(2 years, 11 months ago)
Commons ChamberIt is important to remember that the clinicians who deliver the school-age vaccination programme around the country are very well equipped to deliver information about these vaccines, as they do in respect of others. The information will of course be made available to parents, and, as I have said, the consent procedure will be followed very closely. The infrastructure is not new; it is not something novel about which we might have to hesitate and worry. It is already there, and it is well able to deliver this programme.
There is a great danger in politics that we sometimes make decisions while looking in the rear-view mirror rather than at what is truly the current picture. I have grave concerns about this policy and the fact that the chief medical officers have made their decision on the basis of the educational impact rather than the health of the children at clinical level. I disapprove of this decision incredibly strongly, and I wonder what we can we do to ensure that this kind of thing does not happen again, because I firmly believe that this is a very dark day for our country. Is it going to end with vaccinating five-year-olds when there is no clinical need? This is not about teachers or education. The virus is endemic now; there is not a pandemic any more. We have to get real, and I hope that the Government will reconsider.
I remind the House that the chief medical officers looked at the mental health impact on children before making their decision today. That was an important aspect of their deliberations, and as I have said, the JCVI was in the room as well as the royal colleges. It is also important to remind the House that vaccination will be voluntary, and that no parent or child should be stigmatised in any way. As with our vaccination programme, this is about making all the information available and letting people make their mind up as to whether they want their child to be vaccinated.
(4 years, 3 months ago)
Commons ChamberThe precedent that health trumps liberty must not be the conclusion from this period. I am determined about that, because it is fundamental to our very souls as the British people. We are not a people who take well to surveillance, and it is a little ironic that the country that has probably been surveilling its population more than any other appears to have been the source of this virus. The point is that widespread surveillance really is not acceptable in Britain, so I want to talk a little about the app being proposed as part of the next phase, which may be related to the coming regulations that replace those we are looking at today.
Obviously track and trace and testing are essential parts of getting the population confident again that they can go about their business in a normal fashion. I support those things, and they are an incredibly important part of that. The opportunities that those things present to people must be taken up, but to do that they must be voluntary, decentralised and simple, because they have to be widely taken up to be effective as a process for giving people confidence that they do not have the virus and for spreading that confidence throughout society, so that people can go about their business normally. I am very concerned that it appears that that is not how the intended app has been designed.
The app is centralised, and it is worth understanding that Germany has now abandoned its plan to use an app that would centralise the information that it collected about where people had been and what their health conditions were. I understand that the NHS has itself assessed today that the proposed app may not provide enough security, performance or clinical safety for it to be used here. I would like to hear from the Minister whether those reports, for example on the UK Defence Journal today, are indeed accurate.
The decentralised model is how the app should be implemented by design, so that it is not possible for a security breach to be as serious. It is an essential principle of our democracy and our freedom that we are not tracked by the state, and I think that the centralisation of the data is entirely wrong. I would dump the centralised design and I would dump it now, because I do not think people will take it up in the proportions required for it to be effective if it is a centralised design.
We need to remember what the point is of these big intrusions. I completely agree that the lockdown was necessary, as I have said before, but these intrusions into normal life and our normal economic opportunities are really, really massive. They were done in order that we should not overwhelm the NHS—clearly that was the right thing to do—to give us time to build its capacity and to introduce capacity for testing. The whole idea behind that was so that we could get back to normal. We must never lose sight through this process of what normal means. “Normal” is not being tracked centrally. “Normal” is not being afraid. “Normal” is not being suspicious of every stranger. “Normal” is not dobbing in our neighbours. “Normal” is working when we can, not furloughing.
I genuinely believe that we need to get back to normal when restrictions are eased. We need to communicate that very clearly—much more clearly than has been done on occasion with some of the confusion about the regulations and their implementation. Our economy and our future depend on it.
(5 years, 2 months ago)
Commons ChamberThe hon. Gentleman is right that we need to ensure that access to mental health services improves. As part of the increase in funding we are putting into the NHS, the biggest increase is in mental health services, and it is a critical part of what we need to do to address the sorts of problems he rightly raises.
