Interim NHS People Plan

Lord Clarke of Nottingham Excerpts

Wednesday 5th June 2019 Commons Chamber

[Stephen Hammond]

Perhaps that is the soundbite that the hon. Gentleman and his colleagues—including the hon. Member for Dewsbury, who is shouting across the Chamber yet again—should remember.

[Mr Kenneth Clarke (Rushcliffe) (Con)]

I welcome the Minister’s announcement that the Government are giving higher priority still to the recruitment and retention of staff in the NHS. It is an undeniable fact that there are acute shortages, particularly of nurses, in practically every part of the NHS, and we urgently need to improve our recruitment and retention. With that in mind, will he confirm that in finalising the people plan, serious consideration will be given to the immigration rules that will apply to recruitment after we leave the European Union? About one in 20 of the whole staff of the NHS at the moment are citizens of the European Union, and it would make no sense at all to put new restrictions of any kind on people coming from the European Union who want to make a valuable contribution to our health service. In Nottingham, we used to run recruitment campaigns for nurses in Romania. We are a long way away from being able to in any way put restrictions on staff coming from any part of the continent.

[Stephen Hammond]

My right hon. and learned Friend the Father of the House is completely correct. We want to make sure it is clear that the EU nationals who work in the national health service—there are more than 63,000 of them—are valued and make a huge contribution to our NHS. He will probably be aware that my right hon. Friends the Secretary of State and the Home Secretary are in continuing negotiations, to ensure that there is no change to that position. I guarantee that we want to see EU nationals continue to work in and contribute to our great health service.

Eurotunnel: Payment

Lord Clarke of Nottingham Excerpts

Monday 4th March 2019 Commons Chamber

[Matt Hancock]

Unlike in the question from my hon. Friend the Member for Berwickshire, Roxburgh and Selkirk (John Lamont), what I did not hear in the hon. Gentleman’s long question was a statement about whether he supports the decision or not. I think that is because he does support the decision to ensure we have what we need to get the unhindered supply of medicines. More than that, he and his Scottish National party friends complain endlessly about a no-deal Brexit, yet they do not do what is needed to avoid a no-deal Brexit, which is to vote for the deal.

[Mr Kenneth Clarke (Rushcliffe) (Con)]

It is always a pleasure to see my right hon. Friend the Secretary of State for Health and Social Care, although rather a surprising one on this occasion. The usual reason for settling an action is to minimise your losses when you are obviously on a loser in defending it, but I am relieved to hear that this was done in order to ensure the safety of medicines. As we are on that subject, can he give me some reassurance about the long-term future for the regulation and approval of medicines in this country? If and when we leave the EU—we look as though we are bound to do so—we of course leave the European Medicines Agency, which is leaving this country, and I am not clear what our long-term arrangements will be. Are we going to seek some association with the EMA system, or will we be setting up a totally new British system to replace it? Can he guarantee continuity of the proper regulation of medicines while that process is under way?

[Matt Hancock]

The short answer to that is yes. The medium length answer is that we will ensure that medicines can be licensed in this country with no further burdens than under the EMA system by matching some of the EMA processes, but in a no-deal scenario we would also be looking to introduce our own processes so that some medicines could be brought and licensed here before they could be licensed in Europe. Indeed, changes to this area is one of the examples of advantages from Brexit, which I am sure my right hon. and learned Friend will be delighted to hear about, because they mean that we can grasp some of the opportunities that the future of medicines presents. The long answer is so long that I will be happy to write to him with full details and place a copy of the letter in the Library of the House.

NHS Long-term Plan

Lord Clarke of Nottingham Excerpts

Monday 7th January 2019 Commons Chamber

[Matt Hancock]

Well, I think we discovered from that that Labour has absolutely nothing to say about the future health of the nation. The hon. Gentleman did not even deign to thank the people who work in the NHS for their incredible work. Did we hear any acknowledgement of the million more people who are seen by the NHS, of the record levels of activity going on in the NHS and of the fact that we have more nurses and doctors in the NHS than we had in 2010? He had nothing to say. He talked about the workforce. Chapter 4 of the document is all about the workforce plan. He gives me the impression that, like his leader on Brexit, he has not even read the document he is talking about.

The hon. Gentleman asked about targets and legislation. On legislation, when clinicians make proposals on what legislation needs to change to improve the NHS, we listen. We do not then come forward with further ideological ideas. We listen. So we will listen to what they have said. The clinicians have come forward with legislative proposals and we will listen and study them closely.

On the money that the hon. Gentleman talked about, it was a bit like a broken record. He asked about a £1 billion shortfall in the NHS budget. I will tell him what we are doing with NHS budgets: we are putting them up by £20.5 billion. There is an error in the analysis by the Nuffield Trust, because it does not take into account an improvement in the efficiency of the NHS. Is it true that every year we can improve the way the NHS delivers value for taxpayers’ money? Absolutely. We can and we must, because we on the Government Benches care about the NHS and about getting the right amount of money into the NHS, but we also care about making sure that that money is spent wisely. The hon. Gentleman would do well to heed the views of the NHS itself, which says that yes, the NHS is probably the most efficient health service in the world, but there is always more to do.

The hon. Gentleman argued about various budgets. The budgets in the NHS are going up because we care about the future of the NHS. The Labour party called for an increase of 2.2% a year; we are delivering an increase of 3.4% a year. Labour has nothing to say on health, as it has nothing to say on any other area of domestic business. We will make sure that we are the party of the NHS for the long term.

[Mr Kenneth Clarke (Rushcliffe) (Con)]

First, I congratulate my right hon. Friend on his paying tribute to the work of the late Sir Henry Willink, who served in Churchill’s Conservative Government. I met him once or twice when he became master of a Cambridge college. The Conservatives have shown respect for the NHS ever since, as he foreshadowed.

