(2 weeks, 6 days ago)
Public Bill CommitteesClause 59 provides for the abolition of the Health Services Safety Investigations Body and the transfer of its functions to the Care Quality Commission.
Under the new arrangements, the Care Quality Commission will assume responsibility for carrying out investigations into incidents that have or may have implications for patient safety. It is really important to stress that the core purpose of that function remains unchanged: to identify systemic risks, support learning and drive improvements in the safety of health services, rather than determine blame or liability. It is a central measure in strengthening the framework for patient safety investigations and ensuring a more coherent and effective system for learning from incidents across health services.
With more than 70 types of channels or organisations through which patients or users can share feedback, the current landscape has led to fragmentation between investigation, regulation and improvement activity, thereby diluting the impact that insights from investigations might otherwise achieve. HSSIB has been isolated, undermining its efficacy. We will bring HSSIB into the mainstream as a core but distinct part of the CQC. That will enable HSSIB to use its functions more strategically, working in partnership with the national quality board. Clause 59 achieves that by conferring responsibility for those investigatory functions on to the Care Quality Commission through the provisions set out in schedule 8. In doing so, it embeds a comprehensive investigatory framework with an established statutory regulator.
The CQC will be one organisation with separate functions—a regulatory function and an investigative function—to preserve the integrity of each. Within the CQC, HSSIB will continue to operate as a discrete unit and retain its independence from providers, allowing it to identify learnings and take a no-blame approach.
The Minister will recall that in evidence, Dr Rosie Benneyworth, interim chief executive officer of HSSIB, spoke about the vital work of the organisation, especially with regard to investigations where vulnerable staff and workers do not feel confident about coming forward for fear of reprisal. HSSIB did great work in that area, and I am wondering whether the CQC will carry it on and take on board that learning.
(1 month, 1 week ago)
Public Bill CommitteesQ
Dr Benneyworth: No, we do not make recommendations to provider organisations at all. All our recommendations go to national organisations. I completely agree with Dr Dash that there are too many recommendations. In fact, HSSIB raised that concern through our work two years ago and flagged it to Dr Dash. We wrote a report called “Recommendations but no action”. We are very concerned about the plethora of recommendations going to providers, which create a huge amount of noise but, distressingly for the families involved, do not lead to the changes needed.
I completely agree that there are far too many recommendations. I am leading some work to address that—we are setting up a recommendations hub with the Department of Health and Social Care—but we are not that problem. We have made 39 recommendations since investigations launched and HSSIB started three years ago, and they are all to national bodies. We might reduce the burden on national bodies by taking that away, but it will not have any impact on providers.
Q
Dr Benneyworth: Yes, absolutely—we have seen that in so many of our investigations. It can often be exacerbated by different parts of the system working together.
To give you an example, we looked at mental health in-patient settings. There is national guidance that says that people should not use risk assessment tools around self-harm, but when we looked we found that, on the ground, everyone was using these tools. We asked why that was, and we were given two reasons. One was that the IT systems were set up such that you could not move past the front screen without ticking one of the risk assessment boxes, and the other reason was that people were fearful about being in front of a coroner and asked about risk assessment tools, so we took action on both those fronts.
Another thing that we see is about speaking up. There are definite inequalities at play when people are speaking up. We have seen significant racial discrimination. We wrote a report about temporary workers. We find that people working as locums or agency staff often feel a lot less able to speak up if there are patient concerns. If you are black or from other global majority groups, to be able to speak up is even harder. On the back of that, we made a recommendation to the National Guardian’s Office, and it has done a lot of work with temporary workers, looking at how we can improve their ability to speak up. We still have a huge way to go on culture generally, but particularly on discrimination and the inequalities that we see in every one of our investigations.
Gregory Stafford
Q
I have two questions. The first is about the safe space. We have seen written evidence, and we have heard when others have attended the Health and Social Care Committee, about the fact that if HSSIB is placed inside the CQC, you could have the farcical situation of one set of CQC lawyers, who are representing HSSIB, suing or attempting to sue another set of CQC lawyers, who are looking out for the CQC situation, because they are trying to get information out of part of their own system. Is that parody or is it a possibility and real problem?
