Covid-19

Harriett Baldwin Excerpts

Monday 16th March 2020 Commons Chamber

[Matt Hancock]

The answer is, yes, we want, of course, all the tests that we need.

[Harriett Baldwin (West Worcestershire) (Con)]

Does the test give evidence of no infection? That goes to the point that has been made about frontline health workers. Is the Secretary of State saying today that there is an immunity that builds up? Has that been medically confirmed for people who have had this once?

[Matt Hancock]

On the latter point, the chief medical officer has set out today that immunity is built up by having had this virus. That evidence is constantly being kept under review, but immunity does appear to be built up. On the testing point, as I said to the right hon. Member for Normanton, Pontefract and Castleford (Yvette Cooper), of course we want tests to be available for everyone. Our goal is to beat this virus. We want to make sure that all our frontline medical staff can have the testing and that everyone in the community can have those tests, but where only a limited number of tests are available we have to use them to save life. I am working as fast as I can to increase the number.

Immigrants (NHS Treatment)

Harriett Baldwin Excerpts

Monday 25th March 2013 Commons Chamber

[Mr Hunt]

I agree with my hon. Friend. It is because I support the principle of free-at-the-point-of-use health care that I do not want anything to undermine it, and abuse of the system by people who are not entitled to free NHS care is the single thing that would most shake the public’s trust in an important part of what the NHS has to offer. That is why we must tackle this problem.

[Harriett Baldwin (West Worcestershire) (Con)]

The Secretary of State rightly recognises that accident and emergency is a special case, but when I broke my fingers in Brussels I was asked to pay by credit card at the end of my treatment. A lot of people who present at A and E have non-life threatening conditions. Is that something we could do here?

[Mr Hunt]

I understand my hon. Friend’s sense of unfairness at being asked to pay for her treatment by credit card, when we do not do that to foreign nationals who are treated in the NHS. I do not, however, want the NHS to become a service where the first question people are asked relates to their credit card or cheque book. If we are going to protect that much-cherished principle of NHS treatment, we need to get a grip on the kind of abuse that has run unchecked for far too long.

Community Hospitals

Harriett Baldwin Excerpts

Thursday 6th September 2012 Commons Chamber

[Harriett Baldwin (West Worcestershire) (Con)]

I, too, congratulate my hon. Friend the Member for Totnes (Dr Wollaston) on securing the debate and speaking about community hospitals with such passion and experience. May I also congratulate the Under-Secretary of State for Health, my hon. Friend the Member for Broxtowe (Anna Soubry), and say how pleased I am that the debate is taking place within a few days of her promotion, which means that she can hear from the Front Bench what a tremendous asset community hospitals are to all our communities? It is disappointing that only the shadow Minister and the Opposition Whip, the hon. Member for Scunthorpe (Nic Dakin), are on the Opposition Benches for this important debate.

Our experience in West Worcestershire can certainly contribute to a debate on the ownership of community hospitals, because we have three in the constituency: Malvern, Pershore and Tenbury Wells. They all have slightly different models of ownership, and I think that diversity of ownership model is something that has led to their success and will lead to their longevity. I thought that it might be worth sharing with colleagues the different approaches that have been used.

I will take this opportunity to pay tribute to my predecessor, now Lord Spicer, who fought for a new community hospital for Malvern for most of the 36 years he represented West Worcestershire. We used to have a hospital in a beautiful old building dating from the late 19th century, but it had become too small and too old and, although beautiful, was no longer fit for purpose—to use the famous NHS phrase. Everyone in the community, including the league of friends, accepted that was the case and campaigned for many years for a new build hospital. A site was secured in the 1970s but sat empty and derelict for the better part of three decades until the day when my predecessor got the phone call from the right hon. Member for Exeter (Mr Bradshaw) to tell him that a new community hospital would be built in Malvern. It was a great day of celebration after so many decades of campaigning. Indeed, if any Members are in Malvern in the near future, they will see what a spectacular hospital has been built for the community. It opened just over a year ago. It is owned entirely by the Worcestershire Health and Care NHS Trust, which of course is taking the opportunity to sell the old hospital building to help pay for the substantial cost of the new one—about £17 million.

