Adult Social Care in Shropshire: Government Funding

Mark Pritchard Excerpts

Wednesday 22nd January 2020 Westminster Hall

[Daniel Kawczynski (Shrewsbury and Atcham) (Con)]

I beg to move,

That this House has considered Government funding for adult social care in Shropshire.

It is a pleasure to serve under your chairmanship, Mr Stringer. Before I start to outline the concerns we have about Government support for paying for adult social care costs in Shropshire, I will put forward two historical contexts to try to explain to the Minister a little as to why and how we got into this situation.

In 2004, the Labour-controlled Shropshire Council increased council tax in one year by 16.4%. That was the year before my hon. Friend the Member for The Wrekin (Mark Pritchard), my right hon. Friend the Member for Ludlow (Philip Dunne) and I were elected for the first time. I am sure they will recall, as I do, the palpable anger, fear and frustration of many people on low fixed incomes in the face of that massive tax increase. When our party came into office, we incentivised councils to freeze council tax because there had been so much frustration and such a backlash against the massive increases, not only in Shropshire, but in Labour-controlled councils up and down the country where there had been double-digit increases in council tax.

Our local council, which became Conservative in 2005, decided to dutifully follow the advice and froze council tax, not just for one year, but for seven years in a row—clearly to the delight of local ratepayers. The council is now telling me that the Government have not adequately filled the shortfall in revenue that it inevitably had to face as a result of the freezing of council tax. The Minister may correct me if I am wrong, but my understanding from Shropshire Council officials is that the additional support that was envisaged to come from Government tapered off quickly, leaving the council without additional support of, it now estimates, in the region of £20 million per annum.

Labour shadow Ministers always criticise repeated references to their management and stewardship of the economy, but let us not forget that in the good times the Labour party, when it was in office, borrowed £50 billion a year, sold off our gold reserves at rock-bottom prices and put all these new hospitals on private finance initiative contracts, with the result that we will pay exorbitant interest rates for decades.

When the financial crash came in 2008, the kitty was bare. I am not ashamed of repeatedly referring to that. People forget about it, but the Minister will remember the sheer gravity of the situation when we came to office. As a nation, in 2009-10, we were borrowing £152 billion a year.

[Mark Pritchard (The Wrekin) (Con)]

I commend my hon. Friend for securing this important debate. Does he agree that it is not only about the financial pressures on Shropshire Council but the domino effect of the under-provision of social care in Shropshire on the acute trust, and how that affects A&E waiting times? Finally, does he agree that there needs to be cross-party consensus and working together nationally? We do not need another review; we have had lots of those. We know what the problem is. We now need solutions, and that has to be done on a cross-party basis, but quickly.

[Daniel Kawczynski]

I thank my hon. Friend and neighbour for that intervention. I could not agree more.

When we came into office, we of course had to rein in expenditure, and all Government Departments had to have cuts. The cuts to local government have, of course, adversely affected our council. I am pleased that the country’s annual deficit is now below £28 billion a year, down from the £152 billion a year that we inherited. However, now that we are getting the finances under control in a more sustainable way, I urge the Minister to take the message back to the Treasury that we need to increase public funding of our councils, so that they can start to meet the huge rise in demand for adult social care in our county. I will explain why Shropshire is uniquely affected.

[Daniel Kawczynski]

Yes, very much so, and I am sure that some of my colleagues from Shropshire will take up that point in interventions. However, I will make a few quick points before I take another intervention.

During the 2017 general election, we gave the impression to the electorate that somehow they would have to sell their homes in order to pay for their long-term care. I have to tell the Minister that I had never come across such levels of bewilderment, frustration and anger on the streets of Shrewsbury as I did following that announcement, and have not done so subsequently. Whoever came up with that policy for the then Conservative Government was really out of tune with the thinking of many of our natural voters.

Even my own beloved mother—this is the first time I have referenced her in 15 years—Halina, who is a staunch Conservative supporter, said to me, “I haven’t made sacrifices all of my life, I haven’t done the right thing, paid the right amount of tax and done all the right things, for you now to force me to sell my home to look after my long-term social care needs.” I think my mother exemplified the strength of feeling across the United Kingdom.

I am convinced that that policy lost us our majority at the 2017 general election; it was certainly a major contributory factor. I am therefore very pleased that the Prime Minister has indicated that in this Parliament a solution will be found. However, as my hon. Friend the Member for The Wrekin said, we need radical, innovative thinking that has the support of our voters.

Shropshire MPs meet the council on a regular basis. We Shropshire MPs work as a team and hunt as a pack, and one of our greatest strengths is the unity between us all. In fact, we are seeing our council this Friday, 24 January, which happens to be my 48th birthday. I am looking forward to a few bottles of beer from my colleagues during the meeting.

[Mark Pritchard]

Shropshire Lad.

[Daniel Kawczynski]

Shropshire Lad. The clear message from Peter Nutting, the leader of our council, from the chief executive, and from the other senior councillors is that social care is their top concern. The Minister will know—she played a part in it as well—that in the last Parliament, MPs from rural shire counties worked constructively together to get a change to the funding mechanisms for our schools. Rural shire counties were unfairly discriminated against in comparison with inner-city, metropolitan areas. In this Parliament it is my intention, and that of many other Members, to make social care the No. 1 issue, because we have to listen to what our councillors are telling us.

