Oral Answers to Questions

Debate between Jonathan Ashworth and Jo Churchill

Tuesday 10th March 2020 Commons Chamber

[Jo Churchill]

The closure of any GP practice stirs up understandably strong emotions in the local community. The Care Quality Commission inspection last May highlighted safety concerns at Sandiway surgery, and significant investment is required to bring the premises up to standard. I believe Danebridge medical centre has consulted on and looked into the difficult decision to close the practice and increase appointments and services at the other two local practices. As ever, I am happy to meet my hon. Friend to discuss how we can ensure that Sandiway residents have access.

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

I note what the Minister said about GPs and their role in responding to covid-19, and I entirely agree with her. GPs want to do their very best for their patients. They need quicker access to protective equipment and they need clear guidance. Will the Minister lift all the bureaucracy that GPs currently face? I am talking about appraisals and the quality and outcomes framework end-of-year requirements. Will she suspend those requirements so that GPs can focus entirely on responding to coronavirus?

[Jo Churchill]

I am currently having discussions to make sure that, within the bounds of making sure that patients stay safe, we can lift all bureaucracy where appropriate. We now have more than two thirds of personal protective equipment rolled out into GP surgeries, with the rest arriving imminently.

[Jonathan Ashworth]

Many of our constituents, especially those with underlying conditions—from emphysema to chronic obstructive pulmonary disease, diabetes and asthma—will look to GPs for guidance. When they see what is happening today in Italy, they will be extremely frightened. What is the Government’s advice to those with underlying conditions? Will the Minister tell the House, for the benefit of our constituents, what lessons the Government have learned from the Italians about their handling of coronavirus to date, and why we are taking a different approach?

[Jo Churchill]

As we have laid out from the beginning, our approach will be science-led and about the safety of everybody. That is why at some point in future doctors will make decisions and clinical judgments, and those with existing co-morbidities or at the more serious end of an illness will be triaged up into an appointment first. That may mean that some people have to wait a little longer during this period, but it will always be done on clinical advice and with the safety of the patient at the heart of things.

Health Inequalities

Debate between Jonathan Ashworth and Jo Churchill

Wednesday 4th March 2020 Commons Chamber

[Jo Churchill]

The problems we are dealing with are complex across the piece, which is why we have held the public health budget at the same level this year so that we can start to deliver on them. It is important that local people have local ownership over the issues and challenges in their area, because one size will not fit all.

[Jonathan Ashworth]

rose—

[Jo Churchill]

If the hon. Gentleman will bear with me for just a few minutes, I want to push on rather than incur the wrath of Madam Deputy Speaker.

I am clear that there must be integration across Departments, because dealing with these issues is about having a warm home that is suitable for you and those you love, and about having an environment that sustains your health. It is about good education, so that people are equipped with the skills to look after their health. It is about having jobs that are purposeful and rewarding.

The health inequalities challenge is stubborn, persistent and difficult to change, and I recognise the enthusiasm, energy and frustration that those who will speak in this debate will bring. The Government have firmly signalled their intention to take bold action on these issues. We are committed to reducing inequalities and levelling up. To be effective in reducing health inequalities, we need a long-term sustainable approach across all Departments. Early onset diseases, disability and avoidable mortality are concentrated in poor areas, so this is where we must act if we are going to make the system fairer.

--- Later in debate ---

[Jo Churchill]

I thank the hon. Member—he has just got himself a job as an ambassador. I congratulate him on quitting smoking, because it is hard.

The specialist centre showed me that with the right holistic support and encouragement, the health of both mum and baby can be improved. Such services will be crucial in achieving the ambition of becoming a smoke-free society by 2030.

Similarly, we must tackle the health harms caused by alcohol, and support those who are most vulnerable and at risk from alcohol misuse. Through the NHS plan, up to 50 hospitals with the highest rates of alcohol dependency-related admissions will have alcohol care teams. That could prevent more than 50,000 admissions every five years. Currently, eight of those teams are in operation, providing seven-day services focused on those areas with the highest levels of admissions related to alcohol dependency.

Alcohol addiction has a devastating impact on individuals and their families, and it is unfair that children bear the brunt of their children’s condition. I know that this topic is dear to the heart of the hon. Member for Leicester South (Jonathan Ashworth), who has spoken about it movingly. I pay tribute to the way he has influenced this agenda in this place. I am pleased so say that we are investing another £6 million over three years to help fund support for this vulnerable group.

As is often the case with addiction, there is a toxic mixture of several items. On substance misuse, last Thursday I attended the UK-wide drug summit in Glasgow, along with Home Office Ministers and Ministers from the devolved Administrations. We discussed the challenges associated with drug misuse and listened to Dame Carol Black present her findings from the first phase of her review. I am pleased that my Department will fund and commission the second phase of the review, which will make policy recommendations on treatment, prevention and recovery. Only through the combined efforts of different Departments working together can we hope holistically to improve the health and other outcomes of people with substance misuse problems. Many of us know from our constituency work that they often bounce between various parts of the system. Local authority leadership and action on public health prevention is vital as it will help to focus local measures to decrease health inequalities. As a condition of receiving long term plan funding, every local area across England must set out specific and measurable goals, and ways by which they will narrow health inequalities over the next five and 10 years. Local areas know their localities best.

