Oral Answers to Questions

Gareth Thomas Excerpts

Tuesday 5th December 2023 Commons Chamber

[Helen Whately]

I pay tribute to my hon. Friend for the excellent work he did as a Health Minister. It was a real pleasure to work alongside him and see what a difference he made for our constituents across the country. He asks a very good question about the work we are doing to increase the capacity of the NHS and ensure that it has the workforce it needs, including by delivering on our manifesto commitment to 50,000 more nurses for the NHS, which we have achieved.

[Gareth Thomas (Harrow West) (Lab/Co-op)]

One way the Minister could help Harrow’s health services be better prepared for this winter and future winters would be to invest in new intensive care beds at Northwick Park Hospital, which serves my constituents. Given that the Government have been told repeatedly that their promised 40 new hospitals are about as real as the Prime Minister’s meat tax, why do Ministers not invest in a hospital that actually exists and provide a new purpose-built intensive care facility at Northwick Park Hospital?

[Helen Whately]

I assure the hon. Member that we are investing in the national health service and, in particular, supporting it to prepare for this winter, ensuring there is more capacity in the system. There will be 5,000 more beds in hospitals around the country this winter, as well as 800 new ambulances on the road. But we are also doing things differently. The future of healthcare is not just about hospitals, but about caring for more people out of hospital. For instance, we are investing in proactive care, so that in every neighbourhood, the people who are more likely to go into hospital are known and reached out to, and the care is available for them. That is one of the things we are doing to ensure that people receive care when and where they need it.

NHS Workforce Expansion

Gareth Thomas Excerpts

Tuesday 28th February 2023 Commons Chamber

[Aaron Bell]

I welcome the hon. Lady to her place and congratulate her on her recent election. I believe that her predecessor, Rosie Cooper, is now responsible for the issue that she has just raised, so perhaps she will have some luck if she speaks to her about that—[Interruption.] Have I got that wrong? I do apologise. By the way, I would like to pay tribute to Rosie Cooper, because I did not have the chance to do so when she left. She handled herself with great dignity in the face of some very unacceptable circumstances, and I pay tribute to her. I see several by-election victors on the Opposition Benches and I congratulate them all. I cannot speak exactly to the hon. Lady’s NHS trust. I am sure that if she writes the Minister or speaks to the NHS trust directly, she might get some answers as to what is going on in Southport, but if she will forgive me, I represent North Staffordshire.

Before I detail the work that the Government are doing, I would like to praise the work of everybody in the NHS—as the Opposition Front Benchers did—and particularly those in North Staffordshire who working in our hospitals and GP surgeries, our health visitors and clinical staff, and those who support those people. It has been a difficult winter—after a difficult few years—with covid and flu peaking simultaneously in December. I am pleased to report that the most recent figures from the integrated care board for Stoke and Staffordshire show that ambulance handovers hugely improved in February, compared with where they were in January, which was unacceptable, as I said in the House at the time. There has been an 8% increase in primary care appointments, compared with a year ago, with 73% delivered face to face—higher than the national average—and waiting times for surgery are falling, including for cancer treatment at the Royal Stoke Hospital. I pay tribute to everybody working at the coalface in the NHS, because I know what difficult work it is and we are all extremely grateful.

Turning to NHS workforce expansion, this Conservative Government are strengthening the NHS workforce. In hospitals we have 5,000 more doctors and 10,500 more nurses compared with October 2021. Compared with 2010, when the last Labour Government left office, we have 37,000 more doctors and 45,000 more nurses in our hospitals. We are also building up the workforce in primary care, recruiting 26,000 more primary care staff by March 2024—a target that is on track, unlike the target in Scotland. In Newcastle-under-Lyme, the number of doctors, nurses and other clinical staff based in GP surgeries has increased by 46% since September 2019. That is 55 additional full-time equivalent people. So we are seeing a growth in Newcastle-under-Lyme as well.

Workforce expansion is also about retention, as the Minister said. Times are tough for everybody, given what Putin’s war in Ukraine has done to inflation, but we have always prioritised NHS workers, especially those earning the least. A million workers received at least an additional £1,400 in their pay packets in the last year, and we accepted the independent pay review in full. During covid in 2021, we protected healthcare workers, giving them a pay rise during a wider public sector pay freeze and when private sector wages were falling. The full-time basic salary of a newly qualified junior nurse at the bottom of band 5 is now over £27,000, and experienced nurses or midwives at the top of band 6 are earning £40,588. On top of that, they get excellent pension provision, so we are looking after our NHS staff by paying them and retaining them.

More generally, we are also increasing the number of beds across the hospital estate. A new ward with 28 beds recently opened at the Royal Stoke University Hospital, but I know Tracy Bullock wants more, and I will speak to the Minister about that. We will need more beds for next winter, because the Royal Stoke is under incredible pressure, not least because of the burden of the New Labour private finance initiative contract that costs them a fortune to maintain. A previous Health Secretary ranked the worst 10 PFI contracts, and I believe that we were 11th or 12th at the time. The hospital has to live with that burden, and I raise it again with the Minister today; we want what went wrong before to be put right.

