Oral Answers to Questions Debate
Full Debate: Read Full DebateMatt Hancock
Main Page: Matt Hancock (Conservative - West Suffolk)Department Debates - View all Matt Hancock's debates with the Department of Health and Social Care
(4 years, 8 months ago)
Commons ChamberThe 2019 spending round announced real-terms growth in the public health grant for next year, so local authorities can continue to invest in prevention. Every local authority will see a real-terms increase in their grant allocations, which I expect to publish imminently.
Despite the urgency of the coronavirus situation at the moment, we could see local councils planning to cut numbers of nurses, even though they would be very much needed, simply because the councils do not know what their public health budgets are. Does the Minister think that is acceptable?
No, and that is why I have just announced that every local authority will see a real-terms increase in their grant allocation so that that does not have to happen.
Between 2017 and 2020, the Government have cut nearly £4 million from Lewisham Council’s public health grant, and the public health team is facing many challenges, not least from coronavirus. What does the Secretary of State mean by “imminently”? Councils need certainty. Given the pressure that local teams are under, will he look to restore funding to 2010 levels, in line with population growth and inflation?
As I say, every local authority will see real-terms increases in their allocation, and by imminently I mean in the next couple of days.
The Secretary of State keeps saying that local authorities do not need to worry about any of this, as the Government have said that they will be giving local authorities more money. Well, I asked my local authority on Friday whether that reassured it, and, surprise, surprise, it did not. That is because “more” can mean anything. Is it a penny more? Is it a pound more? Is it £100 more? Is it £1 million more? There is a bit of a difference. When will he let them know? He has now said that “imminently” means in a couple of days’ time. Exactly what is he waiting for? Is it the Budget?
As I say, the good news is that local authorities can all plan, with confidence, on the basis that these budgets are going up in real terms, and the exact details will be set out imminently.
Traditionally, public health was about infectious diseases and sanitation. More recently, it has become about lifestyle issues. Given the epidemics of the 21st century, particularly covid-19, what measures will the Secretary of State be taking, in allocating the public health grant, to refocus on infectious diseases, both current and those that are likely to come?
That is an incredibly important question—one that we will be addressing in the run-up to the spending review. The truth is that the public health grant is but one small part of the overall effort of local authorities to improve the health of the residents they serve. Although it is an important part, and it is good that it is going up in real terms for every local authority, we have clearly got to ensure that the whole effort of a local authority is there to improve public health.
All the evidence suggests that coronavirus is of greatest risk to those who are older in our population. The average age in my constituency is 10 years above the national average, yet in public health allocations Cumbria gets only £36 per head, as opposed to the national average of £63 per head and £100 per head for many parts of London. Does the Secretary of State agree that that is a dangerous inequality? Will he fix it in the upcoming statement?
The inequalities in health outcomes are what I am particularly concerned about, especially the length of healthy life expectancy, which is of course affected by both communicable and non-communicable diseases, the public health around both of those important considerations and the wider issues that my right hon. Friend the Member for South West Wiltshire (Dr Murrison) just mentioned. We will take all of that into account as we look at how the public health grant is best allocated and best used, ahead of the spending review.
The UK is a world leader in tackling the global challenge of antimicrobial resistance. Since 2014, we have invested £615 million in the area, over half of which is in research and development, as part of our vision to contain and control AMR by 2040.
Regrettably, the coronavirus outbreak has demonstrated the susceptibility of global society to pandemics and antimicrobial resistant organisms. Lord O’Neill, who chaired the review, estimated that some 10 million people a year could die by 2050 because of AMR. The previous chief medical officer said that we could easily get to a state where fully half of people die from untreatable infectious diseases. Is my right hon. Friend content with the level of work and research being done in his own Department with respect to novel approaches such as genomics, combination drugs and new sorts of vaccinations? Will the importance of those things be reflected in the forthcoming spending review?
Yes, absolutely. My right hon. Friend is right to highlight the threat of AMR, because microbial illness and disease is just as much of a threat as viral disease and we must ensure that we retain the tools that we currently have through antibiotics to tackle it. We are investing in that space with more to come.
The systems that we have in place are already securing access to effective new medicines for many thousands of NHS patients—for instance, cystic fibrosis patients through the drug Orkambi. Our commitment to getting new drugs into the NHS through an innovative medicines fund will further expand the access to medicines for NHS patients.
My right hon. Friend is aware that two children in my constituency have families who are self-funding the cannabis drug Bedrolite, which is their only means of controlling their severe epilepsy. He has very kindly agreed to meet me to discuss their case, but what action is being taken to make Bedrolite available on the NHS for families such as the two in my constituency for whom this really is the last resort?
My hon. Friend is right to raise this issue, and I look forward to meeting him later this month to discuss it. These are desperately difficult cases. We have to trust doctors to make the right clinical decisions for each individual patient. Two licensed cannabis-based medicines have recently been made available for prescribing on the NHS. We keep working hard with the health system, and with industry and researchers, to improve the evidence base. Also, the costs need to be brought down by industry. Last week, the Under-Secretary of State, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), held a roundtable with leading industry figures. I look forward to continued work to make sure that we can get these drugs to the people who need them.
