Oral Answers to Questions

Jeff Smith Excerpts

Tuesday 26th March 2019 Commons Chamber

[Matt Hancock]

That is an interesting proposition and I would be happy to talk to the hon. Gentleman more about the idea. I was in Northern Ireland last week looking at medical services there and at what we can learn, and that might be another idea.

[Jeff Smith (Manchester, Withington) (Lab)]

13. What guidance the Government have issued to sustainability and transformation partnerships on drafting their five-year workforce plans.

[The Minister for Health (Stephen Hammond)]

Workforce is a key priority for the Government, which is why my right hon. Friend the Secretary of State asked Baroness Dido Harding to develop an interim workforce implementation plan for the spring, including a 2019-20 action plan. It is right that local leaders and clinicians should be empowered to shape the services they need, which is why NHS Improvement has written to all system leaders in England to ask for their views on the vision that is coming forward.

[Jeff Smith]

The all-party parliamentary group on mental health’s recent report found that workforce is the biggest challenge to delivering improvements to mental health care. Given that there are 4,000 fewer mental health nurses than there were in 2010, what additional guidance and funding will the Government provide to ensure that local partnerships can recruit mental health nurses, and what are they doing to expand medical school places so that we can train more doctors, particularly in psychiatric specialties?

[Stephen Hammond]

The hon. Gentleman asked a number of questions there. It is true that the NHS has recently asked all sustainability and transformation partnerships and integrated care systems to create new five-year plans by autumn 2019 setting out how they are going to transform services. He will know that mental health is a priority in the long-term plan and that we are expanding the number of places for clinicians.

Oral Answers to Questions

Jeff Smith Excerpts

Tuesday 27th November 2018 Commons Chamber

[Stephen Hammond]

I am aware that the local trust has had a number of problems and that there were a number of bed closures—both temporary and permanent —earlier this year. The trust is closely monitoring how those closures are affecting services and patients. The hon. Gentleman will know that beds are being reopened—five beds have been reopened recently—and that there is a plan to put in place the staffing so that the whole ward can reopen in the near future.

[Jeff Smith (Manchester, Withington) (Lab)]

19. The Department’s own statistics show that more than 23,000 mental health staff left the workforce last year. That is an eighth of the total mental health workforce. How can we possibly get parity for mental health when more than one in 10 posts are vacant and staff are leaving?

[Stephen Hammond]

The hon. Gentleman will know that the Government are committed to having more nurses and more staff in training, that we are putting in place extra measures to ensure that specialities are supported through that training process and that the extra £20 billion in the long-term plan will ensure that there are the staff and nurses needed to fill those vacancies.

Oral Answers to Questions

Jeff Smith Excerpts

Tuesday 19th June 2018 Commons Chamber

[Stephen Barclay]

I am happy to agree to meet my hon. Friend.

[Jeff Smith (Manchester, Withington) (Lab)]

Last November, the Health Secretary committed to ending out-of-area mental health placements by 2020, but the number of people placed more than 100 km from their home rose by 65% over the past year. The earlier response from the Under-Secretary of State for Health and Social Care, the hon. Member for Thurrock (Jackie Doyle-Price), was no answer, so what are the Government actually going to do to turn the situation around?

[Mr Hunt]

There are record numbers of tier 4 beds, and we are putting record amounts of money into mental health.

Surgical Mesh

Jeff Smith Excerpts

Thursday 19th April 2018 Commons Chamber

[Emma Hardy]

The hon. Gentleman is absolutely right. After we have moved on from looking at vaginal mesh, we need to look at rectopexy mesh and mesh that has been used in men as well. I completely agree.

[Jeff Smith (Manchester, Withington) (Lab)]

I congratulate my hon. Friend on her work. The NHS audit recently looked at the women who had suffered as a result. Does she agree that it would have been helpful to look at the number of men who have been affected, so that we get a picture of the true severity?

[Emma Hardy]

Yes, my hon. Friend is right. The all-party group should push for that after we have looked at the issue.

For those who are more statistically minded, NHS Digital undertook the recent audit, which was published on Tuesday. The facts are these: more than 100,000 women had vaginal mesh inserted between 2008 and 2017 to treat stress urinary incontinence, which is common after childbirth.

