Oral Answers to Questions

Kevin Hollinrake Excerpts

Tuesday 23rd July 2019 Commons Chamber

[Matt Hancock]

I thought that the hon. Gentleman would welcome the prevention Green Paper, which was published yesterday. We have been working very hard to publish a huge amount of policy, including the Green Paper, which contains about 80 different policies to ensure that we prevent people from becoming ill in the first place. However, it is also part of a broader drive, which Conservative Members support, to ensure that we are the healthiest of nations, and that people can take personal responsibility for their health, as well as relying on the NHS, so that it is always there when people need it.

[Kevin Hollinrake (Thirsk and Malton) (Con)]

T7. Has the Secretary of State given further consideration to providing extra funds to meet the challenges of running unavoidably small hospitals, such as Scarborough and the Friarage in Northallerton?

[The Minister for Health (Stephen Hammond)]

My hon. Friend has campaigned on this matter for a while, and I was pleased to meet him to discuss it earlier in the year. We absolutely recognise the challenge that small acute providers face, and over the past two years the Advisory Committee on Resource Allocation has been considering how we might meet that challenge. The committee has endorsed a new community services formula to reflect the pressure in remote areas, which may help the two hospitals mentioned by my hon. Friend.

Oral Answers to Questions

Kevin Hollinrake Excerpts

Tuesday 18th June 2019 Commons Chamber

[Mr Speaker]

I am sure the Secretary of State means well, but I am not entirely sure that the hon. Lady’s joy at the endorsement from the right hon. Gentleman was undiluted.

[Kevin Hollinrake (Thirsk and Malton) (Con)]

Will the Secretary of State support one of the key recommendations of the joint report from the Health and Social Care Committee and the Housing, Communities and Local Government Committee into the future funding of social care, which is for a German-style system of social insurance?

[Caroline Dinenage]

Absolutely. We are very keen to look at the Select Committees’ recommendations and the contributions of all key stakeholders. We are committed to ensuring that everyone has access to the care and support we need. The Green Paper will include ideas to protect people from high and unpredictable care costs.

Mental Health Support: Young People

Kevin Hollinrake Excerpts

Tuesday 9th April 2019 Commons Chamber

[Ruth George]

I absolutely agree with both my right hon. Friend and my hon. Friend the Member for Coatbridge, Chryston and Bellshill (Hugh Gaffney). I know that even long after the physical experience of cancer has left young people, children and adults, the mental scars can linger, particularly for families.

The number of children and young people overall with a mental health disorder has increased to nearly one in eight, according to the children and young people prevalence survey in November. That is around 1.25 million young people, yet only one in four young people with a mental disorder is seen by a mental health specialist. Over 400,000 children and young people are not getting any professional help at all in England—that is almost 1,000 young people and their families suffering in every one of our constituencies. The lack of support leads to their condition worsening.

In 2017, 46.8% of young people with a mental health disorder had self-harmed or attempted suicide at some point, and over a quarter of 11 to 16-year-olds. The threshold to access child and adolescent mental health services has become so high that local teachers in my constituency are asked to provide evidence that a child has sought to take their life before a referral will be accepted. It is not enough to be told that they have tried to take their own life—CAMHS wants evidence, and these are schools with children up to the age of 16. Even when young people are accepted, the waiting time for treatment from CAMHS in my constituency is over 12 months, and sometimes 18 months. That is not unusual. It is no wonder that children are driven to more and more desperate measures just to get heard.

[Kevin Hollinrake (Thirsk and Malton) (Con)]

The hon. Lady is making some powerful points in a powerful speech. I speak as the father of four children between the ages of 22 and 11. Any family in the modern era has to face these problems. Does she agree that parents need more support to understand these issues and to learn how to deal with them more effectively to try to help our children?

Oral Answers to Questions

Kevin Hollinrake Excerpts

Tuesday 26th March 2019 Commons Chamber

[Matt Hancock]

This is a core question that Baroness Dido Harding’s workforce review will be looking into, and work is going on right across government to try to fix it.