There is no doubt in my mind that the black hole of approximately £20 million a year that the council faces is affecting not only adult social care costs but many other services in our county. The leader of the council has to take money away from repairing potholes, and all the other things for which the council is responsible, in order to manage the black hole that is staring them in the face.

The National Health Service

Mark Pritchard Excerpts

Wednesday 23rd October 2019 Commons Chamber

[Mark Pritchard (The Wrekin) (Con)]

I don’t know about you, Madam Deputy Speaker, but I am delighted that the age of austerity is over. We have heard from the Government today a commitment to record investment in the NHS. In my political lifetime, I cannot think of any Government of any political colour that was so committed to the NHS or a Prime Minister and Secretary of State similarly committed. And of course that must come on the back of a strong economy, not the magic money tree we hear about so often in politics.

I am also delighted that we are talking about something other than Brexit. I hope that we can get the withdrawal agreement and Bill through so that we can pass the Queen’s Speech and legislate to make sure that these improvements to the NHS actually take place.

I want to go local for a moment and thank the Minister and all the team at the Department for ensuring that Shropshire and the borough of Telford and Wrekin have not lost out in this record investment in the NHS. In fact, in Shropshire we are seeing the largest investment in the NHS in its 70-year history: £312 million. That is fantastic news. What does it mean locally? For my constituents, it means that most of the planned surgery—the majority—will take place at the Princess Royal University Hospital in Telford. My constituents will no longer have to take a journey to Shrewsbury for the majority of their visits to their local hospital trust. That is good news.

There is a debate about the accident and emergency award, but I am delighted that today we have heard from the Secretary of State that the A&E has been saved at the hospital in Telford. In fact, it will be the very latest in modern thinking on how A&E services are provided, under the banner of “A&E local”. Of course, some cynics say, “Maybe that’s ‘A&E lite’”. Well, it will not be as long as I and my hon. Friend the Member for Telford (Lucy Allan) are on the case, working in tandem for local people to ensure that we have an A&E that provides what local people need.

I am glad that the Secretary of State, in releasing the £312 million to Shropshire and the borough of Telford and Wrekin, said it was conditional upon the A&E at the Princess Royal University Hospital being adequately run and sufficiently resourced, with the right staffing levels and expertise and with the clinical and medical cover it requires to service the people of Telford and Wrekin. I and, more importantly, my constituents welcome that commitment.

I am also delighted that new services will be coming into the hospital. There is a lot of doom and gloom in some parts of the local media in Shropshire, which one would expect from Opposition voices in other parties, but the good news is that we are going to see a new cancer unit; the good news is that we are going to see a new MRI scanner; the good news is that we are going to see an extra £7 million spent on a completely modernised radiology service; the good news is that we have just recruited 180 nurses to the trust; the good news, further to that other good news, is that we have now recruited 17 extra A&E doctors to the trust.

May I digress for a moment and raise the issue of recruitment, which overlaps with that of social care? I hope that the Ministers will work closely with Home Office Ministers on the points-based migration system to ensure that we attract not just highly skilled doctors from around the world, but others with fewer qualifications and skills— whether it be from India, the Philippines, or other Commonwealth and non-Commonwealth countries —so that we can provide that expanded social care service. Indeed, I hope that we will continue to retain and recruit the very best from the European Union, when we cannot recruit domestically.

Many positive developments are resulting from the Future Fit programme in Shropshire. Let me also say briefly that I am delighted by the Secretary of State’s announcement today of the immediate provision of an additional £400 million, which will enable us to expand our women and children’s unit and ensure that we have a high-quality, modernised, midwife-led unit. That is good news as well.

Finally, let me issue an appeal to Ministers on the subject of mental health, which I raised earlier today. Can we ensure that veterans who are leaving the military and making the transition into civilian life have a pathway of care?

[Sir Mike Penning]

My hon. Friend has touched on an issue that I did not have time to raise because of the time limits which, understandably, have been imposed. The danger of putting ex-military personnel into one box is that, as I mentioned earlier, some will react almost immediately to what they have seen and done, while it will take others years and years. I have close friends who fought in the Falklands war and who are only now being diagnosed with post-traumatic stress. It is important that in local communities around the country, and particularly in The Wrekin, the NHS understands the mental health needs of those who may have served in the armed forces many years ago

[Mark Pritchard]

My right hon. Friend is absolutely right to underline that. He has served in the armed forces himself, and has been a shadow Health Minister and a Minister in many other Departments. I also think that serving doctors should be given more encouragement to go into the reserves to help to stop this problem. As my right hon. Friend says, if post-traumatic stress is not dealt with by means of early intervention, it can turn into the much more difficult and complex condition of post-traumatic stress disorder.

I am sure that my right hon. Friend will, like me and like other Members on both sides of the House, pay tribute to Combat Stress, which has a unit in my constituency and which does a great job, and to Help for Heroes, whose current campaign is intended to ensure that people who are leaving the military under medical discharge with mental health conditions in particular, but with other conditions as well, have the pathway of care that I mentioned through local NHS trusts in all our constituencies.

This is good news for Shropshire. There are still some battles with the Minister ahead, and I will fight those battles with my hon. Friend the Member for Telford, but overall, this is good news.