[Jonathan Ashworth]

I thank the Minister for her kind words about me a few moments ago. It is an issue dear to my heart and, as she knows, I have run three London marathons to raise funds for alcohol charities—although that is not how I am proposing to fund services in the future.

The Minister has to recognise that whether it is smoking cessation services—I am sure the right hon. Member for South West Wiltshire (Dr Murrison) was not implying that I do not think that smoking cessation is important—or drug and alcohol services, they have suffered from a number of cuts. Directors of public health are desperate to know what their funding grant will be for the next financial year, starting in four weeks’ time. Can she tell us when they will know what their allocations will be, so they can fund all the work that she is talking about?

[Jo Churchill]

I appreciate that they need to know those figures, and they will know them extremely shortly.

I strongly believe that high-quality primary care is also crucial to early and preventive treatment, and key to reducing the health inequalities we are discussing. We are improving access to primary care by creating an extra 50 million appointments in general practice within the next five years, growing the workforce by 6,000 more doctors and 26,000 more wider primary care professionals. Within that, we want to target NHS resources, so that they can help their localities to level up. Through the targeted enhanced recruitment scheme, we are recruiting trainees to work in the areas of the country where we have had vacancies for years, particularly rural and coastal areas, such as Plymouth, and the coastal area of County Durham and North Yorkshire. It has already proved highly successful, with a fill rate of close to 100% last year, and over-subscription in many parts of the country. For that reason, we will increase the places on the TERS from 276 to 500 in 2021, and then up to 800 in 2020, to make sure that we get the skilled staff in the areas where they can do most good.

Practices, working together within primary care networks, will be asked to take action on health inequalities, to be agreed as part of the next 2021-22 GP contract. What happens in one’s early years, even before one pops out into the world, has an impact well into later life. Pregnancy and early years are therefore a key time to have an impact on inequalities. In particular, the fact that women’s life expectancy is so challenged is of acute importance to me. We have many challenges as we travel through life, and making sure that we are equipped to make the best of our lives, particularly as we often act as primary carers, is hugely important.

Pregnancy and early years are a key time to have an impact on inequalities. Many babies do get a fantastic start, but sadly it is not the case for everyone. Children in more deprived areas are more likely to be exposed to avoidable risks and have poorer outcomes by the time they start school. It is right that all universal support has a focus on reducing inequalities, and that it is targeting investment to meet higher needs. Many children are benefiting from investment in childcare and early years education. Fifteen hours of free early years education for disadvantaged two-year-olds and 15 hours of free early years education for all three and four-year-olds is key. We have also announced our commitment to modernise the healthy child programme to reflect the latest evidence to support families.

Oral Answers to Questions

Debate between Jonathan Ashworth and Jo Churchill

Tuesday 29th October 2019 Commons Chamber

[Jo Churchill]

I thank my hon. Friend for all his work leading the all-party parliamentary group on cancer. We are putting more money into diagnostic tests, which means that there will be more than 7.9 million more tests. Making sure that we have the correct data on survivability, in which the one-year test is an important metric, is part of that programme.

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

In the past year, more than 34,000 cancer patients have waited beyond two months for treatment. Every single waiting time measure for cancer has worsened in the past year. Surely, the Minister should be ashamed that so many more cancer patients are waiting longer for treatment.

[Jo Churchill]

I probably know as well as most that waiting for a cancer diagnosis is traumatic and that it needs to be done as speedily as possible. There is nothing more frightening than that wait, so what have we done? In 2018, 2.2 million people were seen by a specialist for suspected cancer—that is more than 1.2 million more people per annum since 2010. Getting to the specialist an individual needs as quickly as possible is what this Government are focused on, and that is why we have put so much emphasis on having specialist clinical nurses in the cancer workforce. We will carry on making cancer a priority.

[Jonathan Ashworth]

But the problem is that that is not happening, is it? Cancer patients are waiting longer for treatment. In recent weeks, we have had an avalanche of hospital board papers blaming understaffing and George Osborne’s pension tax changes for the deterioration in waiting time standards. The Prime Minister promised to fix Osborne’s pension tax mess. How many more patients need to be added to the waiting list before it is fixed?

[Jo Churchill]

The guidance for doctors’ pensions was changed last month. As I said, making sure that everybody can access a GP as soon as they are worried and then get to a specialist as soon as possible is our top priority, and making sure we have a broad-based cancer workforce is part of that plan. Delivering these things, as well as rapid diagnostic centres with £200 million in new machinery, is how we are going to do it.