Proposed Hospital: North Hampshire

Maria Miller Excerpts

Friday 26th April 2024 Commons Chamber

[Dame Maria Miller (Basingstoke) (Con)]

For heart attack patients suffering from cardiogenic shock, every 10-minute delay in treatment equates to a 3.3% increase in the risk of death. That startling fact not only emphasises that every minute matters when it comes to emergency patients receiving treatment, but highlights the importance of locating our new hospitals strategically. After all, a hospital’s reason to be is to save lives, and we must use the most up-to-date clinical evidence to ensure they do that whenever possible.

Last year, the then Secretary of State for Health and Social Care confirmed the biggest infrastructure investment in my constituency’s history: £700 million to £900 million for a new north Hampshire hospital at the Hampshire Hospitals NHS Foundation Trust. We have just completed an extensive public consultation on how the new hospital will evolve, and on the provision of services at two of the hospitals in the HHFT—the Basingstoke and North Hampshire Hospital and the Royal Hampshire County Hospital in Winchester. The results of the consultation are due to be released in the coming weeks. Although I very much look forward to seeing the views of residents on those important plans, I also believe it is essential that hospital services are configured so that they can best deliver treatment to patients, and that must be done by listening to how clinical experts feel we ought to locate services on a hospital and departmental level.

Although funding was confirmed last year, work to identify potential sites for the new acute hospital began in 2019. A comprehensive search for the right location spanned north Hampshire, including Alton, Andover, Basingstoke, Eastleigh, Winchester and the surrounding areas, as well as practical considerations such as price, availability and size. Fundamental to HHFT’s criteria were a series of clinical considerations on how to improve patient outcomes and increase accessibility. In the end, two viable sites were identified, one of which is the trust’s preferred option, between Basingstoke and Winchester near junction 7 of the M3. The other is on the existing Basingstoke hospital site. During assessments, the current Winchester hospital site was also considered as an option. However, it was deemed too small to accommodate all of the services needed at our new acute specialist hospital and, besides, there is no adjacent land that could facilitate future expansion.

A key reason why junction 7 is the preferred site is that the ambulance service has argued in the past that it would enable the sickest patients to access care more quickly. Locating a hospital in the centre of a town or city may be convenient for patients attending elective surgery, but it is increasingly awkward for ambulances in a race against time. As the statistic about heart attacks demonstrates, ambulances are often in a race against time, and junction 7 is a convenient location between Winchester and Basingstoke with easy access to the M3.

Combined with the important access considerations, building a new hospital at junction 7 would also not disrupt existing services while construction takes place. These proposals are rooted in science and clinical experience, and they will save lives. It is clear to me that residents from across north Hampshire should follow the expert opinion and throw their weight behind supporting the junction 7 approach.

Not only is clinical guidance essential to the siting of the new hospital; so too is the location of specific services. The new HHFT hospital consultation introduced the trust’s new model of care, which centralises crucial services. That approach is underpinned by mountains of clinical evidence and research. Medical evidence suggests that centralising services in this way reduces duplication, increases the quality of care and is best for patients.

This model has already been rolled out in some departments, such as cardiology. A person who has a heart attack in north or mid-Hampshire will be sent to an amazing new heart centre in Basingstoke, where they are assured of top-quality care at all hours of the day. The results have shown that this approach saves lives. Members do not have to take my word for it, because seven of Hampshire’s top clinicians, including the chief medical officer, published an open letter in support of this approach:

“Bringing together more specialist services for the most seriously ill patients onto one site would mean we are able to bring services in line with best practice and national guidelines.

This means if you are critically unwell, you will be seen by experienced senior doctors and nurses who are experts in their field. This would have significant benefits for patients, both in terms of improvements to their care and their clinical outcomes.”

To bring the benefits of the new model into even greater focus, I will touch on two particular areas of service: maternity and emergency care. Neonatal care units are graded on a three-tier scale, ranging from level 1, which can treat unwell babies, to level 3, which can care for the most premature or unwell babies. The trust previously had a level 2 rating, which was temporarily changed to level 1-plus in November 2023 following an unannounced Care Quality Commission visit after a series of complaints.

Although the trust’s overall rating remained good, it was concerned that the neonatal units did not see enough seriously unwell babies for the staff to maintain the specialist skills needed for level 2 status. This relegation now means that, each year, around 100 very sick or premature babies have to travel to Southampton or Frimley Park hospitals for treatment. This is clearly not easy for families, but we have been gifted a golden opportunity to make sure the decision is reversed so that more babies can be looked after closer to their families.

Good practice and standards suggest that there should be 98 hours a week of on-site consultant cover, with 60 hours being the minimum requirement. At the moment, both maternity sites in Winchester and Basingstoke are able to provide only the minimum requirement. Were services not duplicated across two sites, the hospital could provide one unit with more hours of consultant cover, thereby reaching the recommended number of cases necessary to regain level 2 status.

