Community Pharmacies

David Crausby Excerpts

Wednesday 2nd October 2019 Westminster Hall

[Several hon. Members rose—]

[Sir David Crausby (in the Chair)]

Order. I will call the three Front Benchers at 10.30 am. Several Back Benchers wish to speak. I will not put a time limit on speeches, but if hon. Members keep them to about seven minutes or less, everybody will get an opportunity to speak.

--- Later in debate ---

[Jo Churchill]

I thank the hon. Lady, but I would like to push through and to come on to the supply of medicines, which the hon. Member for Halifax spent much of her speech discussing.

We must recognise that we need to work in partnership and that this is not only about treating ill health. One of the first services to come online under the new arrangements will be the community pharmacist consultation service, which will start on 29 October. It will establish the first ever national triage system, which will look at community pharmacies referring patients into pharmacy directly from NHS 111 for minor illnesses, wellbeing support and self-care advice, as well as urgent problems. It is important that everybody involved makes this work a success, because we want this to be a two-way process. Over the next five years, we want to include referrals from GPs, urgent treatment centres and NHS Online, but we want to do that based on evidence, sensibly and in collaboration with those in the sector. Registration opened only last month, and more than 2,000 pharmacies have been signed up.

Additionally, by 2020, being a level 1 healthy living pharmacy is expected to be an essential requirement, so that pharmacies can give advice. Integration across primary care is hugely important; the new contractual framework is about not moving minor illness, but about using the whole system better. Community pharmacies are a vital part of the picture if we want to think “Pharmacy First”.

Coming on to the question of medicine supply and shortages, I appreciate the issues that the hon. Member for Halifax mentioned, but, as recognised in last week’s National Audit Office report, we have done an enormous amount in collaboration with pharmaceutical and medical device companies. There are always ongoing shortages, but the Department works all the time to ensure that they are mitigated and that a proper supply of medicine can be got to people. With the issues of Brexit, we know that that is doubly important, and that is what the Department has been doubling down on.

[Sir David Crausby (in the Chair)]

I do not think there is really time for Holly Lynch to wind up.

Question put and agreed to.

Resolved,

That this House has considered the role of community pharmacies.

Acute NHS Care: South-west Hertfordshire

David Crausby Excerpts

Wednesday 13th March 2019 Westminster Hall

[Sir Mike Penning]

rose—

[Sir David Crausby (in the Chair)]

Order; I do not think we have time, Sir Mike. There is no right to sum up in a half-hour debate.

Question put and agreed to.

Green Investment Bank

David Crausby Excerpts

Thursday 29th October 2015 Westminster Hall

[Mr David Crausby (in the Chair)]

Order. If Members wish to speak, they will need to indicate that by standing. Philip Boswell is standing, so I will call him.

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[David Mowat]

Without wanting to take this too much further, I should say that I do not think it was Luxembourg and Malta; I think it was Cyprus and Malta. Perhaps we could clarify that.

[Mr David Crausby (in the Chair)]

You were doing so well.

[Kevin Brennan]

We were indeed, Mr Crausby. All I will say is this. The notion that, had the Conservatives carried on in power after 1997 we would have had a much greener Government than the Labour one, who passed the Climate Change Act 2008, is one that I find slightly difficult to believe. Anyway, without labouring the point too far, I was saying that in my view—

Cities and Local Government Devolution [Lords] Bill

David Crausby Excerpts

Wednesday 21st October 2015 Commons Chamber

[Several hon. Members rose—]

[The Temporary Chair (Mr David Crausby)]

Order. I want to call the Front Benchers at about 2.55 pm. There are still six or more Members who wish to speak, so unless Members keep their contributions below five minutes, we will not get through them all. I would therefore appreciate the co-operation of the Committee.

--- Later in debate ---

[Several hon. Members rose—]

[The Temporary Chair (Mr David Crausby)]

Order. I remind hon. Members that I intend to call the Front-Bench speakers not much later than 2.55 pm.

