NHS Efficiency

Dean Russell Excerpts

Tuesday 2nd November 2021 Westminster Hall

[Dean Russell (Watford) (Con)]

It is a pleasure to speak under your chairmanship, Sir Gary, and an absolute honour to follow the excellent contribution of my hon. Friend the Member for Peterborough (Paul Bristow). I refer to my registered interests and, in particular, I raise the fact that I am the chair of the all-party parliamentary group on digital health, which very much informs some of my points today.

I will be brief, as I am conscious that this is a big debate to have in a small period of time. One of my passions for looking at efficiencies in the NHS comes from my own experience. About 12 years ago, I was asked by the Department of Health to do a strategic review of every NHS website in England and Wales. I will cut to the punchline: there were more than 4,000 live sites. I did the financial calculation and worked out that between £87 million and £121 million a year was being spent on websites, many of which people did not even know existed. That highlighted that one of the challenges for the NHS is that, because of its immense scale, even though people want to do the right thing, duplication inherently causes extra costs on a scale that one cannot really comprehend in a normal business, or even in a global business.

This highlights various points. First, if we want to improve efficiencies, we need to make sure that patient experience and patient care is at its heart. There were 4,000 websites at the time, of which several hundred were about how to stop smoking. It would probably have been more efficient to have one really good stop smoking website, rather than 200 average ones.

Patient experience is not just about the outcome but about how patients find the right information, how they get to the source and how we make sure they are not having to repeat the same thing every time they go for an appointment, which is where technology is so important. We often think of technology in the NHS as big, expensive, lumbering IT systems that are hard to comprehend, but the world has changed. We now have a consumerised approach to healthcare. People have watches that can track their heartbeat. They can go online and book appointments by email. They can use apps to do so much more, even track their covid status.

We need to look to the future, not just on efficiencies for cost savings but on patient experience. Thinking about the sort of experience we want patients to have over the next 10 or 20 years, it has to be seamless and efficient. Seamless in the sense that if a person breaks their arm, they do not have to say that they have broken their arm every time they see a new clinician, go on to a new website or use a new app. Their broken arm might mean they need additional wraparound care or it might affect their ability to work, so what will be the impact on social care? If we start to put patients at the heart of what we do, we can create efficiencies around them, rather than requiring them and the NHS to duplicate their efforts.

There is a great opportunity to look again at patient experience, given the technology that is available not just in the NHS or in social care but generally. We are now used to using social media, apps and phones for so many different things. If we can start to bring that into how we look at the future world of health, we would have a powerful opportunity to say to patients, “What would you like your health system to look like?” Rather than imposing variations of the health system of the past 40 or 50 years, we could ask, “What is it that you, as an individual, would like to see in how we look after you, your children and your parents, not just now but for decades to come?” We could then create an efficient and effective system that has patient outcomes at its heart and that ultimately creates a superior patient experience that helps everyone and, as I always say, is free at the point of use so we can make sure that the NHS continues to live up to its values as it always has.

Let us look to the future and let us see what is available, rather than just relying on what we had in the past.

Covid-19 Update

Dean Russell Excerpts

Tuesday 14th September 2021 Commons Chamber

[Sajid Javid]

I can tell the hon. Lady that there was significant discussion about that with my G20 colleagues, but not all of them have, let us say, behaved in the same way as the UK in offering donations to poorer countries of vaccines. The hon. Lady will know that we are committed to offering 100 million doses to international friends, and that we have already provided or donated 9.2 million doses, most of those for the COVAX programme. We remain committed to that programme, and one of the things we are trying to do internationally, including through the Foreign Secretary, is encourage more countries to honour their commitments to COVAX and encourage those who have not joined the COVAX commitment to come forward and help in that way.

[Dean Russell (Watford) (Con)]

Across Watford, we are served by some amazing GP surgeries, including the Manor View practice and its team. However, I am hearing from constituents that some GP surgeries are still not opening their doors to do face-to-face appointments. Would the Secretary of State agree with me that we should encourage those GP surgeries to start opening up to help with the backlog and help see people face to face?

[Sajid Javid]

Yes, I agree with my hon. Friend, and he is right to raise this. I think everyone can understand why, during the height of the pandemic, GPs could not provide access in the normal way, but we are way past that now. Life is starting to return almost back to completely normal, and as that is happening it should be happening in our GP surgeries too. More GPs should be offering face-to-face access, and we intend to do a lot more about it.

Long Covid

Dean Russell Excerpts

Thursday 14th January 2021 Commons Chamber

[Dean Russell (Watford) (Con)]

I am pleased to pay tribute to the hon. Member for Oxford West and Abingdon (Layla Moran) for securing this debate on such an important topic.