The current level 1-plus status of our maternity service shows that the status quo is not an option. North and mid-Hampshire need a better service, and the surest way to secure it is by following the medical advice and centralising the services of the maternity units into one hub at the new junction 7 site.

Another area where the new model of care will have an enormous impact is emergency care, which is set to be reconfigured to reduce waiting times and streamline patients’ treatment. A large emergency department, complete with trauma unit and children’s emergency department, will be centralised at the new junction 7 site. It will specialise in treating the most serious cases. However, both Basingstoke and Winchester will have an urgent treatment centre, and each will be led and supported by advanced nurse practitioners, doctors and other health professionals. Both will be open 24 hours a day, seven days a week, and have been designed to provide quick treatment. It has been estimated that two thirds of cases currently being treated in A&E could be seen at an UTC, including all but the most serious illnesses and injuries. Restructuring facilities in this way will free up staff in A&E to focus on the most unwell patients, while simultaneously reducing the waiting times for patients with less serious ailments. Plans have been rigorously drawn up in a way that ensures patients are rapidly assessed, diagnosed and treated.

Both those cases, of maternity and emergency services, underline the importance of listening to and following clinical guidance when determining not only the location but the configuration of our new hospital services. The Government have made it very clear that they wish to see both Basingstoke and North Hampshire Hospital and Royal Hampshire County Hospital, Winchester continue to provide services. That has been reiterated by the hospital trust itself. The plans are about a significant reconfiguration of where and how those services are provided. The recommendations are based on expert clinical advice, because clinicians are best placed to identify the best way to treat patients. We would do well to listen carefully to their advice and, as far as possible, to follow the plans informed by their methodological research.

The Hampshire and Isle of Wight integrated care board is due to publish the findings of the consultation that has been carried out imminently. We are all looking forward to seeing those results, but the Hampshire Hospitals NHS Foundation Trust must ensure, on behalf of residents and its patients, that the clinical evidence, best practice and expert experience of clinicians remains at the forefront of its mind throughout.

The £900 million investment in our health service in north and mid Hampshire is a once-in-a-lifetime opportunity to improve what is on offer to residents throughout those communities, but we only have one opportunity to get it right. I hope the Minister, in her reply, can confirm to me her intention to support Hampshire Hospitals NHS Foundation Trust to make sure that it follows clinical advice, while also ensuring that it has listened to residents.

[The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)]

I congratulate my right hon. Friend the Member for Basingstoke (Dame Maria Miller) on securing a debate on this really important issue. I am responding on behalf of the Minister for Health and Secondary Care, my right hon. Friend the Member for Pendle (Andrew Stephenson), who tells me that she has been a tireless campaigner for Basingstoke on this matter, as well as on countless others.

The Government believe that the people of Hampshire should, of course, have a say on where their new hospital should be built. As my right hon. Friend said, we have asked people from across the county to share their views with Hampshire Hospitals NHS Foundation Trust. I am sure she understands, however, that it would be wrong of us to pre-empt their views, or indeed to interfere with their decision making, but I am happy to assure her that we remain committed to delivering the new hospital.

The trust and the integrated care board are going through the responses as we speak. They will submit a business case for NHSE regional approval through the ICB in a few months’ time. I should be clear that while the trust and the ICB do that, there will be no final decision on the new hospital’s location or the services it will deliver, but once a decision has been taken we will, of course, update the House. I am sure my right hon. Friend will have much to say about that herself, too.

I want to address the points my right hon. Friend raised on the importance of clinical guidance in forming decision making. She is absolutely right to say that decisions should be locally led and based on the best clinical evidence. That is why proposals must meet our tests for good decision making, which include a clear evidence base that is in keeping with clinical guidance and best practice. In developing the consultation, the trust has looked at a variety of options to deliver clinical care in Basingstoke and Winchester. Experts have been consulted at every stage of the process to provide appropriate clinical guidance. Two particular examples in the consultation demonstrate how the trust used clinical guidance to inform the options it has put forward.

First, on proposals around accident and emergency services, the trust received expert clinical guidance from local doctors, who strongly agree that maintaining emergency departments at both Basingstoke and Winchester would be unsafe and unsustainable. The trust also received advice from the South East Coast Clinical Senate, an independent panel of senior doctors who expressed concern over retaining an A&E department at both sites, due to serious concerns around patient safety. Instead, it has argued that acute medical services must be twinned with surgical services in order for patients to receive first-class care. Therefore, the proposal includes two brand-new 24/7 doctor-led urgent treatment centres and same-day emergency care to deal with most urgent care needs—one at the new specialist acute hospital and one at Winchester’s Royal Hampshire County Hospital.

Secondly, the proposals give the people of Hampshire an emergency department with a trauma unit and a children’s emergency department at the specialist acute hospital, which will treat the most serious conditions. As my right hon. Friend said in her remarks, it is essential for new mothers and mums-to-be to have the best possible care for themselves and their babies—she will know that this is an area of healthcare that is very dear to my heart. The trust has looked carefully at keeping obstetrician-led maternity services at the Royal Hampshire County Hospital, but found that many patient safety issues have left them not viable, particularly following the 2022 publication of the independent Ockenden review of maternity services at the Shrewsbury and Telford Hospital NHS trust, which set out the need for obstetrician-led maternity services to be in hospitals that can also provide emergency surgery and critical care.

