Ipswich Hospital: Orthopaedic Services

James Cartlidge Excerpts

Tuesday 7th July 2020 Commons Chamber

[Tom Hunt]

I agree with my hon. Friend. There is a national challenge when it comes to tackling waiting lists for hip and knee replacements. There is not one hospital across the country that does not have to meet that challenge, but in meeting that challenge, we need to keep services as local as possible for the people who depend on them. That is what I am arguing for this evening.

So far, neither the hospital trust nor the CCG has presented sufficient detail about how vulnerable patients will be supported in making the journey to Colchester, and the reassurances we have received about joint working and engagement with the public just do not cut it. There is major concern among my constituents about the plans, and it is no surprise that people do not support them while this crucial element is not in place.

Secondly, Ipswich Hospital is currently ranked in the top 10% in the country for both hip and knee replacements, and I would like to thank all the surgeons and staff who work in the orthopaedic services. There are real concerns that the fine quality of care currently available to patients in Ipswich will be diminished when combined with the practice in Colchester. Many of my constituents are currently going through an anxious wait for hip and knee replacements during covid-19, but the knowledge that they will receive first-class surgery at their town’s local hospital provides a great deal of reassurance. Under these plans, however, the surgery would certainly not be at their local hospital, and there are fears that the standard of care could be lower too.

[James Cartlidge (South Suffolk) (Con)]

I am grateful to my hon. Friend and neighbour for giving way. It was great to campaign with him in the election; I knew that he would be a doughty fighter for his constituents, and he is showing that tonight. Does he agree that, however we configure services, the priority must be the people he is talking about who are waiting for elective surgery that has been cancelled or shifted back many months because of covid, and we need to focus on bearing down on that backlog?

[Tom Hunt]

I thank my hon. Friend. As I said to my hon. Friend the Member for Keighley (Robbie Moore), I am not blind to the fact that covid-19 is putting huge pressure on the NHS and hospitals up and down the country, including Ipswich Hospital, where the frontline staff have gone above and beyond to serve my constituents. We need to deal with these waiting times, but we need to do so in a way that keeps services closer to people. That is very important.

Under the current proposals, most of the surgeons in Ipswich Hospital’s orthopaedic team would split their time between Ipswich Hospital and the new centre in Colchester. In many cases, this would mean that the surgeon who operates on a patient in Colchester one day will not be there to make crucial check-ups on their patient in recovery over the following days. Only the operating surgeon is best placed to see how their patient is responding to the surgery that they carried out. These personal check-ups are also an important source of confidence for patients. This important aspect of high-quality care would largely be lost under the current plans. Questions have also been left unanswered about the impact of the plans on the highly rated emergency orthopaedic practice, which would remain at Ipswich Hospital, with doctors and resources diverted elsewhere.

This all feeds into a third main concern, which is about the wider effect of these plans on the reputation and standing of Ipswich Hospital. Addenbrooke’s Hospital, Peterborough City Hospital, Hinchingbrooke Hospital, Norfolk and Norwich University Hospital, Queen Elizabeth Hospital, Princess Alexandra Hospital, Colchester Hospital, West Suffolk Hospital and James Paget University Hospital are all general hospitals in the east of England that provide elective orthopaedic surgery. Under the current plans, Ipswich Hospital would become the only hospital of its size in the eastern region not to provide a full complement of orthopaedic services. In fact, James Paget University Hospital in Yarmouth serves a population under half the size of Ipswich Hospital.

The question is, why should Ipswich Hospital be stripped of its first-class elective orthopaedic surgery and placed in such an unusual position? More and more people in Ipswich are beginning to answer that question by looking at whether the merger of Ipswich and Colchester Hospitals has been beneficial to Ipswich Hospital and whether the promises that were made about both hospitals improving together have been kept.

In fact, there are significant doubts that the hospitals trust fully explored the options that would allow both Ipswich and Colchester Hospitals to improve their orthopaedic care together, without one hospital losing core services. My understanding is that a full assessment was not made of repurposing space at Ipswich Hospital, to open up room for two additional operating theatres, and the borough council’s two alternative proposals to the Colchester centre were essentially dismissed out of hand.

The hospitals trust has insisted, the whole way through, that the Colchester centre is the only way to create enough capacity to cut waiting times and cancellations to planned surgery. I have spoken to the hon. Member for Strangford (Jim Shannon) about what we have to do on that across the country.

