Health
Jeremy Hunt Excerpts(8 years, 9 months ago)
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Mr Hunt
What I accept is that we have 30,000 more professionals working in mental health than when my Government came into office. There has been a decline in the number of mental health nurses, but we have in place plans to train 8,000 more mental health nurses, and that will make a big difference.
[Official Report, 10 October 2017, Vol. 629, c. 163.]
Letter of correction from Mr Hunt:
An error has been identified in the response I gave to a topical question.
The correct response should have been:
Mr Hunt
What I accept is that we have 30,000 more professionals working in the NHS than when my Government came into office. There has been a decline in the number of mental health nurses, but we have in place plans to train 8,000 more mental health nurses, and that will make a big difference.
Health
Jeremy Hunt Excerpts(8 years, 9 months ago)
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Stephen McPartland (Stevenage) (Con)
The Secretary of State for Health (Mr Jeremy Hunt)
Today is World Mental Health Day and the whole House will want to congratulate Time2Change on its 10th anniversary and the remarkable change in attitudes towards mental illness that it has helped to bring about. Our mental health workforce has increased by 30,000 since 2010 and another 21,000 posts are planned.
Barbara Keeley (Worsley and Eccles South) (Lab)
The Secretary of State’s claim that thousands of extra mental health staff will be appointed by 2021 is fanciful unless he tells us how they will be funded. Today, the Care Quality Commission reports that mental health services are struggling to staff wards safely. We have also learned recently that two out of five mental health staff have been abused or attacked by patients in the past year. Most blame staff shortages for that violence. Rather than telling us about recruiting for 2021, what is the Secretary of State going to do today to protect staff from violence?
Mr Hunt
Let me tell the hon. Lady what has happened in mental health. Some 30,000 more people are working in mental health today than when her Government left office—a 5.8% increase in clinical staff.
[Official Report, 10 October 2017, Vol. 629, c. 143-45.]
Letter of correction from Mr Hunt:
Errors have been identified in the responses I gave to Questions to the Secretary of State for Health.
The correct responses should have been:
The Secretary of State for Health (Mr Jeremy Hunt)
Today is World Mental Health Day and the whole House will want to congratulate Time2Change on its 10th anniversary and the remarkable change in attitudes towards mental illness that it has helped to bring about. Our workforce has increased by 30,000 since 2010 and another 21,000 mental health posts are planned.
General Practice Indemnity
Jeremy Hunt Excerpts(8 years, 9 months ago)
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The Secretary of State for Health (Mr Jeremy Hunt)
I am today updating the House on recent developments regarding indemnity arrangements for NHS general practice in England.
The Government are committed to ensuring that general practice is an attractive long-term career option that gives stimulus and stability to our brightest medical graduates. Therefore, today I have announced that the Department of Health is planning, subject to examination of relevant issues, the development of a state-backed indemnity scheme for general practice in England.
Rising cost of indemnity is a great source of concern for general practitioners (GPs). Our ambition is to deliver a more stable and more affordable system for GPs and their patients. The scheme could provide financially sustainable cover for future, and potentially historic, claims arising from the delivery of NHS services.
The Department has benefited from the engagement with the four Medical Defence Organisations (MDOs) and GP representatives over recent months. Any new scheme should meet the needs of current and future GPs, be in the interest of patients and represent value for money for taxpayers. Transfer of historic liabilities from MDOs to a new scheme would be dependent on satisfactory negotiation with the MDOs.
We will explore with GP representatives how to embed new indemnity arrangements, including the future costs, into GP contract negotiations. The Department will set up a stakeholder group and arrange a first roundtable next month with the Royal College of General Practitioners, the British Medical Association and other GP representatives to gather views from general practice and agree how best to engage with the sector going forward.
Any scheme would take at least 12 to 18 months to establish and require careful negotiation. GPs should continue to ensure they have appropriate indemnity cover in line with General Medical Council requirements to enable them to practise. NHS England has already committed to provide additional funding to GP practices to cover the estimated annual indemnity inflation for 2016-17 and 2017-18. NHS England has also announced additional money for indemnity cover over the coming winter.
Indemnity arrangements are a devolved matter and the Department will continue to liaise with the devolved Administrations, who will make their own decisions about indemnity provision in their territories.
[HCWS159]
Oral Answers to Questions
Jeremy Hunt Excerpts(8 years, 9 months ago)
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Stephen McPartland (Stevenage) (Con)
The Secretary of State for Health (Mr Jeremy Hunt)
Today is World Mental Health Day and the whole House will want to congratulate Time2Change on its 10th anniversary and the remarkable change in attitudes towards mental illness that it has helped to bring about. Our mental health workforce has increased by 30,000 since 2010 and another 21,000 posts are planned. [Official Report, 16 October 2017, Vol. 629, c. 4MC.]
Stephen McPartland
On World Mental Health Day, I congratulate the Secretary of State on the work he has done, especially for children. We have had 42% more children receiving care for eating disorders and over 21,000 more children have received access to mental health provision. What targets does the Secretary of State have to help to improve such provision?
Mr Kevan Jones (North Durham) (Lab)
One of the staffing shortages is actually in children and young people’s services. In County Durham in my constituency, the waiting time for autism diagnosis is two years. I have raised this with the mental health trust and NHS England, but the problem seems to be with the clinical commissioning group. What can the Secretary of State do to ensure that the extra money that he has pledged to put into the service actually gets to the service?
Mr Hunt
I would like to thank the hon. Gentleman for speaking out about mental health, like so many colleagues in this House, which makes a massive difference to the Time2Change campaign. It is unacceptable for someone to be waiting that long, and I do not want to stand here and defend it. I will certainly look into the individual case that the hon. Gentleman raises, but the fact is that many Members will know of similar cases. The money is starting to get through to the frontline. It is not just money, though; it is also capacity, and having trained mental health therapists—nurses; psychiatrists—and that is why we are boosting their training, too.
Dr Sarah Wollaston (Totnes) (Con)
As someone who is married to an NHS psychiatrist, may I start by paying tribute to all those volunteers, carers and professionals working in mental health on World Mental Health Day? Has the Secretary of State seen today’s briefing by the Children’s Commissioner, highlighting the vital importance of prevention and early intervention? Will he set out what steps he is taking to support a growing workforce—volunteers and professionals—working in prevention and early intervention?
Mr Hunt
My hon. Friend is absolutely right. I am aware of the report that she talks about. We know that half of mental health conditions become established before the age of 14, which is why early intervention is so important. In July, I announced an expansion in the mental health workforce—another 21,000 posts. A number of those will be in children’s mental health, to address the issues she raises.
