University Hospital Coventry

Marcus Jones Excerpts

Thursday 13th June 2019 Commons Chamber

[Mr Marcus Jones (Nuneaton) (Con)]

I congratulate the hon. Gentleman on securing this debate. These are important services that my constituents also access. Clearly, amalgamating these services is of concern to me as it will take away the choice of residents as to whether they want treatment at Coventry or Birmingham. As the population is growing significantly in our area, amalgamating those services may also lead to longer waiting times. Does he agree with me?

[Mr Cunningham]

The hon. Gentleman makes a valid point, and I will be touching on that a little later on in my comments.

As a bigger hospital in one of the UK’s biggest cities, UHB had a great deal of influence over these discussions. It soon became apparent to the UHCW team that the sacrifices would be one-sided. UHCW felt that it must pull out of the talks, as it was clear that its services would be downgraded and its specialised work would be removed completely—services that it had worked hard to develop. That would be detrimental to the people of Coventry, Warwickshire and beyond.

In November 2018, NHS England served a formal notice on UHCW to transfer specialised liver and pancreas services to UHB in Birmingham or risk decommissioning. UHCW was denied the opportunity to establish the population base required to be an independent centre. There is now a concerted effort from UHB trust management and NHS England to enforce the takeover of the HPB centre at Coventry.

The simple and accepted solution, which is in line with the professional recommendations, is to implement the agreement between UHCW, Worcester Acute Hospitals NHS Trust and Wye Valley NHS Trust to provide the liver and pancreas specialised service at UHCW NHS Trust. It is important to highlight the ongoing capacity constraints at UHB. The realignment from Worcester and Hereford to UHCW would effectively fulfil the required population base to be an independent centre—as per Department of Health and Social Care guidelines—and also reduce the very long waiting times for cancer operations and improve access.

The proposals demonstrate more short-sighted, efficiency-obsessed thinking from NHS England based on the National Institute for Health and Care Excellence guidelines. The findings of the 2015 review, which stated that UHCW’s HBP unit does not serve enough people, totally ignored the good standard of pancreatic care at UHCW. It is of the highest quality and helps to provide patients with the best possible outcomes. NHS England’s proposals threaten the standard of care, which I will raise shortly. The proposals will have a detrimental impact on those in need of this care in Coventry and elsewhere in Warwickshire. Although the 2015 review stated that the HPB unit—

--- Later in debate ---

[The Minister for Health (Stephen Hammond)]

I thank the hon. Member for Coventry South (Mr Cunningham) and congratulate him on securing this important debate. I thank the other Members who have contributed. I want to start this debate, as I try to start all debates in the House when talking about the NHS, by congratulating and thanking the staff who work in the NHS—in particular, given the nature of the debate, the staff who work in the hospitals of Coventry and Warwickshire and throughout the west midlands.

The hon. Gentleman made a number of important points that I will try to address. I know that he wrote the Department a letter in May. I will ensure that there is a response to it, but I can tell him now that the response will be that I would be delighted to meet him and the fellow MPs who have signed the letter to discuss its contents and what I am about to say.

The hon. Gentleman raised a number of important concerns regarding the discussions to transfer HPB services from University Hospitals Coventry and Warwickshire NHS Trust to University Hospitals Birmingham NHS Foundation Trust. HPB services treat patients who have disorders of liver, bile ducts and pancreas, including pancreatic and liver cancer. A large volume of HPB services are delivered in local hospitals, but because of their complex nature and the high cost of care, delivery in conjunction with specialist tertiary centres is often necessary.

As the hon. Gentleman indicated, in October last year, NHS England confirmed that no decision had been made to transfer or close the HPB service in Coventry, despite some concerns that national clinical service specifications were not being met. I understand that he is still concerned about that, but I can confirm that there are currently no plans to transfer HPB cancer services away from University Hospitals Coventry and Warwickshire NHS Trust. However, NHS England is actively supporting the trust to work alongside University Hospitals Birmingham NHS Foundation Trust, to ensure that patients have access to safe, high-quality treatment.

University Hospitals Coventry and Warwickshire NHS Trust has said that it is proud—rightly so—of the HPB service, which has excellent outcomes and feedback about the quality of healthcare provided, as the hon. Gentleman mentioned. In 2015, the West Midlands Clinical Senate reviewed the three HPB services across the west midlands and recommended combining them across two sites, because they did not meet national requirements.

The “Improving Outcomes” guideline document specifies that a population base of at least 2 million is required to make a compliant service. Currently, University Hospitals Coventry and Warwickshire NHS Trust treats a population of about 1 million. The guidance also specifies that for a population of around 2 million, around 215 pancreatic and liver resections a year would be expected as a proportion of the population size.

The hon. Gentleman talked about the number of operations and resections done by this unit. Between 2013 and 2018, an average of 80 resections a year were performed in University Hospitals Coventry and Warwickshire NHS Trust. He quoted a rather larger figure, but it was 80 pancreas and liver resections a year. I am happy to discuss with him at the meeting the number he quoted, but it is not one I recognise.