Women suffering from endometriosis often do not get the medicine or treatment they need. One in 10 women suffer from this condition and it takes, on average, seven years to have a diagnosis. Will the Secretary of State please meet me and the all-party parliamentary group on endometriosis to discuss how we can develop research into this condition, and look at the work being done at Hull University?
Yes, I am very happy to look at that research and for either me or the Minister to meet the hon. Member and those whom she represents through the APPG. This is of course a very important issue. I think that it has been under-discussed for too long and should be brought up the agenda.
Peterborough is the UK’s fourth fastest growing city, home to over 200,000 people, and our hospital serves many, many more. Despite this, Peterborough and fenland patients are forced to travel to Cambridge, or further, for percutaneous coronary intervention and other cardiac medicines to treat or prevent heart attacks. Will my right hon. Friend support my ambition, and that of the trust, to ensure that there will be an elective PCI and other medicines cardiac service at Peterborough City Hospital?
I am very happy to look into that individual case and to meet my hon. Friend, or for the Minister to meet him, to see what we can do.
We are currently considering all options to increase the range of healthcare professionals permitted to administer low-risk medicines. This is all part of making sure that our NHS workforce is as flexible as possible, and we will do that in the light of what can be done, while of course keeping a highlight on patient safety.
My constituent Jessica Warr works as an operating department practitioner in Leighton Hospital. She and her colleagues make a huge contribution to patient care. Would the Secretary of State agree to meet Jessica and other ODPs to hear their case for why allowing them to prescribe would allow them to enhance the care they provide for patients even further?
Yes, of course, I would be very happy to meet my hon. Friend and those he represents to make sure that we can get the right balance—the maximum possible flexibility, subject of course to patient safety.
Yes, the 26,000 extra staff, as well as the extra GPs in primary care, are going to improve the position, but we also taking steps to improve access by making sure that people can access primary care in the best possible way. I can be clear to the House today that we will take a digital first approach to accessing primary care and out-patient appointments, so that, wherever clinically and practically possible, people can access—and should access—primary care through phones and digital means. This is especially important in the current coronavirus outbreak. Already, a roll-out has started, but we will make this across the country with immediate effect.
We have been waiting for a year for the Greenwich clinical commissioning group to reopen a nurse-led practitioner drop-in centre on the Horn Park estate. This was a place where people from that local community could pop in and get minor treatments, but also vaccinations, and it could prescribe low-risk drugs. May I commend this service to the Secretary of State? Could he assist me in urging Greenwich CCG to reopen it as quickly as possible, but also look at it as a possible model for other areas?
Life expectancy at birth is the highest it has ever been. Figures this week showed that last year mortality was the lowest since 2001, but we are not complacent. Already we have made clear our bold commitment to level up left-behind areas.
The truth is that if you live in poverty you will get ill quicker and die sooner. For my constituents in Pharos ward in Fleetwood, life expectancy is 10 years shorter than just five miles down the road in Carleton, and following the report that came out last week we know that life expectancy has stalled and for the poorest women it is now declining. What kind of damning verdict does the Secretary of State think that is on his Government’s 10 years of Tory cuts and austerity?
I agree with most of what the hon. Member said and the starting point in particular—that the gaps in healthy life expectancy are far too big. She will have heard me articulate from this Dispatch Box how important it is that we close those gaps. The news out this week of lower mortality in 2019 was good news that she ought to welcome, but it certainly does not mean that the campaign to close the gap in healthy life expectancy is over. There is far more to come.
Coronavirus has a bearing on life expectancy and I have a particular concern in relation to GPs in surgeries in my constituency. A world-leader on the transmission of infections raised with me a vital question, which is the provision of protective suits and training. At the moment, I am told that they are not being given to GPs, but exclusively to hospital staff. Will the Secretary of State please look into that and do something about it?
I am right across this issue. My hon. Friend is right to raise it, but I can reassure him fully that we have now rolled out personal protective equipment to two-thirds of primary care and the rest of it is in progress. We will absolutely address this issue. It is quite right that we did. We wanted to get the timing of the roll-out right so that the equipment is there should the epidemic hit in a very large way. We have to make sure we protect our health staff.
The global coronavirus outbreak is clearly growing. Last night, Italy placed the whole country in quarantine. We have updated our travel advice to advise against all but essential travel to Italy. All those returning from any area of Italy must self-isolate for 14 days. That is in addition to our advice that anyone who visited the specific areas of northern Italy that were originally locked down in the past two weeks should self-isolate for 14 days. We will do everything we can to keep people safe, based on the very best scientific advice.
