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.

Urgent and Emergency Care Recovery Plan

Greg Smith Excerpts

Monday 30th January 2023 Commons Chamber

[Steve Barclay]

The hon. Gentleman asks how we slow the flow of people going to emergency departments and how we accelerate their discharge once they are fit. The substance of the point he raises is valid and absolutely right. It is why there are schemes such as the community response service and the falls service. We are looking at the likes of the North Tees model and getting more staff into community support, thereby integrating the health and social care side. As I said to my right hon. Friend the Member for New Forest East (Sir Julian Lewis) a moment ago, the trade-offs for individual sites are best determined by ICBs. I am very happy to look with ministerial colleagues at any specific proposals, but it is really for the ICBs to be looking at how to best use their estate.

[Greg Smith (Buckingham) (Con)]

I warmly welcome my right hon. Friend’s clear and credible plan, but on the uplift of 800 ambulances, which is good news, I urge him when it comes to their deployment to look at rural areas first. In these areas, ambulances by definition spend much longer per patient on the road going in between much more diversely spread out hospitals.

[Steve Barclay]

I recognise my hon. Friend’s point, not least as a rural constituency MP myself. I have talked to paramedics, as I am sure he has, and the principal cause of frustration of late has not been the issue of pay—important though that is. It has been frustration over long handover times, which has had a particularly damaging impact. I am happy to look at any specific issues in his area but he is right on the wider point about the pressures in rural areas.

Oral Answers to Questions

Greg Smith Excerpts

Tuesday 19th July 2022 Commons Chamber

[Steve Barclay]

I am very sorry, as I am sure the whole House is, to hear of the circumstances that the hon. Lady sets out. I am happy to look at the case, as I said to her ahead of this sitting, when I discovered that she had written to my predecessor. As I also flagged earlier, the number of face-to-face appointments is increasing. Telephone consultations are not a new thing; they have been around for a long time and are an important part of the mix—indeed, some patients prefer the flexibility that they offer. But of course I am happy to meet the hon. Lady in due course.

[Greg Smith (Buckingham) (Con)]

Long Crendon Parish Council in my constituency has an exciting proposal for an innovative new health and wellbeing centre, including GP services. It has the land from planning gain, and it has an agreement to put Unity Health in as the GP partnership, but we are stretched for funds to build it. I am grateful to my hon. Friend the Member for Charnwood (Edward Argar) for his engagement over the past year. Will my right hon. Friend the Secretary of State meet me over the summer to discuss how we can move the project forward?

[Steve Barclay]

Again, as I am sure my hon. Friend will appreciate, these decisions should not be run from Whitehall and the centre. We should take a place-based approach, letting local decision-makers and commissioners make the decisions to shape the best services through their integrated care boards. My hon. Friend the Minister of State or I will engage with him to ensure that his representations are very much at the heart of any decisions that are taken.

Health and Care Bill

Greg Smith Excerpts

Consideration of Lords amendments
Wednesday 30th March 2022 Commons Chamber

[Mr Deputy Speaker (Mr Nigel Evans)]

A lot of people want to contribute to this debate, and this first group must come to an end at 10 minutes past 5. Those who make long contributions really are doing other people out of an opportunity to speak.

[Greg Smith (Buckingham) (Con)]

I will be as quick as I can, Mr Deputy Speaker. The point underlying my amendments to Lords amendments 123 to 127 is relatively straightforward and simple. I heard what the Minister said in his opening remarks, but I feel that if we act in a way that impacts an industry—in this case, UK broadcasters—as severely as the advertising restrictions will, and we are talking about a £200 million a year loss to our great British broadcasters, it is a matter of fairness and equity that we should give them enough of a lead-in time, enough notice and enough ability to adapt, remodel their services and find a way of surviving, to put it bluntly.

I have spoken before in the House about the fact that I do not agree with the nanny state and telling advertisers what they can and cannot advertise. The Lords amendments that we are considering, and my amendments to them, are very much about the implementation of a policy, and about giving British broadcasters—public service and fully commercial ones alike—a fighting chance. It would be much fairer to give broadcasters at least a year to comply from the point at which Ofcom publishes its guidance and puts it in the public domain. Broadcasters and advertisers will have to go through a lot of processes once this Bill receives Royal Assent, and that cuts the time that they have to put in place new policies, compliance checks and mechanisms to comply with the legislation. Two months on from Royal Assent, Ofcom will not even have got its statutory powers in this regard, and so will not even be able to start work with the Advertising Standards Authority and other bodies on the detail, and the ways and means of implementation.

[Alun Cairns]

I strongly support the amendments that my hon. Friend has tabled. Does he agree that the definition of some of the products, and the work that needs to be done, needs to undergo significant consultation, because of the way in which the efficacy, strength and merits of the policy will be judged?

