Oral Answers to Questions

George Freeman Excerpts

Tuesday 5th January 2016 Commons Chamber

[Christian Matheson (City of Chester) (Lab)]

5. What assessment he has made of the effect of changes to social care budgets on A&E attendances.

[The Parliamentary Under-Secretary of State for Life Sciences (George Freeman)]

Our health and care system is under extraordinary rising demand from an ageing society. There are a million more pensioners this year than there were at the beginning of the previous Parliament, and there will be another million by the end of this Parliament. The number of adults needing care in the next 10 years will rise from 180,000 to 264,000. That is why integration of health and care is so important, and it is why I am delighted that my right hon. Friend the Chancellor announced in the autumn statement £3.5 billion for social care by 2020 through the new adult precept and extra funding for the NHS five-year forward view.

[Christian Matheson]

In any given week at the Countess of Chester hospital, 70-plus elderly patients pitch up and cannot be discharged because care is not available elsewhere. We know that the Government broke their promise before the election to sort out funding for long-term care, and the King’s Fund recently said that the settlement to which the Minister refers will put

“even more pressure on … the NHS to pick up the pieces when there’s a breakdown in … care”.

Will the Minister now accept that that continuing neglect and those broken promises are the key cause of the crisis in our A&E departments?

[George Freeman]

Well—happy new year! Only Labour could take a £3.5 billion commitment to fund social care as “more pressure”. We are leading the way in integration—not before time, after 14 years in which Labour did nothing. We are leading the way on integration and putting in the extra money. I am delighted to say that, through the £3.8 billion for this coming year and the £10 billion funding for the NHS Five Year Forward View for transformation, it is the Conservative party that is investing in a 21st-century NHS. Labour seems to want to take us back to “Call the Midwife”.

[Andrew Bridgen (North West Leicestershire) (Con)]

Does my hon. Friend agree that it is an important step to devolve powers to local authorities, as they are best placed to commission care services for local populations?

[George Freeman]

My hon. Friend makes an excellent point. The key is, of course, more funding and more integration, but crucially more local leadership too, and we are actively making it easier through the devolution programme for local authorities and local health leaders to plan the integrated services that are appropriate for their area. Not all areas are the same.

[Jenny Chapman (Darlington) (Lab)]

17. Having listened to what the Minister has to say, people in my constituency will be disbelieving. The number of days that patients are stuck in hospital, not because they are sick but because there is nowhere to move them, has doubled under his Government. He has to acknowledge that that is due to the neglect of local government and adult social care specifically.

[George Freeman]

It is true that in different areas there are different pressures. In my own area of Norfolk there are pressures. Let me remind the hon. Lady that A&E spending has gone up dramatically over the past decade, from £900 million in 2001 to £2.4 billion. The early evidence from the better care fund, which we launched only this year to tackle this very issue, is 85,000 fewer delayed transfers, 12,000 more older people at home within three months of discharge, and nearly 3,000 people supported to live independently. Through more funding, greater freedoms and local devolution, we are supporting health leaders and council leaders to bring together health and care.

[David T. C. Davies (Monmouth) (Con)]

Despite the pressures, is it not excellent that 95% of patients who present at A&E in England are seen within the target time, unlike in Wales, where the figure is only 81%, as a result of the fact that the NHS is run by members of the Labour party?

[George Freeman]

My hon. Friend makes an excellent point. We hear very little from the Labour party about Wales, where it is responsible for the health service, and an awful lot of questions about England, where fortunately it is not responsible. If we want to get pressure on A&E down, we need to integrate and invest as we are doing in prevention and in keeping people out of unnecessary A&E admission.

[Norman Lamb (North Norfolk) (LD)]

23. The Health Foundation estimates that the gap in social care funding by 2020 will be £6 billion, not taking into account the increase in the minimum wage, so although the spending review narrows the gap, it still leaves an enormous gap which will result in further cuts in social care. How will the Government avoid the totally unacceptable situation in which those with money will still get good care and those without money will get substandard care or no care at all?

[George Freeman]

I pay tribute to the right hon. Gentleman. He is a Norfolk colleague and as Minister did a lot of work in this area. He raises an important point that as a society we need to think profoundly about how we integrate health and social care. As I say, the Government have made a £3.5 billion commitment from the new precept and the better care fund is a significant commitment, but he is right—we will have to go further. Through the devolution programme and the integration programme, we will have to develop more powers so that local health leaders and care council leaders can better integrate services to reduce unnecessary pressure.

[Dr Philippa Whitford (Central Ayrshire) (SNP)]

In Scotland, A&E performance is published weekly, but since June that in England has been published only every month and now after a six-week delay. Since that time, the performance in Scotland has risen and 96% of people were seen within four hours in Christmas week, which is a huge challenge, whereas the last data published for England were for October and show a figure below 90%. Do the Minister and the Secretary of State accept that to improve performance we need to return to more timeous and frequent analysis and publication?