We have another new hospital in West Worcestershire in the town of Pershore. Again, the town had a very old building, although not quite as old as the one in Malvern. Wychavon district council took the unique and unusual decision to create a new build hospital in the centre of town. It used its reserves to do that, and it was able to rent the building out to the local NHS trust. It is paid a much better rate of return on its cash than it would have received if it had left it in the bank—certainly an Icelandic bank, as in the case of some other Worcestershire district councils. This has proved to be a good investment for the district council and a good asset for the community. Both new builds are greatly valued by South Worcestershire clinical commissioning group, which is beginning to review the full range of hospitals, including acute hospitals, in Worcestershire. I am hearing very positive things about finding additional uses for the community hospitals.

Let me finally mention Tenbury community hospital, which has an incredibly successful and active league of friends. The town has only about 2,500 residents, but over the years the league has raised millions of pounds, not only for equipment for the hospital but for its fabric. We have seen two new wards open in the past 12 months. Tenbury hospital therefore almost has a shared ownership not only with the NHS but with the league of friends. Because the league’s investment has been so substantial, it would be unthinkable for the NHS to treat the building as an asset that it could sell on. All three hospitals are well used and increasing the range of services that they can provide in the local area.

I may have saved the Department some time in relation to the motion by delivering a comprehensive database of the community hospitals in West Worcestershire. Thank you, Mr Speaker, for allowing me to put on record the community’s appreciation of the services and buildings that we enjoy in my constituency.

Adult Social Care

Harriett Baldwin Excerpts

Thursday 8th March 2012 Commons Chamber

[Sarah Newton (Truro and Falmouth) (Con)]

I beg to move,

That this House believes there is an urgent need to reform the current system of providing and paying for the care of adults in England and Wales; recognises that social care, unlike the NHS, has never been free at the point of need irrespective of income; notes the central role of informal carers in the provision of care; welcomes the Coalition Agreement pledge of reform and legislation; further welcomes the plans for better integration between adult social care services and the NHS; welcomes the extension of personal budgets; urges the Government to ensure that fairness is central to reform, including access to advice, advocacy, assessment of need, care services as well as funding options; recognises the need to break down the barriers to portability; and further urges the Government to publish its White Paper as soon as possible, and to bring forward legislation.

I am pleased that both the care Minister, the Minister of State, Department of Health, my hon. Friend the Member for Sutton and Cheam (Paul Burstow) and the shadow Health Secretary will be joining us today, and that they have entered into talks to agree a way forward on the reform of our social care system. It is vital that today we show our Front-Bench teams just how much support there is in all parts of this House for their important work. Both teams need to know how important this Parliament feels it is to continue and conclude the talks, so that a White Paper and Bill can be produced as soon as possible.

Today’s debate should also be about our vision: our vision to enable adults living with disability or a chronic illness, or those people who are frail in their later life, to have the support they need to live as full a life in their community as possible. That is something that concerns us all, as it strikes at the heart of the values of our society. There are Members here today who have a lifetime of experience, inside and outside Parliament, tackling the issues we will be discussing today, so I will keep my remarks short to allow their valuable contributions to be made.

Central to this debate is the person who needs care and the people around them supporting them, principally their family members, close friends and neighbours, and the wider community. Of course, care provided by nurses, care workers and other professionals is vital, too. In the few minutes available, I shall focus on the care of the elderly, as colleagues with greater knowledge than I will talk about the care of younger adults, those with chronic illnesses and those living with disabilities. Too often in debates about social care we delve straight into the design details of the services provided by local and national Government. Often, such services were designed many years ago, in response to a very different society, when people died of illnesses and conditions that are now lived with; a society where people lived shorter lives. One of the greatest achievements of the 20th century was a significant increase in life expectancy and the challenge of the 21st century is to respond and to redesign care and support services so that they are fit for this century and the next. That is important not only for the people who need them now but for the young people who have already been born who will make it into the 22nd century.

