Princess Royal Hospital, Telford

Jeremy Lefroy Excerpts

Tuesday 5th November 2019 Westminster Hall

[Edward Argar]

I confirm that that is capital funding for her hospital to prepare for this winter and to meet the challenges it faces.

The detail of the proposal has still to be worked up, and NHS England will work with the trust, its partners and the Royal College of Emergency Medicine to support the development of the model and a timeline for its implementation. I hope my hon. Friend wishes to be involved in that process, and that both of us will be back here to have that conversation later in the year.

[Jeremy Lefroy (Stafford) (Con)]

I congratulate my hon. Friend the Member for Telford (Lucy Allan) on securing this important debate. A number of constituents from the west side of my constituency rely absolutely on the Princess Royal Hospital in Telford. Will the model mentioned by the Minister include, as it does in Stafford, the reception of blue-light services—that is, 999 ambulances —in the medical sphere at least? It is important to understand that, because the ability to receive blue-light services is what distinguishes an A&E from an urgent care centre.

Oral Answers to Questions

Jeremy Lefroy Excerpts

Tuesday 29th October 2019 Commons Chamber

[Matt Hancock]

Getting this right is incredibly important. The change in the guidance last month allows every single NHS trust to introduce the flexibilities, immediately, to ensure that doctors can do the work and the overtime they need, get paid properly for it and not get penalised through the impact on the pensions system. That change came in at the start of last month. I will write to the hon. Gentleman with the details, so that he can tell all doctors that these flexibilities are available so that they can do the work that they need to.

[Jeremy Lefroy (Stafford) (Con)]

Earlier this year, the Secretary of State spoke about the importance of introducing new financing mechanisms to develop and deploy drugs and vaccines to tackle antimicrobial resistance. Will he update us on that, please?

[Matt Hancock]

Yes. In January, with my hon. Friend’s support, we launched the five-year plan to tackle antimicrobial resistance. We have now taken that to a global level; this is a global problem. We have appointed Dame Sally Davies, who recently stood down as the chief medical officer, to be our AMR tsar so that she can continue the drive both domestically and around the world.

Health Visitors (England)

Jeremy Lefroy Excerpts

Wednesday 23rd October 2019 Westminster Hall

[Tim Loughton]

My hon. Friend may well be right. One of my constituents is a health visitor. According to her, the current status of health is not serving families well, based, as it is, on universally delivered process outcomes, which risk, to use a phrase she quoted to me, “ticking the box but missing the point”. That plays to the point my hon. Friend is making.

To illustrate the most successful ways of dealing with vulnerable families, I will use children’s centres as an example, although I will not get into a whole argument about them. The most successful ones that I have seen are those where hot-desking occurs between a district nurse, a health visitor, a social worker, a school nurse and others, who are all signposting. The health visitor may get over the threshold and say, “I am a bit worried that there is a mental health problem there. When I go back and see the community mental health nurse at the children’s centre, I might suggest she has a word.” That is the way it must happen. These are interlinking problems and it is not just down to one professional to treat them.

On the local authority, public health budgets have seen a significant reduction from 2015. The recent 1% increase for 2021 is welcome, but there is a long distance to go to replace some of the past reductions. Some areas have suffered disproportionately. I want to flag Suffolk, where, I gather, the council has been considering plans to slash the health visiting workforce by 25% to save £1 million. I think that is a false economy and short-sighted.

The decline in the number of health visitors since 2015 has been due to qualified nurses retiring or moving to other roles within the health service and too few trainees entering the profession. Alongside workforce cuts by local authority commissioners, the health visiting profession is also facing recruitment and retention problems, falling staff morale and poor progression opportunities. Health visitors have also raised safeguarding concerns as their caseloads increase to meet increasing need and cover shortages.

In a 2017 survey by the Institute of Health Visiting, health visitors reported that children are put at risk due to cuts in the workforce and growing caseloads, finding that 21% of health visitors are working with caseloads of over 500 children, as the hon. Member for Lincoln (Karen Lee) pointed out.

[Jeremy Lefroy (Stafford) (Con)]

When health visitors visited me in my constituency surgery in Penkridge, their frustration was that, although they love their job and want to do it properly, they cannot do it to the best of their professional satisfaction, because of the caseloads and because there were too few of them. Health visitors want to serve my constituents—the mothers, families and children—but they cannot, for those reasons. I had huge respect for their professional attitude, but it showed their real sorrow that they could not do the job as well as they want to.