Tim Farron (Westmorland and Lonsdale) (LD)
The Secretary of State may know that because of a reduction in the number of mental health clinicians in Cumbria, the Cumbria Partnership NHS Foundation Trust has now chosen to end consultant psychiatric call-out care from 8 pm to 9 am. It would have started last week, but it is going to start in the next two or three weeks. That means, as I am sure he is aware, that it will not be possible to section people under the Mental Health Acts between those hours unless they are within an NHS facility. People in police stations, people in care homes and people at A&E departments will not be—
Tim Farron
The question is: does the Secretary of State agree that that is not an appropriate use of resources, and will he provide the resources that are needed?
Mims Davies (Eastleigh) (Con)
Mr Hunt
My hon. Friend is right to draw attention to the issues around Southern Health, which will have directly affected a number of her constituents. That organisation is being turned around. However, she is also right to say that too many people are travelling out of area for their treatment. We have record numbers of children’s beds commissioned, but in the end this is about the capacity of the system of trained psychiatrists, psychologists and therapists, which was why we announced the extra 21,000 posts.
Barbara Keeley (Worsley and Eccles South) (Lab)
On World Mental Health Day, may I thank my hon. Friend the Member for Washington and Sunderland West (Mrs Hodgson) for wearing yellow for #HelloYellow on behalf of our team?
The Secretary of State’s claim that thousands of extra mental health staff will be appointed by 2021 is fanciful unless he tells us how they will be funded. Today, the Care Quality Commission reports that mental health services are struggling to staff wards safely. We have also learned recently that two out of five mental health staff have been abused or attacked by patients in the past year. Most blame staff shortages for that violence. Rather than telling us about recruiting for 2021, what is the Secretary of State going to do today to protect staff from violence? [Official Report, 16 October 2017, Vol. 629, c. 4MC.]
Mr Hunt
Let me tell the hon. Lady what has happened in mental health. Some 30,000 more people are working in mental health today than when her Government left office—a 5.8% increase in clinical staff. On top of that —she asked about money—we have committed an extra £1 billion a year by 2021 so that we can employ even more people. We are the first Government to admit that where we are now is not good enough. We want to be the best in the world; that is why we are investing to deliver that.
Fiona Bruce (Congleton) (Con)
Rachel Maclean (Redditch) (Con)
The Secretary of State for Health (Mr Jeremy Hunt)
Developing new routes into nursing is a priority for my Department, which was why last week I announced plans to train 12,500 new nursing associates through the apprentice route in the next two years and to increase the number of nurses we train by 25%—the biggest increase in the history of the NHS.
Rachel Maclean
I welcome the fact that there are currently record numbers of nurses working in the NHS, but what is the Secretary of State doing to provide assurances to hospitals, such as the Alex in my constituency, that have faced issues with recruitment and retention? I very much welcome the new routes into nursing, including degree apprenticeships. What further actions does he propose to take?
Mr Hunt
My hon. Friend is absolutely right to raise this issue. The Alex is going through a difficult period and I know that as the local MP she is giving it a lot of support. The fact is that in 2014 we turned down 37,000 applicants to nurse degree courses. That is why we think that we need to do much, much better in training a number of people who would make brilliant nurses. That was why we announced the big increase last week, which will help the Alex and many other hospitals.
Mr Ben Bradshaw (Exeter) (Lab)
University admissions departments have reported an 8% fall in the number of people accepted on to nursing courses this autumn, so the situation is getting worse, not better as the Secretary of State claims. What contingency does he have in place, in the event that we crash out of the European Union, to address a further haemorrhaging of European Union staff from the NHS, and when will he review his disastrous decision to abolish nurse bursaries, which has had such a negative impact?
Mr Hunt
Let us be clear: we took the difficult decision on nurse bursaries precisely so that we could have the biggest expansion in nurse training places we have ever had. When we had the higher education reforms in 2011, which the right hon. Gentleman’s party opposed, we also saw a drop in initial applications, but then we saw them soaring to record levels. That is what we want to happen with nurses, because we need more nurses for the Royal Devon and Exeter, and all the hospitals that serve our constituents.
Maria Caulfield (Lewes) (Con)
I welcome the apprenticeship route and the associate nurse route into nursing because living on a bursary of £400 a month is no fun, believe me. However, will the Secretary of State look at nurse training so that when nurses qualify they are able to take on courses such as venepuncture and cannulation as soon as possible? Many student nurses and newly qualified nurses are frustrated that they cannot be used in those roles.
Mr Hunt
I will certainly look into that. Of course, my hon. Friend understands this issue better than many in this House. The really exciting change is that it will now be possible for healthcare assistants who could make fantastic nurses to progress to being nurses without needing to take out student loans because they will be able to carry on earning while they learn. That will open up big opportunities for many people.
Justin Madders (Ellesmere Port and Neston) (Lab)
Although we support moves to broaden access to nursing, these measures are effectively an admission that the scrapping of bursaries has been a disaster, but whatever recruitment strategies there are, the Government need to improve retention. The Royal College of Nursing recently reported that half of nurses surveyed said that
“staff shortages are compromising…care”.
What steps are the Government taking to ensure that nurses can do their jobs properly right now?
Mr Hunt
The hon. Gentleman is right to bring that up. One thing we can do a lot better is to improve the opportunities for flexible working. We have announced that we will be making new flexible working arrangements available to all NHS staff during this Parliament. We are also expanding programmes to encourage people who may have left the profession to come back into nursing.
Dr Philippa Whitford (Central Ayrshire) (SNP)
I think everyone would welcome an expansion of nurse training places, but the Council of Deans of Health stated in June that no new extra places had been funded either in universities or, crucially, in hospitals, where 50% of the course is carried out. Will the Secretary of State clarify when that funding will be made available?
Dr Whitford
Obviously we know that it takes quite some time to train a nurse, and one in 10 posts in England is vacant—that is twice the rate we face in Scotland. We also know that there is a 51% increase in nurses leaving the profession, a 96% drop in those coming from the European Union, and a limit on the use of agency staff, so where does the Secretary of State expect NHS England to find the 40,000 nurses it needs right now?
Mr Hunt
Let me just remind the hon. Lady that there are 11,300 more nurses on our wards than there were just four years ago, so we are increasing the number of nurses in the NHS. She mentions what is happening in Scotland. I gently remind her that nearly double the proportion of patients are waiting too long for their operations in Scotland as in England.
Richard Graham (Gloucester) (Con)
Mr Hunt
I support all universities that are trying to move into offering more courses that can help me to ensure that we have enough staff for the NHS. I am sure that the University of Gloucestershire’s bid will be powerful, but I am aware that other hon. Members are supporting bids from their own constituency—including, I have to say, that of the University of Surrey, which puts me in a somewhat difficult position.