Let us be honest: if we were designing services to support families who care for their elderly and disabled family members, would we have designed the system we have today? Despite the undoubted good intentions of previous Parliaments, our system has developed in fits and starts since the 1920s. It is disjointed and does not deliver joined-up help for the cared for or for carers and it can be utterly frustrating for care and health professionals.

It has been estimated that a total of £145 billion a year of public money is spent on the elderly in social care, NHS and welfare payments. That is £3,000 for every man, woman and child in this country. It does not appear to me that elderly people and their carers are receiving the quality of services and care that such a sum could provide if it were spent differently and more efficiently.

[Harriett Baldwin (West Worcestershire) (Con)]

Is my hon. Friend going to make the point that this problem will keep on increasing? We are all living longer and one in three girls born today can expect to live to the age of 100.

[Sarah Newton]

Yes. As I mentioned, it is a great achievement that people are living longer, but that will obviously present huge challenges in adapting our society as people live for so much longer.

Unfortunately, growing old or living with an illness or disability is frightening to too many in our country today—frightening both to the people involved and to their loved ones who support them. There is fear about physical and mental frailty, about the quality of care they will receive from the NHS and social services and about whether they will have to pay and how they will afford to do so. We need to alleviate as much of that fear as possible by creating services and a way of paying for them that are fair and easily understood by people of all ages, that deliver high-quality care and support to carers and in which those who are employed feel respected and appreciated.

To achieve that aim requires a vision and a plan that everyone understands. That plan should be fair and should offer a route from where we are today to where we want to be. It will then require all political parties, over a period of time, to implement it. That will deliver the lasting, consistent and sustainable reform that despite many good intentions has eluded all Governments for many years.

I believe that the Government have recognised the challenge and taken a number of steps forward. There is a pledge in the coalition agreement to reform care services and funding and, following the excellent work of the Law Commission and the commission led by Andrew Dilnot, we have been promised a White Paper this spring and a Bill soon after. That process will very much depend on the determination of the Opposition to work constructively with the Government.

The Government have also ensured that while a longer- term solution is found to the current funding issues more money is being given to councils, and they have committed £2 billion. The Health and Social Care Bill will enable the integration of social and health care and, through the health and wellbeing boards, local commissioning of new care pathways will be made possible. I have seen some highly effective piloting work in Cornwall through the “Changing Lives” approach to joined-up services, which is based around the person and their carers.

The Government have launched a carers strategy and a dementia strategy with funding attached, but it is very frustrating that the money provided for those services is not always finding its way to the people who need it most. I am a passionate supporter of localism and returning power from Westminster to people and their communities. I believe that services for people in Cornwall should be designed and delivered in Cornwall, but we must recognise that this is a revolution. Although some professionals in the NHS and councils are relishing the new opportunities, some are not, as many of them have served in these important public services for years and are used to the command and control management of the past. It is difficult for some people to change and these are big cultural changes.

At a time when large-scale efficiency savings are needed in the services that support older people, reform is more important than ever. The nurses, social workers and carers I know are all motivated to deliver a high-quality service but I think Ministers will need to give clear direction about the commissioning of new pathways—new pathways that explicitly deliver integrated and joined-up care and new pathways developed on the evidence from the innovative work being provided not only by doctors, nurses and social workers but in partnership with other organisations such as Age UK, Macmillan and a host of other not-for-profit organisations. Within the new framework of outcomes, new outcomes should enable better integration.

Those new outcomes and pathways will need funding. We know that for every £1 spent on social care, £2.65 is saved from the NHS budget, so not addressing the inefficient split of funding between the NHS and social care will mean that we continue to waste more and more money.

Health and Social Care Bill

Harriett Baldwin Excerpts

Tuesday 28th February 2012 Commons Chamber

[Mr Lansley]

I have been to Sam Everington’s practice in Bromley-by-Bow, which has been gearing itself up. It will use the powers in the Bill and will do so very effectively.