[Gareth Thomas (Harrow West) (Lab/Co-op)]

I hope the hon. Gentleman will not mind my encouraging the Minister to look, in addition to the case for more investment in his local hospital, at investing more in Northwick Park Hospital, which serves my constituents. It needs a 60-bed intensive care unit to improve the quality of critical care and, crucially, to help attract more critical care nurses and other medical staff.

[Aaron Bell]

I thank the hon. Gentleman for his point; I am sure the Minister has heard it. I will not say any more about that specific case, because I do not know his constituency that well—although I did work in Harrow once upon a time.

We had 120,000 more GP appointments every day in January ’23 compared with January ’22, and we are delivering the biggest ever catch-up—it is a necessary catch-up—over the next three years, with an extra £45.6 billion in funding to help us recover from covid. That will mean 9 million more scans, 9 million more checks and 9 million more procedures for the people who need them.

We know what Labour would do. It claims to have a plan funded through non-dom status, but I doubt that would raise the money, not only for the reasons I gave in the Opposition day debate at the end of January, but because it has already committed that money to breakfast clubs and various other things. There is a never-ending magic money tree that pays for all Labour’s commitments —[Interruption.] I know that the shadow Health Secretary and others have made many unfunded spending commitments. Labour’s answer is always more money, and the answer to how that will be funded is always a non-dom tax, which would not even raise the money Labour claims, as Ed Balls said, as Alastair Darling said, and as Gordon Brown found out for himself.

Oral Answers to Questions

Gareth Thomas Excerpts

Tuesday 24th January 2023 Commons Chamber

[Mr Speaker]

There will be a 24-hour service at Chorley as well, I hope.

[Gareth Thomas (Harrow West) (Lab/Co-op)]

One way to improve retention and recruitment of NHS staff at Northwick Park Hospital, which serves my constituency and which I believe the Secretary of State visited last Thursday, would be to invest in doubling its intensive care beds. Did the Secretary of State discuss that issue with the chief executive of Northwick Park when he visited last week? Will he tell us when he might be able to announce funding for the new 60-bed unit that Northwick Park needs?

[Steve Barclay]

The hon. Gentleman is right to highlight the importance of bed capacity at Northwick Park, but my discussions with the chief executive were more in the context of how step-down capacity will relieve pressure on A&E. The hon. Gentleman will know that Northwick Park has one of the busiest, if not the busiest, A&Es in London on many days, and the chief executive spoke to me about the value of adding extra bed capacity from a step-down perspective, much more so than from an intensive-care perspective. If there are specific issues for intensive care, I am happy to follow them up with the hon. Gentleman.

Oral Answers to Questions

Gareth Thomas Excerpts

Tuesday 14th June 2022 Commons Chamber

[Edward Argar]

I pay tribute to my hon. Friend for his work supporting the NHS and healthcare in this country both prior to and subsequent to his election to this House. I would be delighted to visit Cramlington with him—indeed, on the same visit perhaps I could visit his local health facilities to see modular construction in action. I should also say that his ever-efficient office has already invited me.

[Gareth Thomas (Harrow West) (Lab/Co-op)]

More nurses across the country, and particularly in Harrow, would make a real difference in helping those who suffer from diabetes. Given that this is Diabetes Week and that diabetes has a disproportionate impact on those from a south Asian background—particularly, for example, among my Gujarati constituents—when will the Minister put extra resources into tackling this terrible health condition?

[Edward Argar]

I am grateful to the hon. Gentleman for his important question. As he highlights, we are investing more in more nurses, but there is also a large piece of work to do on health education and improving access to those services for people with diabetes. I urge him to look forward with eager anticipation to the health disparities White Paper.

Covid-19 Update

Gareth Thomas Excerpts

Friday 26th November 2021 Commons Chamber

[Sajid Javid]

That is a good question, but such is the uncertainty around the variant and the rate at which it seems to be spreading that I am afraid that it is not possible to put a timeline on this action.

[Gareth Thomas (Harrow West) (Lab/Co-op)]

If we are to help reduce the chance of further variants emerging that will threaten the health of our citizens, we clearly need to accelerate vaccination programmes in other countries, particularly in the Commonwealth. Why are Ministers therefore so determined to use the World Trade Organisation ministerial meeting next week to block progress towards achieving—as South Africa and India want—a temporary waiver of intellectual property rules to help developing countries to develop their own vaccine manufacturing capacity?

[Sajid Javid]

The answer is that a temporary waiver of intellectual property for such purposes would be a huge step backwards. It would not help developing countries and it certainly would not help if we needed new vaccines, not just for covid-19 but for a future pandemic; the industry and businesses might step back and not bother developing if they believed that the intellectual property would always be waived in such circumstances. What is important, as I think the hon. Gentleman would agree, is that the companies developing these life-saving vaccines have an appropriate pricing and access policy for each country, so that vaccines are priced appropriately and accessibly for developing countries, and rich countries such as the UK, the US and others continue to do all they can through international vaccine donation programmes.