Dr Benneyworth: It is a problem and something that potentially could happen. I hope that we would work effectively to try to avoid that. Essentially, and just to reassure the Committee, if we see something of a criminal nature, if there are significant regulatory concerns, we have protocols in place to be able to escalate that. But there is a real risk that potentially, if we held information that the CQC needed in part of its regulatory function, in its enforcement function, we would not be able to share that, because of our legislation, and we would not want to share it, because we want to maintain the trust in the system. It would need to go to the High Court to be able to get hold of it.
(1 month, 1 week ago)
Public Bill Committees
Jo White
I was talking about bed-blocking in hospitals and how neighbourhood health plans can work more cohesively with hospital trusts.
Councillor Wright: I think we can answer this together. The whole point of neighbourhood health is to bring in everyone in the voluntary sector, your patient transport and all that, so that your joint strategic needs assessment has a good understanding of what is available to someone in the community when they come home. We talked before about having a strong single patient record so that good communication is there, and neighbourhood health is able to strengthen that. Neighbourhood health should be not just about shifting the need from hospital to community, but about reducing that need in the first place so that fewer people need to go to hospital. At the same time, we are seeing some good developments in the NHS, such as frailty teams and hospital at home teams, all of which help to prevent people from being admitted to hospital in the first place, and to ensure that when people come home, there is a team to visit them.
You are right about the communication issue, although it has not been an issue where I am, as we have very good communication with our local ICB about the people being discharged, to make sure that someone is there to meet them and that nurses come out to see them when they come home—I cannot remember the word for that. We have the right systems in place and they are working. I do not know how neighbourhood health will work everywhere, but in our borough we have a step-down unit called Heathlands, which people quite often go to when they come out of hospital and which does quite a lot of rehabilitation. That already starts the plan to get them home: to go from hospital, to the step-down place and then to home. It is about having good systems in place, all of which should hopefully be supported by neighbourhood health, which should have a good knowledge of what is available locally.
Sally Burlington: It should definitely help, if it works well; we should see more capability and capacity available in the community, closer to where people live, to help them when they come out of hospital. There is a lot of good practice and understanding about good discharge and how you plan from the point that somebody is admitted to when they come out of hospital. The emphasis on integrated neighbourhood teams will be important. It would be helpful if we could all remember that those must include social care and wider local government services and connections in to those, not just integration within NHS teams. It is definitely a positive step forward and, if we can try to make sure that the relationships between health, social care, public health and wider services are brought to life in neighbourhood health, that will help us in this way and in lots of others.
Q
Sally Burlington: As I understand it, the safeguards around data sharing remain in place under the Bill—they do not change. The part of the single patient record that is really attractive to our world is that people will not have to repeat themselves to every professional they meet; they will not have to tell their story again and again or be retraumatised by explaining the detail of what they have been through.
The potential advantages are there, but there are obviously concerns about data protection and how data is used. It is incumbent on us all to take those seriously, think them through and make sure that safeguards are appropriately implemented locally and in all the institutions that have access. That is probably a matter less for the Bill and more for the implementation and supporting regulations, but we and other partners will be keen to be a part of that process to make sure that the safeguards are appropriate.
Laura Kyrke-Smith
Q
Maria Higson: I think we are all agreed that working at the neighbourhood level is absolutely the right way to go about that. That is where health inequalities can best be addressed, because that can be most nuanced and tailored. Working on that smaller footprint is really important. You mentioned voluntary, community and social enterprise organisations, and I think that is a hugely important part that has broadly been missed out from the conversation around these changes. We work closely with VCSE partners and we know they deliver huge amounts for the communities and understand the communities in which they are embedded very well, so making sure that the VCSE voice is part of those neighbourhood teams will be important for that nuance and tailoring in the local element.
Councillor Wright: I agree entirely. Local authorities are in a good position to engage the voluntary and community sector. But again, we are fighting for a voice with the NHS and they are fighting for a voice with us, so we need some honest conversations with ICBs, and a real strategy looking at those health inequalities and what is driving them. It will not purely be access to hospitals; it will also be access to meaningful employment, housing, transport, mental health or social isolation—there will be so much driving those wider determinants of health that are affecting healthy life expectancy. Local authorities are in a prime position to do that, and they need to be listened to. I think the challenge will be how we collectively say, “What needs to be done, other than implementing the Bill? How do we look at the whole health inequality picture and address it?”
