St Peter’s Hospital, Maldon
Helen Whately Excerpts(1 month ago)
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The Minister for Social Care (Helen Whately)
I thank my right hon. Friend the Member for Maldon (Sir John Whittingdale) for securing this important debate about the future of NHS services for his constituents. I know that St Peter’s Hospital, which has a long history of delivering local NHS services, is close to his heart and those of many people in his area. He spoke of the dedication of the staff who have worked there over the years and of many debates about the future. I welcome his sustained efforts to bring together stakeholders and ensure that his constituents’ voices are heard. We also heard from my right hon. Friend the Member for Witham (Priti Patel); she, too, made sure that her constituents’ voices are heard in this place. It is not the first time that she has raised this matter with me.
I want to assure both my right hon. Friends that the Government believe that NHS reconfigurations should be locally led, and based on clinically evidenced decisions. Any decision about St Peter’s will reflect our commitment to investing in health and care services for Maldon and Mid and South Essex. Let me start by reiterating that no decision has been made on the future of St Peter’s, and that a local consultation will run until 4 April 2024. As my right hon. Friend the Member for Maldon is aware, the local NHS is concerned that the hospital does not meet the required standards for services because of issues with the age, condition and suitability of its buildings. Indeed, he spoke about that a moment ago. St Peter’s was built as a Victorian workhouse and has deteriorated in recent years. That makes the building costly to maintain and it would be expensive to refurbish. The cost of getting the facility up to the standard needed is estimated at more than £18 million.
The St Peter’s site has also struggled to staff services properly, despite the increase in the NHS workforce in the past few years. When the birthing unit was at St Peter’s, it had to be periodically closed due to staff shortages, and there were also clinical safety concerns about the isolation of the unit; there were no other 24-hour services in the building. I heard my right hon. Friend explain that in the past there had been more than 300 births a year in the maternity unit, and I believe that my right hon. Friend the Member for Witham had her baby there.
I understand that stroke rehabilitation services in Essex community hospitals are not currently staffed in line with national best practice for specialist stroke units. I am sure that my right hon. Friends’ constituents want services not only on the doorstep, but to be staffed to provide the best possible care. That will be crucial, be it for mothers giving birth and their new babies, or for patients recovering from a stroke, for whom getting the right rehabilitation can make a huge difference to future quality of life. That is why ways to treat and care for patients and better equip facilities with the right level of specialist staff are being considered by the integrated care board.
I understand that other locations in and around Maldon are being considered by the ICB for the other patient services provided at St Peter’s; this will keep services such as out-patient appointments close to the current location. It is crucial that the ICB gets a full understanding of how these proposals will affect local people—of whether expected standards are met, not only of care, but of access. People usually understand that they may need to travel to get to a more specialised service, but it is essential that the services that people need are accessible. As well as considering patients, the ICB must consider families, carers, who need to be able to visit, and of course staff.
My right hon. Friend the Member for Witham emphasised the size and scale of Essex, and both she and my right hon. Friend the Member for Maldon spoke of house building and the growing population in the area, which clearly needs to be taken into account by the ICB. I have been assured that the local NHS is engaging and seeking to understand the views of residents before making any final decision. When that decision is made, the ICB must clearly set out how a decision will benefit the constituents of my right hon. Friends and people in the wider area.
I understand that my right hon. Friends are concerned about the adequacy of local consultation on the proposed changes. I am assured by the local NHS that multiple events are being held to discuss the proposals, and at least three have already taken place in Maldon. As we heard earlier, public meetings have already been held, involving my right hon. Friend the Member for Witham. Almost 3,000 people have already completed the online survey since 25 January.
I thank my right hon. Friend the Member for Witham for raising the closure of St Peter’s in a Westminster Hall debate earlier; my right hon. Friend the Member for Maldon raised it in oral questions the other day. I am glad to hear that the NHS will consider the results of a survey undertaken by my right hon. Friend the Member for Maldon, and that those views will be fed into any decision. The local NHS is giving people more time to come forward, and this week it announced an extension to the consultation by an additional two weeks.
Mid and South Essex is already one of the best parts of the country for the NHS getting patients back home and to appropriate care settings to recover from a stay in hospital. That strong performance has been supported by Government investment. That includes significant capital funding of £20 million for accident and emergency across 2020-21 and 2021-22; £18 million for the targeted investment fund in 2021-22 and 2022-23; and £7 million for a community diagnostic centre across the same two years. We have invested £61 million in operational capital in 2023-24, and £182 million across the 2023 spending review, which can be used for capital projects and work. I am sure that my right hon. Friends will be in no doubt about the Government’s commitment to the health of their constituents.
I can also assure my right hon. Friends that we have now delivered on our manifesto commitment for 50 million more general practice appointments per year, with nearly 370 million appointments booked across the last 18 months. Our primary care recovery plan is making it quicker and easier for patients to get the help that they need from primary care. On facilities for GPs in Maldon, integrated care boards have delegated responsibility for commissioning primary care services and can prioritise capital funding for an essential system of allocation to invest in primary care estates as needed.
In closing, I thank my right hon. Friends the Members for Maldon, and for Witham, for speaking in the debate and focusing our attention on healthcare in Essex, specifically on the future of St Peter’s Hospital. They have both done an excellent job of ensuring that the views of their constituents are heard, and I have no doubt that they will continue to do so. I am very much looking forward to meeting them to discuss in greater detail the questions we debated today. I am confident that the local NHS has been listening, and I know the importance of St Peter’s to the area. Any change in NHS services must be made with the utmost sensitivity to local views.
Question put and agreed to.
Health and Social Care
Helen Whately Excerpts(1 month, 1 week ago)
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Helen Whately
…we have been putting in place changes to Care Quality Commission regulation to make visiting a fundamental right, a fundamental part of care and a fundamental standard of care to ensure better access for loved ones to their family members in care homes and in hospitals. I know in particular how important that is for people with dementia, among others. The CQC is consulting on the implementation of the regulatory change, which will be live shortly.
[Official Report, 6 March 2024, Vol. 746, c. 939.]
Letter of correction from the Minister for Social Care, the hon. Member for Faversham and Mid Kent (Helen Whately):
An error has been identified in my speech in the debate on Dementia Care in Hospital. The correct statement is:
Helen Whately
…we have been putting in place changes to Care Quality Commission regulation to make visiting a fundamental right, a fundamental part of care and a fundamental standard of care to ensure better access for loved ones to their family members in care homes and in hospitals. I know in particular how important that is for people with dementia, among others. The CQC has consulted on guidance on the implementation of the regulatory change, and that guidance will be live shortly.
Dementia Care in Hospital
Helen Whately Excerpts(1 month, 2 weeks ago)
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The Minister for Social Care (Helen Whately)
I sincerely thank my right hon. Friend the Member for Chipping Barnet (Theresa Villiers) for securing this Adjournment debate, and for her powerful speech. She really brought the subject to life through the examples from her constituency of people’s experiences in hospital. They were very difficult stories to hear, and I am very sorry to hear of times when it sounds like the care for people’s loved ones has fallen short.
My right hon. Friend made some powerful points that I want to address, starting with the fact that, as she said, there are many thousands of people living with dementia, and the number is only expected to increase; indeed, there will be more than a million by 2025. Many people with dementia will also be living with other health conditions. At the moment, it is estimated that around a quarter of the beds in hospitals are being used by patients with dementia, so ensuring that people receive the right care when they are in hospital with dementia is really important, as is doing our utmost to avoid unnecessary admissions and ensuring that people are discharged from hospital on a timely basis.
It is really worth emphasising the point that my right hon. Friend made about dignity, and the fact that every single person counts, at whatever stage of their life. There are challenges to ensure that people living with dementia have that dignity, particularly when they are in hospital. I, too, pay tribute to the many unpaid carers who are looking after their loved ones with dementia. I know what a huge burden and challenge that can be. However much someone loves somebody, there is a huge demand on them when they are caring for somebody with dementia. It can be very difficult, very distressing and absolutely relentless, however much they love them. I pay tribute to all carers who are doing that.
My right hon. Friend spoke first about Lisa Rutter, who very sadly lost her mother, who was living with dementia, during the pandemic—in hospital, if I heard my right hon. Friend correctly. I thank Lisa Rutter for the work that she is doing as the founder of Dementia Club UK. It is fabulous to be supporting other people to look after loved ones with dementia, or indeed those with dementia themselves. My right hon. Friend talked about the time Lisa’s mother spent in hospital, and how, for instance, Lisa knew what her mother needed but felt that she was not listened to, and that it may have contributed to her mother’s death. My right hon. Friend also talked about the visiting restrictions during the pandemic. I will talk about those in a moment.
My right hon. Friend talked about another constituent, whose wife was in hospital. She rightly talked about the importance of mobilising somebody with dementia, and how her constituent’s wife was nearly given the wrong medication, which could have been fatal. She spoke about the importance of his intervention. She also spoke about a constituent who was a carer for their father, and the importance of mobilisation, and some of the communication challenges for somebody with dementia.
My right hon. Friend talked about one person who had been screaming all night, as described by the staff. Actually, the family member who knew them understood that they were calling for help, as they needed to go to the toilet. That brings to life how difficult it can be when somebody has dementia and is not necessarily able to articulate their needs and what they want. Those who know them well will often know what they are trying to say or communicate, but that can be difficult in hospital when they may be being looked after by staff who simply do not know them well enough to know what they mean.
My right hon. Friend talked about food being left uneaten. If somebody is not eating in hospital, clearly they are likely to lose weight and their condition may deteriorate. She also talked about medication being stopped, and she talked particularly about somebody whose partner had early onset dementia, and had been coping fairly well at home. He walked into A&E, and that was very sadly the last time he walked. That emphasises the challenge of keeping people moving and maintaining their ability to be mobile during a hospital stay. She also described the fight to visit outside visiting hours.
