Continuity of Medical Supplies
Matt Hancock Excerpts(4 years, 7 months ago)
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The Secretary of State for Health and Social Care (Matt Hancock)
This statement provides an update on my Department’s plans to support the continuity of supply of medicines and medical products into the UK if we leave the EU without a deal on 31 October.
The multi-layered approach put in place by my Department remains essential to help ensure the continuation of medicines and medical supplies across the UK if we leave without a deal. An update on the components are below.
My Department is today writing to pharmaceutical companies, medical device manufacturers and the adult social care sector. As part of working closely with the devolved Administrations (DAs) and Crown dependencies, communications will also be shared with healthcare providers across the scope of the programme.
Improving trader readiness for new border arrangements.
Companies need to ensure they are “trader ready” for the new customs procedures involved with importing and exporting goods that will come into place if we leave the EU without a deal. To support industry in their preparations, I am today announcing that, following engagement and feedback with trade associations, suppliers and distributors, the Government are establishing a dedicated trader readiness “support unit” to provide assistance to suppliers of medical goods. These teams of specialists will be able to provide traders operating in the health and social care sector with up-to-date advice and practical guidance on the steps they need to take to prepare. Details on how to access the support unit are being communicated to industry today.
Building up buffer stocks.
My Department’s approach to buffer stocks remains unchanged from 26 June and involves a range of national measures and asks of industry that are designed to provide contingent measures for medicines, medical devices and clinical consumables, blood and transplants, vaccines and countermeasures, supplies for clinical trials and non-clinical goods and services.
Procuring extra warehousing space for stockpiled medicines.
To help ensure sufficient space to store stockpiled medicines ahead of Brexit on 31 October if we were to leave without a deal, my Department previously agreed contracts for additional warehouse space, including ambient, refrigerated and controlled drug storage. We will continue to provide warehousing capacity.
Securing freight capacity.
The Department for Transport-led cross-government procurement for securing freight capacity by 31 October is progressing as planned. On 20 September, as announced by the Secretary of State for Transport, eight companies were successfully appointed to the freight procurement framework. These include ferry operators Brittany Ferries, DFDS A/S, Irish Ferries, P&O Ferries, Seatruck and Stena, as well as operators from the aviation and rail industries, Air Charter Services and Eurotunnel.
Also, on 20 September, DfT launched two call-off mini-competitions, which set out the Government’s freight requirements in preparation for leaving the EU. These provided freight operators on the framework the opportunity to bid for contracts to transport medicines and medical products—and other category one goods—into the UK in a no-deal scenario. The deadline for framework suppliers to submit bids was 1 October. Subject to evaluation, contracts with successful freight operators to provide capacity on specific routes will be agreed shortly. Once known, Government will inform industry of the details as soon as possible. In advance of this, the Department is today inviting suppliers of medicines and medical goods to register to access this freight capacity.
My Department is also leading a procurement for an “express freight service” to provide access to an end-to-end solution for medical products to deliver small parcel consignments and pallets. This is designed to be used only if suppliers’ own contingency measures encounter difficulties or there is an emergency need for specific medical products. The bid response window for this procurement has now closed and we are currently reviewing the bids. Again, my Department is looking to award the contract(s) as soon as possible.
Changing or clarifying regulatory requirements.
So that companies can continue to sell their products in the UK even if we leave without a deal, the Government have made changes to, or clarifications of, certain regulatory requirements. Statutory instruments, covering the regulation of human medicines, medical devices and clinical trials were considered and approved by Parliament.
Strengthening the processes and resources used to deal with shortages.
In addition to the normal shortage management routes, my Department has also put in place legislation to enable Ministers to issue serious shortage protocols that, where appropriate, enables community pharmacies to supply against a protocol, for example, to issue a substitute medication instead of the prescribed medication without going back to the prescriber first.
My Department will again be standing up a national supply disruption response (NSDR). The NSDR processes will monitor the supply situation and co-ordinate actions to address supply disruption incidents that occur after Brexit where normal procedures are unable to provide a resolution.
Message to NHS and the public.
Our message to the NHS, the adult social care sector, patients and the wider public remains unchanged.
My Department, working with partners across Government, industry, the health and social care system, devolved Administrations and Crown dependencies, are putting in place these arrangements to protect medical supplies from any potential disruption if we leave without a deal for the whole of the UK and its Crown dependencies, so that service providers, patients and members of the public do not have to take action themselves. Local or personal stockpiling remains unnecessary and could cause shortages in other areas, which could put patient care at risk. It is important that patients keep taking their medicines and order their repeat prescriptions as normal.
As the NAO’s recent report recognised, the scale of the challenge has been unprecedented and the Department, working with pharmaceutical companies and medical device manufacturers, has already achieved a great deal in preparing for leaving the EU, whatever the circumstances. I am confident that the Department is doing everything appropriate to prepare for leaving without a deal on the 31 October.
[HCWS1856]
Oral Answers to Questions
Matt Hancock Excerpts(4 years, 9 months ago)
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Douglas Chapman (Dunfermline and West Fife) (SNP)
The Secretary of State for Health and Social Care (Matt Hancock)
Our highest priority is for patients to continue to have access to medicines and medical products in all Brexit scenarios. As a responsible Government, we will minimise any disruption in our exit, deal or no deal.
On 26 June, we set out our approach to ensuring continuity of supply. I discussed this last week with the head of the NHS, and Professor Keith Willett wrote to all NHS trusts yesterday to advise on no-deal planning.
John Mc Nally
Concerned breast cancer charities have asked me and others to ask the Secretary of State if he will confirm to us, and to them, whether he is leasing enough ferry capacity to ship in medicines in the very likely event of shortages in the UK when we leave the EU.
Matt Hancock
Yes, we secured the requirements ahead of a potential exit on 29 March, and we are doing the necessary work to ensure that capacity is available, whatever the Brexit scenario, on 31 October.
Douglas Chapman
My constituent Jonathan Fisher, known as the Bold Joff, has complex health needs due to a rare genetic condition called Lowe syndrome. He requires six regular medications, three of which come from the EU. They are all vital to his health, but one in particular, Epilim, is critical to his epilepsy care. What reassurances can the Secretary of State give to Jonathan and his mother, Fiona, that when we leave the EU there will be no disruption to his supply of this vital medication?
Matt Hancock
The assurance I can give is that, ahead of 29 March, we put in place the measures that are necessary to ensure that the hon. Gentleman’s constituent and others get the medicines they need, and we have taken forward those proposals and that work ahead of an exit from the European Union on 31 October.
Daniel Zeichner (Cambridge) (Lab)
The Secretary of State will be aware of the expert evidence, including from the BioIndustry Association, warning that, although we may be able to stockpile the bog-standard drugs, it will be very difficult to do so for specialist treatments. What guarantees can he give that we will have access to those specialist medicines?
Matt Hancock
Ahead of 29 March, we managed to put in place a full programme to ensure access to drugs. Of course, the approach is not just about ensuring stockpiles—there are adequate stockpiles for so many medicines all the time—but is about ensuring the flow of materials and finished drugs across the channel via ferries and, where necessary, aircraft.
Anne-Marie Trevelyan (Berwick-upon-Tweed) (Con)
Kirstene Hair (Angus) (Con)
The Secretary of State for Health and Social Care (Matt Hancock)
Across the UK, the number of registered nurses and doctors has increased over the past nine years. In England, there were over 112,000 doctors in NHS trusts in March 2019, 17,000 more than in March 2010, and over 8,000 more nurses than in 2010. There is more to do, and the NHS people plan will ensure a sustainable workforce for the long-term future of the NHS.
Kirstene Hair
As the Secretary of State may be aware, earlier this month—conveniently in the Holyrood recess—we learnt that medical students who come from the rest of the United Kingdom and want to apply for an undergraduate course at Scottish universities will find their chances greatly diminished. Most Scots are appalled by this policy. In fact, the British Medical Association, the Royal College of General Practitioners and medical schools are all expressing concern. Does the Secretary of State agree that the Scottish Government need to be attracting the brightest and the best—no matter where they come from across the United Kingdom—to address the GP crisis?
Matt Hancock
Yes, I do. I was surprised by the recent news that I read about medical schools in Scotland being told to discriminate against medical students from elsewhere in the UK. I understand that the Scottish National party itself accepts that this is discriminatory. I doubt that the policy will last and I look forward to an SNP U-turn.
Dr Rosena Allin-Khan (Tooting) (Lab)
Mitie recently signed a £150 million contract at St George’s Hospital, but staff are already facing job cuts. My union, the GMB, balloted its members; 99.6% of them voted to take industrial action. Will the Secretary of State commit to visiting staff on the frontline and show them solidarity during this very difficult time?
Matt Hancock
I am always very happy to visit hospitals around the country, including St George’s. Of course, the individual management of staff is a matter for the hospital itself. I look forward to discussing with the hon. Lady what more we can do.
Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)
The Secretary of State has quite rightly outlined the global progress that has been made on the medical and nursing workforces, but he will be aware that the picture is very different in mental health services, with the loss of 4,000 mental health nurses over the last decade. Indeed, the fill-rate for doctors entering higher training in child and adolescent mental health services this August is only 63% and only half the higher trainee posts in general adult mental health have been filled. What is the Secretary of State going to do to turn the very good rhetoric on mental health into a reality on the ground for patients?
Matt Hancock
The increase in funding for mental health services, which is the largest increase as part of the overall £33.9 billion increase, goes to mental health services. Of course, the vast majority of that will go towards employing more people. As my hon. Friend says, we need to encourage more people into training in mental health services and psychiatry, as well as mental health nursing, which is also under pressure. The expansion of these services ultimately means that we need to have more people doing the work: supporting people to improve their mental health and supporting people with mental ill health. My hon. Friend is absolutely right to raise this issue, which is right at the top of the priorities for the NHS people plan.
Peter Kyle (Hove) (Lab)
Sexually transmitted diseases such as syphilis and gonorrhoea are on the rise. Will the Secretary of State target more resources at staffing and investment to ensure that we tackle this rise?
Matt Hancock
We have recently announced that the way in which we are going to proceed with regard to sexual health services is co-commissioning between local authorities and the local NHS. This is the best way to ensure that we get the services on the ground. I would just slightly caution the hon. Gentleman; although he mentioned that some sexually transmitted diseases have been on the rise, others have been falling quite sharply. We have to ensure that we get the details of what we try to implement right, but I support the direction of travel that he proposes.
Andrew Selous (South West Bedfordshire) (Con)
What can we do to make the workload terms and conditions more attractive for salaried GPs and GP partners compared with locums? GPs in my constituency tell me that a great number want to be locums, but that not so many want to be salaried or GP partners because of the workload. What can we do about that?
Matt Hancock
My hon. Friend is dead right. This is an important part of the work that Baroness Dido Harding is leading in the NHS people plan to ensure that we can make careers in the NHS—whether as doctors, other clinicians or more broadly—the most attractive that they possibly can be. This week we announced a pay rise for doctors and earlier this month we announced a long-term agreement with junior doctors, which I am delighted they accepted in a referendum with over 80% support. But there is more work to do.
Martyn Day (Linlithgow and East Falkirk) (SNP)
The rules around annual and lifetime allowances are having an impact on the NHS workforce in Scotland, and the options contained in the recent consultation on doctors’ pensions do not provide the level of flexibility necessary to resolve this situation. We know that the solution lies with the Treasury, so what pressure can the current Secretary of State put on the Chancellor to ensure that urgent reform takes place to stop this terrible impact on our NHS workforce?
Matt Hancock
I have been working hard with the Chancellor of the Exchequer to ensure that we can resolve this important issue. The hon. Gentleman will have seen the consultation document that we put out yesterday to resolve the problem. The consultation is open and asks open questions about the best way to fix it. I am absolutely determined that we will fix it to remove some of the unintended consequences of changes in pension tax law. It is a pity, though, that the SNP spokesman did not stand up to accept that the proposal mentioned by my hon. Friend the Member for Angus (Kirstene Hair), which would discriminate against people from outside of Scotland, is wrong and should be withdrawn.
Julie Cooper (Burnley) (Lab)
The Secretary of State is in denial. There is a crisis in GP retention. In fact, there are now 1,200 fewer fully qualified permanent GPs than there were in 2010. Because of this, patients are waiting longer than ever to get a GP appointment. He has promised, as he did again today, to address this, but it is a fact that the situation is getting worse, with a pension system that is effectively charging GPs to work extra hours. Does he really believe that this is the best way to retain GPs in the NHS? Does he have a detailed plan, and can he explain how he is going to sort out this mess?
Matt Hancock
I think it is worth starting with a few facts. One fact is that I published a detailed plan yesterday, on which we are consulting, to tackle the pension issue. The other two facts that are worth noting, and that the House will want to know about, are the following. First, there is a record number of GPs in training—3,473. Secondly, the overall number of GPs is rising, with, as of March 2019, 300 more doctors working in general practice than a year earlier. I want to see that number continue to rise.
Afzal Khan (Manchester, Gorton) (Lab)
Karen Lee (Lincoln) (Lab)
The Secretary of State for Health and Social Care (Matt Hancock)
Question 10 is about workforce vacancies, and I can tell the House that one workforce vacancy has just been filled, because Boris Johnson has just been elected as the leader of the Conservative party.
The NHS employs more staff now than at any time in its 70-year history, with significant growth in newly qualified staff from 2012. Our full people plan will help to tackle these issues for the long term.
Karen Lee
Words are all well and good, but it is actions that actually count, and the Government are not creating a health service that supports its workforce. The striking health visitors in Lincolnshire have each lost more than £2,000 a year since they were transferred from the NHS to the Conservative-controlled county council and many have had their professional status downgraded. Does the Secretary of State agree that rather than shifting the responsibility for cuts to health services on to local government, the NHS should deliver fully resourced healthcare services and pay its staff properly?
Matt Hancock
The NHS is delivering healthcare services and it is paying its staff properly. It is working with local authorities to deliver the best possible health services right across the country. We absolutely need to recruit more people to the NHS and we are recruiting more people to the NHS.
Mr Barry Sheerman (Huddersfield) (Lab/Co-op)
Mr Paul Sweeney (Glasgow North East) (Lab/Co-op)
The Secretary of State for Health and Social Care (Matt Hancock)
This week, the Department has released a consultation on the future of clinicians’ pensions, a new five-year deal to support our approach to community pharmacy, the Government’s prevention Green Paper and a £20 million collaboration with the Prince’s Trust on the NHS widening participation initiative, which will allow and support more apprentices into the NHS. There has been a lot done just this week, and there is a lot more still to do.
Mr Sweeney
Another item for the Secretary of State’s list might be to engage with his counterpart in Scotland on the issue of the NHS taper on the pensions programme. When I raised the issue with a Treasury Minister, she seemed unaware that there was more than one NHS in the UK. If there is some co-ordination and joint representation to the Treasury, that might assist matters. Would the Secretary of State agree?