--- Later in debate ---

[The Temporary Chair (Mr David Crausby)]

With this it will be convenient to discuss the following:

Amendment 40, in page 4, line 18, at end insert—

‘(1A) An order under subsection (1) may only be made with the consent of the relevant combined authority; and that consent must be obtained prior to the creation of the office of mayor in the combined authority concerned’.

The intention of this amendment is that a function of a mayoral authority may only be transferred to the mayor with the consent of the relevant combined authority, which must be obtained prior to the creation of the relevant office of mayor.

Government amendments 5 to 7.

Amendment 60, in page 5, leave out lines 9 and 10.

As it stands the Bill removes the right of the Secretary of State to give borrowing powers to an elected mayor but allows for borrowing powers to be given to a combined authority. The amendment will allow borrowing powers to be given to an elected mayor.

Government amendment 8.

Clause 5 stand part.

Government amendments 23 to 25.

That schedule 2 be the Second schedule to the Bill.

Clauses 6 and 7 stand part.

Amendment 41, in clause 8, page 8, line 20, leave out from beginning to end of line 12 on page 10 and insert—

‘(1) The Secretary of State may by order make provision for a function of the Secretary of State that is exercisable in relation to a combined authority’s area to be a function of a mayor of a combined authority;

(2) An order under subsection (1) may not include provision about the exercise of functions currently exercised by local authorities.’

The intention of this amendment is that the only powers that can be given to a mayor of a combined authority are powers currently exercised by central government.

Amendment 54, page 8, line 27, at end insert—

‘(c) make provision for conferring on a combined authority, upon the request of that authority in relation to its area the full retention of business rates, business rate supplements, council tax, stamp duty land tax, annual tax on enveloped dwellings, capital gains property disposal tax, and multi- year finance settlements.’

This amendment will allow local authorities to retain all of their local taxation, including Business Rates and Council Tax.

Amendment 55, page 8, line 27, at end insert—

‘(c) make provision for conferring on a combined authority in relation to its area discretionary control of council tax discounts, business rate discounts and supplements, and other local fees, charges and subsidies in relation to other retained taxes.’

This amendment will allow local authorities to control all of their local taxation discounts, including those applicable to Business Rates and Council Tax.

Clause 8 stand part.

Clause 17 stand part.

Amendment 48, in clause 18, page 17, line 48, after “consents,” insert

‘and in the County of Somerset, as defined by the Lieutenancies Act 1997, approved by a referendum in the local authority area’.

Government amendment 15.

Clause 18 stand part.

Clause 9 stand part.

Amendment 1, in schedule 3, page 32, line 12, after “persons” insert

‘including representatives of parish, neighbourhood, community and other councils in the area of the combined authority’.

This amendment would allow local representation from parish, neighbourhood, community and other council is to attend combined authority scrutiny meetings.

That schedule 3 be the Third schedule to the Bill.

Government amendment 9.

Amendment 58, in clause 10, page 11, line 26, at end insert—

‘(5) The Secretary of State may by order make provision for conferring powers on a combined authority to set multi-year finance settlements.’

This amendment is intended to offer financial stability to city regions, allowing them long-term planning which is something not currently offered by the finance settlement or the funding of local enterprise partnerships (LEPs).

Clauses 10 to 14 stand part.

Amendment 49, in clause 15, page 14, line 43, at end insert—

‘(d) In the County of Somerset, as defined by the Lieutenancies Act 1997, approved by a referendum in the local authority area.’

Clause 15 stand part.

Government amendment 10.

Amendment 2, in clause 16, page 16, line 6, at end insert—

‘(d) the creation of a Constitutional Convention to discuss further local authority governance, functions and related democratic issues.’

This amendment creates the means by which every UK citizen can participate in a national public discussion on local devolution in the context of the wider renewal of UK democracy.

Government amendment 11.