I very much hear my right hon. Friend’s asks on visitor access, volunteers being trained in dementia care, as well as staff training, and avoiding discharge delays, among other things. I will pick up on some of those.
First, on the challenge of caring for people with dementia when in hospital, many hospitals have worked hard to do better for patients with dementia, for example creating dementia-friendly environments by changing the colour and lay-out, ensuring that staff are trained in dementia, and having dementia leads and dementia-lead nurses, as well as having training for volunteers. Standard training in caring for people with dementia is available through NHS England for staff and volunteers.
Clearly, my right hon. Friend the Member for Chipping Barnet described examples where care fell short. I have no doubt that across the NHS, with the work already taking place, we can go further. I will raise the points that she made about secondary care with my colleague, the Minister for Health and Secondary Care, so that we can work together on ensuring that care is right in hospitals. He also has oversight of workforce, and we should focus on whether the training that I know is available is being taken up by enough staff, considering the number of people in hospital with dementia.
On visiting, my right hon. Friend spoke about a subject that is close to my heart. Having been involved in some of the decisions about social care visiting restrictions during the pandemic and knowing how hard those decisions were—weighing up the infection control concerns and ensuring people could spend time with loved ones—we have been putting in place changes to Care Quality Commission regulation to make visiting a fundamental right, a fundamental part of care and a fundamental standard of care to ensure better access for loved ones to their family members in care homes and in hospitals. I know in particular how important that is for people with dementia, among others. The CQC is consulting on the implementation of the regulatory change, which will be live shortly. I believe we have taken a significant step to address concerns expressed about visiting.
Another thing my right hon. Friend spoke about was faster discharge. I am very alert to the risk of patients deconditioning in hospital, particularly patients with dementia. That is why over the past year or so, we have worked hard with the NHS to get better at identifying patients at greater risk of deconditioning, in particular those with dementia, on their admission to hospital. We have done earlier discharge planning and have been getting care transfer hubs established all across the country, which will do the work on more complex discharges. Often someone with dementia may need more access to social care. We may need to increase the access to, availability and supply of social care, so that it is there for those who will need it when they leave hospital. We have made some real progress on that over the past year.
Helen Whately
I have very little time, so I am afraid I will not give way.
My right hon. Friend the Member for Chipping Barnet talked about the social care workforce, another subject close to my heart. We have a strategy for the care workforce. We are building care as a career, in particular to boost recruitment and retention among our home-grown workforce. We recently published the first ever national career structure for care workers, and we are launching a new national qualification to boost the supply of care workers.
Avoiding admission is another priority for me. Clearly, some people should be—absolutely must be—in hospital for the treatment they need, but we know that patients with dementia in particular can deteriorate in hospitals, so we are doing more work with the national health service and social care to avoid admission when it is not truly necessary by putting in place alternatives or, at the other end, supporting earlier discharge through the roll-out of the Hospital at Home initiative, or virtual wards, under which we committed to at least 10,000 hospital-at-home beds or equivalent as part of emergency care recovery plans. The NHS has over-delivered on that, so we now have more than 11,000 Hospital at Home beds, which help people who would otherwise be in hospital receiving acute care. They receive that care and are able to recuperate at home, avoiding the risk of a longer hospital stay and deconditioning.
My right hon. Friend talked about dementia research and the new treatments coming onstream. The Government have committed to doubling our investment in dementia research during this Parliament, and we are on track to do that with our dementia mission. We are also working very closely with NHS England to be ready for the breakthrough treatments lecanemab and donanemab coming onstream. I should be clear that we know very well—I have received clinical advice on this—that those treatments have quite significant side effects, so they will not be suitable for everybody and I put a note of caution there. We are waiting to hear whether they are approved by the Medicines and Healthcare products Regulatory Agency and the National Institute for Health and Care Excellence. In the event of approval, NHS England is taking steps to be ready to put in place the levels of diagnosis required to be able to support those treatments.
That goes hand in hand with the work that we are doing with NHS England to improve the diagnosis rate for dementia. We have a target dementia diagnosis rate of 66.7%. That dropped during the pandemic because dementia services and assessment had to be closed, but it has been gradually building up, and I expect NHS England to get back up to that level during the course of this year. That is really important, because having a diagnosis helps people—the individual with dementia and their carers, for example—to access the support and back-up that they should be receiving.
I am conscious of the clock ticking, so I have tried cover some of the territory that my right hon. Friend set out in her speech, which I thought was very powerful in raising these significant issues for those with dementia receiving care in hospital, their carers and loved ones. I completely agree about the importance of dignified treatment and treating those with dementia with dignity at all times. I know that that can be particularly challenging in hospital, but we have to ensure that that is the case.
We will ensure that we get all the necessary care in place outside hospital, which avoids unnecessary admissions; support people to be discharged from hospital quicker; get ready for the arrival of new dementia treatments; and raise awareness about the significant proportion of dementia cases that can be prevented or at least delayed by looking after our health. In fact, the risk factors for dementia are similar to those for heart disease and other things, and there is relatively low awareness of that. We will see more people with dementia in the years ahead, but we can do more to raise awareness of how people can maintain their health and stave it off.
Helen Whately
I am just coming to a close.
I thank my right hon. Friend for securing the debate. I will continue my work to pursue the topics that we have discussed this evening.
Question put and agreed to.
Oral Answers to Questions
Helen Whately Excerpts(1 month, 2 weeks ago)
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Andrew Lewer (Northampton South) (Con)
The Minister for Social Care (Helen Whately)
A year ago we set out a plan to improve urgent and emergency care, and the plan is working. Performance this winter has been better, with ambulance waits down by nearly a third, and we are learning the lessons from this year to make further improvements in the year ahead.
Mary Robinson
It is welcome news that the brand-new £30 million A&E campus at Stepping Hill Hospital is nearing completion. However, other buildings on this ageing site are failing and urgently need replacing. Will my hon. Friend ensure that Stepping Hill remains at the heart of hospital facilities in Stockport with rebuilt units, and support new hospital investment and specialist diagnostic hubs across Stockport?
Helen Whately
I am delighted that Stepping Hill Hospital will soon have a new emergency care campus, with all the benefits that that will bring to my hon. Friend’s constituents. I know that she is a great campaigner for her local NHS and has already met the Secretary of State about the concern she raises. As well as making her argument so clearly in Westminster, I would encourage her to continue discussions with her local NHS integrated care board, which is responsible for local decisions on capital investment.
Mrs Drummond
Up to £900 million for a brand-new acute hospital is coming to mid-Hampshire and health experts are making the case that it will make huge improvements in care, despite some politically inspired and misinformed opposition. Can my hon. Friend reassure my constituents that those running our local NHS should be listened to, and also that the doctor-led urgent treatment centre in Winchester will continue to provide for three quarters of urgent cases including X-rays, MRI scans and other tests after the new acute hospital is built, which we hope will be at junction 7?
Helen Whately
I commend my hon. Friend for her hard work on supporting the new hospital, for the leadership she is providing and for her work on encouraging residents to have their say in the consultation. I cannot prejudge the outcome of the consultation but I agree with her that the new hospital will be great for patients, with its modern facilities. She is right to say that an urgent treatment centre can provide excellent emergency care for the majority of people who attend A&E.
Andrew Lewer
Northampton has been the beneficiary of many welcome new or improved facilities in recent years, including a children’s A&E, a main A&E and the announcement of a community diagnostic centre. However, the missing piece of the jigsaw is an urgent treatment centre, for which I have been campaigning for many years now. Will the Minister inform me on the progress on that centre?
Helen Whately
I congratulate my hon. Friend on his successful campaigning for healthcare in Northampton, which is, as he says, benefiting from upgrades to the children’s A&E and the main emergency department and will soon have one of our 160 new clinical diagnostic centres. He will know that his local NHS integrated care board will decide whether to fund a new urgent treatment centre, and I have every confidence in his ability to persuade it of doing so.
Sir Chris Bryant (Rhondda) (Lab)
It is one of the great successes of the past few years that we now save the lives of a lot more people with an acquired brain injury. Although we might save them in acute and emergency care, however, a national strategy for acquired brain injury is a really important part of ensuring that people have the proper care thereafter. The Government appointed me and the Minister for Health and Secondary Care, the right hon. Member for Pendle (Andrew Stephenson)—he is just passing the hon. Lady a note to inspire her on the subject—to try to publish one. When does she hope that there will be money available to ensure that that strategy is one worth having?
Helen Whately
I know that the hon. Gentleman is a great campaigner on this issue; he has worked very hard on it with me in the past, and he now does so with my right hon. Friend the Minister for Health and Secondary Care. I assure him that we are in the process of revising the draft strategy, taking on board feedback from patients, their families, charities and the NHS, and we will publish the strategy in due course. I thank all stakeholders for their continued efforts.
Helen Morgan (North Shropshire) (LD)
In January, the average category 2 response time for west midlands ambulance service was over 43 minutes. We know that the problems are worse in Shropshire, following stories such as that of a lady who waited 18 hours before seeing a doctor, having contracted an infection following radiation therapy for her cancer treatment. The situation in Shropshire does not seem to be improving as fast as we would like. What steps is the Minister taking to resolve the problem?
Helen Whately
Across the country, ambulance response times have come down by a third. We have worked very hard, particularly with areas that face greater challenges, including Shropshire. I have spoken to leaders in the local health system about the ongoing challenges. We are learning lessons about what has worked over the past year, and from where we have not made so much progress, to ensure that we do better in areas such as the hon. Lady’s over the year ahead.