Marsha De Cordova (Battersea) (Lab)
The Secretary of State for Health (Mr Jeremy Hunt)
NHS staff do a fantastic job in tough circumstances, and pay restraint has been challenging for many of them. However, given the financial pressures, it is also true that the NHS would not have been able to recruit an additional 30,000 staff since May 2010 without the cap.
Christian Matheson
The NHS is short of 3,500 midwives and 40,000 nurses. What proportion of those numbers does the Secretary of State put down to the public sector pay cap?
Mr Hunt
As I said in my previous answer, without pay restraint we would not have 11,300 more doctors in the NHS and 11,300 more nurses on our wards. The hon. Gentleman will know that we recognise that it was not sustainable to carry on with the 1% rise going forward, which is why we have been given the leeway to have more flexible negotiations next year.
Marsha De Cordova
Hospital wards and GP surgeries are chronically understaffed, and the knock-on effect is that waiting lists are spiralling out of control. Is it not in the best interests of patients to scrap the pay cap so that the NHS can be run with the relevant number of staff in place?
Helen Whately (Faversham and Mid Kent) (Con)
In the work that I have done in hospitals, staff have told me that they are most unhappy about too much reliance on temporary staff, rota gaps and not feeling valued, as opposed to issues around pay. The latter—not feeling valued—often goes hand in hand with poor management practices. What is my right hon. Friend doing about those causes of staff unhappiness?
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)
Mary Glindon (North Tyneside) (Lab)
The Secretary of State for Health (Mr Jeremy Hunt)
Ahead of our autumn Green Paper on children and young people’s mental health, we are having productive discussions with the Department for Education on the vital role that schools can play in tackling both mental health problems and the stigma surrounding them.
Mary Glindon
The YMCA and NHS’s #IAMWHOLE campaign, which was launched this morning, shows that young people seeking help are often dismissed by those around them, largely due to a lack of understanding of mental health difficulties. Will the Secretary of State meet the YMCA to discuss what can be done to combat the stigma?
Mr Hunt
I am more than happy to meet the YMCA. I also want to point out the amazing work done by the “Time2Change” campaign. I was at an event to mark its 10th anniversary, and I heard from young people who have spoken up about their mental health conditions, which takes a lot of courage. Things are changing, and we can draw a lot of hope from what is happening on the ground.
Sir Desmond Swayne (New Forest West) (Con)
Family doctors undertake such work, but why have only a quarter of them had any formal training in mental health?
Mr Hunt
My right hon. Friend is absolutely right to point out that a GP is often the first point of contact for many people. What are we doing? Three thousand mental health professionals will be seconded to GP surgeries over the next few years to give GPs the back-up they need in that area.
Mr Speaker
Not for the first time, I implore the right hon. Member for New Forest West (Sir Desmond Swayne) to issue to colleagues his textbook on succinct questions.
Sir Vince Cable (Twickenham) (LD)
Since the demand for children and youth mental health services far outstrips supply, will the Secretary of State consider diverting resources to voluntary bodies, such as the admirable Off The Record in my constituency, which have a much lower threshold for referral?
Mr Hunt
We will look at the role of voluntary organisations, and I totally agree with the right hon. Gentleman that they have an incredibly important role to play. We must also consider the role of schools, because teachers are extremely enthusiastic to do more around mental health. I think that if we give them more support there is a lot more they could do.
Jim Shannon (Strangford) (DUP)
The Secretary of State will know that when it comes to physical health and stigma, the Department will react right away. Do the Government now recognise the importance of treating mental health with equal status to physical health?
Richard Burden (Birmingham, Northfield) (Lab)
Mr Jim Cunningham (Coventry South) (Lab)
The Secretary of State for Health (Mr Jeremy Hunt)
This week is Baby Loss Awareness Week, and the whole House will want to mark the tragedy faced by too many parents every year by redoubling our efforts to reduce avoidable baby death and harm. I am pleased to tell the House that to mark World Mental Health Day today the entire Cabinet was this morning briefed by two of the country’s leading mental health experts, Poppy Jaman and Professor Sir Simon Wessely, on our plans announced today to roll out mental health first aid to 1 million people in England.
Mr Cunningham
Can the Secretary of State tell us what progress has been made regarding an inquiry into the contaminated blood scandal?
Mr Hunt
I can absolutely tell the hon. Gentleman the answer to that: we have been making very important progress with families over the summer; and we have decided the shape of the inquiry and the leadership of the inquiry and all the factors around the terms of reference need to be decided in close consultation with the affected families. So we are keen to get on as quickly as possible, but we have made some progress in understanding their wishes.
Royston Smith (Southampton, Itchen) (Con)
Jonathan Ashworth (Leicester South) (Lab/Co-op)
Can the Secretary of State tell us how many elective operations he expects to be cancelled by 31 December?
Jonathan Ashworth
I am grateful to the Secretary of State for his answer, but already more than 80,000 elective operations have been cancelled. That is an increase on the past year. A&E attendance is up on the past year, bed occupancy is higher than last year and the Care Quality Commission has today warned that the NHS is straining at the seams. Winter is coming. Last week, the Tory party made spending commitments worth £15 billion, but not 1p extra for the NHS, so will the NHS fare worse or better than last year this winter, or are we set for another winter crisis made in Downing Street?
Mr Hunt
What the CQC actually said this morning is that the majority of health and care systems across the NHS are providing good or outstanding quality; that the safety of care is going up; and that performance is improving. None the less, the hon. Gentleman is right that we are always concerned about winter. Let me tell him the new things that are happening this year to help prepare the NHS: £1 billion more going into the social care system in the most recent Budget; a £100 million capital programme for A&E departments; 2,400 beds being freed up; and an increasing number of clinicians at 111 call centres. A lot is happening, but, overall, let me remind him that our NHS is seeing 1,800 more people every single day within four hours—that is something to celebrate.
Robert Neill (Bromley and Chislehurst) (Con)
John Mann (Bassetlaw) (Lab)
Mr Hunt
That is a very attractive offer, and I am always happy to have a chinwag with the hon. Gentleman. Last week, we announced something that I hope will resolve that, which is that we are looking at holding nurse training courses on-site in hospital and community sites so that experienced healthcare assistants do not have to go to a higher education institution to do their training.
Clive Lewis (Norwich South) (Lab)
Mr Hunt
Accountable care systems are supported by such rabid right wingers as Polly Toynbee, writing in The Guardian, because they are about health systems coming together to co-operate to give the best care for patients. That is what is happening across the NHS, and it is already delivering great results.
