(2Â weeks, 4Â days ago)
Commons ChamberMy hon. Friend the Minister for Secondary Care has been looking in detail at that report. We obviously take all reports immensely seriously. The advice and guidance have been in place for some time and rightly provide huge amounts of support, advice and, actually, improvements in healthcare right across the country. Where there are cases where things go wrong or where cases are raised with us, we will always investigate them and take them immensely seriously. We will also always ensure that the whole regulatory framework is there to ensure that the highest standards are upheld.
Deirdre Costigan (Ealing Southall) (Lab)
I thank the Secretary of State for her statement. Ealing hospital has already had ÂŁ5.9 million of investment from this Labour Government to install 222 solar panels and a new heating system that stops patients and staff getting too hot or cold. Does she agree that her announcement today will not just help the NHS to beat the heat, but help us to save money that we can spend on patient care?
(2Â weeks, 5Â days ago)
Commons ChamberI am going to press on a little bit, if I may.
I remind the House that we are doing this within the existing legal structures, and that our approach is not to put in place additional duties and layers of detail and specificity in primary legislation. I think we should avoid the temptation to create separate statutory obligations for each condition or patient group, particularly in an age where people are living longer and very often with more than one health condition. Instead, we should commit ourselves to tackling inequalities for everyone, everywhere.
We have again heard from the Liberal Democrat spokesperson, the hon. Member for North Shropshire (Helen Morgan), about corridor care. The Government have been consistently clear that corridor care is not an acceptable standard of care and should not be normalised, and it is our intention to reduce and ultimately eradicate it. I think it is worth reminding the House that corridor care does not occur everywhere; some places have made huge steps to avoid it, and we want to share that learning. I particularly commend Barnsley foundation trust, South Warwickshire foundation trust and the Dudley group foundation trust, where there have been zero incidents in the last reporting. We must recognise that corridor care is one of the most visible and distressing symptoms of systemic pressures across the urgent and emergency care pathway, and our focus is on taking action now to tackle those underlying pressures.
We are improving patient flow, strengthening discharge arrangements, investing in urgent and emergency care services, and providing targeted support to the systems and trusts facing the greatest challenges from corridor care, so that improvements can be delivered where they are needed most. To ensure that we can understand where these challenges are, we have already introduced a national definition of corridor care, and strengthened reporting and oversight arrangements.
Deirdre Costigan (Ealing Southall) (Lab)
I thank the Minister for giving way and wish her a happy birthday, too. The NHS trust in north-west London was recently found to be one of the most improved in London in terms of reducing waiting lists. Does she agree that all the changes that she is bringing in through the Bill, including those discussed today, will help us to bring down those waiting lists even further and address the issues with corridor care that she has outlined?
I thank my hon. Friend for her best wishes and commend the work that she and many other Members are doing directly with their trusts to understand the impact of the work that we are doing to bring down those waiting lists and improve access for patients. As I have said, corridor care is a sign of systemic failure in the system and is unacceptable. I think we have all witnessed it in our local trusts, but it is coming down in places, and we want to continue to see it eradicated.
I pay tribute to my hon. Friend the Member for North East Hertfordshire (Chris Hinchliff) for his championing of the families of children suffering from life-threatening illnesses. I know that Members on both sides of the House recognise the profound impact that receiving a diagnosis of a life-threatening condition has on a child and their family. It is vital that all these families feel supported, informed and cared for, and I wholeheartedly recognise that the support that they are offered now is often not proactive or joined up, with the onus, as he said, being on families to navigate the system and seek support themselves.
With that in mind, the Government commissioned a report on the mental health impacts of life-threatening childhood illness on families, named in the memory of Hugh Menai-Davis. I pay tribute to Hugh’s parents for their campaigning and offer them my deepest condolences.
The report process is progressing well, and I can commit to the report being published in this Parliament, with a full Government response issued within three months of publication. For too long, children’s health has not been a priority, which is why my right hon. Friend the Secretary of State for Health and Social Care has directed the Department to make maternal and child health central to its work. We know that a child’s health has ramifications for the wellbeing of the whole family, and there must be better solutions to join up support for parents of unwell children.
The new cross-Government mental health strategy will also address how we better support parents and families, and the Government intend to work closely with parents, families and campaigners to identify workable solutions and make available more proactive support.
I turn now to the Opposition amendments, starting with new clause 142, in the name of the Opposition spokesperson, the hon. Member for Sleaford and North Hykeham (Dr Johnson).