[Kevin Hollinrake (Thirsk and Malton) (Con)]

GPs are the first line of defence against superbugs and antimicrobial resistance, and the Secretary of State is already proving to be a world leader in this area. The idea of a resistance tax has the support of other world leaders including Lord O’Neill and Dame Sally Davies. Would he consider this approach?

--- Later in debate ---

[Kevin Hollinrake (Thirsk and Malton) (Con)]

T9. Breast cancer oncology is the most recent service to be closed at Scarborough Hospital. It follows the closure of the pain clinic, dermatology, the eye clinic and physiotherapy. These are not cuts, but a contrived centralisation by the trust in York. Will the Secretary of State intervene to ensure that there is a full range of service right across my constituency?

[The Minister for Health (Stephen Hammond)]

I commend my hon. Friend for his commitment to raising the local priorities of his constituents and for the campaigning he does on behalf of the local NHS. I think that these plans are best worked through by the local NHS. However, if he would like, I would be happy to meet him to discuss the concerns that he has on behalf of his constituents.

Exiting the European Union (Food and Agriculture)

Kevin Hollinrake Excerpts

Tuesday 19th March 2019 Commons Chamber

[Steve Brine]

It is good to see my hon. Friend here, but not so good to see her there. She knows what I mean.

Along with the shadow Minister, the hon. Member for Washington and Sunderland West (Mrs Hodgson), I chaired the all-party parliamentary group on breast cancer for many years. There is definitely talk in the lobbying community about plastics and their impact, and, as the hon. Member for Washington and Sunderland West knows, pieces of academic work make claims in that respect. Those claims are certainly not proven, and there is a wide range of scientific debate about them.

I take my hon. Friend’s point about biodegradable plastics, but it is not specifically a matter for me. The instruments deal with food standards and food safety. They do not make any degradations in our food safety, but neither do they make any improvements; they are housekeeping measures.

The second SI, the Genetically Modified Food and Feed (Amendment etc.) (EU Exit) Regulations 2019, is also crucial to meeting our objective of ensuring that the current high standards are maintained. It was made under the powers in the European Union (Withdrawal) Act 2018 to make necessary amendments to retained EU genetically modified food and feed law. It will ensure that regulatory controls for GM food and feed continue to function effectively after exit day, and that public and animal health and, crucially public confidence are protected. The EU law governing GM food and feed provides a harmonised regulatory framework, including transparent and time-limited procedures for robust risk assessment and authorisation before these products can be placed on the market, and we believe that those strict controls must be maintained.

[Kevin Hollinrake (Thirsk and Malton) (Con)]

Food safety is a critical element in the fight against antimicrobial resistance and the tackling of superbugs. Will my hon. Friend do all that he can to ensure that the UK remains a world leader in this area after we have left the European Union?

[Steve Brine]

I would have been disappointed if my hon. Friend had not raised the subject of antimicrobial resistance. He is ingenious in managing to get it into every debate. He knows of my commitment in that regard, not just domestically but internationally. This country is rightly respected and looked to for its work in the field, and I thank him for putting that on the record.

Integrated Care Regulations

Kevin Hollinrake Excerpts

Monday 18th March 2019 Commons Chamber

[Jonathan Ashworth]

We keep being told by Ministers, by those who are favour of integrated care and by various interested stakeholders that Labour Members are scaremongering and that we have nothing to worry about—that it is all going to be fine and all going to be in the public sector—yet at the same time we are seeing controversial privatisation after privatisation all across the country, of which the one in Oxford is just the latest example. This has happened since the Secretary of State went to the Select Committee and said that there would be no privatisation on his watch.

In south-east London, private companies are in a three-way fight for the biggest-ever NHS pathology contract—a £2.2 billion contract for 10 years. If the Secretary of State was sincere in his commitment to no privatisation on his watch, he would bring forward legislation to ensure that ICPs are statutory public bodies that are publicly accountable. He would first take the advice of the NHS itself, as embodied in the long-term plan and the subsequent proposals for legislative change, and rid our NHS of the morass of competition law and economic regulation that was brought in by the Health and Social Care Act 2012. Everyone agrees that this particular aberration has had its time.

