New Hospital Programme Review
Edward Leigh Excerpts(1 week, 5 days ago)
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Sir Edward Leigh (Gainsborough) (Con)
Will the Secretary of State forgive me if I give the House a few seconds’ respite from the blame game by trying to make a positive suggestion? Everyone accepts that the real problem facing our hospitals is the number of frail and elderly people who do not need to be in hospital and should be in some sort of care facility. Does the Secretary of State agree that while building brand-new, all-singing, all-dancing hospitals is very expensive, there is a future for smaller cottage hospitals such as the one in Gainsborough and a case for opening other facilities so we can move elderly, frail people out of those big hospitals into a caring environment and free up space?
Wes Streeting
I thank the right hon. Gentleman for a rare constructive contribution from the Conservative Benches—not rare from him, for he is regularly constructive; it is the rest of the Conservative party that we have a problem with. Let me reassure him that one thing we are determined to do is deliver a shift in the centre of gravity, out of hospitals and into communities, with care closer to home and indeed in people’s homes. As I saw on a visit to Carlisle over the new year, good intermediate step-down accommodation sometimes provides better-quality and more appropriate care and better value for the taxpayer. That intermediate care facility in Carlisle, funded through the NHS by a social care setting, was providing great-quality rehabilitation in a nicer environment at half the cost of the NHS beds up the road. This Government will deliver both better care and better value for taxpayers.
Hospice and Palliative Care
Edward Leigh Excerpts(2 weeks, 5 days ago)
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Danny Kruger (East Wiltshire) (Con)
I will not focus on assisted dying/assisted suicide this evening, because as the hon. Member for Wimbledon (Mr Kohler) said in a good opening speech, we are all united in this place in our desire to see improvements in the palliative care system, but I feel compelled to make this simple point of fact. Studies and research show that in jurisdictions and countries around the world that have introduced an assisted dying/assisted suicide law, the investment in and the quality of palliative care has declined, relative to those that do not have an assisted dying/assisted suicide law. That is for reasons that are fairly comprehensible. That is a fact. I implore the House: let us fix our palliative care system before we consider opening up the law on assisted dying.
The United Kingdom is, of course, the birthplace of the hospice movement, and we have some of the best palliative care services and specialists in the world, but as we have heard this evening, our system simply is not working. We have demand for palliative care and hospice services on a scale that was never anticipated in the post-war years in which the NHS was developed. The challenges of growing demand have been sadly exacerbated by decisions that the Government have made, as we have heard.
Sir Edward Leigh (Gainsborough) (Con)
On Friday, I went to St Barnabas hospice in Lincoln, our local hospice, which does wonderful work, and talked to its chief executive officer, who is tearing his hair out. Because of the national insurance increase, he is losing £300,000 a year. He pays his nurses less than the local hospital; he has to. He is literally funding the NHS and cutting his own service in the hospice. I beg the Government to think again about the national insurance increase on hospices.
Danny Kruger
My right hon. Friend makes absolutely the right point. It echoes the experience of hospices across the country. Prospect House, which is on the edge of Swindon and is in my constituency of East Wiltshire, receives only 23% of its funding from the taxpayer. It faced a significant deficit this year, so it took immense pains and steps to bridge its funding shortfall. There was a huge response to a public fundraising appeal, and it raised over £170,000 from the local community, but that was before the Budget. The effect of the national insurance increase alone on Prospect House is £170,000, so the public’s generosity has been entirely wiped away by the Chancellor, and Prospect House is back exactly where it was.
Julia’s House in Devizes is a children’s hospice, and the most wonderful, moving place that I have visited in my time as an MP. It has had a similar experience. It gets only 8% of its budget from the taxpayer. Its deficit has gone up from £900,000 before the Budget to £1.1 million now. We therefore desperately need a comprehensive review of palliative care.
