Hospice and Palliative Care
Ellie Chowns Excerpts(3 weeks, 5 days ago)
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Ellie Chowns (North Herefordshire) (Green)
Like other Members, I begin by paying tribute to our hospices and to everyone who works and indeed volunteers in palliative and end of life care, providing such amazing support to patients and their loved ones around their death—that most difficult time of life—and helping people to have a good death. As many Members have said, that work is so crucial. I would particularly like to mention St Michael’s hospice, Hereford, in my constituency. It is a place I have had an association with for many years, as it has provided amazing care to friends of mine who have died there. It is so well loved in the community.
Is it not such a shame, as so many colleagues have said today, that palliative care is so dependent on charitable funding? As the hon. Member for Huddersfield (Harpreet Uppal) said, it is integral to our healthcare system—except it is not, because it is not fully funded by our healthcare system. It is not actually free at the point of need, except thanks to the grace and kindness of strangers and charitable funding. Government Members have made mention many times this evening of the £100 million capital injection from the Government, which is absolutely welcome; it has been so frequently mentioned, in fact, that one might think the Whips have gently encouraged its mentioning. However, the problem is that this £100 million is a short-term capital injection, when what is needed is a long-term revenue funding solution.
Despite the amazing efforts of fundraisers, revenue budgets in hospices are under extreme pressure. That has been made worse by the rise in employer national insurance contributions; St Michaels will have an additional bill of £240,000 next year because of it. That is a problem. The current funding model for hospice care is a problem. It is good that there is now a statutory requirement for ICBs to fund palliative care, but there is a complete lack of parity across the country. Hospices have to negotiate individually with ICBs all across the country every year. A hospice leader said to me that they have no sight of the future; another said that when they are considering redundancies, it is no use telling people they are going to be resurfacing the car park with the new capital funding.
We need a sustainable revenue funding solution for hospices—a clear, fair, multi-year, long-term funding solution—with parity across the country, to provide those doing that amazing work to support patients and the patients themselves with the support they need and deserve.
Health and Adult Social Care Reform
Ellie Chowns Excerpts(1 month ago)
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Wes Streeting
Further to the previous question, we will be refreshing and updating the NHS workforce plan alongside the long-term plan that we will publish in May, and my hon. Friend is right that rehab is key not just to good recovery but to prevention of future demand on the NHS. I saw a great example of that rehabilitation delivered in social care settings only last week. Whether in the NHS or in social care, we definitely need to do more on rehabilitation, because rehabilitation is often secondary prevention.
Ellie Chowns (North Herefordshire) (Green)
I agree with the Secretary of State that community-based services are crucial. My local NHS trust contacted me in the week before Christmas about Hereford community diagnostic centre, which is currently in the process of being built. It was told to be ambitious with this project, but in December it was told that only a sixth of the funding that it needs is available. Does today’s announcement mean that the Government will fully fund Hereford community diagnostic centre?
Wes Streeting
We will certainly write to the hon. Member with further information about Hereford CDC. On capital investment, I say to her and to other right hon. and hon. Members that we were very pleased with what the Chancellor was able to deliver in the Budget. We recognise that the stop-start we saw on a number of capital programmes under our predecessors was frustrating and we are determined not to repeat that. That is why we are setting out clear and consistent proposals for capital investment in the NHS.
NHS Backlog
Ellie Chowns Excerpts(1 month ago)
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Ellie Chowns (North Herefordshire) (Green)
Thank you, Madam Deputy Speaker. I would like to thank the hon. Member for North Shropshire (Helen Morgan) for securing this debate on the vital area of NHS backlogs, which is of great importance to me and my constituents. We are short of time so I will not talk, as I wished to, about the need to tackle the crisis in social care and the need to invest heavily in public health. I will focus my comments on responding to the Government’s announcement today on elective care.
I hope the Minister will be able to respond in a moment to some of the questions I want to pose, because it is one thing to use spare capacity in the private sector to tackle the absolute crisis we have with waiting lists and backlogs—I can understand that as an emergency measure—but it is quite another to propose in effect long-term outsourcing from the NHS to private providers. To be honest, I fear that today’s announcement could essentially be a form of creeping back-door privatisation of aspects of NHS care, and specifically those in which is easiest for private sector providers to make a profit. We only have to look at PFI to understand the dangers of that approach.
I have read today’s partnership agreement between the NHS and the independent sector, and I am afraid I find it the opposite of reassuring. I will briefly canter through some of the reasons why. Section 2 indicates that the Government do envisage increased private provision of both surgical and diagnostic services.
There is some text in section 3 about trying to seek assurance that those private providers will not essentially cherry-pick the most attractive, easy and profitable patients. However, all it says is that the independent sector will review its patient criteria; there are no teeth there.
There is nothing in section 4 about measures to protect the NHS from the risk of private providers making excessive profits from the services they provide. We have recently heard in this Chamber cases of that happening in the social care sector and the children’s social care centre. Is there not a real risk that that could also happen in the healthcare sector if this is not actioned?
Finally, there is nothing in section 5 to address the risk of transferring services to private providers leading to leaching of staff from the NHS services into the private sector. How can we be guaranteed that there is not going to be excessive competition in a workforce that is already extremely stretched?
