Oral Answers
Lindsay Hoyle Excerpts(1 year, 7 months ago)
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Steve Barclay
The hon. Gentleman is right that we should narrow the health inequalities gap, and we are committed to doing that. That is why in the women’s health strategy, which I set out in the summer, we committed to having women’s health hubs as one-stop shops to tackle some of the gender inequality. It is also why, whether on obesity, smoking or lung cancer, we are targeting our screening and public health interventions to close the gap, which he is quite right to highlight.
Andrew Gwynne (Denton and Reddish) (Lab)
The Secretary of State is absolutely right: we should be narrowing the health inequalities in this country. It is just a shame that, on his watch, we are not. A baby born in Blackpool today will live eight years less than a baby born in Kensington. Under this Tory Government, health inequalities have widened in many parts of the country. They have scrapped their health disparities strategy and cut the number of health visitors by a third, and ordinary families are paying the price. Why does the Secretary of State not get a grip, adopt Labour’s plan to scrap the non-dom tax status and train 5,000 new health visitors, so that every child has a healthy start to life?
Helen Whately
I can assure the hon. Member that not a penny of funding is being cut from adult social care. We are driving forward our reforms to the adult social care system, which have the workforce at their heart. We are introducing a new career path for the social care workforce, new care qualifications and new training, boosting the adult social care workforce and making sure people in that workforce get the recognition and rewards they deserve.
Liz Kendall (Leicester West) (Lab)
The Minister says this Government back social care—I would love to see what the reality would be if they were against it. We already know that the Conservatives have completely failed to deliver their flagship policy of a cap on care costs, and over Easter we learned that they have broken the rest of their promises on social care too. The £500 million promised for the care workforce has been cut in half; the £300 million promised for housing in care has been slashed by two thirds; and as for the £600 million of other promises, your guess is as good as mine, Mr Speaker. They have not had the courage to announce this to Parliament or the nous to grasp that if people are not kept in their own homes, they end up stuck in hospital, with all the knock-on consequences for NHS waiting times and emergency care. Will the Minister tell us where all that money has gone? Why on earth should older and disabled people and their families ever believe the Conservatives on social care again?
Neil O’Brien
Absolutely. In total, public health grants will go up by 5% in real terms over the next two years. We want to reduce the postcode variation, because these are important services. I am keen to speak to anyone who wants to work with us at a local level.
Martyn Day (Linlithgow and East Falkirk) (SNP)
Welcome as the UK Government’s recent announcement is to help more people in England to quit smoking, the Khan review’s key recommendation to increase investment in smokefree policies, making the polluter pay by raising tobacco duty, was not mentioned. Product duty, as we all know, is a wholly reserved matter, so what representations have been made with Cabinet colleagues about implementing that recommendation to improve public health outcomes across all four of our nations?
Steve Barclay
I know we have clinicians in the House who do second jobs, but I did not know that the hon. Lady had expanded that definition to such an extent! She is right to highlight, through her survey, the importance of timely care. There is currently a range of initiatives, such as the development of the NHS app, the review of the 111 service, and the examination of innovations such as artificial intelligence. We are looking into how we can manage demand in the case of, in particular, frail elderly people by noting changes in behaviour patterns, which will allow us to ensure that, for example, someone who has a fall at home receives care much earlier before arriving in the accident and emergency department, because we know that once frail elderly people have been admitted they will often be in hospital for about 14 days. The hon. Lady has raised an extremely important issue through her survey, and one on which we are focusing in our urgent and emergency recovery plan.
Steve Brine (Winchester) (Con)
That urgent and emergency care plan, which was announced in January, was received with acclaim by me and, indeed, with wide acclaim. It was described as a two-year plan to stabilise services by, for instance, returning to the A&E target that the Secretary of State has mentioned. What assessment has he made of the impact of the ongoing industrial dispute among the Agenda for Change cohort, and, of course, the junior doctors, on the delivery of the plan?
Steve Barclay
To be honest, I think the position is mixed. In certain areas we have seen significant improvements in performance: the faster diagnosis standard, for example, was hit for the first time this month. Purdah prevents me from going into the details of the 78-week wait, but I expect to be able to update the House very soon on the progress that has been made. As the hon. Gentleman says, there are still challenges as a consequence of the pandemic, but we are seeing much more progress than the NHS in Wales, and it is also worth reminding the House that, through Barnett consequentials, the Welsh NHS receives more funding that the NHS in England.
Dr Rosena Allin-Khan (Tooting) (Lab)
This may surprise you, Mr Speaker, but I have found evidence that the Health Secretary has got something right. He recently hailed the power of local news outlets, and he was spot on. I have here a story from his local paper, exposing the shocking length of waits in A&E for those in a mental health crisis: 5.4 million hours across England in just one year. He is very welcome to have a look if he would like to. Given his admiration for local journalism, does he feel embarrassed for his Government’s failings and will he apologise to all the people across the country who are stuck waiting in A&E?
Will Quince
You do, too. Mine were not through IVF, but as a Back Bencher I also campaigned on IVF issues, because there was a postcode lottery on that around the country. That still exists to some extent and I would be happy to work with my hon. Friend to make sure that wherever people are in this country they can get IVF services.
Wes Streeting (Ilford North) (Lab)
The Conservatives have cut 2,000 GPs since 2015 and now too many patients cannot get an appointment when they need one: 3,000 patients are waiting a month to see a GP in Dover; 3,500 are doing so in Mansfield; 3,500 are doing so in North Lincolnshire; and 5,000 are waiting a month in Swindon. So why will the Government not adopt Labour’s plan to double the number of medical school places, paid for by abolishing the non-dom tax status, so that patients have the doctors they need to get treated on time?
Steve Barclay
My hon. Friend makes a brilliant point, and that is something that we are committed to doing. There is a huge amount of expertise within the pharmacy network, which is why we are looking, through technology such as the NHS app, at how we can better enable people to get the right care from the right place at the right time. Quite often, that is not by seeing the GP, but it might be by seeing those in additional roles in primary care or going to a pharmacist who can offer the right services.
Wes Streeting (Ilford North) (Lab)
A 13-year-old girl who has already waited more than a year for spinal surgery has seen her operation cancelled twice because of the Government’s failure to negotiate an end to the junior doctors’ strike. Why on earth is the Secretary of State still refusing to sit down and negotiate with junior doctors?
Steve Barclay
It is slightly odd that the hon. Gentleman talks about 13 years when we are actually talking about a current industrial dispute. We have shown, through our negotiation with the NHS Staff Council, our willingness to engage and to reach a settlement. Indeed, the general secretary of the RCN recommended the deal from the AfC unions to her members. Unison—the union of which the hon. Gentleman is a member—voted for the deal by a margin of 74%. We stand ready to have engagement with the junior doctors, but 35% is not reasonable. He himself has said—[Interruption.]
Mr Speaker
Order. I do not need the Minister for Social Care, the hon. Member for Faversham and Mid Kent (Helen Whately), shouting from the end of the Treasury Bench. Okay? I call Henry Smith.
The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)
Successfully containing antimicrobial resistance requires co-ordinated action across all sectors. That is why the UK takes a “one health” national approach to AMR across humans, animals, food and the environment. Since 2014, the UK has reduced sales of veterinary antibiotics by 55% and has seen a decrease in antimicrobial resistance as a result.
Martyn Day (Linlithgow and East Falkirk) (SNP)
The British Medical Journal has warned that the comprehensive and progressive agreement for trans-Pacific partnership trade deal will make it harder for the UK to regulate tobacco and alcohol or banned products such as those containing harmful pesticides. Given that no health impact assessment has been carried out, The BMJ recommends that one should be performed now. Will the Secretary of State commit to assessing the deal’s threat to public health?
Neil O’Brien
I am very happy to meet the right hon. Lady as we work towards the workforce plan and the dental plan.