I understand that, over the past two years, teams in both trusts have been discussing how to work together with a view to creating a single point of access and shared multidisciplinary teams for HPB in the local area. Both trusts have agreed that the most complex services should be conducted on University Hospitals Birmingham’s Queen Elizabeth site. However, the trusts are yet to agree on an established definition of the most complex surgery. The clinicians from both hospitals who are currently delivering the service will continue to work together to develop this new combined model of care. NHS England will determine the best way to meet patients’ needs collaboratively, based on specialist surgical skills and the skills that are available at each hospital, as well as on the volume and complexity of clinical cases.

I would like to reassure the hon. Gentleman and, indeed, other Members in the Chamber that I recognise that discussions concerning service change are controversial, and this case is no exception. However, I would also like to reassure hon. Members that all service changes are designed to drive up service quality, meeting the specific requirements of local populations and trying to achieve what is best for specialist service users overall. The hon. Gentleman has set out, with great emphasis, the significant challenges that remain, and it is right that the trusts continue to work together to determine the best method to deliver these highly complex services.

The hon. Gentleman and, I hope, all hon. Members know that cancer is a priority for this Government. Survival rates are at a record high. Since 2010, rates of survival from cancer have increased year on year. However, as we know, there is more to do. That is why, last October, the Prime Minister announced a package of measures that will be rolled out across the country with the aim of detecting three quarters of all cancers at an early stage by 2028.

As part of the NHS long-term plan that we announced in January, the Government have outlined how we will achieve the ambition to see 55,000 more people surviving cancer for five years in England each year from 2028. The Department invests £1 billion a year in health research through the National Institute for Health Research. It spent £136 million of that on cancer research in 2017-18, which is an increase of £35 million on 2010-11. The NIHR is funding and supporting a range of research relevant to liver cancer, including a £1.76 million trial of liver resection surgery versus thermal ablation for colorectal cancer that has spread to the liver and early research on specialised magnetic resonance imaging scanning to detect liver cancer that has spread from colorectal cancer. There is much still to be done, but much is being done.

[Mr Marcus Jones]

I hear clearly what my hon. Friend says about the improvements that are being made in this area and in wider cancer care, but I am still concerned about the potential loss of what is a good service from Coventry. I am also concerned that at the moment, while no decision has been made, discussions and negotiations are clearly going on in that regard. It is quite obvious from the discussions that the hon. Members for Coventry South (Mr Cunningham) and for Warwick and Leamington (Matt Western) and I have had that not everybody in those organisations is in the loop, actually knows what is going on and is satisfied with this situation. Will my hon. Friend look at what more can be done to make sure, in this situation, that information is disseminated widely between clinicians and organisations so that we ensure we do not unnecessarily lose very high-quality people from organisations such as University Hospital Coventry?

[Stephen Hammond]

My hon. Friend makes an important and valuable point, and as a result of this debate I pledge to write to the hospitals to ensure that the ongoing discussions between the various parties are as inclusive as possible. As I said earlier, I will happily meet him, the hon. Member for Coventry South, and other Members.

[Mr Marcus Jones]

My hon. Friend is kind and generous in giving way, and I thank him for the commitment he has made. There has clearly been little public engagement, but that is what we need with regard to any changes that are made, so that the public can understand the rationale behind these changes. I am aware of one person who has been chasing information about this issue, but they have hit a brick wall.

[Stephen Hammond]

My hon. Friend is assiduous in representing his constituents and making his points. As I have said, these discussions have not yet concluded, and it would be hugely inappropriate for me or any politician to try to prejudge the right clinical outcomes. When those clinical outcomes have been worked through and the discussions finalised, I have no doubt that University Hospitals Birmingham and the Coventry and Warwickshire Partnership NHS Trust will wish to publicise the result of those discussions as widely as possible.

Draft Social Security Coordination (Reciprocal Healthcare) (Amendment etc) (EU Exit) Regulations 2019 Draft National Health Service (Cross-Border Healthcare and Miscellaneous Amendments etc.) (EU Exit) Regulations 2019 Draft Health Services (Cross-Border Health Care and Miscellaneous Amendments) (Northern Ireland) (EU Exit) Regulations 2019

Marcus Jones Excerpts

Monday 25th March 2019 General Committees

[Stephen Hammond]

The hon. Gentleman is a noble exponent of the art of opposition, but he is sensationalising and misunderstanding what I say. I have not said that the arrangements are not going to continue; what I have said is that in a no-deal scenario there may be some circumstances where people have to consider different arrangements from what they have already. It is the Government’s intention, in both a deal and a no-deal scenario, that these arrangements should continue, and that is what we will put in place this afternoon, if we ever get there.

[Mr Marcus Jones (Nuneaton) (Con)]

The hon. Member for Huddersfield seems to be trying to imply that if someone goes on holiday in the EU area at the moment, they do not need to have travel insurance. Now, from my experience of travelling to the EU area, it has always been advisable to have travel insurance, because in my experience, when I have had to access services, the first thing that the hospital in an EU country has asked is, “Where is your health insurance? Where is your credit card?” So it is not necessarily just a given that the card that people can obtain covers them in all eventualities.

