Oral Answers to Questions

Matt Hancock Excerpts

Tuesday 19th February 2019 Commons Chamber

[Peter Kyle (Hove) (Lab)]

1. What discussions he has had with (a) NHS England, (b) Public Health England and (c) local authorities on ensuring that the Government’s commitment to double the number of places on the PrEP impact trial can be implemented in all trial sites as soon as possible.

[The Secretary of State for Health and Social Care (Matt Hancock)]

On 30 January, we announced that we will increase access to PrEP, doubling the number of people who can receive this potentially life-saving HIV prevention drug.

[Peter Kyle]

Funding for HIV prevention has become quite complex, with a complex mix of central funding and local authority funding. Cities such as Brighton and Hove still have the highest contraction rates outside London. Will the Secretary of State meet me and the Terrence Higgins Trust to understand how that is impacting us on the frontline and tell us what more can be done?

[Matt Hancock]

Of course I would be delighted to meet the hon. Gentleman to discuss this matter. In the long-term plan, we made it clear that we are looking at commissioning arrangements for sexual health services. I am delighted that the number of new cases of HIV has been falling and that we have been able to declare that by 2030 we want the UK to have zero AIDS. That is an achievable, but hard, goal, and I will work with anybody to make it happen.

[Dr Sarah Wollaston (Totnes) (Con)]

Does the Secretary of State share the widespread concern about the variation in availability of PrEP treatment, which is surely an unacceptable situation?

[Matt Hancock]

There is a variability in availability. Of course the current model of delivery is a trial—we have doubled the size of that trial but it is still a trial that runs until 2021. I am very happy to work with my hon. Friend as well as with the hon. Member for Hove (Peter Kyle) to try to make sure that it is as available as possible.

[Andy Slaughter (Hammersmith) (Lab)]

Hammersmith is one of the sites that is now closed. When will PrEP be made freely available? Here we have a drug that has almost 100% effectiveness and that will save money for the NHS through HIV protection. When will we see it available to anyone who needs it?

[Matt Hancock]

As I have said, last month we doubled the availability of PrEP, which is an important step in the right direction.

[Will Quince (Colchester) (Con)]

Colchester is one of the sites that is now closed to men who have sex with men who want to access the HIV prevention drug PrEP. When will the Government’s commitment, made almost three weeks ago, to double the number of places on the PrEP trial be implemented across all trial sites?

[Matt Hancock]

It is being implemented as we speak. I am very happy to talk to my hon. Friend about when it will be rolled out in Colchester.

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

I welcome the Government’s commitment to end the transmission of HIV in England by 2030. However, HIV reduction was not mentioned in either the prevention plan or the long-term plan. How will the Government reach that ambitious goal without a concerted and fully costed strategy?

[Matt Hancock]

We do have a concerted and fully costed strategy. Indeed, I have given the commitment of ending new AIDS cases by 2030 with a plan around that. The long-term plan goes into detail about new ways of commissioning sexual health services. This is a very important area, and, as the hon. Lady says, it is an important part of the prevention agenda, and we will make sure that we get it right.

[Several hon. Members rose—]

[Jeremy Lefroy (Stafford) (Con)]

2. What steps he is taking to secure the long-term future of the NHS.

[The Secretary of State for Health and Social Care (Matt Hancock)]

We are increasing the NHS budget by £20 billion, or £33 billion in cash terms, over the next five years. This major investment will support the NHS to continue to deliver world-class care. The long-term plan set out a vision for the NHS, ensuring that every penny will be well spent.

[Jeremy Lefroy]

I thank the Secretary of State very much for his answer. Local accident and emergency departments, such as at County Hospital in Stafford, are absolutely vital for the long-term plan of the NHS. What can he do to ensure that funding is there for these departments because they need an awful lot of block funding and not so much payment by procedure—or payment as you go?