In Hampshire, those services could only be provided at the new specialist acute hospital, because the neonatal units at the Winchester site currently do not treat enough babies to meet the requirements for level 2 care, while consolidated services at the new specialist acute hospital will meet that requirement. The rationale is that the proposals will lead to fewer babies’ being transferred out of the area to receive vital neonatal care, and I think the whole House will agree that the last thing new mothers need after giving birth is an extra journey to receive critical care.

I thank my right hon. Friend for raising this important issue and for continuing to engage with the new hospital scheme. She is a real champion for her constituents in this place, and they will have seen her fighting their corner today. We want to do everything in our power to get the people of Hampshire the world-class care they deserve. We will continue to support the trust throughout the development of the business case, to ensure that plans meet the needs of staff and patients as well as offering value for money for taxpayers. I understand that my right hon. Friend the Member for Pendle has recently committed to visiting Basingstoke and I am sure my right hon. Friend the Member for Basingstoke will take immense pride in showing him around one of England’s extremely beautiful towns.

[Dame Maria Miller]

I thank my right hon. Friend for confirming that her, and my, right hon. Friend the Member for Pendle will be taking the time to come and visit the new hospital. May I encourage her to encourage him to visit the new hospital site that the hospitals Minister has already announced that he is in the middle of procuring?

[Dame Andrea Leadsom]

I shall certainly pass that message on to my right hon. Friend the Member for Pendle, and I again congratulate my right hon. Friend the Member for Basingstoke on securing a debate on this very important topic.

Question put and agreed to.

Hospice Funding

Maria Miller Excerpts

Monday 22nd April 2024 Commons Chamber

[Dame Maria Miller (Basingstoke) (Con)]

May I add my thanks to my hon. Friends the Members for Hastings and Rye (Sally-Ann Hart) and for Darlington (Peter Gibson) for calling for this debate, and to the Backbench Business Committee for granting it? Above all, I thank my constituents, who have contacted me in great numbers to express their support for our hospice in Basingstoke, St Michael’s. That heartfelt support has been echoed by Members of all parties. We love our hospices; they have a special place in our constituencies, our communities and our lives.

It is really important that we take a moment to reflect on exactly what hospices are asking for, because there has been a slight variety in what hon. Members have said. It is as the right hon. Member for Hayes and Harlington (John McDonnell) said; I may not agree with him about having a five-year plan—that is too reminiscent of tractor production—but I agree that hospices are calling for consistency of funding. One of the many constituents who wrote to me talked about the need for a national plan to ensure that the right funding flows to hospices, and so that there are national measures to support integrated care boards with their commissioning decisions—we heard about that earlier. As a result of the Health and Care Act 2022, we also need to make sure that hospices have multi-year contracts, that they are paid the full cost of commissioned clinical services, and that they see the same uplift in payment that other parts of the NHS see. We know that that is not happening in Hampshire.

My constituents are not calling for hospices to be taken over by the NHS. That is a really important point to make. It would be the wrong way forward. The amazing hospice in my constituency, St Michael’s, together with Naomi House and Jacksplace, which my hon. Friend the Member for Winchester (Steve Brine) referred to and are in his constituency, provide support for more than 1,000 families a year in our area. They are amazing because of the people, and I thank all the staff, the volunteers and the people who help run the shops—they are an incredible army. The hospices are also amazing because they are fiercely independent charities and can, as a result of their independence, do things that the NHS finds it difficult to do “at pace”, as they now say. I give the example of the introduction of hospice at home in my constituency many years ago. It was done because there was a need in the constituency, not because that was set out by central Government or the NHS.

The other reason why we need to retain the fierce independence of our local hospices is that they involve the community. I want to mention the people I am joining on Saturday for the bluebell morning in Steventon, which is organised by Julian Pilcher. I am going there with my right hon. Friend the Member for North West Hampshire (Kit Malthouse) and others, because the walk raises thousands of pounds every year to support our local hospice. The hospice is part of our community —we help to shape it, and we absolutely help to fund it—but there needs to be a better balance in the way that our hospices are funded. The Health and Care Act 2022, which introduced the statutory duty on ICBs, forces that point. I hope that the Minister can help us understand how she will assist ICBs to do their job better, but also that she will look at the variance in funding. The hospice in my constituency receives a very small proportion of what some other hospices in Hampshire receive, and the disparity in funding is causing feels unfair, particularly when costs, especially wage costs, are increasing and there is an increase in demand.

I hope that the Minister can consider three points. First, how will she support the ICB to better plan for removing the enormous disparities in funding between hospices? Hospices’ needs are no different, although sometimes their fundraising capacity is a little different. More than 80% of my hospice’s funding comes from local fundraising, but how can we make sure that the NHS disparities are ironed out?