Sally Burlington: I would agree with the others: tackling health inequalities is really difficult. Doing it the same way in every area would not work, particularly in a world where there is not enough resource to do everything we would all like to do. You have to tailor how you approach local service delivery and what is needed locally according to local needs, the local community capability, how people work and what their preferences are locally, and the neighbourhood health agenda is our best shot at tailoring in that way.
I think you will come on to Healthwatch, but we would have concerns that, in separating the Healthwatch duties to look at NHS and social care, we risk missing some of those who are most likely to need both, and that that could exacerbate health inequalities rather than make them better.
(6 months, 3 weeks ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
I congratulate my hon. Friend the Member for Leyton and Wanstead (Mr Bailey) on securing this short but significant debate. I will not take up too much time.
It is vital that healthcare is fully accessible for children. I do not think anyone would disagree that therapeutic play can be instrumental in putting children at ease, as far as that is possible, when they are experiencing medical treatment. The Government must do all they can to prevent and reduce child trauma. I know from my time as Minister for Children and Families that work has already begun to evaluate the benefit of our therapeutic approaches, such as dyadic developmental psychotherapy. I think all of us in attendance would appreciate an update on the Government’s progress in this area. However, while it is important for the Government to evaluate new approaches to providing medical care, it is also critical that medical staff have the skills and knowledge to support children with complex needs, with adequate pay and conditions to retain them long term.
Before I conclude, I want to say how brave Hari sounds. I appreciate everything that the Minister has already shared in this Chamber, and I trust that the Government will keep all these things in mind as they develop their NHS workforce plan.
(2 years, 6 months ago)
Commons ChamberI was delighted that one of my first visits in the new year was to Northern Ireland to see some of the life sciences companies, particularly those based around Queen’s University Belfast. That sector in Northern Ireland is flourishing. We are keen to support companies working in research and bring together world-leading universities such as Queen’s with the private sector and the NHS to deliver improved outcomes for all patients across every part of the United Kingdom.
I know this is an important issue for the hon. Lady in her role as chair of the sickle cell and thalassaemia all-party parliamentary group. We are working hard to provide the best possible care to those living with sickle cell disease. That includes boosting Ro subtype blood donation numbers, identifying improvements in clinical pathways and delivering world-leading treatments, such as the new blood-matching genetic test announced by NHS England yesterday, which will reduce the risk of side effects and offer more personalised care.
I congratulate NHS England on the launch of the new blood-matching genetic test for sickle cell patients, but it has been more than two years since the “No One’s Listening” report, which made the key recommendation that sickle cell patients receive pain relief within 30 minutes of attending accident and emergency. Why is that still not happening for sickle cell patients, and would the Minister like to meet me and the Sickle Cell Society to discuss how to achieve that?
I of course would be happy to meet the hon. Lady and the Sickle Cell Society to look at how we can improve patient experiences and ensure that all patients benefit from timely access to the medications they need. I am delighted that she welcomes yesterday’s announcement. It is an example of how the NHS can bring forward world-firsts and is leading the way to transform patient care and improve patient outcomes.
(2 years, 6 months ago)
Commons ChamberIt is clear that under this Government our NHS dentistry is in crisis. Across Lewisham East a number of dental surgeries are no longer accepting new adult patients. Recent Healthwatch polling shows that one in 10 people in England are paying for private dental treatment because they cannot find an NHS dentist, yet many others cannot afford to do this and instead are suffering. The Government promised to publish their dental recovery plan by the summer of 2023; it is now 2024 and the Government still do not have a plan.
I will focus my remarks on a specific issue facing dental patients, as well as practitioners, that is making this crisis even worse. A constituent of mine contacted me about her father who was driven to suicide after more than a decade of seeking compensation for dental work that left him in severe agony. Despite being awarded a record compensation sum, he never received a penny. The dentist who carried out the surgery was registered with the General Dental Council, which requires all dentists, both NHS and private, to have professional indemnity to be a member. However, it turned out that the dentist did not have full cover. Instead, she was covered only via her membership of the Dental Defence Union. Such organisations are not insurance companies but offer professional indemnity on a discretionary basis against the risk of dental neglect claims and professional conduct proceedings. That means that successful compensation claims by patients are not guaranteed to be paid out. The General Dental Council currently accepts that as appropriate, but in my view it is not, and neither is it in my constituent’s view, especially when it led to such a horrific experience for her late father.