[Tim Loughton]

My hon. Friend is absolutely right. I have met many health visitors. They are a fantastic resource and do huge amounts of good work well beyond their remit. They are frustrated by some of the processes and financial considerations that are stopping them from doing their job to the best of their ability with sufficient support.

NHS Long-Term Plan: Implementation

Jeremy Lefroy Excerpts

Monday 1st July 2019 Commons Chamber

[Matt Hancock]

The answer to that question is being worked on as part of the people plan, which Baroness Dido Harding is putting together. We published the interim plan last month. The full people plan will be available after we have settled, in the spending review, the budget of Health Education England. The hon. Gentleman raises an incredibly important point.

[Jeremy Lefroy (Stafford) (Con)]

I very much welcome the plan, with £33.9 billion being committed by 2022-23. My slight concern is where the money is going to come from. I wonder whether my right hon. Friend has had assurances from the Treasury that that will indeed be the case. With all the other pressures on spending and revenues in the coming years, that might be a little difficult. We have to find ways to ensure that the revenue is there because this money must be spent.

[Matt Hancock]

Yes, it will in all circumstances. This is a firm commitment, supported right across this House and right across our party, and it will be delivered. There is absolutely no question about that.

Oral Answers to Questions

Jeremy Lefroy Excerpts

Tuesday 18th June 2019 Commons Chamber

[Caroline Dinenage]

The hon. Lady is absolutely right to draw attention to this issue. We are very concerned about the diagnosis times, which is why we are reviewing our autism strategy this year and are extending it to include children, whereas before it catered only for adults. We want to ensure it remains fit for purpose. We have launched a national call for evidence and have already received in excess of 1,000 responses.

[Jeremy Lefroy (Stafford) (Con)]

Patient safety in the NHS depends on compassionate care training and staffing levels, but it also depends on patient safety systems. What progress is the national health service making towards implementing those systems in every place where patients are cared for?

[Caroline Dinenage]

Patient safety, as my hon. Friend suggests, remains an absolutely key priority for the NHS. NHS Improvement and NHS England are developing a national patient safety strategy, which will sit alongside the NHS long-term plan. It will be published this summer and will build on existing work to provide a coherent framework that the whole NHS can recognise and support.

Cystic Fibrosis Drugs: Orkambi

Jeremy Lefroy Excerpts

Monday 10th June 2019 Westminster Hall

[Seema Kennedy]

I agree with the Chair of the Health and Social Care Committee and urge Vertex to re-engage with the NICE process. To date, unfortunately, it has continued to refuse to accept the process or has suggested unacceptable conditions on the NICE value assessment of its product, which would render the outcome meaningless. That comes despite NHS England’s latest proposals offering to reimburse Vertex ahead of a positive NICE recommendation, which for a deal of this size is unprecedented; agreeing to implement real-world data collection, as the Committee has called for, to help Vertex to demonstrate the value of its medicines; and offering significantly increased prices in comparison with their offer last July.

NICE has a 20-year history and is internationally renowned and independent. Its methods and processes for the development of its guidance have been in place for 20 years, but it recognises that it needs to evolve. It continues to review its procedures to ensure that they remain fit for purpose; it is now undertaking a review of its technology appraisal methods in line with the commitment in the 2019 voluntary scheme, and it encourages all stakeholders to engage. NICE has recommended 75% of the drugs for rare diseases—some of which I will touch on later—that have been assessed through its technology appraisal programme for the eligible patient population.

Last week, the Association of the British Pharmaceutical Industry made it clear that

“NICE is the cornerstone of NHS efforts to ensure the price being charged by a company represents the value being delivered.”

Commenting on the current situation, it said that

“the APBI would always encourage companies to fully engage with NICE at all stages of the process.”

Furthermore, it commented on the current structure of NHS England’s proposed deal with Vertex, saying that

“the structure of the offer represents exactly the sort of flexibility the industry has been calling for, for some time.”

However, Vertex is willing to accept only its own valuation of Orkambi; I draw your attention, Mr Hanson, to comments directed at Vertex by Members from across the House, including those made by the shadow Minister, the hon. Member for Washington and Sunderland West (Mrs Hodgson).