While the NHS proposals do not yet go as far as Labour Members would want and would not resolve all the problems of the internal market and private sector involvement that our NHS struggles with, they would remove the default assumption for competitive tendering that would currently make many ICSs feel obliged to put contracts for ICPs out to tender for fear of falling foul of the competition rules. Overall, they provide a far preferable base from which to pursue integrated care than the maze of contradictions and obstacles that Andrew Lansley’s Act forced on them. Rather than this regulated change, why is the Minister not bringing forward the legislation that NHS England has called for?

I have two other quick points for the Minister. The new secondary legislation seeks to substantially change the regulations underpinning the existing contractual arrangements for the provision of NHS GP services. We should remember that general practice is already hard to recruit for and we are already losing GP numbers, yet the proposal to incorporate GP practices into ICPs appears to cut across the idea of GPs beginning to work in wider networks covering 30,000 to 50,000 patients, retaining their GP contracts but sharing common resources. That was highlighted as a direction of travel to be celebrated by the Prime Minister when launching the long-term plan.

GP practices can already network and collaborate without this new contract. The contract will offer a sweetener to GPs of new money if a GP practice signs up to the new contract, but the proposals have been opposed by the BMA. Dr Richard Vautrey has said:

“We have repeatedly expressed our serious concerns about ICP contracts which leads to practices giving up part or all of their General Medical Services contract as a result. Practices should not feel pressured into entering an ICP contract as to do so could leave their patients worse off.”

Perhaps the Minister can explain why he is correct and Dr Vautrey is wrong.

I want to make a quick point about the pooling of budgets with respect to universal free-at-the-point-of-use NHS and means-tested social care. If the boundaries between health and social care are dissolved, will the Minister mandate ICPs and clearly specify that which is considered healthcare and that which is considered social care? I raise that because we are already seeing CCGs across the country cutting back on their responsibilities to provide continuing healthcare for some of the most vulnerable people. Can he guarantee that some services currently provided free on the NHS—whether rehabilitation care or nursing care provided by district nurses, such as wound care or continence care—will not suddenly be designated as social care, so that charging creeps into the system?

[Kevin Hollinrake (Thirsk and Malton) (Con)]

The hon. Gentleman talked about the funding of social care. One of the recommendations made by the Health and Social Care Committee, in concert with the Housing, Communities and Local Government Committee, as a solution to adult social care funding, was a system of social insurance. Would he support that on a cross-party basis?

[Jonathan Ashworth]

The hon. Gentleman is a passionate campaigner for his social insurance proposal, and I have heard him make that point many times. I say to him gently that when the Government bring forward their Green Paper—I emphasise the word “when”—we will engage fully in the debate, and I am sure he will make that point then, whether the debate happens this year, next year or the year after; we will wait and see.

There is a problem with the dissolving of boundaries between health and social care and what that could mean, with charges creeping into the system for some services that were previously considered NHS services but are now designated as social care services. Is the Minister prepared to mandate ICPs, so that we have clear guidelines about that? Finally, where is the patient voice in any of this? Where are the guarantees that decisions will be made not only in public but with the public involved in the decisions that affect them locally?

We on the Opposition Benches support integration; we have long called for it. We support greater collaboration. We support the planning of health and social care delivery in local areas. We support restoring local area-based health bodies delivering care, rather than the fragmented mess we have today. We have, of course, had such bodies before—we used to have district health authorities and strategic health authorities, and some have suggested rather mischievously that we seem to be going back to what we used to have in the past.

Until the default assumptions of tendering and wasteful procurement exercises are removed from primary legislation, such secondary legislation will always create further dangers of private operators gaining control of NHS services. Until that is done, Ministers will have no one to blame but themselves if the spectre of privatisation continues to haunt their ICP plans. We oppose NHS privatisation. We oppose NHS cuts. We oppose anything that undermines the fabric of a public national health service. We oppose these regulations. We seek to annul them, and I commend our motion to the House.

Oral Answers to Questions

Kevin Hollinrake Excerpts

Tuesday 27th November 2018 Commons Chamber

[Matt Hancock]

I join the right hon. Gentleman in celebrating World Aids Day and ensuring that we redouble our commitment to making sure that we do everything we can. I will certainly look into the precise commitment that he asks for to make sure not only that it is deliverable but that we work not just here but around the world to end this scourge.