Oral Answers to Questions

Gareth Thomas Excerpts

Tuesday 8th June 2021 Commons Chamber

[Matt Hancock]

I am really glad to say that in Bolton and other parts of the country where we have sent in a big package of support, including surge testing—as we have done in Kirklees—we have seen a capping-out of the increase in rates without a local lockdown thanks to the enthusiasm of people locally and, of course, the vaccination programme. That is our goal. Our goal is that England moves together. That is what we are putting these programmes in place to do, and we are seeing them work.

[Gareth Thomas (Harrow West) (Lab/Co-op)]

Northwick Park Hospital, which serves my constituents, was the first to be hard hit by covid last year. At the height of the second wave in January, its remarkable staff were looking after some 600 patients. It needs investment in intensive care and recovery services. When Ministers receive the business case, can I ask them to look particularly sympathetically at it?

Coronavirus

Gareth Thomas Excerpts

Tuesday 15th September 2020 Commons Chamber

[Matt Hancock]

Yes, of course. My hon. Friend is right to raise the issue, and we have put more testing into Buckingham. There are hundreds of tests available across Buckinghamshire for his constituents and others, and we are working hard to ensure that the overall capacity has increased as well. Our constituents understandably want to get access to a test whenever they want one, and I understand that yearning, but we have to prioritise and, as I said in my opening answer, we have to put NHS and social care needs at the top of the list. I make no bones about that prioritisation, but at the same time we need to get overall capacity up, which is what we are working incredibly hard to do.

[Gareth Thomas (Harrow West) (Lab/Co-op)]

Like elsewhere, the numbers in Harrow with covid are on the rise. Tests are available for key workers, but I am told that parents and their children cannot get a covid test “for love nor money” in Harrow or near Harrow. I say gently to the Secretary of State that that does not yet feel like a world-leading test and trace system. Will he take a specific look at the circumstances in Harrow, and in particular why the nearby test centre at Heathrow is so unused at the moment?

[Matt Hancock]

The hon. Gentleman makes an important case for Harrow and I am very happy to take a look at Harrow specifically. The capacity constraint is in the labs, rather than the centres. We have the centres available to be able to process a huge amount of tests. We have record capacity in the labs, but it is in the labs where there is the constraint. We are bringing in more machines. More are being installed all the time, which is why capacity is constantly going up. Nevertheless, we clearly need to keep driving at that, because demand is going up as well.

Mount Vernon Cancer Centre

Gareth Thomas Excerpts

Wednesday 4th March 2020 Westminster Hall

[Gareth Thomas (Harrow West) (Lab/Co-op)]

I beg to move,

That this House has considered the future of Mount Vernon Cancer Centre.

A devastating report last summer into the future of Mount Vernon Cancer Centre by a clinical advisory panel led by Professor Nick Slevin at the instigation of NHS England stated that there was

“increasing concern as to whether high quality, safe and sustainable oncology services can continue to be delivered…and there is an urgent need to address this concern.”

If media reports are to be believed, that was the first time in the NHS’s 71-year history that a major hospital specialising in such an important disease had been deemed to pose a risk to patients and declared unfit for purpose. The panel went on to note that many of the existing buildings and much of the estate used by the cancer centre was

“dilapidated and not fit for purpose. There is a need for considerable investment in buildings, equipment replacement and IT connectivity”,

as well as staff.

Mount Vernon is a nationally recognised specialist cancer service, up there alongside the likes of the Royal Marsden or the Christie in Manchester, so for it to be so dilapidated and so short-staffed when cancer diagnoses are rising is deeply worrying. The panel recommended a change in the trust managing the service and, crucially, that some parts of the service—it would appear in practice to be most—be relocated to a hospital with comprehensive acute services. The report insisted that significant capital investment should be made available to address the need for a full or even partial move of the service. It argued that the buildings and wider estate used for cancer services should then be managed by the NHS trust actually providing the services to strengthen operational control.

Professor Slevin made it clear that he and his colleagues were greatly impressed by the determination of staff to continue to provide the best quality care that they could in the difficult circumstances they were working under. He also noted the consistently positive feedback from patients about the care they receive at Mount Vernon—a point that many of my constituents who have used the service have underlined to me.

Mount Vernon is a part of the NHS that I have known for a long time, having used the minor injuries centre a number of times and having campaigned to save its then accident and emergency department in the mid-1990s. More than 1,000 residents in Harrow use the service each year, and I have yet to hear a negative view of the professionals there. My constituents and I are keen to ensure that the service is maintained to a high standard and that it stays on the Mount Vernon site, or in the next best scenario, in an area local to Mount Vernon. Critically, we need a sustained period of investment in staff, buildings and equipment. I now believe that despite University College London Hospitals coming on board, there is no plan to shift Mount Vernon’s cancer service to central London, but it would be good to hear that confirmed by the Minister.

Professor Slevin’s report set out a short-term action plan involving the transfer of the leadership, governance and management of Mount Vernon’s cancer services to an experienced tertiary or leading cancer service provider from London—that apparently is now sorted—as well as the appointment of additional staff and urgent backlog maintenance work to existing clinical facilities. I would welcome clarity from the Minister on the progress made in implementing that short-term action plan. In particular, will he publish the list of urgent backlog maintenance work that Professor Slevin and the rest of the clinical advisory panel noted was essential? Crucially, what progress has been made in tackling that work?

