Oral Answers to Questions
Karin Smyth Excerpts(1 month, 1 week ago)
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Sir Edward Leigh (Gainsborough) (Con)
The Minister for Secondary Care (Karin Smyth)
Lord Darzi’s report concluded that the health service is in a critical condition across the country, including in the east midlands, where healthy life expectancy has declined in the past decade. Waiting lists in the region stand at slightly below the national average for 18-week waits, at 57% compared to the national average of 58%.
Sir Edward Leigh
With two thirds of people having to wait more than four hours at Lincoln County hospital’s A&E department and with horror stories from my constituents of people waiting up to 24 hours, does the Minister understand that if we are to save the NHS and give people the timely appointments they need, we must unleash the full power of the private sector?
Karin Smyth
I thank the right hon. Gentleman for helping to underline the shocking inheritance from the previous Government. He is absolutely right. We are committed to cutting waiting times and serving constituents, like mine, by delivering the long-term reform the NHS desperately needs. The Government are committed to the funding model. We are not going to change it. He tries this every time, but we are committed to the funding model as it exists.
Matt Western (Warwick and Leamington) (Lab)
A really important part of improving health outcomes in the east midlands, and across the country, is the use of diagnostics. The Rosalind Franklin laboratory, which was set up in my constituency, was closed down just a few months ago at a cost of £0.6 billion. Does my hon. Friend agree that one of the most important things we could do is to restore good quality diagnostics to our NHS?
Karin Smyth
My hon. Friend is absolutely right. We are committed to improving diagnostics as part of our reform of the health sector. Analysis of waiting lists shows that 20% of people will end up with a hospital admission, most as a day case. To improve waiting times, the focus must be on early prevention, diagnostics and consultant review at an early stage.
Mike Tapp (Dover and Deal) (Lab)
The Minister for Secondary Care (Karin Smyth)
The recent independent report by Lord Darzi makes it absolutely clear that urgent and emergency care services are also struggling, with the latest data published last week showing that one in 10 patients spend over 12 hours in A&E. We are committed to returning to service standards that patients rightly expect through our ambitious 10-year plan to reform the health service.
Mike Tapp
In September 2021, Victoria hospital in Deal lost provision for blood testing. After a long campaign by residents, it was agreed that it would return. However, that has stalled in the tendering process. Will the Minister meet me to discuss how we can move this forward?
Karin Smyth
I commend my hon. Friend for championing this issue on behalf of his constituents. I understand that he has raised it with the chief executive officer of his local trust. He will appreciate that commissioning decisions are a matter for the local integrated care board, in this case Kent and Medway ICB, but I am, of course, very happy to meet him to discuss it further.
Andrew George (St Ives) (LD)
I wish the Minister well in her efforts to address this issue, because it is extremely serious. There are very often more than 20 ambulances queueing outside Treliske hospital, which has a serious impact on expectations for patients. Will the Minister please look at the potential for urgent treatment centres to take pressure away from emergency departments, such as the urgent treatment centre at West Cornwall hospital in Penzance, which really needs to be re-established on a 24/7 basis? That would make a real impact.
Karin Smyth
I thank the hon. Gentleman for his good wishes. It is, indeed, a huge task we have before us. We will maintain ambulance capacity throughout this winter. He makes a valuable point about alternative models to hospital admissions and treatment in the community. That is a matter for the local ICB, as I know he knows. It needs to look at which model is the best fit, particularly in rural areas, to reduce the pressure on frontline A&E services.
Paula Barker (Liverpool Wavertree) (Lab)
Intermediate care for people facing homelessness, which is recommended by the National Institute for Health and Care Excellence, can reduce rough sleeping by around 70%. That is life-changing for people who have been sleeping rough and it plays a significant role in relieving pressure on hospitals. A recent evaluation of intermediate care for people facing homelessness in one county in England found a 56% reduction in A&E visits and a 67% reduction in emergency admissions. What exists currently is a postcode lottery. How can we embed the NICE approach in every integrated care system across England?
Karin Smyth
My hon. Friend has highlighted an issue that is often overlooked. Homelessness has risen to shocking levels in the last 14 years. When it was addressed under the last Labour Government, people were moved off the streets, and there was decent care at the front end of the hospital system and support in the community. My hon. Friend is right: there are good examples across the country, and we would like to see them embedded as part of our overall goal, across Government, of reducing the scourge of homelessness in society and once again supporting the front end of the health service.
Alison Bennett (Mid Sussex) (LD)
I recently met representatives of the Royal College of Emergency Medicine, who told me that the inadequate state of social care was resulting in the deterioration of people’s physical health, leading to more presentations at emergency departments. Does the Minister agree that if social care were properly funded, pressure on our hospitals would be reduced?
Karin Smyth
What we see at the front end of the system is a result of the deterioration throughout the system, and the flow of patients from the community, through discharge and, indeed, through social care. Our ambitious 10-year plan will involve examining the entire patient pathway to ensure that care is provided in the community, closer to home. Prevention is a key part of that, as is the look that we are taking at social care.
Greg Smith (Mid Buckinghamshire) (Con)
Blake Stephenson (Mid Bedfordshire) (Con)
The Minister for Secondary Care (Karin Smyth)
As Lord Darzi outlined, capital development in the NHS is shocking, with a backlog of £11 billion in maintenance. I would be happy to meet the hon. Member to discuss his problem.
Ruth Jones (Newport West and Islwyn) (Lab)
Rebecca Long Bailey (Salford) (Ind)
Karin Smyth
My hon. Friend is right to raise the crisis of midwifery services. We have already had debates in Westminster Hall about this, and the issue affects the entire country. It is a priority for this Government, and I am of course happy to meet her to discuss her constituency issue.
Olly Glover (Didcot and Wantage) (LD)
Baby Loss Certificates Extension
Karin Smyth Excerpts(1 month, 1 week ago)
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The Minister for Secondary Care (Karin Smyth)
My hon. Friend the Under-Secretary of State for Patient Safety, Women’s Health and Mental Health (Baroness Merron) has made the following statement:
I wish to inform the House that an extension to the baby loss certificate service has been launched.
The baby loss certificate service is a voluntary scheme to enable parents who have experienced a pre-24 weeks baby or pregnancy loss to record and receive a certificate to provide recognition of their loss if they wish to do so.
Until this extension, this service was only open to parents who experienced a loss since 1 September 2018. We are removing this eligibility restriction so that the service is now available for all historic losses, with no backdate, as well as future losses.
The baby loss certificate service is not a compulsory certificate; it will remain the choice of all parents how they wish to manage the difficult time around a loss. Its introduction was a recommendation from the independent pregnancy loss review published in July 2023, which examined the impact on families of not being able to formally register a baby or pregnancy loss before 24 weeks gestation. So far, over 50,000 certificates have been issued.
Following this announcement, eligibility will now be:
Either parent (i.e., mothers, fathers, surrogates) who have experienced a pregnancy loss through miscarriage, ectopic/molar pregnancy or termination for medical reasons at less than 24 weeks gestation (i.e. up to 23 weeks plus six days gestation), or pre-28 week baby loss (i.e. up to 27 weeks plus six days gestation) for losses prior to October 1992.
Parents resident in England.
Parents who have experienced a historic pregnancy loss or experience a future pregnancy loss.
Parents aged 16 years and over.