Jim Shannon (Strangford) (DUP)
I thank the Minister for her positive answers; they are really appreciated. Bearing in mind the pressure that GPs are under, which is leading to more pressure on emergency provision, what steps are being taken to provide greater incentives for medical students to take on positions in GP surgeries? That would make a big difference.
Helen Whately
The hon. Gentleman is absolutely right to talk about the whole health system. One thing we are doing as part of our work on urgent and emergency care is preventing people from being admitted to hospital unnecessarily, or from being brought to A&E in the first place. Primary care is part of that. In our investment in expanding medical school places, we are particularly encouraging medical schools, such as the new Kent and Canterbury Medical School near me, to train students to work more outside hospitals, including in primary care.
Karin Smyth (Bristol South) (Lab)
Despite watering down the targets for ambulance response times and the A&E four-hour wait, the Government still cannot meet them. We have heard from Members across the House this morning how patients are waiting longer. The new targets say that there will be further improvements in 2024-25, and the Minister has said that again this morning. Can she let us in on what exactly they will be?
Helen Whately
I am not going to pre-empt the publication of targets for the coming year, but, as I have said, we will continue to learn lessons from the progress that we have made this year, including on ambulance response times, which are down by over a third. Anyway, I will take no lessons from Labour, because we know the state of the NHS in Wales.
Peter Aldous (Waveney) (Con)
The Minister for Social Care (Helen Whately)
We are making great progress on our 10-year vision for adult social care reform. We have introduced the first ever national career structure for care workers, and we have introduced new assessments by the Care Quality Commission, which will shine a light on how well councils are delivering their social care duties.
Peter Aldous
I am most grateful to my hon. Friend for that reply. In Suffolk, where the population is increasingly elderly, social care is under enormous pressure, and it is a significant challenge to recruit carers, pay them fairly and provide them with a proper career path. Therefore, I heard what my hon. Friend said, but will she consider commissioning a long-term workforce plan for adult social care equivalent to that for the NHS?
Helen Whately
My hon. Friend is right about the importance of the social care workforce: social care is its workforce. I can assure him that we already have a plan for the care workforce, set out in the “People at the Heart of Care” White Paper, and now we are putting it into practice. Our care workforce pathway is already being implemented, our new accredited qualification for care workers will be launched later this year, and we are backing social care with up to £8.6 billion in extra available funding.
Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)
I was concerned to hear that a constituent of mine was initially denied access to social care for his mother who suffers from Alzheimer’s despite her inability to administer her own medication. Will the Government look to broadening the criteria of the Care Act 2014 to include those requiring support with administering medication?
Helen Whately
We very much want everybody who needs care to get it and everyone who is eligible for financial support should get it. That, of course, is assessed by local authorities. We are introducing Care Quality Commission assurance of social care commissioned by local authorities, to make sure people get the care they deserve and to shine a light on where local authorities are doing a really good job and where others could do better.
Tom Hunt (Ipswich) (Con)
The idea of a social care cost cap has dropped off the agenda slightly. I know it is incredibly expensive, but I continue to be contacted by constituents who face losing everything. When often their loved ones have dementia and it is already emotionally an incredibly traumatic time, they have the added anxiety of how they are going to pay for care. The only thing that should matter is what works and is best for their loved one, but there is a cloud of anxiety hanging over society, which we all worry about. Will the Minister confirm that this issue has not lost her attention and that we will continue to consider whether we can introduce a cap?
Helen Whately
I thank my hon. Friend for his important question on concerns about the cost of care and how much it costs some people. As he may know—I remind him—the charging reforms were delayed in 2022 by the Chancellor after we listened to local authorities.
Tim Farron (Westmorland and Lonsdale) (LD)
A fifth of the social care roles in Westmorland and Furness are currently vacant and unfilled. Coincidentally that is the same proportion of beds in Morecambe Bay that are occupied by patients who are unable to get a care package and therefore leave hospital. The reasons for this are blindingly obvious: the pay and career structures are derisory for hard-working wonderful people and there is a complete absence of genuinely affordable homes for people in those sorts of roles to enable them to live locally. Does the Minister agree that fixing that crisis in my community and others should be the priority for the Chancellor tomorrow, not silly electoral gimmicks?
Helen Whately
I recognise the challenges in the hon. Gentleman’s area, although nationally vacancies in social care have fallen by over 20,000. We are reforming adult social care careers to make care a career for the UK workforce. We are putting extra funding into social care—up to £8.6 billion over two years—and introducing CQC assurance to make sure local authorities are doing their best on social care. I would encourage the hon. Gentleman to talk to his local authority and make sure it is paying a fair rate for the care it commissions.
Peter Grant (Glenrothes) (SNP)
Joanna Cherry (Edinburgh South West) (SNP)
The Minister for Social Care (Helen Whately)
Care is a skilled profession and I want care workers to get the support and recognition they deserve. In January we took the next step in our ambitious care workforce reforms, launching the first ever national career structure for the care workforce alongside our new nationally recognised qualification.
Peter Grant
I know the Minister will want to join me in thanking every single person who dedicates themselves to working in the social care sector, including perhaps particularly those who have come to the UK from overseas to do so, but it is not sustainable to rely on incoming workers forever. The Migration Advisory Committee has found that Scotland is now less reliant on migrant workers in the social care sector than England, through the simple expedient of paying a decent wage. That might, by the way, also be a good way to stop doctors in England going on strike; the Minister might want to look at that. Has the Minister asked the Chancellor to provide funding in the Budget so that social care workers in England can enjoy the same pay and conditions as their colleagues in Scotland, and if not, why not?
Helen Whately
I agree with the hon. Gentleman that we are grateful to all who work in social care, including those who have come here from other countries to care for our loved ones. We also agree that international migration is not a long-term answer to our care workforce needs. That is why we are reforming social care to work as a career, and we are backing that with extra funding—up to £8.6 billion extra for social care over two years.
Sarah Owen
I am afraid the Minister’s warm words about the social care workforce do not meet the reality check for most people. The Government’s own statistics show that there are at least 152,000 vacancies in social care in England alone, leaving my constituents waiting up to 10 weeks to be discharged from hospital. The Government have been using international recruitment to plug the gaps and as a result have filled over 11,000 vacancies in the past few years, so can the Minister confirm whether recruitment and retention in social care will be better or worse due to Government plans to prevent overseas social care workers bringing family members to the UK?
Helen Whately
As I said a moment ago, vacancies have fallen and the care workforce grew by more than 20,000 last year. We are seeing better retention of care workers as well, but we need to go further. That is why we are reforming social care careers, introducing the first ever national career structure for the care workforce and new qualifications and training.
Joanna Cherry
Edinburgh Trade Union Council recently described changes to the healthcare worker visa route as cruel and inhumane. Many of my constituents who have relatives in care share its concerns, as do I. We know the valuable contribution that foreign care workers make to the sector. Ideologically driven change to visas could further exacerbate the recruitment and retention crisis that other Members have so eloquently described. Given that the Government skipped consultation on these changes, will the Minister commit to meeting trade unions and social care leaders in Scotland to understand the impact of these harmful changes?
Helen Whately
I am grateful to international care workers who have come to the UK to look after loved ones. Their work has contributed to reducing vacancies and increasing the supply of social care, but we need to get the balance right between international recruitment and our homegrown workforce. We are carrying out ambitious reforms of our adult social care workforce, and therefore it is right, alongside that, to ensure that we have the right numbers of people coming here from overseas for social care. That is why we have worked with the Home Office on changes to visas.
Andrew Selous (South West Bedfordshire) (Con)
The managers of the wonderful care home I visited in Dunstable on Friday were annoyed by the number of job applicants for care places who were making the interview stage and then not arriving on the day. Can the Minister have a word with ministerial colleagues at the Department for Work and Pensions to ensure that job coaches are certain that jobseekers are not wasting the time of care homes? It is not fair, and those who work in care homes are busy people with a lot to do.
Helen Whately
I work closely with colleagues in the Department for Work and Pensions on the recruitment of people looking for jobs in social care, and I will raise that point with my colleague in the Department.
Andrew Gwynne (Denton and Reddish) (Lab)
It was the Minister’s party that promised to fix the crisis in social care “once and for all”. With vacancy rates almost three times above the national average and turnover rates for new staff at more than 45%, it is clear that the Government failed. Labour’s plan for a national care service with clear standards for providers and a new deal for staff will give social care the fundamental reset it needs. The Government have done it with our workforce plan, and they have half-heartedly tried it with dentistry. Does the Minister want to copy our homework once again?
Helen Whately
Let us be honest, Labour has no plan for social care. Whatever the shadow Minister says, it is unfunded. There is no funding committed to it and it is not meaningful. Those of us on the Conservative side of the House are reforming adult social care. We not only have a plan, but it is in progress.
Amy Callaghan (East Dunbartonshire) (SNP)
I have asked the Secretary of State a number of times how she intends to recruit and retain social care staff, particularly with the visa changes coming into effect next Monday, stopping those from overseas coming to fill skills gaps from bringing their spouse or dependants with them. I ask again: how does the Secretary of State intend to improve the recruitment and retention of staff in the social care sector while her colleagues effectively work to undermine her?
Helen Whately
We are grateful to international workers coming to support us in social care and improving supply, but we have to get the balance right between international recruitment and our domestic workforce. In England, we are reforming social care careers to make social care work a career for our homegrown workforce, and I encourage her to make sure the SNP does the same in Scotland.
Dame Nia Griffith (Llanelli) (Lab)
The Minister for Social Care (Helen Whately)
As the hon. Lady will have heard me say earlier, we are grateful to international care workers who come to care for our loved ones in this country. We need to get the balance right between international recruitment and our home-grown care workforce. On the question specifically on dependants, I say to her that every care worker who comes here to do work in the UK has a choice as to whether to come here or not.
