Oral Answers to Questions

David Mowat Excerpts

Tuesday 21st March 2017 Commons Chamber

[John Mc Nally (Falkirk) (SNP)]

3. What steps his Department is taking to ensure that clinical commissioning groups follow best practice commissioning policy on access to cough-assist machines for people with muscle-wasting conditions.

[The Parliamentary Under-Secretary of State for Health (David Mowat)]

Cough-assist machines are one of a variety of respiratory treatments that may be appropriate for sufferers of conditions such as motor neurone disease or muscular dystrophy. In the end, it is a matter of clinical judgment.

[John Mc Nally]

There are good examples of best practice cough-assist commissioning policies for muscle-wasting conditions that can be followed by health boards and CCGs. Given the hard work being done to extend the lives of those who suffer from muscular dystrophies, what support and assistance can the Department provide to Muscular Dystrophy UK to ensure that such policy is more widely adopted?

[David Mowat]

It is not for the Government to direct clinicians regarding the efficacy of particular treatments; it is for clinicians to decide, based on guidance from the National Institute for Health and Care Excellence and others. In developing its recent motor neurone disease guidance, NICE found that the evidence base for the routine use of cough-assist machines was weak. However, the matter is kept under review, so that may change as and if new data emerge.

[Charlotte Leslie (Bristol North West) (Con)]

4. What assessment he has made of the effectiveness of the export of procedures developed by NHS professionals.

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[Anna Turley (Redcar) (Lab/Co-op)]

11. What steps his Department is taking to ensure that NHS England’s “General Practice Forward View” has the funding necessary to achieve its goals.

[The Parliamentary Under-Secretary of State for Health (David Mowat)]

“General Practice Forward View” announced that investment in general practice will increase from £9.6 billion in 2015-16 to more than £12 billion in 2020-21. This represents an increase of 14% in real terms, which is almost double the increase for the rest of the NHS. Two years into the forward view, we remain on track to deliver that.

[Anna Turley]

I appreciate the Minister’s response, but the reality on the ground in areas such as Redcar and Teesside is that we face a deficit of £281 million by 2020. How can he reassure my constituents, who are already finding it hard to get an appointment with a GP, that already scarce services will not become even more so?

[David Mowat]

We do recognise that in parts of the country there are shortages of GPs. As Members have heard, we are planning to have 5,000 more doctors working in general practice by 2020, and a proportion of those will be in Teesside. It is important that we meet that goal.

[Mr Steve Baker (Wycombe) (Con)]

GPs in Wycombe cite long hours, bureaucracy and the declining attractiveness of the partnership model as reasons why people do not want to be in general practice. Will the Minister ensure that funding within the forward view is directed to deal with those key problems?

[David Mowat]

Yes, and the contract discussions that we have just completed with the British Medical Association addressed a number of the issues that my hon. Friend talks about, in terms of the pressures on doctors working in general practice. We acknowledge that the workload pressures are enormous, and, through the contract, we need to do all that we can to mitigate them.

[Margaret Greenwood (Wirral West) (Lab)]

More than 80% of clinical appointments are carried out by GPs, but they receive a proportionately much lower level of funding. What steps will the Department of Health take to make sure that all sustainability and transformation plans abide by NHS England’s recommended allocation of funding to general practice?

[David Mowat]

One of the criteria by which STPs are being judged is the extent to which they are making this tilt from secondary into primary care, exactly as the hon. Lady suggests. That is precisely why the extra funding for primary care that I have set out is so important and why it is happening.

[Jo Churchill (Bury St Edmunds) (Con)]

“General Practice Forward View” talks about supporting general practice to improve digital technology for patients. Given the recent data challenges, does the Minister agree that putting a national data guardian on a statutory footing to protect patients and professionals is becoming an imperative?

[David Mowat]

I know that my hon. Friend has introduced a private Member’s Bill in this area, and the Government intend to support it.

[Kate Green (Stretford and Urmston) (Lab)]

The support that is provided to GP practices in relation to IT, information and so on is absolutely crucial to their effective operation, but problems continue today in my constituency with the service provided by Capita. Capita cannot, for example, now get prescribing certificates for locums and new GPs. When are the Government going to get a grip on this failing contract and, if Capita cannot perform adequately, get someone else to do it?

[David Mowat]

The hon. Lady is right. There have been issues with the Capita contract, and we have been let down by Capita. We are working hard to get that sorted, and my colleague the Under-Secretary of State for Health, my hon. Friend the Member for Oxford West and Abingdon (Nicola Blackwood), meets Capita weekly to get this fixed. We are making progress, and we believe that the issues that the hon. Lady refers to will be fixed in the foreseeable future.

[Mr Philip Hollobone (Kettering) (Con)]

There is a shortage of GPs across Northamptonshire, especially in Kettering, and the age profile of local GPs means that a very large number are about to reach retirement, which will make the problem worse. What can be done to encourage experienced GPs to stay on longer and to encourage those who have retired to come back?