I ask what justifies these sweeping plans, for many, including within the hospital itself, have doubts that the plans are even justified on their own terms. The proponents of the plans have highlighted that five new operating theatres for hip and knee replacements would be added, and that these would simply replace five existing operating theatres currently in use at Ipswich and Colchester. Cutting waiting times and delays is undoubtedly an important aim, and I am sure, as I said, that there is no hospital in the country where the pressure on waiting lists for hip and knee replacements has not increased due to covid-19. As I mentioned, these plans would largely replicate existing services, at great financial expense and at the unquantifiable cost of moving them further from where people live. It is therefore disappointing that some in north Essex—some of my colleagues in north Essex—cannot see how important it is that both Ipswich and Colchester improve together side by side.

The last major concern I want to mention is that key voices within Ipswich Hospital have been muffled on this issue. The chief executive of the hospitals trust has claimed that the plans are clinically led and that only three out of 27 consultants are opposed to them, but it is my belief that the cards have been stacked in favour of this position. I understand that the 27 consultants he refers to include spinal surgeons as well as surgeons in Colchester. He has also assumed that surgeons who have not directly expressed their opposition to the plans must be in favour of them. Following the private conversations I have had with senior representatives at the hospital who have approached me, I understand that nine out of 12 surgeons at Ipswich Hospital who deliver non-spinal elective and emergency orthopaedic care do not support the proposals, but, understandably, many of them do not want to put their career at risk by speaking out publicly. However, two surgeons did speak out publicly during one of the consultation events, which turned out to be the only one where the audio recording of a public meeting was not uploaded online. It was eventually put online only when the surgeons themselves pointed this out.

To summarise, the plans are incredibly unpopular in Ipswich. The concerns for patients within Ipswich Hospital’s core service are real, and the decision-making process seems to be nothing more than a rubber-stamping exercise to push through the plans against the wishes of my constituents. When I stood for election and won the great honour of being elected as the Member of Parliament for Ipswich, I said to my constituents that I would fight for them with everything that I have. I love my constituency and I love my constituents, and I know how important the hospital is for them.

That is why it is really important for us to be here today. We do need to deal with the waiting lists, and we do need to make sure that people do not wait in pain for hip and knee replacements, but we need to do so in a way that keeps services closer to people. The merger needs to be about Ipswich and Colchester hospitals thriving together side by side, and I will work with my colleagues across the region to make sure that that is the case. At this late stage, I ask the Minister to look into the matter, reflect upon it, and meet me to discuss my concerns before the decision on 14 July.

[The Minister for Health (Edward Argar)]

I thank my hon. Friend the Member for Ipswich (Tom Hunt) for securing a debate on the important topic of orthopaedic services at Ipswich Hospital. His commitment to his constituency is commendable and well known. He raised this issue with me when we met very recently, and in his recent letter. I pay tribute to the persistence that he has shown in ensuring that his constituents’ voices are heard on this topic, as on all others.

If I recall correctly, when my hon. Friend last spoke in the House on this matter and I responded, he secured my commitment to visit, which I had the pleasure of doing, with him, in February, and it was a visit that I greatly enjoyed. He is undoubtedly a strong voice for his constituents. Of course, when circumstances allow it, I will be very happy to visit Ipswich once again. I also had the opportunity, that same day, to visit Colchester with my hon. Friend the Member for Colchester (Will Quince), who is a similarly strong voice for the interests of his constituents, his local hospital and the needs of his county, and I pay tribute to him.

[James Cartlidge]

Many of my constituents use both Ipswich Hospital and Colchester Hospital, and I pay tribute to their staff for the incredible effort they have put in throughout the pandemic to look after my constituents, and those of my hon. Friend the Member for Ipswich, to ensure that we get through this keeping our NHS intact. We should be proud of that.

[Edward Argar]

I am grateful to my hon. Friend, whom I have known for many years. As ever, he puts his finger on exactly the right point. I join with him in paying tribute to all the staff at Ipswich Hospital, Colchester Hospital and across our NHS for the amazing work they do day in, day out, particularly at this time.

My hon. Friend the Member for Ipswich set out his case very clearly. I would say that his hospital has no greater friend than him. I reassure him that there is no question of Ipswich Hospital continuing to be anything other than the first-class hospital it is today. He highlighted in outline a little of the background on this issue. In 2015, Suffolk and North East Essex sustainability and transformation partnership concluded that change in the organisation of services was needed, particularly in orthopaedic planned surgery. Since then, East Suffolk and North Essex NHS Foundation Trust has been developing a proposal for an orthopaedic elective surgery centre. As he touched on, the proposal outlines that the centre would see a roughly £35 million investment in orthopaedic surgery services for the population, offering at least 48 new beds and up to six state-of-the-art ultra-clean operating theatres, providing additional capacity for emergency patients across the area. The NHS in Suffolk and Essex ran a consultation, between 11 February and 1 April 2020, on the specifics of the proposal to create an elective orthopaedic care centre in Colchester, but, as I have set out, those plans have been in genesis for many years and have been extensively and widely consulted on.

