NHS: Long-term Strategy

Debate between Karin Smyth and Steve Brine

Wednesday 11th January 2023 Commons Chamber

[Steve Brine]

I said in the House on Monday that covid has put the health service on its knees—it has done so to health services in the UK and around the world. To repeat what I have just said, it is disingenuous to suggest that the problems faced by our health service right now are not caused by our covid experience. The number of people presenting with suspected cancers is through the roof. That is good—many of those cases will turn out not to be cancer, which is even better—but so many people are coming forward because we suppressed demand during that time, and it is adding to the demand outstripping the supply in the health service right now.

[Karin Smyth]

The hon. Gentleman chairs the Select Committee, so it is really important that he is clear about this. The Government ran the health service at 96% capacity well through the 2010s, well before the pandemic. They were consistently warned that 96% capacity is too much; we should be running at about 85% capacity for staffing and so on. Capacity in the system has been our problem for a long time. Demand is outstripping capacity—supply is about capacity—and he, as Chair of the Health and Social Care Committee, needs to be clear about that point.

[Steve Brine]

I will choose my words and the hon. Lady can choose hers. I will come to capacity in the conclusion of my remarks—I promise her that.

I will touch on patient flow. Any acute sector that I speak to or visit at the moment is saying clearly that patient flow is hampering everything happening at the front door and the back door. One of the reasons why those in the ambulance service are striking is that they are so heartbroken about not being able to deliver the service that they want to deliver and cannot get out on the road because they are waiting to dispatch their patients.

I said it on Monday and I will say it again now: I welcome the £250 million that the Government have put forward to buy beds. I repeat that two thirds of social care is domiciliary care—care in people’s homes—and we must not forget that, because it is important to getting people through the acute system. The modular work that the Secretary of State talked about—modular units in and around emergency departments—to add extra capacity and meet some of the extra demand coming through the front door, is also very welcome.

I said that we have to separate the now from the long term, so let me address the long term. The elective recovery taskforce is important; the 15 new elective hubs are important. At Prime Minister’s questions today, the Prime Minister talked about eliminating the two-year wait, and that is good—it is not, of course, the extent of his ambition, and to say so is facile. We do not yet have an elective hub in Winchester. The Secretary of State knows that I am on his case about it, but may I just land that point with him again? The Prime Minister’s primary emergency care plan, which we eagerly expect later this month, will be important. It is also part of a long-term strategy and plan, and I think many people in the ambulance service will be pleased with what they see there. I hope that it will be as ambitious as what we hear in some of the rumours.

Some of the things the Select Committee is looking at feed into what the Secretary of State and the Government are doing. Integrated care systems are a creation of this Government. They are about flattening services across the NHS and breaking down those barriers between health and social care. We are in the middle of a big inquiry into integrated care systems, and we are liaising with the Hewitt review, which is a good thing. We were talking to the Care Quality Commission this week, and the Government have not yet laid the regulations on how the CQC will look at ICSs. Will the Minister please look at that?

This morning we talked about the digital transformation of the NHS. There are huge dividends in digital for the NHS, including simple things, such as the amount of money that the NHS spends on sending letters to patients—not least given that they never get there due to Royal Mail strikes. There are clinical dangers to that. Let us pursue our digital transformation, and I know that the Secretary of State is up for that. In terms of the stuff we will be doing this year, we eagerly await the workforce plan.

Diabetes

Debate between Karin Smyth and Steve Brine

Monday 26th February 2018 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Steve Brine)]

I thank the hon. Member for Heywood and Middleton (Liz McInnes), whom I know well and have worked with already on this in my time as a Minister, for giving us the opportunity to debate such an important issue. The turnout for this Adjournment debate suggests that it is of great interest to the House. It is normally just me, the Member introducing the debate, my Parliamentary Private Secretary and the hon. Member for Strangford (Jim Shannon). Tonight’s turnout has been a revelation. In November, I remember the hon. Lady introducing me and leading the event in the Terrace pavilion for the launch of the “Future of Diabetes” report by Diabetes UK, which is the biggest study of its kind. I promised then that I would respond recommendation by recommendation to the report, which I believe I have done. The offer I gave then is the offer I repeat now, which is to work with the all-party group and the charity on each and every one of those recommendations. I hope she knows I am sincere in saying that.