Mark Fletcher (Bolsover) (Con)
The Minister is aware that BUPA recently closed the dental practice in Bolsover, leaving a severe shortage of NHS dentistry in the constituency. I met the ICB yesterday to discuss the various options for the constituency, but will the Minister commit to meeting me and the ICB to talk through those options and see what we can do to maintain NHS dentistry in Bolsover?
NHS Strikes
Lindsay Hoyle Excerpts(1 year, 7 months ago)
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Steve Barclay
The shadow Secretary of State seems to ignore the fact that we have negotiated a deal with the NHS Staff Council, and it is a deal that it has recommended to its members. Indeed, the largest health union has voted in favour of the deal—indeed it is his own health union that has voted in favour of it—and yet he seems to suggest that we should tear it up even though other trade unions are voting on the offer, and their leadership had recommended it.
Secondly, the shadow Secretary of State says that we should sit down and negotiate. We have made an offer of 10.75% for last year, compared with the Labour Government in Wales, who have offered just 7.75%, which means that, in cash terms, the offer in England is higher than that put on the table by the Welsh Government, whom, I presume, he supports. He says that he does not support the junior doctors in their ask of 35%, and neither does the leadership there. We need to see meaningful movement from the junior doctors, but I recognise that they have been under significant pay and workforce pressures, which is why we want to sit down with them.
The bottom line is that the deal on the table is reasonable and fair. It means that just over £5,000 across last year and this year will be paid for a nurse at the top of band 5. The RCN recommended the deal to its members, but the deal was rejected by just under a third of its overall membership. It is hugely disappointing that the RCN has chosen not to wait for the other trade unions to complete their ballot and not to wait for the NHS Staff Council, of which it is a member, to meet to give its view on the deal. It has chosen to pre-empt all that not only with the strikes that come before that decision of the NHS Staff Council, but by removing the derogations—the exemptions—that apply to key care, including emergency care, which is a risk to patient safety.
Trade unions are continuing to vote on the deal. The deal on the table is both fair and reasonable, including just over £5,000 across last year and this year for nurses at the top of band 5. The deal has been accepted by the largest union in the NHS, including, as I have said, the shadow Health Secretary’s own trade union. It pays more in cash to Agenda for Change members than the deal on the table from the Labour Government in Wales. It is a deal that the majority of the NHS Staff Council, including the RCN’s own leadership, recommended to its members. We have always worked in good faith to end the disruption that these strikes have caused and we will continue to do so. None the less, it is right to respect the agreement that we have reached with the NHS Staff Council and to await its decision, which is due in the coming weeks.
Steve Brine (Winchester) (Con)
Reports over the weekend suggest that the British Medical Association has asked its members not to engage with trusts if they intend to strike, as the Secretary of State has confirmed today. That is putting trust chief executives—and this is not their fault—in an impossible position. They are being asked to meet very challenging targets that we are rightly setting them, not least with respect to the covid backlog. What more can he do by his good offices to break that impasse? It is patients who are losing out.
NHS Strikes
Lindsay Hoyle Excerpts(1 year, 9 months ago)
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Will Quince
I am not going to engage in the playing of party politics on this. The hon. Gentleman already knows that the Secretary of State is due to attend a Cobra meeting, which he and I rotate, and the hon. Gentleman may have missed it, but this morning the Secretary of State did do a media clip, and Members will have seen that across multiple outlets.
Where I do agree with the hon. Gentleman is that he is right to talk about the amazing job that our NHS colleagues do on the frontline. I know he does that, and I thank him for that, but that is even more reason why we must find a fair resolution, and NHS colleagues certainly will not get one from those on the Opposition Benches. The Opposition say that they back the independent pay review process, while disagreeing with the body’s decision when it does not suit them. They say they would not increase public spending, while failing to set out any plans for how they might pay for unaffordable pay increases. They say they believe in public safety, too, while criticising the common-sense steps we are taking to ensure safe minimum staffing levels, just as they do in many other European countries. We have got a plan—they do not.
More than 1 million NHS staff have been given at least a £1,400 increase in their pay, representing a 9.3% rise for those on the lowest salaries. NHS staff also received a 3% pay rise last year—even when pay was frozen across the rest of the public sector. We have done this because we know how hard NHS colleagues work and we recognise that there are cost of living pressures on NHS staff.
Our goal has always been a resolution that is fair for colleagues and for the country: to find a way forward that ensures we are spending money where it is needed most, and helping the NHS to recover from the pandemic, but not on pay hikes that would stoke inflation and ultimately make us all poorer. I met GMB members last week, and—together with my ministerial colleagues—I remain fully committed to working together with the unions, the NHS and others to find a responsible and fair way forward.
Steve Brine (Winchester) (Con)
The NHS Pay Review Body was in front of my Select Committee last week, but it will not produce its report for 2023-24 until the end of April. Surely the longer this process goes on, the slower the resolution will be for those on Agenda for Change. Does the Minister agree that a much earlier remit letter would have been helpful, and when does he expect the Department to produce its evidence to this year’s pay review body round?
Urgent and Emergency Care Recovery Plan
Lindsay Hoyle Excerpts(1 year, 9 months ago)
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The Secretary of State for Health and Social Care (Steve Barclay)
Today we have published our new delivery plan for recovering urgent and emergency care services, which has been deposited in the Libraries of both Houses. Given the scale of the pandemic pressures that healthcare systems around the world and across the UK are collectively facing, we are building the NHS back to where we want it to be. That requires the widespread adoption of innovation, building on best practice already applied in specific trusts, together with significant investment in new ways of working, including a £14.1 billion funding boost for health and social care, as set out in the autumn statement.
Today’s announcement is the second of three plans to cut waiting times in the NHS. Our elective recovery plan is already in action, virtually eliminating the backlog of two-year waits in England. Our primary care recovery plan will be published in the next few weeks, to support the vital front door to the NHS through primary care. Today, together with NHS England, we are setting out our plans to reduce waiting times in urgent and emergency care through an increased focus on demand management before patients get to hospital, and greater support to enable patients to leave hospital more quickly through care at home or in the community, supported by a clinical safety net. In addition, the plan sets out how we will adopt best practice in hospitals by learning from the trusts that have displayed the greatest resilience in meeting the heightened pressures this winter.
Today’s announcement on urgent and emergency care does not sit in isolation, but is part of a longer-term improvements plan that builds on the legislative change enacted last year to better integrate health and social care through the 42 integrated care boards, which became operational in July. That was prioritised for additional funding through the £14.1 billion announced for health and social care in the autumn statement. Following the quick spike in flu cases over Christmas, with in-patient flu admissions 100 times that of the previous year and a sevenfold increase in December, we announced £250 million of immediate funding on 9 January for the pressures this winter, giving extra capacity to emergency departments to tackle the issue of patients who are fit to leave hospital but are delayed in doing so.
Today’s plan, developed in partnership with NHS England and social care partners, builds on the actions and investment that I set out to the House earlier this month as we put in place the more substantive changes required to enable the NHS to have greater resilience this time next year. To do that, this plan involves embracing technology and new ways of working to transform how patients access care before and after being in hospital. That in turn will help to break the cycle of emergency departments in particular coming under significant strain in winter.
Our plan has a number of commitments that are both ambitious and credible. First, we are committing to year-on-year improvement in A&E waiting times. By next March, we want 76% of patients to be seen within four hours. In the year after that, we will bring waiting times towards pre-pandemic levels. Our second ambition is to improve ambulance response times, with a specific commitment to bring category 2 response times—those emergency calls for heart attacks and strokes—to an average of 30 minutes by next March. Again, in the following year we will work to bring ambulance response times towards pre-pandemic levels. I am pleased that the College of Paramedics has welcomed the plan, saying that it is
“pleased to see a strong focus in the recovery of those people in the Category 2 cohort”.