I tabled a written parliamentary question that the Minister answered on 11 February, suggesting that removing asbestos from Mount Vernon would alone cost £12 million, while the answer to another written parliamentary question that I tabled, published on 21 October last year, stated:

“Challenges remain around sourcing capital funding for backlog maintenance and long-term solutions for the service.”

On staffing, will the Minister set out how many additional staff needed to be appointed to the acute oncology service in July last year, when the report was published, and the progress that has been made in tackling those staffing shortages? I understand from the answer that I received on 21 October in response to another written parliamentary question that I tabled that a business case for additional staff in that area was developed and approved. Will the Minister release the business case and confirm how many of the staff positions approved for recruitment have been filled?

The short-term action plan noted that robust implementation of policies concerning admission criteria, daily consultant rounds and patient reviews was necessary, which would require additional medical staffing. Again, it would be good for the number of extra clinicians needed from July last year to be published, and to know what progress has been made in tackling those staffing shortages. The answer to my written parliamentary question suggested that a proposal for an enhanced seven-days-a-week consultant model and robust outreach medical acute oncology service provision had been developed. Was it approved? Can the business case be released, and the House informed of progress on its implementation?

I tabled a further written parliamentary question, which was answered on 10 February. That answer did not give me confidence that enough action was being taken to tackle the immediate critical vacancies. The Under-Secretary of State for Health and Social Care, the hon. Member for Bury St Edmunds (Jo Churchill), said in her answer that there was a 25% vacancy rate for nurses at Mount Vernon Cancer Centre, an almost 10% vacancy rate for medical staff, an almost 30% vacancy rate for clinical support staff, and an 8% vacancy gap for scientific, therapeutic and technical staff. Given the seriousness of the findings in Professor Slevin’s report, I am surprised that more progress has not been made in reducing those vacancy rates.

It is the long-term future of Mount Vernon Cancer Centre that most exercises my constituents, and no doubt many others in surrounding areas who depend on its service. The impact of the lack of capital investment is obvious to any visitor or patient. The acid test of the commitment of Ministers to the future of Mount Vernon Cancer Centre is whether they will invest in the new linear accelerators that the service needs. Linear accelerators are fundamental to the delivery of radiotherapy services, but are costly to put in place. Mount Vernon has seven, six of which are due to reach the end of their normal operational lives over the next three years.

Professor Slevin’s report last summer noted the age of the linear accelerators, or LINACs, and an answer to another written parliamentary question on 11 February noted some of the costs of replacing LINACs, particularly if they were being moved to a new site. A day earlier, an answer to another written parliamentary question noted that three of the seven linear accelerators were due to be replaced this year, with three more due in 2022. Will the three linear accelerators due for replacement this year be replaced and, if not, why not?

Professor Slevin’s report noted that the brachytherapy service at Mount Vernon Cancer Centre is nationally recognised, but access to theatres for treatment is “constrained”. What is the long-term plan to sort that issue? The report also noted the desire of East and North Hertfordshire NHS Trust and the Hertfordshire sustainability and transformation partnership to see Mount Vernon Cancer Centre’s services re-provided in fit-for-purpose buildings, replacing the oldest facilities.

Indeed, so old and decrepit are the buildings that leaking roofs have forced “adjustments in service provision”. Nine months on, I ask the Minister whether there are still leaking roofs at Mount Vernon, forcing more of the cancer centre’s services to be moved. There are insufficient rooms for medical staff, specialist nurses, dieticians and speech and language therapists, inadequate electronic systems and poor IT connectivity, slowing the clinical process. There is no direct real-time connection of the X-ray systems between Mount Vernon Cancer Centre and hospitals in its catchment area, undermining the effectiveness of clinical management.

The report stresses that the impact of poor IT infrastructure should not be underestimated. Duplicate paper records, a lack of access to complete scanning images out of hours, and an inability to view a comprehensive patient record lead to clinical risk. In short, doctors cannot access the results of critical CT and MRI scans out of hours. In the short term, according to the answer to a written parliamentary question that I received on 11 February, a plan to digitise patient care records at Mount Vernon is expected to be ready for implementation in May this year. Has the funding been identified to allow that to happen or will it have to wait for a full review of the future of Mount Vernon Cancer Centre to be completed? I hope that it is the former.

Professor Slevin’s report left the exact long-term future for Mount Vernon unresolved. A strategic review of Mount Vernon Cancer Centre to resolve that question is expected to be completed sometime this year, according to the answer given on 11 February to my written parliamentary question. Who will lead that review, what clinical expertise will they have, and how can we be sure that they will see it through to completion? What is the timeline for that review?

Part of the problem for Mount Vernon Cancer Centre is that the Mount Vernon site is owned by Hillingdon Hospitals NHS Foundation Trust, while East Herts NHS Trust runs the cancer service. Add in the confusion regarding which part of NHS England is responsible for owning the future of Mount Vernon, and it is not hard to understand why, despite two concerning Care Quality Commission reports in the past five years, there might have been a lack of NHS focus until now on Mount Vernon’s future.