Amendment 47, in page 16, line 11, after “apply” insert

‘and in the County of Somerset, as defined by the Lieutenancies Act 1997, approved by a referendum in the local authority area’.

Amendment 50, in page 16, line 11, at end insert—

‘( ) In the case of two tier authorities, consent under section 16(3) may also be given where a majority of local authorities in the local authority area have indicated their support.’

Government amendments 12, 14 and 13.

Clause 16 stand part.

New clause 2—Subsidiarity—

‘That Subsidiarity as defined by the Maastricht Treaty 1992 Article 5(3) shall apply to the functions of national and local government.’

This new clause would build in local government’s independence by using the principle of subsidiarity found in European law.

New clause 4—Local Government Constitutional Convention—

‘(1) A convention is to be held to consider and make recommendations on the constitution of local government in the United Kingdom.

(2) The Secretary of State must make regulations to—

(a) appoint a day on which the convention must commence its operations,

(b) make fair and transparent rules about how the convention is to operate and how evidence is to be adduced,

(c) make further provision about the terms of reference prescribed under section (Local Government Constitutional Convention: terms of reference), and

(d) specify how those who are to be part of the convention are to be chosen in accordance with section (Local Government Constitutional Convention: composition).

(3) The date appointed under subsection (2)(a) must not be later than 31 December 2016.’

This new clause creates the means by which every UK citizen can engage in a national public discussion of devolution local government, governance and electoral systems and make recommendations and receive a response from government and parliament to that national debate.

New clause 5—Local Government Constitutional Convention: terms of reference—

‘The convention must consider the following terms of reference—

‘(a) the devolution of legislative and fiscal competence to local authorities within the United Kingdom,

(b) the reform of the electoral system for local government,

(c) constitutional matters relating to local government to be considered in further conventions, and

(d) procedures to govern the consideration and implementation of any future constitutional reforms in relation to local government.’

This new clause creates the means by which every UK citizen can engage in a national public discussion of devolution local government, governance and electoral systems and make recommendations and receive a response from government and parliament to that national debate.

New clause 6—Local Government Constitutional Convention: recommendations—

‘(1) The Local Government Constitutional Convention must publish recommendations within the period of one year beginning with the day appointed under section (Local Government Constitutional Convention).

(2) The Secretary of State must lay responses to each of the recommendations before each House of Parliament within six months beginning with the day on which the recommendations are published.’

This new clause creates the means by which every UK citizen can engage in a national public discussion of devolution local government, governance and electoral systems and make recommendations and receive a response from government and parliament to that national debate.

New clause 7—Local Government Constitutional Convention: composition—

‘(1) The Local Government Constitutional Convention must be composed of representatives of the following—

(a) registered political parties within the United Kingdom,

(b) local authorities, and

(c) the nations and regions of the United Kingdom.

(2) At least 50% of the members of the convention must not be employed in a role which can reasonably be considered to be political.”

This new clause creates the means by which every UK citizen can engage in a national public discussion of devolution local government, governance and electoral systems and make recommendations and receive a response from government and parliament to that national debate.

New clause 10—Housing devolution to London—

“In any enactment relating to housing, any power or duty of the Secretary of State applicable to any person or dwelling shall be exercisable in the Greater London area only by the Mayor of London, with the consent of the Greater London Assembly.’

This new clause provides for devolution to London of the Secretary of State’s housing powers.

New clause 11—Local property taxes devolution to London—

‘(1) There shall be London Consolidated Fund into which shall be paid each month a sum equivalent to the previous month’s tax receipts in relation to properties in the greater London area accruing from—

(a) the stamp duty land tax,

(b) capital transfer tax,

(c) the annual tax on enveloped dwellings, and

(d) capital gains property disposal tax.

(2) The Treasury must consult the Mayor of London and the Greater London Assembly on what band and rates should be applied in respect of the Greater London area for the next financial year in respect of each of the taxes mentioned in subsection (1).’

This new clause provides for devolution to London of the receipts from taxes on property and for formal consultation with the Treasury on the rates of those taxes to be set for the greater London area.