I note the points raised by my hon. Friend in his speech and, indeed, those raised in his letter to the chief officer of Ipswich and East Suffolk clinical commissioning group recently. I encourage the clinical commissioning group to take that letter seriously and to respond fully to my hon. Friend, as part of the local accountability which is so important to all our public services. Let me be clear—I will emphasise this again later—that this is a process and a proposal that is rightly driven by the NHS at a local level in his and my hon. Friends’ constituencies. He is right to commend the performance of Ipswich hospital over recent years. I appreciate that he wants to ensure that for his constituents, and, indeed, for all those who use the hospital, the reconfiguration does not in any way diminish the achievement of his hospital and its staff, or have any impact on its other services.

My hon. Friend will appreciate that in winter the number of emergency admissions is much higher than it is during the summer. One aspect of this consultation is that it seeks to address planning for that by enabling more beds across the hospitals to be used to meet that demand. I would not seek, and nor should I seek, to prejudge the decision that will be reached next week by the CCG on this matter—it is rightly its decision—but I will set out its rationale in putting the proposals forward. It states that, in practice, if the orthopaedic centre were built at Colchester, it would release 24 in-patient beds at Ipswich, where they are indeed needed. The new orthopaedic centre would be adjacent to the main Colchester Hospital, but away from the emergency department.

I greatly appreciate the insight my hon. Friend has shared from his constituents in Ipswich, who are thankful for the brilliant surgeries they have been able to access in the NHS. Indeed, that was something he highlighted again when I went to wonderful Ipswich with him. When the CCG considers this matter, I would of course expect it very carefully and respectfully to reflect on the points that he and his constituents have made. The proposals reflect the importance of the surgeries. I hope he and his constituents will welcome the fact that the proposals will not remove access to orthopaedic services at Ipswich Hospital. Of nearly 46,000 in-patient day cases and out-patient appointments completed for orthopaedic patients at Ipswich last year, only about 3% would move to the new centre at Colchester under what the trust is proposing. In its proposal, the trust sets out that day surgery, including shoulder and elbow joint replacements, would remain at Ipswich Hospital, as would services for emergency patients, such as joint replacement after a hip fracture.

As I just mentioned, my hon. Friend described the life-changing impact such surgeries have had on constituents who have been treated at his hospital. This proposal, as the trust sets out, seeks to achieve shorter waiting times for surgery and shorter stays in hospital, so that patients can seek the comfort of home more quickly, and to minimise the risk of cancellation of surgery, as the proposed centre will be built safely away from the emergency department and the knock-on impacts that a busy emergency department can have. It also seeks to achieve improved clinical outcomes in terms of reliability from the standardisation of care and provide training, education and research opportunities for clinicians. The trust maintains that it is on that clinical basis that it is putting forward the proposals, which, it states, seek to support the excellent performance of hospitals in the area by organising services in a sensible way so that necessary elective operations can take place while the system supports patients admitted in an emergency.

My hon. Friend also mentioned the merger of Ipswich and Colchester in June 2018. At the time, NHS England outlined several service improvements that the merger would bring about. As well as improvements in various services from paediatrics to emergency ambulatory care, the enlarged organisation would also have an expanded catchment area, leading to improved opportunities for training, providing a more attractive option for clinicians, resolving a number of historical recruitment and retention issues at both trusts and improving finances. It is important, however, as my hon. Friend alluded to, that the trust is held to account for those promises and that it ensures, by the merger, that both hospitals continue to improve.

I briefly touched on the consultation earlier in my remarks, and my hon. Friend raised several points about the process. He is absolutely right to say that important decisions are made with the best interests of patients from across the area in mind, and that the views of local clinicians should not be diminished. There has been much lengthy consultation. As well as the formal process, my hon. Friend highlights the petition, which has been signed by many of his constituents and, I suspect, more widely. It is absolutely right that everyone has their say, and I commend him for what he is doing to ensure that they have their say. Again, such views should be considered with respect and care when decisions are reached.

