Oral Answers to Questions

Jackie Doyle-Price Excerpts

Tuesday 10th October 2017 Commons Chamber

[Paul Masterton (East Renfrewshire) (Con)]

4. What discussions he has had with the Medicines and Healthcare Products Regulatory Agency on transvaginal mesh implants.

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

My colleague, Lord O’Shaughnessy, met the MHRA on 27 September to discuss this very important issue. The Department will have further discussions with NHS England on the support given to patients who have suffered due to this procedure and has asked the regulator to work with the clinical community to assess the associated risks and whether alternative treatments offer better outcomes for patients.

[Paul Masterton]

Thousands of women across the country, including my constituent Elaine Holmes, the co-founder of the Scottish Mesh Survivors group, have to live with the catastrophic consequences of transvaginal mesh implants. With health regulators across the globe now waking up to the scandal and issuing alerts or deregistering mesh devices, will Ministers join me in urging the MHRA immediately to reclassify this damaging procedure as high risk?

[Jackie Doyle-Price]

I thank my hon. Friend for his work in this area. I fully sympathise with anyone who has suffered complications as a result of these devices, but we do not currently have enough evidence to warrant our asking the MHRA to reclassify these procedures, and this is a view shared by other regulators across the world. I can advise him, however, that the National Institute for Health and Care Excellence strongly recommends that mesh implants not be routinely offered for the first surgical intervention on prolapse. That guidance is being updated—publication is due at the start of the new year—and will include an overarching document that looks in depth at the devices and the conditions surrounding the need for them, as well as the treatment of complications, to support better health outcomes.

[Karin Smyth (Bristol South) (Lab)]

A constituent came to my surgery to explain how this has impacted on her life. It is truly harrowing. I understand that NHS England has set up 17 regional teams to look into this. I want to be able to assure my constituent that the voice of women and how this is impacting them on will be considered. I would be grateful if the Minister could respond so that we might understand what the future holds.

[Jackie Doyle-Price]

I am absolutely aware that many women experience substantial side effects and complications following this procedure. Equally, however, many women also experience considerable relief from symptoms. We need a good review of the evidence to make sure that we adopt this procedure only when it fully suits women and that women understand the risks associated with the procedure. But I fully sympathise with the hon. Lady’s constituent.

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

It is deeply worrying, though, that this procedure was introduced with so little evidence to support it. I think we all have to agree it has led to unacceptable complication rates for certain products. Will the Minister heed the words of Professor Heneghan and hold a public inquiry into the numbers of women adversely affected and why the safety of so many women was disregarded?

[Jackie Doyle-Price]

I say again that many women have received relief from their symptoms following this procedure, but we need more evidence before we can properly review it, so it is important that we allow NICE to undertake its work so that we can take a clear view. Any procedure comes with risk—no surgery is without it—but obviously the more evidence we can gather, the better we can advise women of those risks.

[Rebecca Pow (Taunton Deane) (Con)]

5. What plans he has for the implementation of the NHS’s five year forward view for mental health.

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

We are making good progress on the implementation of the five year forward view for mental health. We have published a workforce plan and invested more money than ever before, and we are providing care to 120,000 more people this year compared with 2013.

[Rebecca Pow]

The charity Mind recently produced a report called “Feel better outside, feel better inside”, which advocated the benefits of eco-therapy—using activities such as gardening, farming and exercise. The National Garden Scheme has also produced a publication on this. Is the treatment being utilised within the NHS?

[Jackie Doyle-Price]

I thank my hon. Friend for her work in this area. Yes, I can give her that assurance. It is welcome that local authorities and clinical commissioning groups are considering innovative approaches concentrating on wellbeing, as well as acute services, and eco-therapy is part of that agenda.

[Anna Soubry]

I am sure that you, Mr Speaker, and the rest of the House will send their condolences to the family and friends of Rebecca Nevin, a constituent of mine who died aged 32 after many years of poor mental health and an addiction to alcohol. Her father, Stephen, like many parents of adult sufferers of poor mental health, felt largely excluded by health professionals. Does my hon. Friend agree that we need health systems and workers who maintain patient confidentiality while recognising and acting on the genuine concerns of parents of adults?