New clause 12—Local Government Financial Integrity—

‘(1) Local authorities shall be financially independent of central government, save as otherwise provided for by this section.

(2) Central government may not place any restriction on decisions by local authorities about the exercise of their financial powers.

(3) The distribution of central government funds between local authorities shall continue on the basis of existing equalisation arrangements. Distribution will continue to be based on the principle of ensuring fairness and balance between local authorities. The basis on which this distribution is carried out must continue to be made public.

(4) Each local authority shall receive from central government a guaranteed share of the annual yield of income tax, as follows. Central government must in each financial year assign to the Secretary of State responsible for the distribution of central government funds between local authorities an amount of money equivalent to the yield from ten pence in the pound of income tax. The Secretary of State must make arrangements to inform each taxpayer in England of the amount of their income tax which makes up the central government funding distributed to English local authorities as a whole.

(5) The amount of the income tax yield referred to in subsection (4) shall be renegotiated between central and local government whenever service provision responsibilities are transferred between central government and local authorities.

(6) Local authorities may raise additional sources of income in their areas in any way they wish, and with the consent of their electorates as expressed through arrangements to be determined and put in place by the local authority concerned.

(7) Local authorities shall be able to raise any loans, bonds or other financial instruments which their credit rating allows and as independent entities will be exclusively responsible for their repayment. All local authorities shall operate a balanced budget so that in any one financial year all outgoings, including interest repayments on borrowings, shall not exceed income.

(8) Central government may not cap, or in any other way limit, local authorities’ taxation powers.

(9) The financial transparency standards that apply to central government shall apply to local authorities.

(10) Central government and local authorities may contract with each other in order to pursue their own policy objectives.’

The intention of this new clause is that receipts from income tax should be assigned to the Department for Communities and Local Government who will then pass it on to councils.

New clause 14—Power to create new council tax bands—

‘(1) Section 5 of the Local Government Finance Act 1992 is amended as follows.

(2) In subsection (4) omit “The Secretary of State may by order, as regards financial years beginning on or after such date as is specified in the order” and insert “A local authority may for any future financial year”.

(3) Omit subsection (5).’

The intention of this new clause is to devolve to councils the power to create new council tax bands.

New clause 15—Abolition of referendums relating to council tax increases—

‘(1) In Part 1of the Local Government Finance Act 1992 (council tax: England and Wales) after Chapter 4 omit the Chapter set out in Schedule 5 to the Localism Act 2011.

(2) Schedule 6 to the Localism Act 2011(council tax referendums: further amendments) ceases to have effect.’

The intention of this new clause is to end the council tax referendum system.

New clause 16—Effective devolution committees—

‘(1) The functions of local authorities include the formation of committees to collect and analyse data on effective performance by local authorities of powers and functions devolved to them.

(2) The Secretary of State must not give any directions to such committees.’

The intention of this new clause is to enable Local Government to set up its own “what works” organisation on devolution to examine what’s effective, either independently or in partnership with, but separate from, the Department for Communities and Local Government.

New clause 17—Scale of devolution—

‘(1) The extent of the devolution of powers and functions to local authorities must not be dependent on the size of the population of the local authority.’

The intention of this new clause is to provide flexibility for devolution on varying scales and foot prints instead of linking the amount of devolution to the size of the recipient.

Government amendments 26, 30 and 31.

[Mr Brady]

I shall be brief. Amendments 40, 41 and 45 relate to a variety of questions regarding the precise powers that are to be transferred under a devolution settlement, including whether powers can be devolved down from Government and whether there is any danger or any possibility that might preclude the danger of powers being pulled up from local government and vested at a level further from the people, which I believe to be the case under the Bill as it stands.