[Kevin Hollinrake (Thirsk and Malton) (Con)]

Everyone in this place has lost someone close to them to the terrible and terrifying disease that is cancer. How will the NHS 10-year plan help to improve detection rates?

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

The Prime Minister will set out our ambition that three quarters of all cancers will be diagnosed early, up from just half today. Our cancer survival figures are our best ever, but we do not have world-class outcomes yet, as we must and want to. That is why early diagnosis will be absolutely at the heart of the NHS long-term plan—for instance, in radically overhauling the screening programmes that the Secretary of State mentioned earlier.

Oral Answers to Questions

Kevin Hollinrake Excerpts

Tuesday 23rd October 2018 Commons Chamber

[Matt Hancock]

No, that is not true. We are working very closely with the pharmaceutical industry to make sure that, in the event of a no-deal Brexit, which I regard as unlikely, we mitigate as much as possible the impact on the supply of medicines and that the supply of medicines can be unhindered.

[Kevin Hollinrake (Thirsk and Malton) (Con)]

Will my hon. Friend, the Minister with responsibility for antimicrobial resistance, consider a 10% levy on antibiotics? If such a levy were applied globally, it would raise £3 billion a year, which is the amount specified in the O’Neill review to fund research into this area properly.

[Steve Brine]

I thank my hon. Friend for his consistent work in this area. Stimulating the pipeline for new antimicrobials and alternative treatments is a complex matter. I can assure him that we continue to work with our international partners—I mentioned the G20 earlier —and that absolutely involves market entry awards, which, as he knows, is a global problem that requires a similar solution.

Social Care Funding

Kevin Hollinrake Excerpts

Wednesday 17th October 2018 Commons Chamber

[Barbara Keeley]

We have indeed been doing more work on this, but we laid out in our manifesto—the hon. Gentleman’s party did not—what our future plans for social care funding were. We said what the three options for funding social care were and that it would either be one of those three options, or perhaps a combination of all three—I think that the party that is being left behind here is his.

The impact of social care cuts means that less care is now available for older and younger adults alike. Four hundred thousand fewer older people got publicly funded care in 2015 than in 2010, and 1.4 million older people now have unmet social care needs. Put simply, that is over 1 million people who are not getting help with washing, dressing, going to the toilet, making meals or taking medication.

[Kevin Hollinrake (Thirsk and Malton) (Con)]

The hon. Lady mentions the plans in the Labour party’s manifesto, but since then the Health Committee and the Communities and Local Government Committee have produced a joint report on the future funding of adult social care that unanimously recommends adoption of the German-style social insurance system. Will Labour consider those recommendations? Is she minded to support that cross-party recommendation?

[Barbara Keeley]

The hon. Gentleman asked me the same question six months ago, on our last Opposition day debate on this subject, and I will give him the answer I gave him then: he should really be trying to influence his own party. I thank those Committees for the work they did, as the Prime Minister did today. Labour has got as far as producing a White Paper—not a Green Paper. We have a 2010 White Paper, and I have a copy with me. I recommend that Conservative Members who keep asking about this look at the extensive proposals in that White Paper, which followed a Green Paper and an extensive consultation. The party being left behind is the Conservative party.

--- Later in debate ---

[Barbara Keeley]

I very much do and thank my hon. Friend for making that point. There is a great place for co-operatives and mutuals and other such organisations. Organisations like Shared Lives are producing outstanding care in some parts of the country, and we must look at all those models.

I want to talk about hard-pressed family carers, because the situation of less care and lower quality care means that family carers are under pressure as never before to step in and provide care. The strain of caring has seen almost three quarters of carers suffer mental ill health and nearly two thirds suffer physical health problems, according to Carers UK. But too few carers can access respite from caring; they are at breaking point.

Problems with poor care quality and a lack of support were highlighted earlier this year in a report by Age UK entitled, “Why call it care when nobody cares?” At the launch of that report, both I and the Care Minister heard from carers like Joyce. At 73, Joyce cares full-time for her husband David who has had a stroke and a massive brain haemorrhage. Joyce has to do everything for David to make sure he is

“clean and comfortable at all times”.

