Oral Answers to Questions
David Tredinnick Excerpts(4 years, 10 months ago)
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Matt Hancock
As we discussed in the answer to an earlier question, I have both decriminalised the use of cannabis oil and introduced the National Institute for Health Research clinical trials. However, individual rules about prescriptions have to be for individual clinicians, and when it comes to funding it in Scotland, that has to be a matter for the Scottish NHS.
David Tredinnick (Bosworth) (Con)
Will the Secretary of State look at making greater use of chiropractors and osteopaths in support of orthopaedic surgeons?
Matt Hancock
How could I say no as my wife was an osteopath? I understand very strongly the importance and value of those professions.
The National Health Service
David Tredinnick Excerpts(4 years, 10 months ago)
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Jonathan Ashworth
It loses elective orthopaedics, loses urology, loses brain injury and neurological services, loses gynaecology, and loses podiatry.
Jonathan Ashworth
Let me just finish this point and then I will bring in the hon. Gentleman. [Interruption.] He is a Leicester Member of Parliament, after all.
The Leicester General can have a sustainable future under this Secretary of State only if he moves the midwifery unit from St Mary’s Hospital in Melton Mowbray. If that is what he is proposing, I hope he is making it clear to Leicestershire MPs.
David Tredinnick
I am most grateful to the hon. Gentleman, who is a Leicester Member, but I have to say that I am astonished by his tone. Almost the entire county and city welcomed this huge, major investment and reorganisation. Years ago, my former right hon. Friend Stephen Dorrell—he is no longer in the House—explained why the General was likely to close. That is not the case—the hon. Gentleman should recognise that massive investment.
Matt Hancock
I have great regard for the campaigning that the hon. Lady does on many topics, but I am afraid to say that she was factually inaccurate in what she said just now; it is not true. We are putting the largest and longest investment into the NHS in its history, and I think that that is the right thing to do.
David Tredinnick
May I just tell the Secretary of State what an amazing job he is doing for Leicestershire and how proud the county is of this forward investment? May I draw his attention, however, to the NHS carbon footprint in England, which is around 27 million tonnes of carbon dioxide equivalents, and suggest that with the new hospital builds across the country, he ought to make better use of zero carbon medicines and treatments? That means embracing acupuncture, herbal medicine, homeopathy, chiropractic and osteopathy. Will he also ensure that the osteopaths and chiropractors who have been regulated by Act of Parliament since 1993 and 1994 work with the orthopaedic surgeons?
Matt Hancock
I am absolutely delighted to work with my hon. Friend on that subject, and also on the capital investment into Leicester. I do not want to spend too long on the issue of Leicester, because we almost had an Adjournment debate on that subject a few minutes ago. We have announced 40 new hospitals over the next decade, which we will ensure include carbon neutral and green elements; we have discussed that. While we are doing that, however, such is the hon. Member for Leicester South’s commitment to opposition that he even opposes the new hospital we are building in his constituency. He described the £450 million of investment on 29 September as “downgrading” when he talked about local opposition. This is long-term investment that the trust chief executive describes as “completely transformational”. The hon. Gentleman should rejoice at this excellent news. He is so good at opposition that I have a long-term plan for him, and that is to keep him in opposition for the long term.
Oral Answers to Questions
David Tredinnick Excerpts(5 years, 2 months ago)
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Matt Hancock
The right hon. Lady, as always, puts the case for Pontefract very powerfully. The truth is that we will need more nurses and more midwives, as well as other health professionals, over the next five years because we are putting in a record amount of funding. More people are needed to deliver better services, and I am happy to meet her to discuss this specific case. Coming from and representing towns myself, I understand the importance of keeping services such as maternity services close to the people they serve.
David Tredinnick (Bosworth) (Con)
Will my right hon. Friend make sure that his interim people plan looks again at the hugely underutilised resource of the allied health professions, including osteopaths and chiropractors? What is the point of having a professional standards authority to regulate them if the Department will not use them?
Matt Hancock
My hon. Friend makes an important point, one that we have frequently discussed. As he knows, I am married to an osteopath, so I do recognise the value that osteopaths bring to all of us.