Ensuring this important service is available for all losses, regardless of how long ago the loss was or when it may occur in the future, demonstrates this Government’s commitment to delivering personalised and compassionate care for women, and support for parents who have suffered a baby loss.
[HCWS123]
Maternity Services: Gloucestershire
Karin Smyth Excerpts(1 month, 1 week ago)
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The Minister for Secondary Care (Karin Smyth)
It is a pleasure to serve under your chairmanship, Sir Christopher.
With your leave, I will start with a few words to mark Baby Loss Awareness Week. Many mums and dads across the country have suffered the heartbreak of losing a baby. Everyone deals with grief in a different way, but it has been moving to hear from parents how baby loss certificates have allowed them to process what they have gone through and have helped give them closure.
That is why this week we launched an extension to the baby loss certificate service, which is a voluntary scheme to enable parents who have experienced a pregnancy loss to record and receive a certificate to provide recognition of their loss, should they wish. Until now the service was only open to parents who had experienced a loss since 1 September 2018, but today we are removing that restriction, making the certificates available for every parent who has lost a child. We will update the House with a formal written statement shortly. The Government are committed to delivering compassionate care for women and support for parents who have suffered a baby loss. It is the right thing to do.
I think this has been a genuinely good debate. We have heard from experts—I commend the Opposition spokesperson the hon. Member for Sleaford and North Hykeham (Dr Johnson) and my hon. Friend the Member for Stroud (Dr Opher) for the work they do—and others have shared experiences. I knew that the hon. Member for Cheltenham (Max Wilkinson) would bring forward good points too, so I contacted the trust myself so that I could give the hon. Gentleman and hon. Members present my frank assessment of what is happening on the ground.
To reiterate, as of August 2024 the midwifery vacancy rate in the Gloucestershire hospitals NHS foundation trust stood at 13%—the equivalent of 32 full-time midwives. That level is high for the south-west, though roughly in line with the national average. In April 2022, the Care Quality Commission gave the trust a warning notice for the maternity service, and rated it “inadequate” a year later. In May this year, the CQC issued the section 31 notice—a severe warning that requires at minimum an immediate action and improvement plan, which, as colleagues will know, in some other settings could result in a closure. It issued that after seeing postpartum haemorrhage rates, poor foetal monitoring and high levels of agency staffing.
The hon. Member for Cheltenham and others from the area are right to be concerned. We can all agree that it is unacceptable when new mothers do not receive the highest possible standard of care. As my right hon. Friend the Secretary of State has said, we should be honest about the problems in our NHS and serious about fixing them. Maternity services are very far from where we want them to be. Childbirth should not be something that women fear or look back on with trauma. Safety is obviously paramount. As the hon. Member for Cheltenham said, it should be a special moment.
I thank the hon. Member for Thornbury and Yate (Claire Young) for sharing her experiences. I was in hospital for two weeks after having my first child, and it is a traumatic time, so the length of time she mentioned must have been very difficult. My second came out so quickly that I was in and out of hospital before we knew it. My third child, as has been mentioned, was almost delivered at home by my husband after we had chosen a home birth. He is not medically qualified, so I can tell you that the sound of the doorbell ringing for the midwives’ arrival was the best sound I have heard in my life.
To the second question asked by the hon. Member for Cheltenham, I will outline the steps the trust is taking to improve the situation. They include a new director of midwifery, an education and training midwife and a perinatal quality and governance lead. To improve retention, the new leadership has introduced a retire and return scheme and is holding monthly events for senior leadership to listen to staff and address their concerns. The trust has recruited 33 new midwifery starters since 2023, including from overseas. Ten midwives are due to start this month, with a further 10 expected in January. But there is still a gap. That is why the Aveta birthing unit and the postnatal beds at Stroud maternity will remain temporarily closed until they reach safe levels of staffing. The trust clearly felt that it could not continue those services without putting new mothers at risk, which is an impossible situation to be in.
I am pleased that the birthing unit at Stroud remains open, but the other closures have had an impact on women, their families and the local community, as has been eloquently expressed by my hon. Friend the Member for Gloucester and mentioned by my hon. Friend the Member for Thornbury and Yate. The impact goes further afield to my own city of Bristol. In addition to those measures, the trust is developing new apprenticeship schemes; building partnerships with universities, including Worcester and Oxford Brookes; and launching a midwifery attraction campaign in the autumn.
Although the trust has had positive feedback from last year’s new starters, I am pleased that it is carrying out regular assessments, as per the recommendations in the Ockenden review, to ensure that midwives have the right skills to serve the people of Gloucestershire. The turnover rate is now settling, and I know the hon. Member for Cheltenham and other colleagues will do everything they can to help convince midwives that his county is a great place to live and work. The passion for those units is very evident here today, which I am sure will be welcome to those trusts.
I know from my career in the NHS that such changes take a long time. It is too soon to make an assessment until all the new midwives have started. However, we are not waiting for the CQC to do the rounds to ensure that the picture is improving. The local maternity and neonatal systems team and the regional NHS England team are meeting with the trust on a fortnightly basis to review progress. The trust’s monthly board reports will report on progress; I know hon. Members will be watching carefully.
It is important to give the new team space to prove themselves. I am hopeful that we will see improvements in time. At a national level, whenever trusts and maternity units do not perform on our watch, we will steer them back to safer ground. That is why we are supporting Gloucestershire maternity services through the national maternity safety support programme. That means that the trust is supported by a maternity improvement adviser for midwifery and obstetrics, who helps the trust to embed the maternity improvement plan.
I know that the hon. Member for Cheltenham and others will continue to hold the trust to account, until it is delivering for women in their constituencies. I am grateful to him for obtaining this debate and giving me the chance to put the Government’s position on the record. With regard to his third question, like many trusts in this position, the trust does have the budget for establishment; it is the recruitment and retention of midwives that is the issue. Some trusts do different things with incentives; I do not know whether this trust is particularly doing that. That might be something he would wish to pick up with the trust at another time.
On more general maternity improvements, in September the CQC published a report that demonstrated how much the previous Government let down new mothers in this country. Lord Darzi’s report has shown that, despite some improvements, there is still a disgraceful inequality of outcomes for black and minority ethnic women, as we have heard again today. We will look at every recommendation in the CQC report, and if officials object to any of them, I expect to hear a very good reason why.
There is ongoing work to improve maternity and neonatal services across England. The NHS put in place a three-year delivery plan to make maternity and neonatal care safer, fairer and more tailored to every new mother’s needs.
I shall now discuss the Government’s wider ambition. Choice—which was mentioned today by my hon. Friend the Member for Stroud and the hon. Member for Thornbury and Yate—is for us absolutely a key part of maternity care. As the hon. Member for Winchester said, our NHS must listen to and work with women and families on how their care is planned and received, based on what matters to them.
To get maternity care back on its feet, we need to train thousands more midwives as part of the NHS workforce plan, while encouraging experienced midwives to stay in the NHS. Many hon. Members, including the hon. Member for Cheltenham, spoke of recruiting midwives, with regard to morale and workload. That was also mentioned by the hon. Members for Tewkesbury (Cameron Thomas) and for Carshalton and Wallington (Bobby Dean). The NHS will deliver the people plan, giving a stronger focus to a modern, compassionate, inclusive culture, which absolutely has to be part of our forward look in the 10-year plan.