(1Â year, 7Â months ago)
Commons ChamberThe NHS has always worked constructively with the independent sector, and I do not believe that ideological hobby horses should come before patients getting faster access to care. This Government are investing in our NHS, and before the hon. Lady complains about that, I would just point out that the Green party’s manifesto on the NHS said that it would require an
“additional annual expenditure of £8bn in the first full year”
of this Parliament, rising to ÂŁ28 billion later. The Chancellor has just delivered a Budget that delivers ÂŁ26 billion of additional investment, and the Greens complain about it.
Deirdre Costigan (Ealing Southall) (Lab)
I welcome the new Minister, my hon. Friend the Member for West Lancashire (Ashley Dalton), to her place. Hundreds of my constituents are on waiting lists for knee and hip operations, and while the hon. Member for North Herefordshire (Ellie Chowns) says that she would like to see those waiting lists reduced, the Green party has done everything it can to oppose Labour’s plan for change—it opposed our Budget, with its record investment in the NHS, and it opposed our agreement with the independent sector to bring down the backlog. Does the Secretary of State agree that it is time for the Opposition parties to stop wishing for a reduction in waiting lists and start backing Labour’s credible plan to make a real difference?
I wholeheartedly agree with my hon. Friend. As we know from the Greens’ experience in local government, they cannot clear the bins, let alone the waiting lists.
(1Â year, 8Â months ago)
Commons ChamberI am happy to report that people will not have to wait three years for action on social care. In fact, we have seen lots of it in the last six months. We have had the biggest expansion of carer’s allowance since the 1970s; the legislation for fair pay agreements in the Employment Rights Bill, brought in within the first 100 days of this Government; the uplift in funding provided by the Chancellor through her Budget; and the expansion of the disabled facilities grant. There will be more for us to do this year, including reform to make the better care fund more effective. Baroness Casey’s first report will in fact be next year. It will set out the action required on social care throughout this Parliament. I hope that reassures people right across the House and, more importantly, right across the country that social care is a priority for this Government. We will seek to do better than our predecessors of all parties—I have made this point before—because we have to tackle this generational challenge facing our country.
Deirdre Costigan (Ealing Southall) (Lab)
I was shocked when a young man came to my last constituency surgery to ask me as his MP to help him get a GP appointment. Morning after morning, he had spent hours queuing on the phone, and he was desperate. If my constituents cannot see a GP, they end up in A&E instead. How is the Secretary of State continuing to work to undo the Conservatives’ abject failure to fix the GP crisis, which is fuelling winter pressure on hospitals?
My hon. Friend is absolutely right about the challenge caused by the Conservatives’ failure on general practice, which has placed pressure not just on stretched GPs, of whom there were thousands fewer when the Conservatives left office than in 2015, but on other parts of the system. That is not just worse for patients—it is certainly not a pleasant experience at the moment to be sat waiting in A&E for treatment—but more expensive for the taxpayer, because while it costs £40 for a doctor’s appointment, it can cost £400 for accident and emergency attendance. That is the legacy of the Conservative Government: things are worse for patients and more expensive for taxpayers. That is the rotten legacy that we are seeking to overturn.
(1Â year, 8Â months ago)
Commons ChamberI welcome the former Prime Minister’s question, and he is right to commend the research. We are actively looking at it. Given that he is here and that we are currently taking through the Tobacco and Vapes Bill, I thank him for his leadership on that issue.
Deirdre Costigan (Ealing Southall) (Lab)
The last Government treated mental health as a Cinderella service, with my constituents waiting days in A&E to be admitted to hospital mental health wards. The Solace Centre in Ealing Southall provides help and support in the community for those with mental health problems, at a fraction of the cost of a hospital stay. How does the Minister intend to move more mental health services from hospital to the community, and to create more great services like the Solace Centre?
I thank my hon. Friend for her excellent question. She is right that it is vital to move services from hospital to community. The Chancellor made funding available for 380,000 more talking therapies for patients and put in place a ÂŁ26 million capital investment scheme for mental health crisis centres. A lot of work has been done, but there is a lot more still to do.
(1Â year, 8Â months ago)
Commons ChamberIt seems to be the Conservative line across the board now to say, “You’ve had 14 years in opposition, so why haven’t you sorted it all out in six months?” I say gently that the Conservatives had 14 years in government, and it will take longer than six months to clean up their mess. Honestly, their contributions to discussions in this House might have more credibility and a stronger landing zone if they at least acknowledged their part in the deep mess and malaise that they have created over the past 14 years.