[Matt Hancock]

My hon. Friend, who is an advocate for Stafford beyond compare and an advocate for its A&E—he has personally put much effort into saving it and ensuring that it is in good shape—rightly makes the point that paying per person who comes through the door does not accurately reflect the costs of providing A&E, so we are moving to a much greater proportion of block funding for A&Es, with a smaller element that varies according to the costs of serving everybody, to ensure that the finances follow the need.

[Laura Smith (Crewe and Nantwich) (Lab)]

The latest figures show that more than one in five patients visiting Leighton Hospital A&E in Crewe has had to wait for more than four hours, yet instead of receiving support, the trust has been financially penalised, unable to access capital support to fund improvements to its A&E, while at the same time losing out on the performance element of the provider sustainability fund. Can the Minister explain how the Government are supporting Leighton Hospital?

[Matt Hancock]

We are supporting Leighton Hospital through the delivery of the long-term plan and the extra £20 billion—£33 billion in cash terms—the first £6 billion of which comes on stream in April, in two months’ time. It is true that a record number of people are going to A&E. We have to make sure that the record numbers being treated within the four-hour target are supported, but that we also support hospitals to do yet more.

[Lucy Allan (Telford) (Con)]

In Telford, we have been waiting five years for the chance to ask the Secretary of State to call in for review a highly controversial plan called Future Fit. We now have that chance, and the Secretary of State has been really generous with his time in listening to MPs’ concerns. The local council, however, has still not yet made any submission to the Secretary of State. Can he confirm that without that submission he cannot call in that scheme for review?

[Matt Hancock]

My hon. Friend has made the case very powerfully for the future of Telford Hospital, and I have enjoyed working with her, but it is true that the call-in powers that I have as Secretary of State can be exercised only when a scheme is referred to me by a local council. Should that happen, I will consider it very carefully.

[Ms Angela Eagle (Wallasey) (Lab)]

Will the Secretary of State now come clean with the House and admit that the Lansley Act, which fragmented the NHS into tiny pieces, caused huge inefficiencies; and that successive Governments, including the one of whom he is a member, have starved the NHS of resources, which has caused a lot of the problems that our constituents face in increased waiting times and increased pressure on staff?

[Matt Hancock]

We care about securing the future of the NHS. That is why we are putting £20 billion extra into it over the next five years—£33 billion extra in cash terms. Yes, we will consider proposals being made for legislative changes, but what we care about is making sure that the NHS gets all the support it needs, and not just political nonsense.

[Richard Drax (South Dorset) (Con)]

Does my right hon. Friend agree that one of the vital components to ensure the long-term future of the NHS is community hospitals? Will he meet me to discuss what can be done to recruit more qualified staff, so that beds at the Portland Community Hospital can be reopened?

[Matt Hancock]

I would be very happy to meet my hon. Friend to discuss that, because community hospitals have a vital role to play in the future of the NHS as more care is delivered close to home.

[Mr Dennis Skinner (Bolsover) (Lab)]

It was not insignificant, what happened between ’97 and 2010 under a Labour Government. They trebled the amount of money going to the national health service. It was a system of hypothecation, whereby a 1% increase in national insurance went directly to the national health service, and nobody else fiddled with it.

[Matt Hancock]

It is unusual, but I am delighted to be able to agree with the thrust of the hon. Gentleman’s question. As he knows, we both come from Nottinghamshire mining stock, and it is surprising that we do not agree on more, but we do agree on the importance of having a properly funded NHS. That is why we have put the largest ever, longest ever cash injection into the NHS, because we care that it should be fit for the future.

[Christine Jardine (Edinburgh West) (LD)]

3. What assessment he has made of the effect of toxic air on children’s health.

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[Ian Murray (Edinburgh South) (Lab)]

17. What progress his Department has made on contingency planning for the UK leaving the EU without a deal.

[The Secretary of State for Health and Social Care (Matt Hancock)]

Leaving the EU with a deal remains the Government’s top priority, but we are preparing for every eventuality. I am confident that if everyone does what they need to do, the supply of medicines will continue unhindered.

