Oral Answers to Questions

Jeremy Hunt Excerpts

Tuesday 7th February 2017 Commons Chamber

[Mr Philip Hollobone (Kettering) (Con)]

1. What steps he is taking to ensure that foreign nationals who are not entitled to free NHS treatment pay in full for the treatment they have received.

[The Secretary of State for Health (Mr Jeremy Hunt)]

Under this Government, the amount recovered from international visitors has trebled from £81 million to £289 million. Yesterday, I announced that we were going further by introducing upfront ID checks and payment for elective care, stopping IVF being available for those who pay the health visa surcharge and asking GPs to help to identify European citizens at the point of registration so that we can recharge their costs to their home country.

[Mr Hollobone]

My constituents in Kettering welcome the Government’s latest crackdown on this abuse of our national health service at a time when we are struggling to find enough money to pay for the care of elderly people who have paid into the NHS all their lives. We simply cannot afford to provide a free international health service.

[Mr Hunt]

My hon. Friend is absolutely right. It is a national health service, not an international health service. I was disappointed to see comments from the Opposition yesterday that the money this would raise would be a drop in the ocean—[Hon. Members: “It is.”] We are seeking to raise £500 million. That is enough to finance 5,000 GPs, who could help the constituents of everyone in this House.

[Mr Ben Bradshaw (Exeter) (Lab)]

Is it not a coincidence that, whenever we hear about disastrous figures for NHS performance and a huge deterioration in waiting times, as we did at the weekend, the Government re-announce yet another measure to crack down on health tourism? Is not the main problem with our health and social care system the fact that it is chronically underfunded, and that this Government are doing nothing about it?

[Mr Hunt]

I will tell the right hon. Gentleman what we are doing about the underfunding. We are raising three times more from international visitors than when he was a Health Minister, and that is paying for doctors, nurses and better care for older people in his constituency and in all our constituencies.

[Dr Sarah Wollaston (Totnes) (Con)]

Given the Government’s stated objective of reducing health inequalities, will the Secretary of State set out how he will guarantee that those who are, for example, homeless or who have severe enduring mental illness—the most disadvantaged in our society, who are unlikely to have the required documentation—will receive the treatment they need?

[Mr Hunt]

I can absolutely reassure my hon. Friend. What we are doing is based on good evidence from hospitals such as Peterborough hospital, which has introduced ID checks for elective care and has seen absolutely no evidence that anyone who needs care has been denied it. This is not about denying anyone the care they need in urgent or emergency situations; it is about ensuring that we abide by the fundamental principle of fairness so that people who do not pay for the NHS through their taxes should pay for the care we provide.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

Has the Secretary of State actually been recently to a clinical commissioning group like ours in Huddersfield, where one more duty would really break the camel’s back? We have just heard that the CCG is changing its constitution, excluding GPs and totally changing the nature of the CCG. Like most of them, our CCG is under-resourced and under stress, and asking it to do something else like this, which will be complex, difficult and perhaps impossible, will kill the poor bloody animal.

[Mr Speaker]

With reference to foreign nationals, and including a question mark at the end of the hon. Gentleman’s observations.

[Mr Hunt]

I very much hope that the extra money we raise from international visitors will help all Members of this House because it will lead to more funding for the NHS, including for Huddersfield CCG.

[Mr Peter Bone (Wellingborough) (Con)]

When I was in the travel industry, I learned that anyone wanting to travel to, say, America had to have medical insurance. Could it not be a requirement for people coming into this country to ensure that they had such insurance?

[Mr Hunt]

We looked at this extremely carefully, and I have a lot of sympathy with what my hon. Friend is saying. People do not have to have medical insurance if they visit countries such as America as a tourist, and we do not want to insist on that for visitors to this country because of our tourism industry here. We concluded that it was better to have a system in which people who get a visa to come and live here have to pay a surcharge. That is why we have introduced the visa health surcharge, which raises several hundred million pounds for our NHS.

[Helen Jones (Warrington North) (Lab)]

I have always supported the view that we are not running an international health service, but as well as directing his energies towards that question will the Secretary of State direct them towards stopping the waste of money that occurs elsewhere in the NHS when highly trained surgeons and theatre teams are forced to wait to operate because beds are not available for their patients and have to spend their time doing nothing? How much is wasted in that way because of the chronic underfunding that this Government have introduced?

[Mr Hunt]

The constant accusations of underfunding would have a little more credibility if Labour was actually promising any more money for the NHS. Instead, at the last election it committed to £5.5 billion less than this Government.