A recent survey by the Teenage Cancer Trust found that 29% of young people who were treated for cancer did not have a discussion about their fertility with a healthcare professional. Of those who did, 44% were not satisfied with that discussion. Will the Secretary of State meet me and representatives of Teenage Cancer Trust to work towards some much needed progress in ensuring young people and their families that fertility is of extreme importance?
I know that the hon. Lady has personal experience in this area. I entirely understand the concern she raises. The personal plans that are being brought out from next year should help to address this problem, but the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), is very happy to meet her to make sure we get this exactly right.
Personal protective equipment can be as important in social care settings as it is in hospital or GP settings, but care staff report having to buy their own gloves and one care provider had their order of protective equipment requisitioned by the NHS. The Secretary of State says that he is all over this issue, so what plans does he have to ensure that care staff have access to protective equipment to protect them and the people they care for?
Of course care staff too are absolutely vital in the national effort to address coronavirus, not least because of the increased risk to many people who are in residential settings and who receive domiciliary care. The work to make sure that protective equipment is available extends to social care staff. Of course, most social care is provided through private businesses, and the delivery model is therefore different, but that does not make it any less important. I am very happy for the hon. Lady and the Minister for Care to have a meeting to make sure that we can listen to the concerns that she has heard about, because we want to address them.
There are already 120,000 vacancies in the care workforce and we now face the prospect of large numbers of care staff having to self-isolate because of coronavirus. With the NHS also needing staff, as we have discussed already, what plans does the Secretary of State have to ensure that care providers are still able to fulfil their contracts and provide their clients with support?
This is also an incredibly important issue that we are considering and working on. We will make sure that we address any barriers to social care operating. In all contingency plans on the reasonable worst-case scenario, plans are needed for being able to operate with a 20% reduction in workforce, but making sure that the best care can be provided in what is going to be a difficult time for social care is a really important part of the effort that we are making.
My hon. Friend is quite right to raise this—it is true that that the NHS has had to rise to address the scandal over mesh. There is a lot of work still to be done.
No, the hon. Gentleman is wrong to raise this issue in this way. It was addressed in the House yesterday actually—the Prime Minister was explaining that that is not Government policy.
Let us try to keep a sense of perspective. Last weekend, Government sources indicated that the worst-case scenario would be 100,000 deaths due to the current virus outbreak. Given that China has reported just over 3,000 deaths and that it has been at the epicentre of the virus for 10 weeks but has a population 20 times greater than the United Kingdom, was the 100,000 figure a helpful reference?
Of course we have to plan for a reasonable worst-case scenario, but we are working incredibly hard to avoid it. The Chinese Government undertook some very significant actions, and it is not yet clear whether the impact of those actions was to slow the spread such that when those actions are lifted the spread will continue, or whether the virus has in effect gone through the population of Hubei. We do not yet know that, so it is not yet possible to interpret the epidemiological consequences of the deaths figure in China.
Last Friday I held an open meeting so that my residents could better understand the proposals for Epsom and St Helier University Hospitals Trust. While I understand that the Minister cannot comment on the consultation, does he not agree that my residents would do better to consider the evidence that shows these proposals will improve access and quality and have no adverse impact on health inequalities?
I can confirm that we will ensure that whatever the status of people working across the economy, whether they are self-employed or employed but working fewer than the set number of hours a week, they will get the support that means they are not penalised for doing the right thing.
There are numerous reports of people with symptoms of coronavirus being refused a test by 111 because they cannot name an individual who has been diagnosed with the virus. Yesterday the Secretary of State’s ministerial colleague, the noble Lord Bethell, said about 111 that there must be people who had had “bad experiences”. Will the Secretary of State confirm whether it is indeed policy not to test those with symptoms who cannot be contact traced, or whether many people are simply having a bad 111 experience?
The 111 protocols are of course driven by the clinicians. I will look into the specifics of the case that the hon. Lady mentions was raised in the other place yesterday, but we keep those protocols under constant review—not least as the epidemiology of the virus changes as the number of cases increases—to ensure that we have the very best advice.
Although Blackpool Victoria Hospital has one of the busiest accident and emergency departments in the region, its staff reduced A&E waiting times this winter thanks to changes in the triage process. Will my right hon. Friend congratulate those staff, and will he work with them to ensure that the planned £11 million investment in A&E can reduce waiting times still further?
I thoroughly enjoyed my visit to Blackpool. I cannot remember whether it was in November or in the first half of December, but it was very enjoyable. It was great to see what the trusts are planning to do with the extra investment that is coming their way. I also want to congratulate all those at the trust who have done such a fantastic job in deciding how best to ensure that people are treated as quickly as possible. They have improved their systems, they have learnt from what works, and they are doing brilliantly.
Research has shown that CT scans can diagnose covid-19 with 98% accuracy, taking less than 10 minutes. Have the Government any plans to use CT scans in diagnosis?
Yes, we are looking at all possible methods of diagnosis, and we have funding to ensure that we can improve the research. Diagnostics must be effective, but our goal is to for them to be done next to the patient and turned around rapidly, which, obviously, is what everyone the world over is seeking.