The National Health Service

Mark Pritchard Excerpts

Wednesday 23rd October 2019 Commons Chamber

[Matt Hancock]

My hon. Friend has campaigned incredibly hard. As she knows, the local NHS brought forward the plan, which we are proposing to amend. I am working on that with her. However, I am delighted to announce that the Princess Royal in Telford will be benefiting from £4 million of winter capital funding that will come on stream for this winter, partly as a result of my hon. Friend’s campaigning.

[Mark Pritchard (The Wrekin) (Con)]

I am grateful to the Secretary of State for giving way. I get on very well with the shadow Secretary of State on a personal basis and do not expect an apology from him, but was he not wrong on the A&E at the Princess Royal Hospital in Telford? It is not closing. We are having the latest modern thinking on how A&E care is delivered through an “A&E local”, so will the Secretary of State put a little more flesh on the bones of what that means?

[Matt Hancock]

My hon. Friend is right that the local NHS came forward with its plans, but I want to ensure that A&E facilities continue in Telford. We are working on the details, and he will be the first to know.

--- Later in debate ---

[Matt Hancock]

Yes, I will look precisely into the matter that my hon. Friend raises, because care plans should be the norm. Across the country, a high proportion of people now leave in-patient care with a care plan in place. If the proportion is not high enough in her area, I will look into it, write to her and make sure that she gets the full details.

[Mark Pritchard]

I am grateful to the Secretary of State for giving way again; he is being very generous. What conversations has he had with the Secretary of State for Defence about people who are medically discharged with mental health issues from the military and who then transition into civilian life with healthcare provided in civvy street? How do we ensure that the pathway for care is unbroken, is consistent and provides a wraparound service for them as they transition out of the military?

[Matt Hancock]

This is another incredibly important point. I will be working with the new Minister for Defence People and Veterans, as well as the Minister for Mental Health, my hon. Friend the Member for Mid Bedfordshire (Ms Dorries), to address exactly that sort of concern. This is a long overdue—

Children and Mental Health Services

Mark Pritchard Excerpts

Tuesday 16th July 2019 Westminster Hall

[Andrew Griffiths]

My hon. Friend is absolutely right. During that time, babies become children, children become adults, and the problem gets worse and worse. I do not deny the Government’s commitment and determination in this, but it is just not happening quickly enough.

The other thing we need to bear in mind is that, although we have heard about CAMHS and the pressures on the workforce, a huge number of brilliant voluntary sector organisations are also delivering these services. I am very lucky to have in my constituency an organisation called Youth Emotional Support Services, which delivers in schools in Uttoxeter, as well as Burton and District Mind. There are so many great organisations. However, even in my own patch, I have heard that a tendering process is currently going on in which the bar is so high, the requirements so difficult and the boxes to tick so numerous that third sector organisations simply feel unable to compete. The challenge is that the tender to provide the facilities goes to a private company, and the experience, dedication and benefits of those voluntary sector organisations are lost.

I was staggered to learn that some of the children’s mental health charities operating in my constituency are providing 85p of frontline services for every pound they receive. That is tremendous value, representing help for young people, and few businesses could get anywhere near matching that. However, the tender process that we go through makes it impossible for voluntary sector organisations to compete. I hope the Minister will look into that; I will be raising with her my particular issue in Staffordshire.

I think the Minister recognises that in this place, we are simply voicing the real concerns and fears of parents up and down the country. Like a snowball coming down a hill, young people’s mental health is under greater pressure than ever before, and as a result they are self-harming, committing suicide, or getting themselves into a situation in which they will, in future years, suffer from greater mental health disorders, addiction, and so many other long-term problems. I hope that the Minister will go away feeling that she has great support across this House for her campaign to get even more resources and focus on mental health services, particularly for children, because quite frankly our children’s lives depend on it.

[Mark Pritchard (in the Chair)]

I do not propose to enforce a formal time limit of four minutes, but I ask colleagues to be mindful of the number of people who wish to contribute to the debate.

Heated Tobacco

Mark Pritchard Excerpts

Wednesday 26th June 2019 Westminster Hall

[Mr Jones]

Clearly, the ideal is for people to give up smoking altogether, but there are ways of reducing it. I will go into that in my speech. The hon. Gentleman makes a point to which I shall also refer: there is a need for research on the effects of alternatives to combustible tobacco.

E-cigarettes have had a revolutionary effect on efforts to reduce smoking rates in this country, and credit must go to the Government for facilitating that. E-cigarettes have had a highly positive impact on helping smokers to quit. In 2010, a particularly enlightened member of the behavioural insights team, David Halpern, influenced the Government’s decision not only to resist banning e-cigarettes—other countries were poised to do so—but to seek deliberately to make them more widely available. David Halpern advanced the principle of harm reduction: it is more effective to give somebody a reduced risk product than to insist unrealistically on immediate total abstinence. An expert in harm reduction, Professor Gerry Stimson of Imperial College, has supported that argument, pointing out that it is easier to persuade people to do something if that thing is enjoyable rather than a painful chore. He said:

“For those trying to stop smoking, e-cigarettes have profoundly changed the experience. For the first time quitting cigarettes is no longer associated with being a ‘patient’ and personal struggle.”