I pay tribute to the hon. Member for York Central (Rachael Maskell), and to Baroness Finlay in the other place. They are leading a review of palliative care, with a view to coming forward soon with recommendations for the Government on how to improve the system. Indeed, thanks to Lady Finlay’s amendment to the last Government’s Health and Care Act 2022, integrated care boards are required to commission palliative care. Unfortunately, no money was attached to that amendment, and as we have heard, the way in which some ICBs commission care is not good enough. I regret, for instance, that the ICB in our area will not commission Julia’s House, the children’s hospice that I mentioned, so we need a better commissioning model.
I take issue with the point made by the hon. Member for Birmingham Erdington (Paulette Hamilton) that ICBs cannot find the money for these services in their budgets. They could if they did their job properly and commissioned services locally. They should be able to move budgets around. The fact is that if proper investment is made in palliative care, money is saved elsewhere in the NHS; that is the crucial point. Expensive bed stays in hospital would be reduced, as would demand on ambulances and other services. It should be possible to improve palliative care within the ICBs’ current envelope.
We do not want a system of enforced uniformity, or a great new national bureaucracy. I am concerned to hear some hon. Members suggest that we nationalise the system; I do not think that is right. We need to ensure that ICBs can do the job that they need to do, and that hospices can innovate as they want.
Health and Adult Social Care Reform
Edward Leigh Excerpts(3 weeks, 5 days ago)
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Sir Edward Leigh (Gainsborough) (Con)
I welcome the consensual parts of the Secretary of State’s statement, but I wonder whether we have been entirely honest with the public about the sheer unaffordability of the cap proposed by Dilnot. I do not absolve my own Government from this: maybe we should start telling the truth to the public. Does the Secretary of State think we need a new social compact on bringing in social insurance so that people can plan for their entire life? They would know that they will have to pay more in taxes during their life for their old age, but at least they would have certain rights.
Wes Streeting
The right hon. Gentleman is right to say that we need a debate as a country about the balance of financial contribution between the individual, the family and the state. I well understand why David Cameron was so concerned about catastrophic care costs and people having to sell their homes to pay for their care and the problem he was trying to solve. With every Government since, the issue has been seen as less urgent than others, but that does not mean it does not matter or that we should not consider it as part of the Casey commission. We need to consider all these issues in the round and, as much as we can, build a consensus not just in this House, but throughout the country about the balance of financial contribution and what is fair, equitable and sustainable.
National Insurance Contributions: Healthcare
Edward Leigh Excerpts(2 months, 2 weeks ago)
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Sir Edward Leigh (Gainsborough) (Con)
We all know that a lot of the debate on assisted dying revolves around the lack of hospice places to help people pass in the best way possible. Similarly, much of the debate on the NHS is about the lack of care home spaces. Leaving aside the cross-party name-calling, may I beg the Minister to consider exempting hospices and care homes from this national insurance increase?
Oral Answers to Questions
Edward Leigh Excerpts(3 months, 2 weeks ago)
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Sir Edward Leigh (Gainsborough) (Con)
The Minister for Secondary Care (Karin Smyth)
Lord Darzi’s report concluded that the health service is in a critical condition across the country, including in the east midlands, where healthy life expectancy has declined in the past decade. Waiting lists in the region stand at slightly below the national average for 18-week waits, at 57% compared to the national average of 58%.
Sir Edward Leigh
With two thirds of people having to wait more than four hours at Lincoln County hospital’s A&E department and with horror stories from my constituents of people waiting up to 24 hours, does the Minister understand that if we are to save the NHS and give people the timely appointments they need, we must unleash the full power of the private sector?
Karin Smyth
I thank the right hon. Gentleman for helping to underline the shocking inheritance from the previous Government. He is absolutely right. We are committed to cutting waiting times and serving constituents, like mine, by delivering the long-term reform the NHS desperately needs. The Government are committed to the funding model. We are not going to change it. He tries this every time, but we are committed to the funding model as it exists.
NHS: Independent Investigation
Edward Leigh Excerpts(4 months, 2 weeks ago)
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Sir Edward Leigh (Gainsborough) (Con)
I greatly respect the Secretary of State, and, as an older person who relies on the NHS, I support his radical zeal. I repeat what he said in his statement: cancer is more likely to be a death sentence for NHS patients than for patients in other countries. We have had this conversation previously, but can he at least look at the health systems in other countries, particularly those in the Netherlands, Australia, France and Germany? Those countries, which have wonderful health systems protecting the vulnerable, use a mixture of social insurance and public and private funds to maximise inputs into their health services.