Of course, this will not be the limit of our ambition, but it is vital that we get these first steps right and that we are credible as well as ambitious. To put these targets in context, achieving both would represent one of the fastest and largest sustained improvements in the history of the NHS.
Underpinning these promises is one more essential commitment: a commitment to better data and greater transparency. On data, the best-performing hospitals have benefited from the introduction of patient flow control centres to quickly identify blockages in a patient’s journey, and e-bed management systems to speed up the availability of beds when they become free. Through this plan, we will prioritise investment in improving system-wide data, both within the integrated care boards and on an individual trust and hospital site basis. This will allow quicker escalation when issues arise and a better system-wide response when individual sites face specific challenges.
On greater transparency, for some time voices across the NHS have called for the number of 12-hour waits from the time of arrival in A&E to be published. This is something I know the Royal College of Emergency Medicine has long campaigned for—I can see the hon. Member for St Albans (Daisy Cooper) nodding her head—and there has been criticism of the Government, including from Opposition Members, for refusing to provide this transparency. Instead, the data published to date has been a measure of 12 hours from the point of admission rather than from arrival in A&E. For the commitment to transparency to be meaningful, we must be prepared to publish data, even when that transparency will bring challenges, so today I can inform the House that from April we will publish the number of 12-hour waits from the time of arrival. Dr Adrian Boyle, the president of the Royal College of Emergency Medicine, has previously said:
“The full publication of this data will be an immensely positive step that could be the catalyst for transformation of the urgent and emergency care pathway that should help to improve the quality of care for patients.”
I hope this transparency will be welcomed across the House.
Our plan focuses on five areas, setting out steps to increase capacity in urgent and emergency care; grow the workforce; speed up discharge; expand and better join up new services in the community; and make it easier for people to access the right care. Action in each area is based on evidence and experience, learning lessons from the pandemic and building on what we know can work. More than that, we are backing our plan with the funds we need, and the Government are committing to additional targeted funding to boost capacity in acute services and the wider system. That is why this package includes £1 billion of dedicated funding to support hospital capacity, building on the £500 million we have provided over this winter to support local areas to increase their overall health and social care capacity.
Taken together, this plan will cut urgent and emergency care waiting times by, first, increasing capacity with 800 new ambulances on the road, of which 100 are new specialised mental health ambulances. This comes together with funding to support 5,000 new hospital beds, as part of the permanent bed base for next winter.
Secondly, we are growing and supporting the workforce. We are on track to deliver on our manifesto commitment to recruit more than 50,000 nurses, with more than 30,000 recruited since 2019. The NHS will publish its long-term workforce plan this year. We are also boosting capacity and staff in social care, supported by investment of up to £2.8 billion next year and £4.7 billion in the year after.
Thirdly, we are speeding up the discharge of patients who are ready to leave hospital, including by freeing up more beds with the full roll-out of integrated care transfer hubs, such as the successful approach I saw this morning at the University Hospital of North Tees.
Fourthly, we are expanding and better connecting new services in the community, such as joined-up care for the frail elderly. This includes a new falls service, so that more elderly people can be treated without needing admission to hospital.
Virtual wards are also showing the way forward for hospital care at home, with a growing evidence base showing that virtual wards are a safe and efficient alternative to being in hospital. We aim to have up to 50,000 people a month being supported away from hospital, in high-tech virtual wards of the sort that Watford General Hospital has been pioneering, as I saw last month.
Finally, we are improving patient experience by making it easier to access the right care, including a better experience with NHS 111 and better advice at the front door of A&E, so that patients are triaged to the right point in the hospital without always needing to go through the emergency department—this new approach can currently be seen at Maidstone Hospital, as I saw earlier this month.
These are just some of the practical improvements already being delivered in a small number of trusts that, through this plan, we will adopt more widely across the NHS and, in doing so, deliver greater resilience ahead of next winter.
I am pleased that NHS Providers has welcomed today’s plan, and that the Royal College of Emergency Medicine has called it
“a welcome and significant step on the road to recovery”.
Taken together with all the other vital work happening across health and care, including our plan to cut elective and primary care waiting times, today’s plan will enable better care in the community and at home, for that care to be more integrated with hospital services and for existing practice to be more widely adopted. I commend this statement to the House.
Steve Barclay
The hon. Gentleman started by thanking me for advance sight of the statement, and then he made a series of remarks that simply ignored what was in it. Even his last point shows how riddled with contradictions the Opposition’s approach is. He says in interviews that he supports the pay review body process—that is the official position, or at least it was—but then he says, “No, we should be negotiating individually with the trade unions and disregarding the pay review process.” There is no consistency on that at all.
The shadow Secretary of State talks about operational performance—[Interruption.] He has just had his go; he should listen to the answers. He says that it is about operational performance, but in my remarks I tried to be fair and said that these are challenges that are shared across the United Kingdom and globally. He seems to think that they are unique to England alone. We need only look at Wales to see that more than 50,000 people—notwithstanding the fact that Wales has a smaller population—are waiting more than two years for their operations, when we cleared that figure in the summer in England, leaving fewer than 2,000 in that cohort.
The shadow Secretary of State talks about the workforce. Obviously, he did not bother to read or listen to what was said in the statement. We are on track to deliver our manifesto commitment of more than 50,000 nurses. We have more than 30,000 so far. We have 10,500 more nurses in the NHS this year compared with last year. The grown-up position is to recognise—[Interruption.] Well, in the first five years we were dealing with what that letter said, which was that there was no money left. [Interruption.] Labour Members just do not like the response, but the facts speak for themselves. We have 10,500 more nurses this year than last year. The grown-up position, as I was saying, is to recognise that we have an older population with more complex needs, and that the consequences of the pandemic are severe—they are severe not only in England, but across the United Kingdom, in Wales and Scotland, and indeed in countries around the globe.
The shadow Secretary of State says that the statement did not cover the plan for GPs. Well, again, I was clear that this was one of three plans. We had the elective plan in the summer, which hit its first milestone. We have the second component today on urgent and emergency care, and we will set out in the coming weeks our approach to primary care. That is the approach that we are taking. [Interruption.] The shadow Secretary of State keeps chuntering. We did not have the pandemic 13 years ago. [Interruption.] I can only surmise that he did not get his remarks quite right the first time, which is why he feels the need to keep chuntering now and having a second, third and fourth go—perhaps next time.
On ambition, the shadow Secretary of State ignores the fact that we need to balance being ambitious with being realistic. These metrics, in the view of NHS England, show the fastest sustained improvement in NHS history. Clearly, his remarks are at odds with NHS England.
On funding, we are putting an extra £14.1 billion of funding into health and social care over the next two years, which reflects the fact that the Chancellor, notwithstanding the many competing pressures he faced at the autumn statement, put health and social care, alongside education, as the key areas to be prioritised.
On virtual wards, I had not quite realised that the shadow Secretary of State was the clinician who had invented virtual wards. I think that the credit for virtual wards actually goes to the staff, such as those I met at Watford, who are driving forward that innovation. It is slightly strange that he sometimes wants to claim ownership of something that has been clinically led by those working on the frontline. We have recognised the value of virtual wards, which is why, at North Tees this morning, at Watford last month, or on various other visits, I have been discussing how to scale up those plans.
Steve Brine (Winchester) (Con)
We look forward to going through the plan in detail with the Secretary of State when he speaks to the Select Committee tomorrow. May I just ask him about the ambition on the two-hour response to falls at home of the frail and elderly to prevent them from being admitted into the acute sector? Obviously, he will know that that was committed to in the long-term plan. What does he need to put that ambition into practice?
Oral Answers to Questions
Lindsay Hoyle Excerpts(1 year, 10 months ago)
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Steve Barclay
I welcome my hon. Friend’s drawing attention to the investment that has been made, which is in no small part due to his campaigning and championing his constituents, as he does so assiduously. I think the Minister of State, Department of Health and Social Care, my hon. Friend the Member for Colchester (Will Quince) has plans to join him to mark the opening of that important facility, which shows our investment in the estate within the NHS.