We will ensure that trusts failing on maternity care are robustly supported into rapid improvement. We are setting an explicit target to close the black and Asian maternity mortality gap. NHS England is on the right track, boosting the workforce through training, apprenticeships, postgraduate conversion, return to midwifery programmes and international recruitment. I have been clear that the Government will build on those programmes, not replace them.
Finally, I want to end by restating our unwavering commitment to maternity services across the nation, including in Gloucestershire. We are actively working to improve staffing levels and are planning for the future needs of Gloucestershire’s maternity services. I say to the constituents of the hon. Member for Cheltenham that I hear his concerns and completely understand them, and I will work with him to set this right.
The Opposition spokesperson is an assiduous writer, and I have answered a number of her letters, but if I have not responded to particular points from the previous debate before recess, I apologise, and will ensure that that happens after this debate. She has raised important questions.
In the constituency of the hon. Member for Cheltenham and in mine, women have had to bear the brunt of inaction for the past 14 years, but this Government will deliver for women, not just in the south-west but in the country as a whole.
Sir Christopher Chope (in the Chair)
I call Max Wilkinson to respond to this very well-informed debate.
NHS Performance: Darzi Investigation
Karin Smyth Excerpts(1 month, 2 weeks ago)
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The Minister for Secondary Care (Karin Smyth)
I thank all Members for their contributions to this debate. We should all be grateful to Lord Darzi for his rapid and comprehensive review, although we still do not seem to know at the end of this debate whether the Opposition agree with the diagnosis or not. Essentially, it is evidence of their record, and they do not like it.
This has been a passionate debate with colleagues from all parts of the House addressing how 14 years of failure have damaged their constituencies, let down the people they represent and broken the NHS. Lord Darzi’s report is as breathtaking as it is distressing, whether it is discussing the chaos unleashed by Andrew Lansley’s top-down reorganisation, the plunge in productivity and patient satisfaction, the disproportionate impact of the pandemic compared with countries across the world or the failure to modernise ways of working. It beggars belief how the previous Government allowed that to happen on their watch. Behind every page of that report, we should remember the real-world suffering caused by the neglect. It is a record of missed opportunities and squandered potential.
Those things are all the more galling for me, as someone who has worked in the NHS and who still cares passionately about its survival. In fact, the reorganisation was so bad that it led me to stand for Parliament. I would not be here today, were it not for Andrew Lansley. The House can make of that what they will. When I worked for the NHS under the previous Labour Government, I saw at first hand the power of politics to improve the system. I saw a health service delivering the shortest waiting times and highest patient satisfaction in history, and since then I have seen it decline in my constituency and the effect that has had on my constituents. When the system lets them down, they have no other options. They cannot afford to go private, they do not have the assets to sell and their families are in the same boat. Health inequalities and inequality of access led me to join the health service, and the Lansley reforms drove me to become an MP. That is why I will not rest until we have completed our health mission to restore the fundamental promise of our NHS: that it will be there for all our constituents when they need it. The charge sheet is too long for me to make too many comments on it.
In the short time I have, I will address the maiden speeches in particular. I worked with my hon. Friend the Member for South Norfolk (Ben Goldsborough) in opposition. I was so delighted to hear that he had won the day after the election. He talked about the global reach of South Norfolk and in particular productivity at the University of East Anglia, which I went to as a student 40 years ago this week, astonishingly. It makes a huge contribution to the economy of South Norfolk, and I know that he will be a good champion. I wish him good luck on SEND and justice. South Norfolk is lucky to have him.
The hon. Member for Esher and Walton (Monica Harding) gave a lovely history of her constituency. She moved us all with the tragic story of the death of her constituents’ 19-year-son. She has kept her promise to that mother already in her place today.
My hon. Friend the Member for South West Norfolk (Terry Jermy) is a worthy successor to his predecessor. He rightly highlights poverty, particularly in rural areas, and he spoke so eloquently about his father, his care and sadly his death. That is an experience that many people will recognise from covid and will be moved by. I am pleased he is using that experience in this place. His dad and Councillor Thelma would be very proud of him.
My hon. Friend the Member for Gloucester (Alex McIntyre) —I am delighted to have another new Labour Member in the south-west—did a great campaign while having a young family. His passion and pride for Gloucester shone through, whether that is the Romans’ military innovation or that Viennetta comes from Gloucester, which I did not know—shame on me. He wants to achieve for all the people in the rich diversity of Gloucester.
The hon. Member for St Neots and Mid Cambridgeshire (Ian Sollom) is the first and longest-serving Member for his constituency, and long may that last. I look forward to his explaining black holes to us all.
It is not a thing, but the hon. Member for Mid Dunbartonshire (Susan Murray) certainly wins the award for suited people coming to represent their constituents. She spoke movingly about her predecessor and the cost of caring for her partner.
Finally, my hon. Friend the Member for Basingstoke (Luke Murphy) spoke movingly about his family’s hard work and dedication that led him to this place. Cromwell and Jane Austen would be very proud of his editing capabilities.
There is an old Irish joke about somebody travelling down from the city to a wedding in the countryside. He cannot remember how to get there so asks a farmer for directions. The farmer says, “I wouldn’t start from here.” None of us wants to start from here, but this is where the last Government left us, with a broken NHS, a social care system on its knees and an economy failing its people. That is why early next year the Government will publish a 10-year plan setting out how we will deliver the three big shifts that will make the NHS fit for the future.
As my right hon. Friend the Secretary of State said, the choice before us today is to reform or die. There are no quick fixes. But as Lord Darzi reminded us, the NHS’s “vital signs are strong”. We can tap into the immense reservoir of dedication and talent in our universities, life sciences sector and, above all, the NHS. Getting the NHS back on its feet will be a team effort. Working with patients and the public, alongside 1.5 million NHS staff, we will rebuild our public services, fix the foundations of our economy—
Medicines
Karin Smyth Excerpts(2 months, 1 week ago)
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The Minister for Secondary Care (Karin Smyth)
I beg to move,
That the draft Human Medicines (Amendments Relating to Naloxone and Transfers of Functions) Regulations 2024, which were laid before this House on 29 July, be approved.
I, too, congratulate you on your election, Madam Deputy Speaker; it really is a pleasure to see you in the Chair.
The draft statutory instrument will amend the Human Medicines Regulations 2012 to expand access to naloxone: a lifesaving medication that reverses the effects of an overdose from opioid drugs. In addition, the SI will keep the regulations current by updating references to Public Health England and the Health and Social Care Board, following the dissolution of those bodies.
Hon. Members will no doubt know of the devastating impact of illicit drugs. Drugs destroy lives, tear families apart and make our streets less safe. Almost 3,000 people died of drug misuse in England in 2022—the highest number since records began in 1993. Drug misuse deaths have doubled over the past 10 years, and people die from drug misuse at a tragically young age, often in their 40s. Almost half of drug misuse deaths in 2022 involved opiates such as heroin.
These deaths are avoidable. Dedicated drug treatment services provide the path to recovery, and my Department is continuing to invest in improvements to local treatment services, which have faced significant cutbacks. We also know that over half the people struggling with opiate addiction are not engaged in treatment at all. That means that significant numbers of an incredibly vulnerable population are at increased risk of accidentally overdosing and dying.
