Oral Answers to Questions

Luke Pollard Excerpts

Tuesday 19th June 2018 Commons Chamber

[Luke Pollard (Plymouth, Sutton and Devonport) (Lab/Co-op)]

Much of the health and social care for people with learning disabilities in Plymouth is provided by Livewell Southwest, a social enterprise. The new pay increases for NHS staff will not be mapped over to social enterprise staff, so when they merge back into the NHS, we risk a two-tier workforce. Will the Minister consider extending the pay increases to support those who work with people with learning difficulties in the social enterprise sector so that we ensure that everyone doing the same job is paid the same amount?

[Caroline Dinenage]

The hon. Gentleman makes an excellent point. It would be terrible to see a health and social care sector in which people doing the same work are valued differently, so I will look carefully at the point he raises.

GP Recruitment and Retention

Luke Pollard Excerpts

Wednesday 28th March 2018 Westminster Hall

[Luke Pollard (Plymouth, Sutton and Devonport) (Lab/Co-op)]

It is a pleasure to serve under your chairmanship, Mrs Moon. I congratulate my hon. Friend the Member for Houghton and Sunderland South (Bridget Phillipson) on making such a powerful opening speech. I want to talk about primary care in Plymouth, because I am worried that the crisis we have is at risk of getting much worse in the coming months, as GPs are considering whether to hand back their contracts in the next couple of days.

A lot has been done in Plymouth to integrate our healthcare system and our social care system. Sometimes our distance from London has meant that we have managed to avoid the headlines, but not the hard work. There has been a huge effort of innovation and integration in the west country, merging social care, mental health provision and our acute hospital trust together. Enormous thanks and credit should go to the hard-working staff who have pioneered that, along with the city council and other providers.

There is, however, a problem with primary care in particular. That is exacerbated by other parts of the system that do not seem to work, as my hon. Friend the Member for Stroud (Dr Drew) said, but there does seem to be a real crisis in primary care that needs to be addressed. I welcome the news given by Simon Stevens on his visit to Plymouth last week that we will get an additional 12 GP training places for our university, but there is a real crisis today. I am looking for actions from the Minister to assist us in combating that crisis today.

Nurse and GP vacancies persist in Plymouth’s primary care sector, and waiting lists continue to be high. It is important to say that this is not because the superb staff in our NHS are not working their socks off, because they really are. However, there is persistent underfunding of not only general practice but the wider sector. NHS England estimates that one in seven GP posts in Plymouth have not been filled, which is an alarming statistic. I have heard of one GP surgery in the heart of the city that has been advertising a GP vacancy for a year and has had no applications so far.

[Michelle Donelan]

I have similar issues in Melksham in my constituency. Is the hon. Gentleman aware of the targeted enhanced recruitment scheme, which offers £20,000 to attract trainees in areas that have failed to fill places for a number of years? That is available in Swindon, in Wiltshire, but also in Plymouth.

[Luke Pollard]

The problem is that the schemes that currently exist are not having the effect that we need them to in Plymouth, because we have a crisis today.

I want to talk about the concern that a lot of GPs have expressed to me. My remarks will be about what GPs have told me, rather than my analysis of what I believe GPs are saying, because I think it is important that their voice is heard in this debate. Will the Minister meet those GPs so that they can raise their concerns in person? There are a number of GPs who have solutions or suggestions about what can be done.

At the moment each GP in Plymouth has about 2,364 patients. As we heard earlier, the average is about 1,700, so there is a greater demand on the GPs we have in Plymouth. One GP told me last night:

“I’ve just walked in the door after a day where I saw my first patient at 0825 and left my last patient’s home at 8.15pm. Because the district nursing service is currently unreliable (through no fault of their own), I will go back to the latter at 0800 tomorrow as the patient is housebound and needs blood tests.”

He went on to say:

“A large part of the pressures on...GP’s is the fact that other community services have had such drastic cutbacks.”

He said:

“I feel very...lucky to have a secure well-paid fascinating and rewarding job but it is all a little overwhelming and I constantly worry that just one major problem will mean things become very, very unsafe.”

[Alex Chalk (Cheltenham) (Con)]

Will the hon. Gentleman give way?

[Luke Pollard]

I will continue, if I may. Apologies.

Another GP, Dr Williams, said that the system is failing and it feels as though it might be intentional. GPs have heard NHS England say that it is watching Plymouth as a place where primary care could fall over, a sentiment that several GPs have expressed to me in private. They believe that Plymouth’s city-wide system is facing bigger concerns in primary care than elsewhere. A meeting with the Minister is vital, so that he can reassure those GPs that the Department of Health and NHS England are on top of this.