Gareth Thomas (Harrow West) (Lab/Co-op)
One way to improve retention and recruitment of NHS staff at Northwick Park Hospital, which serves my constituency and which I believe the Secretary of State visited last Thursday, would be to invest in doubling its intensive care beds. Did the Secretary of State discuss that issue with the chief executive of Northwick Park when he visited last week? Will he tell us when he might be able to announce funding for the new 60-bed unit that Northwick Park needs?
Steve Barclay
The hon. Gentleman is right to highlight the importance of bed capacity at Northwick Park, but my discussions with the chief executive were more in the context of how step-down capacity will relieve pressure on A&E. The hon. Gentleman will know that Northwick Park has one of the busiest, if not the busiest, A&Es in London on many days, and the chief executive spoke to me about the value of adding extra bed capacity from a step-down perspective, much more so than from an intensive-care perspective. If there are specific issues for intensive care, I am happy to follow them up with the hon. Gentleman.
Dr Rosena Allin-Khan (Tooting) (Lab)
In mental health we rely on staff, not shiny machinery, so why is the Secretary of State rehashing old announcements and scrapping plans? It is because the Government have run out of ideas. Labour has a plan. We will recruit 8,500 more mental health professionals, ensuring a million more patients get treated every year. We will double the number of medical school places. We will train 10,000 extra nurses and midwives every year, and we will focus on retaining the fantastic staff we already have. Where is the Government’s plan? We have had our plan for two years, but they are binning theirs.
Maria Caulfield
I thank my hon. Friend, who has always been campaigning for better health services in Kettering. Let me reiterate what he has just said: that announcement followed the announcement last week of £10 million for NHS breast screening services, to provide 29 new mobile units and static breast care units across England.
Feryal Clark (Enfield North) (Lab)
The women’s health strategy was an opportunity to fundamentally change the inequalities women face. Women were promised a clinical women’s health lead in the NHS, yet a former Health Minister, the hon. Member for Sleaford and North Hykeham (Dr Johnson), admitted that there has not even been a discussion about establishing the role. Women in east Kent were promised change after the damning review of local maternity services, yet the Care Quality Commission is now threatening the trust there with enforcement action. Time after time, women’s voices are at best being ignored and at worst being silenced. So I ask the Minister: when will this Government stop letting women down with empty promises? Is the women’s health strategy worth the paper it was written on?
Maria Caulfield
Perhaps the shadow Minister will reflect on her comments when she receives the “Dear colleague” letter later today outlining the eight priorities areas for our first year of the strategy, with work such as the prepayment certificate for hormone replace treatment being done already; it is launching in April and saving women hundreds of pounds on the cost of HRT. May I say that I am gobsmacked by the Labour party’s position on this? Not only does it struggle most days to define what a woman actually is—for reference, it is a female adult human—but it cannot stand up for women either. There was no greater example of that than what we saw in this Chamber last week, when Labour Members were heckling the hon. Member for Canterbury (Rosie Duffield) and intimidating my hon. Friend the Member for Penistone and Stocksbridge (Miriam Cates). Come back to us when the Labour party is reflecting on the behaviour of its own MPs before dictating to us.
Mohammad Yasin (Bedford) (Lab)
Maria Caulfield
I am happy to write to the hon. Gentleman with that information. However, I must be clear that we planned for an increase in admissions this winter. That is why we got on and delivered on our plans for 7,000 extra beds, and why we brought forward our flu and covid vaccination programme and lowered the age of eligibility. There are a number of factors, and they are the same factors that have driven excess deaths across the United Kingdom and across Europe.
Andrew Gwynne (Denton and Reddish) (Lab)
There were 50,000 more deaths than we would otherwise have expected in 2022. Excluding the pandemic, that is the worst figure since 1951. The Health Secretary—part man, part ostrich—says he does not accept those figures, but as many as 500 people are dying every week waiting for essential care, and we are still getting the same old Tory denial and buck-passing. In her answer, will the Minister finally take some responsibility, accept the ONS excess deaths figure, and recognise the damage that she and her Government are doing to our NHS?
Helen Whately
If the hon. Gentleman had been listening to earlier questions, he would have heard about the increased number of GPs in England, with more than 2,000 more GPs now working in England. Coming to the question of the NHS in Scotland, which is of course run by the SNP-led Scottish Government, I have heard that NHS Scotland is “haemorrhaging” staff, in the words of the chair of the British Medical Association in Scotland.
Martyn Day (Linlithgow and East Falkirk) (SNP)
With more than 4,000 fewer specialist doctors from the EU or the European Free Trade Association in the UK than in pre-EU referendum trends, there is clear evidence that shutting off free movement is a totally unnecessary barrier to recruitment for our care and health services. Have the Minister and Secretary of State made representations to the Cabinet to discuss the disastrous effects of Brexit on the UK?
Will Quince
We are increasing capacity by introducing an additional 7,000 beds and the £500-million discharge fund. In addition to that, an extra £250 million was announced in January. Over and above that, alternative capacity is being created through the independent sector, we are engaging with patients on choice, and we are working with the most challenged trusts. Of course, I understand the impact that this has on patients, and we are working hard to address the backlog.
Liz Kendall (Leicester West) (Lab)
Ministers will never deal with the record waits for NHS treatment until they stop older people being stuck in hospital because they cannot get decent social care in the community or at home. Does the Minister understand that this is not just about getting people out of hospital, but about preventing them from being there in the first place? Is he aware that more than half a million people now require social care but have not even had their needs assessed or reviewed? Where on earth is the Government’s plan to deal with this crisis, which is bad for older people, bad for the patients waiting for operations and bad for taxpayers?
Steve Barclay
My hon. Friend makes an extremely powerful point. I hope the Labour-run NHS in Wales takes heed of her comments. She brings professional experience to this issue and is absolutely right that there needs to be investment in the NHS estate in Wales.
Wes Streeting (Ilford North) (Lab)
Labour founded the NHS to be free at the point of use, and we want to keep it that way. Given that the Prime Minister has advocated charging for GP appointments, and one of the Secretary of State’s predecessors has urged him to charge for A&E visits, will he take this opportunity to rule out any extension to user charging in the NHS?
The Parliamentary Under-Secretary of State for Health and Social Care (Neil O’Brien)
My hon. Friend is right. Although pharmacies are private businesses, we invest £2.5 billion in the clinical services they provide. We put in another £100 million in September so that they can provide more services. The number of community pharmacists is up by 18% since 2017, and we have introduced the pharmacy access scheme to ensure that we support pharmacies in areas where there are fewer of them. Clearly, the solution is for pharmacies to do more clinical work, take the burden off GPs and provide accessible services. That is exactly what we will keep growing.
Martyn Day (Linlithgow and East Falkirk) (SNP)
When I brought up pension tax rules in November, the Secretary of State agreed that pensions were an important issue and said that he would meet the Chancellor later that day. Can he give an update on the progress that his Cabinet colleagues are making to provide a permanent solution that will help retain NHS staff?
Neil O’Brien
Unlike the Opposition, we do not regard GPs’ finances as murky and we do not want to go back to Labour’s policy of 1934 by trying to finish off the business that even Nye Bevan thought was too left-wing. We do not believe in nationalising GPs; we believe in the current model. [Interruption.] We do not believe that people with a problem should immediately go to hospital, driving up costs and undoing the good work of cross-party consensus in the last 30 years. A plan that was supposed to cause a splash has belly-flopped.
Mr Speaker
Mr O’Brien, when I move on, I expect you to move on with me. I have all these Back Benchers to get in. I do not need the rhetoric; I want to get Members in—I want to hear them, not you.