My hon. Friend also rightly raised the issue of patients and transport, and that they must be supported to travel should the plans go ahead. He has raised the need for a comprehensive plan, both locally and with Ministers, to ensure that all patients can be supported to access the right care. Access to the current patient transport scheme will, the trust states, be available for those unable to make the journey themselves. Under the proposals, pre-surgery and post-surgery appointments would still take place at the patient’s normal point of care at Ipswich or Colchester. Indeed, I pay tribute to my hon. Friend for fighting his constituents’ corner, should the decision not turn out the way he wishes, and for playing an important part in highlighting that issue as well. The only change for patients would be the actual site travelled to for the planned surgical procedure, which would involve a lengthy stay of three days in hospital. I have also been reassured that local partners completely recognise that, alongside these provisions, additional support will be needed for some patients and, should the proposal be approved, further work is already under way to address that.

Being conscious of the time, I reassure my hon. Friend that the Department of Health and Social Care recognises how important these decisions are and recognises that the right accountability, consultations and people must be included in the process of discussing proposals to change services. This is, of course, not a decision for me or, indeed, for the Secretary of State. The next step, as my hon. Friend said, is the final decision, which will be made locally by the CCG on 14 July, but the proposal is not to downgrade or diminish Ipswich, but to promote an alternative way of delivering clinical services. I have no doubt that the CCG will have heard my hon. Friend’s case today, as will his constituents, in whose interests he has spoken so eloquently. I again encourage the CCG to ensure that it carefully considers his words and the representations in making its decision.

I conclude by thanking my hon. Friend and congratulate him on securing this debate. I also thank those other Members who have intervened. My hon. Friend has set out his case powerfully and his constituents are lucky to have him as their Member of Parliament.

Question put and agreed to.

Social Distancing: 2 Metre Rule

James Cartlidge Excerpts

Monday 15th June 2020 Commons Chamber

[Edward Argar]

The hon. Gentleman makes a typically sensible point. It is important that the review is able to be conducted with proper scientific and economic rigour to ensure that we have the evidence base we need. I am not going to prejudge what the decision will be or what the review will say, but he is also right to highlight the importance of businesses having as much time as possible to prepare for whatever decision may be made.

[James Cartlidge (South Suffolk) (Con)]

On the health arguments, should we not remember that our hospitals have lost capacity in order to operate at 2 metres, and will the Minister assure me that the review will look at how many more beds we could get into hospitals to deal with the elective surgery backlog once they are safe in terms of covid?

[Edward Argar]

My hon. Friend makes an important point about getting our NHS back up and running again not just for emergencies, but for elective procedures and other procedures, which is what we have been doing. The infection control context within a hospital is slightly different—indeed, considerably different—from that in businesses and other contexts, but he is right to highlight the impact that the necessary restrictions are having in a range of contexts on the ability to treat people or to serve people and businesses.

Covid-19 Response

James Cartlidge Excerpts

Tuesday 2nd June 2020 Commons Chamber

[Matt Hancock]

The hon. Lady is quite right to report the views of local public health staff, who are right to raise the question. I am pleased to say that the turnaround speed has significantly improved in the past couple of weeks, and now 83% of tests are returned from the drive-through centres within 24 hours. There is continued work to speed that up and get the proportion even higher, and the Prime Minister has very kindly set me a goal of ensuring that all tests from the drive-through centres are returned within 24 hours.

[James Cartlidge (South Suffolk) (Con)]

My right hon. Friend will be aware of the excellent work taking place at Colchester and Ipswich hospitals in partnership with local independent providers to increase capacity for dealing with non-covid cases such as cancer. What more can we do to increase capacity in the independent sector so that we bear down on the backlog in elective surgery?

[Matt Hancock]

That is an incredibly important point, because the backlog has of course built up as we had to protect the NHS in the heat of the crisis. The independent sector has played a critical role in helping us get through the crisis and will play a critical role in future. That has put to bed any lingering, outdated arguments about a split between public and private in healthcare. What matters is the healthcare that people get. We could not have got through the crisis without the combined teamwork of the public and private sectors.

Oral Answers to Questions

James Cartlidge Excerpts

Tuesday 5th May 2020 Commons Chamber

[Mrs Flick Drummond (Meon Valley) (Con)]

What steps he is taking to support children and young people to continue learning at home while nurseries, schools and colleges are partially closed as a result of the covid-19 outbreak.

[James Cartlidge (South Suffolk) (Con)]

What steps he is taking to support children and young people to continue learning at home while nurseries, schools and colleges are partially closed as a result of the covid-19 outbreak.