Essentially, amendment 45, by providing a veto for any one authority in a combined authority or mayoral authority area over any decision, would establish what, in the context of the Prime Minister’s negotiations on the EU relationship, we would refer to as sovereignty. It is the opposite of the arrangement in the Bill, which we would, I suppose, call qualified majority voting. The current provisions would clearly allow a majority position in the mayoral authority to prevail over a serious objection from one, two or perhaps three authorities. If I read the Bill correctly, in fact, I think that most of the vetoes in the Greater Manchester agreement would require two-thirds opposition to a measure to prevent it from proceeding.

Amendment 45 makes it very clear that although we are pleased to participate in the new arrangement, or to enhance the existing arrangement of a combined authority, which works very well, we believe that the fundamental power in this relationship ought to reside with the local authority or with each of the local authorities in the area. If the amendment were to be agreed, it would provide that protection. As with the amendments we discussed in the earlier group, which I did not press to a vote, I do not intend to press these amendments to a Division in Committee, in the hope that Ministers will reflect on them and consider whether there are more effective ways in which these guarantees and safeguards could be provided.

Similarly, amendment 40 seeks to establish what one might call a “foundation status”. It would give a special status to the original devolution agreement, which has been acceded to by the leaders of the local authorities in Greater Manchester, which is obviously the instance I know best. The intention is that it would limit the transfer of powers from local authorities, in particular, to any transfer that might take place before the establishment of the mayoral authority and would therefore prevent any further transfers. The amendment might not be perfect, and there might be flaws in how it is drafted, but I hope that my hon. Friend the Minister will accept that there is a real and important point that at the moment of the inception of the mayoral authority there is a degree of consent from the local authorities, but that consent might be less certain at a later stage.

Finally, amendment 41 seeks to provide an explicit guarantee. Ministers are very clear in their statements and Members on both sides of the House have been quite enthusiastic about the principle that we are seeking to move decision making and spending closer to people, taking functions away from central Government and moving them to a more local or regional tier. The hon. Member for Nottingham North (Mr Allen) spoke previously to his amendments seeking to establish a principle that could allow powers always to cascade down to the lowest level—something with which many of us feel a natural sympathy.

However, the Bill as it stands provides the possibility for powers to move in the opposite direction—for a local authority in any one year under any political control to decide that it wishes to cede decision making to the mayoral authority level. It is conceivable that the present Conservative Government will last for no more than another three or four Parliaments, and at some point in the future there could be a Government of another party in place. It is conceivable that a Minister less benign and less wise than my hon. Friend on the Front Bench may seek to lock into a mayoral tier of government powers sucked up from the local level.

Amendment 41 would provide a guarantee that what Ministers say they intend to achieve through the Bill and what most of us would like to see—the transfer of powers down from central Government—will indeed be the effect of the Bill, and not the reverse, the danger that the process will lead to decisions being taken further away from people, rather than closer to them.

Drugs: Ultra-rare Diseases

David Crausby Excerpts

Tuesday 16th June 2015 Westminster Hall

[Mr David Crausby (in the Chair)]

The Speaker’s Commission on Digital Democracy recently recommended the use of regular digital public discussion forums to inform debates held in Westminster Hall. A digital debate has taken place on Twitter ahead of today’s debate on access to drugs for ultra-rare diseases. For this reason, Mr Speaker has agreed that for this debate members of the public can use hand-held electronic devices in the Public Gallery. Photos, however, must not be taken. I encourage Members who wish to refer to the Twitter debate to call it the rare diseases Twitter debate, rather than using people’s individual Twitter names.

[Greg Mulholland (Leeds North West) (LD)]

I beg to move,

That this House has considered access to drugs for ultra-rare diseases.

I am delighted to have the chance to speak on this important topic today. I was also delighted to lead and take part in the historic Twitter debate yesterday, which was a great success. On top of the very strong show of support from Members of all parties, the fact that nearly 1 million people took part in the debate yesterday shows how important the issue is.

