Oral Answers to Questions Debate
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Main Page: Jeremy Hunt (Conservative - Godalming and Ash)Department Debates - View all Jeremy Hunt's debates with the Department of Health and Social Care
(10 years, 11 months ago)
Commons Chamber12. What steps his Department has taken to ease the short and long-term effects of winter pressures on the NHS.
In the short term, a record £400 million has been assigned to help the NHS through this winter, with £250 million announced in August, much earlier than before. For the long term, we are restoring the link between GPs and vulnerable older patients by bringing back named GPs for all over-75s—something that was broken in 2004.
I thank the Secretary of State for that answer. My constituents, including a family who came to my surgery on Saturday, are frustrated by the brick walls that sometimes seen to exist between different bits of the health service, and which are all the worse in urgent and traumatic winter cases. Different health services in Norwich have come together in Operation Domino to improve services in the face of demand, and they have used winter funding money to run a new style of urgent care unit at Norfolk and Norwich hospital. Does my right hon. Friend agree that Norfolk is leading the way?
I congratulate the health services in Norfolk—and indeed in Norwich—on what they are doing to break down those barriers. That is the key issue, and this year I am working closely with the Minister of State, Department of Health, my hon. Friend the Member for North Norfolk (Norman Lamb), to merge the health and social care systems—a £4 billion merger—to ensure that medical records can be shared across all the different systems, and that there is a named accountable doctor for the entirety of people’s time outside hospital. I hope that will make a difference in Norwich as elsewhere.
My constituency has a high proportion of elderly people. What steps is the Secretary of State taking to reduce admissions of elderly people to hospital this winter?
We are doing a very great deal and the £400 million announced to help the NHS through the winter is a record amount. My hon. Friend will be pleased to know that a lot of that money is being spent not inside A and E departments but in the community to help GP practices, and to try to recognise properly that for many older people—particularly vulnerable people with dementia —a busy A and E department is not the best place to go when something goes wrong, and if we possibly can we should avoid it.
Is it the case that worries about winter pressures are greatest in A and E, and that the crisis in A and E is entirely of the coalition’s own making? Ministers have been warned about cuts to elderly care and letting GPs off the hook on office hours and opening in the evenings and at weekends, and about the increasing costs of locum staff. They have been warned but they have not acted. What will the Secretary of State do now, late as it is, to ensure that A and E has enough doctors to see patients safely through the winter?
The Opposition try to talk up a crisis in A and E, but unfortunately, such talk does not withstand the facts. Let us look at the facts on how A and E is doing and perhaps the right hon. Gentleman will understand. We are seeing 2,000 more people every single day within the four-hour target than were seen when Labour was in power; we have 20% more A and E consultants; and the waiting time to be seen in A and E is half what it was under the Labour Government. However, we are doing more: we are addressing the long-term pressures in A and E, including the barriers to the social care system, which were mentioned in an earlier question, and the lack of good primary care alternatives. That is why we are restoring named GPs for the over-75s.
A and E is in crisis across the country, but getting people out of hospital in a suitable time frame is also important. What is the Secretary of State doing to better connect the health service with other social care providers? Does he acknowledge that, in places such as Telford and Wrekin, there has been a substantial cut in continuing health care funding, which means the system is in danger?
Thank you for that guidance, Mr Speaker. Let me assure you that this winter, a lot is happening in Telford to break down the barriers between the health and social care systems. One big change we are championing—it is starting to happen for the first time—is a seven-day social care system, so that hospitals can get people assessed and discharge them at weekends. With respect to the hon. Gentleman, if he looks at the facts, he will see that that is beginning to happen in a way that it did not when Labour was in power. He should welcome it.
I congratulate my right hon. Friend on the planning for, and the extra resources he has committed to, relieving winter pressures in A and E departments. What effect does he expect the additional combined budget for health and social care to have on admissions to A and E, particularly of older people?
We know that every year, 1.2 million of 5.2 million admissions to hospitals are avoidable if we have better alternatives in the community. The Government believe that restoring that personal link between doctors and the people on their lists—the people in their communities—who could often be much better looked after outside hospitals is the way to deal with that. That is why we are making that major change to the GP contract—it is the biggest change since named GPs were removed in 2004. That will benefit my hon. Friend’s constituents and those of all hon. Members.
