Social Care Funding

Debate between David Mowat and Roberta Blackman-Woods

Monday 12th December 2016 Commons Chamber

[David Mowat]

In terms of quality in Buckinghamshire and Birmingham, we look at the CQC reports right across the system, and we are not finding a geographic variation based on those sorts of statistics. That is just the fact of the matter.

[Dr Roberta Blackman-Woods (City of Durham) (Lab)]

I have heard nothing from the Minister to demonstrate that he understands the severity of the situation facing social care. Last week, the Local Government Association met a cross-party of group of MPs. It said that local government needs £1.3 billion to stabilise social care, and pointed out that that money cannot be raised by a council tax increase, especially because that raises the least money in the areas with the highest need.

[David Mowat]

In terms of council tax increases, this is not about the local government settlement that has already been announced. The additional better care fund will start to deliver more money from next April, and will deliver more money after that. During the course of this Parliament, there will be a 5% increase, in real terms, in money spent on adult social care.

Clinical Commissioning: North Durham

Debate between David Mowat and Roberta Blackman-Woods

Wednesday 23rd November 2016 Westminster Hall

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

It is a pleasure to serve under your chairmanship today, Mr Davies. I, too, congratulate the hon. Member for City of Durham (Dr Blackman-Woods) on obtaining the debate, and I congratulate the other hon. Members who spoke too. It is good to have a chance to discuss the matter and weigh up the pros and cons of what is being done.

The context is the CCG in the hon. Lady’s area, which consists of 31 GP practices. It has been rated as a good CCG by the Care Quality Commission. Its treatment referral time is above the national standard, at 92% within 18 weeks. I want to talk first about the policy area, and then about the specifics of the decision to employ About Health in North Tyneside and North Durham.

The first thing to say about the policy is that referral management is not a new area. In 2007, something like 70% of primary care trusts had a type of referral management system in place. The intention is fairly clear: when a GP is making a referral, it will be absolutely obvious in many cases that it needs to happen. In many other cases it will be clear that a referral is not needed. There will also, frankly, be a grey area in the middle—that will happen in any profession.

[Dr Blackman-Woods]

Will the Minister focus on this specific referral system, under which, we understand, all referrals to specialists from GP practices in the CCG area are subject to private company screening and there is also a target to send back at least 50% of all referrals made?

[David Mowat]

I was explaining the purpose of the policy and the fact that this referral mechanism was used widely in 2007. A King’s Fund report from 2010 sets out the pros and cons of using referral management—I suggest the hon. Lady reads it.

These things are not new. They are a mechanism by which a consultant, or a GP with a specialist interest in the area of what is being referred—there are six areas of referral in this CCG, as the hon. Lady said—has two to three days to either accept that the referral goes on to the secondary system, or to contact the GP and have a discussion about what the best alternative pathway might be. There is an appeals process if the GP does not agree with that decision.

The hon. Lady asked where else such referral management was being done across the NHS in England. It was introduced in 2007, as I said, and it is being done very commonly. It is being done in Bromley, Cambridge, Peterborough, Imperial in London, and Southampton. I saw a similar system in Tower Hamlets to the one working in her area—indeed, the GP was very proud of the way they reacted, with an email referral system, when there was every possibility of things not going ahead.

This is not rationing. It is completely wrong to say that. It was brought in by the CCG, which is GP-led. If the GPs in the CCG do not agree with it, they have the mechanism to replace the chairman of the CCG.

--- Later in debate ---

[David Mowat]

I have given way a lot; I want to make some progress.

That is also of benefit to GPs, because they can quickly validate decisions on the best pathway for those grey areas that may or may not require a referral with a consultant who knows more than them about that particular discipline. Of course, it is of benefit to the providers because it takes away something like 20% of unnecessary outpatient appointments. Indeed, one of the providers for the scheme in North Tyneside has asked for it to be extended to an additional discipline, because they feel that some of the referrals they receive are unnecessary and that the referral management system—in the way we have been doing it in the NHS for the past decade—is a mechanism for preventing that.

[Dr Blackman-Woods]

The only information that North Tyneside CCG has put into the public domain is how much money it has saved through this system. It has not made an assessment of clinical outcomes for patients at all.

[David Mowat]

I am going to talk about the About Health situation and the people who have been awarded the contract in North Durham. It is a one-year pilot that builds on the one-year scheme in North Tyneside. I think it started last month; it covers six disciplines and it does not cover urgent referrals, in particular cancer. All the national requirements for referral-to-treatment times still count in exactly the same way. The local CCG performed a risk analysis before it decided to take the scheme forward and build on what happened in North Tyneside, and the scheme is monitored.

I have been told that a very important feature is that there is a clear GP appeals process. If they are not happy with a decision that has been taken, that process can happen very quickly.

Economic Growth and Employment

Debate between David Mowat and Roberta Blackman-Woods

Wednesday 23rd November 2011 Commons Chamber

[Roberta Blackman-Woods]

My hon. Friend has made an excellent point. It is interesting to note that before the general election, in my region at least, the Liberal Democrats were apparently in favour of regional development agencies.

[David Mowat (Warrington South) (Con)]

Will the hon. Lady give way?

[Roberta Blackman-Woods]

I am sorry; I am running out of time.

We know that the RDA helped to invest in a new generation of advanced technologies with expanding markets around the world, which greatly helped growth in the north-east. Through industry, Government and university collaborations, a number of sectors were identified in which growth should be prioritised, including the processing and chemical industries, automotive and advanced manufacturing, and printable electronics. Those sectors, critically, were underpinned by centres of excellence supported by the regional development agency.

Did the incoming Government seek to build on that? No. What they did instead was get rid of One North East, although it had extensive support from businesses and the community in the north-east, and what we have in its place is the regional growth fund, about which I shall say more in a moment. The loss of the regional development agency led to a loss of expertise in regard to the sectors that needed to be developed in the north-east, and a loss of what was necessary to support that development. In great contrast, the regional growth fund not only has less money but is not strategic at all. I am very pleased that a number of north-east companies have benefited from the RGF, although the Secretary of State must address the fact that getting the money through to the companies is taking a long time.