Craig Tracey (North Warwickshire) (Con)
This Friday marks Secondary Breast Cancer Awareness Day. In 2015, the Government recognised that data collection for this type of cancer was not good enough. However, research by Breast Cancer Care shows that less than a third of trusts collect the number of people diagnosed with secondary breast cancer. Will the Minister confirm what actions the Government are taking to ensure that all trusts are collecting this information, given its importance to improving outcomes?
Grahame Morris (Easington) (Lab)
Will the Minister abolish the patient penalty and scrap hospital car parking charges, which punish both the sick and hard-working NHS staff, as well as causing problems for residents living adjacent to NHS hospitals, such as Peterlee Community Hospital in my constituency?
Kevin Hollinrake (Thirsk and Malton) (Con)
Antibiotic resistance is a major threat to humanity. Will the Minister outline the progress we have made in opening up the £50 million global antimicrobial resistance innovation fund to applications?
Dr Rosena Allin-Khan (Tooting) (Lab)
There is a crisis in mental health staffing levels. Does the Secretary of State accept that today, throughout the country, there are 2,000 fewer mental health nurses than there were when he took charge five years ago?
Mr Hunt
What I accept is that we have 30,000 more professionals working in mental health than when my Government came into office. There has been a decline in the number of mental health nurses, but we have in place plans to train 8,000 more mental health nurses, and that will make a big difference.[Official Report, 17 October 2017, Vol. 629, c. 6MC.]
Richard Graham (Gloucester) (Con)
The Gloucestershire Hospitals NHS Foundation Trust capital expenditure bid would fund a 24-hour urgent care service, and it would also increase bed capacity and improve hospital performance in Gloucester and Cheltenham, to the benefit of patients throughout the county. When do Ministers expect to announce the results of the bid? Will they take this particular bid into careful consideration?
Kate Green (Stretford and Urmston) (Lab)
GPs in my constituency tell me that because of changes to personal data rules they will no longer be able to charge for providing reports for private insurance and legal claims. Will Ministers update the House on the situation? What assessment has been made of how GPs will cope with the additional costs they will face?
Helen Jones (Warrington North) (Lab)
If nurses or other NHS staff are awarded a pay rise above the current pay cap, will the Government fund that pay rise fully, or will they require it to be met by cuts in patient services?
Mr Hunt
That is something I cannot answer right now, because the latitude that the Chancellor has given me with respect to the negotiation of future pay rises is partly linked to productivity improvements that we will negotiate at the same time. The fact is, though, that we do have that flexibility, and I hope we can get a win-win as a result.
Heidi Alexander (Lewisham East) (Lab)
May I take the Secretary of State back to the issue of nursing associates? Given that evidence shows that for every 25 patients for whom a professionally qualified nurse is replaced by a non-nurse, mortality on an average ward rises by 21%, how comfortable is he with reports that hospitals in Lincolnshire and Leicester are using nursing associates to plug gaps in the nursing workforce?
Bill Esterson (Sefton Central) (Lab)
Under this Government, there has been an unprecedented fall in the number of nurses: the NHS is short of 40,000 nurses and more than 6,000 have gone since 2010, under this Conservative Government. When will the Secretary of State acknowledge that he is failing the NHS and failing patients, and when will he do something about it?
Mr Hunt
With respect, I really think the hon. Gentleman needs to get his facts right. The number of nurses has gone up, not down, since this Government have been in office. The number of nurses in our hospitals has gone up by more than 11,000, because this Government are supporting safer care in all our hospitals.
John Cryer (Leyton and Wanstead) (Lab)
The number of unfilled nursing posts in London is now more than 10,000—whatever the Secretary of State’s figures say, it is more than 10,000. When will they be filled?
Jo Swinson (East Dunbartonshire) (LD)
Suicide is the most common cause of death for men under the age of 45, and men are significantly less likely than women to seek support from loved ones or medical professionals when they have mental health problems. How can services be better targeted at men to encourage them to seek help more quickly and thereby reduce misery?
Mr Hunt
This is a very important issue and the hon. Lady is right to raise it. The Time to Change campaign has said that this year it will focus on men, specifically to try to address the issues she mentioned. We are rolling out crisis plans throughout the country to make sure we are better able to reach people who reach out to us.
Mike Amesbury (Weaver Vale) (Lab)
What reassurance can the Secretary of State give to the Amplify youth project in Northwich in my constituency that timely and improved access to mental health services will be provided?
Mr Hunt
We have said that by 2020-21 we want to be treating an extra 70,000 young people every year, but the truth is that that is still not enough. We need to bring down waiting times much more dramatically, which is why we are doing a lot of work across Government and we have a Green Paper coming out shortly.
James Frith (Bury North) (Lab)
Newly released NHS guidance makes it clear that walk-in services can have a future as part of urgent treatment centres. Does the Secretary of State agree with me and thousands of patients in Bury North that Bury walk-in centre can, should and must stay open and that Bury CCG should ensure this when it concludes its review?
Mr Geoffrey Robinson (Coventry North West) (Lab)
Is the Secretary of State aware that there is widespread support in the House for his Government’s commitment to enact the principle of deemed consent for organ donation? He knows from a previous meeting that my private Member’s Bill is due for its Second Reading early in the new year. Will he therefore agree to an early meeting now, so that we can co-ordinate the two and see how to advance his intentions? I know that my hon. Friend the Member for Barnsley Central (Dan Jarvis) will be with me again and, with the Secretary of State’s commitment to this, we look forward to an early meeting.
Mr Hunt
I very much enjoyed our previous meeting, which was not so very long ago. I hope the hon. Gentleman is happy that we have made good progress since that meeting, with the Prime Minister announcing that we will start a consultation, but I am always happy to see him and his colleague the hon. Member for Barnsley Central (Dan Jarvis).
Gareth Snell (Stoke-on-Trent Central) (Lab/Co-op)
The Secretary of State will be aware that he and he alone has responsibilities under the Health and Social Care Act 2012 to deal with referrals from local authorities of clinical commissioning group decisions. Almost a year ago, Stoke-on-Trent City Council and Staffordshire County Council referred a matter to the Minister regarding the closure of community care beds. To date we have had no response. Letters from me and my hon. Friend the Member for Stoke-on-Trent North (Ruth Smeeth) have gone unanswered. When will we get a response? Is this a case of wilful indifference towards his responsibilities or just ignorance of the Act?
Mohammad Yasin (Bedford) (Lab)
Yesterday the private ambulance service that provided non-urgent patient transport at Bedford hospital ceased trading, leaving the East of England Ambulance Service NHS Trust to pick up the pieces. Will the Minister order an inquiry to establish what went wrong, and does he agree that using private companies to run key services for our NHS is simply not working?