[Rehman Chishti (Gillingham and Rainham) (Con)]

2. What steps his Department is taking to support people with post-polio syndrome.

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[Lucy Frazer (South East Cambridgeshire) (Con)]

10. What progress he has made on improving hospitals in special measures.

[The Secretary of State for Health (Mr Jeremy Hunt)]

In the last four years, 31 trusts have been put into special measures—more than one in 10 of all NHS trusts. Of those, 16 have now come out, and I congratulate the staff of Addenbrooke’s and all at Cambridge University Hospitals NHS Foundation Trust, which came out of special measures last month.

Let me also take this opportunity to thank Professor Sir Mike Richards, who has announced his retirement as chief inspector of hospitals. His legacy will be a safer, more caring NHS for the 3 million patients who use it every week. He can feel extremely proud of what he has achieved.

[Chris Green]

Royal Bolton hospital was in special measures four years ago, but it has since come out following a huge amount of hard work. The trust is now running a surplus, which is being reinvested into patient care. Will my right hon. Friend join me in congratulating all the staff on their excellent hard work?

[Mr Hunt]

I am happy to do so. It is a fantastic example of what is possible in challenging circumstances with a lot of pressure on the frontline, so the staff should feel proud. Trusts put into special measures go on to recruit, on average, 63 more doctors and 189 more nurses and see visible improvements in the quality of patient care.

[Lucy Frazer]

The Secretary of State is right to congratulate Addenbrooke’s, which came out of special measures in the last month due to the dedication of its staff, but we still need to reduce pressure on the A&E. One way of doing that is to increase care locally in rural hubs. Does the Secretary of State agree that money spent on the minor injuries unit at Ely’s Princess of Wales hospital would be money extremely well spent?

[Mr Hunt]

I remember visiting my hon. Friend in Ely last autumn, and I know how much she campaigns and cares for her local health services. The Cambridgeshire and Peterborough CCG knows the importance of Ely’s minor injuries unit. It is setting up some public engagement meetings, but if any changes are deemed necessary, I reassure her that there will be a formal consultation before anything happens.

[Heidi Alexander (Lewisham East) (Lab)]

The Heath Secretary’s self-congratulatory tone is astonishing. In the last year, the number of people waiting longer than four hours in A&E has increased by 63%, the number of people waiting on trolleys has gone up by 55%, and the number of delayed discharges is up by 22%. While all of us want hospitals in special measures to improve, what is the Health Secretary’s answer to those urgent problems that affect the NHS across the board?

[Mr Hunt]

I will tell the hon. Lady what is happening in the NHS compared with when her party was in power: 130 more people are starting cancer treatment every single day; 2,500 more people are being seen in A&Es within four hours every single day; and there are 5,000 more operations every single day. None of that would be possible if we cut the NHS budget, which is what her party wanted to do.

[Neil Coyle (Bermondsey and Old Southwark) (Lab)]

Norfolk and Suffolk NHS Foundation Trust has been taken out of special measures, despite continued growth in the number of people with mental health problems dying in unexpected or avoidable circumstances from things such as suicide. “Panorama” and the Health Foundation have shown that in 33 trusts the number of avoidable deaths has doubled in the last three years as those trusts have collectively experienced a real-terms cut of £150 million. What specific measures is the Secretary of State taking to tackle the problem of avoidable deaths of people with mental health problems?

[Mr Hunt]

We have committed, and the Prime Minister affirmed the commitment only last month, to spend £1 billion more every year on mental health services, but we recognise that it is not just about money. It is also about having a proper suicide prevention plan—we have updated the plan—and making sure that, across the NHS, we properly investigate and learn from avoidable deaths. That is why, following the tragedy of what happened at Southern Health, we have now started a big new programme—the first of its kind in the world—whereby every trust will publish its number of avoidable deaths quarterly.

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

21. A year ago, East Sussex Healthcare NHS Trust was rated inadequate. Thanks to the hard work, dedication and care of all its staff, the hospitals are now good on many measures, albeit further improvements need to be made. Will the Secretary of State join me in thanking the staff? Does he agree that we need to talk up our successes, as well as recognising challenges?

[Mr Hunt]

I join my hon. Friend in doing that. It is really important, contrary to what the former shadow Health Secretary, the hon. Member for Lewisham East (Heidi Alexander), says, that we praise NHS staff when they do remarkable things. There is a lot of pressure everywhere in the NHS, and praising NHS staff is not being self-congratulatory; it is recognising when a good job is being done.