Matt Hancock
Of course, in solving this problem, many of the changes can take place within the NHS, and we are working on that with the Treasury. I am happy to ensure that discussions take place with devolved colleagues, but of course, the NHS is devolved in Scotland.
Rachel Maclean (Redditch) (Con)
Jonathan Ashworth (Leicester South) (Lab/Co-op)
My I pursue the question asked by the Chair of the Select Committee, the hon. Member for Totnes (Dr Wollaston)? We know that obesity is a major cause of cancer and other diseases, and we know that we have severe rates of childhood obesity, so why does the prevention Green Paper say only that the sugar tax “may” be extended to milkshakes? The evidence is clear. Is the Secretary of State not kicking this into the long grass?
Matt Hancock
I have asked the chief medical officer to review the evidence to ensure that our policy for tackling obesity is evidence-driven. Follow the evidence: that is what we do on this side of the House.
Jonathan Ashworth
A year ago the Secretary of State said, to great fanfare, that prevention was one of his priorities. Now the prevention Green Paper has been sneaked out in the night on the Cabinet Office website. Health inequalities are getting wider and wider, and life expectancy is stalling, but the Secretary of State still cannot give us any clarification on the future of the public health ring-fenced grant. Is it not the truth that he has buckled under pressure from the sugar industry, is not taking on the alcohol industry, and is not taking on the tobacco industry? That is more about trying to get in with the new Prime Minister than putting the health needs of the nation first.
Matt Hancock
I thought that the hon. Gentleman would welcome the prevention Green Paper, which was published yesterday. We have been working very hard to publish a huge amount of policy, including the Green Paper, which contains about 80 different policies to ensure that we prevent people from becoming ill in the first place. However, it is also part of a broader drive, which Conservative Members support, to ensure that we are the healthiest of nations, and that people can take personal responsibility for their health, as well as relying on the NHS, so that it is always there when people need it.
Kevin Hollinrake (Thirsk and Malton) (Con)
Paul Masterton (East Renfrewshire) (Con)
I welcome the consultation on NHS pensions that was announced this week, and while I do not think that 50:50 is the ultimate solution, I welcome the invitation to present other proposals. However, given that this is causing an issue now, how quickly does the Department think that it will be able to turn the outcome of the consultation into action?
Matt Hancock
We are working very hard to turn it into action as soon as possible, and I can give my hon. Friend an absolute commitment that the new rules will be in place in time for the new financial year.
Mr Barry Sheerman (Huddersfield) (Lab/Co-op)
Sarah Newton (Truro and Falmouth) (Con)
I greatly welcome the publication of the prevention Green Paper. How will that strategy enable people to keep well by living in warm homes?
Matt Hancock
Clearly, the need for join-up across Departments of Government is a vital part of this agenda, as my hon. Friend knows from her work across different Departments; the specific point she raises is one example of that, and we must drive it forward.
Chi Onwurah (Newcastle upon Tyne Central) (Lab)
Matt Hancock
Technology and the data that show these inequalities are an important part of the answer, but of course it is much broader than that, and tackling health inequalities is an underpinning part of the long-term plan for the NHS; it is absolutely critical in order to address the sorts of inequalities that the hon. Lady rightly raises.
Ruth George (High Peak) (Lab)
Life skills courses can be key to helping people out of depression, loneliness and isolation, and into work and training, yet the course in Glossop in my local area has been cut by the county council, in spite of it having a £2.8 million underspend this year. Do Ministers agree that local authorities should be looking to spend the public health money that they have, and to use it effectively?
Matt Hancock
Yes, emphatically we do, and there is a drive across the country for more of the sort of social prescribing that the hon. Lady talks about. The clinical solution to many people’s health issues, and in particular mental health challenges, is often about changes in behaviour and activity, and the support people are given, rather than just drugs. On the face of it, the project the hon. Lady mentions sounds very good; of course I do not know the details, but I would be very happy to look into it. However, we wholeheartedly and emphatically support the broad direction of travel of helping people to tackle mental illness both through drugs where they are needed and through activity and social prescribing.
Clive Efford (Eltham) (Lab)
I recently met three care workers who work for Sanctuary Care. Between them, they have 60 years of experience of, and dedication to, caring for vulnerable people, but Sanctuary Care has decided to cut their pay and conditions because they were TUPE-ed over from the Borough of Greenwich. Is this the way to treat dedicated care staff? Will the Minister meet me and those care staff to discuss what is going on at Sanctuary Care, whose chief executive gets a handout of almost a quarter of a million pounds a year, while it cuts low-paid staff’s wages?
Alison Thewliss (Glasgow Central) (SNP)
The prevention Green Paper talks about the risk of an opioid epidemic. In Scotland, we feel that that is already here, with 1,187 deaths in Scotland last year, 394 of them in Glasgow. Will the Secretary of State work with the Scottish Government and Glasgow health and social care partnership and support the opening of a medically supervised drug consumption room in Glasgow?
Matt Hancock
Yes, the risk of an opioid epidemic across the UK is a serious one. We have seen that risk materialise in the United States. I was as shocked as anyone to see the recent figures for the growth in opioid addiction in Scotland. While public health and the NHS are devolved to the Scottish Government, and they must lead on tackling this issue, for the UK elements of my responsibilities, we in England will do absolutely everything we can and put aside all party politics to tackle this serious problem.
Several hon. Members rose—
Ruth Cadbury (Brentford and Isleworth) (Lab)
In January the Health Secretary declared air pollution a health emergency, yet today, tomorrow and Thursday we will see ozone layers in the south and south-east of England that will be a health hazard to the old, the young and the sick. Unlike in equivalent situations in other countries, the Government have released no warnings to people or advised how they should take appropriate action. How bad does air pollution have to get before the Government use their not inconsiderable communications budget to warn people to take appropriate action?
Matt Hancock
We have. Through Public Health England, which is the responsible agency, we have absolutely put out communications, which I heard this morning. The communications that the hon. Lady asks for are out there. Of course air pollution is a significant risk to public health. I am delighted that it is falling to its lowest levels since the industrial revolution, but there is clearly much more that we need to do.
Thelma Walker (Colne Valley) (Lab)
Can the Secretary of State confirm that the Care Quality Commission has recently inspected Calderdale and Huddersfield NHS Foundation Trust, and that patient safety was raised as an issue during that inspection? If that is the case, what action is he taking?
Pensions: NHS Clinicians
Matt Hancock Excerpts(4 years, 9 months ago)
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The Secretary of State for Health and Social Care (Matt Hancock)
The NHS pension scheme is a generous and valuable part of the package of pay, terms and conditions for NHS staff, which continues to compare favourably with schemes in other sectors. However, the interaction between the NHS pension scheme and the tapered annual allowance means some clinicians are facing unintended consequences. The tapered allowance rightly aims to see more higher earners contributing towards the public purse by reducing the amount they can save into their pensions tax-free.
The Government have been listening to concerns about the impact on patient care as clinicians decline to take on additional work or seek early retirement in response to the prospect of incurring pension tax charges, and evidence that some NHS clinicians are changing their working patterns due to this issue. The Government are determined to find a solution that provides the right balance of incentives for clinicians to provide the services that patients need. Retaining and maximising the contribution of our highly skilled clinical workforce is crucial to delivery of the ambitions for patient care set out in the long-term plan for the NHS.
The Government have therefore launched a full public consultation setting out proposals to make the NHS pension scheme more flexible for clinicians, to give them more control over their pension growth and tax liabilities. Greater pension flexibility will help clinicians avoid cutting their hours allow them to undertake additional shifts to reduce waiting lists, or take on further supervisory responsibilities.
The consultation proposes a 50:50 flexibility, which lets clinicians halve their pension contributions in exchange for halving the rate of pension growth, balancing simplicity with the need to offer flexibility. Following discussions with clinicians and employers, the consultation goes further and invites views on other measures that Government should consider.
For NHS pension scheme members who do incur annual allowance tax charges, the “scheme pays” facility offers an alternative to finding funds up front to meet any tax charges for saving into their pension while they work. Instead they can choose for the pension scheme to pay the tax charge. The pension scheme will then recoup the tax paid plus interest by deducting it from the value of their pension at retirement. The consultation proposes a potential improvement to the calculation of “scheme pays” deductions so that it is more transparent and staff can better assess the effect on their pension.
The consultation will listen to feedback on all potential ideas on pension flexibility before making changes in time for the new tax year.
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NHS Pay Review Body 32nd Report: Government Response
Matt Hancock Excerpts(4 years, 9 months ago)
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The Secretary of State for Health and Social Care (Matt Hancock)
I am responding on behalf of my right hon. Friend the Prime Minister to the 32nd report of the NHS Pay review Body (NHSPRB). The report has been laid before Parliament today (Cm 147). Copies of the report are available to hon. Members from the Vote Office and to noble Lords from the Printed Paper Office.
This is the second year of the three-year Agenda for Change pay and contract reform deal (2018/19 to 2020/21); the NHSPRB was asked therefore not to make any pay recommendations for 2019/20.
The Government welcome the 32nd report of the NHSPRB and are grateful to the Chair and Members for all their work and helpful observations, on effective workforce planning and how best to support the development of the NHS workforce.
We are pleased that their observations broadly reflect the themes published in the Interim People Plan and will help inform the upcoming final People Plan.
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47th Review Body on Doctors’ and Dentists’ Remuneration Report: Government Response
Matt Hancock Excerpts(4 years, 9 months ago)
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The Secretary of State for Health and Social Care (Matt Hancock)
I am responding on behalf of my right hon. Friend the Prime Minister to the 47th report of the Review Body on Doctors’ and Dentists’ Remuneration (DDRB). The report has been laid before Parliament today (Cm148) and a copy can be viewed online at: http://www.parliament.uk/business/publications/written-questions-answers-statements/written-statement/Commons/2019-07-22/HCWS1765/ . I am grateful to the Chair and members of the DDRB for their report.
The Government are today announcing pay rises for doctors and dentists working across the NHS.
Building on our ambition to make the NHS the best place to work, as set out in the NHS interim people plan, this is a pay rise that recognises the hard work and dedication of doctors and dentists and puts forward an approach for a potential multi-year deal with contract reform for specialty and associate specialist (SAS) doctors to enhance recruitment, retention, morale and productivity for this group.
We have recently agreed multi-year deals for both non-medical Agenda for Change staff and doctors and dentists in training and this is part of our approach to make the NHS the best employer in the world while supporting the NHS workforce to deliver excellent patient care.
Thanks to the Government’s balanced approach to public finances—getting debt falling as a share of our economy, while investing in our vital services and keeping taxes low—we are able to continue our flexible approach to pay policy, allowing us to attract and retain the best people for our hospitals.
We consider all pay awards in light of wider pressures on public spending. Public sector pay needs to be fair both for public sector workers and the taxpayer. Around a quarter of all public spending is spent on pay and we need to ensure that our public services remain affordable for the future.
It is also vital that our world-class public services continue modernising to meet rising demand for the incredible services they provide, which improve our lives and keep us safe.
This pay rise represents one of the biggest uplifts in pay for medical staff for over a decade. In addition to their pay, medical staff continue to benefit from defined-benefit pensions, which are among the most generous available.
Today’s pay award is worth:
Between £1,940 and £2,630 for consultants
Between £970 and £1,820 for specialty doctors
Between £1,360 and £2,250 for associate specialists
The DDRB were asked not to make a pay recommendation for general medical practitioners as this is the first year of the recently announced five-year contract deal. As part of this agreement, core general practice funding will increase by £978 million per year by 2023-24 providing greater certainty for GMPs to plan ahead.
The Government’s response to the DDRB recommendations takes account of affordability in the context of the NHS long-term plan and the 2019 spending review. Given the NHS budget is now set for the next five years, there is a direct trade-off between pay and staff numbers and our response takes account of this trade-off.
The Government’s response is as follows:
Consultants
A 2.5% general uplift in pay backdated to April 2019.
The value of both national and old style local clinical excellence awards (CEAs) to be frozen.
Specialty Doctors (New Grade 2008) and Associate Specialist (Closed Grade) (SAS Doctors)
The Government take note of the DDRB’s comments on the particular issues of morale and motivation in relation to this group that led to their pay recommendation. We agree that investment in raising the profile and attractiveness of SAS doctor roles is important and we are committing to negotiations on a multi-year pay agreement, incorporating contract reform for SAS doctors. SAS doctors will receive:
A 2.5% general uplift in pay backdated to April 2019.
The potential for an additional 1% on top of the 2.5% already paid to be added to pay in 2020-21 conditional on contract reform, through a multi-year agreement.
Doctors and Dentists in Training
On 27 June the Government announced that junior doctors had overwhelmingly backed a four-year deal incorporating pay increases and improved flexibility and working conditions. This brings to an end the junior doctors dispute and the British Medical Association (BMA) and NHS employers have now collectively agreed the amended junior doctor contract.
The four-year deal guarantees pay increases of 2% per annum for the next four years and there will in addition be around £90 million of investment into the contract including a new pay point for the most senior doctors in training, an allowance for those working less than full time to support flexible working and increased pay for those working the most weekends or whose shifts end in the early hours of the morning. Taken alongside an 8.2% four-year pay rise, this will give junior doctors and current medical students the support they fully deserve.
General Dental Practitioners
A 2.5% general uplift in the pay element of their contract backdated to April 2019.
General Medical Practitioner Trainers and Appraisers
A 2.5% increase in full to the value of the GMP trainers grant and the GMP appraisers’ grant.
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NHS Long-Term Plan: Implementation
Matt Hancock Excerpts(4 years, 10 months ago)
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The Secretary of State for Health and Social Care (Matt Hancock)
Mr Speaker, I would like to update the House on the implementation of the NHS long-term plan and the delivery of improvements to the health service. Today marks the 100th anniversary of the Ministry of Health, founded under the Liberal and Conservative coalition of Lloyd George, and the Department has been staffed by brilliant, impartial civil servants ever since, and is today.
I can tell the House that on Thursday last the boards of NHS England and NHS Improvement agreed the long-term plan implementation framework. Alongside the clinical review of standards, and the interim workforce plan, published last month, this framework is a critical step in delivering on our 10-year vision for the NHS, and in transforming our health service with the record funding that this Government are putting in. The document sets out the framework within which each of the 300 commitments in the long-term plan will be delivered, and it also sets out the 20 headline commitments and how we will monitor the delivery of the plan. In the past, there have been criticisms that NHS plans have not led to full delivery. We are determined to ensure that the long-term plan fulfils its potential to transform the health service for the better, and I am placing a copy of the implementation framework in the Libraries of both Houses.
I wish to draw attention to three particular areas, the first of which is cancer care. I thank my hon. Friend the Member for Basildon and Billericay (Mr Baron) for his efforts to ensure that we focus on the vital indicator of cancer survival. The Prime Minister set out the ambition that by 2028 three quarters of all stageable cancers are detected at stage 1 or stage 2. Early detection and diagnosis are essential to the enhancement of people’s chances of surviving cancer.