Oral Answers to Questions
David Tredinnick Excerpts(5 years, 3 months ago)
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Mr Speaker
This is a general question about best practice in the NHS, into which the hon. Member for Bosworth (David Tredinnick) could legitimately shoehorn his concerns about acupuncture, chiropractic therapies, osteopathy and other non-drug based, non-addictive options for pain management, about which I think he is keen to expatiate.
David Tredinnick (Bosworth) (Con)
Matt Hancock
Mr Speaker, I am glad that you have used your considerable flexibilities to bring this question in, because I wanted to say that NICE is in the process of developing a guideline on the management of chronic pain, which will look at the biological, physiological and social factors, including some treatments mentioned by my hon. Friend. There is progress in this space, and I am glad that we have been able to raise this matter in the House today.
Healthcare: East Midlands
David Tredinnick Excerpts(5 years, 3 months ago)
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David Tredinnick (Bosworth) (Con)
Thank you, Mr Hollobone, for allowing me to speak first. I think it is the first time I have heard a Chair say that there is no time constraint, but I will not detain the House for too long. At the risk of being called to order, I had planned to raise the work that you have done for Kettering General Hospital and your impassioned demands for improvements to it over the years, which no doubt the Minister has listened to many times. I was with some friends last week who said, “Ah, Northamptonshire. That’s the Bones—Peter and Philip—isn’t it?” Kettering General Hospital came up. At the risk of being called to order—I do not see you doing that—let me say what a good job you have done for that hospital. As was said in the Chamber this week, your whole identity in the House is linked to the work you have done there.
I congratulate the hon. Member for Lincoln (Karen Lee) on securing not just half an hour but an hour and a half in what used to be called the Grand Committee Room but is now Westminster Hall. She spoke passionately and with detailed knowledge, as a former nurse, about the problems in her area. I listened to her speech, and I have sympathy with what she said about some of the consolidation that has taken place, but inevitably there have to be some changes and rationalisations in the health service.
I will talk mainly about the changes in the great town of Hinckley, in my west Leicestershire constituency of Bosworth, which is some way from Lincoln. We were very fortunate that the Secretary of State himself—ipse—recently came to Hinckley to look at the changes that will be made thanks to the £8 million grant that has been secured for upgrading the facilities in Hinckley. Mayur Lakhani, the chair of the West Leicestershire clinical commissioning group, spoke warmly about the way the Secretary of State had responded to their bid, and the support of Hinckley and Bosworth Borough Council, which happens to be Conservative-controlled, and which I will refer to later.
I was lucky to be elected to this House a long time ago—in fact, so long ago that I sometimes forget the date. I have been a Member for more than 30 years, and the one health issue that has bedevilled my constituency above all others in that period is what to do with the Mount Road hospital—the old hospital in the middle of Hinckley. Because of the £8 million grant that the Secretary of State awarded to the clinical commissioning group, we are now able to make some substantial changes to the health improvements in Hinckley. Given your interest in Kettering General Hospital, Mr Hollobone, you will understand my joy at seeing the improvements that are about to take place—consultations are going on at the moment.
I have a letter from the West Leicestershire clinical commissioning group setting out exactly where we are now. It says that the investment supports plans to provide modern, fit-for-purpose facilities, and more services in the local community and closer to home in Hinckley. I say to the hon. Member for Lincoln that part of that will be about shutting down old facilities. One is a portakabin and another is the old hospital. In exchange, the investment will make better use of all available existing space in Hinckley Health Centre on Hill Street, not far from the old hospital, and Hinckley and Bosworth Community Hospital, which we call Sunnyside because it is on a hill and gets the sun all day long—it is a marvellous place for a hospital.
As part of the £8 million package, the Hinckley Health Centre will be refurbished to accommodate X-ray, ultrasound and physiotherapy, and to increase the number of consulting rooms, which is extremely important. Out-of-hours primary care services will be relocated from Hinckley and Bosworth Community Hospital—Sunnyside—to the newly developed urgent care hub in the Hinckley Health Centre, which will provide out-of-hours urgent care for local patients. A combined day case surgery and endoscopy unit with day case beds will be created. That will provide an increased range of day case procedures and cancer screening services for local patients. We will be removing services from the old Hinckley and District Hospital and the physiotherapy portakabin, which are unfortunately not fit for purpose, and physiotherapy services will be relocated to Hinckley Health Centre.
