Breast Cancer Screening

Huw Merriman Excerpts

Wednesday 2nd May 2018 Commons Chamber

[Mr Speaker]

The hon. Member for Bexhill and Battle (Huw Merriman) will be a master of the pithy question because he was educated magnificently in my own constituency.

[Huw Merriman (Bexhill and Battle) (Con)]

And I am very proud to have been.

The Secretary of State knows well and cares deeply about safety matters. As he also knows, I have spent too much of my time with the clinicians in the cancer centres of Maidstone and Tunbridge Wells. Will the review perhaps look at administrative and back-office resources and at whether they play any part in improving survival rates?

[Mr Hunt]

The whole House is thinking of my hon. Friend who, like many people in this country, is going through a huge amount of personal pressure as cancer strikes close to home. He is right that back-office systems are often poor when it comes to contacting patients, which is in contrast to the superb clinical care that we are usually able to offer, so we will absolutely consider that as part of the review.

NHS Staff Pay

Huw Merriman Excerpts

Wednesday 21st March 2018 Commons Chamber

[Mr Hunt]

I recognise that there have been pressures on the CPD budget, and that is because we have made increasing the number of nurse training places our main priority. We have increased that by 25%, which has meant that difficult decisions have had to be made about other parts of the budget. I can reassure the hon. Lady, however, that I think that CPD will continue to have a vital role, and we will need to return to the issue.

[Huw Merriman (Bexhill and Battle) (Con)]

Efficiency and productivity deserve to be rewarded, and, given the 16% increase in emergency admissions, NHS professionals have certainly earned that. In the light of this new working relationship, does the Secretary of State envisage staff and the Government working in partnership to challenge patients to be more respectful to those who work in the health service?

[Mr Hunt]

I thank my hon. Friend for making that point. He often raises difficult issues that need to be talked about in this place. We all know that the vast majority of patients are incredibly grateful for the care that they receive from NHS professionals, but occasionally that does not happen. Occasionally, people use services that they do not need to use, which creates pressures and denies other patients what they do need. My hon. Friend is absolutely right that as we start to expand NHS capacity, we need the public to understand their responsibilities as well.

Oral Answers to Questions

Huw Merriman Excerpts

Tuesday 20th March 2018 Commons Chamber

[Caroline Dinenage]

We know that the sector is under pressure because of the ageing population, but the Government have given councils access to £9.4 billion more dedicated funding over three years. The hon. Lady is right to emphasise the importance of putting power back in the hands of residents and their families, which is why we published a package of measures to ensure and protect consumer protections in the social care sector, and we will continue to look at that very closely.

[Huw Merriman (Bexhill and Battle) (Con)]

6. What progress his Department is making on reforming the provision of social care.

[The Secretary of State for Health and Social Care (Mr Jeremy Hunt)]

This afternoon I will make a speech setting out the principles with which we will approach the social care Green Paper, including a focus on the highest standards of care, integration of the health and social care system and developing a long-term sustainable funding solution.

[Huw Merriman]

Given that the arithmetic of this place is so tight, it is clear that there will need to be some form of cross-party consensus for any meaningful reform. Given that the Opposition appear to favour a wealth tax and our party has mooted the idea of individuals paying more for their own care, surely cross-party consensus is within reach; what is the Secretary of State’s view on that?

[Mr Hunt]

My hon. Friend always speaks very thoughtfully on this matter, and it is important, because social care issues will continue for decades ahead unless we find a solution and both parties will have to deal with this issue in government. In truth, both parties have made things worse by politicking in the past, whether by discussion about a death tax in 2009 or a dementia tax in 2017.

Mental Health Act: CQC Report

Huw Merriman Excerpts

Tuesday 27th February 2018 Commons Chamber

[Huw Merriman (Bexhill and Battle) (Con)]

It is absolutely essential that every one of us should challenge the system to give more, but could we also talk up progress where it has been made? The Sussex partnership has had a difficult past, but it has gone from being rated as requiring improvement to being rated as good, and one of its categories has been rated as outstanding. Can we praise the staff who are doing things well?

[Jackie Doyle-Price]

We absolutely should do that. I often think that when we are challenging each other in this place about things that are poor, we end up talking our services down, but it remains the case that the NHS is the best health service in the world, and we should always celebrate that fact. Also, the fact that we are putting mental health services under such scrutiny is in itself driving an improvement in performance, because, as we all know, sunlight is the best disinfectant.