I got involved in the issue because Katy and Simon, the parents of Sam Brown, a six-year-old boy in my constituency, came to see me. In 2009, when Sam was 16 months old, he was diagnosed with Morquio syndrome, an ultra-rare disease that 88 people in the United Kingdom have. It is a degenerative life-limiting condition with a typical life expectancy of around 25 years. It limits considerably what those suffering from it can do. All of us here can only imagine what it must feel like as a parent to receive the devastating news that your child will deteriorate before your eyes, not live to an old age, and may not even see much, if any, of their adulthood. Imagine how it feels when a nurse rings up and says, “There might be a treatment, but it is only a trial.” Of course, on hearing such news, what parent would not want to sign up for a trial for the drug Vimizim, supplied by the drug company BioMarin? That is exactly what Katy and Simon did: they signed up Sam to the trial without hesitating.

For the past three years, Sam has been doing a 100-mile trip from Otley to Manchester every Thursday to get Vimizim, his enzyme replacement therapy. Without it, Sam would see his growth stunted more than it already is, with further skeletal deformities and possible heart and vision problems. With Vimizim, Sam’s parents, and, even more importantly, Sam’s medical team, say that he is clearly physically more capable and stronger, with more stamina than ever before. To quote Katy, his mother:

“The drug has given him the freedom to be a child again.”

I ask right hon. and hon. Members to take the opportunity to share the single, “There is a Boy”, produced by the Keep Sam Smiling campaign and produced at his primary school, the Whartons in Otley, where they have shown huge support to an ordinary little lad who wants to be an ordinary boy and an ordinary man. The video for the single shows Sam being a fireman, a doctor and an astronaut, the kinds of things that he has the right to hope one day to be, but he can have that hope only if he gets treatment and is able to continue to take Vimizim.

We are here today because, after three and a half years, in just nine days’ time, Sam’s access to Vimizim looks set to be cut off.

--- Later in debate ---

[Several hon. Members]

rose—

[Mr David Crausby (in the Chair)]

Order. I intend to call the three Front Benchers at 3.30 pm. Three Members are standing, so if they can keep their contributions to less than four minutes, they will all get in.

--- Later in debate ---

[Andrea Jenkyns (Morley and Outwood) (Con)]

I thank and commend the hon. Member for Leeds North West (Greg Mulholland) for his work.

I find it heartbreaking that we have today heard about many constituents who have had access to drugs that have given them hope and improved their lives but which have then been taken away. Like the hon. Member for Leeds North West, I have a constituent who suffers from Morquio, Angela Paton. She is 35 years old; it has taken 35 years to find a drug that works, and it is now being taken away from her. Matthew Firth is another constituent, a young man with special needs who can no longer get a basic cream that he needs.

The case of Abi Longfellow is much in the news at the moment. She is a 12-year-old girl with a rare form of dense deposit disease. She needs a kidney transplant to live. Her father has been prepared in the past 12 months to give her his kidney. He should have had the operation on Friday, but for that to go ahead she needs the drug eculizumab. NHS England and NICE say that the drug will not work in Abi’s case—she has a very rare form of DDD—but there is research from the US, Canada and Italy indicating that the drug does work.

I thank the Prime Minister for intervening and asking NHS England to examine the case, and I ask my hon. Friend the Minister to ensure that that happens. There is research available; I find it difficult to understand whether, when the likes of NHS England and NICE say the drug will not work, that is just a tick-box exercise, or whether they look at research from outside this country. It is important to consider that. I would like a joined-up approach between NICE, NHS England and the Department of Health. I ask the Minister to consider the matter comprehensively, and to ensure that NHS England and NICE look into it.

[Mr David Crausby (in the Chair)]

I will now call the Front-Bench Members; there may be a vote, in which case I shall suspend the sitting for 15 minutes. The new rules allow Mr Mulholland to wind up the debate briefly, if there is time, but for that to happen, the Minister must be allowed enough time.

Oral Answers to Questions

David Crausby Excerpts

Tuesday 24th February 2015 Commons Chamber

[The Minister of State, Department of Health (Norman Lamb)]

No, I do not regard that as satisfactory and I am happy to talk to the local commissioners. We have ensured that there will be real-terms increases in mental health funding for 2015-16, and that should be regarded locally as a matter of urgency.