[Mark Pritchard (The Wrekin) (Con)]

I am grateful to my right hon. Friend for securing this important debate. As a non-smoker, I think there is nothing worse than sitting outside a café in London or Shropshire and having my lungs full of somebody else’s smoke, or indeed trying to walk to Parliament and taking in a street full of smokers’ smoke. Having said that, I am a libertarian—if people want to smoke, they should be free to do so. His substantive point on public health education is absolutely right: the campaign against smoking is not over. In my constituency of The Wrekin, 19,000 people still smoke. Does he agree that public health is important?

[Mr Jones]

I do indeed. I will also comment on my hon. Friend’s point about other people having to endure smokers’ smoke. One point that the Government make in their response to the Science and Technology Committee’s report is that heated cigarettes are far less offensive to other people than combustible cigarettes.

Consumers’ principal reason for using e-cigarettes is to give up smoking. According to Action on Smoking and Health, 62% of ex-smokers use e-cigarettes for that purpose, and the majority of users have successfully quit smoking. However, it might well be that we have now passed the apogee of the e-cigarette effect. According to the Office for National Statistics, the number of new e-cigarette users peaked at 800,000 in 2013-14. Since then, the number has approximately halved every year, down to 100,000 in 2016-17. It is not the case that the remaining smokers do not want to quit; the ONS reports that nearly 60% do. For some, however, the experience of using e-cigarettes does not come sufficiently close to that of smoking to be an adequate substitute. In this context, I urge the Government to consider the alternatives.

In Japan, heated tobacco is proving very successful in helping smokers to quit. Evidence there shows that 70% of heated tobacco users give up smoking altogether. That is a better conversion rate than for any other alternative nicotine-containing product on the market.

Princess Royal Hospital Telford

Mark Pritchard Excerpts

Tuesday 12th September 2017 Westminster Hall

[Lucy Allan]

My hon. Friend says “Shrowsbury; I say “Shroosbury” and so do all my constituents. That highlights one of our great differences.

The hospital trust has reassured me that it is not the case that services are being moved, but it is my constituents who need reassurance. I make the simple plea that the Minister put on the record that, whatever delivery model the hospital bosses decide for the future of emergency care in Shropshire, our Princess Royal Hospital will continue to have A&E care delivered by emergency consultants, and that our brand new women and children’s unit will continue to deliver services to women and children.

[Mark Pritchard (The Wrekin) (Con)]

I congratulate my hon. Friend on securing the debate. The women and children’s unit, which opened two years ago and cost the taxpayer £28 million, is very welcome in Telford and central and east Shropshire. Does she agree that the same arguments that prevented the women and children’s unit from relocating to Shrewsbury two years ago are even stronger today because of the expansion of Telford and environs? The demographics of the county also show that the majority of its children are in the youngest part—Telford and its localities.

[Lucy Allan]

My hon. Friend is absolutely right: the women and children’s unit is a vital resource in an expanding population with many young women and children. That is because Telford is a new town; many people come to build a new life and build their family. That resource is vital to us, and the concept of moving it elsewhere so soon after it has been brought to Telford is farcical. I am assured that that is not happening, but we need clarity. At the end of the day, if people keep telling us something, ultimately we are going to believe it is true.

[Lucy Allan]

My hon. Friend is absolutely right: we have seen some shameless politicking around this issue. The local council has weaponised our hospital year after year, which is not helping the process of reaching a decision. I will talk about that in more detail later, because it is a vital point. The council should be working constructively with my hon. Friend the Member for The Wrekin and me to try to get the best possible hospital emergency care for all our constituents, but that is not happening now. That is why it is important to highlight this issue and bring it to the Minister’s attention.

There is no avoiding the fact that the body charged with deciding what our future emergency services will look like has been inept in its communications. Despite the growing uncertainty, anxiety and ultimately anger of my constituents, not once has that body been willing to communicate with them. Although a consultation is planned at some point, year after year goes by and that has not happened. Each year, my hon. Friend the Member for The Wrekin and I come to this House to beg the Secretary of State for Health to intervene, and each time nothing happens. We have moved no further forward.

[Mark Pritchard]

For many years people throughout the country were fed up with Whitehall and Westminster and successive Secretaries of State for Health interfering in local health decisions. The Government recognised that, and as part of the devolution agenda said that local health decisions should be made by local doctors, clinicians and medical practitioners. Does my hon. Friend accept that that is right? Does she also therefore accept that those decisions are being made locally, and without interference from Whitehall, which is part of the misinformation, disinformation and fake news campaign of the Labour-led Telford and Wrekin Council?

[Lucy Allan]

My hon. Friend is absolutely right: this is a process led by local clinicians who were supposed to come up with a local decision that suited local people. However, that has not happened, and I see no light at the end of the tunnel. The process is in stasis; there is utter paralysis in the decision-making process, and all the while our Labour council is making hay with the total vacuum of information. We cannot go on saying, “It is nothing to do with Government. It is supposed to be a local issue,” because that has not worked. I will come on to the difficulties that that is now creating in recruitment and retention of vital consultants, who make the whole service operate for everybody.

It is not right that the local decision makers are failing to contradict our local council. It is not right that they are not standing up to some of the bullying rants that we hear day in, day out on our airwaves and read in our local newspaper, in which the local council tries to convince the electorate that the A&E and children’s services will close. The mixture of fear and the weight of NHS bureaucracy keeps the local decision makers like rabbits in the headlights. Nothing is happening.