Since 2010, rates of cancer survival have increased year on year. However, historically our survival rates in the UK have lagged behind the best-performing countries in Europe. The implementation framework sets out our goal of measuring the one-year cancer survival rates as one of the core metrics for the long-term plan. The one-year survival rate is how we measure our progress in achieving the ambitions set out in the plan. To realise those ambitions and ensure that we do everything we can to give people diagnosed with cancer the best chance of survival, the framework sets out first, a radical overhaul of screening programmes; secondly, new state-of-the-art technology to make diagnosis faster and more accurate; and thirdly, more investment in research and innovation.
From this year, we will start the roll-out of rapid diagnostic centres throughout the country, building on the success of a pilot with Cancer Research UK, so that we can catch cancer much earlier. NHS England is further extending lung health checks, targeting areas with the lowest survival rates, and Health Education England is increasing the cancer workforce, which will lead to 400 more clinical endoscopists and 300 more reporting radiographers by 2021. With these steps, our ambition is that 55,000 more people will survive cancer for five years, each year from 2028. Improving the one-year survival rate is how we ensure that the NHS remains at the forefront of cancer diagnosis and treatment and continues to deliver world-class care.
The second area is mental health. The Prime Minister and her predecessor rightly prioritised the treatment of mental health so that we can ensure that mental health finally gets parity with physical health. The £33.9 billion cash-terms settlement, which is the longest and largest cash settlement in the history of the NHS, includes a record £2.3 billion extra in real terms for the expansion of mental health services. The framework sets out how 380,000 more adults and 345,000 more children and young people will get access to mental health support. I pay tribute to the mental health Minister, the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Thurrock (Jackie Doyle-Price), who has done so much work to put the issue on the agenda.
We are introducing four-week waiting-time targets for children and young people and testing four-week community mental health targets for adults. The implementation framework refers specifically to the vital improvements to community mental health services that we all know are needed. Those improvements include services for adults living with serious mental disorders, including eating disorders, and for those coping with substance misuse. The framework also sets out how we will create a new workforce of mental health support teams to work with schools and colleges to help to identify young people who need help and reach them faster. In all, it is a fundamental shift in how we treat mental illness and how the NHS will prioritise mental health services.
The third area that I wish to touch on is people. Three quarters of the NHS budget goes on staff, because people are the most valuable resource that we have in the NHS. We need not only the right numbers but to ensure that staff have the right support. The long-term plan sets out our ambition to recruit, train and retrain the right numbers of staff over the next decade. Last month, Baroness Dido Harding set out the interim people plan, which sets out how we will build the workforce we need and create the right culture, so that doctors, nurses and other NHS staff have the time to care for patients and for themselves.
Last week, the British Medical Association accepted in a referendum the new agreement with junior doctors that will improve both pay and working conditions. Thanks to the hard work of my predecessor, we are already taking steps to increase the number of clinical training places by opening five new medical schools and increasing the number of routes into nursing through apprenticeships and nursing associates. Last year, more than 5,000 nursing associates started training through apprenticeships. This year, it will be up to 7,500.
Those are just three of the most vital areas from the 10-year vision for the NHS set out in the long-term plan. Across England, based on the implementation framework, local strategic plans are now being developed and will be brought together as part of a national implementation plan by the end of the year, and all of this will be underpinned by technology. Today sees the official opening of NHSX, the new part of the NHS, which will drive digital transformation to give citizens and clinicians the technology they need and save and improve lives. I am delighted that NHSX has received such a warm welcome across the NHS because it has so much potential to transform every part of health and social care for patients and staff.
The forthcoming spending review will settle budgets for health education, public health and NHS capital investment, and the settlements will feed into the final implementation of this plan. As part of the spending review, we will also review the current functioning and structure of the better care fund, which is rising in line with NHS revenue growth.
On this the 100th anniversary of the foundation of the Ministry of Health, this framework sets out how we will go about securing the foundations of the national health service into the next century and the creation of an NHS that delivers world-class care for generations to come. I commend this statement to the House.
Jonathan Ashworth (Leicester South) (Lab/Co-op)
I am grateful to the Secretary of State for an advance copy of his statement. I had hoped for a greater sense of urgency from him. He talks about the 100-year anniversary of the Ministry of Health, but this year is the first time in 100 years that the advances in life expectancy have begun to stall, and even go backwards in the poorest areas. Just the other week, we saw that infant mortality rates have risen now for the third year in a row. As this is the first time that they have risen since the second world war, I would have hoped for a greater focus on health inequalities in his statement today, not least because public health services—the services that, in many ways, lead the charge against health inequalities—are being cut by £700 million. Now he says that we should wait for the spending review for the future of public health services, but we do not know when the spending review is. The Chief Secretary to the Treasury has said that it will be delayed, so it could be next year.
In the past, the Secretary of State has talked about a prevention Green Paper. Will that prevention Green Paper be before the spending review or after the spending review? Will he also tell us whether it is still the intention of the Department to insist that local authorities fund their public health obligations through the business rates?
At the time of the publication of the long-term plan last year, the then Secretary of State for Health said that we cannot have one plan for the NHS without a plan for social care, yet we still have no plan for social care. We have been promised a social care Green Paper umpteen times. We are more likely to see the Secretary of State riding Shergar at Newmarket than see the social care Green Paper. Where is it?
The Secretary of State talks about the better care fund revenue increase. May I press him further on that? Is he saying that the clinical commissioning group allocations to the better care fund, which tend to be the bulk of the better care fund, will increase in line with the NHS revenue increase, or is he saying that there will be new money available for the better care fund? Adult social care has been cut by £7 billion since 2010 under this Tory Government, which is why hundreds of thousands of elderly and vulnerable people are going without the social care support that they need. Presumably, we will have to wait for the spending review for proposals on social care.
The Secretary of State talks about the workforce. We have 100,000 vacancies across the NHS. We have heard about the interim people plan, but of course we have seen the bursary cut, the pay restraint, and the continuing professional development cut. That plan is all good and fine, but when will it be backed up by actual cash?
The Secretary of State talks about IT systems and apps—we know that he is very fond of that—but again he gives us no certainty on capital investment. Hospitals are facing a £6 billion repair bill—ceilings are falling in and pipes are bursting. The repair bill designated as serious risk has doubled to £3 billion. When will we have clarity on NHS capital?
We broadly welcome what the Secretary of State said about mental health, but 100,000 children are currently denied mental health treatment each year because their problems are not designated as serious enough, and over 500 children and young people wait more than a year for specialist mental health treatment. He talks of a fundamental shift, so can he guarantee that clinical commissioning groups will no longer be allowed to raid their child and adolescent mental health services budgets in order to fill wider gaps in health expenditure? On mental health resilience and prevention, only 1.6% of public health budgets is currently spent on mental health, so will he mandate local authorities, when setting their public health budgets, to increase the money they spend on mental health?
On cancer, we broadly welcome what the Secretary of State has said, but patients are waiting longer for treatment because of vacancies and out-of-date equipment. Today we learned that consultant oncologists with shares in private hospitals are referring growing numbers of patients to those hospitals. Is that not a conflict of interest? When will we see tougher regulation of the private healthcare sector?
The Secretary of State talked about the clinical review of standards that is being piloted in 14 hospitals, yet those hospitals are not publishing the data. If he wants to abandon the four-hour A&E target, will he insist that those pilot hospitals publish all the data? He did not mention waiting lists. We have seen CCGs rationing treatment because of the finances. We have seen 3,000 elderly people refused cataract removals. We have seen CCGs refusing applications for hip and knee replacements. We have even seen a hospital that until last week was inviting patients to pay up to £18,000 for a hip or knee replacement—procedures that used to be available on the NHS. When is he going to intervene to stop that rationing of treatment, which we are seeing expand across the country because of the finances?
Finally, there are many laudable things in the long-term plan that we welcome. Alcohol care teams were a Labour idea. Perinatal mental health services were a Labour idea. Gambling addiction clinics, which the Secretary of State announced last year, were a Labour idea. Today he is talking about bringing catering back in-house, which is also a Labour idea. Why does he not just let me be Heath Secretary, and then he could carry on being the press secretary for the right hon. Member for Uxbridge and South Ruislip (Boris Johnson)?
Matt Hancock
Well, it is great that by the end of his questions the hon. Gentleman finally got to the future of the NHS, which is what we are here to discuss. However, what I did not hear—unless I missed it—was a welcome for the extra £33.9 billion that we are putting into the NHS. I did not hear him welcome the fact that life expectancies are rising, or our plan to drive up healthy life expectancy still further. I did not hear him say whether the Labour party supports our efforts to ensure that the NHS is properly funded and supported not only now but into the future, because that is what this Government are delivering.
I will go through some of the questions that the hon. Gentleman did raise. He asked about the prevention Green Paper. Indeed, he will know that preventing people getting ill in the first place is a central objective of mine, and it will be forthcoming shortly. He mentioned the better care fund. I was very precise in what I said about the better care fund, because its funding is rising in line with NHS revenue growth. In fact, the overall funding available to deliver social care in this country has risen by 11% over the past three years. Of course there is more to do to ensure that we have a social care system that is properly funded and structured to ensure that everybody can have the dignity of the care they need in older age, and that people of working age get the social care they need, but the Labour party ought to welcome the increase in funding, as well as the aim of ensuring that we get the best possible value for every pound.
The hon. Gentleman mentioned the clinical review of standards, which he welcomed when it was announced recently. The pilots that he mentioned started just four weeks ago, and of course we will be assessing the results and ensuring that we get the right structures in place in future. I am glad that he welcomed it, but in relation to publishing data, after just four weeks it is unsurprising that we are still in the early stages.
The hon. Gentleman asked me to ensure that the increase in funding for mental health will happen and that CCGs will be required to see that increase flowing through to make sure that patients get better service. I can confirm that NHS England is already intervening. The £2.3 billion increase that we have set out in the long-term plan will be required to flow through to the frontline. This implementation framework is part of the system that we are putting in place to make sure that that happens.
Mr John Baron (Basildon and Billericay) (Con)
I very much welcome the Secretary of State’s announcement on putting the one-year cancer metric at the very heart of cancer services as a means of encouraging earlier diagnosis. You will be well aware, Mr Speaker, that the all-party parliamentary group on cancer has long championed the need to put this metric at the very heart of our services in order to encourage earlier diagnosis. The inconvenient truth is that despite the best will of those on both sides of this debate on the need to focus on process targets, we have failed to close the gap on international averages in our cancer survival rates. I chaired the APPG for 10 years, and I know that the current chair, the hon. Member for Scunthorpe (Nic Dakin), is waiting to speak as well. Will the Secretary of State ensure that sufficient funds are allocated to the one-year metric, because history would suggest that this metric has been there, or thereabouts, in the mix before, but because the money has been attached to the process targets, local NHS systems have ignored it?
Matt Hancock
I pay tribute to the work that the APPG, so ably led, has done in putting the measurement of improvements of cancer services at the forefront of the debate. I particularly acknowledge the point about early diagnosis. Here in the UK, we are one of the best countries in the world at treating cancer once it is diagnosed, but we are behind the curve on early diagnosis. Putting a one-year cancer diagnosis metric at the heart of the implementation of the long-term plan is a critical step in making that happen. What is going to happen now is that each of the local systems will feed into the framework in terms of how they will be putting this into action. The full implementation plan, which will be published shortly after the spending review, will take that into account, as well as all the budgets that need to be settled in the spending review. I would recommend to my right hon. Friend—my hon. Friend—[Interruption.] Just for now. I recommend that he keep up this campaign, because we have made significant progress in the implementation framework but there is still more to do.
Mr Speaker
The hon. Gentleman was temporarily elevated to the Privy Council by his right hon. Friend on the Treasury Bench. He might—who knows?—regard that as an earnest of what is to come.
Diana Johnson (Kingston upon Hull North) (Lab)
There is no reference to GPs in the statement—I have just been looking through it. This comes at a time when my constituents are telling me that they are having to wait three weeks to get a GP appointment. Faith House GP surgery on Beverley Road, which I have raised with the Secretary of State directly, is now due to close. It is all very well training doctors for the future, but what is he going to do about the crisis in primary care now?
Matt Hancock
I picked out three of the 20 areas that we are particularly focused on in this implementation framework, one of which is the number of GPs and the broader primary care workforce, because it is not just about GPs but about all those who also support primary care across the board. We have a clear target of 5,000 more GPs, based on the 2015 baseline. We have a record number of GPs in training. Last month, the Minister for Health, my hon. Friend the Member for Wimbledon (Stephen Hammond), announced the consultation on changes to the pension to remove some of the unintended consequences of pension tax changes for GPs to ensure that we retain our highly trained, highly qualified GPs. There is a whole load of work in the people plan being led by Baroness Dido Harding to make sure that we have the number of GPs that we need and the wider primary care health workforce that is necessary.
Sir Peter Bottomley (Worthing West) (Con)
As my right hon. Friend said, the first Minister of Health was Christopher Addison, then a Liberal, who abolished his position as President of the Local Government Board to succeed himself as the first Minister of Health in 1919, but the first Secretary of State to hold up a White Paper saying “national health service” was the Conservative Sir Henry Willink in 1944. We must give credit to the Labour party for bringing in the health service, agreed by the coalition Government, in 1948, although we have to recognise that Aneurin Bevan decided to nationalise the hospitals and not the GPs, when most people expected it to be the other way round.
In the experience of my wife, who did five years as Minister for Health and Secretary of State for Health, we should be praising all those who support the clinicians—the support workers, administrators and others who help doctors, nurses and other professionals—to look after us at all stages of our lives. We must have the extra money. I am glad that we have gone beyond the Labour party’s ambitious targets to meet our own ambitious targets, and that we can look forward to doing more, because we have to recognise that health will require a greater proportion of our wealth as we live longer and want better services.
Matt Hancock
I wholeheartedly agree with the entirety of what my hon. Friend said. It is true that for the majority of its 71-year history—71 this week—the NHS has been run by Conservative Secretaries of State, and the largest cash injections have come from this party. It is a truly national institution that we should all support, and we have to support not only the doctors, who lead many parts of the NHS, and the nurses, but all the health service staff, because it is a true team effort.
Norman Lamb (North Norfolk) (LD)
The Secretary of State may remember that I brought a group of mental health reformers to see him, to make the case for culture change in mental health services to address clear human rights abuses such as locking people up when they do not need to be locked up, often for a long period, shunting people around the country in ways that would never happen with physical health and the endemic use of force in mental health services. We argued that ending inappropriate institutional care would free up money for better prevention and early intervention. He said he loved that approach. Is he doing anything to actually implement it?
