Oral Answers to Questions

Jackie Doyle-Price Excerpts

Tuesday 7th May 2019 Commons Chamber

[Kate Green (Stretford and Urmston) (Lab)]

1. What steps his Department is taking to ensure that patients with no (a) fixed address and (b) proof of identity can register at GP surgeries.

[The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)]

We are very clear that GP surgeries cannot refuse to register somebody who is of no fixed abode or has no proof of identification. Where a practice does not properly provide correct access to vulnerable groups, the commissioner will intervene to ensure that it corrects that. Ultimately, the commissioner can issue a remedial notice and can terminate a contract or practice that still does not abide by its obligations.

[Kate Green]

Has the Minister seen the report by a mystery shopper from Friends, Families and Travellers who attempted to register with 50 GP practices without ID or proof of address? Twenty-four refused to register her or would not register her; all but two of those were rated outstanding by the Care Quality Commission. The Minister says GPs must properly follow the guidance, but does she agree that the CQC needs to ensure that it uses the inspection regime to enforce that guidance?

[Jackie Doyle-Price]

I totally agree. I have seen the report, which I welcome; I will certainly take it up with the CQC. It is very important that we use all tools to ensure that everyone has access to the healthcare they deserve, because it is all too easy for some groups to remain discriminated against. I am grateful to the hon. Lady for shining a light on this important issue.

[Andrew Bridgen (North West Leicestershire) (Con)]

We have one of the very few free at point of need health services in the world. Does the Minister agree, however, that checks are important in cracking down on health tourism? Does she have the latest assessment of the cost of health tourism to our NHS?

[Jackie Doyle-Price]

My hon. Friend is absolutely right—health tourism is a major cost to the taxpayer, so it is important that we establish that people are entitled to care. However, it is important to ensure that people without proof of ID and of residence are still entitled to healthcare. Where someone is not entitled to it, we will, of course, pursue them for payment.

[Grahame Morris (Easington) (Lab)]

2. What funding his Department plans to allocate to radiotherapy services in the next five years.

--- Later in debate ---

[Daniel Zeichner (Cambridge) (Lab)]

4. What discussions he has had with the Secretary of State for Education on the provision of NHS mental health services for university and college students.

[The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)]

The Secretary of State for Health and Social Care met the Secretary of State for Education in February to discuss concerns about mental health and the prevalence of self-harm among young people. “The NHS Long Term Plan” states that we will

“extend current service models to create a comprehensive offer for 0-25 year olds”,

and I expect to have regular dialogue with our counterparts in the Department for Education to make that a reality.

[Daniel Zeichner (Cambridge) (Lab)]

The all-party parliamentary university group has heard consistent evidence about the rising number of students presenting with mental health problems. We have been told that it has increased sixfold in the last 10 years, from 9,675 to 57,000. That poses huge challenges to what used to be counselling services but are now becoming a mainstream part of health provision, funded by universities. What are the Government going to do about it?

[Jackie Doyle-Price]

Young people often fall out of care when they leave their home addresses to go to university. To deal with that transition, we extended the service to nought to 25-year-olds through the forward plan rather than cutting it off at adulthood. That will ensure that we can do more to achieve continuity of care.

I pay tribute to the efforts that universities have made. They have seized on the challenge posed by the increasing prevalence of mental health problems, and I will continue my dialogue with them.

[Vicky Ford (Chelmsford) (Con)]

The students union at Anglia Ruskin University—which is based in Chelmsford as well as in that other “C” place, Cambridge—carried out a big study on student mental health. One of its requests was for students to be able to register with two GPs, one at home and one at university, so that they would not be stuck without a GP in the holidays or in term time. Can we look at that again?

[Jackie Doyle-Price]

I will definitely look at it. As I have said, the transition poses real challenges, because of a process failure rather than any lack of willingness or commitment on anyone’s part. We must ensure that people retain access to services as they move around.

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)]

The all-party parliamentary group on psychology, which I chair, heard just last week that young people who have done extremely well with child and adolescent mental health services are being put on waiting lists when they move away from home to colleges and universities, and are having to start again from the beginning. They are falling through the gaps. Will the Minister ensure that that does not happen any more, that there is no longer a postcode lottery, and that people who have done extremely well in getting into university receive all the support they need?

[Jackie Doyle-Price]

I see that there is a meeting of minds. Not only do I agree with what the hon. Lady has said, but I have met the hon. Member for Dewsbury (Paula Sherriff) to discuss exactly that issue. There is clearly a systemic weakness in respect of those who move between home and university, and we will continue our dialogue to ensure that it is fixed.

[Sir Vince Cable (Twickenham) (LD)]

The Minister will be aware of the close and often tragic link between mental illness and suicide, which is now the biggest killer of young people and is at record levels. What specific measures do the Government have to address that issue?

[Jackie Doyle-Price]

The right hon. Gentleman will be aware that we expect all local communities to have suicide prevention plans, part of which will be that they engage in areas of greatest risk, whether it be regarding place or their populations. Suicide is the biggest killer of young people and I expect local authorities to engage with education providers to make sure that sufficient measures are in place. We are in the process of challenging the plans to make sure they are fit for purpose.