David Linden (Glasgow East) (SNP)
Steve Barclay
The hon. Gentleman is just factually wrong. We have increased medical undergraduate places by a quarter—I was in the Department at the time the decision was taken—so he is wrong on the facts. We also need to look at new ways of getting medics in and having more diverse recruitment in relation to social profile. That is why the apprenticeship route is an extremely important one that I am keen to expand.
Steve Brine (Winchester) (Con)
The Select Committee looks forward to hearing about the major conditions strategy and engaging with it, as I hope Ministers will engage with our major prevention inquiry, launched last week. One of our national newspapers has contacted 125 acute trusts and asked them about visiting rights. Some 70% of them still have some form of restrictions in place, most commonly limiting the time that people can spend with their loved ones and the number of people who can sit by the bedside. On 19 May last year, the chief of NHS England said that we should return to pre-pandemic levels—
Mr Speaker
Order. The hon. Gentleman may be the Chair of the Select Committee, but I have to get other people in—it is not just his show.
The Minister of State, Department of Health and Social Care (Will Quince)
I thank my hon. Friend for his question. National NHS guidance is absolutely clear: providers are expected to facilitate visiting for patients in hospital wherever possible and to do so in a risk-managed way. It is up to individual providers—they do have discretion—but I understand the benefit that this brings to patients. It is a very important factor, and I will meet NHS England to discuss this further.
NHS Winter Pressures
Lindsay Hoyle Excerpts(1 year, 10 months ago)
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The Secretary of State for Health and Social Care (Steve Barclay)
Mr Speaker, I wish to take this first opportunity to update the House on the severe pressures faced by the NHS since the House last met. I and the Government regret that the experience for some patients and staff in emergency care has not been acceptable in recent weeks. I am sure that the whole House will join me in thanking staff in the NHS and social care who have worked tirelessly throughout this intense period, including clinicians in this House who have worked on wards over Christmas. They include my hon. Friend the Member for Lewes (Maria Caulfield), the Minister for mental health, and the hon. Member for Tooting (Dr Allin-Khan), the shadow Minister for mental health.
There is no question but that it has been an extraordinarily difficult time for everyone in health and care. Flu has made this winter particularly tough: first, because we are facing the worst flu season for 10 years—the number of people in hospital with flu this time last year was 50; this year, it is over 5,100. Secondly, it came early and quickly, increasing sevenfold between November and December. It also came when GPs and primary and community care were at their most constrained. When flu affects the population, it affects the workforce too, leading to staff sickness absence that constrains supply just as it also increases demand.
These flu pressures came on top of covid. Over 9,000 people are in hospitals with covid, while exceptional levels of scarlet fever activity and an increase in strep A have created further pressure on A&E. All that comes on top of a historically high starting point. We did not have a quiet summer, with significant levels of covid, and delayed discharges were more than double what they were during the pandemic. I put that in context for the House: in June 2020, there were just 6,000 cases per day of delayed discharge—patients medically fit and ready to leave hospital—whereas throughout last year the figure was between 12,000 and 13,000 per day. The scale, speed and timing of our flu season have combined with ongoing high levels of covid admissions in hospital and the pandemic legacy of high delayed discharge to put real strain on frontline services.
Since the NHS began preparing for this winter, there was a recognition that this year had the potential to be the hardest ever. That is why there was a specific focus on vaccination. There were 9 million flu shots and 17 million autumn covid boosters. We extended eligibility more widely than in the past, to cover the over-50s, and became the first place in the world to have the bivalent covid vaccine, which tackles both the omicron and the original covid strain.
NHS England also put in place plans for the equivalent of 7,000 additional beds, including the introduction of virtual wards of a sort that one can see at Watford General Hospital. That innovation is still at an early stage of development, but has the potential to be significant in reducing pressure on bed occupancy in hospitals; in Watford alone, it has saved the equivalent of an extra hospital ward of patients. In addition, our plan for patients put £500 million specifically into delayed discharge, with a further £600 million next year and £1 billion the year after. Although the funds are already starting to make a difference, efforts have taken time to ramp up operationally with local authorities and the local NHS.
In addition, our 42 integrated care boards, recognising how bed occupancy in hospitals and social care are connected, will fully integrate health and care in the years to come. But likewise, they are at an early stage of maturity, with ICBs having become fully operationalised only in July 2022, less than six months ago.
Our plans involving the integration of hospital care and social care, additional funding for discharge, increased step-down capacity, the equivalent of 7,000 additional hospital beds and a vaccination programme at scale have provided the groundwork for the Government response, but it is clear we need to do more right now in light of the level of flu and covid rates and given that hospital occupancy remains far too high and emergency departments are too congested. Recognising that, we launched the elective recovery taskforce on 7 December, and in the coming weeks, we will publish our urgent and emergency care recovery plans. NHS England and the Department of Health and Social Care have been working intensively over Christmas on these plans, which were reviewed with health and care leaders at an NHS recovery forum in Downing Street on Saturday.
The recovery falls into three main areas of work: first, steps to support the system now, given the immediate pressures we face this winter; secondly, steps to support a whole-of-system response this year to give better resilience during the summer and autumn—as we have seen with the heatwave this summer and with the levels of covid, pressure is now sustained throughout the year, not just, as in the past, during autumn and winter; and, thirdly, our work alongside those two areas on prevention, on maximising the step change potential of proven technologies, such as virtual wards, and on the wider adoption of innovations such as operational control centres and machine reading software to treat more conditions in the community, away from someone reaching an emergency department in the first place.
Let me first set out the measures I can announce today to provide support to the NHS and local authorities now. First, we will block-book beds in residential homes to enable some 2,500 people to be released from hospitals when they are medically fit to be discharged. When that is combined with the ramping up of the £500 million discharge funding, which will unblock an estimated 1,000 to 2,000 delayed discharge cases, capacity on wards will be freed up, which will in turn enable patients admitted by emergency departments to move to wards, which in turn unblocks ambulance delays. It is important, however, that we learn from the deployment of a similar approach during the pandemic by ensuring that the right wraparound care is provided for patients released to residential care. I have asked NHS England to particularly focus on that, so that it is the shortest possible stay on patients’ journey home and into domiciliary care, and indeed it is in the NHS’s own interests for those stays to be as short as possible. Taken together, this is a £200 million investment over the next three months.
Next, our A&Es are also under particular strain. From my visits across the country I have seen and heard how they often need more space to enable same-day emergency care and short stays post emergency care. Our second investment is in more physical capacity in and around emergency departments. By using modular units, this capacity will be available in weeks, not months, and our £50 million investment will focus on modular support this year. We will apply funding from next year’s allocation to significantly expand the programme ahead of the summer. We are giving trusts discretion on how best to use these units to decompress their emergency departments. It might be for spaces for short stays post A&E care, where there is no need for a patient to go to a ward for further observation, or for discharge lounges that previously have not been able to take a patients in a bed—many of those are often simply chairs—or for additional capacity alongside the emergency department at the front end of the hospital.
The third action we are taking to support the system right now is to free up frontline staff from being diverted by Care Quality Commission inspections over the coming weeks, and the CQC has agreed to reduce inspections and to focus on high-risk providers in other settings, such as mental health. Those are the actions we are taking that will have an immediate effect.
I turn to the measures we are taking now that will give greater resilience into the summer and next winter. We now have 42 NHS system control centres in operation across England, staffed 24 hours a day, seven days a week, tracking patients on their journey through hospitals, helping us to identify blockages earlier and getting flow through the system. Where we have implemented these systems, such as the one I saw in operation in Maidstone, they have had a clear impact. We will therefore allocate funding in next year’s settlement to apply these systems more widely.
Similarly, we have also seen how the use of artificial intelligence and data can demonstrably reduce demand and release patients sooner. NHS England has been tasked with clarifying and simplifying the procurement landscape, taking on board best international practice, so that a small number of scalable interventions are taken forward where international experience shows they can deliver meaningful benefits to patients.