Matt Hancock
Yes. First, in terms of the review led by Simon Wessely of the legal powers set by the Mental Health Act 1983, there will be a Government response and then legislation in due course. We want to get that legislation right and bring it forward on an open basis, to ensure that we get a consensus behind it before introducing it formally to the House. On the administrative side, a programme of work is under way to deliver exactly what the right hon. Gentleman mentioned. In my statement, I specifically referenced the expansion in community mental health services that must happen, which will be good value for money and, of course, much better for many patients.
Several hon. Members rose—
Matt Hancock
I thank my right hon. Friend for his question. The shadow Secretary of State is so nice behind the scenes that he sometimes has to get a bit spiky in public, just to prove to his masters in the Leader of the Opposition’s office that he is on their side.
Over the rest of this year, we will deliver the plan to ensure that these targets are put in place. The truth is that we can only manage what we measure, and having a target for access to mental health services and pilots on how we do that for children’s health services is an incredibly important part of ensuring that the system lines up behind the rapid availability of mental health services, which, as I imagine every Member knows from constituency casework, is critical.
Nic Dakin (Scunthorpe) (Lab)
I very much welcome the ambition of this plan, the recognition that it will need appropriate resources—it very much needs appropriate staffing, because the human resource is most important—and the emphasis on cancer and early diagnosis. May I ask the Secretary of State how he will ensure that improvements in early diagnosis for less survivable cancers are central to the target to diagnose 75% of cancers at stage 1 and stage 2? There is a concern that the less survivable cancers will get neglected, given the nature of the plan at the moment.
Matt Hancock
I am grateful to the hon. Gentleman for the tone that he takes, and he is absolutely right in his analysis. I know he met the cancer Minister, the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for South Ribble (Seema Kennedy), last week on this point. We absolutely will address it, and we will not miss the less survivable cancers. Indeed, the focus on early diagnosis will of course help survivability, but it is also a focus across all cancers equally, rather than just on those where survivability has improved so much.
Mrs Pauline Latham (Mid Derbyshire) (Con)
This long-term plan for the NHS has been developed by the NHS, not imposed by Government. Does my right hon. Friend agree that this sets the plan apart and means it is much more likely to work for staff and patients alike?
Matt Hancock
Yes, my hon. Friend is absolutely right. The plan is of the NHS by the NHS for the NHS. We in Government will absolutely facilitate it and support it, and of course we are putting in the money, but the NHS as a whole should be very proud of what this plan proposes and the way the implementation is being done in such a rigorous fashion.
Mr Chris Leslie (Nottingham East) (Change UK)
May I press the Secretary of State a little further on the section of the plan that relates to prevention and early intervention? We are all waiting still for the prevention Green Paper. In particular, there are some diseases and illnesses, such as stroke, where apparently four out of five cases could be prevented by such early action, whether it is diagnosis of atrial fibrillation, or blood pressure and cholesterol testing devices. What more can be done for this Government to show they are serious about preventing ill health, such as stroke?
Matt Hancock
I completely agree with the hon. Gentleman. The whole plan—the whole NHS long-term plan—is about prevention as well as cure. The focus of the NHS needs to switch more towards prevention as well as, of course, helping people get better when they get ill. Taking the example of stroke, there is a lot on the prevention of stroke in the draft prevention Green Paper—just to give him a bit of a teaser for that. At the core of improving prevention of stroke is both behaviour change but also better use of data, because being able to spot people who have symptoms that are likely to lead to stroke can then help much more targeted interventions. I find it striking that with the big stroke charities, as with the big heart charities, their big ask is for better and more access to data.
Sir Bernard Jenkin (Harwich and North Essex) (Con)
May I thank my right hon. Friend for his statement and his commitment to this implementation plan, alongside the commitment to increase clinical standards? That is not a criticism of the medical professions; it is just a determination to make sure that the NHS is an infinite learning organisation and can learn from its mistakes. In that respect, will he recommit to HSIB—the healthcare safety investigation branch of his Department—which is devoted to doing clinical investigations without finding blame, so that these problems can be surfaced and the learning can be implemented across the NHS? In particular, will he recommit to the legislation, which has been through prelegislative scrutiny and is still waiting to be introduced?
Matt Hancock
Yes, I am looking forward to that legislation being introduced. The work that my hon. Friend’s Select Committee—the Joint Committee on the Draft Health Service Safety Investigations Bill—did in the prelegislative scrutiny was incredibly important. The HSIB Bill promises to improve patient safety, which is an important part of the agenda, and I look forward to its being brought forward to the House.
Janet Daby (Lewisham East) (Lab)
I have recently become the vice-chair of the all-party parliamentary group on sickle cell and thalassaemia. Sickle cell is very much a hidden disability which is lifelong. Some people take up to five medications a day, which is very costly. If they have a relapse, they can be hospitalised, but it is more cost-effective and preventive to have free prescriptions than to end up in hospital. Will the Secretary of State review the matter and do what is both best for those patients and in the public interest?
Matt Hancock
I will certainly look at the matter. When I was on a night shift with a London ambulance crew, we attended a patient who suffered from sickle cell, and it was horrific to see the degree of pain that they were in. I have therefore seen at first hand exactly how horrific the condition can be and I will look into the hon. Lady’s suggestion.
Sir Hugo Swire (East Devon) (Con)
I was delighted to be able to show the Secretary of State the health and wellbeing hub in Budleigh Salterton and the opportunities at Ottery St Mary community hospital, and that he confirmed that both places had a role to play in the future of health provision in East Devon. However, last week, the National Audit Office found that community hospitals and GP surgeries were struggling to pay the rents charged by NHS Property Services and that, nationally, outstanding debt has almost tripled since 2014 to £576 million. If my right hon. Friend is interested in securing a legacy before he moves on to even higher political office, will he please look at that, particularly in advance of the review planned for 2021?
Matt Hancock
I certainly will. I also draw my right hon. Friend’s attention to an announcement, which we made last month, to allow local hospital trusts to request property from NHS Property Services so that it can be transferred to the trusts if it can be used better and more flexibly locally, in the way that the hub I saw at Budleigh Salterton absolutely delivers. I can also see such an opportunity for the potential hub at Ottery St Mary, which was a community hospital and has enormous promise for delivering services closer to the community.
Jim Shannon (Strangford) (DUP)
I thank the Secretary of State for the statement and the substantial moneys that the Government have committed to the NHS long-term plan, particularly given the need for the cancer strategy to be fully implemented. On rare diseases, will he confirm that drugs such as Orkambi, Spinraza and medicinal cannabis will be simple to apply for and accessible for those who desperately need them now, when time is not on their side?
Matt Hancock
I understand the importance of those drugs. Each one is in a slightly different part of the process. We have opened up availability of medicinal cannabis. Indeed, I was talking this morning to the head of NHS England to ensure that our plans to normalise access to medicinal cannabis for those with a clinical need for it can be brought forward. The hon. Gentleman should expect to hear more news soon on the progress that NHS England and the National Institute for Health and Care Excellence have made. On Orkambi, we are still engaged with the company, Vertex, to try to bring that to patients in a cost-effective way. I greatly hope that Vertex will make some progress.
Vicky Ford (Chelmsford) (Con)
It has been great to hear my right hon. Friend mentioning the new medical schools. The one in Chelmsford is fantastic. It is 12 times oversubscribed for next year—we would love an increase in places. It was lovely to meet three of the medical students last week, when they raced across the high street to have selfies taken with my right hon. Friend’s predecessor.
We are also doing well on nurse apprenticeships, but there is an issue, especially with mature students coming in to study adult nursing. Will my right hon. Friend look again at how to give them financial assistance?
Matt Hancock
I thoroughly enjoyed visiting my hon. Friend’s local medical school and seeing the expansion that has taken place. The two of us walked into a room occupied almost entirely by dead bodies, which was quite an experience. [Interruption.] It was nothing like this place. On the specific and substantive questions she asks, we are looking at both the funding for the expansion of medical schools and how we ensure that we get the nurses we need into the profession. That will be part of the spending review process with the settlement of the budget for Health Education England.
Chris Bryant (Rhondda) (Lab)
Having been diagnosed earlier this year with a stage 3B melanoma, I always get a bit sweaty when people start talking about how important it is to have early diagnosis to ensure survival rates, but of course they are absolutely right. The number of people, in particular men, with melanoma is rising and people are still dying. I have heard horrific tales of people going to GPs five, six or seven times before a GP was able to send them on to see a dermatologist. I have heard about dermatologists saying, “I’ll look at this mole here, but I’m not going to look at that one because you haven’t been referred for that one. That will have to be a separate referral.” I have heard of people waiting six or seven weeks for histopathology to come back. All those things delay the process. Do we not need to have a wholesale approach to melanoma to ensure that we save more people’s lives?
Matt Hancock
Yes, the hon. Gentleman is absolutely right. I agree with what he says. There is a need for the whole medical profession to be constantly up to date with the latest treatment and diagnostic science. I am determined that part of the drive for early diagnosis is about not just diagnosis once referred, but better referral. We all have a part to play in that—wider society, as well as primary care.
Martin Vickers (Cleethorpes) (Con)
Many people in my constituency find it difficult to obtain NHS dentistry. While that is part of the short-term plan, on the ambitions outlined in the plan for long-term improvements to oral health, what assurance can the Secretary of State give that NHS dentists will be in place to deliver them?
Matt Hancock
NHS dentistry is incredibly important. Ultimately, dentistry is part of prevention; it prevents oral ill health. We are doing a lot of work on what further we can do to support oral health. In fact, I had a meeting with the Minister with responsibility for public health on that subject this morning. I would love to meet my hon. Friend to discuss it further.
Justin Madders (Ellesmere Port and Neston) (Lab)
The Secretary of State clearly identified three critical areas for improvement to cancer survival rates. He is absolutely right about early diagnosis. I do not want to make my hon. Friend the Member for Rhondda (Chris Bryant) any more sweaty than he already is, but it cannot be repeated enough times that spotting these issues early on is critical to improving survival rates. The Secretary of State is also right about the importance of mental health. The third point he touched on was that the workforce is key to underpinning all this. In that regard, does he know how many specialist mental health and specialist cancer nurses we will have at the end of the 10-year period?
Matt Hancock
The answer to that question is being worked on as part of the people plan, which Baroness Dido Harding is putting together. We published the interim plan last month. The full people plan will be available after we have settled, in the spending review, the budget of Health Education England. The hon. Gentleman raises an incredibly important point.
Jeremy Lefroy (Stafford) (Con)
I very much welcome the plan, with £33.9 billion being committed by 2022-23. My slight concern is where the money is going to come from. I wonder whether my right hon. Friend has had assurances from the Treasury that that will indeed be the case. With all the other pressures on spending and revenues in the coming years, that might be a little difficult. We have to find ways to ensure that the revenue is there because this money must be spent.
Matt Hancock
Yes, it will in all circumstances. This is a firm commitment, supported right across this House and right across our party, and it will be delivered. There is absolutely no question about that.
Toby Perkins (Chesterfield) (Lab)
We know that areas of greater deprivation have greater health needs than other areas. Will the Secretary of State tell us what more there is in the long-term plan specifically about increasing the resources for GP practices that serve areas of greater deprivation? They have longer waiting times and greater vacancy lists and we need specific action to support those practices.
Matt Hancock
Making sure that we have the right allocations for CCGs across the country that reflect the needs of the local population is a very important responsibility for NHS England—as the commissioner of those services—to make sure that the money follows need. After all, the principle of the NHS is that it is available to everybody according to need, not ability to pay.
Bim Afolami (Hitchin and Harpenden) (Con)
We all know that the Secretary of State is a great fan of technology and of improving the mental health of young people, and all people across the country. In my constituency, a man called Richard Lucas has set up a new online system called govox, which is a revolutionary, technologically enabled way of improving mental health among young people. Will the Secretary of State advise the House how innovative new technological solutions at a local level can best get into CCGs and the local NHS, so that we can improve mental health for everybody?
Matt Hancock
My hon. Friend has raised with me before the new technology developed by Mr Lucas. A new technology such as this can be picked up by all sorts of different parts of the NHS—by different CCGs or mental health trusts—which can then use it. One of the reasons that we have brought in NHSX, which opens today, is to make sure that there is a central place to which people with a good idea for how to improve the health of the nation by using technology can go to find a way into the NHS, so that great practice and good technology can be promulgated across the NHS as quickly as possible.
John Grogan (Keighley) (Lab)
Speaking of revenue, what is the Secretary of State’s attitude to NHS trusts that set up subsidiary companies, if one of the main motives is clearly seen to be VAT avoidance, as in the case of Bradford trusts where nearly half the extra revenue of setting up a company in the first five years would be VAT-related?
Matt Hancock
If the hon. Gentleman writes to me with the specifics of the case, I will be very happy to look into it. The use of subsidiaries in the way that he described in principle has been available to NHS organisations for some time, and I am very happy to take up the case that he asked about.
Robert Halfon (Harlow) (Con)
I strongly welcome the 10-year plan and particularly what the Secretary of State said about apprenticeships, and I urge him to push more degree apprenticeships in the NHS. If it is right to have a 10-year long-term plan for the NHS in England, does he agree that we also need a long-term NHS plan for my constituency of Harlow? The only way that we can achieve that is by having a new hospital health campus. He has visited our hospital and realises that it is not fit for purpose.
Matt Hancock
Few people make the case for their constituencies better than my right hon. Friend, and nobody makes the case for Harlow better than him. He invited me around Harlow hospital. I went into the basement to see some of the work that is needed, and the basement of Harlow hospital is in a worse state of disrepair than the basement of this building. That means that it needs work, so I am considering his proposal. The future NHS capital budget will be settled in the spending review, so I suggest that he has a conversation with Treasury Ministers as well. I look forward to seeing the case progress.
My right hon. Friend is also right about how important degree apprenticeships are. Both of us are former Skills Ministers and have heralded the arrival of degree apprenticeships as a route for people into high-paid, high-quality jobs without them having to go to university.
Rachael Maskell (York Central) (Lab/Co-op)
Delayed discharge has a knock-on effect on the whole NHS. The fact that the Secretary of State has said today that all he will do is review the better care fund and that he will not publish a White Paper on social care shows what a low priority this is. When will we see the White Paper on social care for which we have been waiting not just months, but years?
Matt Hancock
The statement was about the implementation of the NHS long-term plan, to which of course the future of social care is vital, which is one reason why the spending power available within social care has risen by more than 10% over the past three years. We continue to work on the long-term future of social care. We will have to wait for a new Prime Minister before publishing the Green Paper—I think that is fairly obvious—but it would also be good to get a bit of cross-party collaboration. When my right hon. Friend the Member for Ashford (Damian Green) made some proposals that were in line with the cross-party work of two Select Committees of this House, within half an hour the shadow Secretary of State’s friend, the shadow Chancellor, had rubbished the idea—I do not think he took the time even to read it. We could do with a bit of cross-party work on the future of social care in this country.