Wes Streeting
Every time the right hon. Gentleman praises my zeal for NHS reform, Labour Members get very nervous. Let me reassure him that I have looked at other countries, and I will definitely continue to do that. I genuinely do not think that it is the model of funding that is the issue—the publicly funded, public service element. I hope that he knows me well enough to understand that if I did think so, I would be more than happy making, and would quite enjoy taking on, the argument, but I think that the equitable principle that underpins our NHS is one that we should cherish and protect. The single-payer model has enormous potential for the century of big data, AI, and machine learning. There is huge potential there that we must unlock, but that does not mean that we cannot learn from the way that other countries organise care, particularly in the community and particularly social care. This week, I met virtually with my friend the Health Minister in Singapore. I will continue to work with my international counterparts to learn from other countries whose health outcomes are far better than ours.
Tobacco and Vapes Bill
Edward Leigh ExcerptsTuesday 16th April 2024
(9 months, 2 weeks ago)
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Victoria Atkins
I thank my hon. Friend for bringing to the Chamber his professional experience and the real-life consequences for his patients. If I may, I will unpack some of the details behind that invaluable intervention. The premise behind the Bill is exactly as he says—to stop the start—because there is no safe level of smoking and no safe tobacco product. In fact, it is the only product that, if consumed as the manufacturer intends, will kill two thirds of its long-term users.
The Bill is not about demonising people who smoke or stopping them from buying tobacco if they can do so today. It will not affect current smokers’ rights or entitlements in any way. Indeed, we want to help them to quit. We are supporting them by almost doubling funding for local stop-smoking services. Instead, the Bill is looking to the future, to give the next generation the freedom to live longer, healthier and more productive lives.
Sir Edward Leigh (Gainsborough) (Con)
How does the Secretary of State counter the Conservative argument that if we ban something, we massively increase criminality?
Building an NHS Fit for the Future
Edward Leigh Excerpts(1 year, 2 months ago)
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Sir Edward Leigh (Gainsborough) (Con)
I congratulate my hon. Friend the Member for Uxbridge and South Ruislip (Steve Tuckwell) on a superb election victory and on a great speech from a real local champion. That result shows how important it is for the Government and the Mayor of London not to get ahead of public opinion on green energy. We all want more green energy but it must be economically driven and we must take the general public with us. I am afraid that the Mayor of London, certainly in outer London, has not taken the public with him. In Lincolnshire we have an aspect of green energy that affects my constituency, with 10,000 acres ringing Gainsborough to be put under solar panels. That will involve a huge loss of agricultural land, enough to feed the city of Lincoln every year. We all want solar panels as long as it is proportionate, but 10,000 acres ringing one small town in Lincolnshire is overdevelopment.
The advantage of the King’s Speech debate is that we can range quite widely, and in the few minutes I have, I shall raise a few general points. We have a new Foreign Secretary, a new Home Secretary and a new Health Secretary. The challenges facing the Foreign Secretary are enormous, both in the middle east and in Ukraine. On the earlier intervention, I am all in favour of a ceasefire, but it must be by both sides, and there is no intimation yet that if Israel were to announce a ceasefire, Hamas would follow suit. If Hamas are now prepared to commit themselves to a permanent ceasefire with Israel and respect the right of Israeli citizens to live in peace and tranquillity, I am sure we can have a negotiation on that basis, but I do not see that happening.
We also need to have a tone of compassion for the Palestinian people. The Palestinian people are not Hamas. I was quite impressed by what President Macron was saying on this. The Israeli Government have the right to defend themselves, but it must be in proportion, and I think we are all devastated and concerned about the plight of women, children and babies in Gaza. The Israeli Government have to deal with this issue in a proportionate way.