I am a member of the Health and Social Care Committee, and over the past year we have heard lots of evidence from lots of areas of the NHS—from social care, patients and staff—about the challenges that they have stood up to in the face of covid and the issues that have been raised. Throughout the year, I have seen a constant change in the landscape and the battles that we are having to fight, and a constant process of relearning what we thought we knew about this terrible virus. Long covid is part of that ongoing story, as we continue to learn about it and to fight the challenges that it will bring.

The Government and the NHS must be thanked in many ways for the work that they have done to set up 60 specialist centres for long covid and for putting in place the five-point plan, but, of course, there is always more to do. The repercussions of coronavirus will be with us not only until we are all vaccinated, and not only until we all deal with this over the next few years and start to get back together again; they will be with us for years.

There are unknowns—things that we will not know until we face them in the future. Long covid is one of the challenges that we will face and learn more about as the months—and, sadly, the years—go on. Similarly, we are facing challenges around mental health, and in that respect we are learning more not just about ourselves, but about society and how we support each other. I pay tribute to the Minister for Patient Safety, Suicide Prevention and Mental Health, my hon. Friend the Member for Mid Bedfordshire (Ms Dorries), for the incredible work that she and the Government are doing to tackle the challenges around mental health, and in this area.

I say to everybody out there: let us work together on this. We have to make sure that we are sharing the stories of the challenges, because we do not yet know whether some of the health challenges that we might be facing ourselves are due to long covid. It might be affecting our families, but they might not be sharing their stories.

Let us make sure that we learn from this excellent debate and all the wonderful words that have been spoken. My message to everybody out there, including Members, is this: “Please share the challenges you are facing. Speak to your GP and your family and share those stories, because you might be one of many silent people out there. Together, combined, your voice is so much greater than on its own, and you can save lives and change lives as we move into the future.”

Mental Health Act Reform

Dean Russell Excerpts

Wednesday 13th January 2021 Commons Chamber

[Matt Hancock]

One of the things that we have tried to do, which has been made more important because of the pandemic, is to ensure that access to IAPT therapies is available and that mental health support is as widely available as possible. We have managed to bring down some of the waiting times even while the pandemic is on, although it is more difficult in lockdown. This is an area of a huge amount of focus for us, particularly for the Minister for Patient Safety, Suicide Prevention and Mental Health. It is a very important subject on which we are working very hard.

[Dean Russell (Watford) (Con) [V]]

I thank my right hon. Friend and the Lord Chancellor for this landmark announcement. I am a member of both the Joint Committee on Human Rights and the Health and Social Care Committee, and we have covered the serious impact of the Mental Health Act in detail, particularly on people with learning disabilities and autism, and especially over the past year. Can my right hon. Friend set out what steps he is taking to change the way that people with learning disabilities and autism are treated within law?

[Matt Hancock]

My hon. Friend has done so much, alongside other members of the Select Committee and more broadly, on this piece of work to ensure that the law treats people with learning disabilities and autism separately from how it treats people with mental ill health, and as appropriately as possible for both. This has been the big development on top of the Wessely report, which is in the White Paper, and it builds on the learnings we have had over the last couple of years, when the focus on this subject has become yet more acute, and rightly so. It is about the need to ensure that people get the appropriate provision, in the community if at all possible, and, critically, the need to ensure that the legislative underpinning supports that and does not wrongly use mental health legislation when that is not the appropriate legislation. I am really glad that we have been able to build that on top of the Wessely report and that it has had such a warm welcome. Now we have to get the details right, and I look forward to working with my hon. Friend, who has done so much work on this, and others to ensure that the details of how this is framed in legislation are got right.

Ockenden Review

Dean Russell Excerpts

Thursday 10th December 2020 Commons Chamber

[Ms Dorries]

It is probably in the Secretary of State’s domain to make that kind of statement at the Dispatch Box, so I cannot give the hon. Lady that reassurance myself, but we are delighted about the huge number of new nurses and doctors that we have in training. Recruitment of our workforce in the NHS is going well, and I hope that that will be the ultimate goal.

[Dean Russell (Watford) (Con)]

Reading this report is utterly heartbreaking, and my heart goes out to the families who have been involved in this terrible situation. Leadership, workplace culture and patient safety clearly go hand in hand, so what steps is my hon. Friend taking to strengthen clinical leadership, in order to ensure that all maternity wards are the safest they can be?

[Ms Dorries]

I pay tribute to my hon. Friend for not only his work at Watford General Hospital—he is probably there more often some of the patients—but his commitment to mental health in his constituency. He has launched a programme of 1,000 mental health first aiders, which is a tremendous boost to his constituents. I am aware of his work, and I thank him for it.