Vicky Ford (Chelmsford) (Con)
Priti Patel (Witham) (Con)
Mid and South Essex integrated care board is seeking to remove vital community health services from St Peter’s Hospital in Maldon. Will the Minister meet me and our right hon. Friend the Member for Maldon (Sir John Whittingdale) to discuss the proposals? They will affect both our constituencies and are causing a great deal of concern.
Helen Whately
I would be very happy to meet my right hon. Friends to discuss those concerns.
Christine Jardine (Edinburgh West) (LD)
I thank the Secretary of State for her offer to help cut waiting lists in Scotland. I listened to the frankly delusional statements from the SNP Benches about the state of the NHS in Scotland. We are in dire straits and suffer the same problems, particularly about GPs and appointments disappearing. When are we going to see an improvement in appointment availability?
Richard Foord (Tiverton and Honiton) (LD)
Wendy Hart had a high white blood cell count when she was discharged from the Royal Devon and Exeter Hospital. Her husband, Terence, described a dreadful, pointless 60-mile round trip home and back to hospital before Wendy died of sepsis. Will the Minister consider distances between acute hospitals and rural communities when reviewing hospital discharge guidance?
Helen Whately
I am very sorry to hear about what happened to the hon. Gentleman’s constituent. I send my condolences to her family and loved ones. Clearly, it is very important that discharge decisions are led by clinicians, who can make a clinical decision about whether somebody is medically ready to be discharged. I have no doubt that the family may well take up that decision with local NHS organisations.
Will Quince (Colchester) (Con)
No doctor wants to be on strike, so I welcome the new deal with the consultant unions. It shows that by being reasonable, pragmatic and acting in good faith, unions can deliver for their members. Does my right hon. Friend agree?
Young Adults with Spinal Injuries
Helen Whately Excerpts(1 month, 2 weeks ago)
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The Minister for Social Care (Helen Whately)
I thank the hon. Member for Dulwich and West Norwood (Helen Hayes) for securing this debate and for her powerful speech telling us about Tom Lazarides’s experience, his tragic accident and his injury. I welcome his family, who the hon. Lady said are here in Parliament today. I offer them my sincere condolences on the loss of Tom, who sadly died in November 2023.
I listened carefully to the hon. Lady’s speech, although I did not have advance sight of her comments, and I will do my best to respond. I assure her that I am happy to write to her with further details about the points she has raised this afternoon. I am responding as the Minister with oversight of continuing healthcare and discharge, so I will be able to say more on those points. Particularly in her summing up, she talked more generally about care for people with spinal injury, which can have such a devastating impact and can mean that a person needs a great deal of care from multidisciplinary NHS teams.
I could go into the way NHS England commissions services for spinal cord injuries—there is a national specification and a range of support—but I think I could make better use of the time today by picking up on the question of continuing healthcare and the discharge situation, which the hon. Lady outlined. She described how Tom’s family feel that the system failed him and his clearly complex health needs as a result of his injuries. She described the long time he spent in hospital and the long-term rehabilitation he needed, which meant he needed significant ongoing clinical care. She described how he was considered for continuing healthcare and the experience of the eligibility assessment, and how Tom and his family felt it did not take into account his injuries and health conditions, and did not take full account of his medical records. She described how he and the family were then told that he was not eligible. They subsequently and rightly appealed, and I heard how difficult the hon. Lady said that process clearly was for the family and for Tom, with the lack of transparency, the uncertainty, and the feeling that meetings happened without them and their involvement. I heard how Tom felt under pressure to move into a care home, when he really wanted to live well at home. All of us can completely understand that. Anyone, whether a young person such as Tom or someone of old age, wants to live as independently as possible, whatever their health needs at home. I also heard about the experience with discharge to assess.
Clearly, a process is in place for accessing NHS continuing healthcare. The intention of the process is to consider the individual’s clinical needs, the combination of those needs and how they come together, and therefore to assess whether somebody is eligible. The intention is to design a package of care around the individual to support them where they wish to live, be it at home or in a care home. First, a checklist is used, which leads to someone having an eligibility assessment. If I understood it correctly, Tom experienced and went through the eligibility assessment, but, as the hon. Lady mentioned, the initial decision was that he was not eligible. I am happy to make some inquiries. As a Minister, I cannot make a call on any particular decision that is made on an individual, but clearly I want always to be assured that the right process has been followed. It is probably helpful if, with the help of officials, I try to seek some further information outside the Chamber from the hon. Lady to see what I can do to understand fully what happened and to be assured as to whether there is anything we need to do to make the process work better, particularly in the circumstance that she has described, where somebody such as Tom has clearly had some severe injuries. I am also happy to meet her and Tom’s family to understand this process better.
The hon. Lady raised a point about discharge to assess and how it did not work for someone with a catastrophic injury. Again, we should pick that up in a conversation outside the Chamber. In general, the purpose of discharge to assess is a good one: to avoid people having long and unnecessary stays in hospital, where we know that frail and elderly people, in particular, are likely to decondition and live less independently as a result. She knows that well from the work that she does on social care. Once somebody has been discharged home, they are often able to live with more independence and regain mobility in a way that was not clear when they were assessed in hospital. Sometimes assessment in hospital will lead to delays and a longer stay in hospital, and to what is called over-prescription, with somebody ending up living longer in a care home when they might have continued at home. In general, discharge to assess is a good thing but, as I say, I am happy to look into the specific question of whether there might be circumstances, such as when somebody has had a very serious injury, when the process works differently. I will take that away.
The hon. Lady made a point about the involvement of patients in decisions about their care. It is fundamental that patients should be involved in decisions about their care, as should families and carers. In many circumstances, the patient and those around them will be the experts on what they will need. They need to be involved in the ramifications of whatever decisions are made. That should take place, but let us investigate further outside the Chamber whether that is working as it should be, together with the points she made about transparency and trying to ensure that people are involved when continuing healthcare is being assessed and considered.
I receive a significant amount of correspondence about continuing healthcare. The NHS has a challenging job to ensure that the decisions go the right way. I know the process can be long and hard for those involved in it. I want to ensure it works as well as it possibly can, so that those who should be eligible receive such care. I understand in Tom’s case that, after the appeal, the decision was made that he should be receiving continuing healthcare. How sad that that came after his death and after all the suffering that he and those close to him must have gone through.
I thank the hon. Lady for bringing Tom and his family’s situation to my attention. I commend her for her powerful speech and how clearly she put across the concerns. I look forward to speaking about this further outside the Chamber.
Mr Deputy Speaker (Mr Nigel Evans)
I pass on the deepest condolences of everybody here at the House of Commons to Tom’s family, friends and all who mourn his passing. It was a very moving speech.
Question put and agreed to.
Internationally Recruited Health and Social Care Staff: Employment Practices
Helen Whately Excerpts(2 months, 2 weeks ago)
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The Minister for Social Care (Helen Whately)
I am grateful to my right hon. Friend the Member for Spelthorne (Kwasi Kwarteng) for opening the debate and setting out some of the challenges we face in international recruitment in health and social care. I pay tribute to our international health and care workers, who play an important part in our health and care system, looking after people and bringing their skills, equipment and compassion to look after loved ones. We benefit enormously across the UK from their knowledge and skills. In return, it is imperative that employers, whether in health or social care, provide a safe and supportive environment for their staff to work in.
I want to be clear that international recruitment is not the long-term answer to our health and social care workforce needs. We have been clear about that as a Government, and I have been clear about that personally. That is one of the reasons why, on the NHS side, we have our long-term workforce plan, investing in training our home-grown healthcare workforce. On the social care side, we have a 10-year vision for social care, which includes ambitious workforce reforms, which are in progress, including the first ever national career structure for care workers and new national qualifications. I am determined that care workers—indeed, care professionals —be recognised for their skills and supported in their work and career.
I would say to the SNP spokesperson, the hon. Member for East Dunbartonshire (Amy Callaghan), that she should read up on these care workforce reforms, as should the shadow Minister, the hon. Member for Denton and Reddish (Andrew Gwynne), who called a moment ago for a care workforce pathway. I know he is relatively new to this role—we have not done that many debates opposite each other—so I ask him to go take a look online. He will see our care workforce pathway programme, which we have published and which we worked closely with the sector on to develop this national career structure. We did so exactly because it was one of the things we knew was missing from social care, and because when people come into social care, they want to see that they have an opportunity to progress in that career. We are also developing national training that will be recognised across different employers. Those are just two of the headline policies of a truly ambitious reform programme for the social care workforce.
Amy Callaghan
I do not particularly appreciate being given homework by a Minister who is doing so much damage to the health and social care sector in Scotland. I have certainly done my homework already—I do not need to be given some by her.
Helen Whately
I think it is probably helpful if I move on, rather than our having some sort of back and forth.
I turn to the question in hand, which is specifically to do with international recruitment and the reasonable concerns raised by my right hon. Friend the Member for Spelthorne about the exploitation of some workers who come to support us in this country in health and social care. One of the things he spoke about was the code of practice. He is absolutely right that we have a code of practice for the international recruitment of health and social care personnel, which sets out ethical recruitment and employment standards that employers must adhere to. The code is kept under regular review. In fact, my right hon. Friend referred to the update of the code last year. I can assure him that my Department works closely with the Royal College of Nursing and other trade unions and stakeholders to strengthen that code and make sure it addresses the current issues and ethical concerns. For instance, we have set out stricter principles on the use of repayment clauses in employment contracts, and the code is now explicit that charging recruitment fees is illegal under UK employment law. I absolutely agree with my right hon. Friend that we should continue to make sure the code of practice truly captures all that it needs to, and is as effective as it can possibly be.