Secondly, how can we make sure that as funding moves from NHS England to local ICBs, funding streams such as the children’s hospice grant do not create administrative nightmares? My hon. Friend the Member for Winchester talked about that—about places like Naomi House having to negotiate with up to six ICBs to ensure that it continues to receive the same amount of funding.

Thirdly, I hope that my hon. Friend the Minister can touch on the situation following the introduction of the Health and Care Act 2022, because there needs to be more certainty in forward planning for hospices. There need to be multi-year contracts to provide that certainty, especially given the cost pressures that hospices face.

I draw my remarks to a close by giving additional thanks to all the organisations throughout my constituency and north Hampshire that help fund my local hospice, whether through the Sherfield Oaks golf day or the moonlight walk around Basingstoke. I thank our local furniture store and the six shops—the list goes on. People go above and beyond, giving their time, money and energy to make sure that St Michael’s hospice is at the heart of our community. I do not want to see that changed, but I want the Minister’s help to make sure that that fantastic organisation gets support from the NHS when it needs it, and certainty around funding.

International Health Regulations 2005

Maria Miller Excerpts

Monday 18th December 2023 Westminster Hall

[Cat Smith (Lancaster and Fleetwood) (Lab)]

I beg to move,

That this House has considered e-petition 635904, relating to the International Health Regulations 2005.

In March 2021, a group of world leaders including the then UK Prime Minister Boris Johnson announced an initiative for a new treaty on pandemic preparedness and response. The initiative was taken to the World Health Organisation and will be negotiated, drafted and debated by a newly established, intergovernmental negotiation body. This is the second time that the Petitions Committee has scheduled this issue for debate. In April this year, a petition that called for the Government to

“commit to not signing any international treaty on pandemic prevention and preparedness established by the World Health Organization (WHO), unless this is approved through a public referendum”

was debated after it reached the threshold of 156,086 signatures. Today’s e-petition calls on Parliament to

“Hold a parliamentary vote on whether to reject amendments to the IHR 2005”.

The Government have responded to the petition, explaining that the UK supports strengthening the IHR and the amendment process.

Having met the petitioner, I know that she would like the Minister to address the concerns of the petitioners in his response, specifically which amendments, if accepted, would require changes to UK domestic legislation; who represents the UK; if the information will be publicly available; the Government’s position on the amendments that change language in the regulations from “may” to “shall”; and if the UK will vote against those changes. What is the UK’s position on whether the regulations should be binding or non-binding, and has it proposed any amendments? I hope that the Minister will be able to address those issues in his remarks when we get to that stage of the debate.

In the March 2021 joint article, the group of leaders said:

“The main goal of this treaty would be to foster an all of government and all of society approach, strengthening national, regional and global capacities and resilience to future pandemics. This includes greatly enhancing international co-operation to improve, for example, alert systems, data-sharing, research and local, regional and global production and distribution of medical and public health counter-measures such as vaccines, medicines, diagnostics and personal protective equipment.”

Given the weekend news coverage of the fallout from some of the challenges faced in the procurement of PPE, it is perhaps timely that we debate the petition today. When the next pandemic happens, I hope that any future Government will have learned the lessons from the past.

On specific questions of UK sovereignty and amendments relating to restrictive measures, the UK Government have explained in their response to the petition that

“we have been clear that the UK will not sign up to any IHR amendments that would compromise the UK’s ability to take domestic decisions on national public health measures. There are currently no plans to hold a vote on IHR amendments. Should the UK Government wish to accept an IHR amendment, then depending on the content of the respective IHR amendment, changes to domestic law considered necessary or appropriate to reflect obligations under the IHR amendment, may be required. The Government would prepare such draft legislation before Parliament in the usual way. In all circumstances, the sovereignty of the UK Parliament would remain unchanged, and the UK would remain in control of any future domestic decisions about national public health measures.”

Finally, I take the opportunity to thank all our healthcare workers who worked through the pandemic. As we go into the Christmas period, many of them will be working while we are enjoying turkey dinners with our families, so I pay tribute to their commitment and to all others who work in our healthcare systems. The pandemic affected us all differently, and I hope that in this season of good will we are mindful of all those who are more vulnerable than ourselves. With that, and on behalf of the Petitions Committee, I thank all members of the public who have engaged with e-petitions, including this one in 2023. I look forward to hearing the well-informed contributions of hon. Members.

[Dame Maria Miller (in the Chair)]

Before I call the first speaker, I remind Members that if they wish to contribute, they should bob. I remind those sitting in the Public Gallery that there should be no applause and no photographs at any time.

--- Later in debate ---

[Danny Kruger (Devizes) (Con)]

I am very pleased to be able to speak in this debate. I thank all the petitioners and members of the public who are interested in the debate, and the hon. Member for Lancaster and Fleetwood (Cat Smith) who introduced it. It is worrying that so few Members are present. I am always proud to act in concert with my band of brothers here—we happy few who seem to fight on multiple fronts. This is a fringe issue in Parliament, as demonstrated by the empty Benches, but significant numbers of the public have a real interest in this topic, so what is going on?