People who experience addiction often have multiple complex needs, and we know that there is a strong link between addiction and deprivation. The rate of drug misuse deaths in the most deprived areas of England is almost three times higher than in the least deprived. Nearly a third of people in treatment for drug or alcohol problems reportedly have a disability, around one in six have a housing problem, and around 70% have a mental health treatment need. Tackling this issue supports the Government’s health mission, ensuring that people can live longer, happier lives, as well as our collective efforts to break down barriers to opportunity and create a fairer society.
Naloxone is a highly effective antidote against opiate overdose. It can be administered quickly and safely by anyone in an emergency, but currently exemptions in the human medicines regulations targeted at specific providers enable supply only by drug and alcohol treatment services, which limits the reach of this lifesaving medicine. Widening the statutory framework will mean that more services and professionals are able to supply this medication. That means easier access to it for people at risk and their loved ones. In short, the legislation will save lives. We are already seeing the benefits of professionals outside the health service, such as police officers, being able to administer naloxone. North Yorkshire police have already saved seven lives since April, when naloxone was rolled out across the force.
The draft instrument proposes two key UK-wide changes to existing regulations. First, it will expand the list of services and professionals named in the regulations who are able to give out naloxone without a prescription. In short, that means that professionals such as registered nurses and probation officers will be able to provide take-home supplies of naloxone where appropriate, should they wish to do so. Secondly, we propose to establish national registration services across the whole of the United Kingdom. That will enable all other services and professionals who are unable to be named in the legislation, including housing and homelessness services, to register and procure naloxone, subject to the passage of this statutory instrument. I look forward to working with colleagues across the devolved Governments on this important issue; I thank them for their work to date, and their continued support.
I reassure hon. Members that we are not compromising on safety with these changes. This is an extremely safe and effective measure, even when administered by a layperson with no prior experience. It has an effect only if the person has taken opioids, and is already widely used across the UK and internationally. We are taking steps to mitigate any, very limited, risks associated with wider access. We will provide updated guidance for services in scope, and set out robust requirements for training and safeguarding. The new powers are enabling but not mandatory. The intention is not to create new burdens for services, but to provide an opportunity for provision based on local need. I am confident in the support for the changes across sectors, which was evident in the responses to my Department’s consultation earlier this year, over 90% of which were in support.
I recognise the long-standing calls for these changes among experts in this area. For instance, the Advisory Council on the Misuse of Drugs is an independent expert body that advises the Government on drug-related issues in the UK. In 2022, it published a review of naloxone implementation that called for more work to widen access to the medication. Similarly, Dame Carol Black’s independent review of drugs also highlighted expansion as a vital harm-reduction measure. I pay tribute to Dame Carol for the work that she has done to drive improvements in drug treatment and recovery, and express my gratitude for her continued advice and expertise.
The importance of this work only continues to increase as time goes on. Hon. Members may be aware of the growing threat posed by synthetic opioids. These synthetic drugs, such as nitazenes and fentanyl, are often more potent and more deadly. The Government are taking a range of steps to prevent the rise of these dangerous drugs in the UK, but the availability of naloxone will be vital to our ability to respond and save lives.
Addiction is not a choice. It is often fuelled by wider issues, such as trauma and housing instability. This is a complex public health issue and must be tackled as such. We must change the narrative on addiction to one that is about preventing drug use, reducing harm and enabling recovery. The changes in the legislation are simple and low risk, but have the potential to save countless lives. On that basis, I commend the draft regulations to the House.
Karin Smyth
This evening, I am standing in for my hon. Friend the public health Minister, who could not be here. I might offer to stand in again, such has been the rare outbreak of unanimity across this House. I know from my own experience in the sector that that is often the case with public health measures, as so much work is done in the background, and there is broad agreement on the need for prevention and the great work that has been done before. I thank Members, particularly the Opposition spokespeople, for their support this evening and their comments, which are testament to the work done by officials and by the previous Administration to get us to this point. The consultation was very well received.
I support the comments of the Opposition spokesperson, the hon. Member for Runnymede and Weybridge (Dr Spencer), about recognising World Suicide Prevention Day. Suicide, particularly among men, is something that has affected most families—most of us, I think—and it has certainly affected many people in this House, so the hon. Member is right to raise those issues. He asked about training, and I can confirm that training and data reporting requirements will be attached to this measure. That training will be required to meet some broad objectives, including the safe administration of naloxone, safe storage, and how to train someone else to handle and administer it safely. Training on its use is already well established in most parts of the country alongside naloxone provision, and each product has its own established training set out by the manufacturer. I have heard the professional points that the hon. Member has raised, and if he has any further requirements, my hon. Friend the public health Minister would be happy to write to him.
Other excellent points were made about keeping this issue under review, which we absolutely will be doing. The hon. Member for Brighton Pavilion (Siân Berry) made her points well, and they are now on the record. The Government will be looking to work on our prevention strategy across all Departments—including the Ministry of Justice, the Home Office, the Ministry of Housing, Communities and Local Government, the Department for Work and Pensions, and the Department for Education—to ensure that we take a preventive, public health-led approach to this issue. I also thank the hon. Member for South Antrim (Robin Swann), who has brought his expertise in Northern Ireland into this House for this debate. I am sure this issue will come back before the House in the future.
Jim Shannon
In my contribution I asked a question—which the hon. Member for South Antrim (Robin Swann) has reminded me of—about ensuring that medical staff who have the expertise to administer naloxone, but do so outside of their job, are covered and that there is no comeback against them. Could the Minister answer that question?
Karin Smyth
I understand that there are some concerns about that issue, and we will make sure that the hon. Member receives a full answer from my hon. Friend the public health Minister.
In short, these changes will widen access to life-saving medicine. I am sure hon. Members will agree that any death from an illicit drug is tragic and preventable, so I am pleased that we are taking this step and that we have the support of the House this evening for reducing drug-related deaths. On that basis, I hope hon. Members will join me in supporting these important regulatory changes, which I commend to the House.
Question put and agreed to.
Resolved,
That the draft Human Medicines (Amendments Relating to Naloxone and Transfers of Functions) Regulations 2024, which were laid before this House on 29 July, be approved.
Gareth Snell (Stoke-on-Trent Central) (Lab/Co-op)
On a point of order, Madam Deputy Speaker. Last Thursday, during questions to the Leader of the House on the statement of business, I asked a question about BTecs in relation to colleges. Although it is registered in the Register of Members’ Financial Interests that I am a governor of two colleges, I failed to draw the House’s attention to that fact before asking my question. The two colleges that I am a governor of are affected by the answer, so I take this opportunity to place that on the record, and offer my unreserved apology to the House accordingly.
Preventable Baby Loss
Karin Smyth Excerpts(2 months, 2 weeks ago)
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The Minister for Secondary Care (Karin Smyth)
It is a pleasure to serve under your chairmanship, Mr Dowd, and to speak for the Government in this important and moving debate. I am grateful to the hon. Member for Ashfield (Lee Anderson) for raising this important issue. As my hon. Friend the Member for Washington and Gateshead South (Mrs Hodgson) said, it is the last taboo, and the hon. Member for Clacton (Nigel Farage) articulated well the difficulties that many people have in knowing what to say.