[Greg Smith]

I am grateful to my right hon. Friend for that point, as the argument that I am making is very much that these things take time. Two months on from Royal Assent, Ofcom gets its statutory powers. Only then can it start the consultation, and the work of defining the restrictions on advertising that come under the broad categories in the Bill. Let us assume that two months on from Royal Assent is some time in the next couple of months. There would then be 10-week or perhaps three-month consultations to get the detail right, for a go-live date of 1 January 2023. That does not give our broadcasters sufficient time to put in place their processes, remodel their whole service, and find a way of working when they are so many hundreds of millions of pounds down on their operating models.

[Steve Brine]

I am listening carefully to my hon. Friend. I joined the Department of Health and Social Care in 2017 and we made it very clear that this was our direction of travel. Our child obesity plan part 2 made it very clear that this was our intention. The truth is that broadcasters have known for a long time that this is the Government’s intention. My fear is that what lies behind what he is proposing is not questions of practical implementation, but argument with the principle.

[Greg Smith]

I make no secret of the fact that I am against the principle of these restrictions. The Government’s own data shows that the restrictions will save only 1.74 calories a day, which is less than what is in a Tic Tac. However, that is not the place we find ourselves in today; these amendments are specifically about implementation. Given that it is clearly the will of this House and the other place to push the legislation through, I want us to give our broadcasters a fighting chance to survive, adapt and continue being successful, great broadcasters.

Oral Answers to Questions

Greg Smith Excerpts

Tuesday 1st March 2022 Commons Chamber

[Maria Caulfield]

The hon. Lady raises an important point. She is right that women are under-represented in clinical research and are waiting far too long for diagnoses of conditions such as endometriosis. The women’s health strategy will be published very shortly and I think that she will be pleased with some of its recommendations to drive improvements forward.

[Greg Smith (Buckingham) (Con)]

I am grateful to the Minister for Health for giving his time over recent months to hear the case for an exciting and innovative new health centre for the village of Long Crendon in my constituency, as proposed by the parish council and action group. Will he update the House on where we are with finding funding to help the construction of the project?

[Edward Argar]

My hon. Friend is, as ever, persistent and tenacious in his advocacy of Long Crendon’s surgery plans; not only at the Dispatch Box but whenever he runs into me around this place, it is often the first thing on his lips. I will continue to work with him on the surgery bid and I encourage him to continue to work with his local NHS systems.

Covid-19: Forecasting and Modelling

Greg Smith Excerpts

Tuesday 18th January 2022 Westminster Hall

[Fleur Anderson]

I am going to move on. I do not want another speech from the hon. Member, given the time constraints. I am waiting for the Minister to answer my questions.

The Public Administration and Constitutional Affairs Committee also had problems with the communication of the modelling. It is there that I might have some common ground with the hon. Members who have spoken earlier. The Committee said in its report last March that communication has not always been transparent enough, and accountabilities have been unclear. I agree with this. If the time is not taken carefully to explain what modelling actually is to the public and media, and instead room is allowed for scenarios to be interpreted as predictions, inevitably the practice of modelling and forecasting will be rubbished and scoffed at and Government scientists blamed as doom-mongers. Not communicating the data and models properly creates more uncertainty and misery for small businesses, who have been asked enough as it is, as we saw over the Christmas period.

[Greg Smith]

Will the hon. Member give way?

[Fleur Anderson]

No. The PACAC report makes it clear that no one in Government has taken responsibility for communicating the data. The report states:

“Ministerial accountability for ensuring decisions are underpinned by data has not been clear. Ministers have passed responsibility between the Cabinet Office and Department of Health and Social Care,”.

That is why, as a member of the shadow Cabinet, I am responding to this debate. There are questions about the use and communication of the data.

I want to come to why we needed to rely on modelling and forecasting. Significant mistakes made throughout the last 10 years of Conservative government are the problem. There could have been much better information, and we could have been much better informed, if there had been better pandemic and emergency preparedness.

[Bob Seely]

Will the hon. Member give way?

[Greg Smith]

Will the hon. Member give way?

[Fleur Anderson]

I will give way—

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health and Social Care (Maggie Throup)]

It is a pleasure to serve under your chairmanship, Sir Edward. I thank my hon. Friend the Member for Isle of Wight (Bob Seely) for introducing today’s debate, and all hon. Members for their thoughtful and wide-ranging contributions.

Throughout the pandemic, we have been supported by world-leading scientists, epidemiologists and modellers, many of whom have worked around the clock, often without being paid for their contributions. During the fast-moving and uncertain pandemic, that support has been critical to ensuring that the Government have access to the latest and most reliable scientific advice.

The UK is very fortunate to have such strong academic expertise to drawn upon. Without the tireless work of our country’s scientists both within and outside SAGE, the UK would have been left in the dark at many key moments over the past two years. Scientific advice from disciplines ranging from immunology through to behavioural science have all played a role. Virologists have helped us to understand how different variants behave in the body, while clinicians have advised on higher risks to different patient groups. Similarly, epidemiology and infection disease modelling help us to understand the spread of covid-19 across the population, and the impact it might have.

It is important, however, to remember that such modelling is a tool to enable Ministers to make evidence-based decisions. Modelling provides a good way of understanding the range of possible futures that the pandemic might have in store for us; a good way of identifying what will determine which of those future we could face; and a good way of exploring how different policies, rules and guidance could determine which of those futures we could face.