In fairness to those tasked with delivering this decision-making process, they will not have reckoned on the weaponising of our local hospital for political purposes and have not factored that into the work they are doing. We have seen the local council threatening the NHS with judicial review. We have seen the local council sending out letters with every council tax demand claiming that our hospital is at risk. It has been organising street protests, whipping up anger, misleading people and misrepresenting the proposals, and turning public meetings into events where our local clinicians, who are doing the best possible job for our patients in Telford, say they have felt intimidated and unable to do their job.

The propaganda machine in Telford is well oiled. At every coffee morning that I host, and at every school I visit, someone will ask me, “Why are you closing our hospital? Why do you want to move services away from your home town to Shrewsbury?” That technique has totally failed to win elections in Telford, but it none the less has successfully created huge anxiety and prevented the evolution of our emergency care for the future. Playing politics with our hospital has been the trademark of Telford’s council leadership, with complete disregard for the consequences for our area and our future healthcare. Instead of working constructively for the best healthcare for our people, they have simply engaged in a never-ending war of words, whipping up anger and even trying to bring down the local health trust officers.

Instead of a brand new facility that we could all be benefiting from and new investment, now we have dwindling services that do not meet the needs of local people, despite the best efforts of staff. That paralysis has put our services at risk. It has led to difficulties in attracting and retaining staff, so much so that there is now a genuine risk that insufficient staff may lead to night-time closures of our A&E—and if that does happen, I hold the Labour leadership of our council totally to blame.

My constituents have lost out in these political games. We have hours of council officers’ time being spent, constant activity of the council PR department and expensive lawyers threatening the NHS with legal action. We do not even know how much of our council tax has been spent on this, although we do know that £100,000 has been set aside for campaigning activities, which really should not be the role of a local council. The time has now come when it is not enough to stand by and for Ministers to say that this has nothing to do with Government. I accept fully that it did have nothing to do with Government, but it is evident that because local politicians have hijacked the process, it is now wholly out of control. It is also evident that the local NHS has spent millions on a decision-making process that has failed to reach a decision.

My hon. Friend the Member for The Wrekin and I have pleaded with Ministers time and again, year after year, but we are still no further forward. Nothing has changed, and our constituents are none the wiser about the future of their hospital. I invite the Minister to try to give some clarity to my constituents. They deserve to know what is proposed on this most important of issues. If the council is misleading them and providing them with misinformation, they deserve to know that too. This issue matters to my constituents. I am here to represent their needs and concerns, and that is what I am doing today. It is not good enough for Government to wash their hands of something that matters so much to my constituents and the future of our town.

I invite the Minister to work with me, with my hon. Friend the Member for The Wrekin, with the Minister of State, Department of Health, my hon. Friend the Member for Ludlow (Mr Dunne), who is responsible for hospitals, and with the Secretary of State for Health to try to find a practical way to end the complete paralysis that has ruined the prospect of great emergency services in Telford. There is money to invest in better emergency care but we are not even able to access that money in funding rounds because we cannot reach a decision. I look forward to the Minister’s comments.

--- Later in debate ---

[Jackie Doyle-Price]

It is a matter for reflection that this has been going on for four years, which generates considerable uncertainty. Clearly we should reflect on that, to ensure that the process becomes more efficient. Equally, it takes time to have those debates. I know that the particular issues under consideration here are quite difficult to grapple with. The important thing is that the local NHS is seen to be leading the debate and not allowing anyone else to fill that vacuum when there are decisions to be taken.

My hon. Friend the Member for Telford invited me to make some comments. Obviously there are limits, but perhaps I could set out the process, so that we can put in context exactly where we are now. As I mentioned, all service changes will be based on the fact that they deliver real outcomes for patients and will be taken forward in consultation with the local community. Ultimately, the most important factor is that this is what is best for the health service in the area, driven by clinical leadership. Again, it really should be the local NHS leading this debate, and not local authorities filling the vacuum.

The issues that my hon. Friend raised affect not only her and my hon. Friends the Members for The Wrekin (Mark Pritchard) and for Shrewsbury and Atcham (Daniel Kawczynski), but also service users in Wales. As she alluded to, it has now been four years, so everyone knows that change is in the air. Until the vacuum is filled, there will continue to be uncertainty. I expect the CCG to bring forward a consultation, to have an open discussion as soon as it can. I urge everyone to participate fully in the consultation and I encourage my hon. Friend the Member for Telford to lead that debate. Where there are issues that she is concerned about, she should challenge the local NHS leadership, and where there are things that she welcomes, she should highlight them.

The proposed service changes should meet four key tests: they should have support from GP commissioners, be based on clinical evidence, demonstrate public and patient engagement, and consider patient choice. Until those four criteria can be met, no decision can be taken.

[Mark Pritchard]

On the clinical evidence points, there was a so-called independent review, which the two clinical commissioning groups—Shropshire and Telford and Wrekin—and the NHS hospital trust commissioned. KPMG undertook that review. How independent it was and how knowledgeable KPMG, headquartered here in London, is of Shropshire’s health system is questionable, but I will just ask the Minister this. On clinical evidence, does she agree with me that if the demographics show that the younger part of Shropshire county is in Telford, it would not make sense to relocate the new—two-year-old—£30 million women and children’s unit from Telford to Shrewsbury, where there is an older, or elder, population?