[Nick Smith]

Will the Secretary of State say how much has already been spent since the NHS no-deal contingency plans were active, and what the overall bill will be?

[Matt Hancock]

Yes. About £11 million has been spent already. The NHS is not generally buying the extra medicines that are going into the elongated stockpiles, but the pharmaceutical industry is. We will of course eventually buy most of those medicines for the NHS. There have been costs to the pharmaceutical industry as well, but the cost so far to the taxpayer is £11 million. I expect it will remain at about that level, or a little higher.

[Vicky Ford (Chelmsford) (Con)]

Some of my constituents with diabetes have contacted me about supplies of insulin. Will the Secretary of State give us an insulin-specific answer?

[Matt Hancock]

Yes. Whereas across all medicines we have requested that the pharmaceutical industry has an extra six weeks of supplies in case of a no-deal Brexit, in the case of insulin the two major providers have already made stockpiles of at least double that. That shows that those with concerns about access to insulin can know that the plans we have in place for insulin are being enacted even more strongly than elsewhere.

[Ian Murray]

But the Secretary of State is refusing to provide any reassurance to constituents up and down the country, and particularly to my constituents. I got an email yesterday from a constituent—I have no shame in quoting this—who said:

“I have type 1 diabetes, as does Theresa May, and the supplies of insulin, needles and blood testing equipment all come from Europe. Insulin is perishable. Without it, so am I.”

Will the Secretary of State come to the Dispatch Box and say to my constituents that, whichever disease they have and whichever medical supplies they require, they will get them even if we leave the European Union with no deal? Would not the best thing to do be just to rule out no deal?

[Matt Hancock]

I have already given the assurance that if everybody does what they need to do, I am confident that supplies will be unhindered. In the case of insulin, the stockpiles are already double what we requested. However, on the point about the deal, the hon. Gentleman has a really important point about ruling out no deal being the best thing for people’s supply of medicines. He knows as well as I do that if we want to rule out no deal, we need to vote for a deal, so he and everybody in this House should vote for the deal.

[Dr Philippa Whitford (Central Ayrshire) (SNP)]

The serious shortage protocol statutory instrument would allow pharmacists to dispense alternative drugs when there is short supply, but, crucially, without consulting a GP. The problem is that they cannot access patients’ records and might dispense a drug that has previously caused serious side effects. Is the Secretary of State really expecting such extensive shortages that phoning a GP will be impractical?

[Matt Hancock]

This change is to respond to the shortages that happen from time to time regularly in the NHS. Given that the supply of 12,300 drugs is typical across the NHS, there are always some logistical challenges. This protocol is to try to ensure that we can respond to those challenges as well as possible. Pharmacists are highly trained in what they do and perfectly able to carry this out as proposed.

[Dr Whitford]

The problem is that the key issue is not consulting the GP. The medical legal responsibility for any problems normally lies with the prescriber, yet the General Medical Council was not even consulted on this SI. Does the Secretary of State really think that such a significant change should be pushed through with a negative resolution and no scrutiny and debate?

[Matt Hancock]

Well, it is getting scrutiny and debate now. The change that is being proposed is about making sure we can get people the drugs they need. Of course the responsibility is on the pharmacist to ensure that it is the appropriate drug and, if necessary, that the GP is involved. However, it is absolutely right that we make changes to ensure that we have an unhindered supply of medicines whenever there are shortages—whether that is to do with Brexit or not.

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

The Secretary of the State spoke with his characteristic self-confidence about the supply of insulin, but at the end of last week Diabetes UK said that

“despite reaching out directly to the Department of Health…we still have not seen the concrete detail needed to reassure us…we cannot say with confidence that people will be able to get the insulin and other medical supplies they need in the event of a no-deal Brexit.”

Why is Diabetes UK wrong and the Secretary of State right?

[Matt Hancock]

Diabetes UK is not a supplier of insulin. Of course, it plays an important role in representing those who have diabetes. We have given Diabetes UK reassurances, including, for instance, that the stockpiles we have for insulin are more than twice as long as we proposed and as required. That is an important assurance.