[Harriett Baldwin (West Worcestershire) (Con)]

Foundation trusts will be given the freedom to increase private services and patients will have the right to choose any provider that meets NHS standards. Was the Secretary of State as surprised as I was to learn that that was in the Labour party’s 2010 manifesto?

[Mr Lansley]

I am grateful to my hon. Friend. I suppose that we should not be surprised that the Labour party in opposition has abandoned everything it said in government, but for it to abandon so quickly so many of the things it said even in its manifesto is pretty dramatic.

NHS Risk Register

Harriett Baldwin Excerpts

Wednesday 22nd February 2012 Commons Chamber

[Harriett Baldwin (West Worcestershire) (Con)]

Has the right hon. Gentleman read the article in The Times today by Stephen Bubb, which says:

“When in government . . . Labour’s Shadow Health Secretary spoke of his vision for a preventive, people-centred NHS that would allow the maximum freedom for local innovation… And yet, to judge by the reaction that”

the Secretary of State’s

“Bill has provoked, one would think that a centralised, bureaucratic and too often inefficient NHS is politically sacred and permanently untouchable”?

[Interruption.] Is that the impression that the shadow Secretary of State is trying to create?

[Mr Speaker]

Order. I remind the House that there is a lot to get through, many Members wish to contribute, and interventions in any event should be brief.

Bowel Cancer Screening

Harriett Baldwin Excerpts

Wednesday 23rd November 2011 Commons Chamber

[Guy Opperman (Hexham) (Con)]

Thank you, Mr Deputy Speaker, for giving me the opportunity to raise this matter in the House. Bowel cancer affects men and women, and it is the second-highest killer after lung cancer. The debate is, I suggest, both timely and genuinely needed.

I have personal experience of the NHS that is probably too long to list. When I was a jockey, I was saved by a gastro-surgeon at Warwick hospital. I hoped I was riding the winner at Stratford races, but we turned over and the horse ruptured my spleen, perforated my left kidney and broke nine bones in my ribs. I can assure the House that it hurt a great deal. The surgeon saved my life on that occasion. Subsequently, it is well known that I had a meningioma in April and was recently given the all clear by Mr Neil Kitchen and the amazing staff at Queen Square hospital in north London.

My grandmother was an NHS matron and I have had bowel cancer screening. Certain family members have had this cancer, so I had the colonoscopy that was medically advised in those circumstances. I would certainly not be an MP were it not for the campaigns I waged on behalf of Savernake hospital in Wiltshire, where I was born; that hospital also saved my mum’s life.

I would like to declare an interest as a taxpayer. The NHS’s approach to individual screening is surely an issue in which we should all be interested—from the point of view of prevention of loss of life and the maintenance of good health, but also in respect of how NHS funding, which is clearly finite, is spent on preventing future problems.

I pay tribute to the Beating Bowel Cancer regime, to Cancer Research UK, to the British Society of Gastroenterology, and to Professor Wendy Atkin, her funders and the 170,000 volunteers who took part in her definitive study of flexible sigmoidoscopy, which is known as a flexi-scope. I also pay tribute to Imperial College London, University College London, the University of East Anglia and St Mark’s hospital, and to the variety of doctors, constituents, charities and members of the public who have worked so hard to combat this problem and have helped me to prepare for the debate—including the clinicians, particularly Dr Colin Rees.

As a Member of Parliament representing a constituency in the north-east, I am proud to say that the north-east leads the way in bowel cancer screening. It was the first to complete coverage of an entire region in April 2010.

Before I embark on the substance of my argument, I also make an apology on behalf of my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi), who sponsored the Beating Bowel Cancer reception in the House last year. Much to his regret, he cannot be here tonight. He is a good friend of mine, but he is well known in the House—and, indeed, throughout the world—for having worn the Beating Bowel Cancer tie, which I am now wearing, in the Chamber after that reception. My hon. Friend, who has quite a generous build, was attempting to restrain that generous build with his suit when he accidentally touched a button on the tie, setting off a melody that lasted for nearly two minutes. Madam Deputy Speaker virtually extracted him from the Chamber. I understand that the incident was reported in 25 countries, and did more for the screening of bowel cancer worldwide than anything that anyone has said since.

