Oral Answers to Questions
Debate between Lyn Brown and Caroline Dinenage(5 years, 6 months ago)
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Caroline Dinenage
Of the original 2015 cohort that the hon. Lady mentioned, 6,325 people have been discharged and 476 beds have been decommissioned, but the thing is that people are still coming in. The only way we can achieve permanent, long-term cuts is if we invest in community health. That is why the long-term plan commits to an extra £4.5 billion a year for community health. Local providers are expected to use some of that to develop the right specialist services in the community to reduce avoidable admissions.
Lyn Brown (West Ham) (Lab)
Children with Life-limiting Conditions
Debate between Lyn Brown and Caroline Dinenage(5 years, 9 months ago)
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The Minister for Care (Caroline Dinenage)
Of course, Ms Dorries. It is a great pleasure to serve under your chairmanship. I congratulate the hon. Member for Strangford (Jim Shannon) on securing the debate and on his enduring and passionate commitment to this incredibly important cause.
We heard incredibly powerful speeches from both sides of the Chamber, with lots of great examples of amazing practice in different regions. Some worrying issues were mentioned; I thank the hon. Members for West Ham (Lyn Brown) and for North Tyneside (Mary Glindon) for raising the issue of the life-saving drug that they are keen to get hold of for their constituents. I will of course commit to looking at that with the Secretary of State, but I share the concern of the hon. Member for West Ham that children should never be used as pawns in communications between drug companies and Government organisations.
Caroline Dinenage
Absolutely. The meeting probably would not be with me, because the issue does not fall under my portfolio, but it is really important that the hon. Lady meets the relevant Minister.
The debate has been very broad, and a lot of questions were asked. I will attempt to answer as many as I can, but I commit to writing to hon. Members with all the answers they asked for if I miss any out. Whenever we discuss this issue, we must keep at the back of our minds the powerful point made by the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron), despite her throat issues, that at a time of their lives when they are dealing with unimaginable stress and grief, parents should not have to fight for what they need to best care for their children.
The hon. Member for Swansea East (Carolyn Harris) painted a picture of how the world ends when you lose a child. I cannot even begin to imagine that, but it must feel the same to be told that your child may die at a young age. That must, quite simply, be devastating. As the hon. Member for Strangford said, almost 40,000 children and young people aged 19 or under in England live with a life-limiting condition and may need palliative care. Of those, around 1,000 die every year.
As outlined in the NHS long-term plan, we know that children’s palliative and end of life care have not kept pace with the growth in clinical care costs or with inflation. NHS England’s hospice grant programme provides £11 million a year for children’s hospices, which are incredibly valuable. I have spoken before—probably in this room—about my great passion for children’s hospices. That comes from my mum who helped raise money to build Naomi House children’s hospice just outside Winchester, and throughout my twenties she made the whole family partake in a range of humiliating fundraising exercises to raise money for that. I went to visit Naomi House again last year, many years later, and I saw at first hand the incredible, valuable services that it offers, not just for end of life care, but because of its respite and outreach work, which is a lifeline for so many families.
Hon. Members will know the invaluable services offered by children’s hospices, and I was pleased that in the long-term plan additional funding has been made available each year for children’s palliative and end of life care services. I understand the confusion about the different amounts that have been mentioned and issues around that, and Department officials are currently working with NHS England to clarify those numbers and what they mean. I am clear that funding for children’s hospices is vital. We must ensure they get the money they need, and that money must increase from its current levels.
As the hon. Member for Strangford pointed out, there is regional variation in how palliative care is delivered. I know that such care is exceptional in some parts of the country, and many staff up and down the country go above and beyond to ensure that experiences for children with life-limiting conditions, and those at the end of their life, are as good as they can be. We know, however, that there are areas where we need to do considerably more, and NHS England is firmly focused on providing support and challenge to achieve that. Choice at the end of life is a centrepiece of the Government’s drive to improve end of life care, and for choice to be meaningful it needs to be personalised and matched by healthcare services that respond in an effective way that places patients, families and carers at the heart of decision making. We know when we achieve that that we have got it right, but also that we have a long way to go. I pay tribute to the all-party group for children who need palliative care, and charities such as Together for Short Lives, and the work they are doing to take that crusade forward.
Transgender Equality
Debate between Lyn Brown and Caroline Dinenage(7 years, 11 months ago)
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Caroline Dinenage
I will come to that. Detailed guidance has been provided to staff on how to implement the changes. An advisory board has been set up to inform policy and establish best practice on the treatment and care of transgender and non-binary offenders in prison custody and under the supervision of the national probation service. I will write to the hon. Lady about immigration detention services. I know that the advisory board had its first meeting on 25 November.
Several hon. Members spoke passionately about health, particularly the hon. Member for West Ham (Lyn Brown). As she said, ensuring accessible and prompt health services for trans people is of continued concern. I am pleased that good, collaborative, progress is being made. Discrimination against trans people in the NHS is not allowed and is unacceptable. NHS England has convened a number of multi-agency symposiums to begin to address this issue. The hon. Member for Brentford and Isleworth (Ruth Cadbury) will be pleased to know that NHS England and the General Medical Council have acted on the Select Committee’s recommendations by publishing new guidance on GPs’ responsibilities in treating trans people. We are also tackling the very long waits to access gender identity services, and we are beginning to see results: the average waiting time for patients to receive reconstruction surgery at Imperial College Healthcare NHS Trust has dropped from 94 weeks to 61 weeks, and is getting better.
Lyn Brown
The Minister is doing a remarkable job on the Front Bench at the moment, so I thank her. May I ask her to push her colleagues in the Health team on a root-and-branch review of transgender and LGBT health, as the Select Committee requested? That is fundamental, rather than having small working groups working on small bits of the matter.
Caroline Dinenage
I will of course pass that sentiment on to my colleagues in the Department of Health.
NHS England has increased financial investment in gender identity services from £26 million to £32 million this financial year. In addition to funding, we need to increase capacity in this specialism. That is why a joint initiative between NHS England and Health Education England was launched on 20 October to develop a programme of work to address national workforce and training constraints in that specialty. The planned outcomes will be recommendations for the future workforce, and will include curriculum development, continuing professional development and general awareness training among NHS staff.
The GMC and NHS England are also currently considering piloting a formal process for accrediting competencies in gender identity. To provide a better service nationwide, we will revolutionise service provision. We are seeking new providers to host gender identity clinics, and we will tender for them via national procurement in 2017. We will ensure that they can deliver the requirements of the updated service specifications for adult services. That means not only clinics offering better services, but ensuring better geographical spread.