Oral Answers to Questions

Jeff Smith Excerpts

Tuesday 19th December 2017 Commons Chamber

[Steve Brine]

I can come back to the hon. Gentleman in more detail on that. As part of the life sciences sector deal, there is just over £210 million of industrial strategy challenge funding for early diagnosis. This includes funding to build on the UK’s leadership in genomics, where we are very strong, and to establish programmes in digital diagnostics and artificial intelligence in healthcare.

[Jeff Smith (Manchester, Withington) (Lab)]

11. How many mental health staff the NHS employed in (a) 2010 and (b) 2017.

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

Although we cannot meaningfully compare between 2010 and today, I can advise that the number of NHS staff working in mental health and learning disability trusts was 162,611 in July 2013 and 166,905 in July 2017—an increase of 4,334.

[Jeff Smith]

That did not actually answer my question. Earlier, my hon. Friend the Member for Ellesmere Port and Neston (Justin Madders) read out a long list of concerned professionals, so let me add one more—Professor Wendy Burn, the president of the Royal College of Psychiatry, who said after the Budget:

“There is a real and imminent danger that the promises made to improve mental health services for the millions of people who need them are about to be betrayed.”

Is she wrong? Is it not true that without proper funding for more staff, the Prime Minister’s pledge to transform mental health services will not be met?

[Jackie Doyle-Price]

As the hon. Gentleman knows, we have published a workforce strategy to deliver exactly on the commitments that the Prime Minister has made. I can report that we have had a significant increase in the workforce. For example, in IAPT—improving access to psychological therapies—the number is up by 2,728 since 2012, a 47% increase. The number of psychiatry consultants is up from 4,026 in 2010 to 4,292. The number of community psychiatry nurses is up from 15,500 in 2010 to 16,658 in August 2017. We are delivering the workforce to implement the Prime Minister’s commitments. The most important thing is that rather than trade numbers, we should look at outcomes for patients and improving patient care.

Hormone Pregnancy Tests

Jeff Smith Excerpts

Thursday 14th December 2017 Commons Chamber

[Jeff Smith (Manchester, Withington) (Lab)]

I pay tribute to the right hon. Member for Hemel Hempstead (Sir Mike Penning) and my hon. Friend the Member for Bolton South East (Yasmin Qureshi) for securing the debate and for their work on this issue over the years. I pay tribute to other hon. Members who have doggedly pursued justice for the victims of Primodos over a long period.

I have come relatively late to this issue, but it is very clear to me that, as my hon. Friend the Member for Liverpool, Riverside (Mrs Ellman) said recently at the all-party group, the lesson we have to learn from previous scandals is that any inquiry must have the confidence of the victims. The report of the expert working group has already failed that test.

I am speaking today because constituents of mine have been affected by the tragic events relating to hormone pregnancy tests. They have contacted me to say that they have no confidence in the process or in the conclusions of the report. The Pierce family and the McLellan family have had their lives changed by Primodos. They are convinced that their family’s issues are as a direct result of Primodos use. Louise, the daughter of my constituent Edward, suffered life-changing multiple health issues. They are just one of many thousands of families who need to see justice for the harm caused by this drug. The announcement of the review gave them some hope, but, having been in contact with them in recent weeks, I know they share the disappointment and anger experienced by many following the publication of the report.

There are too many question marks over the process and over the conclusions of the report of the expert working group. The report itself flags up the difficulty of drawing robust conclusions on the analysis of the studies available. It admits that the available evidence was very limited. It then concludes that the body of evidence did not “on balance”—key phrase—support an association between the use of HPTs and congenital anomalies. We need more explanation and more justification of what is meant by the words “on balance” in the light of such limited evidence.

In 1977, the medical regulator wrote that there was an association between the tests and birth defects. We must therefore ask what new study or evidence is available to dispute that conclusion. It strikes me that, without new research that tries to establish a new body of evidence, it is not possible to determine whether Primodos is safe. I agree with the suggestion that the Government create a ring-fenced fund to enable new studies, perhaps using imaging analysis and molecular study to try to get to the truth. Even new studies are unlikely to resolve the issue definitively—it is likely to come down to a Government judgment on where the responsibility lies—but they may at least give comfort to the victims that the whole process has been carried out thoroughly.