[Jackie Doyle-Price]

Of course everybody wants to be able to access health services as close as possible to where they live, and my hon. Friend’s points about demographics are sensible. However, it is also important that we build critical centres of excellence. Where everything is together in one place, people can get better care. Wherever these services are ultimately located, there is a strong case for the children’s unit to be by strong A&E services, but obviously that needs to be tackled as part of the debate. My hon. Friend questions whether the KPMG study was objective. These are really serious questions that he should put to the local NHS leadership when we get into open consultation. I know he is looking for comfort from me, but I am not best placed to make the decision sitting in Whitehall.

--- Later in debate ---

[Mark Pritchard]

I am grateful to the Minister for giving way again; she is being very generous. Does she agree, though, in terms of transparency and openness and the fact that the public purse will have paid for the KPMG report, and given the seriousness of the issues, that that report should be published in full, in its entirety, for the public to see, in particular the Shropshire Star, which has done an excellent job in holding the local authority’s feet to the fire, to use one councillor’s term, on some of its most outrageous claims about this process?

[Jackie Doyle-Price]

It surprises me that the report is not in the public domain, according to what my hon. Friend has just said, if it is informing the approach that is being taken. I tend to take the view that sunlight is the best disinfectant, and if things are not done in an open and transparent way, the conditions are created for exactly the kind of speculation and scaremongering that we have been talking about. Having said that, I reiterate that the consultation has not yet started. It is very important that when the consultation does start, the CCG makes extremely clear the basis on which it is going forward with the proposals that it chooses.

I do not need to advise my hon. Friends of exactly what we are talking about. Clearly, they know more about their local healthcare situation than I do, and it is clear that local NHS leaders have to address significant challenges in bringing forward the entirety of their proposals as they affect the Royal Shrewsbury Hospital and the Princess Royal Hospital in Telford. I understand that they are 18 miles apart. In some areas of the country, that might not seem far at all, but when we are dealing with communities that have very separate identities, they could be oceans apart. That is another reason why we need to be very clear in our dialogue with those communities about why we are bringing forward the conclusions that we are.

Clearly, at a time when there is no money, things that it would be nice to have are not possible. It would be nice to duplicate services in both locations, but frankly that is not a luxury open to us at this stage in the economy, so where there is duplication of services, where we could bring them together and make a better service as a result, we should explore that. It is up to the local clinical leadership—there is a clear task and challenge for them—to demonstrate that whatever they bring forward will deliver better outcomes for patients. When it comes to winning over public hearts and minds, the public will not get away from the fact that services are being moved away from them. Automatically, there is a diminution of service in their mind, but bringing services together can often make a better service. We can see, with patient outcomes in particular circumstances, where that has been achieved. I therefore encourage the CCG to bring forward as much evidence as possible in making its case.

Of course, we all understand that whenever the consultation takes place, after four years of quite feverish speculation on some parts, people will be nervous. I encourage all my hon. Friends to continue this debate in public and with Ministers, so that we can reassure the public that we have their best interests and those of patients at heart with whatever decision is taken. As I have said, the more transparent and open the debate is, the better. Perhaps between them, my hon. Friends can lead the CCG to have those public discussions, away from the council, away from organised intimidation at public meetings, which will not lead to the best outcomes for patients at all. I have witnessed this myself. The left is very good at organising mobs at public meetings, but the last thing we want is for local clinical leaders to bring forward proposals in the best interests of serving the community and then be intimidated, by those who shout loudest, into changing their views because they are faced by a herd.

Rare Diseases Strategy

Mark Pritchard Excerpts

Tuesday 28th March 2017 Westminster Hall

[Ben Howlett]

I thank my hon. Friend for that intervention. He is a great champion for his constituents. I share his hope in the Prime Minister’s commitment, made at an early stage in her office, and in a Minister who obviously understands rare diseases, having one herself, and who has made a clear personal commitment to resolve the issue. Having worked alongside the Department of Health for many years, I have been wanting to see this come to fruition. I am glad that we now have a leadership commitment in place to deliver it for the first time, at least in my memory of working alongside the NHS.

The UK is doing superb work and leading internationally on rare diseases. I hope that our all-party parliamentary group’s report will make a significant difference and help to steer the Department of Health to a place conducive to both the Minister’s requirements and ours. I look forward to hearing his response.

[Mark Pritchard (in the Chair)]

Before I call Margaret Ritchie, I will give some guidance. I am sure that hon. Members are aware that the spokesman for the Scottish National party will have five minutes, as will the shadow Minister. The Minister will have 10 minutes. This debate is due to finish at 5.30.

--- Later in debate ---

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

It is a pleasure to serve under your chairmanship this afternoon, Mr Pritchard.

I welcome this important debate and I thank the hon. Member for Bath (Ben Howlett) for securing it and for his excellent introduction to it, although I am sorry that I missed the start of his speech because it started four minutes early before my hon. Friends and I were in our places.

I also thank other hon. Members for their contributions this afternoon, including the hon. Member for South Down (Ms Ritchie), my hon. Friend the Member for Cambridge (Daniel Zeichner) and the hon. Member for Linlithgow and East Falkirk (Martyn Day), the spokesman for the Scottish National party, who all made excellent and insightful speeches.