Alongside the code of practice, we have the ethical recruiters list. This contains a cohort of recruitment agencies that have agreed to operate in accordance with the rules of the code. The list is run by NHS Employers, and it makes it easy for employers in the NHS and the social care sector to check that recruitment agencies are signed up to meet the high ethical recruitment standards we expect. Any organisation suspected of breaching the code will be investigated, and can be removed from the list.
Most overseas staff have a positive experience working in the UK, but I acknowledge that, regrettably, this is not the case for all. We know there are some rogue agencies and employers that take advantage of people who want to come to the UK to work. We have published guidance for prospective overseas candidates to help them make informed decisions and prepare for life in the UK. The guidance sets out what candidates should check in their employment contracts before signing them, what working rights and standards they can expect in the UK, and how to recognise and deal with exploitation, should that unfortunately be something they experience.
My Department is working with colleagues in the Foreign, Commonwealth and Development Office to disseminate that guidance effectively, so that it reaches prospective candidates at an early stage and helps make informed decisions and avoid scams and unethical practices. We want them to be able to do that in their home countries, before they even apply to work here in the UK.
My right hon. Friend the Member for Spelthorne mentioned punitive repayment clauses in employment contracts. We are clear that those are unacceptable, and in certain cases illegal. There are some instances where repayment clauses may be used legitimately to cover some up-front costs incurred, should an employee decide to leave their job after a short time. But in all cases, employers must make it clear in contracts what is to be reclaimed, and how and when that will take place. Instances where repayment clauses are excessive, or extended over a lengthy period, have the effect of trapping international workers into jobs, and that is unacceptable. Repayment clauses cannot be used by employers to cover the cost of agency fees, certificates of sponsorship or the immigration skills charge.
As I mentioned, the code was updated to address that issue. The NHS has gone further, producing additional bespoke guidance for NHS employers to explain how to implement the code’s principles when using repayment clauses. That will ensure transparency and fairness in employment contracts for all international recruits working in the NHS.
Another issue raised by my right hon. Friend is that of recruitment agencies charging international candidates high fees to find them work in the UK. For UK-based agencies the law is clear: charging a candidate any recruitment fee to find them a job in the UK is illegal. The Employment Agency Standards Inspectorate is the organisation responsible for regulating employment agencies, and it will investigate such misconduct and prosecute where appropriate.
However, we do face the challenge of agencies based overseas that fall outside the UK’s jurisdiction. Regrettably, we have limited direct levers to stop the unethical treatment of workers overseas, but we have taken steps to try and mitigate the risk as far as possible. First, our international candidate guidance, which I mentioned a moment ago, warns potential candidates that they should not be paying any kind of fee to find work in the UK, and that they should not work with any agency that requests such a fee. Secondly, our embassies and high commissions are actively working with higher-risk countries to tackle exploitative practices by recruitment agencies overseas. NHS Employers, as holders of the ethical recruiters list, undertakes regular spot checks of agencies on that list to ensure they are complying with the code of practice.
As a Department, we are working collaboratively with the labour enforcement agencies that take action against those breaking the law in the UK. Those include the Gangmasters and Labour Abuse Authority, UK Visas and Immigration, and the Employment Agency Standards Inspectorate. We therefore have a multi-agency approach across Government which uses our collective intelligence, capabilities and resources to respond to concerns about exploitation. That includes providing insight, advice and guidance to businesses and supply chains in relation to possible labour market offences.
My right hon. Friend mentioned language skills and the potential challenge for somebody whose English might not be fluent, to navigate the landscape and know their employment rights, for example. It is clearly important that the language skills of anyone providing care in England are good enough to communicate with their employer, the people they provide with care, and other care and healthcare professionals.
Care providers must ensure that their chosen candidates have the skills needed to work in care and should assess a candidate’s English proficiency at the interview stage of recruitment. For somebody to work in social care, employers should ensure a good standard of English. For staff from overseas, the Home Office sets English language proficiency requirements. Individuals are required to prove they can speak, read, write and understand English to at least level B1 on the common European framework of reference for language scale.
My right hon. Friend also asked about cross-Government work in general on tackling exploitation. I can assure him that we are working across Government. My Department is working particularly with the Home Office and UKVI, both at official and ministerial level. I have had several conversations with Home Office Ministers about our care worker visa scheme and what we are doing to tackle the risk of exploitation and abuse.
I worked closely with Home Office colleagues on the recent changes to the care visa. We agree about striking the right balance with overseas care workers, who are supporting us in some of the challenges of meeting the social care and healthcare need in the UK. We also need a balance between international workers and our home-grown workforce, ensuring that there are safeguards for international recruits.
Following those conversations, we have announced changes to the care visa scheme, as referred to during this debate. One is that, as of March, we will no longer allow care workers to bring dependants with them. Another safeguard is that we are restricting sponsors to CQC-registered care providers. At the moment, as long as someone is providing social care, CQC-registered or not, it depends on the sort of care provided.
The Government do not have all the answers at the centre, and I feel strongly about that. That is one reason why, as we have introduced the care worker visa, we put £15 million funding into regional partnerships of local authorities, to have established leads around the country for international recruitment, to support employers and recruits. I meet our regional leads, to hear what it is like in their areas, and to discuss what they are doing on the ground to support employers and social care staff. For instance, they are supporting providers with legal and HR advice on recruiting and employing international staff.
There is a specific example relevant to this debate. East of England has commissioned Unseen to run seminars and provide one-to-one support for care providers on safeguarding and spotting signs of exploitation. I continue to work with those leads to get the best possible insight on the ground on the extent to which internationally recruited workers may face difficulties. That could happen if someone has been brought here for a job with a particular sponsor who loses the licence to employ them, and the leads are working hard, trying to support recruits in that situation. I am also setting up a meeting directly between our regional leads and the Home Office and UKVI, to ensure that they share their intelligence directly, making the most of the leads’ work and insights.
I want to come briefly to some of the points made by the hon. Member for Westmorland and Lonsdale (Tim Farron). He mentioned the connection between social care supply and delayed discharge in his local area, which is something that I have done a huge amount of work on over the past year. I want to be clear, particularly on this topic, that social care does not exist just to discharge and support the discharge of patients from hospital. Social care is absolutely an end in itself, supporting both older people and those of working age with care needs.
We know that there is a connection between discharge delays from hospital and social care, because some people who are delayed in hospital, when they are medically optimised for discharge, are in need of social care packages. That is why we put in an extra £600 million in funding to support discharge over the past year, and there is another £1 billion coming this year. We have also put in an extra £570 million of funding to support social care. Just this morning, I was talking to a number of directors of adult social services from local authorities who assured me that that funding has made a meaningful difference to social care funding and supply.
I know that there are still significant financial pressures, and the national living wage increase puts an additional pressure on care providers and local authorities for the coming financial year. While that increase is a good thing for those at the bottom of the pay scale, it also places financial pressure on employers and those funding social care. I assure the hon. Member for Westmorland and Lonsdale that that increase in supply, thanks in part to the extra funding, has helped to speed up discharges over the past year and reduced some of the delays, and we have seen an increase in the number of people being discharged both overall and particularly with social care support. We have made progress on that point.
I come back to this point in closing. I want to be categorically clear, in the light of this debate, that no member of staff in health or social care should face abuse of any kind, and illegal and unethical international recruitment and employment practices will absolutely not be tolerated. Internationally recruited staff play a really important part in caring for people across health and social care. They have helped us to build and increase our health and social care workforce. On the NHS side, we have achieved our manifesto commitment of 50,000 more nurses. On the social care side, we have over 20,000 more care workers in the care workforce. We have seen vacancies come down and retention improve, so we have been making progress on both the social care and the NHS workforces. While international recruitment plays an important part, it goes hand in hand with our work as a Government to build up our home-grown workforce both on the NHS side, with our NHS long-term plan, and the social care side, with our ambitious social care workforce reforms.
Oral Answers to Questions
Helen Whately Excerpts(2 months, 3 weeks ago)
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Sarah Green (Chesham and Amersham) (LD)
The Minister for Social Care (Helen Whately)
Discharging people on time is better for them and frees up hospital beds. We are changing how our health system works to do that: joining up health and social care and care transfer hubs; helping people to recover at home, with more than 10,000 new virtual ward beds; and investing in social care. And it is working. Last month, delayed discharges were down 9% compared with the end of December 2022 despite almost 1,000 extra urgent admissions to hospitals every day in December.
Sarah Green
Nearly one in six beds in my local healthcare trust in Buckinghamshire continues to be occupied by patients fit for discharge. A recent King’s Fund report found that the Government’s current practice of providing one-off funding to reduce delay, while welcome, comes with insufficient advance notice to allow for effective planning. What steps is the Minister’s Department taking to ensure the best use of this funding?
Helen Whately
One reason we distributed discharge funding back in April last year was to give more advance notice to organisations, so that they could put in place what is needed to speed up discharges. I say to the hon. Lady that our plan is working. That is why, in her own trust, discharges at the end of December were down by a third compared with the previous year.
Will Quince (Colchester) (Con)
I note the progress that my hon. Friend referenced, but delayed discharges are still a major issue. Patient flow through a hospital is a critical factor, especially at the front door through emergency departments. We know the role that electronic bed management systems can play in helping that flow. What steps is my hon. Friend taking to ensure that more hospitals roll out that technology?
Helen Whately
My hon. Friend is right. I know how much work he did when he had oversight of urgent and emergency care services, which included his contribution to our urgent and emergency care recovery plan that was published almost a year ago. That plan included a host of steps to improve the flow through hospitals, including investment in bed management systems, as he described. The plan is working, which is why we are improving the flow through hospitals and seeing reductions in delayed discharges.