I also congratulate my right hon. Friend on the large increases in funding that are almost as big as some of the funding increases that I received when I was a Health Minister and then Secretary of State. Ever since it was founded, all Governments have increased spending on the NHS—they are bound to—and whichever party is in opposition we always have these knockabout exchanges about whether it is enough. As my right hon. Friend rightly says, what matters is how effectively the money is spent to produce the right patient outcomes. The plan appears to reflect that very well.

Does my right hon. Friend agree that the biggest pressure facing the health service is the extraordinary growth in demand, and the change in the nature of that demand, which is being caused by the ageing population, with chronic conditions playing such a large part? Does he also accept that his most urgent priority is to build further links between the hospital service, the GPs, the community services and local authority social services, so that we have people working no longer in silos, but together to produce the best package for the patient? We have achieved something, but not very much. I hope that when we produce our adult social care policy, which I hope is soon, my right hon. Friend will begin to think about some reforms to make sure that all elements of the service work together properly to produce the proper and most cost-effective personalised treatment for each individual patient.

[Matt Hancock]

I pay tribute to my right hon. and learned Friend, who of course did so much to set in train the modern health service that we know and whose reforms were kept and, indeed, enhanced during the period when Labour was in government. He is right about the need to run the NHS so that it can be the best that it possibly can be. Yes, we need the money, but we also need to run it well. It is no good just to argue about the money. On that he may have a surprising ally, because the shadow Secretary of State, who is currently looking at his mobile phone—well, he is not any more—said a couple of months ago:

“we need to augment the debate beyond the current mantra of ‘we can spend the most’”.

However, it appears that the Labour party only has a mantra of “We can spend the most.” We care about the money, but we care about the NHS being the best that it possibly can be, too.

NHS Winter Crisis

Lord Clarke of Nottingham Excerpts

Monday 8th January 2018 Commons Chamber

[Mr Dunne]

I am glad that the hon. Gentleman mentioned the Secretary of State. I want to put on record my tribute to my right hon. Friend, who has served in that position for almost as long as Aneurin Bevan, who was the first Secretary of State for the NHS.

I am delighted to be here to respond to the hon. Gentleman, who, as usual, listed a cacophony of allegations, very few of which are directly related to the challenges that our hospitals face today—the increase in demand and pressure on our NHS as a result of a combination of the increase in population and challenges posed by demographics, as well as the weather and the presence of flu in many parts of the country, adding to the pressure on staff at this time of the year.

The hon. Gentleman asked several questions. On the funding issue, he is well aware that the £337 million announced in the Budget was allocated in December. His own local trust, which includes the Leicester Royal Infirmary, received £4.2 million. It is a great shame that he chose not to welcome that extra money for his local trust. The money announced in the Budget has been allocated, but we have kept £50 million in reserve to allocate this month if particular pressures that become apparent during the course of the month need addressing.

The hon. Gentleman asked about the impact of the cancelled operations. We do not know that operations are cancelled. There have been a few thus far; procedures and treatments are being deferred. It will not become apparent until after this period has finished how many actually do end up being cancelled, so it is not possible to calculate the financial impact on any of the trusts where deferral is taking place.

The hon. Gentleman referred to the situation as unprecedented. I gently remind him that we have a winter crisis of some kind or another every year. He will have been in Downing Street in 2009-10, when, as it happens, the then Conservative shadow Health Secretary chose not to try to take advantage of the near flu pandemic at the time because he recognised that there were operational pressures on the NHS and it was not down to him to score party political points. The hon. Gentleman has unfortunately chosen to do that. At that time, tens of thousands of elective procedures were cancelled to provide capacity to cope with the emergency at the front doors of our hospitals. So this is a routine way to deal with pressure coming through hospital front doors.

What distinguishes this year from previous years is that in the past elective procedures were cancelled within hours of operations being due to take place. Sometimes it was the day before and sometimes it was on the day. That caused patients considerable distress and gave rise to considerable problems for staff. We have set up the national emergency pressures panel to anticipate problems when we see the signals, and we can then give notice to patients that their procedures are going to be deferred. That is a much more humane and sensible way to do things and it provides much more opportunity for hospitals to cope with the pressures that are coming through the door.

[Mr Kenneth Clarke (Rushcliffe) (Con)]

NHS acute services have never been better and are among the best in the world. As the Minister just said, every year we have this slightly ritual exchange about winter pressures, but does he accept that the problems are changing because of the increased number of elderly people in the population and the increased urgency of the need to solve the problem of how to admit them promptly to the right part of the service and then discharge them properly and safely as soon as they are recovered? Will he advertise further to the many people who are not aware of it the availability of emergency GP services? Will he concentrate on the reform and integration of the community care system, the social care system and the primary care services and make sure that co-operation among them is steadily improved so that they can cope better in future years, because this problem is undoubtedly going to develop?

[Mr Dunne]

I am grateful to my right hon. and learned Friend for making those points. He brings to the House considerable experience of what it is like to be responsible for the NHS. He is absolutely right: the number of over-80s who are presenting to hospital A&Es is going up exponentially each year. Hospitals need to adapt the way that they treat such patients to try to keep them as healthy as possible so that they can live independently for as long as possible. That is why many hospitals are now introducing frail elderly units close to or at the front door of A&E departments so that they can turn around patients and avoid admissions. My right hon. and learned Friend is also right to point to the increasing integration between the NHS and social care that is necessary to encourage more people to live independently out of hospital and leave emergency departments for those people who are urgently ill.