[Stephen Hammond]

Where my hon. Friend is absolutely right is that, of course, it has always been the advice that people should purchase travel insurance when they travel, wherever they travel, including within the EU. The EHIC card is clearly in place. If the withdrawal agreement is signed, that arrangement will continue, but it has always been the Government’s advice that people should take out the appropriate travel insurance when travelling abroad, and he is absolutely right to make that point.

Eurotunnel: Payment

Marcus Jones Excerpts

Monday 4th March 2019 Commons Chamber

[Matt Hancock]

This was a cross-Government decision. It is all taxpayers’ money, at the end of the day.

[Mr Marcus Jones (Nuneaton) (Con)]

It is important that people with long-term health conditions are reassured that they will have access to the right medicines, so my right hon. Friend is right to make sure that there is proper access across the channel. What are the pharmaceutical companies doing to keep a greater stock of reserves over and above those that they usually hold?

[Matt Hancock]

We have a multifaceted approach to making sure that we have an unhindered supply of medicines, and stockpiling is of course another important part of that. The vast majority of the 12,300 medicines that are commonly used in England can be stockpiled. For those that can be stockpiled, we asked for a six-week stockpile to be put in place, and we have plans in place for almost all of those. For the very small number remaining, we are putting plans in place right now. We are doing all that with the confidence that by the time we get to 29 March, so long as everybody does what they need to do between now and then, we will be able to have confidence in that unhindered supply.

NHS Long-term Plan

Marcus Jones Excerpts

Monday 7th January 2019 Commons Chamber

[Matt Hancock]

I will absolutely look into the request that the hon. Lady makes. The example that she gives locally in Hull is actually reflected across the country in terms of the need for greater access. For the first time, we are going to have access targets for community mental health, because it is critical to make sure that we have accountability and understand what is happening in mental health trusts in terms of access so that we can then drive policy to meet it. But I appreciate that that is a medium-term goal: in the short term, she has made a specific request for a specific organisation, and I will absolutely look into it and write to her.

[Mr Marcus Jones (Nuneaton) (Con)]

Mental health issues are often part of the very complex causes of rough sleeping. They are also a barrier to getting rough sleepers off the streets. Will my right hon. Friend say more about how his plan fits in with the Government’s plan to eradicate rough sleeping?

[Matt Hancock]

Yes, my hon. Friend is absolutely right about this. I pay tribute to the work that he did as a Minister in this area. We have put forward £30 million to support mental health services for rough sleepers. It is about so much more than just the money, though—it is about co-ordinating care and co-ordinating different agencies. There is a lot of work going on on this inside Government that he was very much involved with.

Prevention of Ill Health: Government Vision

Marcus Jones Excerpts

Monday 5th November 2018 Commons Chamber

[Matt Hancock]

Yes, we are considering this as part of the long-term plan. We have already announced that more than £2 billion extra will be going into mental health services and services to tackle eating disorders, and there will be more to come on this very shortly.

[Mr Marcus Jones (Nuneaton) (Con)]

Will my right hon. Friend join me in congratulating Whitestone surgery and its patient participation group, who have brought forward a social prescribing model that has reduced the prevalence of early-onset dementia and reduced the number of anti-depressant drugs being prescribed at that surgery?

[Matt Hancock]

Yes, I absolutely will. I am a huge fan of social prescribing. I essentially think that because drugs companies have a big budget to try to market their drugs—and of course many drugs do wonders—there is not the equivalent level of organisation to drive up the use of social prescribing. Examples like the one that my hon. Friend mentions are incredibly important.

Ovarian Cancer: Diagnosis and Treatment

Marcus Jones Excerpts

Tuesday 30th October 2018 Westminster Hall

[The Parliamentary Under-Secretary of State for Health and Social Care (Steve Brine)]

It is a pleasure to see you in the Chair, Mr Bone. I, too, congratulate my hon. Friend the Member for North East Derbyshire (Lee Rowley) on securing the debate. As vice-chair of the all-party parliamentary group on ovarian cancer, the subject means a great deal to him. We also heard more about why it means a lot to him. I place on record my thanks to the all-party group and to the excellent ovarian charities. Target Ovarian Cancer is the biggest, but others work tirelessly in that space, such as Ovacome.

Watching my hon. Friend brought back memories of sitting in that exact chair as one of the vice-chairs of the all-party parliamentary group on ovarian cancer almost exactly seven years ago, in October 2011. I was talking about ovarian cancer, which has also had an impact on my family, although sadly not with the outcome that my hon. Friend currently has. I described it as a “silent national scandal”, which was then trending—quite something in 2011. I was also present for the 2014 debate that he remembers, which was the last time the subject was specifically debated in the House. It was a pleasure to hear him today; he reminded me of me—but I put on record the warning that this is where I have ended up.

I was pleased to meet with the hon. Member for Washington and Sunderland West (Mrs Hodgson) and Target Ovarian Cancer a couple of weeks ago to discuss the all-party group’s report, as the hon. Lady said. As she knows, I take the all-party groups very seriously. I have the report here—this is my coffee table copy in the Department of Health and Social Care, and anybody who knows my office knows that what is on the coffee table is what counts. It is an excellent report with many important recommendations and I will return to it a lot in my remarks. I have already committed to responding fully to it and the hon. Lady knows that I will do that.