I think the explanations are partly that it is a complex matter. It requires significant delving into pretty abstruse documentation and websites. As the debate goes on, it is not always thrilling. It is also that we debate issues of principle, such as the abstractions of sovereignty and individual rights, that often fail to get traction in the media. Although occasionally generating headlines, they do not generate proper attention in Parliament or the media.

The fundamental reason why the topic and the proposed regulations and treaty from the World Health Organisation have not generated the sort of disquiet that we few Members feel among our colleagues, the wider public and the media is that we want, as individuals and citizens, to trust in the Government when it comes to healthcare. We really do. That is why we have such a commitment to the NHS in our country. We want the state to be trusted, authoritative and capable when it comes to our health. We instinctively recoil at suggestions that there is a problem when it comes to the management of healthcare, and yet, as we have heard today from colleagues who put the details very well—I will not reiterate the points that have been made—there is clearly a difficulty, a challenge, a problem with the proposed regulations and treaty.

It is suggested by the World Health Organisation and the Governments who are contributing to the design of the regulations and the treaty that the WHO should move from being responsible for identifying pandemics on behalf of countries, and towards taking responsibility for co-ordinating the response to pandemics. That is an enormously significant change. It would co-ordinate the response of nation states and how they managed their health care. We have heard expressed very well the threat that that represents; it could mean enforced mandates, forced lockdowns and so on. I echo the call on the Minister to address the question whether the World Health Organisation will be able to impose a lockdown, or any other intervention, without the consent of Parliament.

I would also like the Minister to reflect on the provision in the proposed regulations that suggests that the World Health Organisation would require countries to tackle misinformation and disinformation. We must remember that in January 2020, the organisation aspiring to this power denied that there was human-to-human transmission of covid-19. For many months, it denied the possibility that the virus had a human origin and originated in a Wuhan facility. This is the organisation that we propose giving the power to intervene in national debates, and to close down discussion about the origins and appropriate response to pandemics under the guise of tackling misinformation and disinformation.

We should be concerned about the value of the World Health Organisation, given its record, and we should, I am afraid, have the same scepticism about our Government’s role. The trust that we all desperately want to have in healthcare has been badly tested by the experience of recent years. I echo many of the points made by my right hon. Friend the Member for Rayleigh and Wickford (Mr Francois) about radicalisation; we both experienced that radicalisation over the course of the covid experience. We went from a position of trust in the state to profound scepticism.

I want to call attention to a new book that has come out, to which I contributed the afterword.

[Dame Maria Miller (in the Chair)]

Order. I do not think that we do advertising in here.

[Danny Kruger]

Okay. Forgive me. I will not advertise the book, although I derive no benefit from it, I should emphasise. It is written by the campaigners UsforThem, who did such good work in calling attention to the effect of the lockdowns on children, and who became radicalised through the experience of covid. UsforThem has written a very good book about the lack of accountability for the response to covid. I do not share some of its concerns about particular decisions made by particular officials or Ministers, but I absolutely share its concerns about the failure of accountability in the system as a whole.

The inquiry into the whole covid episode, which we are all watching, is performing a fairly useful function in identifying misdemeanours, confusions, and, in a rather whodunnit way, which Ministers, officials and advisers deserve individual blame. What we are really getting out of it, however, is evidence that the system as a whole failed. There is no point in identifying the culpability of individuals when the fundamental problem that the inquiry, and the experience of us all, demonstrates is that the British state failed.

On the regulations, as I said in April, during the last debate we had on this subject in this place, the problem during the whole covid episode was not the lack of international co-operation; there was a very high, remarkable, degree of that. Almost every country did exactly the same thing, following China’s example. What we did not have enough of was independent decision making at nation state level. The bits that worked at nation state level were times when individuals and communities on the ground, local government, local public services and local businesses took the initiative to collaborate and develop their own responses, and took responsibility for supporting communities. That is what we needed at the national level, too—more independent decision making, while obviously collaborating and sharing information about what works.

I recognise the point made by the hon. Member for Lancaster and Fleetwood. I hope that the Minister will say that the Government are committed to ensuring that British national sovereignty is reflected in the wording of any new treaty. I am afraid—we are familiar with this from current debates—that peppering legislation with the language of sovereignty is not sufficient. What we really need is the practice of sovereignty and the declaration of principles. Principles are only valid in so far as they are put into practice. We want actual practice of the principle of sovereignty through the treaty that emerges, and in any amendments to the regulations.

I conclude with four questions for the Minister, who I hope will be able to answer them. First, when will we see the next iteration of the draft regulations? I had understood that they were expected now. Secondly, which Minister is responsible for negotiating the treaty and the regulations? Is it him or a colleague? I would also be interested to know which civil servants are involved. We knew who the civil servants negotiating Brexit were. I wonder who has been delegated to the WHO and is working on our behalf there.