The Paterson inquiry recommended that the Government should, as a matter of urgency, reform the current regulation of indemnity products for healthcare professionals. In 2018, the Government launched a consultation on indemnity cover for healthcare professionals including dentists, but little progress has come from it, despite the majority of stakeholders arguing against discretionary indemnity. I have written to the Secretary of State highlighting calls for the Government to outlaw discretionary indemnity options for what is considered appropriate cover for practising dentists, but I am yet to see a response. Therefore, I would welcome it if the Minister met me and my constituent to discuss this matter and the response to the consultation.
I am sure we all know that the Horizon scandal was a terrifying injustice, but in its own way the situation I am speaking about is also a scandal. Through no fault of their own, people are being denied huge amounts of compensation that they are legally entitled to. There is nothing in place to stop what is happening to my constituent’s father happening to many more people— I hope that it does not, but that is the reality. The Government have a duty to address safeguarding for patients and dentists. To exacerbate the problem, most patients and professionals do not know that their discretionary indemnity arrangement could still leave them out of pocket. When will the Government bring about change, or are they just incapable?
(2 years, 6 months ago)
Commons ChamberWe have gone from no winter crisis when Labour left office to an annual winter crisis—and now a crisis all year round under this Conservative Government. Patient satisfaction with the NHS is at a record low. Instead of there being a blame culture, when will the Secretary of State accept responsibility for that appalling record?
I think the hon. Lady was claiming that there was no winter under Labour, but perhaps that is yet another thing that does not quite stack up. I fully endorse her call for an end to blame culture, but point her to the real and practical measures that we have taken to improve urgent and emergency NHS care. I assume that she joins those on the Government side in condemning the unprecedented strike actions that the junior doctors committee has called at this particular time of year.
(2 years, 9 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
It is an honour to speak with you in the Chair, Mr Pritchard. I thank my hon. Friend the Member for Wirral West (Margaret Greenwood) for securing such an important debate.
The NHS was set up in 1948. It was the first of its kind in the western world, leading the way for free medical care—what a great achievement. So many societies still wish that they had what we have.
As has been said by other hon. Members, we have already had 13 years of the Conservatives leading the way—unfortunately with much failure and neglect. We do not have enough doctors or nurses, there are long waiting lists for appointments, and primary care is also not what it should be. People are finding it very difficult to get a GP appointment, there are no NHS dentists, and even pharmacies are really struggling to ensure they have enough medicines to give to people. In addition, mental health services remain the poor relative to the NHS. Under this Government, there has never been enough investment in NHS mental health services.
I will focus my remarks, conversations and questions on the future of the NHS for sickle cell patients. Sickle cell disease is a serious condition which predominantly occurs in people with African and Caribbean backgrounds, and approximately 15,000 to 18,000 people live with it. It has been two years since the “No One’s Listening” report was published by the Sickle Cell Society, which found evidence of serious failings. Failings were found in acute services, and there was evidence of attitudes “underpinned by racism”, meaning that patients were not treated with care. They were ignored, often not believed, and not given the pain relief and oxygen they needed. Unfortunately, we have seen many fatalities because of this.
In January, the NHS Race and Health Observatory found that sickle cell patients undergoing a crisis were deprioritised and undermined. This is in keeping with the “No One’s Listening” report, which presented evidence regarding the death of Evan Nathan Smith in North Middlesex University Hospital in April 2019. The inquest found that Evan’s death would not have happened if it were not for failings in the care that he received. It is shocking every time I say that and every time I mention that.
I have worked with Government Ministers, the NHS and other important bodies to get implemented in full the recommendations that have come out of the “No One’s Listening” report. I ask the Minister to go further and to focus more on those recommendations. If we are looking at the public purse, which has been mentioned a few times in this Chamber, we see that it is more cost-effective to put in preventative measures that help and support people to not get into a crisis where they need to be in hospital.
I therefore ask the Minister: will the NHS develop individual care plans in partnership with the sickle cell patient? Will all NHS trusts require haematology teams to be told when a sickle cell patient accesses outpatient or inpatient care? Will the Minister instruct all integrated care systems to develop plans to provide community care in this area? Will the Minister ensure specialist training opportunities for nurses? Will the Department co-ordinate work between organisations and senior sickle cell service representatives to engage in effective workforce planning for sickle cell services?