I am responding to my third cancer debate in the House in less than two weeks, which demonstrates that improving cancer diagnosis and treatment is a priority for right hon. and hon. Members, as it is for me as the Minister with responsibility for cancer, the Government, the Prime Minister and the Opposition. In this job, I am fortunate to see first hand the superb work being done by our NHS staff and by our many partners and charities across the cancer community in implementing the 96 recommendations in the cancer strategy for England.

We are three years into that work and cancer survival rates have never been higher, as has been said. About 7,000 people are alive today who would not have been had mortality rates stayed the same as before Cancer Research UK and Harpal, who led the work, published the strategy. As I make clear every time I respond to a cancer debate, however, I know that we must do more and that people want us to do more, because we still lose 12,000 women a year to breast cancer and far too many women to ovarian cancer. We must do better. Despite the huge strides that I have mentioned, and the best-ever survival rates, ovarian cancer survival rates in the UK are among the lowest in Europe with fewer than half of all women diagnosed surviving five years or more, so there is much that we need to do.

[Mr Marcus Jones (Nuneaton) (Con)]

The Minister has mentioned the success rates in dealing with cases of ovarian cancer in our country compared with some of our European partners. Can he set out what we can learn from them in improving outcomes for women in this country?

[Steve Brine]

I will certainly cover that. Put bluntly, as I will come on to in a second, and as almost all hon. Members have mentioned, it is about early detection. That has an impact because, as the former chair of the all-party parliamentary group on cancer, my hon. Friend the Member for Basildon and Billericay (Mr Baron), has said many times, early diagnosis is cancer’s “magic key”. We have that magic key in some cancers in this country. We do very well in breast cancer, where the early-stage survival rates are well over the 75% target that the Prime Minister set out at the party conference earlier this month, but it is true that we do not yet have the magic key in enough cancers. I will come on to what we need to do.

I was pleased when the Prime Minister announced the ambitious package of measures for cancer care and treatment earlier this month, which will be at the heart of our long-term plan for the NHS. It will be backed up by the new funding that was announced in the summer and confirmed in yesterday’s Budget. We will overhaul screening programmes, provide new investment in state-of-the-art technology to boost our research and innovation capability and, critically, transform how we diagnose cancers earlier. As I have said, our ambition is to diagnose 75% of all cancers at an early stage, which will result in an estimated 55,000 more people surviving cancer for five years in England each year from 2028.

All hon. Members have mentioned early diagnosis, and many have mentioned some stats—or the same stats. The important one for me is that a quarter of women with ovarian cancer are diagnosed through an emergency presentation. When I first became an MP, I remember going to meetings with the all-party parliamentary group on ovarian cancer and the all-party parliamentary group on cancer, where I was shown the stats for my constituency of the number of people who presented in the emergency department with cancer. That really frightened and shocked me—it still does—and along with my personal history, it was one of the reasons I wanted to get involved in health and cancer when I joined the House.

Of that quarter of women with ovarian cancer who are diagnosed through an emergency presentation, just 45% survive for a year or more. That is no surprise—if someone is diagnosed in an emergency department, they have exhibited more outward symptoms, so they are at a later stage and their survival rate is lower. The survival rate is more than 80% when women are diagnosed following a GP referral, so it is crystal clear where improvements are urgently required. That is why early diagnosis is a key strategic priority in the cancer strategy. As has been said, it allows for more options for treatment and, crucially, the earlier a cancer is diagnosed, the more likely it is that doctors will be able to provide successful treatment or operate on the “bunch of grapes”—that is a good analogy, which I have heard before.

My hon. Friend the Member for North East Derbyshire talked about the multidisciplinary diagnostic centres. NHS England and the Department are testing new innovative ways of diagnosing cancer earlier. As regular attendees of cancer debates will know, I never tire of praising the accelerate, co-ordinate, evaluate—ACE—centres, which are the multidisciplinary diagnostic centres for patients with vague or non-specific symptoms. As the hon. Member for Washington and Sunderland West said, they are being piloted across 10 sites in the country. They offer patients a range of tests on the same day—a point that has been made by several hon. Members—with rapid access to results.

The centres are magnificent. I visited the ACE centre at the Churchill Hospital in Oxford earlier this year. I met the practitioners who work there, the commissioning group and the GPs who are involved in it. GPs are tremendously, and rightly, excited about the centres. They will make a huge step-change improvement in early diagnosis, particularly for cancers such as ovarian cancer, where symptoms can be vague and can appear less serious at first. The plan is for that innovation to address the delay that the hon. Member for Washington and Sunderland West and other hon. Members spoke about, so instead of a GP having to refer for one test and wait for the results, then refer for the next test and wait for an appointment, the ACE centres will allow for a snappy, quicker turnaround. They could be a game-changer and could unearth the magic key when it comes to ovarian cancer.