Thirdly, colleagues raised the issue of the WHO mandates potentially imposing a very significant bill on the taxpayer. Has work been done to quantify the potential cost to the taxpayer of implementing the requirements of the treaty? Finally, I appreciate that the Minister is probably not in a position to do so today, but will the Government commit to publishing their red lines—what they will and will not accept? Vague commitments to preserving sovereignty are not sufficient. What exactly will be acceptable and not? I appreciate that the negotiations are going on with other states, but I think it would be appropriate for our Government, at this advanced stage of the negotiations, to declare publicly what they are and are not prepared to cede, by way of our independence.

--- Later in debate ---

[Sir Christopher Chope]

Absolutely; I agree with my right hon. Friend. We do not want to withdraw; there is no need to withdraw from a voluntary organisation that is confined to giving us advice and providing data and information. Who would resent having access to data and information? Indeed, the essence of the relationship between a responsible society and its Government is that the Government should provide information to enable individuals to decide for themselves whether they want to take particular medicines, go on trips to particular countries, be vaccinated in a particular way, or whatever.

I see the proper role of the WHO as providing information to Governments across the globe. Those Governments can then decide for themselves what they like and do not like, having regard to the fact that the WHO’s chairman seems to have been imposed on it by the People’s Republic of China, and was strongly opposed by our Government. It seems very much as though the whole WHO is too beholden to China. The WHO is also beholden to some of its big donors; if one analyses how the WHO is funded, one sees that organisations such as the Bill & Melinda Gates Foundation are significant supporters. He who pays the piper calls the tune. I think that is a good starting point when looking at these things. In the case of the WHO, there is too much evidence that the people paying the piper are calling the tune to too great an extent.

Once bitten, twice shy. Let us remind ourselves what happened during the pandemic. As others have mentioned, the WHO went into the pandemic with a policy of saying that lockdowns were not, and could not be, the right answer to a pandemic for all sorts of reasons. We can now see the adverse consequences that flowed from our country’s decision to have a lockdown, and we can compare that with what happened in Sweden. Then, during the early part of the pandemic discussions, and without any evidence being brought forward, the WHO suddenly changed its advice. Why? There is a suspicion that it was because of undue influence from the pressures that I have been describing. We will never know why it changed its advice. All we know is that somebody who changes their advice like that, without any evidence, should not tell us what to do. We should say, “If you want to change your advice, fine, but why do you change it? We don’t have to follow it.” However, under the proposed treaty amendments, we would have to follow it. That is obviously of great concern, because people can see what happened in the past, and that is potentially a guide to the future.

Even more sinister than the change in advice on lockdowns was the WHO’s approach to finding a treatment for covid-19 patients. There was a lot of evidence to suggest that ivermectin—it was not the only such drug—could be used to really good effect to improve outcomes for patients suffering from covid-19. Strong evidence suggested that treatment with ivermectin might improve someone’s chances of survival by as much as 81%, but the WHO intervened at the behest of certain pharmaceutical companies that were in competition with the producers of ivermectin. It gave very dubious advice, to the effect that ivermectin should be used only in clinical trials.

To those who are not familiar with too much of the detail, I commend a book by Dr Pierre Kory, a distinguished physician and epidemiologist—I think he is an epidemiologist. He certainly deals with pulmonary and critical-care medicine; he is a specialist in that. He was in charge of the Front Line COVID-19 Critical Care Alliance, and produced a book called “The War on Ivermectin”. It was a war, organised by the WHO, against a remedy for covid-19, because, obviously, the whole vaccine development programme was premised on there being no cure for covid-19, and no effective treatment for it. In the absence of such treatment, it was legitimate for experimental vaccines to be brought into play without undergoing the full process set out in the Licensing Act 2003, because there was there was nothing else. We were in the desperate situation of there being no other way out. Actually, however, there was a lot of evidence to suggest that ivermectin—

[Dame Maria Miller (in the Chair)]

Order. I am sure that the hon. Member is not intending to use a prop. Let us leave it to Amazon to sell books.

Radiotherapy: Accessibility

Maria Miller Excerpts

Tuesday 18th July 2023 Westminster Hall

[Dame Maria Miller (in the Chair)]

Before we start, may I point out that there will be some videoing by the education department? Please do not be distracted. The Doorkeepers are aware and the video will simply be used to illustrate how a Westminster Hall sitting works, so just ignore it.

[Selaine Saxby (North Devon) (Con)]

I beg to move,

That this House has considered the accessibility of radiotherapy.

It is a privilege to serve under your chairmanship, Dame Maria. I thank the Backbench Business Committee for granting this important debate, all colleagues who supported the application, and Professor Pat Price for her tireless work in supporting the all-party parliamentary group for radiotherapy and championing this vital treatment.

We all know that the cancer backlog was affected by the pressures of covid-19, but in May this year there were 7.47 million people waiting for cancer treatments and 3 million of those have been waiting for over 18 weeks. Only 61.7% of patients receive their first treatment within two months, far below the operational standard of 85%. Radiotherapy is a key part of cancer care. It is the second most effective treatment for cancer and is needed in four out of every 10 cancer cures.