I understand too that a further transfer of responsibility for Mount Vernon’s future from NHS East of England to NHS London is inevitable when University College London Hospitals NHS Foundation Trust takes over direct responsibility for the cancer centre. Given that, and given the number of Ministers in the Department of Health and Social Care who have answered my questions about Mount Vernon so far—answers for which I am very grateful—it would be good to know who among the Secretary of State’s ministerial team will continue to have immediate and ongoing responsibility for the project. If it is the Minister present today, given his seniority within the Department, I am sure that my constituents and I would welcome that news.

This 117-year-old hospital is not one of the six named for rebuilding or one of the 40 for which a rebuild or upgrade appears to be on the cards over the next five years. Unsurprisingly, I have been asked whether Mount Vernon Cancer Centre is set to close. The omens certainly do not look good, but assuming that that is not Ministers’ intentions, and that central London is not their intention for a move either, that would suggest a local move—to Hillingdon Hospital or Watford General Hospital, where I understand that upgrades have been announced or are planned. Failing those two options, either Northwick Park Hospital or Stevenage, Cambridge or Luton is likely.

My constituents and others deserve to know that the problems of Mount Vernon Cancer Centre are being sorted out. To give confidence to that end, transparency for the local community is essential. Given the seriousness of Mount Vernon’s situation, regular quarterly updates that are easy to understand and that offer a route to track progress are surely not much to ask for all those who use the cancer centre. To make such updates helpful, they should include consistent answers to three fundamental continuing questions. First, what extra staff does Mount Vernon need and what is being done to fill the vacancies? Secondly, will the three linear accelerators due to be replaced this year be replaced? Thirdly, when will a decision be made on Mount Vernon’s future, who will have a say in it, and how can they be influenced? I hope that the Minister will agree to give those updates.

Lastly, it would be remiss of me not to mention the fact that, earlier this week, a clinician at Mount Vernon Cancer Centre was suspected of having coronavirus. I understand that, after testing by Public Health England, the member of staff has fortunately proven to be negative for the virus. Inevitably, that initial concern will have been profoundly worrying for staff and patients. It is a further tribute to the professionalism of the staff at Mount Vernon Cancer Centre that they have maintained care and the high standards for which they have a deserved reputation. I look forward to the Minister’s response.

NHS Funding Bill

Gareth Thomas Excerpts

Legislative Grand Committee & 3rd reading: House of Commons & Legislative Grand Committee: House of Commons & Programme motion: House of Commons & 3rd reading & Programme motion
Tuesday 4th February 2020 Commons Chamber

[Justin Madders]

I thank the hon. Gentleman for his intervention. I understand his frustration absolutely. I think he has a very fair point, Dame Rosie, that because of the Barnett consequentials there is a role for SNP Members—indeed, all Scottish and Welsh Members—in this debate. Clearly, that is a separate issue to the whole English votes for English laws process, but the fact is clear that on the face of the Bill there are Barnett consequentials, which mean that the devolved nations ought to have a say.

It is really no wonder, given the background I have just set out, that children are reaching a crisis point before getting the support they need, and that the number of children attending accident and emergency for their mental health in a situation of crisis is increasing year on year. That is not inevitable. With real investment, we could reverse the trend of long waits, rationed treatment and inadequate care if we allocated more of the NHS budget to mental health. As we know, mental health illnesses represent 23% of the total disease burden on the NHS, but just 11% of the NHS England budget. That is a long way off the parity of esteem that we all seek to achieve.

We know that the Government plan to put in an extra £2.3 billion a year by 2023-24, but that is not enough. The Institute for Public Policy Research has said that to achieve parity of esteem for mental health services, funding for those services needs to grow by 5.5% on average not just next year, but over the next decade. The NHS plans to spend £12.2 billion on mental health funding in 2019, but the IPPR estimates that that needs to reach 16.1 billion by 2023-24 alone.

Of course, we support the increased funding for mental health in the Bill, but we know the NHS has to live within the 3.3% uplift provided under the Bill. The Institute for Fiscal Studies, the Health Foundation, NHS providers, the British Medical Association and many of the royal colleges say that health expenditure should rise across the board by 3.4% just to maintain current standards of care. By definition, there will actually be less money for funding in other areas. That means there is a risk of further raids on the mental health budget. In previous years, money allocated to mental health services, particularly children and adolescent mental health services, has been diverted back to hospitals to deal with the crisis there.

Labour would have done what was desperately needed. We would have put in an extra £1.6 billion a year immediately into mental health services, ring-fenced mental health budgets and more than doubled spending on children’s mental health. That is why we are seeking to amend the Bill to ensure mental health services do not lose out because of other financial pressures in the system. We are calling on the Government to ensure that guarantees for mental health funding are protected by ring-fencing mental health funding. We also seek to require the Secretary of State to come to the House annually to report on the amounts and proportion of funding allocated to mental health services, and on their plans to achieve parity of esteem for mental health services.

