Oral Answers to Questions

Greg Smith Excerpts

Tuesday 15th October 2024 Commons Chamber

[Karin Smyth]

What we see at the front end of the system is a result of the deterioration throughout the system, and the flow of patients from the community, through discharge and, indeed, through social care. Our ambitious 10-year plan will involve examining the entire patient pathway to ensure that care is provided in the community, closer to home. Prevention is a key part of that, as is the look that we are taking at social care.

[Greg Smith (Mid Buckinghamshire) (Con)]

3. What steps he plans to take to reform adult social care.

[The Minister for Care (Stephen Kinnock)]

After 14 years of Tory neglect and incompetence, adult social care is on its knees. The number of people receiving long-term care decreased between 2015 and 2023, and there were a staggering 130,000 staff vacancies in the system. Last Thursday, recognising the central role of our amazing care workforce, we took a critical first step by introducing the groundbreaking legislation that will establish the first ever fair pay agreement for care professionals. I think it fair to say that this Government have done more for our adult social care workers in 14 weeks than the last lot did in 14 years.

[Greg Smith]

Given unfunded schemes such as the proposed national care service, given the new negotiating body’s aim of establishing a minimum pay floor, and given what clearly amounts to an expensive top-down reorganisation of the care system, can the Minister explain how he will maintain and enhance the role of local authorities, including Buckinghamshire Council, in targeting and delivering care, and how he plans to maintain day-to-day spending alongside this grand plan for reform, without raising taxes?

[Stephen Kinnock]

It beggars belief that Opposition Members should lecture us on fiscal discipline when there is a £22 billion in-year black hole. We are committed to consulting widely on the design of a fair pay agreement, and we will engage with all who may be affected. We are keen to ensure that all voices are heard so that the financial impacts on the adult social care market, local government and self-funders can be considered, but in a week in which this Government have attracted £63 billion of investment and just days after the publication of the Employment Rights Bill, we are seeing a Government who are pro-business, pro-worker and pro-growth.

NHS

Greg Smith Excerpts

Thursday 23rd May 2024 Commons Chamber

[Victoria Atkins]

I am very grateful to my hon. Friend, who, of course, brings her professional expertise into the Chamber. On the Bill, she will appreciate that we are at a very delicate stage, which I am not allowed to say anything about at the Dispatch Box, but she should be confident of my commitment, and that of the Prime Minister, to this important legislation and to a smoke-free generation.

[Greg Smith (Buckingham) (Con)]

Buckinghamshire has seen significant improvements to the NHS estate, not least with a new paediatric A&E at Stoke Mandeville Hospital, but my right hon. Friend will know that we have had many conversations about getting a new primary care facility into the village of Long Crendon and about critical upgrades to Wycombe Hospital to replace the ageing tower. Can she confirm that a future Conservative Government will remain absolutely on track to deliver on those facilities?

Oral Answers to Questions

Greg Smith Excerpts

Tuesday 23rd April 2024 Commons Chamber

[Victoria Atkins]

I would be delighted to join my hon. Friend, and I thank him again for a really positive visit to his local hospital. That is a great example of a local MP working in his local area for his constituents and, what is more, delivering for them.

[Greg Smith (Buckingham) (Con)]

As a practical measure to improve radiotherapy waiting times, will the Minister agree to further work on the radiotherapy dataset, to include the collection of data on delays at each stage of the radiotherapy pathway, and by tumour type, so that we can better understand pinch points in services?

[Andrew Stephenson]

We are working to improve radiotherapy services across the NHS, and I would be happy to meet my hon. Friend to discuss that in more detail.

Oral Answers to Questions

Greg Smith Excerpts

Tuesday 5th March 2024 Commons Chamber

[Julie Marson (Hertford and Stortford) (Con)]

7. What steps her Department is taking to improve access to primary care.

[Greg Smith (Buckingham) (Con)]

8. What assessment she has made of the adequacy of primary care provision in rural communities.

[The Secretary of State for Health and Social Care (Victoria Atkins)]

We have met our manifesto commitment to deliver a record extra 50 million GP appointments annually. Our primary care recovery plan addresses increased GP access and expands community pharmacy services nationwide with Pharmacy First. Our NHS dentist reform plan also allocates resources for 2.5 million appointments, targeting rural and coastal communities.

[Victoria Atkins]

I congratulate my hon. Friend on the enormous amount of work she has done in her constituency to secure that community diagnostic centre. We have rolled out some 160 or so of those centres across England —we want to do more—and they are supplying some 6 million tests and scans for patients across England.

On the important issue that my hon. Friend raised, my officials and Levelling Up officials are already considering how primary care infrastructure can be better supported in the planning process to ease the pressure on primary care estates, particularly in areas of housing growth. I know that she will continue to be as conscientious in her campaigning on that as she is on other matters.