Next, we will capitalise on the incredible potential of virtual wards. Last week at Watford General Hospital, I saw how patients who would have been in hospital beds were treated at home through a combination of technology and wraparound care. Patients released sooner are often much happier, knowing that they are receiving clinical supervision and always have the safety net of being able to quickly return to hospital should their condition deteriorate. There is scope to expand these measures to many more conditions and many more hospitals in the months ahead.
We are also opening up more routes for NHS patients to get free treatment in the independent sector and offering even greater patient choice. The elective recovery taskforce is helping us to find spare operating theatres, hospital beds and out-patient capacity.
We must also take steps in primary care. We are clear that our community pharmacists can support many more things to ease pressure on general practice. From the end of March, community pharmacists will take referrals from urgent and emergency care settings; later this year, they will also start offering oral contraception services. But I want to do even more, as they do in Scotland, and work with community pharmacists to tackle barriers to offering more services, including how to better use digital services. The primary care recovery plan will set out a range of additional services that pharmacists can deliver.
Finally, notwithstanding very severe pressures, we know that to break the cycle of the NHS repeatedly coming under severe pressure, the best way to reduce the numbers coming through our front doors is to address problems away from the emergency department. On Friday, we signed a memorandum of understanding with BioNTech —a global leader in mRNA technology—to bring vaccine research to this country, which will give as many as 10,000 UK patients early access to trials for personalised cancer therapies by 2030. This builds on the 10-year partnership we struck with Moderna in December to also invest in mRNA research and development in the UK and build state-of-the-art vaccine manufacturing here.
We are also reviewing our wider care for frail, elderly patients in care homes long before they ever get to A&E or our hospitals. Take the brilliant work being done in Tees valley, where community teams are being used to help with falls to prevent unnecessary ambulance trips to hospitals. We have looked at what more support we can offer elderly patients further upstream. With an ageing population, and many more people with more than one condition, it is clear that we have to treat patients earlier in the community and go beyond individual specialties to better reflect patients with multiple conditions to give the right support to people where they are, which is often at home or in residential homes.
Today’s announcement provides a further £250 million of funding, which recognises the spike in flu on top of covid admissions and high delayed discharge numbers from the pandemic. The funding will provide immediate support to reduce hospital bed occupancy and decompress A&E pressures, and, in turn, unlock much-needed ambulance handovers. This funding builds on the £500 million announced in the autumn statement specifically for discharge, which is ramping up, and the additional funding for next year.
All this work ultimately builds on the much-needed greater integration of health and social care through the 42 integrated care boards, which we will strengthen through the Hewitt review, and through a step change in capability, including operational control centres.
This immediate and near-term action sits in parallel with our wider life science investment, such as the deals with BioNTech and Moderna, and underscores our commitment to recognising the immediate pressures on the NHS and investing in the science that will shift the dial on earlier, upstream treatment at scale, particularly for the frail elderly, long before a patient reaches an emergency department. This is a comprehensive package of measures, and I commend this statement to the House.
Steve Barclay
The hon. Member talks about a fresh start, but even his own shadow Cabinet colleagues do not seem to agree with his plans. His own deputy leader seemed to distance herself from his plans to use the private sector, and his own shadow Chancellor seems to have distanced herself from his plans for GPs. Perhaps he can share with the House exactly how much his unfunded plans for GPs will cost, because the chief executive of the Nuffield Trust has said:
“It will cost a fortune”,
and is
“based on an out of date view”.
The point is that he has no plans that his deputy and his own colleagues support, and he has not set out how he would fund those plans in a way that does not divert resource from other parts of the NHS.
The hon. Member talked about pressure, yet there was no mention of the fact that the NHS in Wales, the NHS in Scotland and, indeed, health systems across the globe have faced significant pressure as a result of the combination of covid spikes and flu spikes, particularly in recent weeks. This is not a phenomenon limited to England and the NHS; this is a pressure that has been reflected internationally, including for the NHS in Wales.
The hon. Member refers to talks with the trade unions, and it is right that we are engaging with the trade unions. I was pleased to meet the staff council of the NHS today. Indeed, the chair of the NHS staff council, Sara Gorton, said the discussions had made “progress”, notwithstanding one trade union leader who was not in the talks giving an interview outside the Department to comment on what had and had not been said in those talks. We want to work constructively with the trade unions on that.
The hon. Member says that we are only announcing measures today, but again, he seems to have written those comments before he got a copy of the statement. The integrated care boards took operational effect in July last year—[Interruption.] Because they are scaling up, we are putting control centres in place and we are integrating health and social care. In the autumn statement, we announced £500 million for discharge, a further £600 million next year and £1 billion the year after, recognising that there is significant pressure, and that is ramping up. NHS England set out its operational plans in the summer, including the 100-day discharge sprint. That, for example, set out the greater use of virtual wards, which is new technology being rolled out at scale. It also announced the extra 7,000 community beds. Indeed, we also set out the additional measures in our plan for patients.
What is clear when we have a sevenfold increase in flu in a month—50 cases admitted last year compared with 5,100 this year—is that there is a combination of a surge in demand on top of the existing high-level position, and the surge in demand corresponds with a constraint on supply as staff absences also increase because of flu, so during the Christmas period community services are more constrained. Those two things together have created significant pressure on our emergency departments. That is why in the engagement I have had with health leaders the two key messages they gave to me were the importance of getting flow into hospitals, which is constrained by the high bed occupancy—that is why getting people out of hospital is so central to relieving pressure—and, within the emergency departments specifically, the need to decompress those services with same-day emergency treatment and having short stay post-emergency departments. That is a better way to decompress those emergency departments—through the triaging and bringing other clinical specialties closer to the front door. We have listened to the NHS frontline and those were the two key requests made to me, alongside other issues such as care quality inspections and how to make them more flexible. However, alongside those immediate pressures, we need to recognise that we had pressures last summer during the heatwave and we had pressures in the autumn, which is why we have announced a wider set of measures today.
So we have listened and we have acted; we have taken measures to deal with the immediate pressure, but we have also set out how we will build further capacity that will go through into the autumn. Alongside that, we have signed deals, for example with Moderna and BioNTech, and we are bringing forward the life science investment so that that has a better impact on pressures on the frontline.
Steve Brine (Winchester) (Con)
There is no doubt that, in some places more than others, patient flow in acute hospitals is the issue gumming up the system, and the Secretary of State is right to say that demand far outstrips supply, in part because of the very high flu numbers. Today’s injection of funding is very welcome as is the additional surge capacity the Secretary of State spoke about in his statement. His mention of prevention is especially welcomed by me; let us do so much more on this. Another £250 million is a lot of the public’s money. What real-time oversight does he have to ensure that NHS England spends it wisely, and may I make a plea that domiciliary care is not overlooked, because the lack of care in people’s homes is every bit as much the enemy of patient flow as the lack of care home places that he has identified today?
NHS Industrial Action: Government Preparations
Lindsay Hoyle Excerpts(1 year, 11 months ago)
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Urgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
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Will Quince
The fact is that Labour is all over the place when it comes to strikes. They criticise Ministers while admitting that the unions’ pay demands are unaffordable. The hon. Gentleman and his party leader are too tied to their union paymasters to be on the side of patients. He knows that we have an independent pay review body, and is important that both sides respect that independent body. We accepted the independent body’s recommendations for this year’s increase in full, meaning that over 1 million NHS staff have been given at least a £1,400 increase in their pay. That is on top of a 3% pay rise last year at a time when pay was frozen across the wider public sector. The RCN, one of the unions taking action, is asking for an increase that is 5% above the retail prices index. Based on latest figures, that is an increase of 19.2%, or the equivalent of 6.5% of the NHS budget. To meet such demands, we would have to take money away from clearing the elective backlog that the hon. Gentleman referred to, something no responsible Government would wish to do.