[The Secretary of State for Education (Gavin Williamson)]

I am determined to help learning continue in these challenging times. We have committed over £100 million to provide devices and internet access to vulnerable children and published a list of high-quality online educational resources, and we continue to support parents and teachers in supporting children at home.

--- Later in debate ---

[Gavin Williamson]

I do indeed join my hon. Friend in thanking the teachers, the support staff, the social workers, Hampshire County Council and all those who have been involved in making sure that schools stay open and available for vulnerable children. They have done amazing work. The attendance rate she highlights is truly outstanding. Since the Easter holidays, we have seen a doubling of the number of vulnerable children who are attending school, and that is down to the work of teachers, school staff and social workers, reaching out and encouraging them to come into school. Mental health, which my hon. Friend also raised, is an important issue. That is why we have committed £5 million of funding to support charities to help children with mental health concerns and issues while they are at home.

[James Cartlidge [V]]

While schools are closed, the issues of home-school transport affecting my constituents have effectively been paused, but they will come back eventually and potentially result, for example, in siblings having to go to separate schools. Although this is a county council matter, the Government issued a consultation on home-school transport last October, and five Suffolk MPs, including me, wrote to the Government asking them to consider changing the guidelines to state that siblings should not be separated by changes in school transport policy. Has my right hon. Friend had time to consider that consultation, and will he publish the response soon?

[Gavin Williamson]

The consultation closed in October last year. We were hit by twin issues of purdah being imposed and now, obviously, our principal focus being on dealing with the coronavirus. We hope to respond to the consultation in the near future, but I am not currently in a position to give my hon. Friend an exact date.

Covid-19

James Cartlidge Excerpts

Monday 16th March 2020 Commons Chamber

[Matt Hancock]

We are going to do that as soon as possible, but I am sure the hon. Member will understand that we have just published new guidance that we have been working on and it is a very rapidly evolving situation. We will translate it as soon as we possibly can.

[James Cartlidge (South Suffolk) (Con)]

I endorse the point made by the hon. Member for Glasgow South West (Chris Stephens) about having an hour in supermarkets—I believe Iceland is already doing this—when older people can purchase food before it is stockpiled and so on. Can mothers of very small children be included in that? I am afraid I have heard today of some scarcity in baby products, which is of course of great concern for us all.

[Matt Hancock]

Yes, that is a very good suggestion. It is one for the Secretary of State for Environment, Food and Rural Affairs and the supermarkets, of course, but is an example of people pulling together to help the most vulnerable.

NHS Funding Bill

James Cartlidge Excerpts

2nd reading & 2nd reading: House of Commons
Monday 27th January 2020 Commons Chamber

[Matt Hancock]

The funding for training more nurses comes on top of what is in the Bill—the Bill is for the day-to-day running costs of the NHS—and it has already been committed to. The Bill will help us to create 50 million more GP appointments every year so that we can reduce the time that people have to wait to see their GP. It will help to pay for new cancer screening and faster diagnosis so that we can save tens of thousands of lives of people suffering that terrible disease. It will help to pay for the prevention, detection and treatment of cardiovascular disease so that we can prevent over 100,000 strokes and heart attacks. At its heart, the funding will help us to create more services in the community, closer to home, with pharmacies playing a much bigger role. For the first time in a generation, the proportion of NHS funding going to primary and community care will increase, shifting resources to the prevention of ill health, because prevention is better than cure.

[James Cartlidge (South Suffolk) (Con)]

My right hon. Friend and neighbour talks about how we pay for the NHS, and he said that we cannot know what will happen in future, but does it give him good heart that in the last 24 hours, Ernst and Young has predicted that our growth will be higher than expected on the back of the election of a Conservative Government, which we all have confidence will deliver the growth that we need to fund the NHS?

[Matt Hancock]

Yes. That just shows how sensible the British people were to elect a majority Conservative Government. The funding will also allow the NHS to invest in innovative technology, such as genomics and artificial intelligence, to create more precise, more personalised and more effective treatments. That will help the life sciences industry, which is one of our fastest growing industries, and in turn, help to support growth.

Health and Social Care

James Cartlidge Excerpts

Thursday 16th January 2020 Commons Chamber

[Jonathan Ashworth]

It is a serious point, and I am grateful for the way in which the right hon. Gentleman has put it. Of course, we are very happy to engage. My hon. Friend the Member for Worsley and Eccles South, who sits in the shadow Cabinet and leads on social care, is happy to sit down with Ministers at any point.