Medicines and Medical Devices Safety Review

Huw Merriman Excerpts

Wednesday 21st February 2018 Commons Chamber

[Mr Hunt]

I totally respect the right hon. Gentleman for airing his constituents’ concerns, but, as he will know from my answers to earlier questions, the difficulty in the case of Primodos—and this is incredibly distressing for the families involved—is that scientists do not agree about the issue, and as a result we do, unfortunately, find ourselves having to review what has happened. The review conducted by the expert working group was our first attempt. We are now giving Baroness Cumberlege a free hand to consider that and any other evidence that has come to light, and to draw her own conclusions.

[Huw Merriman (Bexhill and Battle) (Con)]

Just an hour ago I met my constituent Carol Short and Emma Friedmann, a constituent of the hon. Member for Leicester South (Jonathan Ashworth), to discuss the next stage of the valproate campaign, but because of the statement, that meeting was adjourned. I am happy that they are now in the Chamber, and I am sure that they are pleased to hear about the review.

Is it possible to ensure that GPs are giving out the excellent advice that the Medicines and Healthcare products Regulatory Agency has put together? I am sorry to say that it seems that far too many are not, and there appear to be no regulatory sanctions to ensure that they do.

[Mr Speaker]

Order. I mean no discourtesy to the hon. Gentleman, but I hope that the people whom he mentioned are in fact in the Gallery rather than in the Chamber. That would be greatly reassuring to us, and quite possibly to them.

Oral Answers to Questions

Huw Merriman Excerpts

Tuesday 6th February 2018 Commons Chamber

[Steve Brine]

As the hon. Gentleman knows, there are a record number of training places. We know that one of the main reasons why GPs leave general practice is retirement, which is why we have put in place comprehensive measures to ensure that we meet our commitment to deliver an extra 5,000 GPs in the NHS by 2020. GP career plus, the GP retention scheme and the national GP induction and refresher scheme will all help get to valuable experienced GPs back into our NHS, doing the valuable work our constituents so benefit from.

[Huw Merriman (Bexhill and Battle) (Con)]

14. What steps he is taking to increase the capacity and availability of GP services.

[The Parliamentary Under-Secretary of State for Health (Steve Brine)]

We recognise the acute shortages in general practice, which is why we remain, as I said in my previous answer, committed to delivering the additional doctors in general practice by 2020. Millions of patients have already benefited from being able to access evening and weekend GP appointments. We expect everyone in England to have access to this by March 2019.

[Huw Merriman]

I am fortunate to work very closely with the GPs in my constituency. It would be appear that, for a variety of reasons, younger GPs are not as likely to buy into the partnership model as their predecessors. Does the Minister agree that we need a mixed model of both private partnership contractor and direct NHS state provision if we are to get GPs to the places where the public need them?

[Steve Brine]

My hon. Friend works very closely with the GPs and commissioning groups in his constituency and they value him greatly as a local MP. We back the partnership model. As the Secretary of State said last month at the Royal College of General Practitioners, we believe in its many benefits as the cornerstone of primary care. That is why we are embarking on a new piece of work to explore other models with the British Medical Association and the RCGP, which have kindly agreed to work with us on this, and to look at the partnership model in the context of primary care at scale.

NHS Winter Crisis

Huw Merriman Excerpts

Wednesday 10th January 2018 Commons Chamber

[Dr Whitford]

There will obviously be lots of bandying around of figures, and talking about the four-hour target and the achievements and the numbers, and, as I have said, it serves as a thermometer to look at the entire system from the patient turning up at A&E to their going home. That is what this is a measure of, and it is there to flag up concern. While we will be getting that data, we do not need it; we have already seen ambulances 12-deep, and have already heard that 75,000 patients are stuck in ambulances for between half an hour and an hour, and 17,000 stuck for more than an hour. As was mentioned by the right hon. Member for North Norfolk (Norman Lamb), who is no longer in his place, this means that those ambulances are not available to respond to other 999 calls, which endangers patients.

[Huw Merriman (Bexhill and Battle) (Con)]

I think the hon. Lady for giving way, and I apologise if she was still answering the point made by the hon. Member for Dewsbury (Paula Sherriff). I accept her point that many of those who are in A&E need to be in A&E, but the reality is that admissions to A&E have gone up 20% over the past 10 years to 6 million per year. Does she agree that more interventions could be made by GPs to prevent some of those admissions from being made and to allow people to be looked after in their own homes?

[Dr Whitford]

I am not 100% sure whether the hon. Gentleman meant attendances at A&E or admissions, which is what he said—

[Huw Merriman]

Attendances.