As others have said, here in the UK one in 17 people will be affected by a rare disease at some point in their life, which equates to approximately 3.5 million people in the UK. It cannot go unsaid that those 3.5 million people have a wide range of symptoms, which vary from condition to condition, some of which we have heard about this afternoon. It is clear that there are common experiences that people with these conditions all share. As Rare Disease UK has estimated that it takes on average four years for a patient to receive a diagnosis, it is clear that there are many missed opportunities to help those people living with rare diseases. Each and every person who suffers from a rare disease deserves the necessary support to live a fulfilling life.

That is why it was welcome that in 2013 the coalition Government published their UK-wide strategy for rare diseases, which was seen as heralding a new era in the treatment and care of rare disease patients across all four home nations. The 51 recommendations are all to be welcomed, as they each take us a step further in addressing concerns about the care and treatment of rare diseases, and the strategy’s aim is to make sure that no one gets left behind just because they have a rare disease. It is an aim that Labour welcomes wholeheartedly.

Most of my contribution to this debate will focus on the issues with the implementation of the strategy, but I will take a moment to mention some of the positives. It is welcome to see that the National Institute for Health Research has launched the Rare Diseases Translational Research Collaboration—I will use the acronym, RD-TRC, as it is much easier to say—which aims to empower patients to engage and become involved with research and research funding decisions. To date, the NIHR has invested £4 million in the RD-TRC, and the programme is expected to continue for another five years, with a £5 million investment.

Work has also been done by Public Health England on data recording, to bolster diagnosis and early intervention, and we have also seen Health Education England collaborate with the National School of Healthcare Science to produce two educational videos for healthcare professionals, in order to raise awareness of the problems faced by families who have a child with an undiagnosed condition and the importance of considering whether it is a rare disease. All this work is to be welcomed and should not go unnoticed.

Yet the sticking point in all of this, and the reason why we are here today to debate this issue, is that the Government are digging their heels in and not getting on with drafting an implementation plan, while the other home nations’ Health Departments are making significant strides. That betrays not only those patients living in England who wish this strategy to be properly implemented but the strategy itself, which stated that all four home nations must see the vision behind the strategy become a reality by 2020. It also undermines all the excellent work that I mentioned previously to implement the recommendations.

The strategy was published in 2013 and we are now just three years from the date set for the vision to be realised. However, the all-party group that the hon. Member for Bath so ably chairs has discovered that the Department of Health does not intend to publish an implementation plan, believing that it should be published by the NHS. Yet the NHS has said that it does not intend to do this either, as it does not have responsibility for other arm’s length bodies of the Department of Health. I want to ask the Minister why. I want to know why we are seeing patients and their families caught in this dispute between the NHS and the Department of Health. This situation cannot continue; there are people suffering right now who need this strategy to be implemented correctly.

I have briefly mentioned the report by the all-party group on rare, genetic and undiagnosed conditions on the lack of an implementation plan, but I know that it covers other issues as well, and I will take a moment to touch on some of them. One of the main issues raised was the lack of communication between organisations responsible for implementing the various aspects of the plan, and the failure to provide patients, families, doctors, industry experts and patient organisations with updates on progress of the strategy. That is deeply worrying, as it is important that people are made aware of the issues that affect them so personally. Therefore, it is not surprising that the all-party group heard from more than 300 patients that widespread disillusionment and disappointment had become the common feeling about the strategy, despite the optimism felt when it was published five years ago. The sting in the tail is that there are implementation plans for the strategy across the UK, with the exception of here in England. I share the frustration of the many others who are affected by the Government’s complacency. The Department’s rationale for not providing updates on progress is that patient organisations can disseminate information to patients and families, but it sadly fails to grasp that those organisations and charities are often very small and do not have the resources to pull together updates and send them out.

Also, issues that have not been worked on since the strategy was published have been identified, including prevention and identification of rare diseases, improving care pathways and failing to implement structures that would facilitate collaboration between the four home nations. In his response, I would be grateful if the Minister could provide us with an update on those points and tell us what his Department plans to do to see the recommendations through.

The strategy is now five years old, and although there has been work to see it realised, it has not gone far enough. The failure here is that the Department of Health in England is not fulfilling its duty to draft an implementation plan to realise the visionary goals in the strategy, which undermines the work already under way and hinders any future work. The Minister must set that right, and I hope he plans to do so today. He has the power to rectify the situation and he cannot be complacent when it comes to supporting people living with rare diseases.

We are not talking about a handful of people; many of our own constituents are being failed by the Government, and all they ask for is that the Department of Health do what Departments in the other home nations are doing and provide an implementation plan to enable the strategy to be fully realised and make the impact it was intended to have. I once more thank the hon. Member for Bath. I hope that the debate will make the Minister think again about the Government’s opposition to taking responsibility for a plan, and that he will honour the whole vision of the strategy, instead of cherry-picking from it.

[Mark Pritchard (in the Chair)]

If the Minister does not use all the time allocated—10 minutes is a guide, but clearly there is more time on the clock—it will allow me to call the hon. Member for Bath for a brief winding up, but that is entirely in the Minister’s gift.

Community Pharmacy in 2016-17 and Beyond

Mark Pritchard Excerpts

1st reading: House of Commons
Thursday 20th October 2016 Commons Chamber

[David Mowat]

I repeat that we absolutely recognise the vital role that community pharmacies can play, and we want to make them move towards an even more vital role by providing more services, which is what pharmacies want to do, rather than getting all their money from their dispensing activities, as they do at the moment. High quality pharmacies will be in a position to really prosper in the new world that we are talking about.