I am suggesting to the Secretary of State, rather gently, that there is a degree of political consensus on free adult personal social care. The House of Lords Committee, which includes Michael Forsyth and Norman Lamont, not socialists red in tooth and claw by any means, alongside Alistair Darling, has proposed it. We, as a Front-Bench team, have proposed it. There are forms of it in some of the devolved nations. It is the Secretary of State who is standing outside that consensus. If he wants to engage with us on those terms, and on the point about a cap as proposed by Dilnot, then of course we are prepared to have those levels of engagement.

There is also a degree of consensus around the need for better integration between health and social care, and better co-ordination of health and social care. That is why we are intrigued by the Secretary of State’s proposal to consult on the NHS Funding Bill.

[James Cartlidge (South Suffolk) (Con)]

Will the hon. Gentleman give way?

[Jonathan Ashworth]

For the last time, because a lot of Members want to speak.

--- Later in debate ---

[James Cartlidge]

This is directly relevant. The hon. Gentleman made a point about the House of Lords Committee, but he will be aware that the House of Commons Committee recommended a social insurance system—perhaps along the lines of Germany’s, for example. Is he, in principle, supportive of that solution?

[Jonathan Ashworth]

No, because we do not think it would work—it is not feasible. It is not just the Committee in the Lords that says that—plenty of think-tanks have said it is not feasible as well.

There is broad consensus about the principle of better integration between health and social care. We have long argued for it, and now the Government have come round to arguing for it as well. The Government are proposing an NHS Bill along the lines of what Simon Stevens of NHS England has proposed. We long warned that the Health and Social Care Act 2012, which was introduced by Andrew Lansley and supported by sitting many of the Ministers on the Front Bench, would not lead to the levels of integration and co-ordination of care that was needed but to a fragmented mess.

We also long warned that the compulsory competitive tendering provisions of the Act would lead to more contracts being handed to the private sector. About £9 billion-worth of contracts were handed to the private sector, despite the Secretary of State telling us that there would be no privatisation on his watch. If his Bill gets rid of those compulsory competitive tendering provisions—the so-called section 75 regulations—we would welcome that, but we want competitive tendering to be abolished completely. We do not want clinical services privatised. We do not want clinical services outsourced, such as pathology labs in London, as is happening on the Secretary of State’s watch. We do not want tinkering in the Bill: we want the Health and Social Care Act binned so that we can restore a universal public national health service. [Interruption.] The Secretary of State says that it is universal. He is clearly not aware of the rationing that is going on across the country because of austerity and the privatisation of the NHS that is his policy.

As I indicated in the debate on the Gracious Address before the election, we will work constructively with Ministers to ensure the speedy passage of the health service safety investigations Bill. We will look to strengthen the independence of medical examiners. We call on the Government to do more to roll out medical examiners across NHS trusts. It is disappointing that so far only about 50% of trusts have medical examiners. These are absolutely vital to improving patient safety, because we know that things do go wrong in the delivery of care. We have all been shocked by the revelations at Shrewsbury and Telford Hospital NHS Trust. This is the worst ever maternity scandal, with clinical malpractice apparently allowed to continue unchecked since the ’70s. It is absolutely horrific and astonishing. I cannot imagine the grief that the families affected must have had to endure. Will the Secretary of State update the House on what is happening at Shrewsbury and Telford? I appreciate that there was an Adjournment debate on that matter last night, but I think the House would appreciate his offering us some reflections on what is happening at Shrewsbury and Telford. Will he also commit to reinstating the maternity training fund to help to improve maternity safety in our hospitals?

I am sure that the Secretary of State will agree, more broadly, that the delivery of safe care depends on adequate staffing levels as well, so would he support enshrining safe staffing levels in legislation? We are short of 44,000 nurses in England. Community nurses have been cut by 6,000 since 2010. Learning disability nurses are being cut. Mental health nurses have been cut by 10%. Health visitor numbers are down. School nurses have been cut. We have been warning for years about the detrimental impact on safe care of these staffing shortages. That is why, for example, we fought the Government on the abolition of the training bursary. We welcome the fact that Ministers are now bringing back a partial version of the bursary in the form of a maintenance grant, but why not bring back the whole bursary? Without bringing back the whole bursary, many are sceptical that the Secretary of State will deliver on his commitment for 50,000 new nurses, because as quickly as—[Interruption.] Well, he is rather stretching the definition of the word “new”. He gave the impression in the general election campaign that there were going to be 50,000 new nurses, but that soon unravelled, because when he went on the media it turned out that he was including in his figures 19,000 nurses who already work in the national health service. I of course have some sympathy—