The APPG’s report says that we should roll out ACE centres nationwide, so I am delighted, as I know the hon. Member for Washington and Sunderland West is, that the Prime Minister recently committed to doing just that, as part of our long-term plan. I do not get excited easily, Mr Bone, as you well know, but I am excited about the ACE centres and they are potentially transformative.

I turn now to early diagnosis in primary care. Other support measures are necessary to ensure that more cancers are caught in primary care. The NICE guidelines for suspected cancer referral recommend safety netting for those people who are at higher risk of cancer but who do not meet the referral criteria. Both Cancer Research UK and Macmillan have produced additional advice and support for GPs to implement those guidelines, including the safety netting that I have just mentioned, over the last few years.

I was blown away to meet Macmillan GPs at Britain Against Cancer earlier this year. They are an excellent innovation and have an awful lot to give, but they are few in number. I am very interested in them and I talk to Macmillan about the potential use of Macmillan GPs in helping to transfer specialist knowledge of cancer to wider general practitioners. I always say of GPs that they are not dissimilar to MPs when we hold our surgeries, in that almost everyone who comes to our surgeries is more of an expert on the subject that they have come about than we are, because we are general practitioners. So GPs get a hard rap, but they are general practitioners and that is the area of the profession that they have chosen to go into.

We need to support GPs better through diagnosing cancer, from our targeted lung cancer screening in the lorries in car parks in the north-west—we trialled that approach in Manchester and it has been very successful—to the ACE centres that I have mentioned. That is all aimed at supporting the NHS, especially GPs, to identify cancer earlier.

The shadow Minister asked about the review of the referral pathway. As she knows, the implementation of the faster diagnosis standard requires trusts to review and speed up diagnosis pathways for suspected cancers. NHS England and NHS Improvement are working closely together to emphasise the key principles for improvement that we need in this area, which include ensuring that the most value is derived from each appointment. The standard is being measured for a year from April 2019 to April 2020, when it comes into place. That will ensure that patients are told that they have a cancer diagnosis or an all-clear within a maximum of 28 days of being urgently referred by their GP for suspected cancer. As I always say, 28 days is not a target; it is a maximum. When someone has a cancer worry, 28 minutes can seem like a lifetime, and such things always seem to come on a Friday night, when the weekend lies ahead. Twenty-eight days is our new target, but it is certainly not what we aim for; we aim to do better than that.

We heard from several Members—including the hon. Member for Strangford (Jim Shannon) and the shadow Minister—about Be Clear on Cancer. That campaign is one of the great successes of public policy in recent years. The APPG’s report also recommends, as the hon. Lady said, running a Be Clear on Cancer campaign to raise awareness of ovarian cancer symptoms. However, she is experienced and smart enough in this area to know that Be Clear on Cancer cannot focus specifically on a cancer type, such as breast cancer; it is about clusters. That is where we have found it to be most successful.

Public Health England, for which I have ministerial responsibility, takes a number of factors into account when deciding which campaigns to develop; of course, there is healthy competition in this space and unfortunately there is always more demand than supply. One of the main criteria in deciding which campaigns to run with is the scope to save lives through early diagnosis; that measure is what I will judge that work against.

Campaigns can be effective only if the cancer has a clear early sign or symptom that the general public can act upon if it should emerge. Being honest, even blunt, that is part of the challenge here, as has already been said and for the reasons that have already been given. So the regional Be Clear on Cancer pilot for ovarian cancer took place in the north-west of England in February and March 2014—a while ago now—with this simple key message:

“Feeling bloated, most days, for three weeks or more could be a sign of ovarian cancer. Tell your doctor.”

PHE is currently undertaking new data analysis and research to determine Be Clear on Cancer campaigns for next year, which is 2019-20. At this time, no decisions have been made, and I will take the bid from today’s debate very strongly. The outcomes from the regional pilot—and a pilot that focused on a range of abdominal symptoms such as diarrhoea, bloating and discomfort, which can be indicative of a number of cancers, including ovarian cancer—will of course be taken strongly into consideration, and that is where I think we will head with this work.

However, let me clear that PHE and NHS England have had a very clear steer from me that I want to run the campaign on lower abdominal symptoms as soon as practicably possible. We have to make sure that the operational capability is in place across the NHS, because the worst thing that we could do is create a demand without being able to meet it. That is a rather boring, practical reality, but it is a reality. I reiterated this point to the APPG recently when we met and I will of course keep Members updated; I know they follow these matters very closely.

The hon. Member for Strangford also asked about genetic testing and its role in identifying the increased risk of ovarian cancer. One area where England is very much at the cutting edge of cancer diagnosis is in the creation of the new national genomic testing network, which will be delivered through seven new genomic laboratory hubs, as we call them. They will give patients access to state-of-the-art tests that can diagnose their disease or help to inform their treatment. So the genomic lab hubs will do three things: provide consistent and equitable access to genomic tests, which is very important, as it will ensure there is a level playing field; operate to common national standards, specifications and protocols; and deliver the single national genomic testing directory, which will cover the use of all the genomic technology, from the single gene to the whole-genome sequencing for cancer and for rare and inherited disease.