[Jonathan Ashworth]

I hope the Secretary of State will contact Diabetes UK to give it those reassurances directly.

On the various no-deal medicines statutory instruments that the House will debate today and on other occasions, the Government’s own impact assessments say that, in a no-deal scenario, the NHS will pay more for drugs, UK firms will face more red tape, and NHS patients will go to the back of the queue when it comes to international innovation. Given that the consequences of no deal would be so devastating for the NHS, will the Secretary of State—as, apparently, the Justice Secretary will—resign from the Government if it means blocking no deal?

[Matt Hancock]

If the hon. Gentleman really cared about stopping no deal, he would vote for the deal. There is something else that is worth saying about this shadow Secretary of State. He is a reasonable man—he is a sensible man—and I like him. My politics are probably closer to his than his are to those of the leader of his party, so why does he not have the gumption to join his friends over there on the Back Benches in the Independent Group, instead of backing a hard-left proto-communist as leader of the Labour party?

[Bim Afolami (Hitchin and Harpenden) (Con)]

8. What steps the Government are taking to support charities and other organisations working on treating acquired brain injury.

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[Tommy Sheppard (Edinburgh East) (SNP)]

T1. If he will make a statement on his departmental responsibilities.

[The Secretary of State for Health and Social Care (Matt Hancock)]

To provide the best care, the NHS needs the best technology, and we are therefore bringing together leaders of the digital agenda across the NHS under a new organisation called NHSX. We are also publishing a new code of conduct for the use of artificial intelligence in the NHS. NHSX will report jointly to the NHS and to me, and it will lead this vital agenda so that the NHS can be a world leader in emerging technologies that help to cut costs and save lives.

[Tommy Sheppard]

Meanwhile, in the real world, Scottish Care reports that 30% of social care staff in the highlands are nationals from other European countries. They are paid the real living wage of £9 an hour as a matter of public policy, but that is well short of the Government’s proposed limit of £30,000 for new immigrants in the future. Will the Secretary of State fight in the Cabinet to change that policy, or is he content to let these new immigration policies choke off the supply of labour to our social care sector?

[Matt Hancock]

We welcome people working in social care from the EU and from the rest of the world, and we need to ensure that that can continue, but we also need to ensure that we can train people locally to work in social care. That is incredibly important.

[James Heappey (Wells) (Con)]

T2. GP surgeries across the Wells constituency are innovating with the employment of nurse practitioners, paramedics and other types of clinician to fill vacancies when recruitment of GPs has not been possible. While this often works well, we still have too many vacancies for doctors. What steps will my right hon. Friend be taking to encourage the thousands of GPs in training to consider practice in rural and coastal areas like mine in Somerset?

[Matt Hancock]

My hon. Friend makes an incredibly important point. As important as new technology is and new ways of working and nurse practitioners are, we still need more GPs, and we need more GPs especially in rural and coastal areas. The targeted enhanced recruitment scheme offers a £20,000 salary supplement to attract GPs to parts of the country where there are serious shortages, including in Somerset.

[Neil Coyle (Bermondsey and Old Southwark) (Lab)]

T5. The Terrence Higgins Trust has made it clear that men are being diagnosed with HIV as a direct result of the limited number of places on the current PrEP trial. The Secretary of State has already said this morning that the doubling of the places on that trial is being implemented now, but that commitment was made over three weeks ago; when will implementation be completed across all trial sites including Burrell Street in my constituency?

[Matt Hancock]

I want to see this being implemented as soon as possible. It has already started, but we need commitment from local authorities as well as the NHS to deliver. I am very happy to work with the hon. Gentleman and all other interested Members to see it happen.

[Dr Sarah Wollaston (Totnes) (Con)]

T3. Key parts of our NHS workforce are registered and regulated by the Health and Care Professions Council. Does the Minister share their concern about the steep rise in professional fees that they face—in particular, the loss of the 50% discount that applied to graduates within two years of qualifying—and will she look again at whether anything can be done to assist this key group of our workforce?