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[Damian Green (Ashford) (Con)]

It is always a pleasure to follow the hon. Member for Blaydon (Liz Twist). As somebody who is in the early weeks of their seventh Parliament, I can say that I have therefore sat through many waves of maiden speeches over the years. The quality of the speeches that we have heard not just today—we have just heard from my hon. Friend the Member for Sevenoaks (Laura Trott) and from several Members from the Labour Benches—but throughout this debate over the past few days has been breathtakingly high. As somebody who has been round the block a few times, I can say that that is not only very welcome, but slightly alarming.

What I want to do is concentrate specifically on the social care element of today’s debate. It is a hugely important part of the wider health agenda and also obviously vital in its own right. I welcome a number of elements in the Government’s approach. The first is the recognition of the urgency of the need to solve the issue of social care, which has been left on the backburner for far too long. The second is the desire to work on a cross-party basis. I appreciate that that is going to be challenging for the Opposition Front Benchers over the next three months, because they will have other things on their mind, but for the past 18 months I have been working from the Back Benches with both Labour and Lib Dem Members. Although none of them is here at the moment, there are Lib Dem Members who are interested in this issue. I think that that cross-party approach is the best one. The third element is the Government’s recognition that the system today is incredibly fragile and needs extra money to tide it over. I am glad that the Government are helping local authorities with £1 billion in the coming year, but although it may be the world’s most expensive sticking plaster, it is still a sticking plaster, and we all know that we need a much more wholesale approach.

Many aspects of the problem need solving. There is the question of where the workforce are going to come from. Home adaptations will be needed so that more people can live in their own homes for longer. We will need the provision of extra places in care homes, where a shortage is developing. There are also problems when it comes to dementia patients. I think the Alzheimer’s Society has sent many Members a briefing for this debate, and everything it says is very sensible, but beneath all these questions is the issue of money. Where is the extra money going to come from? If there were a simple solution, a Government would have adopted it a long time ago.

I warn Ministers against reaching for the simplest and easiest solution, because the easy solution is to say, “We’ll make it free and we’ll fund it out of general taxation.” That is easy and seductive, because many people think social care is free anyway, but that would be wrong and unfair. It would be wrong not just because of the public spending implications, but for intergenerational fairness. If we fund the solution from the taxation paid by working-age people, we would be telling 20, 30 or 40-somethings not only that we are going to tax them to pay for their own social care if they need it in the future, which would be fair enough, but that we are also taxing them to pay for the social care of their parents’ generation, which would not be fair. That would be particularly unfair in this country, where there is a preponderance of wealth among the baby boomer generation. So much of the wealth in this country is tied up in housing, and that generation are far more likely to own their own homes than their children’s generation.

[James Cartlidge]

My right hon. Friend is making a brilliant speech, with great passion. Surely the definition of “sustainable” here is someone in their 20s who is entering the workforce and being asked to pay into a new system believing that the same quality of care will be available when they reach their 70s or 80s. That will not be the case if the model is unsustainable.

[Damian Green]

My hon. Friend is exactly right, and I wanted to talk briefly about the various ways in which we can achieve a sustainable system. We could have a compulsory social care payment that is made by everyone of working age and, indeed, beyond working age. That has been recommended by Select Committees of this House. Alternatively, I would suggest that we could have not a tax, but a hugely desirable saving, based on the model of the pension system, whereby the vast majority of people are encouraged to—and do—subscribe to auto enrolment pensions, but it is not compulsory.

In that pensions model, we would have the equivalent of a state pension—a universal care entitlement—which would have to be better than the current provision of care. On top of that, we would urge millions of people voluntarily to save for a care supplement, as they do for a private pension. That would guarantee them the quality of care that they would want in their old age. Of course, not everyone will be able to make those savings, and the system needs to be better for those who cannot contribute towards their own care if they need it in old age, but it is essential that we use this massive wealth, particularly among those who are 60 and above; a small sliver could help us to achieve these aims.

At the moment, the equity in housing of those over the age of 65 is £1.7 trillion. Just a small sliver of that would provide a much greater sum of money and therefore a much more sustainable system. The Prime Minister is absolutely right when he says that nobody should be forced to sell their own home to pay for care. People have worked for that, and will want to give some of it to future generations, but a small sliver saved into the sort of insurance system that I am suggesting would make a huge difference and would put the social care system on a sustainable level.