On Ukraine, I do not suggest a ceasefire, because that would simply benefit President Putin, but if there is a stalemate, I am not sure that we can go on thinking that we can solve the problem by pouring in more and more weaponry. Eventually there will have to be some sort of settlement.
This is a debate primarily about the NHS. We in Lincolnshire suffer from a poorly performing NHS. I have constituents—people of my age—who have paid taxes all their lives and who suddenly fall ill, go to A&E in Lincoln and have to stay there for 24 hours, often in pain and difficulty. More and more doctors are insisting that people who want an appointment have to go online, and fewer and fewer doctors are providing prompt face-to-face service. The NHS simply cannot continue as it is.
We have a new Health Secretary and, as I have said before, I think we need fundamental reform. Frankly, our counterparts on the continent, in France, Italy and Germany, get a much better service. We have to look at some sort of social insurance system by which people who pay taxes all their life are entitled to treatment within a certain period and, if they do not receive that treatment, the state will assist them to go private.
I have made the point many times that a previous Conservative Government gave tax relief for private health insurance. This Government have not progressed that idea, which I do not think would be a wildly popular one, but we have to do something. The NHS is consuming an ever-larger proportion of the national budget and delivering a worse and worse service.
Over the next 12 months up to the general election, I hope the new Health Secretary will think big ideas to try to give people, particularly those of pensionable age, some right to the healthcare that they have paid for all their life and that they do not get at present. Having more children brushing their teeth at school under a putative Labour Government will not solve the problem; it is far greater than that.
Of course, we also have a new Home Secretary, who has an enormous challenge. I have confidence that he will speak up for Conservative Britain and Conservative voters who are deeply unhappy about the very high levels of both legal and illegal migration. It is completely unsustainable to carry on with the current net migration rate of some 600,000 people a year, which is overwhelming our services, the NHS, housing and everything else. It is said that we need these people to work in the NHS or in care homes, but we need to provide proper wages so that people who already live in Britain want to work in the NHS or in care services.
We should not allow employers to think they can solve their problems by constantly importing labour from abroad. There is a simple solution to help solve this problem. The average wage in the UK is about £34,000 a year and, at the moment, a person can enter this country for a job paying £26,000 a year. If we said that migrants have to earn a minimum of, say, £34,000 a year, we would bring in high-quality staff and not undercut our own indigenous labour.
Mr Jayawardena
Does my right hon. Friend agree that we have a structural problem because of our country’s ageing population, and that we need to have more children in this country so that we meet our replacement rate for the first time since the 1970s?
Sir Edward Leigh
I have made a personal contribution by having six children. They are all now in their 20s and 30s, and they are finding it unbelievably difficult to get on the housing ladder. The Government really have to solve this problem. We cannot just fill this country with more and more people so that our young people cannot get on the housing ladder and cannot find a place to rent.
I am a bit dubious about reforming how landlords can evict tenants. I just want supply-side reforms to ensure there is more housing coming on to the market for young people to rent. I want the Government to be far more proactive on building houses, if necessary in grey areas on the green belt. That might not be universally popular with my colleagues, but we certainly have plenty of room in Lincolnshire. If people want to come up to Lincolnshire and build houses, they are very welcome. We will do our bit.
I am very dubious about the smoking ban and, as a libertarian, will vote against it. It will not solve the problem, and I believe it will result in a massive increase in criminality. Every time we ban something, we simply increase the criminal class. I am not sure a ban is even enforceable. In 50 years’ time, old boys will go into a tobacconist and say, “I am 64 years old and am entitled to buy cigarettes, but my friend here, who is 63, cannot buy cigarettes.” It is ridiculous, and it is not enforceable. I do not smoke, and smoking is decreasing all the time. The people who smoke are heavily taxed. I do not believe we can solve this or any other problem by banning things. Conservatives have to be primarily about freedom. They have to be about low taxation and deregulation. We have to give something for our own people to vote for, which is why I have talked about these issues and, in particular, curbing legal and illegal migration. I am a victim of that, as is the Home Secretary, because the previous Home Secretary was going to open a camp for asylum seekers in his constituency. I do not know whether the Home Secretary is still going to do that; if he decides to row back on that idea in his constituency, I hope he will not close that camp in Essex but keep open the putative camp at RAF Scampton in Lincolnshire, as that would be completely unfair. Being a fair-minded person, he will not do that, I am sure. I shall be knocking on his door soon to say that we need a compromise, as we cannot have 2,000 illegal migrants overwhelming local social services. After that brief run around the King’s Speech, I am sure you will be grateful if I now sit down and let others have a go, Mr Deputy Speaker.