Before Christmas, the Secretary of State said that the A and E crisis is behind us. However, NHS data released last Friday show that patients have just experienced the worst week in A and E so far this winter. The A and E target was missed; 103 trusts failed to meet their individual target; and, shockingly, more than 5,000 patients were left waiting on trolleys for more than four hours—more than double the number in the previous week. The Secretary of State asks us to look at the facts, but those are the facts. They are apparent to all except, seemingly, him. Is he really still of the view that the crisis is behind us?
Let us look at those facts for last week and compare them with the facts in the identical week when the right hon. Member for Leigh (Andy Burnham), the shadow Health Secretary, was Secretary of State. When he was Secretary of State, 362,462 people were seen within four hours. Last week, we saw 365,354 people—3,000 more people—within the target. A and E is doing better under this Government than it ever did under Labour.
3. How many mesothelioma cases are being treated by the NHS; what strategies have been adopted for treatment and prevention of mesothelioma; and if he will make a statement.
5. What steps he is taking to promote the health and well-being of older people.
We will ensure that everyone over the age of 75 has a named GP responsible for delivering proactive care for our most vulnerable older citizens in the best tradition of family doctors. Through our £3.8 billion better care fund, we are also merging the health and social care systems to provide more joined-up health and social care.
Dementia is a terrible blight for an increasing number of older people. Last week, I had the great privilege of opening Henffordd Gardens in Hereford, a supported living scheme that will allow dementia sufferers in my constituency to enjoy a better quality of life for longer and is a model of good practice for the country. Will the Secretary of State join me in congratulating Herefordshire Housing and all those who have worked so hard to bring this plan to fruition?
I absolutely join my hon. Friend in congratulating Herefordshire Housing. One of the key things about people with dementia is that relatively small adjustments to their homes can make it possible for them to live at home healthily and happily for much longer under the care of a husband, wife or partner without having to go into residential care. Those are precious years that we should treasure and do everything we can to facilitate, so I am delighted that that is happening, and he will be pleased to know that, thanks to the Government’s initiative, it is happening all over the country.
Figures from the House of Commons Library show that £1.8 billion has been cut from social care budgets since 2010. Does not that imply that delayed discharge among older people will be driven upwards because the finances are just not there to look after them?
I think the figures the hon. Gentleman is talking about are efficiencies and not actual cuts. [Laughter.] Well, Members should look at the figures carefully. If they are the figures from the Association of Directors of Adult Social Services, that is what they will find. If the hon. Gentleman looks more specifically at the figures related to delayed discharges, he will find that, year on year, the number attributable to the social care system went down by 50,000 bed days in the last year.
One of the principal ways of promoting the health and well-being of older people in my constituency would be a rapid sign-off for the rebuild of the Townsland hospital complex. I recognise that the decision lies with NHS Property Services, but will the Secretary of State join me in using whatever influence we have to put pressure on it to get a move on?
I have spoken to my hon. Friend about the scheme, which sounds excellent. Obviously we want to encourage it, while working within the correct processes. The Under-Secretary of State for Health, my hon. Friend for Central Suffolk and North Ipswich (Dr Poulter), has agreed to meet him to do all we can to speed it along.
One of the things that some older people would like is to move closer to their families. Will the Secretary of State update me on what discussions he is having with the Scottish Government on the portability of home care packages across the border?
We are very keen to make home care packages much more portable. There are problems with home care packages across the board, particularly the 15-minute slots that, frankly, are completely unacceptable. We are definitely looking at that issue and I encourage the hon. Lady to talk to the Minister responsible for care services, my hon. Friend the Member for North Norfolk (Norman Lamb), to get more details on the progress we are making.
Does my right hon. Friend agree that the question asked by my hon. Friend the Member for Hereford and South Herefordshire (Jesse Norman) is the most important single question facing the health and care system? Do not too many elderly people—the greatest single source of growing demand on the health and care system—experience our system not as a national health service but as a national illness service? Is not the challenge facing the system to ensure that, as people live longer, we enable them to get greater quality out of those extended life years?