The debate gives me the opportunity to put on the record my deepest sympathies to the bereaved families: thank you for making the decision to come here today. Others might be listening in on the Parliament channel. The decision to attend is brave, and I commend the hon. Member for Ashfield for giving voice to the moving and harrowing stories of Emma and Rob, Bianca Chapman, Amelia Bradley and Hayley Moore, about their babies, Olivia, Imiza and Theo.
We know that preventable baby loss remains a serious issue every time such debates come before the House. Today, we have heard how many people have taken part in previous debates; I have listened in before. What little consolation they must be for parents and wider families who have lost a loved one, but I am always inspired. I hope that the families present today recognise that every Member of Parliament is also a human being, with their own experience and that of their families. The issue touches every family; as the hon. Member for Strangford (Jim Shannon) said, it stays with families for decades. Sharing such experiences is brave of hon. Members, but they have given voice to how important the issue is.
Every baby’s death is tragic, but all the more devastating when parents are told that it could have been prevented. As we have heard, report after report has told us that this remains a serious issue in our health service, and that is backed up by the data. Two years ago, the Office for National Statistics found that almost 2,300 stillbirths were recorded in England and almost 1,700 neonatal deaths, a rate of 2.9 per 1,000 live births.
In 2022, I welcomed the Ockenden review, as many did, but it made for harrowing reading. The Government’s position is that any preventable death is unacceptable. We are committed to ensuring that all baby deaths that can be prevented will be prevented. Donna Ockenden’s review shone a light on maternity staff too exhausted to do their jobs. It showed patterns of poor care, a lack of adequate training for staff, and failure in governance and leadership that led to widespread avoidable harm and death, and to shocking inequalities in maternity provision. Dr Bill Kirkup’s review of East Kent identified similar themes, but also showed that leadership and culture changes were needed. That is why this Government stood on a manifesto commitment to train thousands more midwives and to set an explicit target to close the black and Asian maternal mortality gap.
There are a number of initiatives, some of which we have heard about today, and I will run through some of them. If I do not address some concerns expressed by hon. Members in my update, we will get be in touch with people, including the official Opposition—I commend the hon. Member for Sleaford and North Hykeham (Dr Johnson) on her experience in this area as a clinician as well as a spokesperson.
The NHS put in place a three-year plan to deliver the reviews’ recommendations to make maternity and neonatal care safer, more tailored to every new mother’s needs, and more equitable. That includes the Saving Babies Lives care bundle, which is being rolled out to every trust. That provides maternity units with guidance and interventions to reduce stillbirths, neonatal brain injury, neonatal death and pre-term birth. That will need to be updated regularly, but I will confirm the details to the hon. Lady.
The plan also includes initiatives to reduce inequalities. As we have heard, a serious cause for concern is the higher rate of stillbirths, neonatal deaths and pre-term births among babies from the black and Asian ethnic groups. Babies of black ethnicity are about twice as likely to be stillborn as babies of white ethnicity. That is unacceptable in modern Britain. We will not rest until outcomes are equally good for everyone in this country.
We also know that women living in deprived areas, not least my own constituency, are more likely to suffer adverse outcomes. In 2022, the stillbirth rate per 1,000 births in the 10% most deprived areas in England was 5.0, or 389; in the 10% least deprived areas in England, the stillbirth rate was 3.7 or 155. All local maternity and neonatal systems have equity and equality action plans in place to tackle such inequalities. NHS England is investing £10 million every year to target the 10 most deprived areas of England.
Wider work is also important. NHS Resolution’s maternity incentive scheme is improving maternity safety by rewarding NHS trusts that demonstrate that they are taking concrete steps to improve the quality of care for women, families and newborns. The National Institute for Health and Care Research has commissioned studies into how we can prevent pre-term births and improve care for mothers and babies. This year it launched a £50 million funding call, challenging researchers and policymakers to come up with new ways of tackling maternity inequalities and poor pregnancy outcomes.
There are ongoing initiatives to ensure that lessons are learned from every individual tragic event and to prevent similar events from happening in the future. All hospitals already carry out internal perinatal mortality reviews, which create reports that aim to provide answers for bereaved parents about why their baby died. They also help hospitals to improve care and ensure they try to learn something from every tragedy, wherever it happens.
The maternity and newborn safety investigations programme conducts independent investigations of early neonatal deaths, intrapartum stillbirths and severe brain injury in babies following labour. All trusts are required to tell the programme about these incidents. It will then carry out an independent investigation and make safety recommendations to improve maternity services. Coroners are also required to investigate deaths that are violent, unnatural or of unknown cause, although their remit excludes stillbirths; but that should leave no stone unturned when it comes to uncovering the cause of death, including an inquest where appropriate. Additionally, as of June 2024, I am assured that all NHS trusts have signed up to the national bereavement care pathway, which many hon. Members have raised today.
The existing measures, taken together, are helping to achieve improvements; we have already heard about some of the positives. Since 2010, the neonatal mortality rate has decreased by 25% for babies with at least 24 weeks’ completed gestation, the stillbirth rate in England has decreased by 23%, and the overall rate of brain injuries occurring during or soon after birth fell by 2%. But we know, and have heard so movingly today, that more must be done.
People rightly expect assurances that lessons will be learned and that things that went wrong are not repeated. As hon. Members have pointed out, the sad truth is that we are likely to be debating these issues in the future, when the CQC releases its next report on maternity inspections and when Donna Ockenden completes her investigation into Nottingham. I expect to be speaking with hon. Members again about this issue, and my noble Friend Baroness Merron, Minister for Patient Safety, Women’s Health and Mental Health, will be following that very closely.
Many of the issues identified locally are being repeated across the country, so I am clear that national leadership is needed. The Government will be honest about the challenges facing the health service and are serious about tackling them. I will listen to women and their families and do everything I can as a Minister to help deliver safer and fairer maternity and neonatal services for women and their babies. I really commend hon. Members who have shared their experiences today— particularly new Members; I do not think I would have been able to do that as a new Member of Parliament. My hon. Friend the Member for Washington and Gateshead South spoke very honestly about how long it took for her to do that. That was valuable.
It may not be for me to say as Government Minister, but I commend the work that my hon. Friend the Member for Washington and Gateshead South and other colleagues across parties have done in the APPG on baby loss. They have raised these issues and worked with Government Ministers, which is really important as parliamentarians. I hope that is reassuring to families here today. That work will hopefully be continued by parliamentarians across the House. Perhaps that will be an outcome of the issue being raised today, so early in this Parliament.
We need to listen to these women and their babies. We need to make sure that we have the midwives and other staff necessary to keep women and their babies safe. Before I finish, I should say that if I have missed anything, hon. Members should please get in touch. I say to my hon. Friend the Member for Sheffield Hallam (Olivia Blake) that we welcome the Tommy’s miscarriage pilot, and my ministerial colleague will be looking closely at those recommendations.
As a new Government, we want to end sticking-plaster politics; that means real and lasting change in the health service. That will take time, but we will build a better future for women in this country. That includes by making sure that all baby deaths that can be prevented will be prevented.
Healthcare Provision: East of England
Karin Smyth Excerpts(2 months, 2 weeks ago)
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The Minister for Secondary Care (Karin Smyth)
It is a pleasure to serve under your chairmanship, Sir Christopher. I will try not to be too evasive, and to be pleasant.