If the Minister cannot answer all of those questions towards the end of this debate, I ask him to put it in writing, to do his best, and to also attend the all-party parliamentary group on sickle cell and thalassaemia, which I chair.
The Minister is nodding, so I take that as an indication that he is willing to do that, which is really good. I also implore him to consider that sickle cell is a long-life disease, a hidden disease, a disability, and very serious.
The disease, however, has not had the research funding that it really needs. Looking at people with cystic fibrosis and haemophilia, we that they have had so much more funding invested into medicines to improve the treatment of those illnesses. The National Institute for Health and Care Research funds research programmes, but sickle cell research is woefully inadequate compared with the diseases that I have already mentioned. According to the data produced by that organisation, approximately 18,000 people are living with sickle cell, compared with the 10,000 that are living with cystic fibrosis, but in 2017-18 over a million pounds more was spent on research for cystic fibrosis. In the present day, 2022-23, still over a million pounds more is being spent on research for cystic fibrosis compared with sickle cell. That is entirely unacceptable, especially when there are more people living with sickle cell. I do not wish to take away funding from other research, but I do want equality of funding. I am sure the Minister also wants this as well.
As I draw to a close, I have already mentioned that prevention has to be the ultimate way to help people live a good quality of life and to keep them out of hospital, and it also helps to take of care of the public purse. In conclusion, the NHS is a wonderful creation that has helped every single person in this Chamber, and indeed every single person in our country.
I am afraid that we are going to have to restrict the last two Back Bench contributions to five minutes each.
(3 years, 1 month ago)
Commons ChamberI thank the hon. Member; it has been a pleasure to work with him in every single debate about mental health that I have held in the past three years, since I started my role. He speaks to the important point that prevention is the watchword that counts when it comes to mental health.
My hon. Friend is making a powerful speech. Does she agree that the Government are failing people who are experiencing mental ill health, or even a mental health crisis? Psychiatrists are leaving the country because they are finding jobs overseas more accessible. People experiencing mental health crises are having to wait in A&E departments for too long; they waited for a total of 5.4 million hours during 2021, which is entirely unacceptable. Things need to change.
I thank my hon. Friend for assisting me in writing my speech; she has pre-empted much of what is to come. She is a powerful advocate for her community and I am proud to share the Opposition Benches with her.
I completely agree about its tremendous importance, and I take this opportunity to mention the incredible work on this hugely important issue by brilliant charities such as Beat. I will outline some of the general things we are doing to increase capacity further.
Only a few weeks ago, I met a constituent who endured an awful kidnapping and rape. She had some initial counselling and therapy from specialist services, but she has now been on the waiting list for more than a year and a half. What would the Minister say to my constituent, who desperately needs therapy?
I am terribly sorry to hear about the hon. Lady’s constituent’s case, which I will look at extremely closely. This is why we are putting in extra investment and tackling waiting lists.
(3 years, 2 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
I beg to move,
That this House has considered the future of stoma care.
It is an honour to serve under your chairmanship, Mr Betts. In July last year, I hosted a truly inspirational event called Stomas in Parliament, which welcomed participants in a unique relay race from a London hospital to Parliament. For colleagues who might be unaware, a stoma is an opening on the abdomen that can be connected to either the digestive or the urinary system to allow waste to be diverted from the body. The race was led by people of all ages who have a stoma, including a seven-year-old girl called Jessica, and other members of the stoma community, such as incredible nurses and charities, and suppliers of stoma services and products, as well as my hon. Friend the Member for Peterborough (Paul Bristow). Sadly, I did not and do not have the legs for such running, but the event was a symbolic display of the activities that people with a stoma can do when they receive high-quality care and support. I am delighted to see representatives here today. Thank you so much for coming.
The purpose of the race was to deliver a “calls to action” statement, which was passed to me in Victoria Tower Gardens, just outside Parliament. The statement was developed by people with stomas, and it sets out the improvements needed to ensure that everyone with a stoma has access to optimal care so that they can live their life to the full. It was good to see people doing that, but sadly many individuals still receive suboptimal care, which has a significant impact on their quality of life, including their ability to work, as well as placing additional pressure on the NHS through potentially avoidable GP or nurse appointments and emergency admissions.