The labs are in a period of transition, to embed fully the new infrastructure and the new national genomic test directory. I hope that this transition will ensure the safe roll-out of the service without disrupting clinical care. Patients will continue to receive the testing they need to inform their clinical care, and the new national test directory will also include the BRCA testing for women with ovarian cancer in line with NICE guidance, which the hon. Gentleman rightly mentioned.

While I am talking about the hon. Gentleman, or “the hon. Member for Westminster Hall” as I like to call him, I note that he also touched on screening programmes, as did the Opposition spokesperson and my hon. Friend the Member for North East Derbyshire. The UK National Screening Committee is awaiting the updated results of the UK trial of ovarian screening, which is the UK collaborative trial of ovarian cancer screening, as it is known. The secretariat is in contact with the researchers and the committee will review the findings as soon as they are published.

The hon. Gentleman was absolutely right to talk about the workforce. On page eight of its report, the APPG outlines the importance of sonographers. There will be increased emphasis on diagnosing cancers earlier, but we will not be able to find the magic key without those people who do the searching, who are our NHS workforce. So we must ensure that we have the right workforce in the right place to deliver that frontline care and meet the Prime Minister’s ambition.

Last December, Health Education England published its first ever cancer workforce plan, committing to the expansion of capacity and skills. HEE will follow that plan up with a longer term strategy that will be aligned with the NHS long-term plan, which seems sensible to me, and that will look at workforce needs beyond 2021. We have to look at a very long landscape when it comes to the NHS workforce. I will not pre-empt that plan, but I can assure hon. Members that it will set out how we will ensure that a sustainable cancer workforce are in place to deliver on the ambitions that we have set out.

My hon. Friend the Member for North East Derbyshire talked about the cancer dashboard. The APPG report, which of course he was involved in drafting, also recommends including ovarian cancer data within the dashboard. The dashboard was first published in May 2016 as a tool to help the cancer alliances, the commissioners and the providers in the acute trusts to quickly and easily identify the priority areas for improvement, and to enable easy tracking of progress towards our national ambitions.

PHE is working with NHS England’s cancer programme team on the next phase of the dashboard development, and that will be informed by the needs of the key stakeholders and the cancer charities, with which I hold a regular roundtable; some of those charities’ staff are here in the Gallery today. It is no secret that hon. Members know that I am frustrated about the cancer dashboard. I am impatient about most things, as my private office will sadly attest, and I am incredibly impatient about the dashboard being limited to the top four cancers. I want to see it expanded and I intend to see it expanded: NHSE and PHE have a very clear direction from me that I will be watching their work and I expect to see it producing what I and other Members in this House want.

The hon. Member for Washington and Sunderland West spoke about surgery and the mixed picture around the country. I do not want to short-change her by not giving her the detailed answer I want to provide to her good point, so I will look into it and write to her and the other Members who have been in the debate today. We obviously must diagnose early, as that gives us better and less radical treatment options, but for some surgery is a sad reality. We must ensure that the NHS is good at not only sharing best practice but implementing it, and that is as true in surgery as anywhere else.

I pay tribute to the hard work and professionalism of our dedicated cancer workforce, and to the Members who care so passionately about the subject and have brought it to the House today. Ultimately, it is our workforce who will determine the success of the cancer strategy and the long-term plan for the NHS. We can only set the direction and the ambition and ensure that the resources are in place, and I believe that I am doing that, as Minister for cancer.

I am excited by the huge potential for the next 10 years of cancer diagnosis, treatment and support. We have fully established the 19 cancer alliances. We have backed them with the funding they need to transform services, and will go on doing that, to ensure that the NHS long-term plan can be delivered on the ground through the alliances, with cancer at its heart. The plan can turbo-charge all that we have achieved through the cancer strategy. I have said before, and I will say again, that I want the alliances to be much more open and accountable and much more approachable, especially by Members of Parliament in England, who should be able to call them to account much more than they do. I suspect that many Members here have the chief executive of their local trust on speed dial; I hazard a guess that they do not have the leader of their cancer alliance there also, and that should change.

It was interesting to get the Scottish perspective from my hon. Friend the Member for Berwickshire, Roxburgh and Selkirk (John Lamont). We would like to see the ambition in England matched across the whole United Kingdom and we absolutely stand ready, as always, to work with Scottish Members and the Scottish Government. If there is anything we can do to help share that ambition, we will do it.

NHS England, Public Health England and I, with the tireless support of our cancer community—team cancer as I always call it—are committed to making a reality the ambitions that the Prime Minister has set out. That will ensure, as I said in this place not two weeks ago, that we continue to make huge leaps forward over the next 10 years to a future where cancer has no future.

Budget Resolutions

Marcus Jones Excerpts

Tuesday 30th October 2018 Commons Chamber

[John McDonnell]

We are currently seeing local councils—the first wave has been Conservative—virtually going into administration. That must say something about the impact of a 50% cut in local government funding over the last eight years.

People no longer accept the trickle-down economics that has gripped the Tory party for four decades.

[Mr Marcus Jones (Nuneaton) (Con)]

Will the right hon. Gentleman give way?