[Jackie Doyle-Price]

I am sure that we are all very sorry to hear of the death of my right hon. Friend’s constituent, and we send our condolences to her family. It is extremely difficult to balance patients’ right to confidentiality with the needs and requests of their families, and we will study any recommendations that emerge from the coroner’s investigation.

[Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)]

I heard what the Secretary of State said about funding earlier, and what the Minister said a moment before. However, I sent freedom of information requests to every CCG in the country, and found for the second successive year that more than half of them are not increasing the proportion of their budgets that they spend on mental health. That flies in the face of a commitment made by the Secretary of State at the Dispatch Box, and it flies in the face of the spirit of the Five Year Forward View for Mental Health. On World Mental Health Day, will the Minister, along with the Secretary of State, commit herself to ensuring that we ring-fence the money that they say is available for mental health?

[Jackie Doyle-Price]

On World Mental Health Day, I can confirm that we are spending £574 million more on mental health this year. It remains our principle that decisions should be made locally by CCGs, but we have very clear expectations of them, and they will be held to account via inspections.

[Norman Lamb (North Norfolk) (LD)]

The ‘Five Year Forward View’ suggested that the Government accepted the case for comprehensive maximum waiting time standards in mental health to match those in physical health. Given that children throughout the country are routinely waiting for months to start their treatment, may I ask what progress the Government are making with the introduction of a maximum waiting time standard for children’s mental health?

[Jackie Doyle-Price]

The right hon. Gentleman has raised an excellent point. Our Green Paper on children and young people’s mental health will address exactly those issues. We have made clear that we will tackle mental health through early intervention, and early intervention for children and young people is central to that.

[Thelma Walker (Colne Valley) (Lab)]

6. What recent assessment he has made of trends in staffing levels in the NHS.

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[Catherine McKinnell (Newcastle upon Tyne North) (Lab)]

7. What steps his Department is taking to improve end-of-life care.

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

By 2020 we want significantly to improve patient choice in end-of-life care. The Government’s end-of-life care commitment sets out exactly what everyone should expect. In September we published a report on the good progress that we have made over the first year.

[Catherine McKinnell]

The End of Life Care Coalition has said that it remains deeply concerned about the enduring gap in resources for community-based health and social care services. Meanwhile, Together for Short Lives continues to highlight the unacceptable postcode lottery faced by 40,000 children with life-limiting conditions. What is the Minister doing to ensure that all clinical commissioning groups and sustainability and transformation partnerships will meet the Government’s requirements in full for both children and adults by 2020?

[Jackie Doyle-Price]

I thank the hon. Lady for her question, and I know that she, through her role on the all-party parliamentary group for children who need palliative care, will continue to hold me to account on these commitments. We did look at the work undertaken by Together for Short Lives to improve end-of-life care for children, which does require special attention—she is quite right to raise that. NHS England recently co-hosted a policy summit with Together for Short Lives, and I will be meeting it next week to discuss that further. We are also engaging local sustainability and transformation partnerships to support planning for end-of-life care, and helping all trusts to develop and improve their services. This work is ongoing, but it remains a key priority.

[Will Quince (Colchester) (Con)]

When it comes to baby loss, the end of life can often be sudden and unexpected. In this Baby Loss Awareness Week, will the Minister join me in welcoming the launch of the national bereavement care pathway, and pay tribute to Sands, baby loss organisations and charities, the APPG and the former Care Quality Minister, Ben Gummer, who did so much to make it happen?

[Jackie Doyle-Price]

I am of course happy to join my hon. Friend in congratulating those organisations and thank him for all the work that he has done. The 11 pilots launched only last month are very much down to his work and that of hon. Members across the House, who have done so much over the past year to raise awareness of the issue.

[Tony Lloyd (Rochdale) (Lab)]

Many people would prefer to die at home, but that is actually very difficult to achieve, not only because of the lack of support for Macmillan nurses, for example, but because, frankly, of the reluctance of the authorities to effect a speedy transition to a home base. What can the Government now do to ensure that dying at home is a real option?

[Jackie Doyle-Price]

The hon. Gentleman is quite right: many people would elect to die at home, if the opportunity were available. We need to ensure provision to allow people to do that, if that is their choice, because we should be supporting people to honour their choices at the end of their lives, and it enables us to treat more people in hospitals and hospices.