[Paula Sherriff (Dewsbury) (Lab)]

Universities UK has warned that it simply cannot keep expanding to fill the gaps left by inadequate funding for NHS services, after university spending on mental health services rose by almost half in five years. Too often other sectors such as education are left to fill the funding gap this Government have left in mental health, so can the Minister tell me today when her Government will match our pledge to ring-fence funding for mental health?

[Jackie Doyle-Price]

I have always viewed the ring fence as a ceiling rather than a protection. We have the mental health investment standard and NHS England is challenging clinical commissioning groups that are not spending what we would expect.

This is a systemic weakness. We have treated children up to 18 and then considered them as adults, but the reality is that people do not suddenly achieve majority overnight. We intend through the forward plan to have the children and young people service from nought to 25. That should enable transition and stop people falling off the cliff edge at 18.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

5. What recent assessment he has made of the availability of prescription drugs.

--- Later in debate ---

[Gill Furniss (Sheffield, Brightside and Hillsborough) (Lab)]

11. What recent assessment he has made of the effect on patient outcomes of regional variations in mental health funding.

[The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)]

Funding allocations to clinical commissioning groups vary to meet the needs of local populations, including mental health needs. These allocations are determined by a formula managed for the NHS by the Advisory Committee on Resource Allocation. For mental health, the formula takes into account patient-level data covering community, out-patient and in-patient mental health services, as well as improving access to psychological therapies activity and hospital episode statistics.

[Gill Furniss]

One in three early intervention in psychosis services in the north of England does not meet the standard that NHS England expects. What is NHS England doing to end this postcode lottery and ensure that my constituents can access the same high-quality mental health services as people in other areas of the country?

[Jackie Doyle-Price]

The hon. Lady is right to highlight this. Good care depends not only on money but on performance, and we expect the Care Quality Commission to be very challenging in inspections so that we can guarantee consistency in the quality of services, rather than experiencing the postcode lottery she mentions. I am disappointed that the CQC rated Sheffield Health and Social Care NHS Foundation Trust as requiring improvement following the inspection in May and June last year, but we expect that challenge to continue so that there are obvious improvements.

[Steve Double (St Austell and Newquay) (Con)]

The additional money for mental health in the NHS long-term plan is very welcome, but does the Minister share my concern that it is essential that that money reaches the frontline and results in improved services and improved access to services? What steps is she taking to ensure this money does result in improved services?

[Jackie Doyle-Price]

My hon. Friend will know that, in addition to the additional £2.3 billion, we are clear that this money will lead to more rapid treatment. NHS England will also be giving a really direct challenge to clinical commissioning groups and trusts to make sure improved services are delivered on the frontline.

[Greg Hands (Chelsea and Fulham) (Con)]

12. What steps he is taking to increase the number of nursing associates in the NHS.

--- Later in debate ---

[David Duguid (Banff and Buchan) (Con)]

16. What steps his Department is taking to increase awareness of rare, genetic and undiagnosed conditions in mental health services.

[The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)]

Steps to increase awareness of rare conditions in care settings and speciality services, including mental health services, are being taken through the implementation of the UK rare disease strategy. The Department published an update to its implementation plan for achieving the commitments and strategy in England in February this year to coincide with Rare Disease Day.

[David Duguid]

I thank the Minister for her answer. Specific mental health problems are common symptoms of the genetic and often undiagnosed condition of 22q11.2 deletion syndrome and therefore many people with the condition need access to knowledgeable mental health services, but families often report being unable to get the support that they need. With Mental Health Awareness Week fast approaching, will the Minister meet me to discuss increasing awareness of 22q11.2 among NHS mental health practitioners and ensure that people with the syndrome can access the services that they need in all parts of the United Kingdom?

[Jackie Doyle-Price]

I thank my hon. Friend for his question. Of course I will be happy to meet him. He is right to identify the fact that people with long-term conditions are more likely to suffer from mental ill health. It is very important that we achieve good care co-ordination so that all those issues can be tackled in the round. We will continue to work to ensure that professionals are made aware of these conditions.

[Kerry McCarthy (Bristol East) (Lab)]

I have spent much of the past week supporting the parents of a child who has a very, very rare genetic condition and who now needs the support of child and adolescent mental health services. It has become very clear to me that CAMHS is set up only to deal with mainstream children who can go through perhaps its anxiety counselling courses and who can process information in a certain way. It does not seem at all geared up to help children who have very complex needs and perhaps learning disabilities. What can we do to make sure that those children who are more vulnerable are not left behind?

[Jackie Doyle-Price]

The hon. Lady is entirely right. I am particularly concerned about the impact on young people going through a period of mental ill health who have neurodiverse conditions and other conditions. It is very important that we tackle the entirety of the individual’s need. Clearly, we need to do more to make sure that all children with whatever conditions can access help when they need it.

[Mr Speaker]

My ambition is to reach Question 17 so that the House, Mid Sussex, the nation, the European continent and the world can hear the right hon. Member for Mid Sussex (Sir Nicholas Soames).