As so often, my right hon. Friend encourages us to raise our heads above the horizon and to look forward. He is absolutely right. There will be 1 million people with dementia by 2020 and, as he knows, most of those will have other long-term conditions alongside dementia. The name of the game will be looking after people so they can live healthily at home, which will be the focus of health policy.
Regular social interaction and a comfortable home environment are critical to the health and physical and mental well-being of older people. Has the Secretary of State carried out any assessment across Government or within his own Department of the effect of cost of living pressures and cuts in local services on the home environment, and on older people?
Dementia is the disease that people over the age of 50 say they fear the most and it is one of the biggest challenges for our society and for our health and social care systems. One of the ways to meet that challenge is through research, and the coalition Government is to be commended for the doubling of spending on research into dementia by 2015. However, it will take another decade, until 2025, for this Government or a future one to double it again. Will he reconsider that? Surely there needs to be greater ambition and greater pace to deliver the cures, the solutions and the prevention we need.
I commend my right hon. Friend for his work on dementia when he was working at the Department of Health. We are doing our bit as a country but we will not be able to do it on our own. Dementia is an incredibly difficult disease to crack, which is why, in December, the Prime Minister hosted a G8 summit to encourage other leading countries to increase their investment in dementia. We secured a commitment that they would significantly increase that investment and we want to encourage the private sector to do the same.
T1. If he will make a statement on his departmental responsibilities.
I know that the whole House will wish to join me in remembering Paul Goggins at our first Health questions since his tragic death. He campaigned with great distinction on a number of health issues, including contaminated blood, mesothelioma and services at Wythenshawe hospital. I had the privilege of visiting a GP surgery in his constituency with him, and I know how much this utterly decent and selfless man cared about the health of his constituents. He has so sadly passed away, and the whole House will want to honour his memory and pass on our condolences to his family.
I certainly associate myself with the Secretary of State’s remarks. Will he undertake to look carefully at The 1001 Critical Days manifesto, which was recently launched by the right hon. Member for Birkenhead (Mr Field), the right hon. Member for Sutton and Cheam (Paul Burstow), who is in his place, the hon. Member for Brighton, Pavilion and me? Will he look at what more can be done to provide a comprehensive care pathway for the perinatal period?
Yes, we are looking at that closely, with the Minister responsible for paediatric services doing so particularly closely. In principle, we support what my hon. Friend is trying to achieve with that document and we welcome its contribution to the debate.
Last week, we heard shocking revelations about the reasons behind the Government’s U-turn on minimum unit alcohol pricing. In particular, researchers at Sheffield university have confirmed that they were asked by government not to publish a report that would have undermined the Government’s decision to shelve minimum unit pricing. Why were Ministers so keen to suppress the report? Will the Secretary of State please tell us why some of our country’s leading public health experts are accusing Ministers of deplorable practices and of dancing to the tune of the drinks industry?
T4. Given that tomorrow Staffordshire county council intends to confirm devastating cuts to services for those with special needs, including the closure of the purpose-built Kidsgrove day centre in my constituency, does the Secretary of State agree that it is time now for the council to wait and at the very least share its detailed needs assessment and future action plan before forcing these cuts through?
I am very happy to look into the issue that the hon. Lady raises. Obviously, some very big changes are happening in the Staffordshire health economy, and the purpose of those is to improve services for everyone, so if she gives me the details of her concerns, I will happily look at them.
T3. At the end of last year, the Prime Minister hosted the very successful G8 summit on dementia. What plans does the Secretary of State have to continue, and indeed enhance, the UK’s global leadership on tackling dementia in 2014?
My hon. Friend is absolutely right. That is a critical job that we must do this year. The purpose of the G8 summit was to wake up the world to the huge threat posed by dementia, as the world woke up to the threat of HIV/AIDS in the 1980s and the threat of cancer in the 1960s. We need to continue that work. Summits will be going on in America, Canada and Japan over the course of the next couple of years, and we need to keep up the momentum, because everyone agrees on the need to do such work.
T5. On 1 January, the York Teaching Hospital NHS Foundation Trust ceased providing antenatal advice classes for pregnant women and refers them instead to online advice on its website. Is that an approach the Government support, and will they urgently invite the National Institute for Health and Clinical Excellence to review the change in policy and look at its effectiveness?