Mr Rob Roberts (Delyn) (Ind)
Clive Efford (Eltham) (Lab)
The Minister for Social Care (Helen Whately)
Care is a skilled profession, and I want care workers to get the support and recognition they deserve. This month, we took the next step in our ambitious care workforce reforms, publishing the first ever national career structure for the care workforce alongside our new nationally recognised care qualification.
Clive Efford
Ambitious care workforce reforms—it is all blah, isn’t it? We have had 14 years of Conservative Government, and we have a crisis in every area of the NHS. Job insecurity, poor working conditions and low pay—one in five care workers is living in poverty—are all reasons why we have a recruitment and retention crisis in social care. Is not the truth that that is a damning indictment of 14 years of Conservative Government, and the only thing that is going to sort out social care and the crisis in recruitment and retention is a general election?
Helen Whately
I am actually really shocked by the way the hon. Member referred to the care workforce, with terms like “It is all blah”—very shocking. I am determined that care workers should get the recognition they deserve. We have a 10-year plan for social care, and it is working: the care workforce grew by over 20,000 last year, vacancies in social care are down, and retention is up. We are reforming social care so that it works as a career. That is why, as I said a moment ago—I wish the hon. Member had been listening—we have introduced the first ever career pathway for social care workers and a new national care qualification.
Helen Whately
We have a plan for the social care workforce, and it is working. The social care workforce increased by over 20,000 last year, and it is still going up. But I will take no lectures from the hon. Member. In fact, his hon. Friend the Member for Bristol South (Karin Smyth), early this morning on television, made it clear that Labour does not have a plan for social care—or if it does, it is clear that it will cost a lot of money and is yet another unfunded Labour plan.
Sir David Evennett (Bexleyheath and Crayford) (Con)
Mark Pawsey (Rugby) (Con)
The Minister for Social Care (Helen Whately)
Almost a year ago, we published our urgent and emergency care recovery plan. The NHS has already halved the waiting times for category 2 ambulances and brought down waits in A&E. We are determined to cut NHS waits, and our plan is working.
Mark Pawsey
Rugby is one of the fastest growing places in the UK. While we have had additional services introduced at our local Hospital of St Cross, my constituents have insufficient accident and emergency provision. Thousands of local residents have signed my petition for doctor-led accident and emergency care at the Hospital of St Cross. I know it is a matter for the integrated care board, but will the Minister give her support? As a previous Minister, my hon. Friend the Member for Colchester (Will Quince) and the previous Secretary of State have visited in the past few months, and I invite this Minister to do likewise.
Helen Whately
I thank my hon. Friend for his invitation. He has been a tireless campaigner on this issue on behalf of his constituents. The future of healthcare is about getting people the care that they need, where they need it and when they need it, and Rugby is no different. New local NHS services are bringing care closer to home in his area, such as the new imaging unit at the Hospital of St Cross that opened in September.
Mr Gregory Campbell (East Londonderry) (DUP)
Access to urgent and emergency care can be greater facilitated when greater protection is offered to staff, particularly the many who suffer attacks in emergency departments at hospitals across the United Kingdom—often by people who are intoxicated.
Helen Whately
The hon. Member makes an important point. The safety of our staff in the national health service is important, including those in urgent and emergency care departments, as well as the ambulance services. He is absolutely right to point that out, and it is never acceptable for anyone, including patients, to be violent towards staff.
Jeff Smith (Manchester, Withington) (Lab)
Andrew Gwynne (Denton and Reddish) (Lab)
Mike Reader, Labour’s candidate for Northampton South, shared with me the horrific experience of Stanley, who had severe abdominal pain and called an ambulance, only to be told it would take hours and to go to A&E. There, he was told to wait for assessment on a patio chair outside. It was 3°. Who is to blame?
The Minister for Social Care (Helen Whately)
I am very sorry to hear of the experience of that specific constituent. Because of challenges that the NHS faces, particularly our urgent and emergency care services, almost a year ago we set out our urgent and emergency care recovery plan, to speed up care for people in A&E and reduce waits. That plan is working. We are seeing ambulances get to people quicker, and people treated quicker in A&E.
Andrew Gwynne
That is not a one-off. Why will the Minister not take a shred of responsivity for the chaos that her party has caused our NHS? The last Labour Government achieved the shortest waits and the highest patient satisfaction in NHS history. The Conservatives have delivered the longest waits and the lowest patient satisfaction in history. Let us have that general election, so that she can defend her abysmal record to the public.
Helen Whately
The hon. Gentleman obviously was not listening to my answer; in fact, he was reading aloud. Our urgent and emergency care plan is working. It is reducing rates in A&E, and ambulances are getting to people faster. Meanwhile, I am sorry to say that in the Labour-run NHS in Wales, more than half of patients are waiting more than four hours in A&E.
Andrew Lewer (Northampton South) (Con)
Hospice Funding: Devon
Helen Whately Excerpts(3 months ago)
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The Minister for Social Care (Helen Whately)
I thank my hon. Friend the Member for East Devon (Simon Jupp) for securing this debate about the funding of hospice care in Devon. I know that he is a huge supporter of hospices in his area, including Sidmouth Hospice at Home and Hospiscare. We have heard this evening how passionately he campaigns on behalf of the hospices that serve his constituency and how hard he is working to make sure they get the support and funding they need.
My hon. Friend may know—other Members in the Chamber for certain know—that I responded to a Westminster Hall debate in November on support for hospice services in south Devon. I know this subject is of great interest to Members who represent that part of the country, as well as to colleagues across the country. All of us here recognise the importance of palliative and end of life care, which supports people at some of the most difficult times, whether individual patients or their loved ones.
Most palliative and end of life care is provided by the national health service. Hospices are a crucial part of the network of end of life and palliative care, and they do a truly wonderful job caring for people during those difficult times. I experienced that with my grandmother, who spent the last few weeks of her life in a hospice a number of years ago. They did a wonderful job for her and her family as we spent some precious time with her towards the end of her life. I take this opportunity to send my thanks to everyone working in palliative care, whether in the NHS or in hospices, for what they do to support people at that time, and their loved ones.
Across the country, thousands of people receive palliative and end of life care. We have an ageing population, with many people living with complex health conditions. Approximately 600,000 people die every year in the UK, and it is a demographic fact that that number will increase, in turn likely increasing the number of people needing palliative and end of life care. Hospices specifically support more than 300,000 people with life-limiting conditions each year, in addition to providing hugely important bereavement support.
Most hospices are independent charitable organisations that generally receive funding from statutory sources and charitable donations. They are rooted in their local communities and are cherished for the compassionate care that they provide. Indeed, that funding model is one of hospices’ strengths. Although many will receive funding through the NHS, a significant majority of their funding will be raised from their communities. That is part of the strong relationship they have with their communities. That diversity of funding is another strength of the hospice model.
Richard Foord
On the sources of funding for end of life care, the Minister talks about it being a split model in which some is provided by the NHS and some provided as charitable donations and charitable giving. The work of Seaton and District Hospital League of Friends is 100% funded by charitable giving. The same is true for the model that Axminster Hospital League of Friends is seeking to set up. With that 100% funding, the Seaton league of friends built a wing of Seaton Hospital, yet it is expected that that will be given back to NHS Property Services. What can the Minister do about that?
Helen Whately
The hon. Member raised that question in the Westminster Hall debate I referred to. He is talking about a specific situation. Rather than spending the limited time I have addressing that, I am keen to respond to my hon. Friend the Member for East Devon, who has secured this debate on hospice funding in Devon.
I was talking about the enormous importance of hospices and their role in our communities, and the strengths of having hospices in our communities add to the significance of the care they provide. I mentioned my own experience. Hospices do this thing of making a time that can seem completely unbearable become somehow bearable. That makes a difference not only for the individual cared for by the hospice but for all those around them.
Let me turn to Devon specifically. Devon does reflect the national picture, with NHS palliative and end of life services such as a specialist NHS team, community nursing care and a Marie Curie night care service. I mention that because some people may think of hospices as the sole provider end of life care in any community. The picture is broader than that, but of course hospices are important. Indeed, NHS Devon has grant arrangements with four Devon hospices that operate in-patient beds. In East Devon specifically, patients can receive end of life care in hospital, at home, in a care home, or from Hospiscare or Sidmouth Hospice at Home, to which my hon. Friend referred.
In England, integrated care boards are responsible for the commissioning of end of life and palliative care services to meet the reasonable needs of their local populations. As part of the Health and Care Act 2022, palliative care services were specifically added to the list of services that an ICB must commission, reflecting the importance of end of life and palliative care in our healthcare system. Adding that will ensure a more consistent national approach and support commissioners in prioritising palliative and end of life care. In July 2022, NHS England published statutory guidance on palliative and end of life care to support commissioners with that duty. That includes specific reference to ensuring that there is sufficient provision of specialist palliative care services, hospice beds and future financial sustainability.
I acknowledge that hospices, like many organisations—and indeed households—are having to contend with financial pressures including rising energy costs. That is why charities including hospices have already benefited from the energy bills discount scheme, which provides a discount on high energy bills and is running until 31 of March 2024. Hospices may also be entitled to a reduction in VAT from 20% to 5%. In addition to that, in 2022 NHS England released £1.5 billion in additional funding to ICBs to provide support for inflation. ICBs were able to distribute that funding according to local need. It was therefore an option for them to support palliative and end of life care providers, such as NHS contracted hospices, with rising costs from inflation.