[David Mowat]

My hon. Friend is absolutely right that one of the things we need to achieve is either to encourage older GPs to work part time or to make it easier for them to step down into more of a mentoring role. With the Royal College of General Practitioners, we have brought forward a scheme called GP Career Plus, which enables GPs in 10 pilot areas—the pilots are being rolled out now—to work as mentors across practice areas, and not to feel as though they have to retire, as GPs too frequently do at the moment.

[Dr Tania Mathias (Twickenham) (Con)]

12. Which hospitals providing congenital heart disease services do not meet the standard for the co-location of paediatric services; and what plans his Department has to stop providing congenital heart disease surgery at those hospitals.

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[Rosie Cooper (West Lancashire) (Lab)]

14. What plans his Department has to increase the provision of social care for people with unmet needs.

[The Parliamentary Under-Secretary of State for Health (David Mowat)]

Social care continues to be a key priority for the Government. That is why local authorities in England will receive an uplift in the money available for social care over the next three years of 17% in cash terms. That significant uplift will allow councils to support more people and sustain a diverse care market.

[Rosie Cooper]

Does the Minister recognise that the figure he has just given—the additional £1 billion in the Budget—is just half of what is needed to fill the shortfall in social care? Will he tell the House what he is doing to ensure that the sector gets the additional money and to stop councils being bankrupted by their social care requirements?

[David Mowat]

The 17% cash uplift over the next three years exceeds what we have been asked for by a number of stakeholders in the sector. I have conceded at this Dispatch Box many times that the sector is under pressure. The additional moneys that we have come forward with will help to alleviate that and will make a big difference. In Lancashire, the figure is not 17% over three years; it is 18% over three years.

[Andrew Bridgen (North West Leicestershire) (Con)]

The Minister is quite right that central Government are providing extra money for essential care and allowing local councils to raise a precept on the council tax for social care. How will the Government ensure that councils actually spend that money on social care?

[David Mowat]

Much of the money will go through the better care fund and there is conditionality on that. We expect councils to spend this money, as they have requested it, on social care and we believe that that will be the case. We understand the pressures and have acted.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

But 1.2 million older people are living with unmet care needs. The £1 billion that was announced in the Budget for this year is not enough to prop up the failing care sector, when many councils are suffering contracts being handed back. Given that 1 million people over the age of 65 do not have adult children, will the Minister explain how all those people living with unmet care needs are meant to manage?

[David Mowat]

The figure on unmet care needs comes from an Age UK analysis. I am meeting Age UK to go through its recent report, but we do not accept that analysis because the Care Act 2014, which had cross-party support, set statutory consistent definitions for what care councils have to provide. It is illegal for that not to be met, and our follow-up work with the Local Government Association has indicated that it is being met. Furthermore, we have put in a 17% increase over the next three years.

[Rushanara Ali (Bethnal Green and Bow) (Lab)]

15. What recent assessment he has made of the Government’s effectiveness in tackling childhood obesity in the inner cities.

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[Oliver Colvile (Plymouth, Sutton and Devonport) (Con)]

T8. As the Secretary of State knows, I am the vice-chairman of the all-party group on pharmacy. Will he update the House on the progress of the decriminalisation of dispensing errors by pharmacists? What is the hitch?

[The Parliamentary Under-Secretary of State for Health (David Mowat)]

There is no hitch. The Government remain committed to putting this into place, and the legislation will be brought forward shortly.

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[Matthew Pennycook (Greenwich and Woolwich) (Lab)]

Last week, to the distress of its vulnerable residents, Aldingham House care home in Blackheath became the latest care home in south-east London to close. Do the Government accept that the care home industry is at breaking point, and, if so, what are they doing about it?

[David Mowat]

The number of care home beds in the country has remained broadly constant at just over half a million over the last 10 years. There is variation and churn between areas, but I believe that the 17% cash-terms increase that we have injected into the social care market in the Budget, and the better care fund that is to come, will make a difference.

[Mrs Flick Drummond (Portsmouth South) (Con)]

I welcome the new nursing associates role that is currently being piloted. Will other areas, such as Portsmouth, be able to offer the same opportunities in the future, and will the new role be open to older people wishing to return to the workplace?

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[Steve McCabe (Birmingham, Selly Oak) (Lab)]

I do not know if you spotted the rather topical news story about children’s dentistry this morning, Mr Speaker: there were 1,464 hospital admissions for children for teeth extractions across one clinical commissioning area of Birmingham last year, the highest figure since 2010-11. How does the Minister account for this, and what is he going to do about it?

[David Mowat]

The figures for child extractions are clearly disappointing and two key actions need to take place: less sugar, which we expect the soft drinks levy to help with; and getting more fluoride on to teeth, particularly through fluoride varnishing. That has increased across the NHS over the last year, and by 12% in Birmingham. We hope that that will make a difference.

[Dr Sarah Wollaston (Totnes) (Con)]

The NHS mandate was published yesterday, just days before coming into force. Can the Secretary of State set out the reason for the delay, because it allows very little time for scrutiny of this important document by this House? Will he also set out how he is going to prevent money being leached from mental health services and primary care to prop up provider deficits, so that we can meet objective 6 on improving community services?