Radiotherapy targets the cancer with radiation. The cancerous cells are more affected than the healthy cells, which are better at repairing themselves. Modern radiotherapy has come on leaps and bounds, and within the last 10 years breakthroughs have increased the accuracy and focus of the treatment to within millimetres, significantly reducing collateral damage to healthy cells.

Surgical treatments require intensive care, with all of the hospital resources and emotional trauma that that entails, and chemotherapy has a significant impact on the immune system. In contrast, radiotherapy is an out-patient treatment that requires fewer patient visits to care centres. It only costs between £3,000 and £7,000 per patient, despite being incredibly high tech.

The international recommendation is that 53% to 60% of cancer patients receive radiotherapy treatments. However, in the UK only 27% of cancer patients received radiotherapy treatment in 2019. In my North Devon constituency, only 4.7% of my constituents live within the recommended 45-minute travel time for radiotherapy treatment. The other 95.3% are among the 3.4 million people in England for whom distance from a radiotherapy service effectively limits the availability of treatment.

Oral Answers to Questions

Maria Miller Excerpts

Tuesday 11th July 2023 Commons Chamber

[Neil O'Brien]

We absolutely recognise the need for patient safety, which is why there will be clear patient group directions and clear pathways about what pharmacists do. They are not taking on the role of GPs, but are providing additional services that will make things more convenient for all of our constituents.

[Dame Maria Miller (Basingstoke) (Con)]

I warmly welcome the Government’s commitment to investing £645 million to enable pharmacists to provide for far more common conditions. I have already visited one of my own local surgeries, the Shakespeare Road medical practice, and seen at first hand how pharmacists are already working in GP surgeries to try to reduce waiting times. Surely, more surgeries should be doing the same, involving pharmacists with enhanced roles in order to cut waiting times in a manner that is safe.

[Neil O'Brien]

My right hon. Friend is completely correct. That £645 million, of course, comes on top of the £100 million that we have already put in. We have grown the pharmacy workforce hugely—there are 82% more pharmacists now than in 2010—and we are also enabling those people with their high-end skills to do more by reforming regulations. That is not just the blister packs issue; we are enabling them to do convenient things such as hand out bagged medicines even if the pharmacist is not present.

New Hospitals

Maria Miller Excerpts

Thursday 25th May 2023 Commons Chamber

[Steve Barclay]

The announcement and the manifesto commitment were to build by 2030. The hon. Lady touches on the engagement with industry; Lord Markham has been engaging with industry. We have had a significant team, both within the Department and in NHS England, working on the standardised designs. The whole point is that we have seen in other sectors how standardisation allows us to construct much more quickly. It will also allow internal processes in government to be much quicker because we are not looking at each scheme in a bespoke way; we will have much more standardisation. That is how we will move at a much quicker pace. It has required us to take a little more time over recent months as we have finalised the plan, but now that we have that plan and clarity about the RAAC hospitals in particular, we will be able to move with much more pace.

[Dame Maria Miller (Basingstoke) (Con)]

I warmly welcome my right hon. Friend’s statement and the confirmation that the new Hampshire Hospitals NHS Foundation Trust hospital in Basingstoke is one of the cohort 4 hospitals due for completion in 2032-33. It will serve residents in my constituency and those of a number of right hon. and hon. Members. We have a plan, a preferred site and an amazing team on the ground, so how can my right hon. Friend work with me and other colleagues to speed up this new hospital? It is badly needed to replace the current hospital, which was built in the 1970s to last 50 years. We have one of the biggest maintenance backlogs, and we really need the new hospital to meet the needs of our growing population. We have some of the highest levels of house building in the south-east. What can he do to help?

[Steve Barclay]

My right hon. Friend has assiduously and passionately led the campaign on this. I stand ready to have further discussions with her. She is right about the trust going into the rolling programme; that is how it will be taken forward. As I touched on in response to the Chair of the Health and Social Care Committee, my hon. Friend the Member for Winchester (Steve Brine), there are some questions that we are keen to work through—not least around junction 7, the land acquisition, and the service design—and I know that she will be at the fore in making representations on those points.

Urgent and Emergency Care Recovery Plan

Maria Miller Excerpts

Monday 30th January 2023 Commons Chamber

[Steve Barclay]

First, I thank the hon. Lady for recognising the steps that we have taken on transparency. That has been an area of challenge and it is part of my wider commitment to transparency.

The ambition of the targets has to be realistic, and targets are not a ceiling but a floor. It is about saying, “How do we set a target that is realistic?” Of course, we will aim to do better than that, but it is about setting something that the system feels is achievable, because that in turn gets much more buy-in.

On beds, we are increasing capacity, as my right hon. Friend the Member for Wokingham (John Redwood) alluded to. What it is really about is freeing up patients who are fit for discharge from hospital, who should not be there and would actually prefer to be getting care at home. It is about looking at the end-to-end bed capacity, not simply at beds within the acute sites.