As I have the luxury of time, I say to people who have campaigned for years to save the old Hinckley and District Hospital that as it is such an old building, upgrading the hospital to the highest standards would require a phenomenal amount of work at a very high cost, with a low return on investment because all the special cables now have to be run with special conduits for oxygen and monitoring. It simply cannot be done efficiently in such an old structure. Although many of my constituents will have an emotional attachment to the old hospital, the decision that has been taken by the clinical commissioning group is right: it needed to close. In exchange, we are now getting an £8 million grant, which will provide much better facilities. As I mentioned earlier, some of the facilities are coming into the town from the outskirts—from Sunnyside to the health centre. It is quite an achievement.
We were lucky to get the grant of £8 million. My father always said to me that you generate your own luck in life, which is true. In this case, one of the drivers that made it possible for the Department and Secretary of State to agree to the clinical commissioning group’s bid was the extraordinary co-operation in west Leicestershire between the different service providers, particularly in Hinckley in my constituency.
At the beginning of the 2005 Parliament, I was lucky enough to get elected to the Health Committee under the new procedures. Subsequently, I chaired it for a short time. When I was elected to the Committee, I asked the then leader of the council, “Would you like me to come and talk about health on a regular basis?” It was agreed that I would, and that developed into a health and wellbeing partnership, which meets quarterly with the clinical commissioning group; the director of public health for Leicestershire County Council, Mike Sands; and senior officers at Hinckley and Bosworth Borough Council, including Bill Cullen, Simon Jones, Councillor Maureen Cook and many other excellent Conservative councillors over time. We also have doctors from the local surgeries attend.
Over a period of some years, we saw the meeting change from participants sitting with their arms folded and leaning back, to sitting up and listening attentively. We have learned to work together, and the partnership has been leakproof—there is nothing to gain from talking outside. We have had an extraordinary degree of co-operation, and I am absolutely convinced that it has improved the health services in my constituency and the county as a whole. It has reduced costs and brought up a whole a range of new ideas, some of which I shall go through today. The work of the secondary provider, Hinckley and Bosworth Borough Council, has been really remarkable and hugely encouraging, and it is something that all local people in my constituency can be proud of. Leicestershire County Council has done a good job, too, but I am particularly proud of what Hinckley and Bosworth has done through its health and wellbeing partnership—its contribution to health delivered through that partnership.
It might be instructive if I run through some of the areas that Hinckley and Bosworth Borough Council has worked on. I am pleased to see the Minister of State in his place rather than a Parliamentary Under-Secretary; he is the deputy of the Secretary of State. It illustrates how seriously the Government take the issue of health funding in the east midlands. I want to share with him what is going on in Hinckley. First, I reiterate that we have a local delivery of preventive services through co-operation. I mentioned the councils, but we also talk to the voluntary and community sector. We have patient participation groups, school participation groups and elderly patient participation groups.
The information pyramid is broad-based, and the lines of communication are fluid. Information can come from the bottom to the top very easily. From those ideas, the Conservative-controlled Hinckley and Bosworth Borough Council has produced a comprehensive prevention strategy, which sets out the work that the authority will undertake with its partners. The first objective is to prevent issues from escalating by taking action as early as possible. The second is to reduce demand for high-cost services and dependency on statutory services, thereby making spending more efficient.
Another objective is to develop self-help approaches to enable communities to take responsibility for their own health and wellbeing, which is something that the Department of Health and Social Care worked on under the Secretary of State’s predecessor, and the Health Committee in the 2005 Parliament looked at personal budgets and how they work. It was about getting people to think about their own health. With an ageing population, that is one of the areas that really must be brought to the fore in the future. However much money we ask for the NHS, we will never have enough supply of resources to meet demand unless we encourage people to take greater care of themselves. In this respect, the initiatives that Hinckley and Bosworth Borough Council has taken are hugely important in encouraging people to do that.
I will come on to what the council has done in a moment, but the overall aim of the strategy is to ensure that, together with its key partners, the council enables communities—especially people who are most at risk—to keep safe, keep well, stay independent and enjoy life. To support those aims and achieve those objectives, the council provides integrated locality teams, which identify and support people in a more co-ordinated way, focusing on two specific areas. The first is:
“Proactive identification via risk stratification of patients (18+, frail, multiple LTCs) at risk of a hospital admission and assessing the ‘whole person’ and their needs to keep them safe and well at home where it is appropriate to do so.”