That involves regularly lifting him in and out of his bed or chair to wash him, or take him to the toilet, throughout the day and night. She said:

“It is extremely hard to get good respite care where we live in Cheshire. Our local care home is no longer an option due to being cut as a provider by the local council. I had to fight tooth and nail for the care David currently gets in a day centre—but it just isn’t enough.

I don’t know how I’ll continue to cope without more support and regular respite breaks. Our care was cut in March, the third time that we have had respite care pulled. I am so angry and frustrated, I am so worried at what is facing us at the moment I hardly dare think about it.”

What carers like Joyce need is comprehensive support and carers breaks to allow them to look after themselves as well as the person they care for. What they have received from the Government is the damp squib of a “carers action plan” in place of a proper national strategy.

Labour has already pledged to deliver a national carers strategy as we did with our second national strategy in 2009. That national carers strategy pledged £150 million of funding for respite care breaks for carers. That funding has now disappeared into a black hole in the better care fund, leaving carers like Joyce to fight “tooth and nail” to get any respite at all.

[Kevin Hollinrake]

rose—

[Barbara Keeley]

I must make progress.

For care staff, the combination of cuts to social care funding and increasing demand for care has created the perfect storm of pressures, affecting the quality of care. Care staff themselves are reporting seeing a major decline in standards of care over the past couple of years.

Kim, one member of care staff, told her trade union, Unison, that she

“found it increasingly difficult to provide a good standard of care because of staff shortages and the greater need of clients. Often visits to clients have to be rushed, making medication mistakes by staff more commonplace and no social time for clients.”

Another care home staff member from Lancashire said that

“a lot of the time it feels like we are operating a ‘people warehouse’ and just offering the basics of feeding and personal care.”

I find those comments deeply troubling. They show the direct human impact that the underfunding of social care is having. Staff are rushing from one appointment to another, with no time to talk. They are being seen as

“heartless robots as opposed to a lifeline service”.

That is how one care home staff member described her job. Care staff are some of the most dedicated and highly skilled workers in this country, but these pressures, added to their pitifully low pay and their poor terms and conditions, are driving people from a sector where they have never been needed as much as they are now.

The care sector is teetering on the edge of a cliff. Without an urgent response from the Government, it could topple altogether. Ministers in this place talk glibly about making hard choices, but the truth is that this Government have chosen to pursue austerity on the backs of older people and vulnerable adults, who rely on social care. If austerity is now over, as the Prime Minister has claimed, the Government must put in the funding that social care needs to bring it back from the brink.

At last year’s election, Labour outlined a plan to invest an additional £8 billion in the social care system. We want to lift the quality of care and to lift access to care and support for carers before moving on to build our new national care service, as outlined in our White Paper. The Prime Minister said last year that the Government would act. They must now commit to a sustainable long-term funding plan. I urge hon. Members to vote for our motion tonight, to ensure that the Government honour the Prime Minister’s promise, because the people who need care, their family carers, and the care staff who care for them deserve better than this.

--- Later in debate ---

[Matt Hancock]

Yes; I enjoyed reading that report on my summer holidays and thought the research that underpinned it was very interesting. Of course, the taxpayer does contribute to the system, but we cannot rely only on the taxpayer to support the growing cost. Some people propose the answer that the taxpayer should simply fund everything, but I do not think that that is a valid solution.

Alongside the reforms to the funding, we need to transform our care system, so we will look into how the Government can support innovation and encourage new models of care provision. That will include looking at the role of housing and how we can replicate the very best models that combine a home with quality of care. For instance, I love the examples of combing care provision for the young and the old. I pay tribute to the doctors behind the “Old People’s Home for 4 Year Olds” project, which is good viewing on Channel 4. We also need to better support people through well-designed aids and adaptations, and we must ensure better support for carers, too.

[Kevin Hollinrake]

The Secretary of State is making some good points, but may I press him on the point made by my hon. Friend the Member for Northampton South (Andrew Lewer) about the social insurance recommendation in the Select Committee report? The shadow Minister refused to confirm whether she would consider the findings in that report; will the Secretary of State agree at least to consider the proposals and recommendations that were delivered on a unanimous cross-party basis?