[Dame Maria Miller (Basingstoke) (Con)]

I welcome my right hon. Friend’s statement. In the pandemic, the use of local private hospitals by the NHS, particularly in places such as Basingstoke, kept services such as cancer care going uninterrupted. Could the NHS be using more private facilities more widely to relieve some of the pressures that he so eloquently outlined in his statement?

[Steve Barclay]

My right hon. Friend makes an important point. Again, within that is patient choice and how we empower more patient choice—providing services that are free at the point of use—to use what capacity there is within the system, including in the independent sector. I absolutely agree that we should be maximising capacity. At Downing Street with the Prime Minister, we had a very useful roundtable with the independent sector about how we can make more use of its capacity. That is certainly an area that we are exploring.

Oral Answers to Questions

Maria Miller Excerpts

Tuesday 1st November 2022 Commons Chamber

[Neil O’Brien]

The hon. Lady asks a powerful question. As well as the reforms that we started this summer and I announced in our plan for patients, as we start to think about the next dental contract, we are thinking about all the different things we can do to incentivise dentists to work in particularly poorer areas where there is difficulty accessing services. We are also working with the General Dental Council to review the processes that overseas dentists have to complete before they start to provide NHS care, which are sometimes more arduous than those for doctors. We are also thinking about the internal market of the UK and making it easier for dentists in Scotland to practise in England as well.

[Dame Maria Miller (Basingstoke) (Con)]

I welcome the shift in responsibility for NHS dental services in my area to my local Hampshire integrated care board. That will bring a real improvement by focusing on local priorities, rather than the previous regional approach. Will my hon. Friend join me in encouraging ICBs to ensure that they adequately fund dental services, especially for elderly people and children? Dental health is as much of a priority as any other aspect of our health.

[Neil O’Brien]

My right hon. Friend is absolutely right. The shift to ICBs is right and it is an opportunity to integrate services in a way that has not been done before. She is right to stress the important preventive role that dentistry can play, which also reduces demand on other services, including accident and emergency.

Health and Social Care

Maria Miller Excerpts

Monday 5th September 2022 Ministerial Corrections

The following is an extract from the statement on 20 July 2022.

[Dame Maria Miller (Basingstoke) (Con)]

I welcome my right hon. Friend’s statement and its recognition of the need to have specific strategies to make sure that women have equal access to services. However, it is silent on the biggest healthcare injustice that women face in our country—that abortion is still treated under Victorian criminal law, with the most draconian laws in the world. Seventeen women in the past eight years have been subject to criminal investigation, including simply because they suffered the appalling issue of stillbirth. This strategy should stop that by expanding the Government’s own change in the law in Northern Ireland to ensure that abortion is an issue between women and their doctors, and that every woman is protected from criminal investigation at a time when what they need from us is care and compassion.

Women’s Health Strategy for England

Maria Miller Excerpts

Wednesday 20th July 2022 Commons Chamber

[Steve Barclay]

The hon. Lady says that she is not being listened to, but my understanding is that she is co-chair of the menopause taskforce, which has been set up to look at these issues. Indeed, she has also had meetings with officials on the subject of HRT. It is slightly remiss of her to suggest that she is not being listened to when Health Department officials are meeting with her and when we have a taskforce under way. There is much consensus around the points that she raises. She has highlighted, quite rightly, the importance of HRT, and we have acted on that. Part of the reason for the delay until April is that the IT systems need to be put in place. I well recall, when I was a Treasury Minister, being asked to move at pace in response to covid, because of the cash-flow pressures on businesses, and sometimes having the same colleagues complaining that forward controls and other issues had not been put in place. We need to put the right IT in place. We will do that for April, and the work is under way. The issues that she raises are being addressed, but in an effective way.

As I said to the shadow Secretary of State, we will work with the royal colleges to address the issue of training. It is a perfectly fair point, and I do not think there is disagreement in the House on that. On the wider issue of addressing disparities, that is exactly what the taskforce is about. That is why we have such a relentless focus on data, why we have a women’s health ambassador to give greater voice to these issues, and why we have brought forward specific measures, such as the family hubs and mobile breast screening units, to better address those disparities.

[Dame Maria Miller (Basingstoke) (Con)]

I welcome my right hon. Friend’s statement and its recognition of the need to have specific strategies to make sure that women have equal access to services. However, it is silent on the biggest healthcare injustice that women face in our country—that abortion is still treated under Victorian criminal law, with the most draconian laws in the world. Seventeen women in the past eight years have been subject to criminal investigation, including simply because they suffered the appalling issue of stillbirth. This strategy should stop that by expanding the Government’s own change in the law in Northern Ireland to ensure that abortion is an issue between women and their doctors, and that every woman is protected from criminal investigation at a time when what they need from us is care and compassion.

[Steve Barclay]

My right hon. Friend is right that there is a need for care and compassion, and she highlights an extremely important point. She will be aware that the sexual health review is currently being conducted. That will report later this year and will look into the issue that she raises.