As we have heard, there are questions about the regulatory regime surrounding hormone pregnancy tests—I do not have the time to get into the details—but the biggest question is surely over whether this product should have been allowed on the market at all without proper testing.

[Mr Tanmanjeet Singh Dhesi (Slough) (Lab)]

My hon. Friend is making an excellent speech. I commend the right hon. Member for Hemel Hempstead (Sir Mike Penning) for bringing forward the motion, and other hon. Members. I particularly commend my hon. Friend the Member for Bolton South East (Yasmin Qureshi) for all her work over the years. I think that my hon. Friend the Member for Manchester, Withington (Jeff Smith) will be aware that countries such as Finland, Sweden, Holland and Norway actually banned the use of hormone pregnancy tests between 1970 and 1971. Does he agree that the warning signs were clearly indicated at the time, so action should have been taken then to prevent foetal malformations and all the ensuing heartache?

[Jeff Smith]

My hon. Friend is right and makes an excellent point. We must ask why there was so little regulation for so long, given that it is possible to regulate on a precautionary basis, and whether there is a Government liability under general product law that is meant to protect citizens. Those questions need to be considered in detail.

We heard other questions about the transparency of the report, including that the published report is not the original report that was first presented. A number of inaccuracies were identified and key wording was changed, including the word “definitive”, which was removed. So is this a definitive report? If not, we clearly need a new inquiry. I am running out of time and other people have covered transparency, so I am not going to talk in great detail about it.

There are too many question marks over this issue. In order to regain the trust of the victims, the Government must commit to a judge-led independent public inquiry under the Inquiries Act 2005 to look at the issue again. The inquiry must have all the powers needed to bring to light all available evidence relating to the scandal, including the ability to compel witnesses to give oral evidence. The inquiry must be broad enough to look at the scientific and legal issues in the case, including the allegations of liability. Finally, the victims and their families must be involved in the design and implementation of the inquiry following the Hillsborough inquiry’s families first approach.

As we have heard, there are concerns across the House about this matter. It is not a party political issue. Something is not right and we need to get to the truth. We owe it to the victims and to people who may still be taking products related to these drugs. The only way we will get to the truth is with a judge-led inquiry.

Drug Addiction

Jeff Smith Excerpts

Wednesday 22nd November 2017 Westminster Hall

[Craig Mackinlay]

I thank the hon. Lady for that intervention. She has put that issue on the record, and I am sure the Minister will address it later. I will provide some data for Wales that may assist her.

My concerns are somewhat summed up by that old adage, which is usually used in relation to financial markets: when the US sneezes, the UK catches a cold. I am concerned that we may be on the brink of a fentanyl epidemic here in the UK. I want to highlight both the human costs and the financial costs of drug addiction to the UK economy and to the people of this country.

The human costs are fairly obvious. Everyone will have their own points to add to this list, but they include: physical and mental health issues; disruption to families; the effects on children and their life chances, including the increasingly clear link between drug use during pregnancy and various autism spectrum conditions and physical deformities in children; the obvious spread of disease; the often desperate measures that people take to try to raise cash, resulting in prostitution and all manner of human degradation; forgone opportunities and the essence of all that someone could be in life being extinguished; and, of course, premature death.

[Jeff Smith (Manchester, Withington) (Lab)]

The hon. Gentleman is right to highlight the fact that our drugs policy in this country is failing. Does he not think that now might be the time for a shift in drugs policy and for us to focus not on criminalisation but on care and health? Should that not be the focus of our drugs policy?

[Craig Mackinlay]

The hon. Gentleman is right. I have an expansive speech to make, which I think will cover all the issues well. Perhaps he would like to come back in with those points later.