For the Green party and myself, the profit motive has no place in our NHS. I hope the Minister will provide assurances that the NHS will continue to be publicly owned and publicly run for public benefit, and that the concerns I have highlighted will be addressed so that the agreement between the NHS and the independent sector has teeth.
Madam Deputy Speaker (Judith Cummins)
I now call the Liberal Democrats spokesperson, Jess Brown-Fuller.
National Insurance Contributions: Healthcare
Ellie Chowns Excerpts(2 months, 3 weeks ago)
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Karin Smyth
I thank the hon. Gentleman for his comments and for supporting his local hospice. He is an experienced parliamentarian; he knows that this is not simple and that the provider landscape is complicated. As we heard from my hon. Friend the Member for Sheffield South East (Mr Betts), large private equity companies own many social care providers. We want to ensure that any additional funding from the Budget goes exactly where it needs to be: supporting patients—our constituents—where they live and need care. That is why, over the next few months, we will continue to talk to providers in the usual way about the allocation of those funds.
Ellie Chowns (North Herefordshire) (Green)
Since the Budget, I have been contacted by GPs, care providers and charities in my constituency, all expressing concern about the impact of the rise in employer NICs on their ability to serve the most vulnerable in our community. Will the Minister reconsider the change by finding a way to exempt the charitable sector in the same way as the public sector? I have written to Ministers and tabled early-day motions on this issue. Will she take this opportunity to assure the charitable sector that it will not be impacted by the measure?
Karin Smyth
The hon. Lady tempts me to make specific commitments, which I am not prepared to do, as I am sure she understands. She is right that people are expressing concerns about some of these decisions. That is because they are in such a precarious situation as a result of what we have inherited from the past 14 years. As the Prime Minister and the rest of the Government have been clear throughout the election and afterwards, we have a 10-year plan because it will take a long time to fix the foundations and build up the sector to make it more resilient and sustain it for the future. We want to fix those foundations, and we will talk closely with everyone affected over the coming months, but this will take a long time. Those providers are precarious because of the mess that we inherited.
Access to Primary Healthcare
Ellie Chowns Excerpts(3 months, 3 weeks ago)
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Dr Johnson
Essentially, because there is more clinical acute need in primary care hospitals. Given the choice, with one amount of money, between saving a life and preventing a problem for later, it is inevitable that money gets shifted towards acute care. That is where the pressure is, but I agree with the hon. Gentleman that we need to work harder to prevent people from becoming ill in the first place.
Ellie Chowns (North Herefordshire) (Green)
On that point, will the shadow Minister give way?
Dr Johnson
No, I will not give way again, because I know that you will give me eyes if I do, Madam Deputy Speaker.
Labour has spent 14 years in opposition. The Secretary of State has had plenty of time to consider what he would do if he gained office, so, further to the intervention of the hon. Member for Chelsea and Fulham (Ben Coleman), what have the Government achieved in 14 weeks to help the health of the nation? I will tell you, Madam Deputy Speaker. They have opened the Department’s doors to their Labour mates. They have awarded an inflation-busting pay rise to junior doctors without negotiating any modernisation or productivity reform in return. They have overseen GPs entering industrial action and nurses rejecting their pay offer. They have scrapped the social care costs cap. They have produced a report of selected statistics with no policy recommendations. They have broken their manifesto pledge to deliver the new hospital programme. They have taken the winter fuel payment from millions of vulnerable pensioners. They have even stopped the children’s cancer taskforce.
That dire record, underlined by the Labour legacy in Wales, fills me with huge trepidation for the future of the NHS. I hope that when the Government’s plan eventually comes, it is a good one, for all our sakes.
Ellie Chowns (North Herefordshire) (Green)
The Darzi report made it very clear that our NHS is under- funded, overstretched and too hospital focused. That has also been a focus of today’s debate so far. I welcome what I heard from the Secretary of State, in last week’s debate on the Darzi report, about investment and reform, and a shift from hospital to community and from sickness to prevention. We all want those things, but they will not happen without more investment, and without a crucial reform in the way the NHS is funded. We have seen a drift towards an increasing focus on acute services and on hospital services at the expense of investment in preventive healthcare and the primary services that we all recognise are so needed, and that my constituents in North Herefordshire so desperately want. They want to be able to see a GP, and they want to see the community frontline services that will save their health, and will save the NHS money, in the long run.
Can the Minister assure me that she and her colleagues have been doing everything possible to urge the Chancellor to make available the billions of pounds of investment in the NHS that are necessary to bring us back up to scratch in comparison with our peers? Darzi said that we are underfunded in comparison with similar health services. Will she assure me that the Government are considering putting in place some sort of mechanism to protect funding for primary and community care, and indeed to ratchet it up over the years? The way things happen at the moment is that hospitals constantly overspend and those overspends are constantly plugged, which is why the money is going more and more into hospitals and less and less into primary care. Will we get the billions of pounds of investment in the Budget that we need, and will we get that protection and ratchet mechanism for primary care funding that is the only way to ensure that the extra doctors, extra appointments and so forth are delivered?