Alex Chalk (Cheltenham) (Con)
Thanks to the record funding boost for the NHS, Cheltenham General Hospital can plan for the future with confidence, but local trust managers consistently cite difficulties with recruiting emergency medicine doctors as a reason for not being able to expand A&E provision. Does the Secretary of State agree that some of the additional resources must go into training additional A&E doctors so that we can give Cheltenham General Hospital the resources it requires?
Matt Hancock
Yes, I agree very strongly with that. When I said that my right hon. Friend the Member for Harlow (Robert Halfon) was one of the best constituency advocates, I forgot my hon. Friend the Member for Cheltenham (Alex Chalk), who is also one of the best, and certainly the best advocate for Cheltenham, that the House has ever seen. He is absolutely right in the substance of his question, which is that we must have the support for the workforce we need, including in emergency medicine, to ensure high-quality emergency facilities near to people—where they are needed—and he makes that case with respect to the expansion of services at Cheltenham Hospital, which he supports incredibly strongly.
Mike Amesbury (Weaver Vale) (Lab)
Is the privatisation of the urgent care centre in the Runcorn-Halton part of my constituency part of the Secretary of State’s NHS plan?
Matt Hancock
I am not sure what specific case the hon. Gentleman is referring to, but I will tell him this about privatisation: I support the NHS being free at the point of delivery so that everybody can use it, and the most important principle at stake is how to deliver the best possible services for our constituents. That is what I will keep doing.
Mr Philip Hollobone (Kettering) (Con)
The success of the NHS long-term plan in Northamptonshire will depend on urgent short-term reform of the combined health and social care system in the county. There are 1,400 hospital beds in the two hospitals in Northamptonshire; 900 are occupied today by stranded and super-stranded patients as a result of delayed transfers of care. This is the worst situation in the country. The number of patients staying more than seven days in a hospital bed is twice the national average. Northamptonshire’s over-65 population is the fastest growing in the county. We need to take advantage of local government reform to establish an integrated health and social care pilot, but this requires the personal attention of the Secretary of State. Without that, we will not make any progress. Will he meet Members of Parliament from the county this month to get this under way?
Matt Hancock
Yes, and I suggest we meet also with the Secretary of State for Communities and Local Government. I have met the Northants MPs to progress this, and I have also meet the Communities Secretary about it. My hon. Friend is dead right. There is a serious problem, but there is also an opportunity for much more integrated health and social care. If Northants MPs, the Communities Secretary and I can find an opportunity to meet, perhaps we will be able to crack through this one.
Mr Bob Seely (Isle of Wight) (Con)
I thank the Secretary of State for his announcement. I have two questions. First, do he and his Department accept that there are additional costs in providing healthcare on an Island that is of an equal standard to that provided elsewhere? Secondly, will he and his officials agree to meet Island officials to discuss plans for a pilot scheme to help integrate healthcare, adult social care and other local government services to ensure maximum efficiency in the delivery of services, as my hon. Friend the Member for Kettering (Mr Hollobone) just talked about, and to ensure that as much money as possible goes to frontline services?
Matt Hancock
Yes, I shall be happy to ensure that that meeting happens. As for Island healthcare costs, my hon. Friend is right to say that the Isle of Wight is unique in its health geography, and that there are places in this country—almost certainly including the Isle of Wight—where healthcare costs are higher because of the geography. There is a programme for smaller hospitals that are necessarily smaller because of the local geography, as they need special attention.
As I have said, I shall be happy to ensure that the meeting goes ahead, and I shall continue to talk to my hon. Friend, who makes the case for the Isle of Wight better than any other.
Luke Graham (Ochil and South Perthshire) (Con)
Tomorrow I shall attend the funeral of my Auntie Bib, who has just died of cancer. It was discovered at quite a late stage. May I press my right hon. Friend to ensure that rapid access diagnosis centres are rolled out as quickly as humanly possible, and to give the House more details? May I also—as is my job—remind him that he is, of course, the Secretary of State for Health and Social Care for this entire United Kingdom, and ask him how he intends to engage with devolved authorities when targets are being missed to ensure that standards are maintained across the island? Our constituents are all British citizens, and they all require and deserve the same level of support.
Matt Hancock
I am sure that the whole House will want to pass our condolences to my hon. Friend, to his family, and to friends of his aunt. In a way, it is fitting to end this session with a very personal example of why early diagnosis matters.
As for my hon. Friend’s second point, ensuring that we have high-quality health services throughout the UK is, of course, vital. It is true that there has been a smaller increase in funding for the NHS in Scotland, and a consequent smaller increase in the number of healthcare professionals there. We need an improvement right across this country. We are delivering that in England, and I am sure that my hon. Friend will continue to make the case for better health services in Scotland from the Scottish National party Government, who receive the money from the UK Treasury but do not put all of it towards the NHS.
Junior Doctors Contract Review
Matt Hancock Excerpts(4 years, 10 months ago)
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The Secretary of State for Health and Social Care (Matt Hancock)
I am delighted to tell the House that we have successfully brought to an end the junior doctors dispute, following a review of the 2016 contract. The British Medical Association announced yesterday that junior doctors had overwhelmingly—by 82%—backed a four-year deal incorporating pay increases, and improved flexibility and conditions. The vote by BMA members means that the BMA and NHS employers will now move to collectively agree the amended junior doctor contract.
Throughout negotiations we have worked closely with the NHS and the BMA to agree an offer which recognises the dedication of our 39,000 junior doctors to their patients and our nation’s health.
The agreement also includes improved working conditions. The contract changes prioritise doctors’ physical and mental wellbeing through introducing new limits on working hours, more breaks and making it easier to get time off for important moments in their lives.
This is a “something for something” deal—guaranteed pay increases in return for contract reform which will help improve productivity, recruitment, retention and motivation. There will be around £90 million of investment into the contract including a new pay point for the most senior doctors in training, an allowance for those working less than full time to support flexible working and increased pay for those working the most weekends or whose shifts end in the early hours of the morning. Taken alongside an 8.2% four-year pay rise, this will give junior doctors and current medical students the support they fully deserve.
The NHS would be nothing without its dedicated workforce. For our junior doctors, as well as all our staff and volunteers, I want the NHS to be an incredible place to work. This deal marks another step in our long-term plan for the NHS, which will safeguard our health service and benefit us all for generations to come.
[HCWS1668]
Oral Answers to Questions
Matt Hancock Excerpts(4 years, 10 months ago)
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The Secretary of State for Health and Social Care (Matt Hancock)
To increase the access to new technology across the NHS, we have expanded the accelerated access collaborative to get the best technologies in faster, and NHSX is delivering our tech vision to drive forward digital transformation of the NHS.
James Cartlidge
I welcome the way my right hon. Friend has really put a stamp on ensuring that technology is at the heart of his health policy. Can he tell me whether the accelerated access collaborative will engage locally, particularly with the sustainability and transformation partnerships, so that it eventually leads to better outcomes for our constituents?
Matt Hancock
Yes, my hon. Friend is absolutely right. There is a reason why we care about using the very best technology in the world in the NHS, and that is that it improves treatment for patients. The regional delivery of better technology is critical. The 15 regional academic health science networks are a key part of the AAC and they work closely with local hospitals.
Lucy Powell (Manchester Central) (Lab/Co-op)
Matt Hancock
Yes, 100%. One of the reasons we have put NHSX in place is to drive exactly this policy agenda, where we can get better treatment for patients and save money.
Henry Smith (Crawley) (Con)
Earlier this year, the Secretary of State attended the launch of a report on artificial intelligence by the all-party parliamentary group on heart and circulatory diseases. Can I get a commitment from him that AI is very much part of the future through the NHS long-term plan?
Matt Hancock
A most enthusiastic commitment! My hon. Friend has led on this agenda and driven it, because it is all about using technology to save lives. The report that he mentions is optimistic about the power of using data better to ensure that people can live longer.
Catherine McKinnell (Newcastle upon Tyne North) (Lab)
On new technology and saving lives, I met the Secretary of State last month to discuss making the innovative enzyme replacement therapy Brineura— the only treatment available for Batten disease—available on the NHS urgently. I have heard nothing since that meeting, and the wait is agonising for the families, so what will he do urgently to make this life-saving treatment available to children in England?
Matt Hancock
I had an incredibly moving meeting with the hon. Lady, my hon. Friend the Member for North East Somerset (Mr Rees-Mogg) and others, and some of the families and children who have Batten disease. I have since met the chief executive of the NHS. The decision on the availability of the drug in question is, of course, one for the National Institute for Health and Care Excellence and NHS England, but I have had those meetings and I continue to make the case.
Mr Philip Hollobone (Kettering) (Con)
The electronic prescription service is now used by more than 90% of GP practices, and more than 70% of prescriptions are issued in that way. As well as providing a better patient experience, how much money has this saved for the NHS?
Matt Hancock
My hon. Friend is dead right to say that this provides a better service and saves money. I do not have the figure at my fingertips, but I will write to him with the answer and ensure that it is published for the whole House to see.
Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)
Patients in my constituency have to travel vast distances—often in excess of a 200-mile round trip—to be seen at Raigmore Hospital. As and when properly working visual teleconsultations are brought into being, when that technology is developed, may I appeal to the Government to share the technology with the Scottish Government and with NHS Highland?
Matt Hancock
Absolutely. Places like Caithness are a great example of where GP consultations that can be done over the phone or over a video conference can save people hours and hours. Of course they sometimes need to see their GP in person, but not always. We are driving this agenda hard in England, and I would be happy to work with the NHS in Scotland to ensure that that technology is taken up there, too.
Conor McGinn (St Helens North) (Lab)
Nigel Huddleston (Mid Worcestershire) (Con)
The Secretary of State for Health and Social Care (Matt Hancock)
The interim people plan that we published this month puts the workforce at the heart of the future of the NHS and will ensure that we have the staff needed to deliver high-quality care.
Nigel Huddleston
The Secretary of State will be aware that recruitment and retention is particularly difficult for hospitals in special measures, such as the Worcestershire Acute Hospitals NHS Trust, which he recently visited. Such hospitals have to rely heavily on agency staff, which puts pressure on their finances. What specific steps is he taking to help those hospitals with their financial and recruiting pressures?
Matt Hancock
We are working closely with that trust, and it was good to visit and see just how hard working the staff are. They are dedicated to the cause and well supported by their MPs. My hon. Friend is quite right to make that case, and we have a direct package of support for the Worcestershire Royal Hospital and the trust more broadly because it faces unique challenges, some of which are not at all of its own making. The staff at Worcester are working incredibly hard to deliver for their local citizens.
Ruth George (High Peak) (Lab)
My constituents find it very difficult to access their GP, as we have a recruitment shortage in the constituency. The “General Practice Forward View” pledged to boost the GP workforce by 5,000 by 2020. Are the Government on course to meet that target?
Matt Hancock
We retain that target of 5,000 more GPs. We have managed to increase the number of staff working around GPs, because a GP does not need to do everything in primary care, so we have a more mixed workforce with physios and practice nurses working alongside GPs. There is more work still to do, and the NHS long-term plan sets out how we will make that happen.
Joseph Johnson (Orpington) (Con)
The leadership team at King’s College Hospital NHS Foundation Trust has asked for assistance from NHS Improvement to put in post a clinical director at the emergency services department, which has just been rated inadequate by the Care Quality Commission. This vital post, however, remains unfilled. What assurances can my right hon. Friend give that NHS Improvement can help trusts when they request assistance in this way?
Matt Hancock
My hon. Friend makes an important point. This is a vital post in a hospital and a hospital trust that does amazing work—some of the best medicine in the world is done at King’s—but it also has significant challenges with delivery, especially with respect to meeting financial targets and delivering value for money. King’s needs that support, which we are putting in place. I will raise the specific issue of the post he mentions with the head of NHS Improvement.
Gareth Snell (Stoke-on-Trent Central) (Lab/Co-op)
The Royal Stoke University Hospital, in partnership with Staffordshire University and Keele University, is training the next generation of clinicians, but the Secretary of State will know those universities need to be properly resourced to continue that vital training. What conversations is he having with the Department for Education to make sure that partnership thrives?
Matt Hancock
The hon. Gentleman raises an important point. We have expanded the number of medical training places; we have more people going into medicine; and we have a record number of GPs in training. This takes time, of course. I spoke to my right hon. Friend the Secretary of State for Education about this recently, and I will make sure that we keep pushing hard.
Kirstene Hair (Angus) (Con)
Our future immigration policy will be key to ensuring that our NHS is sufficiently staffed across the country. What discussions has my right hon. Friend had with the Home Secretary specifically on the £30,000 annual minimum income? I believe that limit is very detrimental to the sector.
Matt Hancock
I have had those discussions, and the Migration Advisory Committee has raised a specific concern about social care. We need to deliver better social care, with people coming from all around the world in addition to domestically trained people. I take on board my hon. Friend’s point.
Yvette Cooper (Normanton, Pontefract and Castleford) (Lab)
Pinderfields Hospital in Wakefield has struggled to retain midwives. As a result, the trust has proposed to cut and close the popular midwife-led maternity unit in Pontefract. Local mums are up in arms, as it is completely unfair. We keep seeing this pattern. When the NHS is under pressure from austerity, from shortages or from management issues, it is the services in towns that are hit. What will the Secretary of State do to make sure we have enough midwives across the country so that we can keep Pontefract’s midwife-led unit open and so the NHS can continue to sustain services that are vital to our towns?
Matt Hancock
The right hon. Lady, as always, puts the case for Pontefract very powerfully. The truth is that we will need more nurses and more midwives, as well as other health professionals, over the next five years because we are putting in a record amount of funding. More people are needed to deliver better services, and I am happy to meet her to discuss this specific case. Coming from and representing towns myself, I understand the importance of keeping services such as maternity services close to the people they serve.
David Tredinnick (Bosworth) (Con)
Will my right hon. Friend make sure that his interim people plan looks again at the hugely underutilised resource of the allied health professions, including osteopaths and chiropractors? What is the point of having a professional standards authority to regulate them if the Department will not use them?
Matt Hancock
My hon. Friend makes an important point, one that we have frequently discussed. As he knows, I am married to an osteopath, so I do recognise the value that osteopaths bring to all of us.
Dr Philippa Whitford (Central Ayrshire) (SNP)
Research shows that the ratio of registered nurses to patients is one of the most important factors in patient safety, so members of the Royal College of Nursing are calling on the Secretary of State to follow Wales and Scotland and to bring in safe staffing legislation. What is his answer to them?
Matt Hancock
Of course we need to have the right number of nurses. We need to make sure that we also put in the funding. If the SNP Government in Scotland had put the same funding increases into the NHS in Scotland, there would have been half a billion pounds more there over the last five years. So let us start with getting the money in that we are putting in in England, but is not fully being reflected by the SNP Government in Scotland.