I quote from this document—“whole person”—because a key thrust of health policy in the future should be holistic healthcare, which has become slightly muddled up and seen as definitely not mainstream. Actually, it should be at the core of the mainstream, treating the patient as a whole. I will come on to long-term care and conditions when I discuss the Health Committee’s report, “Managing the care of people with long-term conditions”, which I signed off as Chairman.
In Hinckley and Bosworth, we have a council that is proactively segmenting the population to treat people who are most in need as priorities, which I absolutely applaud. It also does that through the use of health ambassadors, who are
“uniformed volunteers who support and encourage people to get more active more often. They undertake this by playing to their strengths. Some give presentations, some lead activities, some encourage and support new participants on current schemes. Some are happy to have a coffee after an activity and talk to new participants. The big thing is they are positive role models who are empathetic with people and can support them to change and be more active in a way that is natural and comfortable to them.”
The programme is particularly effective when dealing with older people. In my beautiful constituency, Desford sports centre provides classes for elderly people, to keep them active. They have a chance to talk to experts—not doctors particularly, but sports therapists. They can play table tennis, sit down and do quizzes, play tennis—there is even tennis for people who are disabled. The whole idea is to get people who are a bit tired of life, or a bit sad by themselves, to meet other people and to engage in activities, thereby making them happier and healthier, and reducing the burden on the health service.
We are trying to divert away from A&E—the Leicester Royal Infirmary has one of the highest patient inputs in the country relative to its geographical footprint. I will not talk about the royal infirmary and the wonderful work of its health workers, but when the chair of the clinical commissioning group came to see what we were doing in Desford—on another visit, without the Secretary of State—we saw the Steady Steps programme. It is a 24-week free postural and stability exercise programme for older adults, aimed at those aged 65 and over who are at risk of falling, unsteady on their feet, lacking in confidence or likely to lose their balance.
One therapy that the sports centre is not employing, but to which I should like to draw the House’s attention, is the Alexander technique, which I have used in the past. Alexander was an opera singer, and he found that he could not sing. Part of the problem was that his chest was constricted all the time, so he could not project his voice—something that politicians are also quite keen to do at time when on the soapbox, if they can ever get there. Alexander discovered that breathing was connected to posture, and most people do not stand correctly with their hips as part of their back; they tend to have a break and swivel around the second and third lumbar vertebrae. He managed to get people to stand correctly to get their weight right. With their weight right, their lungs could perform properly. Those techniques, which have been developed by experts over the years, should be looked at carefully by the Department of Health and Social Care, but I will come to ways that we can take pressure off the Department generally.
Through the Steady Steps programme, it is so exciting and empowering to see elderly people who have become immobile actually get back into the community. Some of them have mental health problems, and Hinckley and Bosworth Borough Council has an active mental health support programme with five main objectives. They are to create networks to co-ordinate comprehensive and integrated mental health services in the community; to implement activities and events for promotion and early intervention and prevention in mental health; to improve awareness of mental health issues among children and young people, so that they do not think it strange that an older person is perhaps not as with it as they were in their 20s; to improve mental health and the impacts in the workplace; and to improve the quality of life of people living with dementia, and of their families and carers.
That is not rocket science; it explains to people simple facts of life about health. The programme brings the community together—it is a project that speaks to cohesion—makes it less likely that people will be upset by the behaviour of other people, and enables instructors to identify core problems. In the Hinckley and Bosworth area, we have over 6,500 dementia friends and 40 dementia champions. That is a lot of people in a constituency of 100,000 with 70,000 electors, and a very serious intervention.
Suicide is another issue that we as MPs deal with regularly. Most colleagues will have had cases in their surgeries about which they have had to approach care agencies. Leicestershire and Hinckley and Bosworth Borough Council have taken very decisive steps, with the Start a Conversation suicide prevention campaign for Leicester, Leicestershire and Rutland. The Start a Conversation website was launched on 10 September to coincide with World Suicide Prevention Day, and aims to provide information and signposting to people who are experiencing distress, to those worried about someone else, or those bereaved by suicide. The website is still in development, but will offer support and training to professionals.