On the Labour Benches we are not convinced that mental health is a priority for this Government, despite what they say. They may want to position themselves as the party of the NHS, but as long as they continue to neglect mental health and push services deeper into crisis, they will not come near that aim. We intend to push amendment 2 to a Division, because we want to hold the Government to account. We want transparency on mental health spending and we want a clear road map from the Secretary of State on how he intends to make parity of esteem a reality.

[Gareth Thomas (Harrow West) (Lab/Co-op)]

I wonder if I could raise with my hon. Friend an example that I think makes his point, which is the state of NHS finances in north-west London, in particular of the acute hospital that serves my constituents, Northwick Park Hospital, and the clinical commissioning group. Both the trust and the CCG are over £30 million in deficit. As a result, they have cut back on community mental health services and, indeed, on a range of other things. Unless there is parity of esteem and unless there is a significantly higher funding boost for the NHS in north-west London than that currently being suggested by the Conservative party, I fear that mental health services, as he so rightly says, are likely to be cut even further.

[Justin Madders]

My hon. Friend sets out very clearly the challenge that the Government face from the debt situation in the NHS. Both in-year deficits and total debt to Government have not been addressed adequately or taken into account in the Bill and that is clearly of huge concern.

Amendment 5 deals with patient safety, which should be front and centre in the NHS. When things go wrong, as they sadly do from time to time, it can have tragic consequences for patients and their loved ones. When three in four baby deaths and injuries are preventable with different care, it seems particularly tragic when things go wrong during birth, leaving families devastated by the loss of a child or having to cope with the long-term impact. There have been many things over the years that I have disagreed with the previous Secretary of State—the right hon. Member for South West Surrey (Jeremy Hunt)—about, but on Second Reading he raised the important issue of maternity safety training, calling on the current Health Secretary to reinstate the maternity safety fund. We absolutely agree with him on that, which is why we have tabled amendment 5.

Improved maternal health is one of four priority areas in the long-term plan for care quality and improved outcomes, and it includes action to achieve 50% reductions in stillbirth, maternal mortality, neonatal mortality and serious brain injury by the middle of the decade. As a party, we have pledged to legislate for safe staffing and to increase funding for NHS staff training, including reinstating the maternity training fund to help to improve maternity safety in our hospitals. The leaked interim report of the Ockenden review last year exposed widespread failures in maternity care at Shrewsbury and Telford hospital trusts and demonstrated, sadly, that Morecambe Bay was not a one-off.

An evaluation of maternity safety training from 2016 found that it had made a difference and improved patient safety, yet it was still axed. Just two years later, the “Mind the Gap” report found that fewer than 8% of trusts were providing all training elements and care needs in the “Saving Babies’ Lives” bundle and called for the maternity safety training fund to be immediately reinstated to address, as it said, the

“clear…inadequate funding for training”.

Given the clear evidence of the need for the training fund’s reinstatement, I very much regret that it is not within the scope of the Bill for us to submit an amendment to include its reinstatement. However, with the amendment we seek to put a greater spotlight on the issue, and hopefully, that will require the Government to set out how much they are spending on improving maternity safety and care for mothers and babies each year in order for them to demonstrate their commitment to improving maternity and foetal safety. I believe that that will enable us to judge and evaluate their commitment to those aims.

--- Later in debate ---

[Gareth Thomas]

In support of the case that my hon. Friend is making, I again mention Northwick Park Hospital, which serves my constituents. It has a huge maintenance backlog. Since the cancellation of the Government’s “Shaping a Healthier Future” NHS reform plan for north-west London in June last year—that programme of reform had been going on for seven years —there has also been no replacement money identified for investment in intensive treatment beds, an extra 30 of which are needed to help to tackle some of the problems in A&E at Northwick Park Hospital.

[Justin Madders]

My hon. Friend is again showing what an assiduous and determined constituency MP he is. He might want to look at the NHS providers’ report today, which sets out some of the challenges from the lack of a long-term capital investment programme. As we have heard, including from him and in relation to other various examples around the country, this is not just about a lick of paint, but about really vital work that impacts on patient care.

--- Later in debate ---

[Justin Madders]

Across the piece, some areas in Wales are actually performing better than areas in England. The direction of travel is the right one. If the right hon. Member is so interested in the performance in Wales, he should stand for the Welsh Assembly; he will have the opportunity to do so in the not-too-distant future. I am sure he was aware when he stood for this place that health was a devolved issue.

[Gareth Thomas]

I want to raise again the example of Northwick Park Hospital, which serves my constituents. It has not met the four-hour A&E target since August 2015. One of the latest issues responsible for the increasing pressure on waiting times at Northwick Park is the closure of our walk-in services, which were one of the great reforms of the previous Labour Government. Alexandra Avenue, which served my constituency, closed in November 2018, and Belmont health centre, which served the constituency of Harrow East, closed in November 2019. The last walk-in service in the London Borough of Harrow, the Pinn medical centre, which currently is in the constituency of the hon. Member for Ruislip, Northwood and Pinner (David Simmonds), is also due to close, and yet it is increasingly difficult to get an answer to a request for a meeting to discuss that closure with Ministers or the chief executive of NHS England.