I would like to use this opportunity to pay tribute to Diabetes UK—led by the excellent Chris Askew, whom I have known for many years wearing other hats when he used to lead the breast cancer charity Breakthrough—which continues to work both with us in government and independently to improve the lives of so many people who are at risk of this increasingly common condition.

Diabetes is one of the biggest health challenges facing the country, and the figures are truly sobering. There are currently 3.5 million people in the UK who have been diagnosed with diabetes. If nothing changes, by 2025 more than 5 million people will have the condition. That is a significant public health challenge. Type 1 diabetes affects 400,000 people in the UK and its incidence is increasing by about 4% a year. It is not preventable, so the emphasis is on improving the lives of people with type 1 diabetes and helping them to manage their condition. During half-term recess, I paid a visit to a brilliant charity in your constituency, Mr Speaker, called Medical Detection Dogs. I met a brilliant dog who looks after a lady with diabetes. As if on cue, when I walked into the room to meet her he sat and put his paw on her knee, which was him assessing her levels and indicating that she needed to take action. It was incredible to watch. If Members are not familiar with Medical Detection Dogs, please do look it up.

Type 2 diabetes, as we have heard, is much more common. It is a leading cause of preventable sight loss in people of working age and a major contributor to kidney failure, heart attacks and strokes, among the many other conditions the hon. Lady read out in her cheery list. Diabetic foot disease, including lower limb amputations and foot ulcers, accounts for more days in hospital than all other diabetes complications put together. According to Diabetes UK, 11.9 million people in the UK are at high risk of developing type 2 diabetes, which is largely preventable.

Aside from the human impact on people’s lives, the financial cost of diabetes and its complications is huge. It already costs the NHS in England over £5.5 billion a year and that figure continues to rise. Managing the growing impact of diabetes is one of the major clinical challenges for us in the 21st century. That is why, as the hon. Lady and the right hon. Member for Leicester East (Keith Vaz) who chairs the all-party group so well rightly say, preventing type 2 diabetes and promoting the best possible care for all people with it is a key priority for the Government.

The hon. Lady mentioned the child obesity plan. She was absolutely right to do so. She knows I am passionate about delivering part 1 of the plan. We always said that it was the start of a conversation and that it was called part 1 for a reason. I am absolutely committed to taking further action if necessary, particularly across marketing, reducing portion sizes and price promotions, to help young people and to make healthy choices become the easiest choice of all. I think she knows me well enough to know I mean what I say and I say what I mean. If we need to take further action we will do so and she should watch this space.

[Karin Smyth]

I just inform the House that this morning, Committee D of the British-Irish Parliamentary Assembly, of which I am vice-chair, had a session in Portcullis House on childhood obesity with Members from all parts of the islands. We produced a report recently and are doing further work. If I may be so bold, I will make sure that the Minister has a copy of that report. He will be interested in some of the reflections that we are bringing together from across the Republic of Ireland, Northern Ireland, Scotland and Wales, and they might help to inform that work.

[Steve Brine]

That would be very interesting—if the hon. Lady did that, I would be grateful. We are working hard to improve diabetes services. The Government are strongly committed to taking action to prevent diabetes and to treat it more effectively. The Government’s mandate to NHS England for 2017-18 includes an objective for NHS England to

“lead a step change in the NHS in preventing ill health and supporting people to live healthier lives.”

Adult Social Care Funding

Debate between Karin Smyth and Steve Brine

Thursday 6th July 2017 Commons Chamber

[Steve Brine]

Indeed I can. We introduced the new, tougher system of CQC inspections, for the reasons I set out. We introduced a care certificate for support workers and healthcare assistants, and we introduced the new quality standards to clarify what excellence actually looks like in care. We brought in new criminal offences of ill treatment and wilful neglect, and we introduced a fit and proper person test to hold directors to account for care. Those are all things that have happened under this Secretary of State that never happened before.

[Karin Smyth (Bristol South) (Lab)]

The care sector is a significant employer in my Bristol South constituency, but people are being lost to other sectors. I listened carefully to the Minister’s response to the hon. Member for Totnes (Dr Wollaston), but I urge him to be much more ambitious in supporting the sector to recruit more people and build on career pathways between health and social care to encourage people who want to do those jobs.

[Steve Brine]

I thank the hon. Lady for her sensible question.