[Mr David Crausby (Bolton North East) (Lab)]

T6. Bolton’s accident and emergency department has been in crisis recently, partly because the clinical commissioning group closed the town’s walk-in centre. Will the Secretary of State support my petition calling for its reinstatement, or will he say, more predictably, “It’s not me, guv; I’m just the Secretary of State for Health”?

[Mr Jeremy Hunt]

I am accountable for what happens in the NHS, so let me tell the hon. Gentleman what is actually happening in Bolton: compared with four years ago, 2,756 more people are being seen at A and E within four hours. That is a record of investment and success.

A and E (Major Incidents)

David Crausby Excerpts

Wednesday 7th January 2015 Commons Chamber

[Mr Hunt]

The main reason is that Labour in Wales chose to cut the NHS budget, whereas in England we chose to protect and increase it.

[Mr David Crausby (Bolton North East) (Lab)]

Before a major incident was declared yesterday morning, 76 patients were awaiting transfer to social care in the Royal Bolton hospital—nearly four wards-full—so when is the Secretary of State going to do something effective about the crisis in social care that is causing mayhem in our accident and emergency department?

[Mr Hunt]

I recognise the pressures that the hon. Gentleman is talking about, but last year, for the first time, the local NHS and the local authority in Bolton sat down together to plan social care for the most vulnerable people—his constituents—who need such joined-up care and have wanted but not had it for so many years. With the better care programme from this April, we will start to see some real improvements.

Oral Answers to Questions

David Crausby Excerpts

Tuesday 25th November 2014 Commons Chamber

[George Freeman]

As I said in the debate, we absolutely support the Bill’s intention, which is to promote the greater use of off-label and off-patent drugs, but that must remain a decision for clinicians exercising their judgment about what is best for their patients. We do not think it right that the Government should be put in the position of effectively sponsoring new drug licence applications to the Medicines and Healthcare Products Regulatory Agency. I have convened a round table working group with all the stakeholders to try to look at how we can maximise information to clinicians to promote the use of off-label and off-patent drugs.

[Mr David Crausby (Bolton North East) (Lab)]

10. How many (a) NHS trusts and (b) foundation trusts are forecasting a deficit.

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

Thirty-three NHS trusts and 60 foundation trusts are forecasting an end-of-year financial deficit, with the remaining 65 NHS trusts and 87 foundation trusts forecasting an end-of-year surplus.

[Mr Crausby]

Earlier this year, Monitor announced that the number of trusts in financial breach had nearly doubled over the previous 12 months. How confident is the Minister that the number will not double again next year?

[Dr Poulter]

I am very confident that the measures already in place to drive efficiencies in the NHS are on course to save £20 billion during this Parliament. Many of those efficiencies are being delivered by improved procurement practice at a trust level. The Government have also invested £15 billion during this Parliament, which is a real-terms increase of £5 billion in NHS funding to support trusts.

Ambulance Resources and Response Times

David Crausby Excerpts

Wednesday 14th May 2014 Westminster Hall

On resuming—

[Mr David Crausby (in the Chair)]

I will adjourn the sitting at 5.15 pm. I call the Minister.

[Jane Ellison]

Thank you, Mr Crausby. Welcome back to the hon. Member for Hartlepool—I think some colleagues may not have been able to rejoin us.

As I was saying, NEAS tells me that in 2013-14, 74.8% of calls categorised as green 2, meaning serious but not life-threatening, received a response within 30 minutes, and 71.2% of calls categorised as green 3, meaning non-emergency, received a response within 60 minutes. Although that does not in any way diminish the tragedy of cases such as Mr Gouldburn’s, which are never acceptable, it is important that we recognise the generally excellent service provided by the trust and its staff.

[Jane Ellison]

I think we can all agree that those are circumstances that we want to minimise.