Dr Whitford
The SNP in Scotland spends £185 a head more than England, so the Secretary of State should check his figures. At over 11%, the nurse vacancy rate in England is more than double that in Scotland. Whereas student nursing numbers have increased every year in Scotland, there are 570 fewer nursing students this year in England. Is it not time to follow Scotland’s approach, reintroduce the nursing bursary and end tuition fees?
Matt Hancock
I am not going to let the SNP spokesman get away with this. Normally, she brings a thoughtful contribution to health debates, but she said that there is more spending in Scotland per head. The truth is this: the increase in spending in England over the last five years is 17.6%, but in Scotland the increase is only 13.1%. That represents half a billion pounds less: the increase in spending that we have seen in England that they have not seen in Scotland. She should recognise that fact.
Peter Heaton-Jones (North Devon) (Con)
Justin Madders (Ellesmere Port and Neston) (Lab)
The Secretary of State for Health and Social Care (Matt Hancock)
This week is Children’s Hospice Week, Loneliness Awareness Week, National Breastfeeding Week and Learning Disability Week, and today is International Fathers Mental Health Day. The Government have made plans to more than double funding for children’s palliative care and end-of-life care services, developed a loneliness strategy and launched a consultation on folic acid in flour to support expectant mothers, and yesterday the Prime Minister announced a package of further work to support people from all backgrounds in the UK with their mental health. I and my brilliant ministerial team will continue to drive forward the health of the nation.
Justin Madders
I want to bring to the Secretary of State’s attention some mental health waiting times that my constituents have recently come to me with. Someone with an urgent referral for trauma counselling is looking at a minimum six-month wait. A teenager who has attempted to take her own life is waiting over a year to see a psychiatrist. Several adults have been told there is a three-year wait just to get a diagnosis of attention deficit hyperactivity disorder. These waits are appalling. The Secretary of State billed himself as the leadership candidate for the future, but he is the Secretary of State for Health now. What is he going to do to address this appalling waiting system?
Matt Hancock
The hon. Gentleman is right that we need to ensure that access to mental health services improves. As part of the increase in funding we are putting into the NHS, the biggest increase is in mental health services, and it is a critical part of what we need to do to address the sorts of problems he rightly raises.
Mr Marcus Fysh (Yeovil) (Con)
Jonathan Ashworth
Indeed.
I dare say that this is the Secretary of State’s final outing at Health questions, because we believe he has secured transfer to pastures new. In his time here, he has failed to deliver a social care Green Paper and failed to deliver a prevention Green Paper, while he is privatising Oxford cancer scanning services and we have hospitals charging £7,000 for knee replacements. Does he really think that is a record deserving of Cabinet promotion?
Matt Hancock
I am agog—and aghast. Over the last year, we have not only delivered £33.9 billion of increased funding, but we have produced the long-term plan for the future of the NHS. Starting this year, with the money already flowing, we are seeing the biggest increase in funding for community, primary care and mental health services. We have developed our work on the prevention agenda, and we have instituted a new verve and energy into the adoption of new technology in the NHS. I look forward to driving forward all these things in the future.
Jonathan Ashworth
Will the Secretary of State tell us about the verve and energy in his own constituency in Suffolk, where 32 health visitors are being cut because of his cuts? He is apparently now supporting a candidate who wants £10 billion-worth of tax cuts for the richest in society. Will that not mean further cuts to public health, further cuts to social care and, ultimately, cuts to the NHS as well?
Matt Hancock
For the majority of its 71-year history, the NHS has been run under the stewardship of a Conservative Secretary of State. At this moment, it is getting the biggest funding increase and the longest funding settlement in its history, along with the reforms to make sure that everybody can get the health care that they need.
Neil O’Brien (Harborough) (Con)
Diana Johnson (Kingston upon Hull North) (Lab)
Matt Hancock
The hon. Lady is quite right. As part of the long-term plan, we have considered the best way to commission sexual health services, which were moved over to local authorities five years ago. We think that the responsibilities are sitting in the right place, but we need to see far more co-commissioning, where local authorities and the NHS together ensure that there is more joined-up provision, rather than the siloed provision that she mentions.
Alan Mak (Havant) (Con)
Matt Hancock
My hon. Friend is quite right to celebrate the development of the NHS app. More than 80% of people are now able to use the NHS app to link to their GP practice. Our plans for the year ahead include API-based connections to a number of third-party products, including the NHS app. More importantly, I want the opening of this system to allow other innovators to be able to develop products for patients to use in a way that we have not imagined before. I want a load of innovations so that people can get the best possible access to their NHS.
Rachael Maskell (York Central) (Lab/Co-op)
Jo Swinson (East Dunbartonshire) (LD)
Matt Hancock
I wish my hon. Friend, with whom I have worked closely and whom I admire very much, great success in her leadership bid. I wish her more success than I had. With the hon. Member for Streatham (Chuka Umunna) sitting next to her, I am sure they will run a great race. I want to reassure her that, as I said the week before last, the NHS is not on the table in trade talks. We now have that assurance from the Americans. NHS data must always be held securely, with the appropriate and proper strong privacy and cyber-security protections.
Mr Speaker
I am sure the Secretary of State means well, but I am not entirely sure that the hon. Lady’s joy at the endorsement from the right hon. Gentleman was undiluted.
Stephen Lloyd (Eastbourne) (Ind)
Matt Hancock
I am very grateful to the hon. Gentleman for raising this case. The ministerial team has not seen the details in advance, but if he would like to write, the appropriate Minister will of course meet him.
Andrea Jenkyns (Morley and Outwood) (Con)
The inquiry into the contaminated blood scandal, the biggest treatment disaster in the history of the NHS, is currently taking place in Leeds. What is the Department doing to compensate the victims of this scandal and to make sure their voices are heard?
Tonia Antoniazzi (Gower) (Lab)
As the Minister will know, two weeks ago I went to the Netherlands with Teagan Appleby’s mother, Emma, to collect one month’s supply of medical cannabis. The Department laid down the requirements for Emma to meet with Border Force, and she met them by providing a UK prescription. Will the Secretary of State and Ministers meet me to ensure that there is no more ambiguity in a policy that currently criminalises parents in possession of a UK prescription bringing their much-needed medicine into the country?
Matt Hancock
As the hon. Lady and other colleagues know from having worked on this important issue, we acted swiftly to change the law to make sure that medicinal cannabis was available. Those patients for whom it is clinically appropriate can now be prescribed medicinal cannabis. As she knows, whether to prescribe is a clinical decision, but those prescriptions are available and flowing and are being issued where it is judged clinically appropriate for the patient. We will continue to work on this to make sure we get it right.
Several hon. Members rose—
Mr Jacob Rees-Mogg (North East Somerset) (Con)
My constituent Max is aged eight and has Batten disease. He is one of only two sufferers of this disease who are not receiving the medicine that can improve their quality of life and keep them alive. Eleven other children in this country with Batten disease are receiving the drug, which is very effective but very expensive. The drug manufacturer has offered six months’ free supply to Max and the other person not getting it and has made other proposals to NHS England, which is currently refusing even to have meetings with the drug company to discuss how my constituent, this dying child, may receive the drugs he needs. Will my right hon. Friend intervene and use whatever reserve powers he has to ensure that my constituent gets this life-saving drug?
Matt Hancock
My hon. Friend speaks for the whole House about the need for these rare diseases to be given the attention they need so that sufferers such as Max can get the medicines if at all possible. As he knows following our meeting, the formal legal responsibilities lie with NHS England and NICE. I have raised this case, and that of others mentioned earlier, with the chief executive of NHS England and will raise it once again following this Question Time. We will do all we can to resolve this.
Stephen Morgan (Portsmouth South) (Lab)
Thousands of my constituents will be left without access to dental care because a Swiss-owned investment firm has decided to shut three practices in my city. What is the Department doing to ensure that the people of Portsmouth have access to vital oral health services?
Marion Fellows (Motherwell and Wishaw) (SNP)
Regardless of which type of Brexit we face this autumn, bureaucracy, customs charges and stockpiling costs will inevitably drive up the price of imported drugs and medical devices. Will the Secretary of State undertake to provide additional funds for NHS England and the devolved nations to cover those Brexit-induced costs and to avoid cuts in clinical services?
Matt Hancock
Additional funds have already been provided to ensure that medicines are available throughout the country, whatever the Brexit scenario.
Brendan O’Hara (Argyll and Bute) (SNP)
Given the increased likelihood that the next Prime Minister will be determined to leave the European Union at the end of October, deal or no deal, will the Secretary of State update the House on what preparations are currently being made to protect the import of critical supplies such as insulin and radioisotopes?
Matt Hancock
Meeting the need for unhindered medicine supplies was an incredibly important piece of our Brexit planning, which was successfully completed ahead of 29 March. Of course we are updating those plans as we speak, but the ability to reassure people that there will be no impact on the supply of medicines is an important part of that work.
Listeria: Contaminated Sandwiches
Matt Hancock Excerpts(4 years, 10 months ago)
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Jonathan Ashworth (Leicester South) (Lab/Co-op) (Urgent Question)
To ask the Secretary of State for Health and Social Care to make a statement on the listeria outbreak related to contaminated sandwiches in hospital trusts.
The Secretary of State for Health and Social Care (Matt Hancock)
I would like to update the House on the actions the Government are taking to protect the public following cases of listeria in hospitals linked to contaminated food. The NHS has identified nine confirmed cases of listeria in seven different hospitals between 14 April and 28 May this year, all linked to contaminated sandwiches from a single supplier. All the known cases involve in-patients. Very sadly, five people have died. I would like to express my condolences to the families of those who have lost a loved one. I promise that there will be a full and thorough investigation, with severe consequences if there is any evidence of wrongdoing.
Lab testing indicated a link between two cases in Manchester Royal Infirmary and one case in Liverpool. Contaminated sandwiches were identified as the likely cause by Public Health England. The manufacturer—The Good Food Chain—and its supplier, North Country Cooked Meats, have withdrawn the sandwiches, and voluntarily ceased supply of all products on 7 June. They are both complying with the Food Standards Agency on a full product withdrawal. The other cases have been identified at these hospitals: Royal Derby, Worthing, William Harvey in Ashford, Wexham Park, Leicester Royal Infirmary, and St Richards in Chichester.
The risk to the public is very low, but any patients or members of the public with concerns should contact NHS 111 or, of course, 999 if they experience severe symptoms. Listeria infection in healthy people may cause mild illness but is rarely fatal. However, for certain groups it can be much more serious, as we have tragically seen. The NHS, Public Health England and the Food Standards Agency have acted swiftly to identify, contain and investigate the cause of this listeria outbreak. These deaths should never have happened. People rightly expect to be safe and looked after in hospitals, and we must ensure that we take the necessary steps to restore that trust that the public deserve to be able to hold.
This is not just about ensuring that the food we serve in hospitals is safe—the NHS served 140 million main meals to in-patients last year—but, importantly, is also about ensuring that food given to patients is healthy, nutritious, and aids their recovery. So I can inform the House that we are launching a root-and-branch review of all the food in our hospitals—both the food served and the food sold. The Government will work with the NHS to build on progress in three vital areas. First, there is eliminating junk food from hospitals. Since the introduction of the NHS action on sugar scheme, we have halved the sale of high-sugar soft drinks, and trusts are taking action to remove unhealthy food and drink items and replace them with healthier alternatives. After all, hospitals are places for good health. Secondly, on improving nutrition, new national standards for all healthcare food will be published this year. All patient menus will have to ensure that minimum patient nutrition standards are met. Thirdly, on healthier choices, we will work closely with the Hospital Caterers Association and others to ensure that healthier food choices are available across the NHS.
The review will identify where we need to do more, where we need to do better to improve the quality of food in our hospitals, and how we help people to make healthier choices. I know that this is an issue that many colleagues in the House feel strongly about, as do the public. We will do everything we can to ensure that the food we eat in hospitals is both safe and healthy.
Jonathan Ashworth
Let me say at the outset that despite our often sharp political differences across the Dispatch Box, the Secretary of State has my commiserations over his entirely noble ambition to want to be the Prime Minister of this country—but perhaps, given Brexit, he has had a lucky escape.
Moving on to the substance of what we have to discuss today, our thoughts really must be with the families of those who have lost their lives. This is, first and foremost, an issue of patient safety and standards of care. Every patient deserves the very safest possible care and absolute confidence about the quality and safety of the food that they are offered. I am pleased that there is an investigation, and I welcome what he said about serious consequences if wrongdoing is found. I am also pleased that he talked about a root-and-branch review, which we have been calling for. As I understand it, NHS Improvement was already reviewing the hospital food plan, which was delayed from April. Is this a new review or an existing review that now has new obligations? Can he explain to the House how the review he has announced interacts with the existing NHS Improvement review?
I know that the investigation will want to get to the bottom of what went wrong and why, and it will no doubt make recommendations for the future, but we would be grateful if the Secretary of State offered some clarification. The first case showing symptoms of listeria was on 25 April, and sandwiches and salads were withdrawn on 25 May. When were Ministers informed, and what action was taken?
I am grateful that the Secretary of State listed the other hospital trusts affected, which include the one in my Leicester constituency. As I understand it, the Good Food Chain was supplying sandwiches to 43 trusts. Can he tell us the status of investigations or what investigations have gone on in the other trusts that he has not listed today? Does he expect cases to emerge in more trusts, and what action is currently under way to contain the spread?
What advice has the Secretary of State received from officials that microbiological controls for listeria need to be improved with respect to pre-packaged sandwiches? Will he consider introducing mandatory testing on all batches of high-risk food? Of course, this is not the first time that there has been a listeria outbreak. There was an outbreak back in 2016, and in response, the Food Standards Agency investigated and issued a report warning Ministers of the dangers posed by pre-packed sandwiches. Can he outline what measures were taken by Ministers in response to that report in 2016?
I have been speaking to hospital catering staff in recent days, and they raised concerns that tight finances and years of capital cuts have left kitchens substandard, which has driven a move to greater outsourcing of catering, with sandwiches and soups steadily replacing hot meals. Recent data show some hospitals spending less than £3 per patient per day. Does the Secretary of State agree that the review he has announced today should be backed up by investment in hospital catering facilities and legally backed, clear minimum-quality standards for hospital food? Healthcare is not just about medicine, surgery, bandages and procedures; it is about nutrition and hydration too. Patients will need urgent reassurance. Can he provide that today?
Matt Hancock
The shadow Secretary of State raises important questions, and I will try to address them all. Ultimately, I strongly agree with him that this is about standards of care. People deserve to be able to trust that the food they eat and are given in hospital is safe and, indeed, nutritious and good for their health—that is an important part of this too. Clearly, the most acute aspect of what we are discussing is safety and the lack of listeria in food, but it is part of a much bigger picture, which is why we are having a root-and-branch review.