[Jeremy Lefroy (Stafford) (Con)]

I am grateful to the Minister for giving way and I apologise for not being here at the beginning of the debate, because of important statements in the main Chamber.

My constituent William Smith, who is a pupil at Cooper Perry Primary School, has cystic fibrosis. Along with his entire class, he presented me with the facts of his case and with letters to the Government, and they made it quite clear that they expect not only the Government but Vertex to come to a decision on this matter. Is it not absolutely vital that a company such as Vertex should engage with the Government given that the lives and futures of people such as William Smith, my 10-year-old constituent, are at stake?

[Seema Kennedy]

My hon. Friend makes a very good point. Members from across the House have told very moving stories of their constituents, the lives they lead, and the stresses and the strains put on them by the lack of an agreement on this matter. However, other drug companies are developing medications for rare diseases, and agreements have been reached on those. I will turn to them very shortly.

We can look at what happened in Spain earlier this year, when Vertex did not accept the terms of Spain’s health outcome-related proposal. The Spanish proposal, which is similar to the recent NHS England offer, is based on the ongoing collection and interpretation of real world data. Why is that not acceptable to Vertex? I also note that dialogue between Spain and Vertex has been ongoing for three years, which is similar to the situation here in England.

We will never walk away, but Vertex must now agree to engage with NICE and we urge it to accept all the flexibilities that NHS England has put on the table. There is nothing unusual about Vertex that means that this is not the right thing for it to do. Recently, we have seen deals reached as part of the NICE appraisal process, including that for ocrelizumab, which is an innovative multiple sclerosis drug, that for Spinraza, which is for people with spinal muscular atrophy, and that for axicabtagene ciloleucel chimeric antigen receptor t cell, or CAR-T, treatments.

Given that Vertex remains an extreme outlier in both pricing and behaviour, it is no wonder that patients and families have been looking at alternative solutions to secure access to this drug, and we have heard about the buyers’ club. Hon. Members have also talked about Crown use licensing, and the hon. Member for Bristol East (Kerry McCarthy) talked about large-scale clinical trials.

Unless Vertex changes its approach and behaves responsibly, I have a moral obligation to look at these other options. Of course NHS England and NICE will carry on the negotiations, because a negotiated outcome is the desired option. However, I have no alternative but to look at these other options on the table.

Oral Answers to Questions

Jeremy Lefroy Excerpts

Tuesday 7th May 2019 Commons Chamber

[Matt Hancock]

As the hon. Lady may know, I am very concerned about this. We are working on what we can do to ensure that opioids are prescribed and used only when they are the most appropriate and right treatment. Opioids save people from significant pain and are used every day right across the NHS, but opioid addiction is a very serious problem. Some other countries have got this wrong, and we must get it right.

[Jeremy Lefroy (Stafford) (Con)]

I thank my right hon. Friend the Secretary of State for coming to County Hospital in Stafford on Saturday. Does he agree that he saw there the importance of small accident and emergency departments sustaining the whole of the regional health economy by giving support to the larger ones?

[Matt Hancock]

Yes. It was brilliant to go to County Hospital in Stafford and see the hard work and team work and to be able to thank NHS staff both in Stafford and across the country working over the long weekend. My hon. Friend is a brilliant and diligent voice of Stafford. I have already stopped A&E closures in west London. I do not think that we should be seeing the closure of small A&E units, and I will work with him on the issue.

Oral Answers to Questions

Jeremy Lefroy Excerpts

Tuesday 26th March 2019 Commons Chamber

[Stephen Hammond]

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

[Jeremy Lefroy (Stafford) (Con)]

Will my hon. Friend meet me to discuss the severe shortage of pathologists to carry out post mortems? Professor Peter Hutton’s report referenced some ideas that we could take forward.

[Stephen Hammond]

My hon. Friend has already mentioned several such ideas and I would be happy to meet him to discuss them.

Healthcare (International Arrangements) Bill (Changed to Healthcare (European Economic Area and Switzerland Arrangements) Bill)

Jeremy Lefroy Excerpts

Ping Pong: House of Commons
Tuesday 26th March 2019 Commons Chamber

[Dr Whitford]

That is why I live there, right beside the sea, but that does not necessarily mean that somebody living in the vineyards of France will think, “You know what? The weather’s a bit boring here. I fancy somewhere with snow, sleet, hail and sunshine all in one day.”