[Greg Smith]

Rural communities need local, easily accessible primary care. Since Long Crendon surgery closed during the pandemic, patients in that village and surrounding villages have been displaced, mainly to Brill and Thame, for GP appointments. For the vulnerable and those without private cars, the absence of regular bus services can mean an unaffordable £25 at least in taxis to see a GP. I have raised many times an innovative approach to building a new health centre in Long Crendon by the parish council, which has the land and the agreement by the ICB for the rent to put Unity Health in there—we just need the money to build it. Will my right hon. Friend break down every barrier to help us get that health centre built in Long Crendon?

[Victoria Atkins]

Again, I very much admire the effort and determination that my hon. Friend is showing to stand up for his constituents. He will know that sadly I am constrained from commenting on individual cases, but what I do know is that the innovation he is showing alongside his parish council—and, indeed, I would hope, his local integrated care board—is the approach we want to adopt across our rural and coastal communities to ensure that they, too, have the access to primary care that we all expect.

Oral Answers to Questions

Greg Smith Excerpts

Tuesday 17th October 2023 Commons Chamber

[Neil O’Brien]

The hon. Gentleman is completely correct. He has been a fantastic champion on this issue. The UK is leading the world on this issue, hitting the UN’s 95-95-95 goals, driving down transmission and reducing stigma. People increasingly realise that as well as suppressing the virus, the treatment makes it impossible to transmit, transforming the lives of people with HIV.

[Greg Smith (Buckingham) (Con)]

8. What recent assessment he has made of the adequacy of the level of access to GPs in rural communities.

[The Parliamentary Under-Secretary of State for Health and Social Care (Neil O'Brien)]

We have increased funding for general practice by about a fifth in real terms since 2018. We have increased the workforce by about 30% since 2019 alone, with 2,000 extra doctors and 31,000 extra clinicians going into general practice. With the hard work of GPs, that has enabled about 15% more appointments than before the pandemic. In rural areas we are going further with things such as the targeted in-house recruitment scheme and the elements of the funding formula that favour rural areas.

[Greg Smith]

I am grateful to my hon. Friend for that answer, but I have repeatedly raised with Ministers the specific case of an innovative model from Long Crendon Parish Council to use land secured through planning gain to replace Long Crendon Surgery, which closed during the pandemic. There is an agreement for Unity Health to provide primary care services there, but no money to physically build. My right hon. Friend the Secretary of State has advised consistently that the money be sought from the integrated care board, but after prolonged talks it has said that there is no money. Will the Minister look at this innovative model again? It is a great way of building rural GP provision in the future, with a mind to his Department making it happen.

[Neil O’Brien]

I will absolutely look closely at that specific case. My hon. Friend has put a huge amount of work into Long Crendon. As he knows, we are already changing the national planning policy framework to enable more developer contributions to flow into such innovative projects. We have more GP practices than we did in 2010, but we continue to look at ways to go further.

Patient Choice

Greg Smith Excerpts

Thursday 25th May 2023 Commons Chamber

[Steve Barclay]

As I touched on in my statement, the choice is there now; it is available right now, but only about 10% of patients exercise it. There is massive variation in the system now, with the existing workforce. We are increasing the workforce. We have made a commitment to produce a workforce plan, but the point is that there is variation within the system now. What patient choice is about is empowering patients to take advantage of it and to access treatment sooner, for example, by being willing to travel often short distances to access it.

[Greg Smith (Buckingham) (Con)]

I really do welcome the revolution in patient choice that my right hon. Friend has outlined, but as chair of the all-party parliamentary group on minimally invasive cancer therapies, it is clear to me that some cutting-edge technologies and treatments are available only in certain trusts under certain consultants. Can he confirm that, within the choice available to them, patients will be able to choose centres that provide unique treatments, rather than the universal treatments that are available everywhere?

[Steve Barclay]

Yes, I can. Part of this is allowing patients to choose according to a number of factors. Some may have had treatment previously and want to go back to a particular consultant-led team. Some may want to look at CQC ratings and other performance metrics. Some may want the convenience of not travelling—relatively small numbers say they are not willing to travel; far more are willing to do so. Patients will look at a range of factors when shaping their decision. The key is to have transparency and the technology that enables patients to take control.

New Hospitals

Greg Smith Excerpts

Thursday 25th May 2023 Commons Chamber

[Steve Barclay]

My hon. Friend has not only championed Watford General Hospital; he has worked there as a volunteer on many occasions. He has been compelling in the representations he made to Ministers across Government on the case for investment in Watford. It is a huge tribute to him, and as he says, it is also a tribute to the wider leadership team in Watford. He is right that it will have a transformative effect, and I have seen at first hand, with him, the urgent case for investment in Watford that he has championed.