Oral Answers to Questions
Edward Leigh Excerpts(1 year, 6 months ago)
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Maria Caulfield
I confirm to the hon. Gentleman that, in the recent spring campaign, we deployed four approved vaccines—Pfizer-BioNTech, Moderna, Novavax and Sanofi-GSK—as part of our roll-out. We are using a range of vaccines to protect us from the pandemic.
Sir Edward Leigh (Gainsborough) (Con)
The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)
We are working with a number of Government Departments, including the Department for Work and Pensions and the Department for Levelling Up, Housing and Communities, to tackle the effect of housing insecurity on young people’s mental health.
Sir Edward Leigh
The mental health of young people is being impacted by the fact that net migration is far too high and we are not building nearly enough houses. The Government need to take action on that, but young people worry that, with an ageing population, the health service will not be able to provide for them in future. May I commend to the Minister the excellent paper published by the former Labour Prime Minister Tony Blair, which suggests things such as co-payments and personalised apps? Would it not be ironic if a former Labour Prime Minister were more radical on reform of the NHS than a Conservative Government?
Maria Caulfield
Actually, under this Government, last year, the number of first-time buyers passed the 400,000 mark, which is the highest number in 19 years. I will not take any lectures from a former Labour Prime Minister because when Labour was in government it saddled the NHS with a £10 billion failed IT system that never saw the light of day, an £80 billion failed private finance initiative contract that NHS trusts are still paying for, and a GP contract that enabled opt-out at weekends and evenings, which patients still suffer from.
NHS Long-term Workforce Plan
Edward Leigh Excerpts(1 year, 6 months ago)
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Sir Edward Leigh (Gainsborough) (Con)
According to the King’s Fund, the proportion of GDP taken by the NHS has increased in the past 50 years from 3.4% to 8.2%. On the same trajectory, in 50 years’ time, it will take a fifth of all our GDP. That is totally unsustainable, especially as someone’s only right, despite the fact they are paying ever increasing amounts of tax, is to join the back of the queue. I ask again: will the Secretary of State launch a study—and, if necessary, appoint a royal commission—on fundamental reform of the whole nature and funding of our health system, so that we can learn from every other developed country, such as Australia, France, Italy and Germany, where they unleash private sector investment into healthcare and give people rights to their healthcare, while ensuring that those who need it get free healthcare at the point of delivery?
Steve Barclay
I hope my right hon. Friend is pleased to see the measures we are taking with the Lord O’Shaughnessy review on clinical research trials to make it easier and faster to do research in the NHS. That in turn attracts private investment to the NHS. He will have seen the announcement I made on Tuesday of £96 million for 93 different research projects, such as at Great Ormond Street Hospital, where we have allocated £3.5 million for research into rare conditions in children. That translates into research that is then deployed, usually in adults. We are investing there, and we are screening 100,000 children through Genomics England. We have got a deal with Moderna and BioNTech so that we can have bespoke cancer vaccines. On Monday, we rolled out national lung cancer screening. Previously, in our most deprived communities we were detecting lung cancer late—80% were diagnosed late—but in those pilots we turned that on its head with 76% detected earlier.
I know that my right hon. Friend, as a former Chair of the Public Accounts Committee, will agree that by detecting earlier, not only are patient outcomes far better but treatment is far cheaper, whether that is for lung cancer or through our innovation on HIV screening in emergency departments picking up HIV in people who do not realise that they have it. When we treat it early, the patient outcomes are better, and it is fiscally much more sustainable. That is how we will address some of his concerns.