I have a final thought, which puts these ideas in the wider context of today’s debate. If we do not sort this issue out, the long-term plan for the NHS will not work. The 2020s need to be a decade of hope for the NHS, and every one nation Conservative will want that to happen, but to make that real we need to solve the social care crisis. I wish Ministers well in achieving this, and urge the House to reject the Opposition amendment.

Oral Answers to Questions

James Cartlidge Excerpts

Tuesday 29th October 2019 Commons Chamber

[Caroline Dinenage]

You will know as well as everyone in the House, Mr Speaker, that that is a sensitive matter on which Members have contrasting views. The right hon. Gentleman is right to continue to raise the issue, but the legislation surrounding it continues to lie with the Ministry of Justice.

[James Cartlidge (South Suffolk) (Con)]

8. What steps he is taking to ensure the adequate long-term provision of mental health services.

[Jack Lopresti (Filton and Bradley Stoke) (Con)]

20. What steps he is taking to ensure the adequate long-term provision of mental health services.

[The Parliamentary Under-Secretary of State for Health and Social Care (Ms Nadine Dorries)]

By 2023, an additional £2.3 billion a year will flow into mental health services across England. Our long-term plan for that increased investment will ensure that more adults, children and young people than ever before are able to get mental health support when they need it. Increased funding will also support further improvements in quality of care and patient experience.

[James Cartlidge]

I welcome my hon. Friend to her position. My right hon. Friend the Secretary of State will be more than familiar with the long-running problems at the Norfolk and Suffolk NHS Foundation Trust, which is our county’s main mental health trust. There is a huge effort to try to improve it, but I know from constituency cases that significant problems still exist. Will Ministers update us on what progress they think has been made at NSFT?

[Ms Dorries]

My hon. Friend works tirelessly on his constituents’ behalf. In fact, I think I am meeting some of his constituents tomorrow. I will look into the issues he raises, but the trust has been working since May 2018 on delivering the immediate improvements suggested by the Care Quality Commission, and leadership support has been provided by East London NHS Foundation Trust. I promise to look into the situation to see where the trust is at this point and what improvements have been made, and I may have that information to feed back to him tomorrow.

Oral Answers to Questions

James Cartlidge Excerpts

Tuesday 18th June 2019 Commons Chamber

[Caroline Dinenage]

The hon. Lady is absolutely right: abuse of any kind must not be tolerated, and we have heard horrific accounts of abuse that must be tackled. That is why in May, we announced much stronger commissioning oversight arrangements, where people are put in place out of area. Local commissioners must visit regularly. The CQC has commissioned two independent reviews, and the findings and recommendations of both will be published. The point is that opportunities to intervene have been missed, and we must be open and transparent in getting to the bottom of what happened.

[James Cartlidge (South Suffolk) (Con)]

2. What steps he is taking to increase NHS access to new technology.

[The Secretary of State for Health and Social Care (Matt Hancock)]

To increase the access to new technology across the NHS, we have expanded the accelerated access collaborative to get the best technologies in faster, and NHSX is delivering our tech vision to drive forward digital transformation of the NHS.

[James Cartlidge]

I welcome the way my right hon. Friend has really put a stamp on ensuring that technology is at the heart of his health policy. Can he tell me whether the accelerated access collaborative will engage locally, particularly with the sustainability and transformation partnerships, so that it eventually leads to better outcomes for our constituents?

[Matt Hancock]

Yes, my hon. Friend is absolutely right. There is a reason why we care about using the very best technology in the world in the NHS, and that is that it improves treatment for patients. The regional delivery of better technology is critical. The 15 regional academic health science networks are a key part of the AAC and they work closely with local hospitals.

Interim NHS People Plan

James Cartlidge Excerpts

Wednesday 5th June 2019 Commons Chamber

[James Cartlidge (South Suffolk) (Con)]

GP retention is a significant challenge in my constituency, and GPs do often raise the impact of the current pension system. May I say to my hon. Friend that I very much welcome the consultation on pension arrangements for clinicians, but can he set out the potential timing of when those changes may come into force? He will be aware that GPs are making decisions right now about things such as early retirement, and we need this as a matter of urgency.

[Stephen Hammond]

I thank my hon. Friend for that question. The Department will launch the consultation at the end of this month. It will set out the proposals, which we spoke about yesterday, to introduce greater pension flexibility. They are designed to take away the disincentives not only for senior clinicians but clearly for GPs. That consultation will last for the normal length of time, and I hope we will be able to proceed quickly thereafter.