(5 years, 5 months ago)
Commons ChamberUrgent 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
The hon. Gentleman is normally a sensible man, but I could not disagree with him more on this one. The point of this settlement is to ensure that we have the unhindered supply of medicines, so that, whatever the Brexit scenario, people can get their medicines. This was a cross-Government decision and I am here, as the Health Secretary, because it is medicines that will be carried on these ferries. If the court case had gone against the Government and the court had struck down these contracts, we would not have been able to be confident about the supply of those medicines. I think it is incumbent on any Government to ensure that they can deliver that. There is something else we can do to deliver the unhindered supply of medicines and he can do it too; it is within his gift—he can vote for the deal.
I welcome my right hon. Friend’s sensible contingency planning for any eventuality, but may I highlight that it is important to focus on all the routes across the channel and everything related to that? Although it is good that Eurotunnel is being focused on, it is worth looking at the transit system as a way to smooth the procedures on the main ferry routes across the channel also.
Yes, and that is exactly what these contracts, with which we can now proceed because of the settlement, do. Essentially, they provide for more capacity away from Dover-Calais so that medicines can be routed into the UK and, indeed, onwards to Ireland through other routes. They allow for that. I am glad of my hon. Friend’s interest in this matter and hope he will vote for the deal.
(5 years, 10 months ago)
Commons ChamberI am not aware of the specific details of that, but I am happy to meet the hon. Gentleman to discuss it if he has particular concerns he wishes to raise.
We are continuing to review the advice from our expert advisory groups on safe levels of folate intake, but, continuing our tradition of announcing things to the House first, I want to inform the House today that we are going to issue a public consultation, as of now, on adding folic acid to flour.
(6 years, 1 month ago)
Commons ChamberIt is a pleasure to follow the hon. Member for Crewe and Nantwich (Laura Smith), who made some interesting points about adult social care. I have similar issues in my constituency, where one of the main care providers increasingly sees private clients effectively subsidising local authority provision. The gap between the costs has been getting wider and wider. The concern of many of my constituents is whether they will be able to afford private care if public provision is not forthcoming.
It is also a pleasure to follow the hon. Member for Dulwich and West Norwood (Helen Hayes), who spoke about King’s College Hospital. My father was a registrar in neonatology—he is a paediatrician—at King’s in the 1980s, so it is a hospital that I know well, and I am sympathetic to the challenges of an inner-city area. In my area we have a rural district hospital, which is very high quality and gets very good results, and the people there do an outstanding job. The hospital is in deficit and has been part of the vanguard transformation initiative, which has meant extra costs. Sometimes the benefits of working in new ways do not show in the money saved initially, because we have to wait for wider population health outcomes to be able to judge that.
The hon. Gentleman raises the important issue of how we transform care to ensure that we do the very best for patients. Does he share my concern—this was raised by the National Audit Office only last Friday—that the vanguard programme has not delivered the depth or scale of transformation in service that was intended? Part of the reason is that there are not enough funds in the rest of the NHS to ensure that the transformation that we want to see can actually occur.
The hon. Lady makes a good point. It is about trying to understand when the effects will show up. Often what we have to do in the meantime is to run two parallel systems, in order to get one up and running, and that can be challenging. I welcome the extra money for healthcare but, as I said on Wednesday, we really should not allow it to crowd out other types of spending, particularly local government spending, which we have heard about in relation to social care.
In Somerset, the Conservative county council has undertaken nine years of efficiency savings. It has cut a lot of money out of its budget, but we are getting to the point where further cuts will make a significant difference to people’s lives and the provision of services. The Liberal Democrats left the county with nearly £400 million of debt. The repayments are £100,000 a day, which is really disappointing because we would much rather spend that money on services for the public. The county really needs about another £20 million. Ministers should look at whether the virements in the estimates are enough. I would like the amount in paragraph (2)(c) to be increased by £20 million to fund the very serious gap the county will otherwise have to make up through serious cuts to real people’s services.