I chair the all-party parliamentary group on the harmful effects of cannabis on developing brains and have a long interest in that topic. The APPG’s principal aim is to raise awareness of the continued and growing danger to children, teenagers and their families of cannabis use in particular but also of wider drug use. I will publish a detailed paper on that subject later. The effects of the early use of skunk cannabis on youngsters’ mental health are increasingly recognised, as is the additional human cost of the significant rise in other effects, such as traffic-related deaths, in some of the US states that have gone down the route of decriminalisation.

I do not just take an abstract, desk-based approach to this topic. I have been a magistrate in Kent for 12 years. For too long, I have seen people go through the same revolving door of committing crimes, coming to court and going to prison. The same drug-related issues come up time and again. On one occasion, someone’s appearance in court arose from offences committed on the day of their release from a custodial sentence. That revolving door has to stop. Too often, I have seen youngsters in their late teens or early 20s who are on employment and support allowance or similar disability benefits and are incapable of holding down work brought to court after bouts of acquisitive crime. Nearly all of them are on long-term anti-psychotic drugs to deal with schizophrenia and bipolar disorders. In my experience, practically every one of those people gives the same mitigation in court: “I’ve had a long-term addiction to cannabis from an early age”—often from the age of 13.

The 2014 NHS National Treatment Agency for Substance Misuse paper was particularly useful in advance of this debate. It highlights that there are 306,000 heroin and crack users in England, with disproportionate heroin and crack use in lower-income areas compared with wealthier parts of the country. Drug use and poverty are linked. More than 1 million people are affected by family members’ or friends’ links to drug addiction. The Advisory Council on the Misuse of Drugs found a substantial increase in the number of people dying from drugs in the UK in recent years. That is mainly down to opioid substances, which, as I mentioned, caused 2,677 deaths in 2015. Opioid-related deaths have increased year on year. A massive increase in the 1990s followed a marked increase in heroin use. Thankfully, the number of deaths flattened and declined in the late 1990s and early 2000s—that was often put down to lower grade and more highly cut heroin being sold—but it has risen markedly since 2004.

Let me move on to fentanyl and various synthetic opioids, which are cited as the reason for the increase in deaths in the US. Fentanyl is a fairly normal pharmaceutical product. It is widely used, often in operations. It was first created in the early 1960s as a pain management drug, and it is very effective at that. It has a fairly easy formulation, but illicit supply increasingly comes from China, hence its street name of China white.

The epidemic of drug overdoses in America is killing people at almost double the rate of both firearm and motor vehicle-related deaths. Between 1999 and 2015, it is estimated that fentanyl and derivatives killed about 300,000 people in the US—the numbers are of virtually biblical proportions.

We regularly hear the argument for legalisation of cannabis, with those demands often coming from our Liberal Democrat friends—I see the right hon. Member for North Norfolk (Norman Lamb) in his place. Let us examine a real case study. In November 2012, Colorado and Washington states voted to legalise the private use of marijuana. In those two states, marijuana use exceeds the US national average and has risen significantly post-legalisation—more rapidly than in states where it is still illegal. We have also seen increases in teen arrests, accidental ingestion by children, marijuana-related poisoning, teenage admissions to treatment, and crime.

According to the Associated Press:

“In Washington, the black market has exploded since voters legalized marijuana…with scores of legally dubious…dispensaries opening and some pot delivery services brazenly advertising that they sell outside the legal system.”

Rather than putting a lid on matters, legalisation has taken the lid off. Marijuana-related traffic deaths—where a driver tested positive—have more than doubled, from 55 in 2012 to 123 in 2016, and there has been a 72% increase in marijuana-related hospitalisations since legalisation.

With that backdrop, let us look at the UK. The Library suggests that drug misuse in England and Wales has fallen in the past decade. That has got to be good news. However, I view some of those figures with a little scepticism; I will refer to such matters later on. Of course, 95% of heroin on the streets originates from Afghanistan, and cocaine invariably comes from Peru, Colombia and Bolivia; it is not manufactured in the UK. For that reason, I very much hope that as we leave the European Union and exercise more diligent control of our borders, we will be able to implement a more rigorous approach to border security, particularly on the smuggling of drugs.

The number of people in drug addiction treatment in the UK is at just a little under 300,000, with opiate dependency involved in more than 52% of cases. More than 100,000 under-18s are living with people in drug treatment. Those are some of the human costs. What are the financial costs?