None the less, on social care, I very sincerely and warmly welcome the Conservative party’s support for the independent commission. It is important, as a matter of principle, to try to establish in broad terms the level of consensus about what social care should look like and how it should be delivered to meet the needs of older and disabled people in the 21st century, with changing demography, changing challenges, changing pressures and a changing pace of technology, and about the balance of provision between the individual, the family and the state, and the balance of financial contributions for social care between the individual, the family and the state.
Of course, those issues will inevitably be contested across the party political divide from one election to the next, but just as we have had broad consensus on the national health service since 1948, just as we have had broad consensus on state education since Rab Butler’s reforms, and just as we have mostly had broad consensus for much of the past century on how public services should be delivered, so too should we try to establish the same consensus on social care. That is not to say that we should agree on everything, but we should agree on as much as possible, because whether it was Gordon Brown and Andy Burnham in 2010 or Theresa May in 2017, we can see the extent to which party political wrangling, rancour and sometimes opportunism has sunk well-meaning attempts to grasp the nettle of reform.
On the question of pace, I reassure people that in our first six months we have already legislated for fair pay agreements, delivered the biggest expansion of carer’s allowance since the 1970s, and immediately injected £86 million into the disabled facilities grant, with another £86 million to follow from April—£711 million in total over the next year—as well as the increased spending power for local government in the Budget and £880 million for social care specifically. With respect to the people who are saying, “Go faster”, I urge them to bear in mind that we have already done quite a lot in six months. We do not pretend that we have solved all the problems—we have not nearly solved all the problems—but that is not a bad start for a Government who are determined to show that we understand the pressures in social care today and are willing to deliver.
The Dilnot proposals were very good technical responses to a question that Andrew Dilnot was set by David Cameron, but we should reflect on why it was that every single Prime Minister since Lord Cameron, including Lord Cameron himself, did not implement those reforms. There has always been something else in health and social care that has been more pressing and urgent. I am sure that Baroness Casey will consider the Dilnot proposals alongside all the other challenges and potential solutions to the wider issues in social care, but we are determined to respond at pace. That is why the first phase of the Casey commission will report next year, setting out an action plan throughout this Parliament. I hope that we can achieve broad consensus on those actions too.
Turning to the winter situation, the right hon. Gentleman has asked what capacity there is. According to the latest figures, there are 1,300 more acute beds this year than last year. Of course, those figures flex up and down depending on pressures, but the pressures are enormous. The number of beds occupied by flu patients is much higher than this time last year—somewhere between three and four times higher. The number of adult beds closed due to norovirus has reduced in the latest figures, but it is still above last year, when 485 beds were closed—the latest figure is 666. On ambulance responses, we have seen many more call-outs this year. There has been a 3.8% increase in emergency admissions compared with the same period last year, with the highest November on record for A&E attendances. Ambulance response times are nowhere near where we would want them to be because of the enormity of the pressure, which is why I have been out on the frontline, including over the Christmas period. We are not just looking at what we can do to mitigate challenges this year; we are already beginning to plan for next year, because I want to see year-on-year continuous improvement in urgent and emergency care.
I now turn to the challenges on the reform plans we have proposed and set out today. Starting with the workforce, one of the reasons we have emphasised the importance of not just investment but reform is the need to free up the staff capacity that we already have in the NHS to best effect. That means dealing with the number of non-attendances by sending reminders to patients and giving them ease and convenience in rebooking. It is why we are getting rid of unnecessary, low-clinical-value out-patient appointments, with the consent of patients in every case. It is why we are asking general practitioners to do more to manage cases in the community with more advice and guidance, and funding them to do so, working with colleagues in secondary care to ease pressure on hospitals.
Today’s reform plan answers the challenge we have heard from people across the NHS: how do we tackle the elective backlog without doing so at the expense of general practice, urgent and emergency care, community care or social care? The truth is that this is a systemic challenge, and we will only be able to deal with the challenge in the elective backlog by also acting on urgent and emergency care, general practice, community care, and delayed discharges in social care. We are taking a system-wide approach to meeting this essential target.
A number of things are different from under the previous Government. For example, on the deal with those in the independent sector, giving them the stability and certainty of working with this Government gives them the confidence to open and invest in new capital estate and new kit, particularly in parts of the country that are relatively underserved by the independent sector. We have insisted they do that with their own staff and resources, and that they put their money where their mouth is in relation to training new staff to deal with some of those pressures. That is how we will ensure that we will not be taking Peter from the NHS hospital to treat Paul up the road at the independent hospital.