[Maggie Throup (Erewash) (Con)]

Hospices, such as Treetops Hospice Care in my constituency, provide outstanding end-of-life care. Although these services benefit from generous charitable donations that enable them to operate on a day-to-day basis, what more can the Government do to help support hospices when capital investment is needed to improve the current setting of new build?

[Jackie Doyle-Price]

One of the strengths of our hospice movement is that it relies heavily on charitable donations, which shows that people are generous and that they want to support good, locally focused care. However, CCGs should look at where they can support hospices with their care costs, and we will certainly consider including that in the end-of-life care programme.

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[Preet Kaur Gill (Birmingham, Edgbaston) (Lab/Co-op)]

15. What estimate he has made of the number of people living with unmet social care needs.

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

By passing the Care Act 2014, this Government established a national eligibility threshold that defines the care needs that local authorities are required to meet. This eliminates the postcode lottery of eligibility across England. Social care continues to be a key priority for this Government. That is why local authorities in England will receive an additional £2 billion for social care over the next three years. In the longer term, we are committed to establishing adult social care on a fair and more sustainable basis.

[Preet Kaur Gill]

Age UK estimates that nearly 1.2 million older people have unmet care needs. After the Government dropped their disastrous dementia tax policy during the general election, all they can offer people is yet another consultation. In the words of the hon. Member for Totnes (Dr Wollaston), the Chair of the Health Committee, is it not time the Government just got “on with it”?

[Jackie Doyle-Price]

I do not recognise Age UK’s assessment of unmet need. As I said, the requirements are enshrined in statute and local authorities should be held to that. In response to the hon. Lady’s final point, let me say that we are getting on with it, but we need a real cultural change in how we tackle these issues. There is a long-term issue to address in the fact that we are all living longer. This is not just going to need a sticking plaster; we will need to take the public with us. So this is not just another consultation; it is a vehicle for making sure that we as a society tackle this issue once and for all.

[Derek Thomas (St Ives) (Con)]

The Royal Cornwall Hospitals NHS Trust was put into special measures last week, but delayed discharge caused by unmet social care needs contributes to the pressure in the trust. I welcome the £12 million that was awarded to the council this April to address that, but what more can the Minister do to help to relieve the pressure? Will he meet me and my Cornish colleagues to discuss the healthcare challenges faced in Cornwall and on Scilly?

[Jackie Doyle-Price]

My right hon. Friend the Secretary of State has visited twice in the past year, and the Minister of State, Department of Health, my hon. Friend the Member for Ludlow (Mr Dunne) is more than willing to meet my hon. Friend next week, with other colleagues.

[Robert Neill (Bromley and Chislehurst) (Con)]

16. What assessment he has made of the level of co-operation between clinical commissioning groups and local authorities.

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[David Linden (Glasgow East) (SNP)]

T3. The palliative care we provide to terminally ill children is an incredibly serious topic. I want to refer to the point made by the hon. Member for Newcastle upon Tyne North (Catherine McKinnell) and to press the Minister on giving children’s care parity of funding with adult care. Will she follow the example of the Scottish Government and provide parity of funding?

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

As I previously advised the House, I am in conversation with Together for Short Lives to look at how we improve palliative care for children. This clearly raises a different set of circumstances and sensitivities, and it is essential that we do our best for these children.

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

Do Ministers have any plans to review the “do not resuscitate” guidance for hospitals? I have a constituent who has such an order placed on him, despite the fact that he has left hospital and is in a care home, it cannot be rescinded and his family have not consented.

[Jackie Doyle-Price]

My hon. Friend is right to raise this issue. Certainly, in CQC inspections in the past, the whole issue of “do not resuscitate” orders has been an area of concern. This is something we will very much look at as part of the end of life policy, but I would like to hear more about the case my hon. Friend mentioned, if he would like to write to me.

[Clive Lewis (Norwich South) (Lab)]

T5. Accountable care systems are a systemic change to the way the NHS will be managed and a significant step towards an Americanised care system, so will the Minister explain why NHS England is having a fundamental reorganisation take place under the radar without a national consultation?