[John McDonnell]

I will in due course. The Parliamentary Private Secretary has done his job and handed out the briefings and questions to everyone. I respect the hon. Gentleman for his diligence and I will allow some interventions but, to be frank, people out there are fed up with parliamentary banter and want a debate that reflects the real world.

People no longer accept the trickle-down economics that has gripped the Tory party for four decades—the idea that somehow if we cut taxes for the rich and the corporations, this wealth will trickle down to everybody. They no longer accept “public sector bad, private sector good”. They no longer accept privatisation and deregulation; in fact, those are anathema to most people now. What was surprising yesterday was how lacking in self-awareness the Chancellor and his colleagues were and how out of touch they were with the reality of our people’s day-to-day lives. His speech reflected how ideologically crushed the Tories are. They are so bereft of ideas that the Chancellor yesterday, in a major parliamentary speech, was reduced to toilet gags. They are so bereft of ideas that they made a pathetic attempt to imitate Labour policies.

[Mr Marcus Jones]

I thank the right hon. Gentleman for his generosity. Is the new economic model that Labour is proposing the same one that left 500,000 more people unemployed in 1979 and 450,000 more people unemployed in 2010 than when it came to office?

[John McDonnell]

A former Local Government Minister gets to his feet in this House and does not express a word of apology for what the Government have done to local government.

For some time, I have had concerns about the nature of the whole debate on austerity. First, many—I accept not all—in the Conservative party seem to have no appreciation of what austerity has meant and continues to mean for our society. I thought at one point that that was because many Labour MPs such as me represented constituencies with a different demographic to many Conservative constituencies. I represent a working class, multicultural London constituency. Yes, it is faced with different challenges from those of leafy Surrey, for example, but most of all our constituents, wherever they are, rely on the NHS, local schools, the police and local council services, so all of us should have some idea of what the public services that support our constituents have been going through.

--- Later in debate ---

[Mr Marcus Jones (Nuneaton) (Con)]

This is my ninth Budget in this place, and the majority of them have been framed by the fact that my party has had to clean up the mess left behind by the previous Labour Government in 2010. They have been framed by the comments of the right hon. Member for Birmingham, Hodge Hill (Liam Byrne), who wrote:

“I’m afraid there is no money. Kind regards—and good luck!”

That was the position that the country found itself in. I feel that yesterday’s Budget was a turning point and we are now starting to see light at the end of the tunnel. We need to give great thanks to the people of this country for their hard work and their determination to see the course through. Yesterday’s Budget means we are now starting to repay the faith of the British people.

I want to focus on three areas, the first of which is public services. The Chancellor was clear yesterday—he was right—that local government had made a significant contribution to tackling the deficit. I firmly believe it needs to be recognised for that, and we need to make sure it is properly funded. I welcome the £650 million package for social care that was announced yesterday, and the £420 million for roads and potholes that will be going to local government.

I also welcome the fact that for probably the first time ever road tax will be paying for our roads rather than being spent on other things. As a consequence, the budget for Highways England will go up by 40%. It is great to see my right hon. Friend the Secretary of State for Health and Social Care in the Chamber because I warmly welcome the additional £20 billion that this Government are committing to our NHS each and every year. I look forward to seeing the 10-year plan for the NHS and, within that, the use of the £2 billion for mental health services, which are crucial. Mental health provision is important because the mental health challenges we are experiencing underpin many of the social challenges that we face in this country, so it will be great to see his proposals.

Security is the most important thing for and the first duty of any Government, so I really welcome the extra £1 billion for our armed forces and the £160 million that is going into counter-terrorism policing. I noted that the Chancellor referred to the police and the challenges our forces face in his Budget statement, so I hope that when the police settlement comes forward early next year, we will see positive progress. My local Warwickshire force is taking on additional officers, but it also faces challenges down the track, such as the pensions revaluation. I sincerely hope that that will be reflected in the policing settlement.

[Sir Edward Davey]

While the hon. Gentleman is talking about police funding, can he explain why he thinks the Chancellor did not announce any extra money, beyond the counter-terrorism policing increase, for community policing yesterday?

[Mr Jones]

Clearly the police have been given access this year to an additional £450 million, and an extra £160 million was given to counter-terrorism policing. I am sure the right hon. Gentleman, who was part of the coalition Government, will recognise that a process needs to be followed and that the police funding settlement will come forward in a few months’ time.

Secondly, on the cost of living, I am delighted that the Chancellor has chosen to freeze fuel duty again. It has not increased in this country since 2011, which is good news for motorists. In that time, the average motorist has saved £1,000 as a result of the decisions made by Conservative Chancellors. I am also really pleased that the rail companies have taken up the railcard for 26 to 30-year-olds, who will get a 30% reduction in fares.

I very much welcome the increase to the personal allowance. The lowest paid will now earn £12,500 before they have to pay income tax. That is a far cry from the £6,500 personal allowance in 2010, and it means that those people will have an additional £1,250 a year in their pockets compared with then. I also welcome the change to the 40p threshold, because although that rate is an important aspect of our tax system, many public servants, such as police sergeants and senior teachers, have been dragged into the 40p rate, as have been many tradespeople such as bricklayers. I do not think that that was ever the intention when that measure was introduced.