[Peter Kyle (Hove) (Lab)]

T6. The head of NHS Improvement, who is also a Tory peer, has said the biggest problem facing the NHS is that not enough people want to work in it. How did the Secretary of State take Britain’s best-loved institution and turn it into something nobody wants to work for?

[Matt Hancock]

Thankfully, the recruitment both of nurses and doctors is going up, which demonstrates that people do want to work in the NHS, and so they should because it is an amazing place to work and it has a great mission, which is to improve the lives of everyone.

[Giles Watling (Clacton) (Con)]

T4.     Last September, the number of medical school places increased by a quarter, as we have just heard. That is great news, but apart from offering premiums, how can we incentivise newly qualified GPs to come to places like Clacton where we have an acute shortage?

[Matt Hancock]

My hon. Friend is absolutely right: the £20,000 bonus is an important part of the solution, but so is having more GPs, and the fact that we have a record number of people going into GP training at the moment is great news that Members in all parts of this House should welcome.

[Toby Perkins (Chesterfield) (Lab)]

T7. A huge number of GP surgeries are struggling to recruit, and meanwhile lots of locums are making a lot more money being locums than working on permanent GP contracts. Will the Secretary of State consider offering his state-backed indemnity to those who commit to being on a permanent contract with a GP surgery?

[Matt Hancock]

Of course the nature of being in a GP practice is changing. For a long time practices, which are essentially private businesses, also had the benefit of rising property prices that brought additional income on top of their income from the NHS. That is no longer the case because property is so expensive, so many people are changing the way that GPs are employed, so they are directly employed rather than through practices. That move is happening, but it is just one of the many changes we are seeing to try to make sure that being a GP is sustainable, and clearly things are starting to improve because a record number of people are choosing to become GPs.

[Tom Tugendhat (Tonbridge and Malling) (Con)]

T8. Mr Speaker, you will be aware of the fantastic work by the Edenbridge War Memorial Hospital in the town just near me, and you will also be aware of the fantastic news that we are having a new clinic built there. Does my hon. Friend the Minister agree that the money from the initial site, which was given by public subscription 100 years ago in memory of the young men who died in the first world war, should now be spent on medical facilities in the town?

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[Paul Masterton (East Renfrewshire) (Con)]

The internet and social media have provided huge opportunities and positives for our young people, but we have been far too slow to react to the negatives, including cyber-bullying and issues around body image. Will the Minister responsible for suicide prevention, or my right hon. Friend the Secretary of State, confirm that they are taking a truly cross-Government approach to this issue and that they will seriously tackle the role of the tech companies?

[Matt Hancock]

Yes; my hon. Friend is dead right to bring up this subject. The rise in material promoting self-harm and suicide online is dangerous, and it needs to be stopped. I am delighted that, under pressure from this House, Instagram has now decided to take down that material, but there is much more to do. In this country, it is this House that makes the rules, not the global companies.

[Bill Esterson (Sefton Central) (Lab)]

The greatest damage from prenatal exposure to alcohol is often done in the first few weeks of pregnancy, yet three quarters of women in the recent Bristol University study said that they drank alcohol while pregnant. Will the Minister commit to ensuring that the chief medical officer’s advice is given loud and clear by all health professionals: do not drink alcohol if pregnant or trying to conceive?

[Royston Smith (Southampton, Itchen) (Con)]

Southampton is above the English average with nearly 6% of GP appointments being missed. Nationally, missed appointments cost the NHS more than £200 million a year. Does my right hon. Friend agree that a standardised online booking system featuring a reminder function with the option of cancelling or rescheduling an appointment would save money and reduce waiting times? Does he have any plans for such a system?

[Matt Hancock]

Yes, I do. This is one of the sorts of things that NHSX will drive forward. A decent IT system can reduce missed appointments in GP practices by a third—[Interruption.] So, while Opposition Members snigger about using modern technology and want to go back to the past, over here we are providing the best technology for the NHS for the benefit of patients.