On his latter point, the hon. Member for Runnymede and Weybridge (Dr Spencer) might want to look at some of the speeches I made during the passage of the Health and Care Act 2022; accountability is writ large through them, although we may disagree about the form it takes. The previous Government had an opportunity to resolve some of these issues, and they did not take it. They destroyed accountability and, indeed, the foundations of the health service with the disastrous Lansley Act—the Health and Social Care Act 2012—which propelled me into coming to this place.
It is a pleasure to be here for the first Westminster Hall debate, and I thank my hon. Friend the Member for Norwich South (Clive Lewis) for securing it. I told my officials that it would be busy. Some of the people in this Chamber and some of those who have left are already my most frequent correspondents because of the state of the NHS in the east of England and more broadly. Getting the NHS back on its feet will be an enormous challenge, but we have the skill, motivation and commitment of our NHS staff. This Government will be unwavering in our support for them, and we will do what is needed to get the NHS back on its feet. We have committed to a 10-year plan because that is what it will take. We will deliver an NHS fit for the future. That is what we promised the British people at the election; that is what we were elected to do.
Jerome Mayhew
The Minister says she will deliver an NHS plan for the next 10 years. Does that include a full rebuild of the Queen Elizabeth hospital and the James Paget?
Karin Smyth
I will come on to those hospitals. As hon. Members will appreciate, we are in the early days of this, so “We will come back to people” may do a bit of lifting—I apologise for that.
We want to be clear and honest with Members of Parliament and the British people. We want to move the health service from treatment to prevention, which hon. Members have raised; from hospital to home, which is very important in the east of England, which has rural issues; and from analogue to digital. As a first step, my right hon. Friend the Secretary of State asked Lord Darzi to give us a raw and frank assessment of the state of the NHS, and these debates and the work that hon. Members are doing will inform that. This autumn, we will also launch an extensive engagement exercise with the public, staff and stakeholders to inform the plan.
I have at least eight questions from my hon. Friend the Member for Norwich South and a number of others. I will do my best to get through them in the next eight minutes, but I will of course respond to people if they want to come back to me on anything I do not pick up.
My hon. Friend talked particularly about prevention, and touched on climate change, dentistry and mental health, which are clearly important to many people. Prevention is a key part of the Government’s health mission and our mission across all Departments. We want to support people to stay healthier for longer. My hon. Friend said that we want the security of good health; the NHS was set up to provide that so that people can lead fulfilling lives. That promotes greater independence and shortens the time people spend in ill health. We have not touched on that much, but that is a critical target for this Government.
The NHS health check aims to prevent heart disease, stroke, diabetes, kidney disease and some cases of dementia among adults between 40 and 74 years of age. Thanks to the hard work of NHS staff, the programme engages more than 1 million people and prevents about 400 heart attacks or strokes, but take-up of the health check is low—hon. Members could perhaps encourage their constituents to take part. We want to improve access to the service and develop a new digital health check that people can use at home. We have now launched the next phase to develop the service, and I am pleased that Norfolk county council has been selected as one of the three pilot sites that are due to start in 2025.
Hon. Members are right that access to dentists is a pressing issue facing patients. We all knew that before the election campaign, and that is why that is a core part of our commitment to the British public. Only 40% of adults have seen an NHS dentist in the past two years. My hon. Friends the Members for Luton North (Sarah Owen) and for Lowestoft (Jess Asato), in particular, highlighted what we all see when we visit primary schools to look at young people’s oral health. Hon. Members have read our manifesto and know what our plans are. To be clear, the Secretary of State and the Minister for Care, my hon. Friend the Member for Aberafan Maesteg (Stephen Kinnock), met the British Dental Association immediately on taking office and are meeting it regularly to resolve the issues with the contract. We will provide 700,000 more urgent dental appointments and recruit new dentists to areas that need them most. We will rebuild dentistry for the longer term by reforming the contract.
I cannot go into too much detail on the proposal from the UEA. It is a place close to my heart, as it is where I went, almost exactly 40 years ago, to university. It is where I fell in love and got married, but sadly I had to leave the east of England. That is a fantastic hospital. I know it is supported by the local ICB, and I understand that individual Members are seeking to meet with the Minister for Care. I hope we will be able to update Members on that shortly.
My hon. Friend the Member for Norwich South talked about the dire state of the mental health service and the Norfolk and Suffolk NHS foundation trust. To update Members—although most will know—the trust has been in the recovery support programme since July 2021, after the CQC’s inspection report of “requires improvement”. To address quality and safety, the trust has implemented and completed a range of actions from that inspection report. In July it published the “Learning from Deaths” report, which was commissioned by the chief executive to review every death that occurred from April 2019 to October 2023. To improve the culture, the trust has launched Listening into Action, a trust-wide programme to improve how staff work together and listen to each other. In April, NHS England formally agreed a revised timeline for the trust to exit the recovery support programme at the end of 2024, and transition planning for post-exit has commenced. Obviously, we will be paying attention to that very closely, and I know hon. Members will also do so.
In response to the concerns about hospital buildings, we are all in no doubt about the inheritance that we have received from the last Government, particularly on capital, and about the state of our hospital estate. Each trust with a hospital with RAAC issues has invested significant levels of NHS capital to mitigate any safety risk. The safety of our patients must always come first. It is clear that the last Government’s promise to deliver 40 new hospitals by 2030 was not achievable, and it did not have the funding required to deliver it. That is why we are reviewing the programme to put it on a sustainable footing, which means a realistic timetable for delivery and clarity of funding. We will be honest with the British people and transparent about what we can deliver, and we will update the House and hon. Members on the programme’s next steps as soon as we can.
My hon. Friend the Member for Norwich South touched on climate change. This is a really big issue for the east of England. I will not have time to go into some of the issues but personally, and, as far as this Government are concerned, the impact of climate change on health and the provision of the health service is a serious issue, with surges in demand for services during periods of extreme weather and heat-related disruption to utilities, such as power outages. We are cognisant of those, and I do think it is an important issue for the health service. The NHS is doing well to become on target to reach net zero by 2040, and all trusts have targets. That is something we will watch closely.
I will give some rapid fire responses. We are not going to look at changing structures. We want to work with the system that we have inherited. It has to work, it has to bring people together, and it has to bring services into neighbourhoods. We have talked about the contract as well. We are keen to work together with local services in the ICB structure. We all know in our own areas that geographies are never quite perfect, but we do not want another reorganisation. We think that detracts from what we need to get on with.
The matter of productivity raised by the hon. Member for Broadland and Fakenham (Jerome Mayhew) is an issue—the concern about what we measure and how we measure it, and making sure that every taxpayer’s pound is used well within the NHS. Part of the issue is the breaking of the foundations of the system. Locally, that has meant it is very difficult for the service to deliver. That is why we are looking at this on a 10-year basis. The foundations need fixing.
Let me finish by once again thanking colleagues for bringing their own insights into heath and care in the east of England. Many new Members have come here from all parties. These are important debates, and it is important for Ministers such as myself to hear directly from Members’ constituents. Many of the issues are symptomatic of an NHS that is broken. That is why we are ending the sticking plaster politics. As the Prime Minister said a week ago, that is worth doing. It will be harder, and it takes more time. We are not going to give deadlines that we cannot meet. I hope that after just about two months in this role, I given answers today that show that we understand the scale of the issues that we face, and that this Government are committed to tackling them. If I have missed anything in particular, I will of course, correspond with hon. Members.