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

Further to the very important question of my hon. Friend the Member for Bermondsey and Old Southwark (Neil Coyle), Members on both sides of the House may have seen “Panorama” last night. Frankly, it was shocking and disgusting. I am ashamed to live in a country where in the past year there have been over 1,000 more unexpected deaths under the care of our mental health trusts. That is not a reflection of a country that cares equally about mental health and physical health. In spite of what the Secretary of State just told us, the money is not getting to where it is intended. What is he actually going to do to ensure that no person in our country—not a single person—loses their life because they have a mental health condition for which they are not being treated properly?

[Mr Hunt]

I agree with the hon. Lady that there is a huge amount that we need to do to improve mental health provision in this country, but a huge amount has been done and is being done. As she knows, we are now seeing 1,400 more people every day with mental health conditions. We are committing huge amounts of extra money to mental health provision, and we are becoming a global leader in mental health provision, certainly according to the person in charge of the Royal College of Psychiatrists. We have to support the efforts happening in the NHS, because we are one of the best in the world.

[Simon Hoare (North Dorset) (Con)]

4. What steps he is taking to prevent mental illness and provide mental health support for children and young people.

[The Secretary of State for Health (Mr Jeremy Hunt)]

Last month the Prime Minister made a major speech in which she made it clear that improving the mental health of children and young people is a major priority for this Government. My Department will work with the Department for Education to publish an ambitious Green Paper outlining our plans before the end of the year.

[Simon Hoare]

I am grateful to my right hon. Friend and the Prime Minister for their commitment to this important area of health and the parity that the Government are giving it. Does the Secretary of State agree that, as well as providing mental health support in both schools and colleges, community hospitals, due to their locality, status and scale, can often provide a useful forum for providing these vital services?

[Mr Hunt]

I am pleased that my hon. Friend raises that point, because when we discuss mental health we often talk about services provided by mental health trusts but do not give enough credit to the work done in primary care, both in community hospitals and by general practitioners, who have a very important role as a first point of contact. He is absolutely right to make that point.

[Dame Rosie Winterton (Doncaster Central) (Lab)]

Will the Green Paper look at the role that educational psychologists could play not only in providing support and assistance to young people with mental health problems but in preventive work? Cuts in local authority budgets have meant that the service has become quite fragmented, but there are practical ways in which it could be improved to help young people with mental health problems.

[Mr Hunt]

The right hon. Lady is absolutely right. We have looked into this and realised that there are two issues when it comes to improving children’s and young people’s mental health. The first is improving access to specialist care for those who need it. The other is prevention: the work that can be done by teachers within schools and in training people in mental health first aid. Those kinds of things can make a huge difference and we want to make sure we do them both.

[Mr Charles Walker (Broxbourne) (Con)]

I welcome the Secretary of State’s focus on child and adolescent mental healthcare, but what is he going to do about out-of-area transfers, which too often mean that children are found beds 200 or 300 miles away from their home? That is not in anyone’s interest, and it certainly is not in a child’s interest to be that far away from their support network.

[Mr Hunt]

I thank my hon. Friend for his continuing campaign on mental health issues. He is right to say that this situation is completely unacceptable, not least because if we want a child to get better quickly, the more visits from friends and family they can have, the better it is and the faster their recuperation is likely to be. We have commissioned 56 more beds, so the total number of beds commissioned for children is at a record 1,442, but we are determined to end out-of-area treatments by the end of this Parliament.

[Ian Austin (Dudley North) (Lab)]

No one is going to disagree with what the Secretary of State has said, but it is not going to help people at Dove house in Dudley, which has been helping people with mental health problems since the 1970s but faces closure this year, for the want of quite a small amount of money. Will he look at this personally and do everything he can to keep this valuable facility open? It is closing because Dudley is losing 20% of its funding, which compares with the figure of just 1% in Surrey, which he represents.

[Mr Hunt]

Dudley CCG has seen its funding go up, and we are asking all CCGs to increase the proportion of their spend on mental health. I am happy to look into the situation the hon. Gentleman talks about, but I will be very disappointed if increasing resources are not going into mental health provision in Dudley.

[Mark Pawsey (Rugby) (Con)]

Will the Secretary of State say a little more about how children’s mental health services can work more closely with schools and the education system more broadly?

[Mr Hunt]

I am happy to do that. Some interesting innovation is going on in many parts of the country. In Hove, a school I visited has a CAMHS––child and adolescent mental health services—worker based full-time in the school. That had a transformational effect, as it meant teachers always had someone they knew they could talk to and their understanding of mental health improved. That is the kind of innovation we want to encourage.

[Mr Gregory Campbell (East Londonderry) (DUP)]

Further to that, what pressure and persuasiveness is the Minister bringing to bear in the education system, particularly in primary schools, where young people have, on occasion, had this kind of a diagnosis and problems have been created within the school environment?

