on the NHS, as we know, are the result of an aging population, with increasing numbers of older people arriving in A and E with complex needs, so the challenge is to ensure that they are better treated in the community. That is why my hon. Friend the Minister of State launched the integrated care pilots last month. We are also seeing more patients treated as day cases than ever before. About 80% of elective admissions are now treated as day cases, which shows a massive improvement in the speed and quality of care in the NHS.

[Mr Philip Hollobone (Kettering) (Con)]

Kettering general hospital is located in an area that has one of the fastest growing populations in the country and above-average growth in the number of patients aged 80 or over. What more can be done to send the correct signals to local authorities that they need to act quicker to get elderly patients out of hospital once they have been treated so that they can have the care they need in the community, thus freeing up hospital beds?

[Dr Poulter]

My hon. Friend is absolutely right that local authorities have a key role to play in integrated care. That is why in April this year the Government set up local health and wellbeing boards, which will bring about greater integration of care between the NHS, housing providers and social care locally. That will hopefully ensure that across the country we have a much greater focus on local health care needs and, in particular, on better supporting older people and people with long-term disabilities at home and keeping them out of hospital.

[Andy Burnham (Leigh) (Lab)]

A moment ago the Minister mentioned more elderly people coming in through A and E, and I want to present the House with new, deeply troubling evidence of that. Nobody wants to think of a very frail elderly person with no other support at home having to come to A and E by ambulance, but that is what increasing numbers of elderly people are having to do. Buried in the general A and E figures is an appalling increase in people aged over 90 coming to A and E by blue-light ambulance, which is up by 66%, equivalent to more than 100,000 of the most vulnerable people in our society. That is an appalling failure and a sign of something seriously wrong in the way we care for older people, and it is set to get worse as home care is cut further this year. Will he investigate that increase urgently and act now to prevent the collapse of social care?

[Dr Poulter]

The right hon. Gentleman is absolutely right—there is almost an outbreak of consensus across the Dispatch Boxes on this issue. We both recognise, rightly, that there is a long-term challenge in providing more integrated, joined-up care to better look after older people. However, it is ironic that he should raise that concern, because a previous Minister in the other place, the noble Lord Warner, has made the case very clearly that the previous Government failed to invest adequately in elderly care throughout their time in office. That is why this Government—I hope that we can count on the right hon. Gentleman’s support for this—are investing in health and social care, more integrated services at a local level through health and wellbeing boards and—

[Mr Speaker]

Order. The answers are too long. They need to get shorter, because we have a lot to get through. It is very simple and very clear.

[Dr Poulter]

The hon. Gentleman is right to point out that historically there have been challenges with intensive care beds. We are now seeing increases in some areas of intensive care, particularly paediatric intensive care and paediatric cots, to ensure that there is greater support in that service, but he is absolutely right that we need a greater emphasis on specialist centres focused on intensive care. That is something that the NHS Commissioning Board, NHS England, is focused on delivering. We need to ensure that across each region of the country there is more focused care and more specialist intensive care.

[Stephen McPartland (Stevenage) (Con)]

6. What progress he has made on improving cancer waiting times and diagnosis.

--- Later in debate ---

[Chris Heaton-Harris (Daventry) (Con)]

13. What recent representations he has received expressing concern about the service provided by the East Midlands Ambulance Service.

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

Over the past year we have received more than 40 letters from MPs in the east midlands, including my hon. Friend the Member for Daventry (Chris Heaton-Harris), local authorities and members of the public, about the service provided by the East Midlands Ambulance Service NHS Trust and its being the best programme. My hon. Friend will also be aware that there was an Adjournment on the matter earlier this year.

[Chris Heaton-Harris]

The Minister will recall that I have raised a number of constituency cases with his Department and the Care Quality Commission about the standard of services provided by EMAS to my constituents, and how it treats its staff. Will he assure me that the Department will continue to monitor EMAS’s performance in the coming months?

[Dr Poulter]

My hon. Friend can be reassured that the trust development authority and the local chief commissioner for Erewash CCGs are closely monitoring the situation. Today, the Marsh review into the east of England ambulance service has been published, and lessons from that review about how management processes can improve front-line care for patients can be learned and applied across other ambulance services.

[Martin Vickers (Cleethorpes) (Con)]

My constituency is also served by EMAS and it is evident that my constituents have cause for concern. Coupled with uncertainty about the future of the Leeds children’s heart unit and higher than average mortality rates in local hospitals, the situation is causing considerable concern. Will the Minister agree to meet me and neighbouring MPs to discuss those problems?

[Dr Poulter]

I would be delighted to do so.

[Pauline Latham (Mid Derbyshire) (Con)]

14. What recent assessment he has made of the national cancer drugs fund list.

--- Later in debate ---

[Zac Goldsmith (Richmond Park) (Con)]

T8. More than 5,000 schools across the UK now serve good-quality, sustainable meals with the Food for Life catering mark, but only three hospitals have achieved the same. It is often said that hospitals cannot do so because of the cost implications, but the three that have done so not only have incurred no extra costs, but, in the case of Nottingham hospital, have actually saved significant amounts. May I urge my hon. Friend actively to encourage take-up of the Food for Life catering mark as a model of best practice?

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

We will certainly look into the issue that my hon. Friend raises, but he will be aware that there are campaigns throughout the NHS focused on supporting local food producers, which is important in many constituencies, particularly rural ones, and developing best practice and encouraging nutrition. Chefs such as James Martin have been involved in helping to drive up standards of care, particularly in Yorkshire and other parts of the country.

[Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)]

T5. I listened carefully to the Public Health Minister’s answer just three questions ago, but the Government have disproportionately cut funding to the most deprived local authorities, including Liverpool, and these local authorities have today been shown to have higher mortality rates. How does the Secretary of State expect to close, rather than widen, health inequalities?

--- Later in debate ---

[Tom Blenkinsop (Middlesbrough South and East Cleveland) (Lab)]

T10. With the Department of Health having awarded Cleveland fire brigade £198,000 from its social enterprise investment fund, will the Minister confirm, pursuant to concerns raised by the Fire Industry Association, that his Department undertook an assessment as to the compliance with the European state aid regulations of the state’s funding of community interest companies that compete to take business away from the private sector?

[Dr Poulter]

I would be very happy to look further into the issue and to meet the hon. Gentleman to discuss it.