NHS 10-Year Plan

Dan Poulter Excerpts

Tuesday 19th February 2019 Commons Chamber

[Stephen Hammond]

I am sure that there will be a number of excellent questions and interventions, but it was a good question. The plan sets out that all local health systems will be expected to outline this year how they will reduce health inequalities by 2023-24, and the intention is that that process will consider exactly the health inequalities that the hon. Member for Sheffield, Heeley (Louise Haigh) mentions.

Additional money for the primary sector will ensure that funding for primary medical and community health services, such as GPs, nurses and physiotherapists, increases by £4.5 billion in real terms in the next five years. That will mean up to 20,000 extra health professionals working in GP practices, with more trained social prescribing link workers within primary care networks. By 2021, all patients will be offered a digital-first option when accessing primary care. The plan also considers the future of the health system, and the new proposals for integration are the deepest and most sophisticated ever proposed by the NHS.

[Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)]

The plan recognises that some proposals in the Health and Social Care Act 2012 were made in error when it comes to the transference of powers to public health bodies and local authorities. However, based on my reading of the plan, the omission from that list relates to addiction services. If we are serious about mental health and about improving care and reducing health inequalities in areas such as Sheffield, which was just mentioned, we need to get the commissioning of addiction services right and transfer that back to the NHS. Such services deal with some of the most vulnerable patients, but they are underfunded and failing to treat people, and the taxpayer is paying the price. Patients badly need those services, so will my hon. Friend take the matter up and give it a push?

[Stephen Hammond]

My hon. Friend makes a good point and urges me to take up the issue, which I will. He is obviously an expert in this field and will know that the Government have asked the NHS to come forward with proposals for legislative reform to support the long-term plan’s ambitions, and I will reflect on his comments in my thinking.

By 2021, every part of the country will be covered by integrated care systems, which will bring together local organisations, including local authorities, to redesign care and improve population health. They will become the driving force for co-ordination and integration across primary and secondary care. Any claim that such reforms might lead to privatisation are misleading. In fact, the Chair of the Health and Social Care Committee said that the proposals

“will not extend the scope of NHS privatisation and may effectively do the opposite”.

The NHS will invest more in preventing ill health and stopping health problems getting worse. That includes offering tobacco treatment services to all in-patients and pregnant women who smoke, establishing new alcohol care teams, and offering preventive treatments to more people with high blood pressure and other risk factors for heart disease.

--- Later in debate ---

[Jonathan Ashworth]

The last Labour Government put record investment into the NHS, which was voted against every step of the way by the Conservatives. That Labour Government delivered some of the best waiting times on record and some of the highest satisfaction ratings, and they increased access to GPs in constituencies such as Ashfield.

The A&E standard is important not only for patients waiting in an overcrowded A&E but because it tells us much about flow through a hospital. Last week we had the worst A&E performance data since records began, with just 76.1% of those attending type 1 A&E seen, discharged or admitted to a ward in four hours. Behind the statistics are stories of patients left waiting in pain and distress and of the elderly languishing on trolleys. In fact, we have had 618,000 trolley waits in the past year. Patients have been waiting without dignity, at risk of cross-infection. There is no road map at all in the long-term plan to restoring access standards. Of course, the A&E standard is being revised in the long-term plan, even though the Royal College of Emergency Medicine has said:

“In our expert opinion scrapping the four-hour target will have a near catastrophic impact on patient safety in many Emergency Departments that are already struggling to deliver safe patient care in a wider system that is failing badly.”

I hope that when the review reports we can have a full debate in the House.

[Dr Poulter]

The hon. Gentleman is right to highlight the Blair Government’s injection of cash into the NHS and the meaningful difference that that made to many patients’ lives. On the waiting-time targets, if we are serious about parity for mental health and physical health, we should reflect on the fact that historically there have not been access targets for mental health of anywhere near the same standards that there are for physical health. Will the hon. Gentleman join me in urging a rethink of that and a much greater push for access targets for mental health services as a way to raise standards and improve the time within which patients get care?

[Jonathan Ashworth]

The hon. Gentleman makes an important point. There are elements of the long-term plan that we welcome, including the access targets for mental health. We also welcome the commitment to save 400,000 lives, although there is no detail in the plan about how those lives are going to be saved. We welcome the rolling out of early cancer diagnostic and testing centres—after all, it is a policy that I announced in the 2017 general election campaign. We welcome the roll-out of alcohol care teams in hospitals—a policy that I announced at the Labour party conference last year. We welcome the commitments on perinatal mental health—again, a policy that we announced previously. We welcome the commitment for preferential funding allocated to mental health services—another policy that the Labour Opposition previously announced—but we will need to study the details carefully, as the hon. Member for Oxford West and Abingdon (Layla Moran) said.

The points about mental health from the hon. Member for Central Suffolk and North Ipswich (Dr Poulter) were well made, because currently three in four children with a diagnosable mental health condition do not get access to the support they need. Child and adolescent mental health services are turning away more than a quarter of the children referred to them for treatment by parents, GPs, teachers and others. That is quite disgraceful, so I hope the extra investment in mental health services reaches the frontline quickly, and I hope that in summing up the debate the Minister will give us more details about when we can expect to see progress on that front.