[Craig Mackinlay]

My hon. Friend makes a good point. We in the judiciary often feel that we put people in prison as a last resort and hope that that is a place where they may seek relief from drugs and get the treatment they need. However, all too often we hear of many examples where that is far from the case.

I want to mention the financial cost, because it is hugely relevant to our economy. Figures I have put together suggest that the financial cost now amounts to a fairly reasonable chunk of our annual deficit. It is very difficult to pull figures together, but one that I have derived from headline data is £20.3 billion a year. That does not include some of the more unknown and abstract costs, such as opportunity costs of lost economic output from a potential workforce who are economically inactive due to drug dependency and the physical and mental effects of drug use.

To break the figure down, drug-related crime is estimated at a fraction under £14 billion a year. The cost to the NHS of ongoing health issues resulting from drug addiction is half a billion. The benefits and treatment cost is estimated at £3.6 billion—£1.7 billion in direct benefits, £1.2 billion in the cost of looked-after children of drug addicts, and £700 million in addiction treatments such as methadone and Subutex. The cost to the courts, the Prison Service and the police in 2014-15 was £1.6 billion. An addicted person not in treatment and committing crime costs on average £26,074 a year. A somewhat dated Daily Telegraph report shows that a problem drug user could cost the state £843,000 over their lifetime—and that was in 2008.

Some of the other human costs are obvious, such as depression, anxiety, psychosis and personality disorders. Some 70% of those in drug treatment suffer from mental health problems. We might ask which follows which, but I think there is a clear link between drug use and psychotic episodes. Cardiovascular disease is also an issue after a lifetime of drug misuse. Muscular and skeletal damage are commonplace among injecting drug users. Lung damage following the smoking of various drugs and derivatives is also prevalent. Poor vein health and deep vein thrombosis is common among injectors. Then there is liver damage, which is expensive to treat, with hepatitis C causing cirrhosis, liver failure, liver cancer and death.

Deaths can come in many forms, including through accidents, suicides, assaults and simple overdose, as well as misadventure from drug poisoning, and drug abuse and drug dependence. Figures from the Office for National Statistics show that 2016 saw the highest number of deaths down to illegal drug use since records began in 1993. That fact is worth bringing to the table. Fewer than 1% of all adults in the UK are using heroin, but about 1% of heroin addicts die each year—10 times the equivalent death rate of the general population—and those deaths are predominantly from heroin and opioid use.

I will give the hon. Member for Dwyfor Meirionnydd (Liz Saville Roberts) some figures for the UK. Between 2012 and 2015, opioid-related deaths in England rose by 58%. She will be pleased to know that in Wales the rise was only—if that is the right word—23%; in Scotland it was 21% and in Northern Ireland, 47%. We now see an ageing cohort of drug users who began their drug-taking lives in the ’80s and ’90s coming through the system with increasingly complex health and social care needs, which have contributed to a recent spike in deaths.

A typical heroin user is likely to spend £1,400 a month on drugs—two and a half times an average mortgage. More than half of all acquisitive crimes—crimes including shoplifting, burglary, robbery, car crime, fraud and drug dealing, whether at a lower or higher level—are down to those on heroin, cocaine or crack. Those crimes have victims. To bring that down to a micro-level, figures from Kent County Council’s road safety team show there were 59 incidents of known drug-driving on Kent roads in 2016, with 16 resulting in serious injury and three in road accident deaths. Those figures are rising. In the last 10 years, Kent has seen 18 fatal, 70 serious and 142 slight accidents due to drug-driving incidents.

When budgets are stretched nationally and locally, the temptation is to reduce treatment, but that is entirely the wrong approach. NHS figures suggest that for every £1 spent on drug treatment, there is a saving of £2.50 to general society. We have a good record on drug treatment in the UK, far better than many other countries in the world. In England, 60% of heroin users are in treatment, compared with only 45% in Italy and 37% in the Netherlands. We have fewer injectors now than we did some years ago. We have an advanced needle-sharing procedure, and that is improving. As I say, it is far better than other countries: 1.3% of drug injectors suffer from HIV, compared with 3% in Germany and 37% in Russia, so we are doing some things very well.