[Dr Whitford]

Attendances at A&E tend to be higher in the summer, when kids are on bikes and trampolines, and up trees. It is admissions that are higher in winter, when A&E is dominated by people who are sick. Of course we want primary care and the 111 system to work, so that people do not use A&E as a first port of call, but the problem comes when that all gets too complicated and patients cannot work out where they should go. That is when they go to A&E. It is important to make it really clear where they should go to address which problems.

Having seen the crisis last year, when there was no flu, snow or ice to blame, I believe that there are underlying structural problems. The target was met comfortably until 2013, when the Health and Social Care Act 2012 changes kicked in and NHS England started to become fragmented and to be based on competition instead of co-operation. I would welcome the establishment of a cross-party group here to work on this, so that we did not always have to have these debates, but it would have to look at the structure and unpick what has been done to NHS England in the past four and a half years. Carrying on breaking it apart will not provide a solution.

--- Later in debate ---

[Huw Merriman (Bexhill and Battle) (Con)]

It is a pleasure to follow the hon. Member for Crewe and Nantwich (Laura Smith) in this important debate on the NHS and the challenges that, unfortunately, it tends to face in winter. We should bear in mind that, for decades, winter has given the NHS challenges to meet, and as a result, clinicians have been asked not to take time off in January. Last Friday, I spent time with a GP practice, where staff confirmed that the flu epidemic is one of the worst they have seen for many years.

From the perspective of patients, it is wrong that those who have waited months for surgery—perhaps routine, but for a condition that has an impact on their lifestyle—have been told that it has been cancelled. We need to change, but I believe we need to change the entire structure. It is all very well and good for the Opposition to write cheques that they know would bounce. What we have to do is reform the NHS within the resources available. We also have to consider the impact of the ageing population and the challenge—which we embrace, of course—of looking after them. In the last decade, 17% of this country’s population was over 65; in the present decade, the proportion rises to 20%; and in the next decade, it will be 30%. That might be why the number of hospital admissions has risen by 40% over the past 10 years. I am delighted therefore that the Department of Health is now responsible for social care, and particularly reform to it; that is long overdue. We need a cross-party approach. I am aware that every governing party tends to say that, but I would ask Opposition Members to please rally round. There are some great ideas that we can all get around.

I want to focus on the pressures facing GP surgeries and the pressures that puts on our hospitals. Too many patients are going to A&E because their GP surgery is not there for them. I spent some time with a GP who had just returned from visiting a patient he had made comfortable at home. He pointed me to another area my hospital trust covers where that patient would have been put into hospital for some weeks, which would not have been good for the patient or all those other patients waiting for their care. We have seen huge demand from the elderly. I am still greatly concerned that the social care system is set up on a local authority basis. Many local authorities to which people retire do not have the same business rates as other areas—they have a lot of elderly folk but not the business to fund them—and certainly not as much council tax. In looking at reforms, I would like the Government to consider putting social care on the same footing as the central NHS.

[Kevin Foster (Torbay) (Con)]

Will my hon. Friend give way?

[Huw Merriman]

I will not, I am afraid, because of time. I am sorry.

I would like to see more powers given to CCGs, or perhaps a tier above, to enable them to intervene where GP surgeries are not functioning as they should be. At the moment, there is no sharing of data, so CCGs cannot see where surgeries might be about to fall over. We expect CCGs to intervene and take over when things go wrong, but that is often too late, so I would like to know if more taskforces could be put in place. It is clear that the GP model that we have continued with since 1947 is not the GP model that younger GPs want to buy into: they do not necessarily want to buy into the practice model, are concerned about litigation and do not necessarily want to stay in the same place for all those years. We need great reform, therefore, and I add my support to the voices on both sides of the House saying that perhaps a royal commission is the way to take this forward.

NHS Winter Crisis

Huw Merriman Excerpts

Monday 8th January 2018 Commons Chamber

[Mr Dunne]

As I have tried to explain to the House, the preparations began earlier, have involved more alternative measures than ever before and have been accompanied by considerable resource allocations right across the country, including, I think, £3.4 million to the hon. Lady’s area.

[Huw Merriman (Bexhill and Battle) (Con)]

Our fine GP surgeries around the country are facing the challenge of their neighbouring practices not being as well run, while many practitioners are choosing to retire because of our pension rules. Is it now time for the state to step in and provide practice where the private area will not cover?

[Mr Dunne]

Clinical commissioning groups have a responsibility to provide cover in every area, so if a practice does close, it is up to the CCG to ensure alternative provision. That responsibility is part of the NHS mandate and remains with it.