[Justin Madders]

There has to be a correlation between the number of closures my hon. Friend is seeing and his CCG’s debts, which he was referring to earlier. The pressure on frontline services is making these decisions, which it is more and more likely can only impact on performance. I hope that when the Minister responds he will be able to give him the satisfaction of at least a meeting to discuss the issue further.

The funding in the Bill is insufficient to reverse the decline in recent years, let alone deliver the aspirations set out in the long-term plan. It is not just the opinion of Her Majesty’s Opposition that the performance targets cannot be met; NHS England has also made it clear that the core treatment targets cannot be met because of the funding settlement imposed by the Government. And who loses out month after month when performance targets are missed? It is patients. Whether for pre-planned surgery, cancer treatment, diagnostic tests or emergency care, our constituents are waiting longer and longer, often in pain and distress, to access the health services they need. The figures do not lie.

We must remember that the figures are also real people. They are real people stuck on waiting lists: the total number of people on waiting lists in England is now 4.41 million, which is the highest since records began, and up from 4.1 million, when the right hon. Member for West Suffolk first became the Secretary of State. They are real people waiting for treatment: the target to treat 92% of patients within 18 weeks has not been met for four years—not since February 2016—and obviously has never been met by the current Secretary of State. They are real people waiting for cancer treatment: the Prime Minister himself agreed last month that it was unacceptable that the target for treating cancer patients within 62 days of urgent GP referrals had not been met for five years. That is five years of failure. They are people waiting on hospital trolleys: the number of people waiting four hours or more on hospital trolleys reached 98,452 last December, which is not only a 65% increase on the same point the previous year, but the highest on record.

As we heard on Second Reading, the failure to meet these targets has real consequences. Research from the Royal College of Emergency Medicine shows that almost 5,000 patients have died in the past three years because they spent so long on a trolley waiting for a bed in an overcrowded hospital. As we have said several times during our consideration of the Bill, the true increase in funding is about 4.1%—I will not list again all the bodies that agree with that figure—yet the money in the Bill will not be enough.

This is all before last week’s news about the Chancellor looking for 5% savings in all Departments, including this one. That might not affect the figures in the Bill, but there might be cuts across the wider Department that do have a knock-on impact on service delivery. Let us take a look at A&E. There is increased demand on our A&E services, for many reasons, including the years of cuts to social care, but that is not covered in the Bill. Will the 5% cut come from there—if it does, more and more people will be forced into A&E by a collapsing social care system—or from public health, as we have heard previously, which would inevitably store up problems in the short and longer term?

None of this can be said to be likely to have no impact on performance targets, which for too long have been treated as a poor relation by this Government. The Government have widely ignored them, to the extent that they are spending more time dreaming up ways to get rid of them than to meet them. We say that patients deserve better. We will push the new clause to a vote, because we believe it is clear that the Secretary of State will not be able to drive down waiting lists or drive up performance with the level of health expenditure that he proposes to enshrine in law.

Rather than presenting the Bill as a panacea, let us ensure that the Secretary of State and the Prime Minister are held to account for the promises that they make, and that the Secretary of State comes to this place every year to tell us whether, in the Government’s opinion, the funding allocated for that year will be sufficient to meet those performance targets. If it is not, the Government must set out what they are going to do about it. It is simply not good enough to continue, year after year, to have a Government who treat the targets as an inconvenience. If those standards are to mean anything to patients, and if the Government are serious about persuading us that they mean something to them as well, they will have to come here every single year and tell us, unambiguously and with reference to the funding package for this year, how they intend to meet those targets.

--- Later in debate ---

[Edward Argar]

My hon. Friend is a sound and vocal champion for her constituents in Stafford. I am sure that she will continue to champion their cause, and I am happy to meet her to discuss the specific issue she raised.

I turn to amendment 3, in respect of capital-to-revenue transfers. Clause 1(2) ensures that the funding specified in the Bill can only be used for NHSE revenue spending, meaning that day-to-day spending for the NHS is protected. As we have highlighted in the House previously, the Government have made a range of capital commitments to the NHS, including the commitment to 40 new hospitals. Nevertheless, going to the point in the amendment itself, we have been clear that the transfers from capital revenue should have only been seen as short-term measures that were rightly being phased out, and we are doing so. My right hon. Friend the Member for South West Surrey (Jeremy Hunt), the former Secretary of State, did, however, set out why a degree of flexibility is required, and we would not believe that a blanket ban set in legislation was the right approach.

[Gareth Thomas]

Will the Minister give way?

[Edward Argar]

I will not, if the hon. Gentleman will forgive me, as I only have 10 minutes or so left.

There are sometimes very good and logical reasons why adjustments between capital and revenue are needed. As the former Secretary of State highlighted, in some cases, for perfectly good reasons a capital pot may not be spent fully within a year and there is an opportunity to achieve patient good from transferring it. While I take his point and believe it is right that we should continue to move away from such transfers, I would not wish to see that rigidly set in legislation.

Amendments 2 and 1, and new clauses 1, 2, 3 and 9, relate to mental health services both for children and adults, and accountability to Parliament and reporting mechanisms. We have rightly seen considerable interest in mental health in this debate, so I will seek to address both those points together. I begin by paying tribute to Paul Farmer of Mind, Sir Simon Wessely, Professor Louis Appleby, the Mental Health Foundation, Rethink Mental Illness, YoungMinds, the Royal College of Psychiatrists, and a host of other individuals and organisations up and down the country, for their fantastic work in making mental health such a feature in our debates and in the public consciousness. It is absolutely right that they have done so.