I would be delighted to give way. The hon. Lady has chosen a great moment to intervene.
I thank the hon. Gentleman for making such a powerful and significant speech to open the debate. I had a stoma in my late 20s, so I understand and recognise the significance of having great care. Does he agree that much more needs to be done to ensure that people get the care and support they need when they have a stoma?
The hon. Lady is absolutely right. This is the message I intend to deliver today: we need more care, and we need to get it right and give it at the right time to the right people. This is about individual cases, as I shall touch on later.
Complications with a stoma can include leakage, which in turn can lead to painful skin rashes, unpleasant odour and isolation, all of which can lead to career and relationship difficulties. I admit that before I was approached about taking part in the Stomas in Parliament event, I had little knowledge or understanding of stomas, or of how many people of all ages across the country are living with stomas. In my Clacton constituency, there are at least 300 people living with a stoma. In the UK, there are between 165,000 and 205,000 people living with a stoma.
People with a stoma face many physical and emotional challenges in their post-surgery life. However, access to specialist stoma care is highly variable across the health system. In addition, such intimate healthcare conditions are often stigmatised and under-prioritised. That leaves too many people suffering in silence, which should not happen.
As I have learned more from people with intimate healthcare needs, I have realised that patient choice and shared decision making are essential. I have with me a fantastic prosthetic, which gives some idea of what a stoma looks and feels like. People live with the condition day in, day out. Unless people are users of particular stoma care services or products, they will not realise how transformative such positive treatment can be.
That message came across strongly during the Stomas in Parliament event. The attendees gave me a strong understanding of how important personal appliance choice is, and needs to be, to help people to live their life to the full. Of course, everybody is different and bodies change over time, which means that getting the right stoma appliance is vital. I hope my hon. Friend the Minister will commit to ensuring that people living with stomas are able to access the right products for them at the right time. I know that work is continuing on the next stage of the Department’s medtech strategy.
The formation of a stoma is a lifesaving procedure for many, but it also produces difficulties. More needs to be done to address those difficulties, and providing equitable access to defined specialist pathways will improve the consistency and quality of care and patient outcomes. Getting that right will support the NHS prevention and self-care agendas while reducing pressure on emergency hospital services and, in the long run, saving the NHS money.
Great work on patient pathways is under way in the stoma community. Just this month, the Getting It Right First Time programme was formed. It is led by the industry and joined by the charities and the surgery lead for the NHS, and its work includes applying an NHS Getting It Right First Time approach. As part of that much-needed work, the group will be undertaking a national audit and developing a best practice and evidence-based stoma care pathway to address the postcode lottery of stoma care, ensure long-term, follow-up services and ensure equity of access to care.
I wish to mention that I have spoken separately with Crohn’s and Colitis UK, which is the leading charity for the 500,000 people affected by Crohn’s and colitis in the UK; I have with me a briefing note from the charity, which I will be happy to share with colleagues. I have also received representations from the Urostomy Association, which has asked me to highlight, regarding the choice of equipment, that one size does not fit all: we need the choice of a variety of products from different companies. In some cases, people can have serious skin issues with a particular type of adhesive used by one company and may therefore need to change suppliers.
I turn to the issue of access to a specialist care stoma nurse. Ideally, annual checks with a stoma nurse would be useful, but in the main that is not possible. Some people with a stoma may rarely need to see a nurse, but others may have constant leakage problems and would benefit from more regular specialist nursing advice. Finally, GP surgeries are required to approve prescriptions for stoma supplies but have been known to delete items requested on a cost basis, not realising that doing so will cause suffering for patients.
I turn to my asks of the Minister. First, I would be most grateful if he committed to a meeting with me and the Stomas in Parliament organisers, Colostomy UK, the Urostomy Association, the Ileostomy and Internal Pouch Association, and Coloplast UK, to discuss the calls to action and the possible impacts of the medtech strategy on stoma.
Secondly, many people in the stoma community and the industry are concerned that the UK is sleepwalking into a position in which our science medtech industry is so stretched that it is seriously considering not having the UK as a primary market for research and development investment. Will the Minister commit to discussing those issues with me and the stoma community?
Finally, will the Minister commit to meeting the group working on the first NHS Getting It Right First Time stoma care pathway and ensure equitable care in the UK for every person with a stoma?