What can drug treatment do to help outcomes for society? Obviously, it stops emergency admissions, as A&E is often the first call, it prevents suicide, self-harm and accidents, and of course it reduces reoffending. Estimates in the NHS document suggest that a city the size of Bristol could cut 95,000 offences a year through effective treatment. The benefit of that to society is some £18 million a year. It is not just the financial effect, however; there are other societal effects: reduced crime, less drug litter and less street prostitution. The area that I used to represent as a councillor in the Medway towns was plagued by street prostitution in the middle of Chatham. With that came the drug litter and sexual paraphernalia literally dumped in the street, costing the council money and being a potential source of infection to others.

Troubled families can be stabilised through effective drug treatment. We can reduce drug-related deaths and blood-borne viruses. I repeat: £1 spent can represent a saving of £2.50 to society.

[Jeff Smith]

The hon. Gentleman is rightly making the case that it is a false economy not to invest in addiction services. Does he share my disappointment that funding for addiction services has fallen by half and that, under this Government, public health budgets are also falling, with councils struggling to fund the addiction services we need?

[Craig Mackinlay]

I could not agree more with the hon. Gentleman: I feel there is a false economy in cutting that type of service. Obviously, they are the sorts of services where we cannot always see what sort of bang we are getting for the pound spent, because the savings come about in a rather disparate way. The hon. Gentleman brings a very powerful case to the table.

The Government have spent vast sums of money over the last few years on the Frank initiative. I do not know whether hon. Members will remember it—“Call Frank”; “Tell Frank”. I have asked many youngsters of late whether they have heard of “Frank”, and they do not have a clue who he is, so I question somewhat the effectiveness of the Frank initiative, which is particularly aimed at teenagers and adolescents. I will be reporting in a detailed paper shortly, so hon. Members should look out for that.

Almost in closing, I want to look at the July 2017 drug strategy. It is a good strategy with recovery at its heart. It looks at the threats and at the actions we can take to reduce homelessness, domestic abuse and mental health issues. The strategies are the usual strategies, which I think are common sense: reducing demand through deterrence and the expansion of education and prevention information, obviously restricting supply through law enforcement responses, supporting recovery and driving international action to reduce the amount of foreign-produced drugs hitting our streets—of course, that does little to stop the ever-increasing rise of cannabis grown in the UK. I believe it is clear that drug misuse destroys lives. It has a devastating effect on families and communities.

Surgical Mesh Implants

Jeff Smith Excerpts

Wednesday 18th October 2017 Westminster Hall

[Jeff Smith (Manchester, Withington) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Owen. I congratulate my hon. Friend the Member for Kingston upon Hull West and Hessle (Emma Hardy) on securing the debate and on her powerful speech. I also congratulate my hon. Friend the Member for Pontypridd (Owen Smith) on raising the issue and on forming the APPG to raise the profile of an issue that I confess I knew virtually nothing about until quite recently. I congratulate the many Members who have made powerful speeches explaining the experiences of women in their constituencies.

As I have said, I knew nothing about this issue, but its seriousness was brought home to me when a constituent came to see me. He had had an inguinal hernia repair that developed complications because of the mesh used in the procedure. It left him in agony; he described it as like having a metal plate wedged in his lower abdomen. Eventually, he had to have corrective surgery, but it did not resolve the chronic pain that he suffers. That points to one of the unique aspects of this problem, which is the difficulty of removing the mesh and correcting the initial surgery. He had the mesh removed, but he is still in constant pain. I think that is partly due to the fact that the expertise in removing mesh implants is not really there.

[Alec Shelbrooke]

My constituent described it as trying to remove hair from chewing gum, which shows just how utterly complicated this surgery is.

[Jeff Smith]

That is an important, well-made point. The failure of the procedure that my constituent went through has changed his life. He was previously a runner, cyclist and mountain-climber—a very active man. He now struggles to get around. When he came to see me, he had to stand throughout our meeting because of the pain that he is in. He is now suffering with a chronic condition as a result of the failed procedure.