[Mark Pritchard (The Wrekin) (Con)]

I warmly welcome the Minister’s statement. If there are closures, what additional support will be given to the pharmacies that are left, particularly to enable them to take pressure off GPs in the community?

[David Mowat]

The volume of business is gradually increasing. If a pharmacy in a cluster should close, that business will be redirected to other pharmacies in the cluster. They will then be in a position to expand, take on more people and all the rest of it.

Meningitis B Vaccine

Mark Pritchard Excerpts

Monday 25th April 2016 Westminster Hall

[Several hon. Members rose—]

[Mark Pritchard (in the Chair)]

Order. Before I call Mark Durkan, may I ask everybody to check that their mobile phones are on silent mode? It affects the broadcasting equipment—[Interruption.] I rest my case—somebody does have their phone on.

Secondly, I am aware that there was an important health statement in the House today. Some colleagues wrote to say that they would arrive late, and I thank them for that courtesy. If Members stand, they will be called, subject to the order of speakers given to me by the Speaker’s office.

--- Later in debate ---

[Several hon. Members rose—]

[Mark Pritchard (in the Chair)]

Order. Normally I would call a Member from the Opposition Benches at this point. It would be Hywel Williams in this case, but he has not been here for one hour of the debate, for reasons that he has explained to me. I have some discretion, but I think it is only fair that I call now Peter Heaton-Jones, who has been here for the whole debate, and then Dr Sarah Wollaston, who was in the main Chamber for the health statement and is Chair of the Select Committee on Health.

Huddersfield Royal Infirmary

Mark Pritchard Excerpts

Tuesday 2nd February 2016 Westminster Hall

[Ben Gummer]

May I just respond to my hon. Friend’s original point?

We must remember that the PFI deal is borne by the entire trust, so it is not as if it fixes precisely on one site or another; it does not influence the decision of where to go. It could be possible to run a cold site on the PFI hospital and fill the hospital that way. It does not have to be filled with the particular function that the CCG wishes to put there. The CCG just believes that the buildings there are better, more suited and more modern—the hon. Member for Huddersfield would agree with that assessment—for the particular purposes it wants to put there.

It is for the CCG to justify that; I cannot speak with any authority about this, because I do not know. However, I really do not think that the PFI has a bearing, because no matter where the services are put, the PFI deal will still exist. All I am saying is that I want to be realistic about our ability to unpick every single PFI in the country, because in many cases they have been very carefully worded and agreed in a lawyerly fashion—

[Mark Pritchard (in the Chair)]

Order. I remind colleagues and the Minister, first, that the Minister should face inwards, so that we can get a good shot of him on camera. This debate is being televised—just a gentle reminder. Secondly, those Members who want to make comments should stand up to do so, so that the Hansard writers can identify who they are. Thank you very much indeed.

[Mr Sheerman]

Thank you, Mr Pritchard. I hope this is a useful intervention. We have written to the Public Accounts Committee to ask it to have a look at this particular PFI, on the basis that it would be a very good one to try to unpick. That might be helpful to the Minister and us.

--- Later in debate ---

[Jason McCartney]

I thank the Minister for his thorough and detailed response, which we will obviously pick through. I thank him also for his specific commitments. We will have a cross-party meeting with the Secretary of State for Health once the consultation is up and running, which is imminent, as we want to get the best value from it. The Minister’s team is considering the PFI deals, including the one at Calderdale. I assure him that he will be seeing a lot more of not just me but my parliamentary colleagues here in the coming months, as the consultation gets under way.

I also thank my parliamentary colleagues for their contributions. I work with the hon. Member for Huddersfield (Mr Sheerman) on so many issues. We co-chair the all-party Yorkshire and North Lincolnshire group. Many people who watch debates in Parliament do not realise that we work cross-party on important issues for our local areas. Such working is not uncommon, and it will continue.

The hon. Member for Dewsbury (Paula Sherriff) gives an extra perspective, and her passion really came across loud and clear today. I thank the shadow Health Minister for his kind comments and support, and the hon. Member for Batley and Spen (Jo Cox), who was here earlier. The hon. Member for Barnsley Central (Dan Jarvis) was here, too, for much of the debate, although he could not stay because of other pressing commitments; his presence shows how our region is closely considering the issue. Also, of course, there was the hon. Member for Strangford (Jim Shannon), from Northern Ireland, who talked about similar issues in his part of the world.

The consultation is about to start and this is where the battle begins—with me and my parliamentary colleagues, the community campaign, the volunteers and the 46,000 people who are now in the Facebook group. We have firm, clinical evidence and logical, safe, patient-led reasoning to persuade the GPs on the clinical commissioning group to keep our A&E at Huddersfield Royal infirmary. We will fight all the way. We have worked together so far and will continue to. We will say once again, “Hands off our HRI, we’re going to save our A&E at Huddersfield!”

[Mark Pritchard (in the Chair)]

I thank colleagues for their co-operation today. My intervention earlier was due in part to some of the microphones not working today, which is unusual. We will have an inquiry into that. But do not worry; Hansard is here and everything was captured on television also.

Question put and agreed to.

Resolved,

That this House has considered A&E services at Huddersfield Royal Infirmary.