Another inner-city GP said:

“I became a GP to help people with physical and emotional health difficulties and this is a job I have really enjoyed for a number of years. During this time patient needs and demand on general practice has increased significantly but unfortunately funding has not kept pace...We only get...£115 per patient per year to provide the totality of patient care so it’s no surprise we are struggling when some patients consult us at least once a week.”

The general medical services contract includes between £73 and £117 per patient, but as we have seen in Plymouth where GP surgeries have fallen over and emergency providers have been brought in, there can be as much as £347 per patient under emergency access contracts. There seems to be a huge financial gap there that could be moderated by supporting GPs—not by giving them more money themselves, but by providing support and assistance so that they can hire more GPs, and by supporting the other professions that make for a successful GP practice.

Worryingly, the doctor I referred to said:

“I no longer enjoy being an NHS GP because I cannot keep pace with demand and I know our patients are getting frustrated with restricted access to their GP. Patients are complaining, and rightly so, but those complaints just compound my loss of joy from the job because I’m working harder than ever to try and provide the service patients want but the majority of feedback we get is negative.”

That has been echoed by a number of GPs in Plymouth, who really want to inject the joy and passion back into their role. They entered the profession not because it was easy—it was hard and difficult—but because their efforts would make a huge difference to their communities.

[Alex Chalk]

Will the hon. Gentleman give way?

[Luke Pollard]

I will continue, if I may.

I am genuinely worried that Plymouth’s primary care crisis is going to get worse in the coming days. We know that there are GPs who are considering whether to renew or to hand back their GP contract—a decision that will be made in the next couple of days. That is deeply worrying not only for them, but potentially for patients.

My GP surgery in Plymouth closed recently, so I know what it is like to lose my GP. At the moment I am especially concerned about people who do not reregister with a new GP, effectively becoming an unregistered cohort of people in the city who then can rely only on acute A&E services. Our staff at Derriford A&E do an absolutely fantastic job, but they cannot keep going if there is a continuing crisis.

The Plymouth Herald reports that a third of GP surgeries are at risk of closure as vacancies in primary care escalate. Will the Minister meet Plymouth GPs so that they can raise concerns directly with him? There is an opportunity to avoid the crisis getting any worse through proactive measures. I do not want to see the crisis getting worse and then more emergency access having to be put in place as GPs who have worked beyond the point of exhaustion hand back their contracts. That decision can be justified because of the pressure on them and their families, but we can avert that situation if we take action today. I hope the Minister will address that in his remarks.

Mental Health Services: Children and Young People

Luke Pollard Excerpts

Thursday 8th March 2018 Commons Chamber

[Steve Brine]

As I have said, we will be considering the four-week pilot as part of the Green Paper. We want to see these mental health first-aiders in schools, and as soon as we can give my hon. Friend an exact timetable on the situation Crawley, as well as elsewhere, I am sure that my colleague the Under-Secretary will do so.

[Luke Pollard (Plymouth, Sutton and Devonport) (Lab/Co-op)]

Some 75% of mental health problems start before the age of 18, but less than 10% of funding goes to young people. What can the Minister do to prioritise more funding for CAMHS?

[Steve Brine]

As I have said, the overall budget is the money we have promised in the Green Paper, but the hon. Gentleman is absolutely right. The Green Paper has at its heart a focus on prevention and significant support—in early years, through schools and, as the hon. Member for Heywood and Middleton (Liz McInnes) mentioned, through higher education—to prevent issues from snowballing in the first place.

Organ Donation (Deemed Consent) Bill

Luke Pollard Excerpts

2nd reading: House of Commons
Friday 23rd February 2018 Commons Chamber

[Michelle Donelan (Chippenham) (Con)]

I begin by congratulating the hon. Member for Coventry North West (Mr Robinson) on getting this Bill here today. I echo the support for the Bill that Members throughout the House have expressed.

When three people die a day because of a lack of organs, while eight out of 10 people say they would be willing to be an organ donor but are not formally on the register, it is time that we take action. I can only begin to imagine the emotional rollercoaster that families and people waiting for organs must go through in the long and trying wait, which can be years. I appreciate the personal stories that Members have shared today, which must be quite distressing. I think we have all gained greater insight.

I do not want to reiterate the merits of the Bill, because we all seem to be very much in favour of it. I want to talk briefly about how we can make sure that the Bill is as successful as it can be. As I alluded to in my intervention, I think that it is only part of the solution and not the complete answer. It is the essential building block, and it is important that we are now laying that building block, but I want us to make sure that we build the house.