I have no future as a surgeon, and I assure the House that I have removed the bottom half of my own tie so that there is no possibility of my being extracted from the Chamber for being too musical.

Let me now make some serious points about the clinical position. Traditional bowel cancer screening involves the faecal occult blood test, known as the FOB. In the last few years 11 million people in the country have been offered the test, 6 million have accepted it, 120,000 scopes have followed, and 12,000 diagnostic findings of cancer have resulted. It is clear from the statistics that lives have been saved. Previously those screened were aged between 60 and 69, but screening has now been extended to those aged between 60 and 74. It should be noted that the north-east—leading the way, as it does so often in a medical context—was the first region to extend the age group.

Tragically, take-up of that vital free NHS screening is only 54%, whereas take-up of breast cancer screening is 74% and take-up of cervical cancer screening is 79%. However, the situation is changing. Professor Wendy Atkin and her team have brought flexible sigmoidoscopy to the forefront of bowel cancer screening. The results of their 16-year study were definitive. Their randomised trial, which followed 170,432 people, established that the flexi-scope examination reduces the incidence of bowel cancer in those aged between 55 and 64 by a third. Mortality was 43% lower among that group than it was in members of the control group.

The flexi-scope test works by detecting and removing growths on the bowel wall, known as polyps, which can become cancerous if left untreated. It can prevent cancer from developing by removing polyps before they become cancerous, and provides long-lasting protection from bowel cancer.

[Harriett Baldwin (West Worcestershire) (Con)]

I congratulate my hon. Friend on securing this very important debate. Does he agree that screening for certain kinds of hereditary cancers, such as non-polypsosis colorectal cancer, should begin at a much earlier age, and should take place relatively frequently throughout the lives of those who are screened?

[Guy Opperman]

I do indeed. I welcome the fact that the guidelines from the National Institute for Health and Clinical Excellence have changed to allow screening to become considerably more frequent in such cases. I am sure that the Minister will comment on that.

Flexi-scope screening will undoubtedly save thousands of lives. FOB screening saved 700 to 1,000 lives a year, and flexi-scope screening will save about 3,000 lives a year. To confirm that, the Government implemented a pathfinder project in three areas. Unsurprisingly, two of those areas were in the north-east, this country’s leading medical region. The three areas were South of Tyne and Wear and Tees, along with Derby. The pathfinder findings are with the Department of Health and have not yet been published, but I can assure the House that, in broad terms, they accord with Professor Atkin’s findings. Last October, the Prime Minister announced a proposal to pilot the scheme nationally in 2012, but there are clinical and funding issues that need to be addressed.

First, when is the Department of Health going to invite bids for the follow-on pilot process, given that that was supposed to be done in 2011 and it is now 23 November?

Secondly, clinicians raise the specific concern that the flexi-scope system is only manageable if we have a sufficiency of trained nurse endoscopists, so where are we in respect of this crucial training? Even with the most amazing piece of equipment, if we do not have the people to operate and interpret it, it is useless. Under this scheme, several hundreds of thousands of endoscopies will have to be carried out, with colonoscopies to follow in about 10% of cases. Therefore, everything will depend on training.

Thirdly, how does the Department of Health plan to assess its age groups? My understanding is that the current group of 60 to 74-year-olds will have FOB testing, and those aged 55 will have a flexi-scope. That is relatively clear, but what will happen for gentlemen and ladies in the 56-to-60 age group is not at all clear. Will they be offered the flexi-scope as well, or is that to be based solely on GP referral? Trusts need guidance on what they are to do with such a large and unknown number of people, as they need to plan budgets, staffing and much more besides.

Fourthly, we need to assess what we are going to do with those who have a flexi-scope at 55 and receive the all-clear and then reach the age of 60. Will we rescreen? Anyone who has ever worked in the health industry will know that there is “health speak”, and in this case the following question would be asked: “What is the parallel screening modality for the future?” As always, “health speak” is gibberish, but the simple question here is: are we going to rescreen people who are fine at 55?