It is worth highlighting the plight of children’s social care. The county has made great strides to deal with issues and modernise the service—it has spent a lot of money doing so—and that is an ambition we should all espouse. The difference between children’s social care and adult social care is essentially that adult social care gets cross-subsidised by private clients, as I said, and to some extent by its integration with the healthcare system. What does not really happen in children’s social care is the same level of integration or thought about how the education service integrates with it. In Somerset, we have very high transport costs for children who wish to be educated in Somerset but are placed outside it, for example in Bournemouth. That is something that we need to address.
The reality is that overall Somerset needs more funding. It needs fairer funding, because it is still massively underfunded relative to urban and other areas. On how to pay for that, we have heard good points about why we should not automatically look to tax rises. Public spending has come in under estimate, so there is scope at the moment for a bit of extra deficit funding. Given the fiscal and monetary tightening around the rest of the world that is taking some of the heat out of western economies, I think that would not be frowned upon. Local government funding in Somerset would be a very worthy recipient of such flexibility.
(6 years, 8 months ago)
Commons ChamberWe have not been very good at making it easy for people to work flexibility in the NHS. Contracts are too rigid and we are looking to change them. We recognise that for many nurses their commitment to the NHS runs very deep, but that they have to juggle that commitment with family responsibilities. We want to do better.
There are many very committed individuals working in health and social care services in Somerset, but one challenge is getting enough registered nurses into the system to allow them to integrate. What can the Minister do to help to get more registered nurses?
My hon. Friend will be aware that last week we published the workforce strategy. One major focus was on meeting the Secretary of State’s commitment to increase the number of registered nurses by 25% and to broaden the routes into nursing. There is a commitment to expand the nursing associate role, which is helping to provide opportunities, through an alternative route, for healthcare support workers to become registered nurses.
(6 years, 10 months ago)
Commons ChamberOur ageing population is undoubtedly one of the challenges of our age, and I am proud of what we are doing locally in Somerset to be in the vanguard in this country on the integration of health and social care, which is an essential part of meeting the challenge. Some of our care providers have faced incredibly big challenges over recent years. The rise in the national living wage has put a lot of pressure on their budgets, as have rising pension costs and rising regulatory fees, the apprenticeship levy, and the normal inflation in rent and other costs. It is my understanding that our current council fee rates for care cover only 70% of the costs.
We also need to focus very carefully on the issue of sleep-in shifts and the national living wage being applied to that. I do not think it is sustainable for us to allow that, and we should try to legislate against it. Care providers in my area have informed me that it is not the same as waking duty hours.
Somerset Care is a well-run not-for-profit company that is performing very well and is a key part of the provision of care in Somerset. It is having to hand back some of its contracts from the local authority because they are underfunded, and we have seen 445 fewer beds in the south-west year on year in 2017.
Local authority funding is a factor. It has been drastically reduced, and I am keen to ensure that Somerset is, if at all possible, a pilot in the retention of business rates. I am a firm believer in giving local areas the revenue opportunities they need to be able to innovate and attract more business in various ways, to be able to fund some of these undoubted needs in future.
The sector must provide newer facilities. Some 85% of care home stock in the UK is now more than 50 years old. We need capital funding solutions to be able to lever in private capital. On current parameters, new care homes need at least 70% of self-funders to have the required return on investment. We also need a bigger workforce, and Members have talked about some of the issues in that regard. We need 53% more people in this sector by 2030.
In terms of solutions, several people have spoken about social insurance, and I think that that is probably the best way to try to pool risk. However, I do not think this is a risk that should be pooled across the whole of society; that would not be fair. We should also incentivise savings schemes better and give tax breaks, and perhaps VAT exemptions, to the providers of new-build care homes. I have mentioned integration before, and we have seen the vanguard in Yeovil: getting patients out of acute beds and into social care settings earlier can save up to £300 a day, which is very encouraging.
I have already mentioned sleep-in shifts and local dynamism, and I am mindful of the fact that others want to speak, but I want to conclude by saying that I welcome the Government’s paying attention to this issue. It is undoubtedly one we need to look at. This is a pressing matter, and I urge the Government to really motor along on this one. This is urgent for some of those providers who are facing serious situations. I do not believe that the answer is higher taxes, either at national or local level, and I do not believe in politicising the issue, as some Opposition Members have been tempted to do. Essentially, we need innovation. We need to create the conditions for the private sector to work with providers to give our older generations the support that they need.