[Greg Smith (Buckingham) (Con)]

I very much welcome this statement, especially the commitment to Milton Keynes University Hospital. It is a key hospital that serves my constituents, alongside Stoke Mandeville Hospital, which also enjoys a new paediatric A&E, John Radcliffe Hospital and Wycombe Hospital. The case of Wycombe shows that it is not just reinforced autoclaved aerated concrete that trusts are grappling with; the tower at Wycombe needs at least £80 million in maintenance and repairs, or preferably, as the trust plans, a full decant, with a £200 million purpose-built planned care centre. That will take national spending. What hope can my right hon. Friend offer Buckinghamshire patients that Wycombe’s plans can become a reality?

Recovering Access to Primary Care

Greg Smith Excerpts

Tuesday 9th May 2023 Commons Chamber

[Steve Barclay]

The funding will include for prescriptions for the seven common conditions, which form part of Pharmacy First. That will be part of a new NHS service that will be offered, as set out in this plan. That is what the £645 million over the two years is targeted at, and obviously we will have further discussions with the sector on the roll-out.

[Greg Smith (Buckingham) (Con)]

I very much welcome this recovery plan. It is the right thing to do and will make a big difference. Does my right hon. Friend agree that it is also critical for rural communities to have local and convenient access to GPs? With that in mind, will he redouble his Department’s efforts, alongside the Buckinghamshire, Oxfordshire and Berkshire West ICB, to find a way to fund the construction of Long Crendon’s innovative model to replace the old village surgery, which sadly had to close under covid. This will not only deliver first-rate primary care to the village of Long Crendon and surrounding villages, but relieve the pressure on Brill surgery, where patients find themselves displaced to.

[Steve Barclay]

My hon. Friend has raised this issue previously, and he is quite right to champion it—I know that it is hugely important to his constituents. I hope the ICB will take heed of the issue he raises, particularly in relation to the level of visibility on the estate plan. Based on our conversations, I think that more can be done to share that with him. I urge the ICB to engage closely with him to make sure that the estate plan addresses the very real needs that his constituents have identified.

Oral Answers

Greg Smith Excerpts

Tuesday 25th April 2023 Commons Chamber

[Will Quince]

I recognise the pressures on the system, but Labour has spent the non-dom money 10 times over. We are taking real action on this issue: real-terms spending on general practice is up by more than a fifth since 2016; as I said, we are investing £1.5 billion to create an additional 50 million GP appointments; we have recruited more than 25,000 additional primary care staff; and there are 2,167 more doctors in general practice; and we have the highest number ever in training.

[Greg Smith (Buckingham) (Con)]

12. What steps he is taking to reduce the waiting time from receiving a cancer diagnosis to first treatment.

[The Secretary of State for Health and Social Care (Steve Barclay)]

In February, the faster diagnosis standard was met for the first time. In addition, we are investing in additional screening, testing and tech in order to detect cancer much earlier.

[Greg Smith]

Recent data for the Buckinghamshire, Oxfordshire and Berkshire West ICB shows that 42.6% of cancer patients are waiting more than 62 days for treatment. That will only get worse without a significant programme of upgrading radiotherapy equipment and ensuring that there is a skilled workforce of radiographers. So what steps is my right hon. Friend taking to ensure that new, cutting-edge radiotherapy equipment is making it to the frontline, coupled with a fully staffed workforce to operate it and save those lives?

[Steve Barclay]

My hon. Friend is right to highlight the interaction of workforce and capacity in equipment. That is why we have 810 more consultant training places over three years, and we have grants to enable more than 1,000 nurses to train, for example, in chemotherapy and 1,400 new recruits to the cancer diagnostic workforce. Obviously, that sits alongside the expansion in capacity, including both in our surgical hubs and our expanded diagnostic centres.

Brain Tumour Research Funding

Greg Smith Excerpts

Thursday 9th March 2023 Commons Chamber

[Greg Smith (Buckingham) (Con)]

It is a privilege to follow the powerful speech from the hon. Member for Mitcham and Morden (Siobhain McDonagh), and like you, Mr Deputy Speaker, I congratulate her on the bravery of sharing that deeply personal family story. No matter how difficult and emotional it was for her to share that story with us, Parliament is richer and this debate is all the more powerful for the story that she has told. I thank her for sticking with it, and for sharing that in the House this afternoon. I also send my best wishes to her sister.