NHS Future Forum

Harriett Baldwin Excerpts

Tuesday 14th June 2011 Commons Chamber

[Mr Lansley]

In that spirit I thank the hon. Gentleman for the generosity of his remarks and encourage him likewise to apologise for the performance of a Labour Government in Wales who are cutting the NHS budget by 5% and seeing the performance of health care in the NHS in Wales deteriorate considerably relative to that in England.

[Harriett Baldwin (West Worcestershire) (Con)]

My constituency has borders with Gloucestershire, Herefordshire and Shropshire. The NHS Future Forum has recommended that commissioning group boundaries should not normally cross local authority boundaries, but will my right hon. Friend confirm that my local commissioning consortia can work with doctors in other areas?

[Mr Lansley]

The Future Forum is perfectly clear that there is a benefit associated with integrating health and social care if clinical commissioning groups do not normally cross local authority boundaries. But it is clear, and we are clear, that they should be able to make a case to do so if they think it appropriate. We have the benefit of being able to look at the pathfinder consortia, of which there are 220 and I think that 16 cross local authority boundaries, so it is already the exception rather than the rule.

Oral Answers to Questions

Harriett Baldwin Excerpts

Tuesday 7th June 2011 Commons Chamber

[The Minister of State, Department of Health (Paul Burstow)]

I think that Members throughout the House share the right hon. Lady’s concern about the events that were revealed in more detail last week. We will deal with an urgent question on one of the other matters later this afternoon. She also asked about funding for social care. In last year’s spending review we not only secured additional resources enabling us to put safeguarding boards on a statutory basis, but ensured that by 2014 an additional £2 billion would go into social services. Much of that will come via the NHS to ensure much closer working between health and social care services, which is an essential prerequisite for the delivery of better outcomes for people with dementia.

[Harriett Baldwin (West Worcestershire) (Con)]

T4. One of my constituents, a vulnerable young adult with complex needs, was recently sectioned under the Mental Health Act 1983, taken from the family home, and placed in Winterbourne View. The mother was very concerned about her child’s care there, and contacted me. However, I was told by adult social services that I could not know the details of the case because of data protection. When reviewing the regulations involving vulnerable adults, will the Minister ensure that questions from Members of Parliament about such cases can be answered, so that they can stand up for even their most vulnerable constituents without their express written permission?

[Paul Burstow]

I am grateful to the hon. Lady for highlighting that issue. I think that Members in all parts of the House experience the same frustration from time to time when they feel that they are unable to discharge their responsibilities on behalf of constituents and obtain the information that they think they need in order to do that job. I will certainly undertake to examine the issue again. Patient confidentiality is complex and we must respect the confidentiality of individual patients, but we should not let that get in the way of ensuring that good-quality care is delivered.

Oral Answers to Questions

Harriett Baldwin Excerpts

Tuesday 26th April 2011 Commons Chamber

[Mr Lansley]

The hon. Gentleman misses the point that what matters to the public is the quality of services that are provided to them. When he asked his question, he might have reflected on the simple fact that the Labour party told us before the spending review to cut the budget of the NHS. We refused to do that, which means that this financial year, £2.9 billion more will be available for the NHS to spend than it spent last year.

[Harriett Baldwin (West Worcestershire) (Con)]

A crucial front-line service is the provision of stroke care. Can the Secretary of State confirm that under his proposed reforms, local clinical practitioners will have much more influence over the location of those stroke services than in the current situation, when management can make somewhat arbitrary changes?

[Mr Lansley]

Yes, I can confirm that. We are looking for commissioning consortia not only to lead from a primary care perspective on behalf of patients, but to work on commissioning services with their specialist colleagues. Of course, the stroke research network has formed a strong basis upon which such commissioning activity can take place.

There have been many improvements in stroke care. Over the last year, we have seen a significant improvement in performance in relation to responses to transient ischaemic attack, and I hope we continue to see improvements in future.