One key issue is fostering a culture and making sure that we educate people from a very young age, so that they see organ donation as a positive thing that they want to do. That will counter the argument about people potentially seeing it as the state owning or seizing our organs. It needs to be seen as people giving their organs to help other people.

We need to spread the message that families should have a conversation about organ donation. It should not be something that we do not like to talk about. We should actively promote a conversation so that when the time comes, people are aware of their children’s or spouse’s decision. That will prevent any possible overriding of the decision, as we see in Spain. At the moment, it is estimated that only half of all families have that conversation.

Fostering a culture in which people want to donate their organs is achievable. At the moment we have one of the lowest donation consent rates in Europe. However, we have one of the highest rates in Europe for donating living kidneys. That implies that it is not against British culture to donate organs, but that we are doing something fundamentally wrong.

One way to achieve that culture is to ensure that there is absolutely no stigma around opting out. While some of us might be organ donors, that does not mean that everybody has to be, and we need to appreciate people’s religious cultures, customs and beliefs. I hope that people will be able to opt out of donating certain organs. I know that people of some religions, including even some denominations of the Christian faith, do not want to donate their heart, so it is very important that we do not exclude people from this process.

[Luke Pollard (Plymouth, Sutton and Devonport) (Lab/Co-op)]

About 10% of people who are signed up to the organ donor register have excluded donating their eyes, sometimes because they are a bit squeamish and sometimes because of the thought of someone else looking through their eyes in the future. Does the hon. Lady agree that in registering as many people as we can to donate, we should preserve people’s ability to opt out of donating organs that they do not wish to donate?

[Michelle Donelan]

I agree. Choice is the key to making the Bill as successful as possible, as is education. Some people might donate those organs if they knew how the process would work, but there needs to be an element of personal choice. It is our body, at the end of the day, and we should be encouraging people to help others rather than forcing them, which will not be successful.

Members have made the point—I do not want to labour it, but it is important—about reaching out to all communities, including those from ethnic minorities, among whom the number of donors is particularly low at the moment. In fact, shockingly, in March 2017 there were 634 people from the black community in need of organs, and only 72 people on the donor list died and were suitable organ donors. That is a really small proportion.

--- Later in debate ---

[Luke Pollard]

During this debate, I went on to my phone and signed up as a full organ donor. Previously, I was a bit squeamish about giving my eyes, but I have been convinced by the arguments. Signing up only took two minutes; it was simple to do, and every Member could be encouraging our constituents to do so, too, by just going on to their phone and registering now, so we can get more donors before this Bill becomes law.

[Mrs Hodgson]

That would be great. Even the most technophobe of us should be able to manage doing that if it takes only two minutes, and maybe there could be one of those clever apps to make it even easier for all the young people to do this.

PACE Trial: People with ME

Luke Pollard Excerpts

Tuesday 20th February 2018 Westminster Hall

[Caroline Dinenage]

I thank my right hon. Friend for her intervention. As has already been said, it is important that we listen to patients. As I will go on to explain, NICE is now looking at reviewing its guidance on this and, in the light of that, it may well be worth discussing the issue more fully.

[Luke Pollard (Plymouth, Sutton and Devonport) (Lab/Co-op)]

Does the Minister agree that believing patients is also important here? Patients with the condition are often not believed and concerns about the PACE trial have not been believed, and that has just loaded concerns on those individuals.

[Caroline Dinenage]

As I have already set out, sometimes it can take a really long time for this to be diagnosed. People have to keep going backwards and forwards to GPs and others with their symptoms. Many other potential conditions have to be discounted before it can be fully diagnosed, which often leaves people feeling that their symptoms are not being taken seriously or they are being dismissed. Obviously, that is massively concerning, which is why, as we have already said, it is important that patients are listened to and that clinical professionals are well-equipped to be able to recognise the symptoms and identify them.

As I said, the data has been examined more widely. Critics, including some clinical academics, have suggested that it shows CBT and GET are not as effective as the trial results suggested. In turn, the trial authors have defended their work. They have responded to criticisms in medical journals and the wider medical printed press. I know the hon. Member for Glasgow North West raised one such criticism at the oral evidence session of the Science and Technology Committee in January, concerning possible conflicts of interest of the PACE trial authors. On that point, in line with normal practice, all such conflicts were published with the trial protocol as well as the results. If she has evidence to the contrary, I would be very happy to discuss that with her afterwards.