T6. On any given day in the Derriford hospital in Plymouth, 75% of patients are over 65 years of age and rising. Does that not demonstrate the demographic pressures that face our acute hospitals, and what more can this Government do to ensure that people, especially elderly people, are treated in the community?
We are doing a huge amount, but the first thing is to ensure that there is someone in the NHS who is accountable and responsible for all vulnerable older people outside hospital, because out-of-hospital care is where we need to have the big revolution. There will be a big change in April with named GPs for the over-75s. The integration of the health and social care systems is the next step. I hope that my hon. Friend will see real progress for his constituents.
T7. The Secretary of State has had a letter from 118 specialists about the MenB—meningococcal B— vaccine. It is available to parents who pay privately, but denied to most of our children by the Joint Committee on Vaccine and Immunisation. Will the Secretary of State agree to meet the families of children who have had meningitis B and consider all the points raised by the clinicians before letting the JCVI rule out access to the vaccine?
I recognise the real concern over the previous advice given by the JCVI. I hope that the hon. Gentleman agrees that, on something as important as this, it is helpful to have an independent body coming to these decisions and making a ruling. When a ruling is made, we are legally bound to accept the advice, which means that there is a measure of independence. I have met families campaigning for the MenB vaccine. We are waiting to hear what the JCVI says in February. We should let it come to its conclusion after re-reviewing all the advice and the literature.
T8. The Government’s decision to increase our dementia research budget was welcome news, and the G8 conference agreement to share research among all G8 members was an important development too. Does my right hon. Friend agree that there is a role for MPs in helping to keep constituents informed about scientific developments that may lead to significant progress?
I do agree, and I congratulate my hon. Friend on his work. I know that he is meeting Alzheimer’s Research UK next month in his own constituency. This matter is something in which we can all be involved in our own constituencies. There is a lack of willingness to talk about dementia. Many people are frightened of it, and the more we can do to raise the profile of this condition, the more we can give people hope that something can be done about it.
Although I support the principles of the Better Care Fund, does the Minister recognise that, in the context of severe cuts to local authorities and cuts in the NHS, the top-slicing of existing budgets is not sufficient? To encourage the kind of innovation that we need to get better integration, we must have additional funding.
T10. I warmly welcome initiatives such as the introduction of personalised GP care for the over-75s, but what more can be done to ensure that personalised care treats the individual’s well-being as opposed to merely a collection of symptoms?
We want people to be treated as individuals, not a bundle of illnesses. That personalised care must happen not only out of hospitals but in hospitals, too. We want doctors to take responsibility for the whole stay and to avoid that sense of people being passed from pillar to post. That is an area in which we hope to announce some important changes shortly.
In an earlier response, the Under-Secretary of State for Health, the hon. Member for Central Suffolk and North Ipswich (Dr Poulter), expressed his dislike for the working time directive. Would the Secretary of State be happy to revert to a situation in which patient safety, already compromised at weekends, is further compromised by over-tired doctors?
No one wants to go back to the bad old days of junior doctors working all the hours God gives, but the working time directive has had a negative impact on patient safety. It has made training rosters more difficult and it has meant that there is less continuity of care as people do not see the same doctor when they go back to hospital. We need to look at whether we can do that better, because it is not helping patients.
By Christmas, almost 2,000 staff at Kettering general hospital had received their flu jab—that is about 60% of front-line staff. Would the Secretary of State like to congratulate the hospital and its members for its bid to become the acute trust in the east midlands with the best flu jab record for three years in a row?
At the excellent James Cook University hospital between 19 December and 1 January, 49 ambulances were delayed for more than 30 minutes, 168 beds were blocked and 82% of admitted patients had been treated within 18 weeks, rather than the Government target of 90%. Why does the Secretary of State think that that is the case?
Is the Secretary of State aware that every fast food outlet in the United States displays the number of calories for each portion of food that it sells? Given that some fast food restaurants in this country, such as McDonald’s, already do that, does he believe that more should be done to make all fast food outlets in this country display the number of calories so that people are educated before they make a choice about what they are going to purchase?