The hon. Gentleman asked about the hospital food plan, which NHS Improvement has been leading. The review will be wider than, but will encompass, some of the existing work that is ongoing. It is about not only how food is procured by hospitals, but the quality of food. Work on the national standards in hospital food is important. It has been ongoing for several years and will come to fruition very soon. More broadly, dozens of hospital trusts have brought their catering in-house and found that they get better quality food that is more likely to be locally produced and is better value for money. We will be examining that model closely, because I am very attracted to it, and it has the potential to reduce the risk of safety concerns such as this.
The hon. Gentleman asked about timings. The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for South Ribble (Seema Kennedy), was made aware of this outbreak on 4 June. I was informed on 6 June, and we published the details of the outbreak on 7 June.
Before that, Public Health England very swiftly identified that there was a link between these particular listeria outbreaks. It is only because of recent advances in genomic medicine and testing that we could work out—that Public Health England could work out—that the outbreak in Liverpool and the outbreak in Manchester were connected, and therefore identify that the source was outside those hospitals, rather than inside the hospitals, and that is what then identified that this was from the food source. The truth is that there are just over 150 listeria cases a year. It is a notifiable disease, so we are confident that we are properly notified of the various cases. Frankly, it was cutting-edge work by Public Health England that allowed us to connect these different cases and work out that a single source was causing these deaths.
The hon. Gentleman mentioned the 43 trusts that we know bought from the Good Food Chain. We have of course been in contact with all hospital trusts, whether or not they bought from this individual company, to try to make sure that we have confidence in their supplies. The Good Food Chain has confirmed that it has followed advice and has disposed of all products. That is what the Good Food Chain company has said to us, but we are of course reconfirming that with the trusts because we want to get this right.
Finally, the hon. Gentleman asked about investment in food and catering facilities. The truth is that it is important to have the best-quality food in hospitals. I am completely open to upgrading hospital equipment if that is what is necessary, and if it provides value for money. I have been struck by the number of hospital chief executives who have said that from the point of view of patient satisfaction, staff morale, and nutrition and the quality of food, bringing such food supplies in-house is the best thing they have done.
Sir William Cash (Stone) (Con)
The Secretary of State will be aware that in my constituency of Stone, where the Good Food Chain is situated, there is obviously very deep concern, not least because we had the horrendous Mid Staffs hospital crisis. I had to campaign on that against the Labour Government’s refusal to give a full public inquiry, which our Government did give.
Having said that, is it not the case that the Good Food Chain is only responsible for the products that the patients consumed, and that the bacteria came from another company, which I am given to understand is called North Country Cooked Meats in Salford? I do commend Public Health England and the Secretary of State for the rapid way in which they identified the connections between these different places. Whereas it is absolutely essential that we have the root and branch review the Secretary of State has provided, is it not also the case that while the companies concerned will have to accept responsibility as far as it falls on them, at the same time there are really important reasons to identify exactly what did happen—where the food was contaminated, how it was contaminated—and then to exonerate the Good Food Chain, if in fact that is the case, because it is very unfair for companies to be caught up in something when it was not entirely their fault?
Matt Hancock
My right hon. Friend—[Interruption.] Not yet. My hon. Friend rightly raises the question of the supply chain, and it is true that the food in question came from North Country Cooked Meats. In turn, we are trying to identify the suppliers to North Country Cooked Meats to get to the real root of this outbreak. He is quite right to identify that this is a supply chain issue, and that there is a complex supply chain in operation.
I join my hon. Friend in commending the work of Public Health England. Within days, it spotted the links between individual cases and, from a local incident, made this into a national incident. At the appropriate moment, it raised the issue with the chief medical officer and with Ministers in the Department, and we could then explain the problem to the public. Its work has identified the problem, and undoubtedly it has potentially saved lives.
Mr Speaker
I hope the hon. Member for Stone (Sir William Cash) will not be saddened by the fact that he is not yet a member of the Privy Council. After all, he is a Staffordshire knight, he has served his constituency without interruption in this House for 35 years, and I remind the House that the hon. Gentleman has a whole chapter named after him in the late Hugo Young’s estimable tome on Britain’s relationship with Europe. There is a chapter in the name of Mr Bill Cash.
Dr Philippa Whitford (Central Ayrshire) (SNP)
I, too, would like to express our sympathies with the families of the five patients who lost their lives, but also the four who remain critically ill. Obviously, we do not know what outcome they face.
As the shadow health spokesperson highlighted, these sandwiches were sold to 43 trusts, and while there have been no cases since 25 May, the incubation period of listeriosis is 70 days, so will surveillance of those 43 trusts continue alongside the Health Secretary’s investigation?
The Food Standards Agency published a report in 2014 about the dangers of hospital food. It cited 32 failures, including sandwiches spending hours outside fridges, and fridges often not being cold enough. Indeed, it has been highlighted that hospital sandwiches have been the commonest source of listeria outbreaks over the past two decades.
As the Health Secretary says, simple cases are often a matter of people being unwell for a few days, but listeria poses a major threat to pregnant women, who may lose their child, and is life-threatening for people who are already ill. Will the Health Secretary therefore pay particular attention in his review to why on earth people who were seriously ill or frail were being fed sandwiches? Someone who has no appetite and is recovering from illness is simply not going to be tempted by a pack of sandwiches. That really makes the case for bringing food preparation in-hospital and producing tempting meals, because nutrition is critical to recovery.
Matt Hancock
I entirely agree with and endorse what the hon. Lady has said. She is quite right to point out that a meal has to be appetising as well as nutritious. The best hospitals deliver that, and I would like that practice to be much more widespread.
I reassure the hon. Lady that the 2014 report by the Food Standards Agency was, as I understand it, looked into in great detail and assurances have been made that what it raised has, correctly, been followed through. Obviously, that was before my time as Health Secretary but I have taken advice on precisely the point she raises and I have been assured that what was necessary happened. I am open-minded, however, on what may have happened and what more needs to be done, and the review will absolutely look into that question.
Finally, the hon. Lady is absolutely right about the incubation period. We remain vigilant. Because listeria is a notifiable disease, Public Health England is told of every case and is able to analyse the links from every new case to existing cases. Notification of most cases takes place after the fact, given the nature of the disease, but we are then able to find genetic links, where they exist, and find out whether different cases have the same source.
Damian Green (Ashford) (Con)
As my right hon. Friend said in his opening remarks, one of the cases took place at the William Harvey Hospital in my constituency, and my constituent Tanya Marston, who is, happily, recovering from listeria, says that there should be a very urgent inquiry, so I welcome the announcement that my right hon. Friend has made today. On the specific safety aspect, however, rather than the wider inquiry on nutrition, what is the timescale for coming to some kind of conclusion so that people can be reassured that hospital food is safe?
Matt Hancock
I am grateful to my right hon. Friend and erstwhile campaign manager for his question. I am glad to hear that the patient who is his constituent is recovering. I am informed that all patients are either stable or have recovered, but for the five who tragically died. On the timescale, the urgent task at hand is to ensure that there are no further cases and that there is no more of the food that we know has the potential to cause problems in the food supply chain. That is what is going on right now. The timescale for the review will be a matter of months.
Lucy Powell (Manchester Central) (Lab/Co-op)
As the Secretary of State knows, two of the tragic deaths occurred at Manchester Royal Infirmary. Our hearts go out to the families. Nothing could be worse than going to hospital poorly and trying to get better, and then dying because of a sandwich provided by the hospital to aid recovery. Like the Secretary of State, I want to pay tribute to Public Health England and the Manchester Royal Infirmary for acting so quickly in identifying the source and closing it down. As others have said, however, there are some wider questions. First, we need a bit more transparency. It is only today that we have learnt which other trusts have been affected. The what, the why and the how—there are still many questions we do not know the answer to. On food outsourcing, I welcome the review he identifies today, but surely we have to be a lot firmer in identifying that the growth in outsourcing food supplies is leading to some real safety issues and, potentially, to deaths.
Matt Hancock
I agree with the hon. Lady on the need for food to be produced in-house whenever possible, especially as the evidence from some of the best hospitals in the country is that it is also very good value for money. There really is no case for not doing that and I look forward to best practice spreading across the NHS. I will, like her, do what I can to make that happen. She asks about transparency. I made it clear that there are hospitals trusts where further information needs to be published. There is a need to tell patients first, which is why the information has come out at the pace that is has. That duty of candour is important, but of course the review will lead to full transparency. All that everybody wants to do is get to the bottom of this and learn lessons for the future.
Sir Peter Bottomley (Worthing West) (Con)
May I join those who have praised Public Health England? Not every hospital involved has necessarily had fatalities or major problems, but it was very important that Public Health England notified all those who might have been supplied by the same people. May I put it to the Secretary of State that we should not just think that there was one cause of listeriosis? It can come from processed vegetables, processed meats, ice cream and other things. May I ask him to recommend to everyone that people try to ensure there is safe handling, safe cooking and safe consumption to reduce the risk of cross-contamination? When an outbreak happens, that is the way, as well as through the work of Public Health England, that people can help to ensure it does not affect them.
Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)
What is happening in hospitals? Surely we should be role-modelling fresh and healthy produce? Giving people packaged produce, including sandwiches, to eat gives them the wrong message about health and rehabilitation. Surely we should be role-modelling correct behavioural choices at every opportunity when somebody goes into hospital? Will the Secretary of State speak to the Government’s behavioural insights team to consider taking that forward? In my experience, kitchens in hospitals do exist. If he looks deeply into the issue, he will find that staff and visitors often have restaurants in hospitals. However, fresh food from those restaurants is not always made available to patients. We need to tackle and stop that inequality, particularly when patients are fragile, frail and elderly.
Matt Hancock
I will happily look into the last point for the hon. Lady. She is absolutely right that a hospital should be a role model of fresh and healthy food, because after all, what is a hospital but a place to try to make us all healthy?
Maria Caulfield (Lewes) (Con)
Although there is no evidence that cost is behind the tragic cases that we have heard about, will the Secretary of State look in his root-and-branch review at the price that hospitals are paying for food? Spending £1 per meal is not enough for a healthy, nutritious meal for patients. Some trusts are spending less than £5 a day on a patient’s food. Will he also look at legislating for safe staffing levels, so that there are enough nurses on wards to feed patients? About a third of patients are eating less than half the food that is served to them and are suffering from malnutrition. Will he look at both those issues to improve patient safety?
Matt Hancock
Making sure that there are enough nurses on wards is incredibly important for delivering good patient care not just in relation to food, but more broadly. My hon. Friend raises the question of price per meal. It is interesting that the hospitals that have brought food production in-house and source not necessarily locally distributed food but locally produced food, have often found that that reduces costs rather than raises them. This is a question not of resources, but of good practice.
Nigel Huddleston (Mid Worcestershire) (Con)
I welcome the announcement of the root-and-branch review and I know that patient safety continues to be a top priority for the Secretary of State, but can he reassure me and my constituents that the overall risk of listeriosis remains low?
Matt Hancock
Yes, of course. Millions of meals are served in NHS hospitals each year. While we regret any death, especially a death that could have been avoided, the overall food in hospitals absolutely is safe.
Mr Philip Hollobone (Kettering) (Con)
The NHS is a pioneer of and, increasingly, an international authority on the new science of genomics. Will the Minister confirm that without this NHS expertise, the source of the outbreak would not have been identified nearly as quickly and that we could well have been looking at far more deaths than in fact occurred?
Matt Hancock
My hon. Friend makes an incredibly important point—even more than he says. Without genomics, which the UK is the world leader in, it would have been impossible to link the different listeria deaths. They would have looked like individual cases in separate, individual hospitals. It is only because through genomics it could be worked out that the exact strain of listeria was the same in cases in different hospitals that we could then work out that there must have been a factor at work that was not internal to the hospital. When it was then identified that the food provider provided food to many different hospitals, that link could be made, too. Science and scientific progress are saving lives here.
Health
Matt Hancock Excerpts(4 years, 12 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Secretary of State for Health and Social Care (Matt Hancock)
It is a great pleasure to respond to this Opposition day debate on health. It is worth saying at the start that, for all we have heard from the hon. Member for Leicester South (Jonathan Ashworth), today’s debate gives the House the chance to discuss the record £33.9 billion of extra funding that we are putting into health services in the UK, how we are going to spend that money and what we will do to improve the nation’s health.
I will respond to the many points that the hon. Gentleman made and explain why it is important to look at the facts when debating these things, but let me start by being crystal clear about what he is trying to do. This debate should start from a point of welcoming the record investment that is going into the NHS. Instead, all we get is Opposition Members talking down the NHS. I will get on to the details but, before I do, let us remember why we can put £33.9 billion extra into the NHS. It is because we have a strong economy, with record employment, not through increasing the tax that people pay, but by having more people in work paying income tax. [Interruption.] I hear those on the Opposition Front Bench say “No”, but just this morning we have seen record numbers of jobs—yet again, record numbers of women in work and record numbers across the board—which means that we can have this money.
It was Gordon Brown who said, “When you lose control of the public finances, it’s the most vulnerable who pay the price”. It is certainly true that we have had to do a big job of fixing the public finances, but now we are able to put in this record investment to be able to make sure that the NHS is always there in the future.
Anna Soubry (Broxtowe) (Change UK)
I am grateful that the right hon. Gentleman has confirmed that this investment in the NHS, which we should all welcome, is as a result of an improvement in our economy and has absolutely nothing to do with what was written on the side of a bus. In other words, whether or not we leave the European Union, does he agree that this money is guaranteed to go to the NHS and it has nothing to do with Brexit?
Matt Hancock
Yes. We can only fund a stronger health service and we can only fund strong public services if we have a strong economy and that would be put at risk by the recklessness of the Labour party. Let us talk about the details of how we are going to improve healthcare in this country, but let us say first and foremost that we can fund public services only if we can ensure that the economy is run well.
Debbie Abrahams (Oldham East and Saddleworth) (Lab)
Would the Secretary of State like to address the issues that my hon. Friend the Member for Leicester South (Jonathan Ashworth) raised? We are seeing a flatlining of life expectancy, with the infant mortality rate having increased for the first time in 100 years. Will he address that in his response, please?
Matt Hancock
As I have said, I will come on to the details because there is undoubtedly work to do. Normally, we work on these issues in a fairly non-partisan way across the aisle. If we take tackling the problems of children of alcoholics, the hon. Member for Leicester South and I have worked together on that, and I pay tribute to the work he has done. In fact, he normally comes to this Chamber—as he did yesterday, for instance—in a spirit of discussion and objectivity to try to improve the health of our constituents. He is normally an extremely reasonable man. He is a very nice man. I know that he agrees far more with me than he does with his own party leader. Generally, he takes the approach of being constructive. I accept, and we accept, that improvements need to be made and we on this side of the House are determined to make those improvements, but we have to start from a basis of objective fact.