Mental Health Act Review
Jeremy Hunt Excerpts(8 years, 9 months ago)
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The Secretary of State for Health (Mr Jeremy Hunt)
The Government have commissioned an independent review of mental health legislation and practice to tackle the issue of mental health detention.
There have been concerns that detention rates under the Mental Health Act are too high. The number of detentions has been rising year on year, and last year on average there were 180 cases a day where people were sectioned under the terms of the act. People from black and minority ethnic populations are disproportionately affected, with black people in particular being almost four times more likely than white people to be detained.
The Government are committed to improving mental health services and ensuring that people with mental health problems receive the treatment and support they need, when they need it. This can mean that people need to be made subject to the Mental Health Act—that is, be detained or ‘sectioned’. In these cases, our dedicated professional staff—including psychiatrists, nurses, social workers, and the police—work tirelessly to ensure that people are treated with dignity under the Act, and that their liberty and autonomy are respected as far as possible.
Professor Sir Simon Wessely, former president of the Royal College of Psychiatrists, will lead the review which will deliver recommendations for change to the Government. Sir Simon will look at the evidence, review practice, and above all consider the needs of service users and their families, and how best the system can help and support them. He will identify improvements in how the Act is used in practice, as well as how we might need to change the Act itself. Vice chairs will be appointed to work with Sir Simon and ensure the leadership of the review has comprehensive professional expertise whilst also being representative of service users and others affected by the Mental Health Act.
Following consultation with stakeholders, Sir Simon will produce an interim report identifying priorities for the review’s work in early 2018, and develop a final report containing detailed recommendations on its priorities, by autumn 2018.
Further detail on the independent review, including its terms of reference, can be found at:
https://www.gov.uk/government/news/prime-minister-announces-review-to-tackle-detention-of-those-with-mental-ill-health.
[HCWS143]
NHS Pay
Jeremy Hunt Excerpts(8 years, 10 months ago)
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The Secretary of State for Health (Mr Jeremy Hunt)
I thank the shadow Health Secretary for introducing this debate. NHS staff are doing a superb job in tough circumstances, and it is right for this House to debate whether we are giving them an appropriate level of support.
I start by addressing the areas on which we agree with the Opposition. First, it is incredibly important to have motivated staff, simply because motivated staff give better care to patients. It is critical for patient safety that we have enough staff in our NHS and social care system, so recruitment and retention matter. It is also true that, right now, it is very tough on the frontline for NHS staff as they cope with the pressures of an ageing population, of financial constraints that have not been as tough in many years, and of changing consumer expectations of what the NHS should deliver. We agree on all that, but there are some fundamental disagreements that I also need to surface.
The shadow Health Secretary talks about the former 1% cap and the pay restraint that we have indeed had for the last seven years, which his party frequently characterises as austerity—some ideological mission by the Conservatives to reduce the size of the state. [Interruption.] I can see some nods, but it is absolute nonsense.
I remind Labour Members that in 2010 we inherited the worst financial crisis in our history and the worst recession since the great depression. The shadow Health Secretary was an adviser to Gordon Brown in 2010—he does not talk about that very much—and he knows just how serious the crisis was. He uses the phrase “Tory economics,” but the 2010 Labour manifesto, which he may well have had a hand in drafting, wanted to cut the NHS budget. The Health Secretary at the time, Andy Burnham, said that it would be “irresponsible” not to cut the NHS budget.
In 2015, five years on from that terrible crisis, the Labour party wanted to put £5.5 billion less into the NHS than the Conservative party did. In short, the austerity that the shadow Health Secretary criticises today is austerity that Labour wanted to go much further with when it comes to the NHS. Labour needs to recognise that if we had followed its advice we would not even have been able to honour a 1% pay rise, we would not have been able to recruit 12,000 more nurses for our wards, we would not have record numbers of doctors and we would not have record funding for the NHS.
Catherine West
Will the Health Secretary apologise for the current dreadful state? We have thousands and thousands of nurse places, and hospital trusts are having to go as far as the Philippines to recruit student nurses. Student nurses are coming out of university with £56,000 fees. NHS recruitment and retention is in a deep crisis. Will he apologise?
Mr Hunt
What I will not apologise for is the dreadful short staffing on NHS hospital wards that we inherited in 2010, which led directly to the problems of Mid Staffs. Nor will I apologise for sorting that out and making sure that we have 12,000 more nurses on our hospital wards today than we had in 2010.
Alison McGovern
The Secretary of State is repeating words that the Tories have used to excuse their cuts for years but that have not dealt with the deficit, which is still with us. My constituents do not care about that; they care about Eastham walk-in centre, which is closed because of staff shortages. Will he answer this simple question? When will Eastham walk-in centre reopen?
Mr Hunt
What the hon. Lady’s constituents care about is that today we announced the lowest unemployment level since 1975, which is a massive benefit to her constituents. She says that we have been repeating our reasons for this terrible financial discipline, which has been so difficult. I am not someone who says that the entire responsibility for the recession in 2010 is the Labour party’s. I recognise that it was a global crash, but what Labour cannot deny is that the recession we faced here was far, far worse than in other countries. Why is that? What did the Governor of the Bank of England say at the time?
Several hon. Members rose—
Mr Hunt
Hang on. I think it is important to listen to what the Governor of the Bank of England said. Sir Mervyn King said:
“we came into this crisis with fiscal policy along a path that was not…sustainable and a correction was needed.”
What was he talking about in 2010? The Government borrowed £1 in every £4 that they spent. The deficit was 10.2%, the highest since records began. The reason that, say, Germany did not have to go through austerity is not because a German equivalent of the Leader of the Opposition was throwing prudence to the wind but because Germany did not allow its public finances to get recklessly out of control, which is what happened under the Labour Government.
Ms Karen Lee
This is a genuine question. I am a nurse, and I see the situation at first hand. I go to work once a month—I still do bank shifts—and the situation is truly awful. We are so understaffed that it is unbelievable. I looked after 10 patients on my last shift. That is not for the audience; it is the truth. The NHS is in that sort of state. Lincoln’s walk-in centre is threatened with closure. All that is going on. I take the Secretary of State’s point about paying for it, but the Conservative party talks about cutting corporation tax and it is paying the Democratic Unionist party more than £1 billion. While that is happening, he cannot talk to us about austerity and say that we cannot have decent NHS services. I am sorry, but he should listen to what I am saying. The NHS really is in crisis.
Mr Hunt
I thank the hon. Lady for her work in the NHS. I am honoured that we have nurses on both sides of the House who do a fantastic job. I agree that we need more nurses. We needed more nurses when I became Health Secretary—the NHS was planning to lose nurses, and I stopped that—and we still need more nurses. I will explain exactly how we will get those nurses.