Oral Answers to Questions
Karin Smyth Excerpts(4 months ago)
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Bill Esterson (Sefton Central) (Lab)
The Minister for Secondary Care (Karin Smyth)
I congratulate my hon. Friend on his re-election. He will know that capital allocations are a matter for the integrated care boards. We are committed to introducing neighbourhood care centres to bring together vital care services, and I look forward to working with him on Labour’s mission to improve the front door to the local NHS.
Bill Esterson
I congratulate my right hon. and hon. Friends on their appointments. The predecessors of my right hon. Friend the Health Secretary—there have been quite a few over the past few years—all agreed with me that a health centre in Maghull in my constituency was a priority for the health service, but as my hon. Friend has just said, the allocation of capital by integrated care boards has meant that the priority has been acute hospitals, sometimes at the expense of community facilities. Will my hon. Friend meet me to discuss the importance of investment in health centres such as the one in Maghull, which make such a difference to reducing waiting times in the NHS and improving patient outcomes?
Karin Smyth
My hon. Friend is first out of the blocks on this issue, and has shown his commitment to improving primary care for his constituents. I am sure the local ICB has listened very carefully to his question, because we know that the existing primary care estate is under a great deal of pressure. That is why building a neighbourhood health service remains at the forefront of our mission to rebuild the NHS, and I would be pleased to meet him to discuss that topic.
Adam Jogee (Newcastle-under-Lyme) (Lab)
Uma Kumaran (Stratford and Bow) (Lab)
The Minister for Secondary Care (Karin Smyth)
I congratulate my hon. Friend on her election, and I also pass on my best wishes to her and her husband, who I know recently suffered a stroke. We hope he makes a speedy recovery. We recognise the great work of NHS staff for them, and indeed for all our constituents every day, but we do know that the NHS is broken. The latest data confirms the terrible state in which the Conservatives left urgent and emergency care services, with one in four patients waiting longer than four hours in A&E. That is why Professor Lord Darzi will lead an investigation into NHS performance, and the findings will inform our 10-year reform of the NHS.
Uma Kumaran
I thank the Minister for her kind words today, and I also thank my right hon. Friend the Health Secretary for his wishes on the day. Mr Speaker, may I also take this opportunity to thank you and your staff for the care and kindness you showed me?
Residents in my constituency of Stratford and Bow are served by Barts health NHS trust, which includes Newham University, Royal London and Whipps Cross hospitals. In May, their A&E departments had the second highest volume of any trust in England and the highest in London. Overcrowding and capacity constraints mean that the staff at those hospitals are having to treat some patients in corridors rather than on wards. This is the broken NHS that we have inherited from the Conservatives. Will the Minister ask her Department to look at capacity issues at those hospitals and at how community pharmacy prescribing services may be used to alleviate some of the pressures?
Karin Smyth
My hon. Friend makes an excellent point highlighting the challenges particularly around hospital capacity, something well-known on the Front Bench with my right hon. Friend the Health Secretary representing a nearby area. This type of patient experience is unacceptable, but it sadly became normal under the last Government of 14 years. My hon. Friend makes an excellent point about pharmacies: they will have a central role in our future system, and I would of course be happy to undertake a visit with her.
Priti Patel (Witham) (Con)
I welcome the new Front-Bench Members to their new portfolios and responsibilities. Essex has actually seen some improvements in emergency care services over the past 14 years, particularly in our ambulance trust, and that should be commended. One way in which pressure on emergency services can be reduced is by having community facilities in our towns and across our districts. Will the Minister commit to meeting me and working with my right hon. Friend the Member for Maldon (Sir John Whittingdale) on looking at ways in which we can safeguard community services at St Peter’s hospital in Maldon, which our communities absolutely need?
Karin Smyth
I thank the right hon. Lady because she again makes for us the excellent point about what has happened in the last 14 years under her Government: these situations have been allowed to get so much worse both in Essex and across the country. She should also welcome our mission to rebuild the broken front door to the NHS and have more neighbourhood services based in communities, bringing those services together where patients are; that is absolutely what we all want and I am very happy to discuss this with her.
Shaun Davies (Telford) (Lab)
For 14 years the community in Telford and I have worked hard to safeguard our A&E, but the last Conservative Government made Telford the largest town without a fully functioning A&E. Will the Health team meet me and other Shropshire MPs to discuss this discredited and disgraceful decision?
Karin Smyth
I welcome my hon. Friend to his place. He knows what we all know, and what we know the entire country knows because we spent the past six weeks campaigning: it is the same story across the country. That is why we are committed to restoring standards and why we will fix this broken NHS, and of course I am happy to meet with him.
Andrew George (St Ives) (LD)
A decision by the Conservatives two years ago means that the urgent treatment centre at the West Cornwall hospital in Penzance is now closed at night, and that has put pressure on the only emergency department in Cornwall—a long peninsula—at Treliske, where routinely 20 ambulances are parked outside creating a new metallic ward at the front of the hospital. That situation has had a detrimental impact, of course including avoidable deaths. Will the Minister meet me and colleagues and the local NHS to discuss this issue, to see how we can restore our emergency services?
Karin Smyth
Again, across the country we see the damage done over the last 14 years, and the hon. Gentleman is absolutely right to highlight that the situation in one part of the system knocks on to other parts. That is why we want a 10-year plan to look at this, an immediate look with Lord Darzi, and, critically, to understand which community and primary care services can be supported to support the rest of the system. I am very happy to meet with colleagues across Cornwall, where we now have many Labour MPs.
George Freeman (Mid Norfolk) (Con)
Bell Ribeiro-Addy (Clapham and Brixton Hill) (Lab)
The Minister for Secondary Care (Karin Smyth)
I congratulate my hon. Friend on her re-election and thank her for raising this important issue. It is not right that three out of four parents are not able to stay with their critically ill baby overnight at such an important point in that new relationship. NHS England recently concluded a review of neonatal estates. It is in the early stages of analysing the findings, which will be used to inform the next steps. We are all determined to support parents to be involved in every aspect of their baby’s care.
Bell Ribeiro-Addy
I congratulate my right hon. and hon. Friends on their re-elections and on taking their places. Recent research from the charity Bliss showed that when a baby receives neonatal care, their parents are routinely expected to leave them in hospital overnight for weeks or even months at a time. Its research found that for every 10 babies who need to stay overnight in neonatal care, there is only one room available for a parent to stay with them. How will the Minister ensure that the existing guidance about facilities for families is followed, and how will she ensure that trusts can access the resources they need to stop the separation of babies and their parents?
Karin Smyth
My hon. Friend is absolutely right that the separation of babies and their parents at that time is not acceptable, and about the shocking state of the estate, as we have just heard. We will look at the findings of the NHS review very quickly, and I will be happy to get back to her on those specific points.
Jim Shannon (Strangford) (DUP)
I thank the Minister for her answer. This issue is clearly not just about accommodation; it is also about providing physical and emotional help for mothers who have been through traumatic circumstances, emotionally and physically. What will be done along those lines to ensure that mothers and babies have all the help they need?
Karin Smyth
The hon. Gentleman makes a really important point about mental health support in that critical period. We will absolutely make sure that is looked at.