[Greg Smith]

Will the Minister give way?

[Maggie Throup]

I am conscious that I need to leave time at the end, but I will endeavour to get through my speech and take interventions.

It is not, however, and never can be, a crystal ball, regardless of who is doing the modelling. Models cannot perfectly predict the future, and modellers would not claim they do so. Contrary to how they may be presented in the media, modelling outputs are not forecasts, nor do they focus only on the most pessimistic outcomes. Model advice to Government is not simply a single line on a graph.

There is always uncertainty when looking into the future: uncertainty from potential policy changes, the emergence of new variants, or people’s behaviour and mixing and the changes that that brings. Central to modelling advice is an assessment of this uncertainty, what factors drive the uncertainty and how the results might change if the model’s inputs and assumptions change as new evidence emerges. As such, the modellers look at a wide range of possibilities and assumptions in order to advise policy makers on principles, not to attempt to say exactly what will happen..

Public Health

Greg Smith Excerpts

Tuesday 14th December 2021 Commons Chamber

[Greg Smith (Buckingham) (Con)]

It is a pleasure to follow my hon. Friend the Member for Newcastle-under-Lyme (Aaron Bell). He was absolutely right in the way he concluded his speech: boosters are the answer to this. Boosters, and the vaccine programme at large, give us hope and a path out of covid and back to normal life.

I congratulate the Government on stepping up the booster programme and aiming to get those jabs into people’s arms by the end of the year. Making that happen will require a lot of focus and attention, and planning of the detail and the logistics. On the basis of my experience yesterday of trying to bring forward my own booster, which is booked for 31 December—I jumped from 7,000 in the queue to 3,000, then curiously to 10,000, before eventually being offered a date in mid-January—there is clearly a lot of work to be done to ensure that we can get those boosters into people’s arms.

I also welcome the Government’s move to get rid of the 10-day isolation period for anyone who happens to have come near someone who has tested positive for omicron, and to replace that with daily testing. That is a sensible measure. Like my right hon. Friend the Member for Forest of Dean (Mr Harper), I feel vindicated in having voted against the 10-day isolation measure two weeks ago.

However, let me set out why I will not be voting for the extended mask mandate, for covid passes or for mandatory vaccination in the national health service. I very much agree with my constituency neighbour, my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom), that this is a slippery slope. This is going to change the way we operate as a country, not just in December 2021 but whenever another variant—perhaps not of covid but of another virus—emerges. It is a fundamental change in the relationship between citizen and state, and one to be resisted.

I have argued throughout this pandemic—at times I have then reluctantly voted with the Government, as I did last Christmas, and at other times, such as a couple of weeks ago, I have voted against extending measures—that all restrictions are not without harm in themselves. Even on masks, it may be an easy thing for many of us to do to put one on, but as others have mentioned, to the dementia patient petrified at the masked figure approaching them, to the child with autism, or to the person who is hard of hearing or deaf and cannot read our lips, it has consequences; it does bring harm. Likewise, I have been scared by reports in my constituency of the rise in mental health challenges, particularly among young people—there has been a rise in self-harm in secondary schools. We cannot stand idly by and just ignore that.

Of course, there is also the damage to our economy. We may not have shut hospitality down, or propose to do so, but I am already hearing from pubs right across my constituency that are losing 20%, 30% or 40%—in some cases 50%—of their Christmas bookings. People are now too scared to go out, and I am afraid that correlates directly with what the Government are saying and how they portray this virus. I took a lot of heart from the news coming out of South Africa this morning that people there were finding it to be a more mild variant and that the vaccines do work. I therefore come back to where I started: let us focus on the boosters and, otherwise, give people back their freedom to choose.

Covid-19 Update

Greg Smith Excerpts

Friday 26th November 2021 Commons Chamber

[Sajid Javid]

The decision to ban the flights—it is obviously a temporary ban—was taken to allow us the time to stand up the red-list managed quarantine system. Once that system starts and we are comfortable that it is functioning as we would like, we will review the decision on those flights. We will consider banning flights from any other country if it is necessary for reasons similar to those taken in respect of this decision.

[Greg Smith (Buckingham) (Con)]

My right hon. Friend is absolutely right to take the new variants as seriously as he does. Given the critical importance of the need to avoid damage to children’s education and development and the economic havoc that more lockdowns would bring, if the news from our world-class scientists who are analysing the effectiveness of our existing vaccines against the new variants is positive, what assessment has my right hon. Friend made of the ability to stretch the booster programme to bring it down through the age categories as we head into winter, thereby getting boosters into more arms sooner than the six-month gap?

[Sajid Javid]

Regardless of the news about this variant, the booster programme remains crucial. In fact, as I said earlier, it is even more important because of this news. My hon. Friend asked about whether the programme can be extended to lower age categories; as he knows, boosters were extended to the 40-to-49 age group on Monday, and the Joint Committee on Vaccination and Immunisation is already considering whether the programme can be extended further. I await its advice.