Several hon. Members rose—
Helen Whately
Opposition Members are raising concerns about staff shortages and about recruiting staff from overseas. I am sure we all have hospitals serving our constituents that have had to go overseas to recruit. We do not want to see that; we want to see nurses trained in the UK and British nurses. I welcome the fact that the Secretary of State has taken action to remove the cap on nurses in training so that we can train more home-grown nurses.
Robert Halfon (Harlow) (Con)
I thank my right hon. Friend for the huge and strong support he has given to Princess Alexandra hospital in Harlow and to our campaign for a new hospital. I welcome the moves the Government are making on the pay cap and I look forward to announcements in the coming weeks. May I urge him to do even more than the Government are doing on nursing apprenticeships, because they are one key way forward? These apprentices do not have any loans and they can do nursing. Finally, let me make the wider point that one of the best ways of helping lower-paid nurses, and everyone in the public and private sectors, is by continuing to do what the Government are doing by cutting taxes for lower earners and acting through the national living wage.
Several hon. Members rose—
Mr Hunt
I am going to make some progress and then I will give way further. I want to talk about the recruitment issues raised by the hon. Member for Hornsey and Wood Green (Catherine West) and others, but I wish to conclude on the point about financial discipline, of which Opposition Members are so critical. The consequences for a Government of losing financial discipline are not just pay freezes and 1% caps, but 1 million people unemployed—as a result of that recession post-2008. Every Labour Government in modern times has left office with unemployment higher than when they arrived. That is why this afternoon’s motion is so bogus, because the difference between the Government and the Opposition is not about a desire to invest in public services; it is about the ability to deliver a strong economy so that we can make that investment.
Mr Hunt
I want to make some progress on the recruitment issues, which a number of hon. Members have raised. The argument we seem to be hearing from the shadow Health Secretary is that Labour’s policies would mean more nurses for the NHS and better care for patients, but nothing is further from the truth. Let us look at Labour’s policies at the last election. What did the independent Institute for Fiscal Studies say then about Labour’s spending plans? It said there was a black hole of up to £29 billion, which made even Gordon Brown look like the paragon of prudence that he never was. How can a black hole like that be filled? There are only two ways of doing it. The first is by raising taxes on ordinary people—this is what the IFS said would be one of the biggest tax increases in the past 30 years, equivalent to a 7% increase in income tax. For a nurse on average earnings, this would be a £1,400 tax hike every year. Alternatively, the hole could be filled by increasing borrowing, but that simply passes on debts to future generations in a con as explicit as the con of telling students before an election that their debt will be waived only to cancel the promise after the election.
Julian Knight (Solihull) (Con)
My right hon. Friend does not even need to cite the IFS to see what things would be like with Labour in charge of the UK NHS—he just needs to look to Wales, where the NHS has been cut by 10% and one in seven people are on the NHS waiting list. That is Labour in action.
Mr Hunt
My hon. Friend is absolutely right about that. The whole problem with the tone of the argument made by the shadow Health Secretary is that he is saying that the difference between the Government and Labour is about our support for public sector workers, but we all agree, in all parts of the House, that they do a fantastic job. I see that in the NHS every week. The difference between us and Labour is about knowing what harms public sector workers the most; it is between ignoring and repeating the mistakes of the 2008 crash, as Labour Members are, and what we think, which is that we need to learn from those mistakes and not repeat them.
James Heappey
Does my right hon. Friend agree that Labour was not the only party with an irresponsible policy at the general election on funding health and social care, and that although the Liberal Democrats can muster only one MP to debate this important subject today, their 1p on income tax gimmick would have gone nowhere far enough to funding the properly increased services they promised?
Lady Hermon
Will the Health Secretary take a few moments to address the serious issue of staff morale in the NHS? In Northern Ireland, we have no Assembly and, thus, no Health Minister, so there is no mechanism by which to give our nurses any pay increase. He needs to speak to the Secretary of State for Northern Ireland, as a start, and to address the crucial and concerning issue of staff morale, which is affected by low pay and the pay cap.
Several hon. Members rose—
Mr Hunt
I will make some progress now, because I know that lots of people want to speak in this debate.
The other completely bogus claim we have heard this afternoon is that somehow the financial discipline of pay restraint that we have had to have has been deliberately targeted at ordinary people. Again, that is absolute nonsense, as we see when we look at what has happened. Despite the recession and the pressures on public finance, this Government have taken 4 million of the lowest-paid people out of income tax altogether. At the same time, the top 1% are paying more and the top 20% are paying more, and we have gone further, introducing the national living wage, which since its introduction in April has increased the pay of people at that level of pay by £1,400 per annum. The record overall—this is where we see the most obnoxious untruth spread by the story on austerity—shows that over the past seven years we have seen 600,000 fewer people in absolute poverty and 200,000 fewer children in absolute poverty. Income inequality has reduced to its lowest level for 30 years. Why is it that this apparently evil Tory Government have reduced inequality? It is because we have done what Labour never does, which is grow the economy, with 1 million new businesses, 3 million new jobs and unemployment at its lowest since 1975. Today, youth unemployment is below 5% for the first time and there has been a 40% drop since 2010.
Several hon. Members rose—
Mr Hunt
I am going to make some progress, because I want to deal with the issue of morale, and then I will give way for a final round of interventions.
A lot of comments have been made about the NHS being at breaking point, at a tipping point and so on. There is huge pressure on the NHS, but, as has been said by my right hon. Friend the Member for Broxtowe (Anna Soubry), who is no longer present, that is not the whole picture. What the shadow Health Secretary did not say is that 7,000 people are alive today who would not have been had we stayed at the cancer survival rates of just four years ago. We are having probably the biggest expansion of mental health treatment in Europe, and an independent NHS England report says that for most major conditions outcomes have dramatically improved over the past three, five or 10 years.
Norman Lamb (North Norfolk) (LD)
I feel that as the sole Liberal Democrat present it is my duty to intervene. Does the Secretary of State accept, as a principle, that ultimately we cannot sustain the NHS on the back of real-terms cuts to people’s pay within the NHS and that that would be unconscionable year after year? Does he also accept that as the difference between public and private sector pay narrows so much, people will just vote with their feet and leave? Therefore, not only is this morally wrong, but it will not work ultimately.
Mr Hunt
I agree with the right hon. Gentleman that when deciding policy on pay we absolutely have to look at the impact on recruitment and retention, and that if we are going to deal with the pressures of an ageing population in the way that he and I would both want, we are going to need to recruit many more doctors and nurses for the NHS over the years ahead.