[Mr Hunt]

This is a very important issue because, as the hon. Gentleman knows, half of all mental health conditions are diagnosed before or become established before people are 14, and the sooner we catch them, the better the chance of giving someone a full cure. We therefore need to find a way whereby there is some mental health expertise in every primary school, so we can head off some of these terrible problems.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

As my hon. Friends the Members for Bermondsey and Old Southwark (Neil Coyle) and for Liverpool, Wavertree (Luciana Berger) have already said, last night’s “Panorama” showed that mental health services are not funded properly. At the Norfolk and Suffolk mental health trust funding cuts led to community teams being disbanded, a loss of staff and the loss of in-patient psychiatry beds. Most disturbing of all is to hear parents talk of what happens to their children when they are denied support in a crisis—when they are self-harming or suicidal but there are no in-patient beds. One parent called it a “living nightmare”. We do not need any more warm words from this Secretary of State—we need action to make sure that mental health services are properly funded and properly staffed.

[Mr Hunt]

Let me tell the hon. Lady what action is happening this year. The proportion of CCG budgets being assigned to mental health is increasing from 12.5% to 13.1%, which is an increase of £342 million. That is action happening today because this Government are funding our NHS.

[Craig Williams (Cardiff North) (Con)]

5. What plans the Government have to bring forward new legislative proposals on surrogacy.

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[Pauline Latham (Mid Derbyshire) (Con)]

T1. If he will make a statement on his departmental responsibilities.

[The Secretary of State for Health (Mr Jeremy Hunt)]

We know that a strong primary care system is the bedrock of the NHS, which is why I am pleased to announce today that NHS England will publish the new GP contract, agreed by the Government, NHS England and the British Medical Association. It will see almost £240 million extra invested in GP services; require GPs to establish whether overseas visitors are eligible for free care, allowing the NHS to better recoup the costs of that care; and improve access for patients by removing extra funding if GPs regularly close for afternoons during the working week.

[Pauline Latham]

Will the Secretary of State consider putting a GP in every A&E department so that they can additionally triage patients who are not so ill and advise them to go home and see their own GP on another occasion?

[Mr Hunt]

My hon. Friend is absolutely right. Actually, the policy is that all A&Es, where space is available, should do that. The hospitals that do it have by far the most successful results—not least Luton and Dunstable, which has pioneered that model.

[Jonathan Ashworth (Leicester South) (Lab)]

With respect to A&Es, diverts have been at twice the level of last year, 4,000 people have had urgent operations cancelled, 18,000 people a week in January were waiting on trolleys in corridors, and nine out of 10 hospitals have been overcrowded and are at unsafe levels. I have even read in the Secretary of State’s local paper that his local hospital had to put patients in the gym overnight. Does the Secretary of State agree with the Prime Minister that the crisis facing our NHS amounts to a “small number of incidents”?

[Mr Hunt]

The NHS is under a lot of pressure, but what we never get from the hon. Gentleman is any solutions. Our solution is 600 more A&E consultants since 2010, 1,500 more A&E doctors, 2,000 more paramedics, and 2,500 more people being seen within four hours every day. His solution at the last election was to cut the NHS budget by £1.3 billion.

[Jonathan Ashworth]

The Secretary of State’s solution has been to blame everybody else but never take responsibility himself.

What is the Secretary of State going to do about the crisis that we are now facing in staffing? Last week, we learned that half of junior doctors are abandoning specialist training. We have already heard that applications for nursing degrees are down by a quarter following the axing of the student bursary and we heard today that there is a shortage of midwives. I know that the right hon. Gentleman has been in the US and that he will try to give us his alternative facts, but when will he give us an alternative plan and deal with the staffing crisis—an issue that the Minister of State, the hon. Member for Ludlow (Mr Dunne), could not respond to a few moments ago?

[Mr Hunt]

Let us look at the reality, instead of the hon. Gentleman’s rhetoric. In his own local trust in Leicester, there are 246 more nurses than in 2010 and 313 more doctors. Some 185 more patients are being seen in A&E every day and next year a new £43 million emergency floor will open at the Leicester Royal Infirmary. That is because we are backing the NHS instead of wanting to cut its budget.

[Mr John Baron (Basildon and Billericay) (Con)]

T2. The recently introduced one-year cancer survival rate indicator is a beacon of light in a system still too focused on process targets. What more can the Government do to hold underperforming clinical commissioning groups to account for that outcome indicator, given that we are still failing to catch up with international averages when it comes to our survival rates?

[John Pugh (Southport) (LD)]

T4. Will the Minister update the House about NHS litigations, which rocketed to £1.4 billion last year? Are they anything like under control?