--- Later in debate ---

[Antoinette Sandbach (Eddisbury) (Con)]

18. What steps he is taking to promote stem cell donation.

[The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)]

Since 2011, the Department has provided more than £26 million to NHS Blood and Transplant and to Anthony Nolan, to improve stem cell donation, and is now establishing a unified UK stem cell registry. I would also highlight the inspirational work of Team Margot, who are working to increase the number of people on that stem cell register by enrolling themselves in the transatlantic rowing race. I urge all hon. Members to support that campaign.

[Antoinette Sandbach]

I hope the Minister will join me in praising my constituent Peter, who has myeloma and set up the “10,000 donors” register. There are now 22,000 donors registered, but Peter has a rare ethnic mix of English, Irish, Chinese and Portuguese. What more can be done to encourage donors from minority communities?

[Jackie Doyle-Price]

My hon. Friend is absolutely right. We have spent a lot of time encouraging donors from minority communities, but the real issue with regard to stem cell donation is that it is about genetic composition. We live in a wonderful society where we all have heritage going back in various, very complex ways, but that makes finding a suitable donor for stem cell donation extremely difficult. It is therefore important that we encourage people to take the test to establish their genetic heritage so that we can have more and more diverse people on the register.

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

20. What recent steps Public Health England has taken to help ensure that the violence against women and girls service commissioning guidelines are implemented throughout the NHS.

[The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)]

I thank my hon. Friend for her important work on the whole issue of violence against women and girls. Clinical commissioning groups are the primary commissioners of NHS services, and, as such, play the lead role in ensuring that service commissioning guidelines on violence against women and girls are implemented through the NHS, as informed by evidence available and current guidance.

[Sarah Newton]

Public Health England is planning to update the public health outcomes framework this summer, but there are no planned outcome measures for victims of domestic abuse or sexual violence. Will my hon. Friend liaise with the Home Office and the clinical commissioning groups to consider measures so that we can all be confident that victims are getting timely access to appropriate services?

[Jackie Doyle-Price]

My hon. Friend is knocking on an open door, because this issue is very close to my heart. The public outcomes framework does include a measure of reported domestic abuse incidents and crimes that is intended to give an indication of the scale of the issue in each area, and we expect CCGs to commission services as a response to exactly those issues. I have written to CCGs to remind them to commission appropriate sexual violence services, as well as those already commissioned by NHS England so that we have proper support for people who have been victims of these terrible offences.

[Mr Laurence Robertson (Tewkesbury) (Con)]

T1. If he will make a statement on his departmental responsibilities.

--- Later in debate ---

[Kate Green (Stretford and Urmston) (Lab)]

T3. Maternity Action reports that migrant women requiring maternity care from NHS hospitals are being deterred from receiving treatment by charges and fear of immigration sanctions. Will the Secretary of State meet me and campaigners to discuss what we can do to address that worrying situation?

[The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)]

The issue that the hon. Lady raises is very concerning. I would be more than happy to meet her to look at that.

[Martin Vickers (Cleethorpes) (Con)]

T9. Some 1,486 of my constituents have been diagnosed as suffering from dementia. The Alzheimer’s Society is urging that, to provide the best support and care, carers should have tier 2 training. Is the Minister doing everything possible to achieve that?

--- Later in debate ---

[Bill Esterson (Sefton Central) (Lab)]

T8. Tens of thousands of children are born every year with brain damage as a result of pre-natal exposure to alcohol, yet most clinical commissioning groups are not providing support for those with foetal alcohol spectrum disorders, despite Government guidance telling them to do so. Will the Government take the action needed and provide support for those suffering with this life-limiting and lifelong condition?

[Jackie Doyle-Price]

The hon. Gentleman is right. Foetal alcohol spectrum disorders are not sufficiently widely understood across the NHS. We must ensure that we give support to those who are affected and also raise awareness, not least to encourage people to understand the risks they are taking when they drink alcohol during pregnancy.

[Mr Steve Baker (Wycombe) (Con)]

Over many years, High Wycombe has established a dramatic way to help tackle obesity. To that end, a week on Saturday, the mayor, a number of councillors and I will be weighed in public, to check whether we have put weight on at taxpayers’ expense. If the Government wish to extend that programme to other Members of the House, I will be happy to ask to borrow the weighing tripod.

--- Later in debate ---

[Emma Hardy (Kingston upon Hull West and Hessle) (Lab)]

As the Minister is aware, I have become concerned about the rising number of suicides in my constituency. When I talk to professionals in the area, they tell me that it is not just funding that is causing some of the problems but the lack of staff. What more can the Minister do to ensure that we have the mental health staff that we desperately need?

[Jackie Doyle-Price]

I am grateful to the hon. Lady for raising that. She is right to do so. We are aware of some of the specific issues in her constituency, and I look forward to visiting and taking up some of the discussions directly.

[Rachel Maclean (Redditch) (Con)]

The Secretary of State has been kind enough to visit Worcestershire Royal Hospital, which serves people in my constituency. He saw for himself how small the emergency department is there. With £20 billion going into the NHS, does he agree that there is a good opportunity to look again at returning services to Redditch—in particular, the maternity and A&E departments, which have been removed?