I recognise the financial challenges that hospices continue to face and the difficulty there is in raising funds from local communities when people themselves are facing pressures with the cost of living. My hon. Friend made a clear case for the financial support that the hospice in his area deserves. I encourage him to continue to argue that point. It is good to hear that he has been in touch with his local integrated care board, which is the organisation responsible for assessing palliative care needs in his community and ensuring that the need is met.
My hon. Friend is not the first Member to ask to meet me to discuss this topic, or to call a debate on it. I am working to increase the transparency and the information available to colleagues and our constituents, so that they can be assured about the provision of palliative and end of life care. To that end, I have organised a meeting next week with representatives from NHS England, and have invited Members from across the House to attend it, for an update on palliative and end of life care and to ask questions directly of NHS England on this topic.
I have welcomed the opportunity this evening to talk about the wonderful work of hospices not only in Devon but across the country. I assure my hon. Friend and other Members present that I am committed to supporting hospices to continue what they do so well in our communities, and to improving access to palliative and end of life care for people across the country, whether that care is given by a hospice or by the national health service.
Mr Speaker
We are so lucky to have the hospice movement, including St Catherine’s and Derian House in my constituency.
Question put and agreed to.
New Dementia Treatments
Helen Whately Excerpts(3 months, 1 week ago)
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The Minister for Social Care (Helen Whately)
It is a pleasure to serve under your chairmanship, Mr Sharma. I congratulate my right hon. Friend the Member for Ashford (Damian Green) on securing this debate. I also commend the campaigning of several charities in this area, including Alzheimer’s Research UK, the Alzheimer’s Society, Dementia UK, Age UK and many others that do so much to raise awareness of dementia, fund research, and support people with dementia and their carers.
I commend my right hon. Friend on his speech. Like many, he has his own experience of dementia with his father, which has clearly informed the significant work that he has done in this area. He spoke about some of the statistics, which I will come on to, and about how a dementia diagnosis can be a bleak prospect. He also spoke about some glimmers of hope for people with dementia and for us as a society—for instance, the fact that dementia can be preventable for some people; our growing understanding of the importance of brain health and how we achieve it; and the progress being made towards treatments that can genuinely make a difference in the future for people with dementia. I heard his specific question about the evaluation by NICE of the treatments and whether the evaluation approach is fit for purpose; I will come on to that shortly.
My right hon. Friend also talked about the importance of better and earlier diagnosis. Indeed, he mentioned that, at the moment, more than a third of people who have dementia are estimated not to have a diagnosis, although, clearly, the other side of that is that about two thirds of people do have a diagnosis. Although we know that the pandemic hit our ability to diagnose people, we have seen some recovery in the diagnosis rate since the pandemic. It is now at the highest level for three years. He rightly said that, overall, for this area, as for many others, prevention is at least as important as a cure. He spoke about the opportunity, in that dementia diagnosis should no longer be a life sentence for this generation, which is an uplifting prospect for all of us involved.
We also heard from the hon. Member for Oldham East and Saddleworth (Debbie Abrahams), who spoke about her experience with dementia and how she cared for her mother Angela when she had Alzheimer’s, until she died. I have huge respect for her, knowing how difficult that must have been. She is also extremely knowledgeable about dementia and spoke about the many different sub-types of dementia, and I thank her for her work as the chair of the all-party group on dementia.
The hon. Lady spoke about hospital stays for people with dementia; a significant number of people are in hospital with dementia. As part of my brief, I have oversight of discharges from hospital and urgent emergency care, and I have spent a lot of time thinking about the flow through hospitals. I think a lot about people with dementia and how we can support them to be discharged to the best place for their care afterwards, or how we can avoid long stays in hospital for them. It can then be so difficult for them to be discharged, given the potential deconditioning that happens to people in hospital.
The hon. Lady rightly talked about how dementia is now the No. 1 cause of death in the UK, but it should not be seen as inevitable for us as we age, and in an ageing society. I heard her three asks, calling for dementia to be diagnosed more often at an early stage; for us to do better at diagnosing sub-types of dementia; and for us to improve access to PET scans and lumbar punctures for diagnosis. I will come to some of those points in a moment. I can definitely agree with the Opposition spokesperson, the hon. Member for Bristol South (Karin Smyth), that we have heard speeches from formidable colleagues in the debate, as well as from a number of others who joined us and contributed through interventions.
I will start with the impact of dementia. We know that close to 1 million people in the UK suffer from dementia. Around 900,000 people over the age of 65 and almost 50,000 people under the age of 65 are estimated to have dementia. We expect those numbers to increase to more than 1 million by next year and more than 1.5 million by 2050.
The stats are one thing, and they clearly point to the scale of dementia in our society, but they do not necessarily bring to life the human cost of dementia—what it means for people who have it, their families and friends, what it means practically for someone with dementia and those close to them, and what the challenges are of living with dementia or caring for somebody with it. There are significant financial burdens, both on people working who are then diagnosed and may be unable to work, so they have lost income, and on carers, who may have to cut back their work hours or leave work altogether. There are then the financial costs of professional care, whether that is state-funded social care for those who receive it, or self-funded care.
Most significantly, there is the emotional cost of dementia—what the diagnosis means for the individual who learns what is making life so difficult for them and knows the prospects ahead as the disease progresses, what it means for those they love, and what the experience is like for people who are close to them and care for them. It can be very difficult to care for somebody while at the same time feeling as if the person they know and love is being stolen from them. That emotional cost is unquantifiable, but we know that it hits very hard.
Like other hon. Members, I feel that I have painted a pretty bleak picture of what dementia means to our society, but I have no doubt that there are real reasons for optimism. First, we now understand that a significant proportion of dementia—it is estimated to be around 40%—is either preventable or at least delayable, and that we can actually make a difference. Secondly, real progress is now being made in the research into treatments, and there is the prospect of treatments becoming available that will genuinely make a difference to the progress of the disease. There are real reasons for optimism, although, as a Government Minister, I feel that optimism on its own is not enough.
The question that I am sure hon. Members would like me to answer is what we are actually doing to realise this potential and turn the optimism into improved outcomes. To prevent and delay the onset of dementia, we are and have already been acting and intervening to influence the risk factors. We know that we can influence them. For instance, the known risk factors for dementia, similar to other conditions such as cardiovascular disease, include high blood pressure, obesity, diabetes, smoking, poor diet and lack of physical activity. These are things that we can and are intervening in.
For instance, we offer a health check for all adults aged between 40 and 74 in England to identify the early signs of stroke, kidney disease, heart disease, type 2 diabetes and, indeed, dementia. Dementia was incorporated specifically into that health check, in part to raise awareness of the fact that people can make a difference and reduce their risk of dementia, and to motivate people to take steps to reduce that risk. There is a much greater awareness that people can make a difference and reduce their risk of suffering from heart disease or diabetes. Alzheimer’s Research UK has found that about 70% of people know that they can reduce those risks, but less than a third of people know that they can reduce their risk of and prevent themselves from getting dementia. We have offered that health check to over 9 million people, and about 3.7 million people have had it already. We will continue to encourage people to take that up.
Looking ahead, there is more that we can, should and, indeed, will do to prevent people from suffering ill health, prevent dementia and help people to maintain their health. That is at the core of our major conditions strategy, to which my right hon. Friend the Member for Ashford referred. Crucially, that includes dementia, alongside the five other major conditions that represent the major burden of ill health in the country, including cancer and cardiovascular disease.
The hon. Member for Bristol South questioned the point of having a standalone dementia strategy. Actually, it is very important to include dementia with other major conditions and major causes of ill health, partly because we are moving towards having a society in which many people suffer from multiple health conditions. In fact, many older people will have dementia alongside other health conditions, so it makes sense to look at people’s health in the round, not just pick one condition.
As I mentioned a moment ago, dementia is a common risk factor for many major conditions, so it makes sense for our health system not to look at any condition in isolation, but to look at how we can improve people’s health in the round and reduce their risks. The major conditions strategy is absolutely the place where I point right hon. and hon. Members to look at our evolving Government strategy to address some of the health and lifestyle factors, to move into prevention and to support people in the event that they receive a dementia diagnosis.
The other area where there is cause for optimism is the progress that is being made in the research and development of new treatments. Finding a treatment to slow or, indeed, cure dementia, rather than just manage it, would change the implications of receiving a diagnosis and make such a difference to thousands or even millions of people in the UK and globally. This is a challenge that we share with many other countries, particularly those in the developed world, and we are rightly collaborating internationally on research.
Since 2018, the Government have spent over £454 million on supporting dementia research. In 2019, we made a manifesto commitment to double our funding for dementia research to at least £160 million a year. We have since launched the Dame Barbara Windsor dementia mission, backed by £95 million of Government funding. The UK Dementia Research Institute, of which the Government are a founding member, recently announced a new partnership with the British Heart Foundation to establish a centre for vascular dementia, backed by £9 million-worth of funding. Vascular dementia is the second most common form of dementia, affecting around 150,000 people in the UK. We are determined to be a world leader in dementia research and to be recognised as such.
I turn to some of the new treatments. My right hon. Friend the Member for Ashford referred to lecanemab and donanemab as two of the treatments about which there is great excitement. Crucially, the Government want to make sure that treatments are made available to people as soon as possible through the national health service. It is important to sound a note of caution, because we know that such treatments do not come without side effects; in fact, the trials saw some significant side effects, such as the risk of brain bleeds. As ever, it is very important that we follow the proper processes that we have in place to assess the use of treatments by the national health service. That includes both licensing through the MHRA and evaluation by NICE. For the two drugs I mentioned, those processes will happen during the course of this year.
My right hon. Friend asked what NICE takes into consideration in its evaluation. I can assure him and other Members that NICE takes into account all health-related costs and benefits, including the health benefits to carers of a treatment. It also considers the publicly funded cost of social care, so there is a social care element taken into consideration by NICE. I say that very specifically: I wanted to make sure, so I have double-checked in order to be accurate in saying it in this Chamber this afternoon.