I pay tribute to the Under-Secretary of State, my hon. Friend the Member for Mid Bedfordshire (Ms Dorries), and her predecessor, my hon. Friend the Member for Thurrock (Jackie Doyle-Price), who brought to the role of mental health Minister passion, dedication and a determination to make a difference. I should also reference some former Members of this House: Norman Lamb, who did so much in this area; the former Prime Minister, David Cameron; and of course my right hon. Friends the Members for South West Surrey and for Maidenhead (Mrs May), who ensured that it was front and centre of this Government’s commitment.

I want to be totally clear that the Government are fully committed to transforming mental health services. That is why we enshrined in law our commitment to achieving parity of esteem for mental health in the Health and Social Care Act 2012. As my right hon. Friend the Member for South West Surrey said, that is driving real change on the ground. We have also committed to reforming the Mental Health Act 1983 to provide modernised legislation. I would also highlight that at £12.5 billion in 2018-19, spending on mental health services is at its highest ever level.

We have made huge strides in moving towards parity, but there is still so much more to do. We are ensuring, through the NHS long-term plan, that spending on mental health services will increase by an additional £2.3 billion by 2023-24. This historic level of investment in mental health is ensuring that we can drive forward one of the most ambitious reform programmes in Europe. It will ensure that hundreds of thousands of additional people get access to the services they need in the lifetime of the plan. I flag that up because we can and will always strive to do more, and it is right that we are always pressed by this House to do so. While proposals for a ring fence in mental health spending are understandable, the approach that this Government have already set out, with long-term commitments to funding, is already driving the results we wish to see.

I now turn to new clause 9, tabled by my hon. Friend the Member for Newton Abbot (Anne Marie Morris). If I may, I will also address new clause 2 in this context because there is a degree of overlap. I welcome my hon. Friend’s new clause. Although I hope that, as she indicated, she will not press it to a vote—and I heard what the hon. Member for Twickenham (Munira Wilson) said in respect of hers—the sentiment behind it is a good one, particularly the focus on outcomes and outputs rather than simply inputs and the amount of money going in, and on adopting a holistic approach. I know that my hon. Friend the Member for Newton Abbot recently met the Secretary of State to discuss the matter, and I am happy to meet both her and the hon. Member for Twickenham. While we do not believe it is the right approach to set additional reporting mechanisms in legislation over and above the different reports that NHS England and the Secretary of State already make to Parliament, which offer opportunities for debate, we are happy to consider whether, within the existing reporting mechanisms, there is a way to better convey to the House and the public more widely the progress we are making against those targets.

The NHS long-term plan represents the largest expansion of mental health services in a generation, renewing our commitment to increase investment faster than the overall NHS budget in each of the next five years. Not only will spending on mental health services increase faster than the overall NHS budget as a proportion, but spending on CAMHS will increase at an even faster rate. The hon. Member for Twickenham was right to highlight the importance of CAMHS. In our surgeries, we have all had constituents come to see us who are deeply worried and concerned about the mental health and welfare of their children, be that in relation to eating disorders, which I focused on when I came to this place, or a range of other factors. We are committed to delivering the NHS long-term plan to transform children and young people’s mental health services, with an additional 345,000 children and young people being able to access those services.

While we are deeply sympathetic to the spirit behind the amendments on mental health spending, we do not believe that putting a ring fence into the Bill is the appropriate way forward, given the work already being done, the money already being spent and the outcomes already being delivered. We believe that the reporting requirements are already extensive and varied. They already give the public and Parliament the opportunity to scrutinise the work of the Department and NHS England. We are happy to look at ways in which those reports might be more accessible and include different metrics, but we believe it would be wrong to legislate on them at this point.

As I said on Second Reading, this is a simple Bill. It has two clauses, of which one is substantive. It has a single, simple aim: to enshrine the funding settlement behind the NHS long-term plan in law. It delivers the funding that the NHS said it needed and wanted, and it delivers on this Government’s pledge to do so within three months of the election. In the light of that, while the amendments are clearly well intentioned and we appreciate the spirit behind them, they are unnecessary additions to the Bill, and I urge their proposers not to press them to a vote. I appreciate that Members have indicated their intention to press some amendments to a vote, I urge them, in the short period remaining before Committee ends, to reflect a little longer on whether they might reconsider and not move their amendments to a vote.

Oral Answers to Questions

Gareth Thomas Excerpts

Tuesday 29th October 2019 Commons Chamber

[Mr Speaker]

Order. We are running late, but I will take a one-sentence question from Gareth Thomas.

[Gareth Thomas (Harrow West) (Lab/Co-op)]

The three walk-in centres that provide a seven-day-a-week service in my constituency are closed or closing. Why?

[Ms Dorries]

I did not hear the hon. Gentleman’s question in full, but I would be happy to meet him afterwards to talk about the matter in more detail.