Sean Woodcock (Banbury) (Lab)
The Minister for Secondary Care (Karin Smyth)
My hon. Friend makes an excellent point about the stress that people face when waiting, and we have talked about the disaster of the past 14 years. People with potentially deteriorating conditions are waiting, and we absolutely need to address this issue as part of our work to reduce waiting lists.
Blake Stephenson (Mid Bedfordshire) (Con)
Tom Rutland (East Worthing and Shoreham) (Lab)
Karin Smyth
I welcome my hon. Friend to the House. He makes an incredibly important point about this very stressful time, particularly for women, in his area. We will listen to women and deliver evidence-based improvements to make maternity and neonatal services safer and more equitable for women and their babies, and we have committed to delivering the long-term workforce plan.
Victoria Collins (Harpenden and Berkhamsted) (LD)
Health Services: Rural Areas
Karin Smyth Excerpts(4 months, 1 week ago)
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The Minister of State, Department of Health and Social Care (Karin Smyth)
It is a privilege to be the first Minister of this new Labour Government to respond to an Adjournment debate. I am grateful to the hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone) for raising this important matter and, indeed, for his kind words.
I hope we can begin this Parliament as we mean to go on, by being candid about the formidable challenges that the NHS faces. As my right hon. Friend the Secretary of State said on his first day in the job, the NHS is broken, and it will be the task of this Government to build a new NHS for the future. That means the NHS in our rural and coastal areas no less than the NHS in our towns and cities. I agree with the hon. Member for Strangford (Jim Shannon) on that point.
Facing these hard truths does not take away from the heroic efforts of the people working in health and care, who have done their utmost in incredibly difficult circumstances. We all owe them, on behalf of our constituents, a debt of unending gratitude.
Instead, we want to focus our attention on what needs to be done, including early action to improve access to primary care, dentistry and dental health services in particular. We await the conclusions of a thorough investigation undertaken by the distinguished surgeon Lord Darzi to properly understand the scale of the problem. The Government will then begin work on an ambitious programme of action—a 10-year plan to put the NHS back on its feet. It is a privilege to be part of a Labour Government who are committed to fixing the NHS and making it fit for the future.
As the hon. Member for Caithness, Sutherland and Easter Ross said, the Department’s responsibility stretches only to the NHS in England. Healthcare is devolved in Scotland, Wales and Northern Ireland, and it will continue to be so.
I congratulate the hon. Gentleman on being first out of the traps to secure this debate on behalf of his constituents. As a committed advocate for his constituents in one of the most rural parts of Scotland, he has a deep understanding of matters affecting rural communities, as we have heard this evening. He also has a deep understanding of care, about which I have often heard him speak in this Chamber. It is good to see him back again doing just that.
I cannot speak in detail about the NHS in Scotland, of course, but I can speak about many of the common issues affecting access to care that are relevant to rural constituencies in England, Scotland, Northern Ireland and Wales. I know how rural the hon. Gentleman’s constituency is, and I know the particular challenges that creates in accessing GPs, dentists and emergency care, and in accessing women’s health and maternity services—an issue he has been passionately raising for so long. Maternity services are a problem across the United Kingdom, but I accept the examples he outlined.
Few places in England are as remote as the hon. Gentleman’s constituency, but I am very aware of similar issues affecting more rural areas near my Bristol South constituency. We have heard from the hon. Members for Glastonbury and Somerton (Sarah Dyke) and for St Ives (Andrew George) about morale and the difficulties we face in the south-west.
I hope that, in the years ahead, we can share and learn from one another across all of our borders. In many rural areas, the challenge of improving access to services is compounded by travel times and by the recruitment and retention of staff. We must recognise the importance of designing services that reflect an area’s particular circumstances, which is a growing challenge. As the chief medical officer has pointed out in his reports, people are moving out of towns and cities to coastal, semi-rural and rural areas as they age. At the time that people are most likely to need care, they are increasingly living in the places where it is most difficult to provide that care.
In England, integrated care systems will have a key role to play in designing services that meet the needs of local people. To do this, they will need to work with clinicians and local communities at place or neighbourhood level. We know that excellent primary care is an essential foundation for improving access, tackling the root causes of poor health and tackling problems early so that people remain in better health for longer, and hopefully do not need to access secondary and tertiary care at the same level. That is why Labour has pledged, as part of our health mission, to train thousands more GPs and bring back the family doctor, and that applies to all the nations.
We are also doing more to use the transformative power of technology. There is enormous potential in ideas such as virtual wards, which allow care to be delivered in people’s own homes. Such models of care can have disproportionate benefit in areas where rurality is a barrier to care.
Equally, we are committed to seeing the NHS app reach its full potential under the new Government. We understand that some people will need support to use that technology and we are aware of the challenges of rural broadband, but we are committed to making the benefits accessible to all.
Andrew George
The Minister has committed the new Labour Government to address those issues, but will she specifically address the matter of the two coroners’ reports into avoidable excess deaths as a result of very long waits for emergency services in Cornwall? They were never addressed by the previous Conservative Government. The reports were about not just the hours spent waiting—sometimes elderly, frail people were on the floors for 10 or more hours—but the fact that sometimes 20 or more ambulances greeted patients when they arrived at the emergency department. Two coroners’ reports were sent to the then Secretary of State, but there was never an adequate response. I very much hope the new Labour Government will review the failings of the previous Government and address those very serious concerns, which affect many other rural areas.
Karin Smyth
I am aware of the issues facing the south-west and, when in Opposition, I spoke in the local media about some of the ambulance challenges. I am not aware of those reports, but if the hon. Gentleman writes to me with the details, I will happily look into the issue and get back to him.
We also recognise the additional cost of providing services in rural areas, for example in travel and staff time. That is why the funding formula used by NHS England to allocate funds to integrated care boards includes an element to better reflect needs in some rural, coastal and remote areas.
The NHS faces significant challenges. It needs fundamental reform. The Prime Minister is personally committed to resetting the UK Government’s relationship with devolved Governments in Scotland, Wales and Northern Ireland. I echo the Prime Minister’s words today about our commitment to rural constituencies across the entire country and I hope we can work with hon. Members from across the House, including the hon. Member for Caithness, Sutherland and Easter Ross.
Jim Shannon
I welcome the Minister’s clear commitment to England, Scotland, Wales and Northern Ireland—and particularly to Northern Ireland. Let me declare an interest: I am a member of the Ulster Farmers Union. I know that the Ulster Farmers Union back home, in conjunction with the NFU here, has been trying to work with the health service and with all those with responsibility in this area on the issue of suicides. Farmers mostly work on their own and suffer from anxiety and depression. They face pressures from finance and pressures from the bureaucracy that exists in farming. I know the Minister is compassionate and understanding—I mean that honestly. When it comes to addressing that issue, does she think that it must be done in conjunction with the farmers unions? Trying to work together to make things better must be a step in the right direction.
Karin Smyth
As ever, the hon. Gentleman makes a valid point. I shall certainly ask my colleagues in the Department for Environment, Food and Rural Affairs about that. His point is extremely well made. I know his constituency in Northern Ireland very well. Let me say that we are very committed to working with hon. Members across the House to share ideas. The hon. Member for Caithness, Sutherland and Easter Ross has put forward more ideas about how that can happen. I do not promise to implement all of those things, but I will certainly look at them. We want to work very closely across all jurisdictions so that we can make progress for all our constituents to improve the health outcomes across the four nations of the United Kingdom.
Question put and agreed to.