(7 years, 1 month ago)
Commons ChamberI thank the hon. Lady for her question and I look forward to engaging with her on such matters. The “General Practice Forward View” is a landmark document, which was published in April last year. As she knows, it sets out extra investment that GPs have been calling for for years: £2.5 billion a year for GP services. That means investment is rising. The good news, as the Secretary of State said, is that more people are coming into general practice. We want to continue to encourage that, but we also have to take action to prevent early retirements and to bring people back to general practice. We are indeed doing that.
6. What steps are being taken to broaden routes into nursing.
Developing new routes into nursing is a priority for the Government. That is why we launched, as the Secretary of State set out, both the new nursing associate role and the nursing degree apprenticeship earlier this year. They will open new routes into the registered nursing profession for thousands of people from all backgrounds and allow employers to grow their own workforce from their local communities.
Health Education England’s “Workforce Plan for England” for 2016-17 indicated an increase of more than 3% in the number of mental health nurse training places. It stated:
“The current level of mental health nurse training is the highest of any nursing branch as a percentage of the workforce it serves”,
which should allow for an increase of some 22% to more than 8,000 full-time equivalent staff members in the mental health workforce by 2020.
(8 years, 9 months ago)
Commons ChamberI am grateful for the opportunity to speak in this debate. I congratulate my hon. Friend the Member for Aldridge-Brownhills (Wendy Morton) on bringing forward the Bill, which would allow this massively important charity to move forward.
My father is a consultant paediatrician, a neonatal intensive care specialist and a former president of the paediatric assocation of the Royal College of Medicine. As a child, I spent many Christmases visiting wards and seeing very sick children. That made an indelible impression on me, and now that I have my own children I remember the many faces that I saw. I therefore have some understanding of what goes on at Great Ormond Street hospital, with which my father worked closely on many occasions. It is truly leading the way on treatment and on research.
There are good facilities for sick children at the hospital in my constituency, and I pay tribute to all the incredibly committed doctors and nurses who work there. As we have heard, more difficult cases are often referred from other parts of the country to the London trusts, and particularly to Great Ormond Street because of its cutting-edge work.
I was involved in helping one family in my constituency, the Bennett family, to go to Great Ormond Street. They were incredibly grateful for the benefits that the Great Ormond Street charity provided, and particularly for the help they received with accommodation at what was an extremely difficult time.
Yeovil has its own hospital charity, Flying Colours. I pay tribute to its manager Sarah Cherry and all the other people at the district hospital, who have managed to raise more than £500,000 for better facilities and an expansion of the hospital’s special baby unit. That is intended to support, in particular, children who are born with addictions, which I know can be one of the most distressing conditions to witness. There are other great charities in Yeovil, including St Margaret’s hospice, which, because of the way in which it was set up, already has the flexibility that allows it to raise money in different ways. It would be great if charities such as Flying Colours had the same ability.
“Peter Pan”, by J.M. Barrie, is a perfect story to associate with the Great Ormond Street charity, and we should thank Barrie for the foresight that he showed in helping those who are indeed forever young in some cases. I should add that I know something else about his relationship with the hospital: his family used to live in Bloomsbury, which was, of course, a great centre of the London literary world, and it is nice that it retains that association with the hospital to this day.
However, the fundraising of the Great Ormond Street Hospital trust goes much wider than the bequest of J.M. Barrie, and I think it needs the flexibility that would allow it, too, to raise money in a number of different ways. J.M. Barrie’s copyright is sometimes disputed, particularly in America. The Bill’s proposal to reduce the liability that the trustees can face is a positive step, because no one wants to be sued by the Americans.
I entirely agree with what my hon. Friend is saying. It is not just a question of the tactics that the trust can use to raise funds. The Bill will enable those who donate, and who participate in fundraising, to feel confident that the charity, and those who are independent of the Government, will spend the money and decide how it will be spent.
My hon. Friend has made a very good point.
The Bill will provide the flexibility, the independence, the reduced liability and the reduced operation costs that will allow the charity to maximise its innovation, the help that it gives to other people, and the great work that is done in the hospital, and I commend it to the House.