My hon. Friend has hit the nail on the head. Midwifery leadership has been strengthened this year by the appointment of seven regional chief midwives, working with local maternity services to ensure the provision of safer and more personal care for women, babies and their families. I am sure that the hon. Member for Ellesmere Port and Neston (Justin Madders) had the same thoughts that I did on reading the report. There is a lack of collegiate working—“Let’s not let the doctors have this. Let’s keep this for the midwives”—and a lack of team working. The recommendations in the report put forward solutions to end that culture and to introduce one where doctors, nurses and midwifery champions work together, as a team, with the mother, who is in control of and owns her birth plan, because that is what it should be about.

Covid-19

Dean Russell Excerpts

Wednesday 11th November 2020 Commons Chamber

[Dean Russell (Watford) (Con)]

I am conscious of time, so despite wanting to make arguments on greater flexibility for worshippers, outdoor exercise, support for pubs—I could go on—I will not cover those things, as there have been excellent contributions on them already.

Today is a really important day of remembrance. As I have reflected on this debate, I have often considered the analogy that we are in an invisible war against the coronavirus—and this has been an invisible war. It is not a fight where we can see footage of battles won on beaches, air-raid sirens do not alert us to run for cover when the enemy is nearby, and this is not a battle where we can look our enemies in the eyes.

Nor, though, can we see the successes of our actions. We will never know the grandparent whose life we saved simply by wearing a mask. We will never know the father who avoided the devastating symptoms of long covid simply because we washed our hands. We will never know the mother who could go to work today simply because we chose to socially distance in a shop. And, God forbid, because we followed the Government guidance, we will never know the nurse who would have held our hand as we fought the virus from a hospital bed.

Our actions have consequences. Covid-19 has no conscience; it does not care who it infects or whose life it devastates. Coronavirus has a singular goal, and that is to multiply—to spread to us all—so it is on us all to stop it. No doubt in some laboratory there is a modern version of Alan Turing beating the code of covid, but until then it is on every single person in this nation to fight this virus. I want to say thank you to my constituents in Watford and to people across the country for following the Government guidance—for washing their hands, wearing a mask and socially distancing. Together we can win this war, and it is through that that we will succeed.

Covid-19

Dean Russell Excerpts

Monday 28th September 2020 Commons Chamber

[Dean Russell (Watford) (Con)]

Throughout the pandemic, we have seen unprecedented support from all our communities. I thank my community in Watford for their incredible work in coming together to tackle the challenge. Often, we talk about the concept of the fabric of society, but fabric is made up of woven threads and each individual thread is easily broken. Throughout the pandemic, we have seen a community woven together to make a much stronger fight against a real challenge across the country and the world.

Those threads are not just individuals; they are made up of our local communities, charities and pubs. Recently I visited the Partridge pub and the Badger pub in my constituency and chatted to people about the challenges they faced. They had been speaking to their punters, as they call them, as they tried to gather back together in socially distanced ways and start to feel part of a community again. We found that the problem is not just covid or communication, but one that threatens the heart of community. The lockdown created a real challenge for many of us.

All of us in the House—in this fantastic Chamber—have been challenged to look at the world differently, to look at our communities differently and to look at our own lives differently. Our constituents want to see how we can challenge our own beliefs to help others. The Chamber is a light and a beacon not only in this place, but to democracy in this country and perhaps even around the world. When we look at the lockdown measures, we must do so in a way that enables us to talk to our communities and constituencies about what we are trying to achieve.

When we look ahead to the coming weeks and months, we must make the argument in this place for why we need the lockdown measures. We may not always get to vote on them, but we need to be able to create the arguments so that people come with us and do not feel that we are against them.

Community is not just about getting together physically; it is about the spirit of how we work together and achieve things. This place has been a beacon of hope at times, but if we do not challenge ourselves to continue to have conversations here about the difficulties we all face, we risk losing people. The darkness that descended upon us has been broken by beacons of light in our community of fantastic volunteering and amazing work. We must now ensure that this Chamber continues to be a beacon of light—the light at the end of other people’s tunnels, so that they know where we are heading, what we are trying to achieve and why we are doing it for their benefit.

Covid-19 Update

Dean Russell Excerpts

Tuesday 8th September 2020 Commons Chamber

[Matt Hancock]

I entirely agree with the premise of the question, which is that tackling obesity is critical for the long-term health of people, and that has been highlighted yet further because of the impact of obesity on the likelihood of someone dying from covid if they get it. Of course I want to see that sugar reduction. The sugar tax has had a very significant impact on the areas that it covers, and we have a wider obesity strategy that the Prime Minister set out in July to drive forward this agenda.