This is an incredibly important debate, and I thank the Backbench Business Committee for giving us the opportunity to debate the issues around brain tumours, finding a cure, and saving and prolonging lives. I particularly thank my hon. Friend the Member for St Ives (Derek Thomas) for the dedication he has shown in opening this debate, for his leadership of the all-party group on brain tumours, for working so hard to raise awareness of brain tumours, and for highlighting the importance of research in improving clinical outcomes for brain tumour patients. It was a privilege to serve under him on the all-party group inquiry that led to the recommendations he spoke of earlier, and the report, “Brain Tumours, Pathway to a Cure—breaking down the barriers”. If I wish to convey a simple message in my remarks this afternoon, it is a sincere plea to my hon. Friend the Minister to take this serious, evidence based report seriously, and to act on its recommendations for the good of all brain tumour patients today and in the future. It is to save lives.

As others have said, despite £40 million being made available by the Department and delivered through National Institute for Health and Care Research in 2018, less than half of that funding made it to researchers. In fact, as of May 2021, only £8.8 million had so far been allocated by NIHR for dedicated brain tumour research. It was said by the Department that more had not been allocated due to

“a lack of new basic science discoveries”

but I suggest that that is completely missing the point, and represents a huge omission in the types of patients being offered trial treatments.

Clinical research is pivotal to improving health outcomes for patients with brain tumours, by developing new methods of prevention, diagnosis and treatment. The benefits of clinical research extend far and wide, with evidence showing that hospitals involved in research provide higher quality care, and have lower levels of patient mortality. The APPG’s inquiry uncovered that there is a gap in research funding along the pathway of discovery, and translational and clinical research. That manifests itself first in an uneven distribution of clinical trials across the country, secondly in the inability of clinicians to secure Government funding for translational research, which takes discoveries from research to the bedside of patients, and thirdly in a lack of staff time for research, and a lack of NHS resource to support those patients on funded research studies.

The all-party parliamentary group report lays out in stark terms the extent to which years of underfunding and neglect for priority areas of research into treatments made the task of reaching parity between patient groups that much harder. In particular, the report highlights how the lack of funding for research into childhood brain tumours, where survival rates for the most aggressive tumours have remained unchanged for decades, have led to frustrated families—upset families, worried families —seeking costly and unproven treatment abroad, which in turn prolongs suffering both for patients and their loved ones. Indeed, five years after the allocation of funding, there are no new treatments and the five-year survival for patients is, I believe, still just 12%. By 25 January, just £15 million had been awarded since June 2018, with £6 million of that not easily identifiable as actually relevant to brain tumours. That, I respectfully put to my hon. Friend the Minister, is not good enough.

The report’s analysis of funding to date highlights that the Medical Research Council and the National Institute for Health and Care Research contribution was £1 million each, with Cancer Research UK contributing £13 million. Researchers have become increasingly reliant on charities such as Cancer Research UK and Brain Tumour Research. These organisations—do not get me wrong, Mr Deputy Speaker—do fantastic work day in, day out, demonstrating the urgent need for more funding, yet their calls are not being met.

At this point, I would like to pay tribute to one of the most inspirational campaigners and fighters on this cause, my constituent Sue Farrington Smith, who is the chief executive of Brain Tumour Research. She raised £108,000 in the first year of the charity following the tragic loss of her niece Ali, who passed away less than three weeks before her eighth birthday. Sue was subsequently invited to talk about Ali’s Dream at the second UK Brain Tumour Society conference in 2002. She then helped to facilitate the meeting of brain tumour charities, researchers and clinicians at a UK Brain Tumour Society workshop in March 2003 to develop a vision for the brain tumour community. Twelve years since its inception, Brain Tumour Research has provided funding in excess of £15 million to early-stage science and continues to support sustainable research across the UK, raising awareness of brain tumours and campaigning for better outcomes. Sue and everyone at Brain Tumour Research are true heroes, making a daily difference. They deserve to be recognised and credited for all they do. Indeed, Brain Tumour Research continues working with and—as others have mentioned—providing the secretariat to the APPG. I am very grateful for the support provided with the most recent report, as outlined by the right hon. Member for Leeds Central (Hilary Benn).

To conclude, I wholeheartedly support the report’s recommendations, as detailed and outlined by my hon. Friend the Member for St Ives, including the establishment of an NIHR trials database that is readily accessible to all clinicians across the UK, with clearly defined and regularly updated eligibility criteria and location information, and an awareness campaign that is delivered through the NHS to ensure that the trial database is available to both clinicians and patients.

I want to end by looking back at the inquiry evidence sessions and reflecting on what consultant neurosurgeon Babar Vaqas told us:

“As a clinician I want to be able to sit down with my patient and input all the relevant data about their brain tumour type and their treatment pathway and then, to search an up-to-date progressive UK trial registry. This would enable me to discuss appropriate trial options there and then, giving the patient choices that a modern health provider should be able to offer.”

Let us heed those words, embrace the report and make a difference.