It is a fact that the disparity is because of the number of pensioners. It is often described as if it is the EU somehow tricking the UK—it simply is not. We are obliged to pay for the pensioners from the UK who have settled in Europe. Indeed, we pay a fixed rate per head that is considerably lower than—just over half—what would be charged for a European citizen settling here.

[Jeremy Lefroy (Stafford) (Con)]

Does the hon. Lady agree that another reason for the disparity is that the NHS, in being free at the point of need, has not over the years been as geared up as other countries for recording the patient episodes of EU nationals and collecting that kind of data? Because it is not an insurance-based system but is free at the point of delivery, it does not necessarily have the mindset or the paperwork to think about healthcare in terms of money.

[Dr Whitford]

I totally agree that that is part of it. The Government have to consider, given the numbers involved, whether creating that entire administrative system will bring more money back in than is spent on administering it.

It is important to consider exactly how we will expect doctors and other health staff to demand to see someone’s settled status. Will it be based on a foreign sounding name, a skin colour or an accent? Will people have to produce an ID card if they were born here, they grew up here, they have never been anywhere else and their family are 20 generations English? That is the point: there is no ID card here. In other European countries, there is an ID card and it will show that UK citizens have whatever the equivalent of settled status is. I think doctors and others are anxious about the circumstances in which they should ask for proof of habitual residency.

We see that already in respect of universal credit. I have dealt with a German lady who has been settled here for 30 years and who was refused universal credit on the basis that she was not habitually resident. We are already seeing these things, and we do not want to see them around healthcare.



As we have heard, there are three main groups. The biggest group is the almost 200,000 pensioners using their S1 rights to register somewhere they have never paid tax—and yet they benefit as if they have. It is important that their rights continue, or they may end up having to come back home. They would cost more here than the Government are paying France or Spain to deliver their healthcare. It is important that they are not limited in some way, so that only people who do not have medical health risks are accepted, as happens with insurance. Ordinary pensioners who have exercised those rights would simply not be able to afford comprehensive private health insurance.

A lot of work is being done to protect those who have settled already, but what about the rest of us, who might fancy settling in the south of France or Spain? Will this be achievable by ordinary pensioners in the future?

Approximately 1,300 UK citizens use S2 forms for planned treatment, and the biggest number is the 250,000 claims a year that are made through the EHIC card, which allows people to travel or study all over the EU. As the hon. Member for Burnley (Julie Cooper) said, that includes people with expensive chronic conditions that require treatment such as dialysis three times a week. I defy any Member to find affordable health insurance that would cover such treatment. That is not a risk of healthcare, but planned healthcare, otherwise the trip simply cannot be made.

Oral Answers to Questions

Jeremy Lefroy Excerpts

Tuesday 19th February 2019 Commons Chamber

[Mr Speaker]

Order. Before we proceed further, I hope that colleagues on both sides of the House will want to join me in extending a very warm welcome to Democratic New York State Assemblyman Sean Ryan, who is with us today. Welcome to you, Sir: we are delighted to have you.

[Jeremy Lefroy (Stafford) (Con)]

2. What steps he is taking to secure the long-term future of the NHS.

[The Secretary of State for Health and Social Care (Matt Hancock)]

We are increasing the NHS budget by £20 billion, or £33 billion in cash terms, over the next five years. This major investment will support the NHS to continue to deliver world-class care. The long-term plan set out a vision for the NHS, ensuring that every penny will be well spent.

[Jeremy Lefroy]

I thank the Secretary of State very much for his answer. Local accident and emergency departments, such as at County Hospital in Stafford, are absolutely vital for the long-term plan of the NHS. What can he do to ensure that funding is there for these departments because they need an awful lot of block funding and not so much payment by procedure—or payment as you go?

[Matt Hancock]

My hon. Friend, who is an advocate for Stafford beyond compare and an advocate for its A&E—he has personally put much effort into saving it and ensuring that it is in good shape—rightly makes the point that paying per person who comes through the door does not accurately reflect the costs of providing A&E, so we are moving to a much greater proportion of block funding for A&Es, with a smaller element that varies according to the costs of serving everybody, to ensure that the finances follow the need.