[Louise Haigh (Sheffield, Heeley) (Lab)]

A recent answer to a parliamentary question from my hon. Friend the shadow Minister confirmed that in nearly half of cases of mental health crisis, it is not NHS staff but the police who are conveying people hospitals. Will the Department conduct a review into the impact that this is having on people in mental health crisis?

[David Tredinnick (Bosworth) (Con)]

A report in The Lancet in March 2018 found that most drugs and injections are useless for lower back pain. What will my right hon. Friend do to find alternative treatments?

[Matt Hancock]

I pay tribute to my hon. Friend, who recently announced that he will be standing down at the next election, for the amount of attention he has given to broadening people’s minds and to looking at what works and what the evidence shows works. We know, for instance, that social prescribing can help people and ensure that they get the support they need, and he has made a great contribution to that debate.

[Rosie Cooper (West Lancashire) (Lab)]

After reviews by ACAS, Capsticks and Dr Bill Kirkup, will the Minister outline how he intends to deliver justice for both staff and patients of the Liverpool Community Health NHS Trust? How will he ensure that the board members who disgracefully refused to give evidence to Kirkup will be held to account and made to give evidence in future investigations?

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[Stephen Morgan (Portsmouth South) (Lab)]

Mental health services need proper staffing, but 2,000 mental health staff are leaving the NHS every month. How do the Government expect to achieve any ambitions in the long-term plan without adequate staff?

[Matt Hancock]

The hon. Gentleman is right. When we put a large amount of money into a service, we of course need more people to deliver it. That is most acute in mental health, which is getting the biggest increase in funding—£2.3 billion of the £20.5 billion overall. I assure him that the Minister responsible for mental health and suicide prevention, my hon. Friend the Member for Thurrock (Jackie Doyle-Price), is working night and day to ensure that we attract the people we need to deliver the services that our people deserve.

[Mr Mark Francois (Rayleigh and Wickford) (Con)]

May I ask a question in memory of my late friend Stephen Horgan, who died a few years ago from a rare form of blood cancer with just a few months’ notice? In his memory, I am a now a supporter of Bloodwise, an excellent charity that raises awareness of rare cancers. Asking on the charity’s behalf, will the new workforce plan for the NHS include clinical psychologists, particularly those with cancer knowledge, to make the absolute best use of the welcome new resources, which I am sure Stephen’s family also welcome?

[Matt Hancock]

Yes, my right hon. Friend puts it extremely well, because he reminds us of who we are here to serve when discussing questions of health and of cancer. He is right to raise this matter, and I can absolutely confirm what he asks for: we will deliver in Stephen’s memory and in the memory of others who have died. That is what gives us the strength to carry on and try to deliver and improve services for everybody.

[Carol Monaghan (Glasgow North West) (SNP)]

The Secretary of State talked earlier about a six-week stockpile of medicines, but radioisotopes for cancer diagnosis and treatment cannot be stockpiled. I have asked many times about the future arrangements for radioisotopes post-Brexit, so will the Secretary of State detail them now?

[Matt Hancock]

In the event of a problem at the Dover-Calais strait, we will bring in radioisotopes by air, and we have already contracted an aircraft to ensure that that happens. That part of the planning is well advanced.

[Mark Pawsey (Rugby) (Con)]

On Thursday, with Rugby’s mayor, I had the great pleasure to open the new Brownsover surgery, which came about because of the hard work of the patient action group. Will the Secretary of State welcome the work of patient groups in delivering NHS services?

[Matt Hancock]

I am absolutely delighted to welcome the work of the group, which has raised so much money, and of my hon. Friend, who stands up and makes the case for Rugby. More broadly, we should welcome all those who want to make a contribution to our hospitals and hospices. We take a broad-minded and open approach to welcoming people who volunteer hours or raise money to improve our great NHS.