Finally—I am happy to take more questions on the detail of the plan—the shadow Secretary of State asked what is different from 2022? In fact, I think he asked me to commend my predecessor Sir Sajid Javid for his work in 2022. In the bipartisan spirit of the new year, let me commend the work that he and Sir Sajid Javid did in trying to undo Lord Lansley’s disastrous top-down reorganisation, and that was a very good thing to do. There will be a very big difference between this Government and our Conservative predecessors: real delivery, shorter waiting times and an NHS fit for the future.
Deirdre Costigan (Ealing Southall) (Lab)
Does the Secretary of State agree that his plan to transform adult social care services has already started with Labour’s Employment Rights Bill ensuring that social care workers will get fair national pay and conditions, and increased access to training and progression? Does he further agree that we will never have a quality social care service in this country if we do not value the people delivering it properly, as this Labour Government intend to do?
My hon. Friend is absolutely rightly. The Employment Rights Bill, introduced in our first 100 days, contains provisions for a new fair pay agreement for care workers, and who better to be leading the charge on that than the care worker turned Deputy Prime Minister, my right hon. Friend the Member for Ashton-under-Lyne (Angela Rayner).
(1Â year, 10Â months ago)
Commons ChamberThe hon. Lady highlights the important matter of the lifetime of some of the machines, which we are finally addressing after the last 14 years of not addressing issues that include providing support to ensure that the machines work properly. Officials regularly meet Radiotherapy UK and the Department values its input. If there are specific incidents that the hon. Lady wishes to highlight, I am happy to respond to her.
Deirdre Costigan (Ealing Southall) (Lab)
Does the Minister agree that the NHS cannot continue to rely on outdated and obsolete equipment? It is ridiculous that GPs still use pagers and hospitals communicate with each other using fax machines. After 14 years of decline under the previous Government, will she commit to bringing our NHS into the 21st century?
My hon. Friend lays bare an important issue. We all know, and critically, staff know, that we are asking them to do the most incredible job with outdated technology. It is bad for staff and it is bad for patients. That is why moving from an analogue to a digital system is crucial. I was fortunate to visit colleagues at NHS England offices up in Leeds last week to see some of the fantastic work they are doing on the app. We will ensure that the NHS comes into the 21st century.
(1Â year, 11Â months ago)
Commons Chamber
Deirdre Costigan (Ealing Southall) (Lab)
There is an old Irish saying, “Your health is your wealth”, and all the money in the world and all the nice things mean nothing if we do not have our health. Too many people in my constituency do not have good health—10% have diabetes, which is higher than the London and UK average, and the rate of preventable deaths is almost 14% higher than the England average. Time and again when I knock on doors across Ealing Southall, people tell me three things: they cannot get a GP appointment when they need it; they cannot see a doctor face to face; and if they are lucky enough to see a doctor, they never see the same one twice. With long-term conditions such as diabetes, not seeing the same doctor is damaging the health of my constituents. They are getting sicker, and they end up relying more on expensive hospital services. In Southall, emergency hospital admissions are 47% higher than the England average. Why can’t my constituents get to see a doctor? For starters, there simply aren’t enough. North-west London has a ratio of one GP for every 2,268 patients—a lot worse than the UK average.
We have had 14 years of the Conservative party running our NHS, and it is clear that it has run it into the ground. It started with a big-bang approach and the disastrous top-down reorganisation of the NHS. That caused so much damage that even they recognised it in the end, and they had to dismantle many of the changes a few years later, but not before the rot had set in. Since then, their approach has been like moving the deckchairs on the Titanic. All they can come up with is piecemeal tweaks and small pilots that never seem to amount to anything. In the meantime the NHS ship is slowly sinking.
Lord Darzi’s independent and honest report found that patients have never been more dissatisfied with the services they receive. I can only take the empty Conservative Benches as proof that they are finally embarrassed about it. We must also ask why Conservative Members have been happy to preside over 14 years of decline in our NHS. Is it because they want it to fail, or to replace our NHS with a privatised American-style insurance system? The mask slipped during covid when they fast-tracked their private healthcare mates and handed them multimillion pound contracts for often dodgy personal protective equipment. Was that the future they have in mind for the NHS? That is not what the public wanted, and it is why the public voted them out. My constituents in Ealing Southall are already impressed by the new Government’s approach. They know that the damage to the NHS is so deep that it cannot be fixed overnight.
Your health is indeed your wealth, Madam Deputy Speaker. The last Government frittered away that wealth, gave it to their private healthcare mates, and squandered it on damaging and costly reorganisations. This new Labour Government will turn the page on over a decade of Tory decay and help us all to live longer, healthier lives.