Throughout this period, we have always sought to have a balanced process. Those in the private sector will not be getting a 19% uplift, and there is a clear need to be fair to the wider economy. We have to avoid inflationary pressures that would make us all poorer in the end.
We will continue to listen to colleagues’ concerns, not just about pay but many other issues affecting the working lives of those in the NHS. We will work with them to make improvements in a range of areas, from working conditions to patient safety, because we believe there is so much that we can agree on. Strike action is in no one’s best interest. We will keep working so that the NHS continues to be there for those who need it most.
Steve Brine (Winchester) (Con)
With your indulgence, Mr Speaker, may I send our heartfelt sympathies to the parents of the little boys who have lost their lives in the west midlands overnight and say thank you to the emergency service workers, many of whom will have been from the NHS? I am sure they have done their best for those they pulled out and those they were unable to save.
The Minister is right that we have an independent pay review process, but it seems that we are coming to an interesting junction point: either we believe in an independent pay review process, or we do not. We cannot be in a situation where everything is agreed until it is simply not, and then Ministers are negotiating pay. That is not what Ministers do.
I am glad the Minister mentioned patients them at the end of his remarks. We must keep them as our focus. I have more information about my train services over the next few weeks than I do about health services. Is the Minister satisfied that patients have enough information about what is being affected and when, and how much it will impact on the backlog? I suspect none of this will help the workload pressures that are impacting our NHS.
Will Quince
I thank my hon. Friend for his question, and I echo his comments on the tragic events in Solihull, the boys who lost their lives and the heroic actions of those in the emergency services.
My hon. Friend is also right to say that we have an independent pay review body, and we either agree and accept that that is the process, or we do not.
On advice to the public, my hon. Friend is right that we have more to do in this space. Derogations are still being worked through with both individual unions and trusts. Patients should continue to call 999 as normal if it is an emergency and someone is seriously ill or injured. If they do not have life-threatening conditions, they should use NHS 111. Ambulances will still be responding to 999 calls. If patients have appointments, they should please turn up unless advised not to do so. He is right to make the point about communications, and I will be ramping this up when we know more about derogations.
Steven Bonnar (Coatbridge, Chryston and Bellshill) (SNP)
Scotland’s First Minister has managed in one day to do what the Tory Government could not—agree with the nursing unions to call off strikes planned for this month. NHS workers are the backbone of these countries. If they do not work, the country does not work, and if the country is not working, it is broken. Britain is broken, is it not? And Brexit has broken Britain, has it not? The Tories will not negotiate and the Labour Opposition spokesperson has branded the British Medical Association as “hostile”, while in Scotland the strikes are off, and they are off permanently. An offer of 7.5% has been negotiated and agreed, with an 11.24% pay rise for the lowest paid across the board in NHS Scotland. Why are the UK Government refusing to give public servants a decent pay increase when they have all the financial power to do so?
Oral Answers to Questions
Lindsay Hoyle Excerpts(1 year, 11 months ago)
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Steve Barclay
I can do much better than that. We have commissioned a full investigation and inquiry into the Government’s handling of covid and, as part of that, I am sure that the inquiry will look at PPE. But it is important to put it into context. We secured 23.2 billion items of PPE, which was a huge step, done at pace, to help protect our frontline.
Steven Bonnar (Coatbridge, Chryston and Bellshill) (SNP)
There are concerns that officials and high-ranking associates have reaped the financial benefits of a deadly disease, shamelessly profiteering on public funds. The SNP has long sought to highlight the Government’s rampant cronyism and corruption, and this PPE plundering is the most egregious case that we have seen so far. In Scotland, the Scottish Government have robust procedures in place to ensure protection of procurement in healthcare. How will the Secretary of State better regulate the cronyism of his colleagues? Will he commit now to scrapping the UK Government’s VIP lane for healthcare contracts?
Steve Barclay
I do agree with my hon. Friend, and I think it would help the House to assess the performance of the Welsh Government if there were more transparency. For instance, the Opposition motion on today’s Order Paper refers to vacancies in England. I am sure it will surprise the House to learn that the Welsh Government stopped collecting statistics for workforce vacancies in 2011. I look forward to Opposition Members’ encouraging their Welsh colleagues to be more transparent.
Feryal Clark (Enfield North) (Lab)
Members on both sides of the House will have been shocked and appalled by the recent deaths of children from streptococcus A, and our thoughts are with all the families affected. Cases are on the rise, and as we head into winter it is vital for parents to be able to secure for their children the care that they so desperately need. The shortage of GPs means that too many are struggling to see a doctor, and now there are reports of shortages of antibiotics as well. What advice can the Secretary of State give parents whose children are exhibiting symptoms but who cannot obtain a GP appointment, and what assurances can he give on the supply and availability of antibiotics?
Neil O’Brien
We are rolling out community diagnostic centres to bring services closer to those who need them, and we are investing in 21,200 extra people working in general practice to make sure that rural services, as well as services in the rest of the country, are improved.
Andrew Gwynne (Denton and Reddish) (Lab)
In 2019, the Tories promised to extend healthy life expectancy by five years, but on this they are failing. In the last year, the health disparities White Paper has disappeared, the tobacco control plan has been delayed and they have chickened out on implementing the obesity strategy because the Prime Minister is too cowardly to stand up to his Back Benchers. Health inequalities are widening as a consequence. Does the Minister plan to revive any of these strategies, or have the Conservatives completely given up on prevention?
Helen Whately
As announced in the autumn statement, we have a record funding settlement of £7.5 billion going into the social care system over the next two years, to improve both access and quality of care. I am happy to meet my right hon. Friend to look into the specific challenge that she has outlined, because it is important that local areas are working together across boundaries.
Liz Kendall (Leicester West) (Lab)
Let’s just tell it like it is on the Government’s record on social care reform. Their cap on care costs was first promised 10 years ago. In 2015, they delayed it and in 2017 they scrapped it. In 2019, the right hon. Member for Uxbridge and South Ruislip (Boris Johnson) again promised to fix the crisis in social care, but last month the Chancellor buried the policy, once and for all. After 12 long years, what have Conservative Members got to show on social care: the highest ever staff vacancies; millions left without the care they need; hospitals full of people who do not need to be there; and families picking up the strain. Isn’t the truth on social care, just as with our economy, transport, housing and schools, that the Conservatives have run out of excuses and run out of road, and the country deserves a change?
The Parliamentary Under-Secretary of State for Health and Social Care (Neil O’Brien)
My hon. Friend is so right. I praise her work with the APPG and I know many colleagues will want to attend. Whistleblowers can save lives and improve healthcare, as I have seen in my own constituency, and she is right to be pressing on this matter.
Wes Streeting (Ilford North) (Lab)
The chairman of the Conservative party claims that NHS strikes are exactly what Vladimir Putin wants, so why is not the Health Secretary negotiating to prevent them from going ahead?
Neil O’Brien
Whatever format our next steps forward are set out in, we will be pushing forward very quickly and aggressively on this. This year, we are putting £35 million into the NHS to support our services for everyone who goes in to stop smoking. We have doubled duty on cigarettes and brought in a minimum excise tax. Women who are pregnant now routinely get a carbon monoxide test. National campaigns such as Stoptober have now helped 2.1 million people to quit smoking. We are also supporting a future medically licensed vaping product as a quitting aid. We will be pressing forward at the greatest speed.
Helen Whately
I point the hon. Member to the answer that I gave to my hon. Friend the Member for Southend West (Anna Firth) a moment ago specifically about face masks. I have asked for updated guidance for the social care sector on the use of face masks. I recognise the difficulties they cause—for instance, in communication—and I am looking forward to being able to give an update to hon. Members and the sector on that shortly.