Oral Answers to Questions

Huw Merriman Excerpts

Tuesday 19th December 2017 Commons Chamber

[Mr Hunt]

We are having fruitful and productive discussions about productivity with the “Agenda for Change” unions, including the Royal College of Nursing. We are looking at all sorts of things, including how the increments system works. I am hopeful that we will have a win-win: a modern contract that is fit for the future for “Agenda for Change” staff and that also allows us to go beyond the 1% cap, as the Chancellor has authorised me to do.

[Huw Merriman (Bexhill and Battle) (Con)]

Of course, this is not just about funding. The Secretary of State recently wrote to East Sussex Healthcare NHS Trust to recognise the fact that its A&E department was the most improved in the past six months. When I spoke to the chief executive, he said that the management focus on targets and delivery against them was the reason why that turnaround has occurred.

[Mr Hunt]

I met the chief executive in person last week and was able to congratulate him on several important changes that are happening. He will be pleased that we were able to find £1.9 million more for East Sussex in the Budget. My hon. Friend is absolutely right that it is not just about money. The difference between the Government and the Opposition is that they say it is all about money whereas we know that quality of leadership makes a critical difference in turning around our hospitals to make them the best in the world.

Autism Community: Mental Health and Suicide

Huw Merriman Excerpts

Thursday 30th November 2017 Commons Chamber

[Huw Merriman (Bexhill and Battle) (Con)]

It is a pleasure to follow the hon. Member for Bristol West (Thangam Debbonaire). She talked of having a constituency surgery exclusive to those who are on the spectrum. I actually had that pleasure last week, although it was not something that I fixed. It was just that everyone who booked an appointment had issues and was on the spectrum. That is telling about how much pressure MPs rightly face from our constituents who have such huge challenges.

I thank the hon. Member for East Kilbride and other parts of her constituency that are harder to say for securing this debate. It is a real pleasure to have the debate, because it is timed very well, coinciding with a report that has been published by the all-party parliamentary group on autism entitled “Autism and education in England 2017”. The report is particularly relevant because, when it comes to mental health and those on the autism spectrum, I am afraid to say that much starts to go wrong in schools, which are still not equipped to deal with the many people who face complex issues that arise from autism.

It was a pleasure for me to co-chair the parliamentary inquiry that led to the report with my constituency neighbour, my hon. Friend the Member for Lewes (Maria Caulfield). We had three inquiries in Parliament, and we heard from young people on the spectrum, parents and educational experts about where things were not working and where they could work better. The report is a positive one that discusses what could be done better, and that is not just down to money; it is a question of sharing best practice. Unfortunately, the reality of the current situation in schools is that less than 50% of the thousands of people who responded to our request for information felt happy at school, which meant that they felt uncomfortable at school. Fewer than 50% of teachers felt that they were equipped to deal with pupils who have autism. A lot of this comes down to a lack of training that many teachers have.

It is fantastic that the Government will ensure that initial teacher training includes autism awareness, but there are many teachers—including headteachers—who have already been through teacher training and are now teaching in schools but do not have sufficient understanding of the needs of autistic children. That can go wrong for the autistic child, and indeed their parents, by leading to exclusion. Of course, exclusion then leads to isolation, and isolation leads to mental ill health and, dare I say it, suicide. That is where we can do better. Unfortunately, an autistic child at school is three times more likely to be excluded than those who are not on the spectrum.

We need more training in schools and better sharing of good practice. It should not just be the case that specialist schools have all the expertise. If 70% of all pupils who are on the spectrum are in mainstream schools, we need the specialist schools to share what they know with the mainstream schools. Only when we start to tackle that will we actually do better.

I was delighted that the Government welcomed the report. We are now very much looking for them to support the recommendations in it. It will be launched by the all-party group at the beginning of next year, and I very much hope that all right hon. and hon. Members who are here today will come along and support us.

In the time I have left, I want to touch on the many challenges faced by those who have left the school system and are now in the workplace. One of the people who came to my constituency surgery last week wanted to talk about the struggles he has connecting with his jobcentre. I have committed to go along with him, meet the new work coaches we have through the roll-out of universal credit, see the application process and see how he can follow it through.

I am particularly pleased that the Government are now looking at tailoring support for those struggling to enter the workplace, recognising that those left seeking jobs have individual needs, and are looking to ensure that individual specialists are in place in jobcentres, including those ready to help people with mental health difficulties.

I want to again ring the bell for what we can do better in schools, so that we can support them to make sure that the issue of mental health for those on the spectrum is recognised. We must also absolutely believe that we can all do better, across parties.