[Matt Hancock]

Yes, absolutely. I am considering them. In fact, I shall go further and say that I am attracted to the insurance and contribution model. There are many different potential details in how such a model can be delivered, but I am very much taking that Select Committee report into consideration as we draft the Green Paper.

Alongside ensuring that the funding is in place, we need to make sure that we support carers. In June, we published the carers action plan, a two-year package of support for carers to ensure that they are properly recognised, helped and valued in a way that supports their health and wellbeing. The Green Paper will go further and propose how society can strengthen support for carers as a vital part of a sustainable health and social care system.

The guiding principles behind the Green Paper will be sevenfold: first, improving the quality and safety of care; secondly, integrated care, with the NHS and social care systems operating as one; thirdly, giving the highest possible control to those receiving support; fourthly, better practical support for families and carers; fifthly, a sustainable funding model supported by a diverse, vibrant and stable market; sixthly, greater security for those born with care needs or who develop those needs in later life; and seventhly, a valued NHS and social care workforce. Those will be the principles behind the Green Paper, and I hope that we can build cross-party support for it.

As a society, we need to rise to the unprecedented social care challenge that our generation faces. For the sake of future generations, we must act now to build a better and more sustainable social care system, in the short term and the long term, that ensures that people are properly valued: a system both for those in need of care and for their carers, a system that supports carers—not only those who work in care homes but those who care for loved ones at home—and with the goal of building a sustainable health and social care system of which we can all be proud.

--- Later in debate ---

[Kevin Hollinrake (Thirsk and Malton) (Con)]

A former US President once said that there are no easy solutions, but there are simple solutions. What we need to solve this problem is a simple, scalable and sustainable solution.

Ideally, when people look for a solution, they try not to invent a new one but to find one that somebody has already used for that problem. That is exactly what the Joint Select Committee inquiry did. It looked at the German system. We looked at it twice, in our earlier report and in the joint report between the Health and Social Care Committee and the Housing, Communities and Local Government Committee. We looked at it cross-party and unanimously came to the conclusion that this was the right solution for us. It is a social insurance, not a tax.

The hon. Member for Central Ayrshire (Dr Whitford) mentioned that national insurance would be a suitable vehicle. National insurance went the same way as every other hypothecated tax—it was spread around general taxation. That is not the right way; it must be separated from government.

This solution is simple and scalable. It is not easy, but it is simple and cross-party, and I very much hope that both the Opposition and the Government will support it.

Baby Loss Awareness Week

Kevin Hollinrake Excerpts

Tuesday 9th October 2018 Commons Chamber

[Victoria Prentis (Banbury) (Con)]

Thank you for letting me speak early in the debate, Madam Deputy Speaker. I should start by apologising for the fact that I have an unbreakable commitment elsewhere and have to leave before the end of the debate. It is the debate that I dread most during the year, but it is also one of which I am determined to be part.

It is a great honour to follow both the Members who have spoken so far, to speak in a debate that marks the beginning of Baby Loss Awareness Week and to serve as vice-chair of the merry band—largely—of people who form the all-party parliamentary group. We have been brought together by horrific circumstances, but we have had extraordinary success. There are hundreds of all-party parliamentary groups, perhaps even 1,000, but very few can boast the success that we have had in the past three years. We have really put baby loss on the agenda, and we have changed the law on, for example, parental bereavement leave.

[Kevin Hollinrake (Thirsk and Malton) (Con)]

Hear, hear.

[Victoria Prentis]

I gesticulate at my hon. Friend, who has joined us so enthusiastically in championing that issue.

We would not be where we are today were it not for the support that we have received from the Government, especially the Ministers in the Department of Health and Social Care, and, indeed, the hard work of the charities that work with us. This year is particularly special for Sands, which is celebrating its 40th anniversary. I am very proud of my constituent Karen Hancox, who has worked so hard for Sands in Oxfordshire since losing her first daughter, Kayleigh, in 2008. She was responsible for lighting up Banbury cross in memory of Baby Loss Awareness Week last year, and she also helped with the fantastically helpful service in St Mary’s, Banbury last year, which we are repeating this Sunday, and at which I hope any hon. Member passing on the M40 will join us.