[George Freeman]

I share the hon. Lady’s interest in data and in proper information. We need to be a little careful about Scottish figures. Over winter, England publishes three times more A&E performance measures than Scotland every week. We publish quality rankings on hospitals, care homes and GP surgeries, which Scotland does not. What we do not hear about in Scotland is A&E closures, A&E diverts, emergency admissions, general and acute beds—I could go on. It is dangerous to compare data that were not prepared on the same basis, but I share the hon. Lady’s enthusiasm, as does the Secretary of State, for information.

[Dr Whitford]

I am aware that the renewed strike call from junior doctors has actually been called in order to meet the new rules created by the Government’s own union laws and that negotiations are ongoing. To avoid an impact on hospital waiting times, what will the Secretary of State bring to the negotiating table to try to reassure junior doctors?

[George Freeman]

I am delighted to be able to announce—the hon. Lady might already have heard this—that the Secretary of State has appointed Sir David Dalton from Salford Royal to lead on that. I repeat the offer that the Secretary of State made this morning: we are very close to an agreement, so the right approach is not to strike, but to come to the table and reach it.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

Three hundred thousand fewer older people have publicly funded care packages than in 2010, and nearly half the current record level of hospital delayed discharges are due to waiting for a care package, and that will get worse as winter pressures mount. It is risky that the proposed increases in the better care fund are back-loaded; they do not reach £1.5 billion until 2019-20. The social care precept funding is uncertain because it will raise only £1.6 billion by 2020 if every single council decides to raise the maximum possible. Social care is in crisis now. Can the Minister explain why the Government are proposing risky, uncertain and late funding?

[George Freeman]

This is the most extraordinary welcome for one of the most important announcements in the autumn statement. Having come under pressure to raise more money for social care, the Chancellor and the Secretary of State announced £3.5 billion extra for social care, from the new adult social care precept and the better care fund. The Opposition say that it is not enough and that it will fail, but the data do not support that. If we look at the early data from the better care fund, which was introduced by this Government early last year, we see 85,000 fewer delayed transfers, 12,500 more older people at home within three months of discharge and 3,000 people supported to live independently. We are making real progress.

[John Stevenson (Carlisle) (Con)]

6. What progress his Department has made on improving the performance of hospital trusts in special measures.

--- Later in debate ---

[Mr Peter Bone (Wellingborough) (Con)]

8. What his policy is on making docetaxel available as a treatment for prostate cancer.

[The Parliamentary Under-Secretary of State for Life Sciences (George Freeman)]

Docetaxel is routinely available in England for the treatment of metastatic prostate cancer, where the disease has not responded to hormone treatment. It is not at the moment licensed for use alongside hormone treatment and has not been appraised by the National Institute for Health and Care Excellence for that indication. In the absence of NICE guidance, NHS commissioners are free to make funding decisions on the best available evidence.

[Mr Bone]

I thank the Minister for stating the current practice. A constituent of mine has prostate cancer. His doctor, consultant and oncologist all say that he would benefit from taking docetaxel, but it is not available in Northamptonshire, although it is available in parts of the rest of the country. He has been told that if he goes down the road to the private hospital, he can have it at £2,700 a cycle. Is that not unacceptable? Should he not get the treatment on the NHS and should he not get refunded the monies paid for private treatment?

[George Freeman]

I congratulate my hon. Friend on being a diligent advocate for his constituent Mr Vann. I am delighted to tell him that the result of the STAMPEDE clinical trial has now been published. Today NICE is publishing an evidence review. NHS England will shortly be publishing its interim commissioning policy based on that evidence. That is very encouraging.

[Daniel Kawczynski (Shrewsbury and Atcham) (Con)]

9. What assessment his Department has made of the need for wi-fi infrastructure in hospitals to facilitate use of developing healthcare technologies.

[The Parliamentary Under-Secretary of State for Life Sciences (George Freeman)]

Digitalisation of healthcare is absolutely essential for the 21st-century NHS—for individual care, for system performance and safety, and for research. Wi-fi is an important part of that, with benefits for doctors, nurses, hospital management and patients. That is why I am delighted that my right hon. Friend the Secretary of State secured the necessary funding in the comprehensive spending review to fund fully the NHS’s plans for digitalisation and transformation. We have announced that we are implementing Baroness Martha Lane Fox’s recommendation of free wi-fi in all NHS hospitals.

[Daniel Kawczynski]

I am grateful for that answer. The new chief executive of the Royal Shrewsbury hospital informed me that people can receive wi-fi in only half of the hospital area. Can the Minister give me an assurance that everything will be done to ensure that wi-fi is available throughout the Royal Shrewsbury hospital?

[George Freeman]

That is an important point. It is up to each hospital to implement digitalisation in its own way, but we are putting in place a series of steps to make sure that all parts of the NHS are supported and encouraged in the drive for delivery of a paperless NHS by 2020. In the new year, we are requiring the clinical commissioning group digital index, which will measure the digitalisation of all health economies, and we are launching a review of best practice. We are absolutely committed to driving digitalisation so that the 21st-century NHS is not running on paper and cardboard.

[Anne Marie Morris (Newton Abbot) (Con)]

10. What plans he has to publish a rural healthcare strategy.