[Dean Russell (Watford) (Con)]

Across Watford and the entire UK, volunteers have been going out on the frontline, helping our brave NHS workers. One group that I met recently was from St John Ambulance, and they explained to me that the red tape in place a year ago would have made it impossible for them to be able to help, and now they have been able to cut through that during the covid crisis. Can my right hon. Friend please assure me that as we move forward, that red tape will not start binding their hands again and they can continue to help?

[Matt Hancock]

Absolutely. My hon Friend is quite right. There are improvements that we made in the heat of this crisis that we should never go back on. He has just highlighted one example. There are legion others. In this House, we discuss the problems that need to be fixed. That is quite right, and often they are raised and I did not know about them in advance and I go out and fix them. That is my job, as the hon. Member for Leicester South (Jonathan Ashworth) raised with his example, but we should also note where things have gone well because of changes and be clear that we will not be going back on that.

Coronavirus Update

Dean Russell Excerpts

Tuesday 14th July 2020 Commons Chamber

[Matt Hancock]

Of course we are doing that work to stress-test the delivery of PPE and to rebuild the stockpile. We had a huge stockpile at the start, but the distribution of that stockpile was extremely difficult for a couple of weeks while we fully sorted it out, got the supplies flowing back in from abroad and built up domestic supplies. Lord, Paul, Deighton has done a remarkable job in putting together the logistical effort. It is exactly as the hon. Lady says. Over the summer, we are doing the work to ensure we are ready for winter.

[Dean Russell (Watford) (Con)]

I welcome the Government’s announcement that the immigration health surcharge will be exempt for health and social care staff. As set out by the Home Secretary just this week, we will launch a health and care visa, providing an exemption to the health surcharge upfront for either themselves or their dependants. There are, however, some in social care who will not be caught by that exemption. Can my right hon. Friend therefore please update the House on how he plans to ensure those social care workers will be exempt from paying the health surcharge?

[Matt Hancock]

Yes, I can. I can announce today that all employees working in health and social care will be exempt from the immigration health surcharge and that all employees in health and social care who have paid the immigration health surcharge on or after 31 March will be eligible for a reimbursement. We value enormously the work that people do right across the NHS and all across social care, and I am glad that we have been able to make this announcement.

Health and Social Care Workers: Recognition and Reward

Dean Russell Excerpts

Thursday 25th June 2020 Commons Chamber

[Dean Russell (Watford) (Con)]

I want to place on record my thanks to the pharmacists, GPs, hospital staff and everyone in between across Watford for the amazing work they have done recently and over many years. I sit on the Health Committee—now the Health and Social Care Committee, importantly—which has given me great insight into the challenges that the health and social care sector has faced over the past few months. Over the past 10 or 11 weeks, I have also been a volunteer at Watford General Hospital, literally on my knees cleaning Zimmer frames at times and carrying water to staff. I have been proud to be part of the volunteer hub there, alongside people like Monica, Theo, George, Denise, Linda and so many more who are offering their time for free to help our brave NHS staff as they tackle this terrible pandemic. The hospital has also been working closely with Watford football club, which has provided amazing facilities, including a sanctuary for staff’s mental health.

During this time, I have also been listening. One of our jobs as parliamentarians is to listen. What I have been hearing is that the pandemic has shown how this Government are trying to be innovative, trying to use technology in different ways and, ultimately, trying to unbind the red tape that has held back so many people on the frontline. For so long, we have been stuck in a process of looking at points and targets, and we have forgotten what frontline workers really want. They want respect. They want trust. They want us to cut through the red tape, so that they can get on with their jobs across the health and social care sector. I am hearing loud and clear that, during this pandemic, we have enabled that to happen because we have had to, but we need to continue that.

We also need to listen to what staff really want. I had an eye-opening moment when I was delivering sandwiches to one of the wards, and the nurse said, “Don’t worry about the sandwiches—we’re getting fed over at Watford football club. We get delicious pizza over there, so we probably won’t eat those.” That really opened my eyes to the fact that, while salary is critical, it is also about what life is like on the frontline day after day.

We need to listen to what staff really want, and that is partly about career pathways and opportunities such as sabbaticals after 10 years of working in the same job. It is about corporate discounts, working with the private sector to enable not just NHS staff but social care workers to have free opportunities and discounts and go to the front of the queue. It is also about innovation and the use of data and technology. I believe that, if we look at all those things, although it may not happen overnight—it might take years, perhaps even decades—we can really make a change for the better for all our brave staff and be, not just the biggest employer, but the best employer in the world.