I acknowledge and recognise the points that my right hon. Friend and others have made about the impact on unpaid carers and the economic cost. It is true that there is a limit to the costs that NICE considers. Clearly, looking at all the possible broader economic costs involved would have implications not only for dementia treatments but for the many other treatments that NICE considers. As that is a very big question, not just one that is pertinent to dementia, it is probably worthy of a separate conversation in its own right. Nevertheless, I assure him and other hon. Members here today that the publicly funded cost of social care is taken into account by NICE in its evaluation process.
There is also the question of the readiness of the national health service to make drugs available if they are successful through both the licensing process and the NICE evaluation. I assure hon. Members that NHS England is indeed working to ensure that the NHS is ready to support the adoption of new treatments, including the diagnosis processes that will be needed, while recognising—I believe the hon. Member for Oldham East and Saddleworth referred to this—that new treatments are likely to require greater access to forms of diagnosis such as PET scans and lumbar punctures, and also recognising that such treatments are likely to require earlier diagnosis in order to be effective.
One thing that I look forward to is that, particularly as treatments that require an earlier diagnosis become available, more people will come forward to seek a diagnosis, as they recognise that getting an earlier diagnosis will really make a difference, and then there will then be access to treatment. I feel optimistic that we will see a virtuous cycle where people learn that getting an early diagnosis can really make a difference in getting access to treatment.
Debbie Abrahams
I am reassured to some extent by what the Minister says, and I am grateful for her tone and her positive approach. Given the inequality—let us call it what it is—in current diagnosis, and these are non-specific dementia diagnosis rates, have she and her Department conducted any analysis of the gaps in more specific PET and CSF testing? Can she publish that data or write to us with it? That would reassure us, because rather than just hoping something will happen, we could identify it: “Yes, in Greater Manchester we are at 90% of the level we need for all these tests,” and similarly in Kent and so on. If she could do that, it would be very helpful.
Helen Whately
I fully appreciate the hon. Member’s question, and I can assure her that I do look at the variation in diagnosis rates between different areas, as she rightly pointed out in her speech. I would be happy to write to her with further detail on the specific question of more sophisticated diagnosis techniques and our readiness for new treatments and for carrying out earlier and more sophisticated diagnoses.
I assure hon. Members of the Government’s ambition for the UK to be a world leader in dementia research, diagnosis and treatment; I would also like us to lead the world in the prevention of dementia. That is why the Government are investing in research. We are getting ready to make new treatments available and building on what we are already doing in prevention with our major conditions strategy. Given the scale and impact of dementia on our society, successful prevention and treatment are not just a nice-to-have, but an imperative for individuals, for their families, friends and loved ones, and for our society.
Oral Answers to Questions
Helen Whately Excerpts(4 months, 2 weeks ago)
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Wendy Chamberlain (North East Fife) (LD)
The Minister for Social Care (Helen Whately)
When someone no longer needs to be in hospital, it is better for them and better for the NHS for them to go home. That is why we have been working hard to reduce delayed discharges, and we have been making good progress. In England, delayed discharges are down 13% since January, meaning thousands fewer people waiting in hospital and freeing up nearly 2,000 hospital beds every day.
Wendy Chamberlain
In my constituency of North East Fife, an average of 14% of social care and social work roles are filled when first advertised, but yesterday the Home Secretary announced plans to make it harder to recruit care workers from overseas. What assessment has the Minister made of the effect of that announcement on hospitals’ ability to discharge patients and free up hospital beds for those who need them?
Helen Whately
The hon. Member refers to yesterday’s announcement on migration. First, I am very grateful to all the international workers who come here to help in our health and social care system and to care for our loved ones. Clearly, we must get the balance right between migration and making sure that our health and care system has the workforce that it needs. That is what we are doing, both with the migration changes announced yesterday and with our reforms to the social care workforce to ensure that working in social care is appealing to home-grown talent.
Abena Oppong-Asare (Erith and Thamesmead) (Lab)
Thanks to their own internal chaos, the Conservatives have utterly failed in their promise at the last general election to fix the crisis in social care once and for all. We now have over 150,000 care vacancies and 390,000 care staff leaving their jobs each year, meaning that 60% of patients in England who are fit for discharge are being kept in hospital each day. Will the Minister therefore back Labour’s plan to deliver a fair pay agreement, with better terms, conditions, training and pay, to ensure that we have the staff required to care for all those who need it?
Helen Whately
Labour really have not got a leg to stand on when it comes to social care reform. They did not do anything the last time they were in government, and they still do not have a plan for social care. In government, we are reforming social care careers—[Interruption.] If the hon. Lady will take a look at what we are doing, we are introducing a new career structure for people working in social care, introducing new qualifications and investing in training for social care. We are doing what needs to be done to ensure that social care as a career works for UK workers. [Interruption.]
Madam Deputy Speaker (Dame Eleanor Laing)
Order. You won’t get your turn if you shout from there.
Catherine West (Hornsey and Wood Green) (Lab)
The Minister for Social Care (Helen Whately)
We know that winter is hard for the NHS, as it is for other health systems. That is why we started planning for this winter earlier than ever before—back in January, when we published our urgent and emergency care recovery plan, which funds more beds and new ambulances for our NHS, funds more social care in our communities, joins up care, and makes the most of technology, so that more people can get the care they need when and where they most need it.
Catherine West
Two accident and emergency departments serve patients in Hornsey and Wood Green. One is now serving double the number of visits by patients and is buckling under the pressure; and the other has seen 4,000 extra patients this year compared with last. What are the Government going to do about overcrowding in accident and emergency?
Helen Whately
The hon. Member is right that our hospitals are busier; we are seeing more patients in A&Es. That is why we are doing two things with our work on urgent and emergency care. One is providing more capacity—more hospital beds, more hours of ambulances on the road, and more capacity in social care to help with discharges. We are also doing things differently by seeing more people out of hospital, avoiding people coming to hospital unnecessarily, and providing more care at home; for instance, our 10,000 “hospital at home” beds are helping people recover at home, which is better for them and better for the system.
Will Quince (Colchester) (Con)
I know the considerable work the Department and NHS England have done preparing for winter. Given the importance of the NHS workforce, who do such an incredible job, and noting that there are still a few months to go, will the Minister update the House on the delivery of our manifesto commitment for an additional 50,000 nurses?
Helen Whately
I pay tribute to my hon. Friend for the excellent work he did as a Health Minister. It was a real pleasure to work alongside him and see what a difference he made for our constituents across the country. He asks a very good question about the work we are doing to increase the capacity of the NHS and ensure that it has the workforce it needs, including by delivering on our manifesto commitment to 50,000 more nurses for the NHS, which we have achieved.
Gareth Thomas (Harrow West) (Lab/Co-op)
One way the Minister could help Harrow’s health services be better prepared for this winter and future winters would be to invest in new intensive care beds at Northwick Park Hospital, which serves my constituents. Given that the Government have been told repeatedly that their promised 40 new hospitals are about as real as the Prime Minister’s meat tax, why do Ministers not invest in a hospital that actually exists and provide a new purpose-built intensive care facility at Northwick Park Hospital?
Helen Whately
I assure the hon. Member that we are investing in the national health service and, in particular, supporting it to prepare for this winter, ensuring there is more capacity in the system. There will be 5,000 more beds in hospitals around the country this winter, as well as 800 new ambulances on the road. But we are also doing things differently. The future of healthcare is not just about hospitals, but about caring for more people out of hospital. For instance, we are investing in proactive care, so that in every neighbourhood, the people who are more likely to go into hospital are known and reached out to, and the care is available for them. That is one of the things we are doing to ensure that people receive care when and where they need it.
Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
Sleaford and North Hykeham is a beautiful rural constituency, but living in a rural area means people are further from specialist medical services, which is a particular challenge in the winter months when the roads can be difficult to travel on. As the winter approaches, what is the Minister doing to ensure that constituents in rural areas are well looked after?
Helen Whately
My hon. Friend makes a very important point about the additional challenges in rural areas. I want to ensure that this winter people get care when they need it and get it faster. We are already seeing progress on that. For instance, we are investing in making sure there are more ambulance hours on the road, and we are seeing ambulances get to people quicker—in fact, this October, they got to people 20 minutes faster than last October. Ambulance handover delays are reducing and we are already seeing progress in A&E, where people are being seen faster, too.
Abena Oppong-Asare (Erith and Thamesmead) (Lab)
Under the last Labour Government, there was no winter crisis. Under the Tories, we have gone from no winter crisis, to an annual crisis, to a crisis all year around. Rather than tackling the crisis at source, this Government have only sticking-plaster solutions for a few months at a time. How will patients know that a winter crisis has been avoided if problems persist into the spring?
Helen Whately
I am really sorry, but the hon. Member’s memory appears to be very short. I was working in healthcare when there was a Labour Government and I remember very well problems for the NHS during winter. She does not even need to look back into the past; she can look at the Labour-run NHS in Wales, where they are having so much difficulty with A&E performance that they even fudged the figures and hid a whole load of patients so people would not notice what was going on.
Helen Hayes (Dulwich and West Norwood) (Lab)
Madam Deputy Speaker (Dame Eleanor Laing)
Order. Can Members please cut their questions in half? Otherwise, I will have to stop this questions session and people will not get a chance at all.
The Minister for Social Care (Helen Whately)
I would be delighted to meet my hon. Friend’s constituent. What the employer does is really important for retention and recruitment of adult social care staff, along with our ambitious workforce reforms for the care workforce.
Imran Hussain (Bradford East) (Lab)