Jim Shannon (Strangford) (DUP)
Whether we are discussing healthcare in the east midlands or in Northern Ireland, the issue of suicide is prominent in my constituency. When I became its MP in 2010, the level of suicide among young people was at its highest. That was dealt with through the involvement of community groups and of people in the community who had lost loved ones. There was also interaction with church groups and those of faith. By coming together, we reduced the incidence of suicide, and by working alongside healthcare in Northern Ireland, which is a devolved matter, we found that together, we could address the issue. It took both the community and healthcare to make that happen.
Mr Philip Hollobone (in the Chair)
Before Mr Tredinnick responds, I remind the Chamber that there is half an hour of Back-Bench time left, with two other Members seeking to contribute.
David Tredinnick
I am sensitive enough to take the hint and will not delay the Chamber for much longer, Mr Hollobone. In response to the hon. Member for Strangford (Jim Shannon), we have a street pastor campaign in Barwell in my constituency, which really gets people in. The point about suicide that is often missed is the tragedy that it leaves behind and the damage to family and friends.
In my wind-up—I know hearing that will excite you, Mr Hollobone—I will focus on the Secretary of State’s announcement yesterday about putting cigarette-packaging style warnings on opioid painkillers, which I absolutely welcome. Of course it affects the east midlands. A report in the Evening Standard yesterday was entitled, “Experts hail our opioids investigation as addiction warnings are announced”. To give credit where it is due, the Evening Standard promoted that campaign, which I think is incredibly important.
The weakness in saying that we must stop all that is that no one has actually come up with any alternatives. People take those painkillers because they are in pain. Hinckley and Bosworth Borough Council has produced a holistic therapists directory, which may be the first of its kind in the country. When my right hon. Friend the Secretary of State visited, I took him to Burbage House Health Clinic, where he could see physiotherapists and chiropractors working together. He has declared his interest—I believe his wife is an osteopath—so I hope that under this Secretary of State, we will see some movement in this matter.
We cannot just stop people taking drugs without offering them an alternative. The three most effective ways to stop back pain are acupuncture, osteopathy and chiropractic. Acupuncturists, osteopaths and chiropractors are all properly regulated, so I implore the Minister of State to look carefully at using them. The other issue I wanted to mention is polypharmacy polymorbidity, which the Health Committee looked at. I gave the Minister as a Christmas present the report of the all-party group for integrated healthcare, which I chair. I do not know whether he put it in his stocking, but I look forward to hearing if he enjoyed it over Christmas. Perhaps he will look at the issue.
We are very myopic sometimes, thinking that our system is the only one around, but the best place to look at for solving some of the problems is India, which has a Ministry of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy. It is responsible for all the herbal medicine and the different services that are not mainstream or opiate drugs. We should look at what Prime Minister Modi has done there.
I have probably indulged myself a bit, Mr Hollobone, but it is so unusual to have any time in the House—thank you very much. I look forward to the Minister of State’s response, and again I congratulate the hon. Member for Lincoln.
Oral Answers to Questions
David Tredinnick Excerpts(5 years, 5 months ago)
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Matt Hancock
We are determined to do everything we can to support people, especially at the time—in the first 1,000 days—that is so critical to people’s whole lives, and that is an incredibly important part of the work. Improving maternity services is important, but the link-up with other broader agencies is also important, and we should not denigrate or downplay the vital role that charities too can play in supporting people.
David Tredinnick (Bosworth) (Con)
I thank my right hon. Friend for coming to Hinckley to see co-ordination and social prescribing in action. Will he be taking steps to further develop personal budgets, which save money and improve lives?
Matt Hancock
Yes, absolutely. Driving the social prescribing agenda, which is based on increasingly strong evidence of the power of social prescribing to help people stay healthy and get them healthy again when they are ill, will also involve wider use of personal budgets. Almost 1 million people have personal budgets.
Matt Hancock
The relative funding across the country for different areas is assessed independently, and by law NHS England makes that assessment. I am happy to write to the hon. Gentleman with the precise details of how those allocations are devised—I am sure that he has got them; they are widely available—and an explanation of the conclusion that NHS England independently reached.