It is good to see the Under-Secretary of State for Work and Pensions, my hon. Friend the Member for North Swindon (Justin Tomlinson), on the Front Bench, because I welcome the universal credit changes, which will further underpin the principle that it always pays to work. It is excellent that £1.7 billion will be put into universal credit year on year, and that is in addition to last year’s package. It looks as though tweaks are being made to the system constantly to make sure that it responds to some of the challenges. I hope that another look will be taken at the assessment period, because several of my constituents have had challenges with that part of the process.

Finally, on high streets, I am delighted that 30% will be knocked off rates bills for people who own small retail businesses with a rateable value under £51,000. Business rates are an analogue tax in a digital world, and I am pleased that the Chancellor has started to recognise that. I recognise that larger retailers occupying anchor positions in high streets and town centres will not benefit from that change, so perhaps in future we will need to consider those businesses, too. A £675 million fund for the regeneration of our high streets is a massive start to help high streets throughout the country to regenerate. We need to make sure that we preserve our high streets, but not in their current form. We need to make them fit for the 21st century because they are places of massive community value. They are the community centre of towns and cities throughout the country.

Clinical Waste Incineration

Marcus Jones Excerpts

Tuesday 16th October 2018 Commons Chamber

[Stephen Barclay]

My hon. Friend is absolutely right. One of the key issues was to have alternative provision in place as quickly as possible so that we were not in the situation of waste being stored on site beyond the absolute minimum. It is a tribute to officials in the Department and in the NHS, the Department for Environment, Food and Rural Affairs and elsewhere that a quite complex set of legal arrangements has been mobilised in such a short period to ensure that services are maintained.

[Mr Marcus Jones (Nuneaton) (Con)]

While the backlog is being cleared, will my hon. Friend confirm that any waste will be kept in a secure and safe fashion? Will he also be more exact about when he thinks the backlog of waste currently in the system will be cleared?

[Stephen Barclay]

There are two different components to that. There is the waste on sites, such as at Normanton, where HES has allowed a degree of waste to be stored, but I think my hon. Friend’s question is driving at the waste on hospital sites. As I said in my statement—[Interruption.] If the hon. Member for Leicester South (Jonathan Ashworth) waits for the reply, he will hear that the stock on those sites is being cleared. Perhaps he has been busy checking social media again. The bulk of the sites will be cleared by the end of the week; there will be two remaining beyond this week. We are very much focusing on that issue.

Oral Answers to Questions

Marcus Jones Excerpts

Tuesday 19th June 2018 Commons Chamber

[Mr Hunt]

This is a huge challenge in all parts of the United Kingdom. In England, about 22% of bed days are occupied by people who have been in hospital for more than three weeks, and probably less than 20% of those people should be in hospital. We are taking urgent steps to rectify that, because it is very, very bad for the patients involved.

[Mr Marcus Jones (Nuneaton) (Con)]

9. What steps he is taking to increase the size of the mental health workforce.

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

The mental health workforce plan published last summer underpins our expansion of mental health services, as set out in the “Five Year Forward View for Mental Health”. We aim to create 21,000 new posts in mental health by 2021.

[Mr Jones]

I thank the Minister for her response. Mental health is one of the many complex drivers of rough sleeping, and can add to the complexity of getting rough sleepers off the street and into accommodation. Will my hon. Friend say how the new mental health employees in the NHS can help us to get rough sleepers off the streets and into accommodation?

[Jackie Doyle-Price]

I hope the expansion of mental health services will stop people becoming rough sleepers in the first place by bringing forward support earlier in the process. In January, we announced a £1 billion investment in mental health, part of which will be focused on crisis care and helping people who are experiencing crisis to stay out of hospital. The workforce plan backs that commitment by planning 5,200 posts to support those in crisis. We will be working with the Ministry of Housing, Communities and Local Government on a forthcoming strategy to make sure we honour our commitments.

NHS Long-Term Plan

Marcus Jones Excerpts

Monday 18th June 2018 Commons Chamber

[Mr Hunt]

The hon. Gentleman has just proved my point about Labour making speeches about the NHS. He talked about a “measly” increase under David Cameron; what he forgot to tell the House was that his own party’s plans that year were to cut the NHS budget because of the train crash of an economy that they left the country with.

[Mr Marcus Jones (Nuneaton) (Con)]

This is a massive and welcome boost for our NHS, and I very much welcome it. Will my right hon. Friend say more about the importance of public health and social care in the context of his announcement today and what his plans are? The issue is not just about getting people to live longer, but getting them to live well for longer.

[Mr Hunt]

My hon. Friend asks a very smart question. The truth is that no healthcare system anywhere in the world, faced with our demographic challenge, would ever feel it had enough money unless it transformed its model of care to one based on prevention rather than cure. That is why public health and the social care system are absolutely critical. One of the big lessons that we need to learn with this new funding is to spend it in a way that brings down the long-term rate of growth in demand for hospital services. That is the only way in which we can make it work.