My constituent has been in contact with a number of other men—and is aware of many others—who are in this difficult situation. He asked me to ask the Minister two questions. First, how many men have gone through this procedure and had it fail? Secondly, will the scope of any future NHS investigations be widened to include men as well as women? I do not want to downplay the seriousness of the issue for women, which has been clearly explained by a number of Members today, but any investigation needs to take the experience of men into account.

As it happens, my constituent underwent his procedure in a private hospital, which points to three wider issues that he asked me to raise. First, there is a lack of clarity—as we have already heard—about the roles and responsibilities within private hospitals and between hospitals, surgeons and others involved in the process. Secondly, there is no mandatory reporting of chronic pain incidents following unsuccessful operations; that clearly needs to be addressed.

Thirdly, there is a three-year limit to medical negligence claims, which has had an impact on my constituent and possibly others as well. My constituent had his operation just under three years ago, but he has been managing his agonising pain and chronic condition for the last two years and has not really been able to think about whether there is a medical negligence claim. He does not really have time now to lodge one within the three-year limit. I would be interested to hear the Minister say something on those matters.

I conclude by supporting the other points that have been made by hon. Members about the prioritisation of this issue by the National Institute for Health and Care Excellence and the need for a full public inquiry.

Oral Answers to Questions

Jeff Smith Excerpts

Tuesday 10th October 2017 Commons Chamber

[Mr Hunt]

My hon. Friend, who has a lot of experience of working in the NHS, is absolutely right. The new Care Quality Commission inspection regime is designed precisely to identify good, strong leadership, because that has the best impact on staff and, through that, the best impact on patients.

[Jeff Smith (Manchester, Withington) (Lab)]

9. What assessment he has made of the advice of the Advisory Council on the Misuse of Drugs on the level of funding for drug treatment services.

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

We thank the ACMD for its report, and we take its advice seriously. Discussions will happen across Government, and we will respond fully in due course in the usual way.

[Jeff Smith]

The ACMD says:

“England had built a world class drug treatment system… This system is now being dismantled due to reductions in resources.”

More than 100 local authorities have had to reduce spending on addiction services this year as a result of Government cuts. Will that reduction in addiction treatment budgets not just cost the NHS more in the long term?

[Steve Brine]

The Government are already investing £16 billion in public health services over the spending review period. We made it a condition of the public health grant that local authorities have regard to the need to improve the take-up and outcomes of their drug and alcohol services. Local authorities are best placed to make those decisions. The investment in effective services means that the average waiting time is just three days and, according to our monitoring systems, treatment outcomes in Greater Manchester are generally better than or in line with the rest of England.

Oral Answers to Questions

Jeff Smith Excerpts

Tuesday 15th November 2016 Commons Chamber

[Mr Hunt]

I am happy to talk further with my hon. Friend. He knows that this is a local matter. It was, I think, looked into in 2014, but if the pattern of demand changes it should be kept under review.

[Jeff Smith (Manchester, Withington) (Lab)]

11. What assessment he has made of the effect of changes to local authority social care budgets on the demand for health services.

[The Parliamentary Under-Secretary of State for Health (David Mowat)]

Social care plays a vital role in keeping people healthy and independent, which is why the Government are making a further £3.5 billion available by 2020—a real-terms increase over the lifetime of this Parliament. There is an overlap between care and health, which is why faster integration is our major priority.

[Jeff Smith]

The Secretary of State’s Conservative predecessor, Stephen Dorrell, has said this month that we are increasingly using our acute hospitals as “unbelievably expensive care homes”, and he described this as a “grotesque waste of resources”. Is it not the case that the Government have simply outsourced the hardest decisions on social care cuts to the hardest-pressed local authorities to ensure that councils get the blame, not the Government, and that ultimately it is the NHS that suffers?

[David Mowat]

As I said earlier, we agree that the social care system is under pressure, but we also make the point that there is a massive disparity between the performance of different parts of that system. For example, Manchester, the hon. Gentleman’s own patch, has a DTOC performance seven to eight times worse, per 10,000 patients, than Salford, in spite of the 15% increase in its budget this year.