Rebecca Pow (Taunton Deane) (Con)
The Secretary of State is making a really powerful case. On mortality, I would say that, far from the age going down in Somerset, it is going up. This is a good thing, but the conditions from which people are suffering are getting more complex. This is something we have to address. Indeed, I know the Government are seriously looking at it with many of the models they are bringing in.
Matt Hancock
I will give way in a moment, if I may just make a bit of progress.
Of course extending healthy life expectancies is a central goal of the Government, and we will move heaven and earth to make it happen. Yes, that does involve ensuring that the entire budget of the NHS—not just the public health budget, important though it is, but the entire budget of the NHS—and all those who work in it are focused more on preventing ill health. The entire long-term plan of the NHS, which sets out how we are going to spend all the extra taxpayers’ money that is going in, is about focusing the entire NHS more on prevention than on cure. To choose just to look at the public health grant—it is important, but it is smaller by far than the entire budget of the NHS—is entirely to miss the point.
Clive Efford
The right hon. Gentleman must accept that it is not acceptable that, in the fifth richest economy in the world, life expectancy has flatlined across the country and in some areas has actually gone backwards. Is that not an indication that wider policy approaches by this Government than just those on health are not working?
Matt Hancock
It is true that across the western world the incredible rise in life expectancy is continuing but the rate of improvement has slowed. Our task here is to ensure that we extend healthy life expectancies.
Matt Hancock
I have taken the hon. Gentleman’s point. That is the purpose of the entire prevention agenda: to help people to stay healthy in the first place.
Let me give a few examples. The hon. Member for Leicester South talked about deaths of despair, and each one of those suicides is a preventable tragedy, but he did not mention that the suicide rate in this country is the lowest it has been in seven years. We should be celebrating that while also resolving to drive it down further. Similarly, he talked about some of the sexually transmitted infections that are rising around the world, including in America, France and Belgium, but he did not mention that STIs overall are down. Indeed, HIV is down very significantly, and the UK is one of the leading countries in tackling HIV. It is important to look at the objective facts and not just pick out some. Of course there are STIs that we must tackle, and we will, but we must look at the overall picture. I will give one more objective fact: the number of attendances at sexual health clinics has gone up. That is one of the reasons why STIs overall are down.
Neil Coyle (Bermondsey and Old Southwark) (Lab)
When will the Secretary of State meet his commitment to expand the PrEP—pre-exposure prophylaxis—impact trial? He made that commitment some time ago but it has still not been delivered.
Matt Hancock
Yes, I have made that commitment and we have made that available. The NHS is doing its part but some local authorities have not yet chosen to make that available and, because sexual health services are delivered through local authorities, I cannot direct that to happen. What I can do is ensure that I play my part, and I have.
Neil Coyle
I thank the Secretary of State for giving way again; he is being generous. The bottom line here is that there are men who have contracted HIV as a direct result of PrEP not being available. He must get a grip on the situation because he cannot keep passing the buck to local councils. He does have the resources and it is his commitment.
Matt Hancock
We have made those resources available. The resources from the NHS to make PrEP available have been put forward. I find it deeply frustrating that in many areas that has not yet been delivered by local councils. We are working with local councils and urging them to take up the offer that is already available from the NHS. I totally understand and share the hon. Gentleman’s frustration. We are working to push local authorities to do this, but responsibility for public and sexual health services was transferred to local councils, as a result of a decision taken by this House. I am doing my part. I would love to work with him to ensure that it can actually be delivered on the ground because he is absolutely right that it is the right thing to do and the right direction to go in.
Rushanara Ali (Bethnal Green and Bow) (Lab)
The objective fact is that the public health grant has gone down by £700 million between 2014-15 and 2019-20. If a person gets on the tube at Westminster station and travels to Whitechapel station in my constituency, average life expectancy drops by six months at every stop. That is the reality in constituencies such as mine. My appeal to the Secretary of State, if he is serious about tackling health inequalities, is to back local authorities with the resources they need.
Matt Hancock
The public health grant is of course an important part of this, but it is only one part. The overall funding of the NHS is rising by £33.9 billion, the first £6.2 billion of which came on stream last month. I understand the hon. Lady’s point. That is on the money. On the health inequalities, I entirely agree with her that they should be tackled. Doing so is at the heart of the NHS long-term plan. It is a vital task that we do not shirk. Indeed, we embrace it and are addressing it.
Let me turn to the details of the motion. While I care deeply about making sure that we have the best possible health in this nation and the strongest possible NHS—and we are prepared to put the resources in to see that happen—I also care about good governance of the nation. The way that we are run is one of the reasons this country has been strong over generations, and I believe that using the Humble Address to undermine the ability of experts, clinicians, and civil servants to give me the benefit of their frank and wise advice not only undermines me as Secretary of State, but makes it harder to make good decisions. I know the shadow Secretary of State sits on the Front Bench with revolutionaries, but I thought he was a grown-up. I do not know what his mentor, Lord Mandelson, would make of his posturing today. Of course, we will object to the motion and, if he searched the depths of his heart, he would too.
The hon. Gentleman has obviously had a missive from the Leader of the Opposition’s office—LOTO, as it is called—telling him to present the Humble Address, but it is not his style. I hope that we can get back to debating these issues on a proper motion in the future. I respect and like the hon. Gentleman: he is a really nice guy. If he had asked for the information directly—perhaps he could have sent me a message on the app—
Matt Hancock
Now that is an insult! There are only two types of people in the world—the people who are on the Matt Hancock app and the people who are not on the Matt Hancock app yet. I can see that the hon. Gentleman falls into the latter category. I digress.
If the hon. Gentleman had asked for the information directly, I would have been more than happy to provide it. To show willingness, I am happy to provide the House with the information requested in the motion. We will republish the impact assessments on the public health grant. They have already been published, but I am happy to do that. We will republish the Office for National Statistics stats and the Public Health England report on life expectancy. We will publish a statement on the “Agenda for Change” decision that he mentioned. It had been released already this week, as it happens, before we saw the motion.
If the hon. Gentleman wants to know about the “Agenda for Change” pay rises, I am delighted to keep talking about them. Perhaps he should ask the 1 million NHS staff who last month received a pay rise of up to 29%, including £2,000 extra a year for new full-time nurses. That came into force at the start of last month. I will debate with him the “Agenda for Change” pay rises any day of the week. Because the Government are running a strong economy, we can afford to put the money in to make sure that under “Agenda for Change” nurses get the pay rise they deserve.
Jonathan Ashworth
I am delighted that the Secretary of State wants me to join his Make Matt Hancock Great Again WhatsApp group. Please add me to it. Perhaps in the group I can get some style tips from him, because he looked rather Alan Partridge-esque in the photos on Friday. I digress.
On Agenda for Change, it was reported in the Health Service Journal that the Government will not honour the pay rise for public health staff such as health visitors, sexual health staff and school nurses—all the sort of staff we have been talking about this afternoon—and that there was a dispute between NHS England and the sector about who will fund that £50 million pay rise. Is he telling us today that the Government will honour that pay rise for public health staff working in public health services?
Matt Hancock
We are honouring the pay rise proposed—of course we are. I love the HSJ, which is an absolutely terrific journal, but it was wide of the mark on that. We are putting in record funding.
John Redwood (Wokingham) (Con)
The Secretary of State has done well in getting the extra money that the NHS needs. Will he briefly summarise what extra service and capacity we will get for that money? It is important to spend it wisely.
Matt Hancock
My right hon. Friend anticipates my very next point. It is important to get value for the extra taxpayers’ money we put in. I always try to refer to it as taxpayers’ money, because there is no Government money or NHS money. Every single penny we put into the NHS—rightly, in my view—comes from the taxes that people pay, and it should be treated with the respect that that deserves.
Geraint Davies
The thesis of a strong NHS is based on a strong economy, yet will he accept that under this Government since 2010 overall debt has gone from 45% of GDP to nearly 90% of GDP? It is not about tax; it is just borrowed money from a failing economy.
Matt Hancock
No. I agree with the hon. Gentleman about the importance of clean air, but I gently point out that dealing with the deficit—the annual amount by which the Government was overspending—is, and must be, the precursor to getting the debt down. Now, thankfully, the debt is falling relative to the economy, but there has been an awful lot of hard work to get us there.
Let us look at some of the things the NHS is delivering. The entire population now has access to evening and weekend GP appointments. More than a million GP appointments a month are now booked online, and consultation increasingly takes place online. More than three million repeat prescriptions are done online. There are more than 2 million more operations a year than in 2010, and we see 11.5 million more out-patient appointments than in 2010. Since last year, more than 500 extra beds a day have been freed up in hospitals.
When it comes to the future, only yesterday we announced that a new treatment aid for brain cancer can be rolled out across the country, benefiting up to 2,000 patients, all because of the extra money we are putting in. My right hon. Friend the Member for Wokingham (John Redwood) is quite right that in return for the extra taxpayers’ money we are putting in, we must get extra out, too.
Dr Paul Williams (Stockton South) (Lab)
Extra investment in the NHS is welcome, but when will the Secretary of State start talking about health visitors, school nurses, drug treatment services and other services funded out of the public health grant—the topic of the debate?
Matt Hancock
The public health grant is settled in the spending review. The NHS settlement has come before the spending review, and the public health grant is only one part of the approach to public health. In 2015, this House agreed, with broad acceptance across parties—I know the hon. Gentleman was not in the House then—that local authorities should take responsibilities for public health, to ensure that the entirety of local authority activity could be focused on better public health.
Public health is not just what happens in the NHS, with councils or in GP surgeries or hospitals. For instance, the Government have taken a global lead in getting social media companies to remove suicide and self-harm content online because of the danger that poses to people’s mental health, and in particular that of children and young people. That is a public health issue. Likewise, the efforts we are making to reduce air pollution in the environment Bill—a broader piece of legislation than just a clean air Act—are about a public health matter. It is not in the public health grant, but it is a public health matter.
Anna Soubry
As a former Public Health Minister, I understand the huge remit of what we call public health. The Secretary of State is right that we should invest more in prevention, particularly with regard to certain diseases and conditions, but the real concern about the Government’s plan is that, while that is happening, all the other important services not in the “prevention is better than cure” envelope, such as sexual health and the treatment of alcohol and smoking, delivered at a local level, will be cut in real terms.
Matt Hancock
I respect the right hon. Lady’s work as Public Health Minister—she was excellent in that role—and I was going to turn to this point. It is very important that we understand the base we are starting from, but we also have the spending review, in which these budgets will be settled, and that is clearly an important cross-Government question that we will be addressing in the coming months.
Smoking cessation services have been mentioned. Now, the smoking rate has fallen since 2010 from 20.1% of the population to 14.9%, which is excellent, although it is part of a fall over a generation, not just the last 10 years. Likewise, the drug use rate has fallen from over 10% to 8.5%. We have to provide the services for those we still need to get off smoking and to support people to stop using drugs, but the number of people smoking and using drugs has fallen too.
On clean air, the World Health Organisation has called the clean air strategy we published an example for the rest of the world to follow, so I think in this area the necessary action we are taking should be being welcomed across this Chamber.
Geraint Davies
I know the Secretary of State accepts that the environment Bill is the vehicle to deliver cleaner air, but is he aware that, as it stands, it does not include indoor air quality? Given that we spend 90% of our time inside and that the medical research now shows a cocktail effect of outdoor dirty air conflating with indoor air that has poisons in it—from sprays, cleaning products, chemicals in furniture and all the rest—if we are to properly tackle the problem of dirty air causing 64,000 deaths a year, indoor air quality has to be included in the environment Bill. Will he press the Secretary of State for the Environment, Food and Rural Affairs to ensure that it is?
Matt Hancock
The Secretary of State for Environment, Food and Rural Affairs and I are working incredibly closely on this because clean air is a public health matter. The challenge is that, although measuring outdoor air quality is essentially a public matter and in public buildings it may well be a public matter, inside most people’s homes it is far harder to make a direct intervention, but I accept the premise of the hon. Gentleman’s point. It may be something we can look at in public spaces. [Interruption.] He mentions schools and hospitals. I accept the premise of that point and I think it is something we can take away. The same is true inside vehicles, but that is a wider question.
Anna Soubry
I want to come back to the Secretary of State’s answer to my intervention. I am worried because, if I may say so, it is rather simplistic to say—I think this is what he said—that because the levels are falling we can accordingly reduce the amount of money being spent on those services. I would suggest that he listen to the experts and the evidence, because I suspect they will say that we must continue to invest to make sure those reductions continue and to take account of any eventualities. Police spending is a good example of how Government can cut too far.
Matt Hancock
I am glad I took that intervention because that was not the intention I was trying to convey at all. We need to do more to tackle smoking, and we will, and we need to continue to tackle the abuse of drugs, and we will. My argument is that this House decided that public health was better delivered through a broad approach by local councils working with the NHS than separately. On sexual health services, I gently say that many such services—for instance, the provision of PrEP—are preventive, not just reactive. However, the boundary between what is prevention and what is cure in sexual health services is, by nature, more complicated.
Nick Smith (Blaenau Gwent) (Lab)
May I take up that issue of prevention? Earlier this afternoon, the Secretary of State said that he would move heaven and earth to achieve healthy outcomes. When will we see a ban on junk food advertising before the watershed?
Matt Hancock
We have not discussed obesity much during this debate, but the Government have a whole programme to tackle it. That includes tackling advertising and, in particular, tackling the pro-obesity environment in which too many children grow up. There is a broad range of actions on our agenda, with more to come.
Rachael Maskell (York Central) (Lab/Co-op)
Will the Secretary of State give way?
Matt Hancock
I will give way one final time, but I want to leave some time for Back-Bench speeches.
Rachael Maskell
The Secretary of State has boasted about the amount of money that is going into the NHS, but the Government have transferred public health services to local authorities, whose funding is being slashed, and as a result funding for those services is also being cut. Can the Secretary of State say how much of that NHS money will support the role of local authorities in delivering the public health agenda?
Matt Hancock
Local authorities and the NHS work very closely in delivering a huge number of services, and authorities often commission services back from the NHS. I can tell the hon. Lady that between 2013 and 2017, the number of attendances at sexual health centres increased by 13%. The suggestion made by many Opposition Members that there has been a cut in the number of such attendances is not supported by the facts.
We will not rest until we can solve these problems.
Matt Hancock
We are putting money in, and we are putting commitment in. The NHS was proposed from this Dispatch Box by a Conservative Minister, under a Conservative Prime Minister, and its expansion has been overseen by Conservative Governments for most of its 71-year history.
Madam Deputy Speaker (Dame Eleanor Laing)
Order. The Secretary of State is not giving way, and we are running out of time.
Matt Hancock
Once again, a Conservative Government are expanding the NHS and planning for the future to ensure that it will always be there for us, with a record £33.9 billion investment and a focus on preventing ill health in the first place. I believe that, from the bottom of our hearts, we all know that we need to deliver.
Several hon. Members rose—