Margaret Ferrier (Rutherglen and Hamilton West) (Ind)
What assessment has the Secretary of State made of geographic variation in access to innovative liver cancer treatments, such as selective internal radiation therapy?
NHS Workforce
Lindsay Hoyle Excerpts(1 year, 11 months ago)
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Mr Speaker
I inform the House that I have not selected the amendment. I call the shadow Secretary of State for Health and Social Care.
Covid-19: PPE Procurement
Lindsay Hoyle Excerpts(2 years ago)
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Urgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Mr Speaker
I remind all Members that “Erskine May” states that the conduct of Members of the House of Lords can only be criticised on a substantive motion, and therefore not during these exchanges. Also, as there is the prospect of further legal proceedings concerning some of the contracts entered into, I remind Members of the sub judice resolution and the requirement not to refer to live cases.
Angela Rayner
Thank you for granting this urgent question, Mr Speaker. I welcome the Minister to his place—I think this is the first time we have met at the Dispatch Box—but to be honest, to his defence of due diligence I would say, “What due diligence?” Last night, documents seen by The Guardian revealed yet another case of taxpayers’ money being wasted, with a total failure of due diligence and a conflict of interest at the heart of Government procurement.
In May 2020, PPE Medpro was set up and given £203 million in Government contracts after a referral from a Tory peer. It now appears that tens of millions of pounds of that money ended up in offshore accounts connected to the individuals involved—profits made possible through the company’s personal connections to Ministers and the Tories’ VIP lane, which was declared illegal by the High Court. Yet Ministers are still refusing to publish correspondence relating to the award of the Medpro contract, because they say that the Department is engaged in a mediation process. Can the Minister tell us today whether that mediation process has reached any outcome, and what public funds have been recovered, if any? Will he commit to releasing all the records, both to the covid-19 public inquiry and to this House, once the process is completed?
Rightly, there are separate investigations into Baroness Mone’s conduct, but the questions that this case raises are far wider. It took a motion from the Opposition to force the Government to release records over the Randox scandal. Will they agree today to do the same in this case without being forced to do so by the House? Can the Minister say now what due diligence was performed when awarding the Medpro contract?
Today’s reports concern just one single case, but this Government have written off £10 billion just on PPE that was deemed unfit for use, unusable, overpriced or undelivered. Worse, Ministers appear to have learned no lessons and to have no shame. As families struggle to make ends meet, taxpayers spend £700,000 a day on the storage of inadequate PPE. Can the Minister confirm whether the Government’s new Procurement Bill will still give Ministers free rein to hand out billions of pounds of taxpayers’ cash all over again?
Mr Speaker
Order. Can we please stick to the rules of the House on time limits? I do not make the rules; the rules are meant for us all. This is happening too often.
Neil O’Brien
The right hon. Lady asks two main questions, the first of which is what we are doing on PPE Medpro. It has been widely reported that it had an underperforming contract. Let me set out what we do in such cases. The first step is to send a letter before action, which outlines a claim for damages. That is followed by litigation in the event that a satisfactory agreement has not been reached. To answer the right hon. Lady’s question directly, we have not got to the point where a satisfactory agreement has been reached at this stage.
On the high-priority group, let us be clear about what it was and what it was not. Approximately 9,000 people came forward. All Ministers will have had the experience of endless people ringing them up directly to try to help with the huge need that there was at the time. Many of us, as Back Benchers, will have been approached by constituents who were keen to help and needed to be referred somewhere. All that the route did was handle the huge number of contacts coming in to Ministers from people offering to help. Let me be clear that it did not give any kind of successful guarantee of a contract; indeed, 90% of the bids that went through it were not successful. Every single bid that went through the route went through exactly the same eight-stage process as all the other contracts—it looked at the quality, the price and the bona fides of the people offering to produce.
On the point about PPE that has not been useful, I set out in my answer the extraordinary context in which we were operating. There was a global scramble for PPE. People were being gazumped: goods would be taken out of the warehouse if people could turn up with the cash quicker than them. It was an extraordinary situation in which we had to act in a different way. Loads of us will remember standing up in this House and saying to Ministers, “What are you doing to get more? More, quickly!” That was the context in which we were operating.
Neil O'Brien
That was the underperforming contract that I referred to in my previous answer, and I set out the process that we go through when we take action on underperforming contracts. There is the initial letter before action, and then a process in which we look to see if a satisfactory agreement can be reached. If not, that leads on to litigation. Of course, there was wasted PPE—my hon. Friend is absolutely correct about that—but I have already set out the context of the global scramble and the huge amount of PPE that was successfully delivered, saving lives and protecting workers in our NHS.
Brendan O'Hara (Argyll and Bute) (SNP)
From the moment we learned about the existence of this VIP lane for the politically connected, it was almost inevitable that it would come to this. This get-rich-quick scheme to fast-track cronies, politically connected pals and colleagues was never going to end well. I suspect that today’s revelations, however shocking, are simply the tip of a very large iceberg—an iceberg that could yet sink this ship of fools.
Transparency International UK has flagged as a corruption risk 20% of the £15 billion given out by the Tories in PPE contracts at the height of the pandemic. As we have already heard, they are spending £770,000 every single day to store much of that useless equipment in China. One Tory politician who had absolutely no background in PPE procurement personally made millions from those contracts, so do the Government plan to investigate proactively how many others like that are in their ranks, or are they content to sit there and watch this dripping roast of sleaze, corruption and scandal unfold on its own?
Mr Peter Bone (Wellingborough) (Con)
I think there is a little rewriting of history here. At one stage in the pandemic, getting PPE was the most important thing, and I remember Members on both sides demanding quicker action from the Government. The Minister has explained the situation fully, and I regret that the Opposition are making political points from what was actually a great success in protecting our NHS staff. Does the Minister agree with me or with that lot?
Neil O'Brien
My hon. Friend is completely correct. Some have short memories. Many of us stood up in this House to chivvy Ministers, asking, “Why aren’t you going faster? Why don’t you do more? Take the risks, get the stuff—we need it.” That was the priority. Many Members want it both ways: they criticised us at the time for not going fast enough or taking enough risks, and now they do not accept that we are going through all the contracts that did not perform.
Neil O'Brien
My hon. Friend is completely correct. When Mrs Justice O’Farrell went through these cases, she noted in her summing up that given the time-sensitive nature of the work, it was not irrational for the Department to decide that it was prepared to take more risk than usually would be acceptable, because of that extraordinary context that is so quickly forgotten in the questions we are hearing in the House today.
Christine Jardine (Edinburgh West) (LD)
The Minister has made much of the context of the time and the speed and the calls for PPE, but what my and, I am sure, everybody else’s constituents wanted was PPE quickly and appropriately. Earlier this year the High Court ruled that the Government’s VIP lanes were not only inappropriate, but unlawful, and in breach of the obligation of equal treatment. Does the Minister appreciate that constituents across the country are calling for an explanation? Will he back the Liberal Democrat amendment to ban VIP lanes for all future Government contracts?
Ruth Cadbury (Brentford and Isleworth) (Lab)
The Minister says that lessons will be learned about Government procurement from this PPE scandal. Will he look at the contracts that the Home Office has for accommodating and feeding asylum seekers, which are ripping off the hotels and the food suppliers, causing asylum seekers to live in malnutrition and squalor? These contracts have many of the same characteristics—vast profits and executive salaries, and an opaque network of subcontractors run by people who may not pass fit-and-proper tests—
Mr Speaker
Order. I think the hon. Lady is stretching things a bit too far. [Interruption.] I know it is lessons learned, but it is too clever and not clever enough. We will leave it at that.
Sam Tarry (Ilford South) (Lab)
Today’s revelations show further evidence that the Government’s VIP lane was possibly criminal and was exploited by Members of the Government party. Will the Minister today commit to publishing in full the names of the Ministers, MPs or officials who referred firms on to that fast-track lane? Stop being evasive. We need to know what corruption happened.