Ambulance Services (Devon)

Luke Pollard Excerpts

Wednesday 12th July 2017 Westminster Hall

[Dr Wollaston]

I think we are all glad to hear that Murphy is making a good recovery. As my hon. Friend says, we must focus not just on the immediately life-threatening incidents but on the kinds of incidents that he described, where an ambulance is very important and somebody’s condition could deteriorate because of a long wait. For SWASFT we must keep an eye on not just the category 1 incidents, but the others as well, and I hope the Minister will do so.

In this debate we should also celebrate the successes, because there are undoubtedly those as well. We have seen examples of very good co-working between our blue light services. For example, in the “collapsed behind closed doors” scheme fire services co-operate with the ambulance service where there are concerns that somebody might be collapsed in a residence. In the past the police may have responded, but now the fire service can also provide that assistance, and I pay tribute to those co-responders in the fire service. From my time as a rural GP in Chagford, I remember the number of occasions when people phoned me in surprise because the fire service had arrived instead of the ambulance service, but it is actually providing a fantastic resource. On occasions when it is absolutely critical that somebody has a defibrillator on site as soon as possible, the fire service can and does perform an amazing job. We have got further to go, particularly in remote rural communities where a fire resource might be closer to hand. I hope the Minister will look at how we can go further to make sure that we develop a multi-skilled workforce who are properly rewarded for the expertise and skills that they develop across the fire service.

[Luke Pollard (Plymouth, Sutton and Devonport) (Lab/Co-op)]

The ambulance crews across Devon do a fantastic job. I represent an urban seat in Plymouth, but the demand that is placed on both urban and rural ambulance services has a knock-on effect, because there is no wall that divides Plymouth from the rest of Devon. Demand needs to be understood between both urban and rural areas. Will the hon. Lady comment on what happens in the summer months when the south-west becomes an even more popular tourist destination and additional demand is placed on not only the ambulance services but our wider emergency services? That moves the ambulance resources out of their normal patterns. Ambulances are increasingly moved to further away places with longer response times than their normal patterns might take them.

[Dr Wollaston]

The hon. Gentleman makes an extremely important point. He will know that for both our ambulance services and our police services those kinds of influxes from outside are not adequately reflected in the funding formula. That is in addition to the rurality that he referred to. In fact, the key point remains that the greater danger is to people living in rural areas where, for example, a resource might take somebody to Derriford Hospital but not return, and then when the ambulance service dispatches the nearest ambulance it will be in Derriford. That is why ambulance services tend to get tied up.

I would briefly like to mention the impact of the 111 service. SWASFT is doing extremely well—it is, in fact, the best-performing in the country—at treating patients at home rather than conveying them to hospital. That is the so-called “see and treat” model, and they are also doing well with “hear and treat”. However, there is a concern about the increase in calls, because there has been an overall increase in calls of 24% for the whole of the SWASFT area over five years, with 470 more calls per day, although only an additional 81 people per day are having to go to hospital. While that may reflect the great success of paramedics’ expertise in seeing and treating at home, will the Minister consider whether it also reflects unnecessary calls and the impact of 111, which has been raised many times in this House? Are too many people still having an ambulance called on their behalf when it could have been avoided?

Finally, I would like to end on a positive note in thanking all our volunteers who do so much to save lives across Devon, working alongside our blue light services. I would like to praise all those who support our Devon air ambulance service, all the volunteer community first responders and those who support, fund and supply defibrillators in our communities. On behalf of all in this House, we thank them and our wonderful paramedics and ambulance service crews.

Oral Answers to Questions

Luke Pollard Excerpts

Tuesday 4th July 2017 Commons Chamber

[Steve Brine]

I will ask NHS England, but if that is what it has told my hon. Friend, that is what will happen.

[Luke Pollard (Plymouth, Sutton and Devonport) (Lab/Co-op)]

14. What plans he has to improve the integration of mental health services for young people and adults.

[The Parliamentary Under-Secretary of State for Health (Jackie Doyle-Price)]

We are investing a record £1.4 billion in children’s mental health services. The transition from children’s services to adult services can cause distress, so NHS England has prioritised transitions when offering financial incentives for improvements. We will consider that in the forthcoming Green Paper.

[Luke Pollard]

I thank the Minister for that answer. There is a growing crisis in young people’s mental health in Plymouth and the far south-west. Despite 75% of mental health problems starting before the age of 18, only 8% of funding is allocated to young people. Will the Minister consider ring-fencing that young people’s mental health spending so that the funding gets to where it is needed?

[Jackie Doyle-Price]

The hon. Gentleman makes a good point. We have to balance the need to give CCGs the flexibility to dedicate funding and prioritise in their own way. We have been told by mental health professionals that the targets for physical health are more rigorous than those for mental health. We need to keep that under review, but we have imposed additional targets, which are being met.