David Tredinnick (Bosworth) (Con)
What is being done to improve co-ordination between orthopaedic surgeons, osteopaths and chiropractors to reduce the burden on surgeons?
Matt Hancock
It is an important part of the agenda that we look right across the piece at interventions that can benefit patients. I know full well, not least because I am married to a former osteopath, the positive impact that that can have.
Oral Answers to Questions
David Tredinnick Excerpts(5 years, 6 months ago)
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Jackie Doyle-Price
The hon. Lady raises an important point. This is something that I am taking forward with the Minister for Policing and the Fire Service. We are acutely aware of the impact that this is having on policing services, and that is one of the reasons why, in the forward plan, we have directed so much support and priority to ensuring that the NHS 111 service works and that we have the community and crisis care services to back it up.
David Tredinnick (Bosworth) (Con)
A report in The Lancet in March 2018 found that most drugs and injections are useless for lower back pain. What will my right hon. Friend do to find alternative treatments?
Matt Hancock
I pay tribute to my hon. Friend, who recently announced that he will be standing down at the next election, for the amount of attention he has given to broadening people’s minds and to looking at what works and what the evidence shows works. We know, for instance, that social prescribing can help people and ensure that they get the support they need, and he has made a great contribution to that debate.
Oral Answers to Questions
David Tredinnick Excerpts(5 years, 7 months ago)
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Stephen Hammond
The hon. Gentleman is right. I recognise that the overall CQC rating was that the hospital requires improvement. I understand that the funding that has gone into it has been more than adequate and that it is improving. However, I recognise the concerns he raises and I would be delighted to meet him to discuss them.
David Tredinnick (Bosworth) (Con)
Will my hon. Friend congratulate Conservative-controlled Hinckley and Bosworth Borough Council’s health and wellbeing board, and its approach to NHS workforce shortages? It has, for several years, been working on collaboration between GPs and community services, which is in line with the 10-year plan. Will he look at the registers of the Professional Standards Authority, which are not mentioned in the long-term plan, and see if he can make better use of the 80,000 properly regulated practitioners on those registers?
Stephen Hammond
My hon. Friend is right to recognise that community provision lies at the heart of the long-term plan, and that a number of health service professionals make up that community provision. If he wishes to write to me about registers, I will be delighted to respond.
Oral Answers to Questions
David Tredinnick Excerpts(5 years, 9 months ago)
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Matt Hancock
I am afraid that I will have to let my right hon. Friend know that we are leaving the European Union on 29 March.
David Tredinnick (Bosworth) (Con)
The Parliamentary Under-Secretary of State for Health and Social Care (Steve Brine)
The NHS long-term plan, backed by the extra investment by 2023 and confirmed by the Chancellor in the Budget, will set out a sustainable vision for the NHS to make strides towards it being the safest, highest-quality healthcare system anywhere in the world, learning from everywhere and anywhere in the world over the next 10 years.
David Tredinnick
According to the flyer for the post-launch party, the integrated care systems will be considered. Will the Minister make sure that he looks at the use of homeopathy by French pharmacists, the three quarters of a million doctors using traditional healthcare in the Ayush Ministry in India and the 55,000 state hospitals using acupuncture in the People’s Republic of China?
Steve Brine
The NHS should always look to learn from the best healthcare systems and practices anywhere in the world provided they are backed by evidence.
Prevention of Ill Health: Government Vision
David Tredinnick Excerpts(5 years, 9 months ago)
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Matt Hancock
The statement talks all about the wider determinants of health. If the hon. Gentleman wishes to talk about poverty specifically, it is absolute poverty, not relative poverty, that has a link to ill health, and that has fallen.
David Tredinnick (Bosworth) (Con)
Is the Secretary of State aware that experts have warned that a million patients are getting useless drugs and injections for back pain, but his Department makes very little use of statutorily regulated osteopaths and chiropractors? Is he also aware that there is a Faculty of Homeopathy here and that the doctors are not employed enough, despite the fact that there are a quarter of a million homeopathic doctors in India?
Matt Hancock
I respect my hon. Friend’s understanding of these issues, not least because I am married to an osteopath, so my back is feeling okay and I hope that other people can access such services, too.