I want to turn briefly to one or two specific local points, and then to one or two wider points. Most recently, the Government recognised the importance of investment in front-line services with £14 million provided to ambulance services last December. Obviously, it is for local commissioners and trusts to decide how that money is used. I recognise that in the hon. Gentleman’s region, local commissioners see that more investment is needed for ambulance services, and we recognise that the trusts are working with local commissioners on that, making sure that they get that commissioning piece right.

More generally, there is also an issue about staffing in the ambulance service. Since 2010, the NHS has recruited 16% more paramedics, but we know that in some areas of the country, there is insufficient academic capacity, for example, to produce paramedics in the numbers required. Again, the Association of Ambulance Chief Executives is working with Health Education England to address that issue in the medium term.

The hon. Gentleman also alluded to ambulance handover delays. We absolutely recognise the role that they can play in making the job of the ambulance service more difficult. I believe there has been an ongoing issue, to which he alluded, for NEAS at County Durham and Darlington NHS Foundation Trust hospitals. Local commissioners have advised that there has been recent improvement, helped by winter initiatives supported by the urgent care working group. That has included support from the fire and police service, but I know there is more to be done.

Indeed, my colleague from the east of England, my hon. Friend the Member for Suffolk Coastal (Dr Coffey), who has not been able to rejoin us, was talking as we went to the vote about work that had been done specifically in her area to look at some particular issues that affect handover delay. As she said in her intervention on the hon. Gentleman, it is well worth local Members exploring some of that detail with their board as well to see whether lessons can be learnt from other parts of the country.

The urgent and emergency care review is being led by Sir Bruce Keogh, the national medical director of NHS England. He was asked to undertake a review of urgent and emergency care, looking at all aspects of the sustainability of the urgent and emergency care system. That does not exclude ambulance services. The review proposes the development of 999 ambulances; they would become more like mobile treatment services, not just urgent transport vehicles. There is a lot of fresh thinking in all sorts of areas of delivering excellence in emergency health care, and it is right that we look at new ways of delivering that health care with regard to ambulances as well, rather than just looking at the old model.

I want briefly to put a point on the record in the 30 seconds left to me. Let us not minimise the importance of people being asked about a rash as a symptom on the phone. It is one of the signs of meningitis and the royal colleges have advised that that should be asked as a question, so it is not an insignificant point.

With regard to private ambulances, that provision was brought in by the right hon. Member for Leigh (Andy Burnham), when he was in office—

[Mr David Crausby (in the Chair)]

Order.

Oral Answers to Questions

David Crausby Excerpts

Tuesday 1st April 2014 Commons Chamber

[Mr David Crausby (Bolton North East) (Lab)]

2. What his most recent estimate is of the cost to the public purse of reorganisation in the NHS.

[The Secretary of State for Health (Mr Jeremy Hunt)]

According to official figures, the new structure set up by the Health and Social Care Act 2012 will save £5.5 billion in this Parliament and £1.5 billion every year after that, all of which will be reinvested in front-line care.

[Mr Crausby]

Given that he promised in 2010 that there would be no top-down reorganisation of the NHS, how can the Secretary of State justify spending billions of pounds on top-down reorganisation on the day on which Simon Stevens, the new chief executive of NHS England, has warned that the NHS is facing the biggest

“budget crunch in its 66-year history”?

[Mr Hunt]

As Simon Stevens is starting today, I think that this is a good moment to welcome him to his post. He is an outstanding individual, and I know that we all wish him well in what will be a challenging but incredibly important job.

As for the reorganisation, the official figures make it clear that it is saving more than £1 billion every year during the present Parliament—money that is being reinvested in the provision of 1,600 more nurses, 1,700 more midwives, 1,800 more health visitors and nearly 8,000 more doctors than we had under Labour. I am afraid that that shows that Labour has not learned the lessons of Mid Staffs. Labour Members still want to turn the clock back and spend all that money on administration.