The progress that we have made in the NHS in improving outcomes for patients, despite the huge pressure on the frontline, is possible because of the brilliant staff we have in the NHS. I want to recognise that pay restraint has been extremely challenging, which is why yesterday my right hon. Friend the Chief Secretary to the Treasury announced a new policy, allowing Departments flexibility where there are recruitment and retention issues, and where productivity savings can be found. We will also honour the commitment we made prior to yesterday’s announcement, which was that before we take any decisions we will listen to the independent advice of the pay-review bodies.
To value staff also means to look at non-pay issues as well. It means we should look at making sure that we are training enough staff, so that when hospitals have the budgets to employ staff, they are there for them to employ; it means we should look at flexible working—on which, frankly, the NHS can do a lot better—if we are to tackle the agency bill that the shadow Health Secretary spoke about; it means we should put in place measures to encourage nurses to return to practice, which is why Health Education England is increasing the number of return-to-practice training places to 1,250 from 2019-20; it means we should look at new support roles for nurses, such as the 2,000 nurse associates who are starting training this year; and it means we should look at new routes into nursing, such as the nurse apprentice route that we are opening this year.
Mr Hunt
I am going to wind up my comments now, because lots of people wish to speak. [Hon. Members: “Oh!”] Okay, the House has persuaded me. I shall give way first to the hon. Member for Hornsey and Wood Green (Catherine West) and then to my hon. Friend the Member for Redditch (Rachel Maclean).
Catherine West
I thank the Secretary of State for his generosity in giving way to me twice. Will he look again at the issue of student bursaries? It is such mistake.
Mr Hunt
I assure the hon. Lady that we are making reforms because we want to train more nurses and to fund more nurse training places. There has been a dip in the number of people taking up nurse training places this year, as there was when the higher education reforms were introduced in 2012, but it recovered soon after that and we now see in other parts of higher education record numbers of students from poorer backgrounds going to university.
Rachel Maclean
On my right hon. Friend’s earlier point about the recruitment and retention of staff, one problem, which I know from having spoken to the Worcestershire Acute Hospitals NHS Trust and the Alex Hospital in my constituency, is the constant negative messaging the public receive. Members from all parties deeply back NHS workers, appreciate and respect how hard they work, and recognise the challenges. If Opposition Members really care about easing the recruitment and retention crisis, I call on them to join us in talking about some of the good news and the good messages that are coming out of the NHS. Those are the things that get through to the public’s mind and that encourage nurses to join the profession, and that is why we have twice the number of applicants for nursing places this year.
Mr Hunt
My hon. Friend is absolutely right. From some of the debates we have in this House, a person would never know that in July, for the second time running, an independent American think-tank looked at health systems in all the world’s major countries, compared us with the United States, Germany, France, Australia and others, and said that the NHS was top—the best healthcare system of any major country. We have a huge amount to be proud of.
Several hon. Members rose—
Mr Hunt
I am going to conclude my comments by asking three questions. First, who is the real friend of public sector workers—the party that wrecked the economy, leading to massive cuts, or the party that turned the economy around with 3 million new jobs? Who is the real champion of public services—the party that did not only wreck the public finances but wants to do so all over again, or the party that is restoring discipline to the public finances so that we can start to invest more in our public services? Who is the real friend of the NHS—the party that has delivered more doctors, nurses and funding than ever before in its history, or the party that plays politics with the NHS in election after election, despite doing it so much harm?
Medicines and Healthcare Products Regulatory Agency
Jeremy Hunt Excerpts(9 years ago)
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The Secretary of State for Health (Mr Jeremy Hunt)
On Wednesday 12 July, Ministers at the Department of Health were informed by the Medicines and Healthcare products Regulatory Agency (MHRA) about an issue identified during a routine inspection of Bio Products Laboratory (BPL). The MHRA provided confirmation on Monday of this week that, in light of all of the information currently available, their assessment is that no patients have been harmed and none put at additional risk of harm due to the issue.
BPL is responsible for the supply of a range of plasma products to the NHS and a range of other major health systems around the world. The company, in line with best practice, operates a three stage process to ensure the safety of its products:
1. Selection of healthy donors, with all donations tested and traceable to the donor.
2. Further safety tests of plasma in advance of the manufacturing process.
3. During the manufacturing process, all products are specially treated to inactivate viruses.
The MHRA informed Ministers that their inspection identified a problem with the computer software, which controls the stage one process set out above. Following the identification of the issue by the MHRA, a manual review was undertaken by the company to ensure that no inappropriate donations made it through this stage of the process due to the problems with the computer system. This manual review confirmed that no inappropriate samples had made it through to the next stage of the process, and a range of other risk mitigation steps were also implemented.
The MHRA have continued to provide progress updates to Ministers regularly since notification on 12 July.
On Monday of this week the MHRA confirmed to Ministers their assessment that the problem had been addressed through interim measures to provide the necessary assurance while long-term solutions are being implemented. In the opinion of the MHRA, due to the three stage process outlined above, and in light of all of the information currently available, no patients have been harmed and none put at additional risk of harm due to the issue.
The MHRA is continuing to undertake all necessary regulatory activities in order to ensure patient safety, and will continue to keep Ministers informed of this work.
Although there is no evidence of risk to patients in this case, in the interest of transparency, I wanted to update the House to this situation as quickly as possible with the relevant information. In the unlikely event of any changes, I will update the House accordingly.
[HCWS70]
NHS Transformation: Investment
Jeremy Hunt Excerpts(9 years ago)
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The Secretary of State for Health (Mr Jeremy Hunt)
This Government are backing the NHS’s own plan for the future, the Five Year Forward View, and funding it with an additional £8 billion a year in real terms by the end of the Parliament. Delivering that vision relies on health and care organisations working together at a local level, which the NHS is taking forward through sustainability and transformation partnerships. These are clinically led, locally driven—and can deliver real improvements for patients. The independent King’s Fund has called STPs “the right approach for improving care and meeting the needs of an ageing population”.
In the spring Budget the Chancellor of the Exchequer announced an additional £325 million of capital funding to invest in local areas who have come together and developed robust plans.
Today, I announce the provisional allocation of this first tranche of capital funding. From a large number of proposals, 25 schemes have been selected in total from across the 15 STP areas as follows:
Greater Manchester
Lancashire and South Cumbria
Dorset
Leicester, Leicestershire and Rutland
Milton Keynes, Bedfordshire and Luton
Derbyshire
West, North and East Cumbria
Nottinghamshire
Suffolk and North East Essex
Herefordshire and Worcestershire
South Yorkshire and Bassetlaw
Mid and South Essex
Norfolk and Waveney
Buckinghamshire, Oxfordshire and Berkshire West
North East London
Further detail on the schemes that will receive funding is available as an online attachment.