It is a pleasure to serve under your chairmanship, Mr Betts. I congratulate my hon. Friend the Member for Clacton (Giles Watling), my near neighbour, on securing this important debate. He is a tireless advocate for his constituents and for patients across the country who suffer from conditions such as bowel cancer. They are fortunate to have him as their advocate.
Let me start by touching on the importance of reducing stigma. Stoma care is a topic that not everyone feels comfortable talking about, and as a Minister at the Department for Health and Social Care I want to play my part in reducing the stigma around living with a stoma. I hope that this debate and the event to which my hon. Friend referred will play some part in encouraging people to talk more about stomas and to come forward for services such as bowel cancer screening. I am hugely grateful to him for the opportunity to discuss this important issue in Parliament.
We know how important prevention and early detection are to health. Bowel cancer screening is available to everyone in England aged 60 to 74, and since 2021 we have been expanding the screening offer in England to younger patients so that everyone aged 50 to 59 will be included by 2025. We also know that the early proactive management of bowel disease is far better for patients, as my hon. Friend rightly pointed out. In many cases, it will reduce the amount of surgery resulting from stomas.
My hon. Friend referred to patient choice and the differing quality of stoma products. I know how important patient choice is, not just in this area but in so many areas across our NHS. I also know—my hon. Friend put this point eloquently and articulately—that one stoma product does not always work for all patients, which is why it is so important that there is patient choice. I recognise that having the right stoma product to support patients’ quality of life is as important as the medical need itself. My hon. Friend raised a serious point about general practitioners deleting items; I will ask my officials in the Department to investigate that point and write to him.
I am grateful for the opportunity to update the House on the levels of NHS spend. Current NHS expenditure in this field is about £350 million every year, which is predominantly used to provide stoma products to patients. Over 9,500 different stoma products are available on the NHS, and these products are prescribed to patients under part IX of the drug tariff. I am pleased to remind colleagues that one area of focus in our inaugural medtech strategy published in February this year, which has been widely and largely welcomed by industry, is medical devices used in the community, which include prescribed stoma products.
We have a stoma products consultation, which I will touch on, and the Department of Health and Social Care is leading a piece of work to review how the tariff operates in order to ensure that appropriate and effective products are prescribed to patients. I acknowledge that it is currently difficult to know the position and to compare the differences between products on the drug tariff. We will work to make things as transparent as possible so that clinicians are far better informed and can provide the right product for each and every individual patient.
We will also continue to support the provision of a range of stoma products through part IX of the drug tariff to ensure equitable access for patients, an issue that my hon. Friend touched on. We do not want a postcode lottery. I want to make sure that patients, regardless of where in the country they live, have a voice in determining the product range available on the tariff, so that the interests of patients are at the heart of how the tariff operates.
I thank the Minister for responding to the questions that have been asked. When the Government are looking to purchase products for people who have a stoma, will there be some consultation with patients so that they can help to make a decision as to the types of product that they feel will work for them?
I thank the hon. Lady for her intervention and for sharing her personal experience, which is a hugely valuable part of this debate. As I have said, a large number of products are already available on the NHS. She is absolutely right to say that we should engage with patients, because product selection should always be based on the clinical need of individual patients, not on manufacturing brand, pressure from particular companies or relationships with individual trusts. Yes, patients will be at the heart of the decision-making process, and rightly so. We are currently engaging on that exact point with a number of patient groups and with the industry, which is an important part of this as well. We will launch a targeted consultation over the summer, and I encourage patients, charities, organisations and industry to take part; I think they naturally will. We must ensure that the tariff continues to provide effective products to patients, wherever they live in the country.
My hon. Friend the Member for Clacton touched on patient care. I, too, recognise that the patient pathway for stoma care differs depending on the model of care that commissioners have adopted, hence my reference to a postcode lottery. Stoma service delivery models have been supported nationally through past NHS initiatives such as the QIPP, the national quality, innovation, productivity and prevention programme—it is a mouthful —which published recommendations on best practice for delivering stoma services. There are already really good examples across the country, such as in Rotherham, Nottingham and the midlands, of stoma services being delivered effectively based on those fundamental principles. It is important that we share that best practice and ensure that it is rolled out across all the country’s integrated care systems.