[Mr Hunt]

The hon. Gentleman is absolutely right; this issue is a very big concern. The only way, in the long run, to reduce those litigation costs is to have safer care. That is why the Government have prioritised safety in everything we do.

[Derek Thomas (St Ives) (Con)]

T3. If someone in St Ives suffers a severe stroke, they will have a far better chance of a full recovery if they get quick treatment and then proper therapy and rehabilitation in the community. That does not happen for everybody. What is the Department going to do to ensure that there will be a national stroke strategy?

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[Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

T7. Last year, hospital trusts were urged by Department of Health officials to raid their capital budgets to cover resource funding. Does the Secretary of State think that is a good way forward, and what instructions is he giving officials this year?

[Mr Hunt]

I recognise that it is not a sustainable position to have to do that. Pressures on the frontline meant that it had to happen, but we do need to invest for the future and I agree with the hon. Lady that capital budgets are very important.

[Andrew Selous (South West Bedfordshire) (Con)]

Young people with severe anxiety can spend years out of school and become very isolated. Does the Secretary of State agree that we need to think more imaginatively about community and voluntary solutions to reach out to those young people, whose futures we must not give up on?

[Mr Hunt]

I absolutely agree. About 3% of schoolchildren have severe anxiety, but if we get treatment to them quickly, often we cure the condition and it does not come back. My hon. Friend is absolutely right that we need to be as imaginative as possible.

[Norman Lamb (North Norfolk) (LD)]

T8. I have to report back to a constituent who is desperate for treatment that the current waiting time for the adult ADHD clinic is two years. In 2014, the Secretary of State and I published a vision to achieve comprehensive maximum waiting time standards in mental health so that people with mental ill health had exactly the same right to access treatment in the same time. Why on earth can the Government not end the outrageous discrimination against people with mental ill health?

[Mr Hunt]

I am always somewhat disappointed by the right hon. Gentleman’s rhetoric, given that we are spending about £1 billion more every year than when he was mental health Minister. This April, we will reintroduce maximum waiting times for eating disorders. As he knows, we have committed to publish pathways for all conditions during this Parliament. That will include his constituent who, I agree, is waiting much too long at the moment.

[Jake Berry (Rossendale and Darwen) (Con)]

Some GP practices in east Lancashire have, through sheer frustration, started publishing the number of missed appointments. When will the Secretary of State consider giving GPs the power that they want, and that the public want them to have, to charge those who miss repeated GP appointments, including in east Lancashire?

[Mr Hunt]

I have sympathy for people who are frustrated about that issue. As I have said before, my objection is not one of principle; it is whether it is practical to do it. Perhaps that is something that GPs could decide at a local level.

[Paula Sherriff (Dewsbury) (Lab)]

T9. The Health Secretary said there was a “small” number of incidents in the NHS this winter. What is his definition of “small”? We had what I would call a large number in my constituency alone. I extend an invitation to him to visit my local hospital and see that for himself, as the shadow Health Secretary will later this week.

[Mr Hunt]

May I gently tell the hon. Lady that I do not think our debates on the NHS are helped by her taking my comments out of context? I was quoting Chris Hopson, from NHS Providers, talking about a specific week when he said there were, in that week, a small number of incidents. We recognise the pressures across the NHS, which is why this Government are backing the NHS with record funding.

[Mr Steve Baker (Wycombe) (Con)]

A small business in my constituency was driven out of business by slow payments for relatively small sums by NHS providers. Will he ensure strict compliance with the guidelines for timely payments?

[Steven Paterson (Stirling) (SNP)]

The Royal College of Psychiatrists warns that half of all child and adolescent mental health training posts are unfilled. With 11% of trainees being EU nationals, how do the Government plan to avoid a Brexit-inspired staffing crisis?

[Mr Hunt]

Because, as we have said many times, post-Brexit this country will remain open to the brightest and the best.

[Dr Tania Mathias (Twickenham) (Con)]

My constituent, Nicola Johnson, has had primary breast cancer. The secondary was discovered at 10 months. Will the Minister meet me and Nicola, because she falls within the six-month to 12-month period? She is eligible for neither pertuzumab nor trastuzumab emtansine.

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[Tom Pursglove (Corby) (Con)]

Thank you, Mr Speaker. Corby and east Northamptonshire is taking thousands and thousands of new homes. What reassurance can Ministers give to my constituents that GP services will keep up with housing growth?

[Mr Hunt]

I can absolutely reassure my hon. Friend that we take that into account in all the funding we give for NHS primary care, but it depends on having a strong economy. That is something this Government will always do for the NHS.