In order to qualify for this first tranche of funding, these areas were all judged to be sufficiently advanced on the basis of the STP assessment data (that NHS England will publish on Friday). This data allows patients, managers and the public to see how their STP area is performing across three themes: hospital performance, patient-focused change, and transformation. Each theme is underpinned by key metrics, such as performance in emergency and elective care, safety and leadership. It is a mechanism by which organisations, patients and the public can hold their STP to account.
The quality and diversity of proposals put forward show that the NHS is working innovatively to identify opportunities for transformation in the delivery of health services across their local footprint. The Government are fully committed to supporting this process and the schemes selected for funding will make a substantial difference to the performance of local health systems.
Final confirmation of this funding will be subject to the successful approval of business cases. Organisations receiving funding will also be required to demonstrate that their proposals form part of a robust capital and estates strategy which maximises all opportunities for generating receipts from surplus land disposals within their STP area. We will also expect them to agree a clear delivery plan for generating these receipts. This process will be supported by a central team of strategic estates advisers
The Government remain committed to considering a further round of local proposals for funding in the autumn Budget, subject to the same rigorous value for money tests. In considering these bids we will look to STPs to demonstrate further progress on generating funding from disposals receipts and other sources of finance.
Attachments can be viewed at:
http://www.parliament.uk/business/publications/written-questions-answers-statements/written-statements/Commons/2017-07-19/HCWS71/.
[HCWS71]
Annual Assessment of NHS England
Jeremy Hunt Excerpts(9 years ago)
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The Secretary of State for Health (Mr Jeremy Hunt)
Today, I am laying before Parliament my annual assessment of the NHS Commissioning Board (known as NHS England) for 2016-17. A copy is available as an online attachment. This draws on and responds to NHS England’s annual report and accounts 2016-17, which were laid earlier today (HC101).
The Government’s mandate to NHS England sets out the steps that we expect it to take to help deliver our shared vision for the safest, most compassionate, highest quality health system in the world. We recognise that this can only be achieved through the outstanding contribution that the 1.3 million NHS staff across the country make each and every day in delivering care and support for patients, and I would like to pay tribute to their diligence, professionalism and expertise.
NHS England’s annual report sets out the progress made in delivering the mandate. It describes an organisation that continues to ensure that high-quality care is delivered in the face of rising public demand and cost pressures across the system, and emphasises the need to deliver the next steps on the five year forward view to address these challenges. The Government support the NHS’s plan, including the development of clinically led and locally supported sustainability and transformation partnerships.
My annual assessment welcomes the good progress that has been made in challenging circumstances, while recognising that there remains a great deal more to do, particularly to improve quality, access and safety while maintaining financial sustainability for the future.
NHS England’s core aim is to deliver excellence in access and outcomes for patients and, this year, substantial advances have been made across a number of areas, including mental health, maternity care and diabetes prevention. NHS England has also made a significant contribution to overall financial balance in the NHS.
However, continued growth in demand has put pressure on services and the NHS is not meeting core patient access standards. This remains a key priority and, to help address this, in 2017-18 NHS England will need to better manage demand, including by working with local government to ensure patients are transferred to more appropriate care when they are fit to leave hospital. To support this, the Government have provided an extra £2 billion for local authority-funded adult social care over the next three years, with £1 billion available in 2017-18.
My assessment sets out the Government’s expectation that the NHS will make further progress in the year ahead on achieving parity of esteem for mental health. Continuing the constructive joint working with NHS Improvement and Health Education England to better manage the challenges the NHS experiences over winter, as well as continuing progress to retain and increase the workforce, will be key. We will also look to NHS England, working with NHS Improvement, to deliver a balanced NHS budget.
We will continue to work closely with NHS England to address the significant challenges ahead and provide a sustainable and efficient health service with quality, transparency and safety at its heart.
Copies of my annual assessment and NHS England’s annual report will be available from the Vote Office and Printed Paper Office.
Attachments can be viewed online at: http://www.parliament. uk/business/publications/written-questions-answers-statements/written-statement/Commons/2017-07-18/HCWS64/
[HCWS64]
Ambulance Response Programme
Jeremy Hunt Excerpts(9 years ago)
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The Secretary of State for Health (Mr Jeremy Hunt)
I am today announcing the publication of the University of Sheffield report on the ambulance response programme and subsequent recommendations by Sir Bruce Keogh, NHS England’s national medical director. The report evaluates a series of pilots that I announced to the House in my written statement of 6 January 2015, intended to support ambulance services in England to maintain and improve clinical outcomes for patients in the face of unprecedented increases in demand. Copies of the report and Sir Bruce’s recommendations are attached.
Based on the extensive evidence base detailed in the report, NHS England is proposing a new framework of ambulance performance standards and related operational changes that are focused on patients’ clinical needs and will help the service to operate more efficiently. In particular:
enabling ambulances to dispatch resources much more clearly based on the clinical needs of patients ensuring the consistent delivery of very rapid responses to those who genuinely need them, through putting in place a four tier response time based on the clinical needs of patients;
introducing specific standards for stroke and heart attack, aimed at ensuring patients start the right treatment in hospital as quickly as possible;
improving performance management of “tail” waits by introducing mean and 90th centile measures; and,
achieving greater consistency and transparency for less urgent calls by bringing all response standards into a consistent national framework.
These ambulance response times are more stringent than anywhere else in the UK. Moreover, evidence from the pilots suggest that these changes will be beneficial for rural populations, narrowing the gap which currently exists in the time it takes for an ambulance resource to transport patients to hospital.
In my statement in January 2015 I said I would apply the following three tests before extending the ambulance response programme:
there is clear clinical consensus that the proposed change will be beneficial to patient outcomes as a whole, and will act to reduce overall clinical risk in the system;
there is evidence from the analysis of existing data and piloting that the proposed change will have the intended benefits, and is safe for patients; and,
there is an associated increase in operational efficiency. The aim is to reduce the average number of vehicles allocated to each 999 call and the ambulance utilisation rate.
I have accepted Sir Bruce’s advice that these tests have been met. I am authorising NHS England to implement the ambulance response programme recommendations in all ambulance services in England so that patients across the country will benefit from the improvements seen in the pilot ambulance services.
1. Report on Ambulance Response Programme (ARPReport_Final.pdf)
2. Letter with Sir Bruce Keogh's recommendations (13.7.17 Jeremy Hunt - Ambulance Response Programme letter.pdf)
The above documents can be viewed online at:
http://www.parliament.uk/business/publications/written-questions-answers-statements/written-statement/Commons/2017-07-13/HCWS45/ .
[HCWS45]