Mental Health Act: Independent Review (Final Report)
Matt Hancock Excerpts(5 years, 5 months ago)
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The Secretary of State for Health and Social Care (Matt Hancock)
“Modernising the Mental Health Act: Increasing choice, reducing compulsion”, the final report of the independent review of the Mental Health Act, has been published today.
The Government committed in their manifesto to reform mental health legislation. As a first step towards this, the Prime Minister asked Professor Sir Simon Wessely to chair a full and independent review of the Mental Health Act 1983. We welcome this report, and would like to thank Sir Simon and his vice chairs for their achievement in setting out a set of recommendations that have the overall purpose of increasing patient rights and improving the way the Act works for people.
I can confirm that the Government will consider the report and its recommendations in detail, and will respond in due course. Our intention remains to reform mental health law and so the Government will develop and bring forward legislation when parliamentary time allows.
I can today accept two of the report’s recommendations, which both highlight the review’s focus on increasing the rights and autonomy of patients:
the establishment of new statutory advance choice documents (ACDs), so that people’s wishes and preferences can carry far more legal weight. These would enable people to express preferences on their care and treatment, to help ensure that these preferences are considered by clinicians, even when the person may be too ill to express themselves.
ensuring that people have a say in which relative has power to act for them, through the creation of a new role of nominated person, to be chosen by the patient, rather than allocated to them from a list of relatives. This person would have enhanced powers in their role; both to be informed about the person’s detention in hospital and to be involved in decisions made about their care.
The report is available at:
https://www.gov.uk/government/groups/independent-review-of-the-mental-health-act.
I have deposited a copy of the report in the Libraries of both Houses.
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Oral Answers to Questions
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Michael Tomlinson (Mid Dorset and North Poole) (Con)
The Secretary of State for Health and Social Care (Matt Hancock)
Community pharmacies play a vital role in our health service, but we know they can do more, and we are determined to see them do more, to keep people healthy.
Michael Tomlinson
I am grateful to the Secretary of State for that answer, because he is absolutely right in what he says. The Dorset Local Pharmaceutical Committee is very active and is promoting the policy of Pharmacy First, which should help to relieve pressure on our general practitioners, and even on our accident and emergency facilities. What is he doing to support that policy?
Matt Hancock
I agree very much with my hon. Friend that pharmacies can play an increasing role in helping to make sure that people get their healthcare where they need it, and in keeping the pressure off GPs and off secondary care by making sure that people can help themselves to stay healthy. We are piloting 111 directing people to pharmacies as well as to GPs and, where appropriate, to secondary care, and encouraging people to use pharmacies for minor ailments, but there is much more we can do together on this.
Julie Cooper (Burnley) (Lab)
The NHS Confederation has warned that, following Brexit, the supply of some medicines and medical technologies may be delayed in reaching patients, and some may not be available at all. The chief executive officer of the Association of the British Pharmaceutical Industry has been clear that we cannot stockpile the amounts we are going to need, because we do not have sufficient cold warehouse storage. The Medicines and Healthcare Products Regulatory Agency is worried therefore that diabetics will not be able to access insulin. What steps is the Minister taking to ensure that community pharmacies are able to supply vital medical supplies post Brexit, particularly in the event of no deal?
Matt Hancock
Community pharmacies, like everybody else, should support the Prime Minister’s deal, which will make sure that that eventuality does not occur.
Emma Hardy (Kingston upon Hull West and Hessle) (Lab)
The Secretary of State for Health and Social Care (Matt Hancock)
Prevention is indeed better than cure. As well as having a right to expect NHS services to be free at the point of use, we all have responsibility for our own health, and to use the NHS responsibly.
Jim Shannon
I recently met Breast Cancer Now—the Secretary of State will be aware of it. It has 10 priorities for the NHS long-term plan. Has he made an assessment of the impact of the real-terms 5% cut in public health budgets on reducing the incidence of cancer?
Matt Hancock
There are many things we need to do to diagnose cancer early, and of course public health is part of that, but there is a much bigger agenda, and that includes more screening. We have seen an increase in the number of people invited to screening, but we need to get the screening right, so I have instituted a review of all our screening processes for cancer and other diseases.
Robert Neill
Will my right hon. Friend look at the work done by Connect Well Bromley, a partnership funded by the local clinical commissioning group but delivered by Bromley Third Sector Enterprise and Community Links Bromley? That partnership sets out what is in effect a social prescribing programme of activities and services to deal with wellbeing issues at an early stage. Is that a model for elsewhere in the country?
Matt Hancock
Yes, it is. I have been briefed on the example that Bromley is setting, which has been brought to my attention by its brilliant local representative, my hon. Friend. Social prescribing systems such as this one are on the rise, because the evidence shows that social prescribing helps to keep people healthy and out of hospital.
Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)
A fortnight ago, during his statement to the House on prevention and how the Government intend to keep our nation well, the Secretary of State told me that he would look at my Health Impacts (Public Sector Duty) Bill, which had its Second Reading on Friday. Unfortunately, on Friday, the Government objected to my Bill. Which elements of the Bill did the Secretary of State object to?
Matt Hancock
I know the hon. Lady has done an awful lot of work on this, and I respect that work. We did look at the Bill, but we thought it was, unfortunately, technically deficient. I know she cares a lot about this, however, as do I, and I want to work with her to see what we can do.
Dan Jarvis (Barnsley Central) (Lab)
According to Office for National Statistics figures, over the past five years, there have been 150,000 excess winter deaths—a mortality rate twice that in Germany and Norway. What specific work is the Secretary of State doing to reduce the number of deaths this coming winter?
Matt Hancock
This year, since I became Secretary of State, we have put an extra £420 million in to make sure we are as well prepared as possible. The NHS is of course under pressure, although it is performing exceptionally well, in terms of how much it does for the money going in, and from next year, we will put in the extra £20 billion. I want part of the long-term plan to be about how we can plan for the long term, instead of having this annual cycle of winter pressures.
Tracey Crouch (Chatham and Aylesford) (Con)
Earlier this year, I had the pleasure of joining volunteer leader John Goodwin and others on a health walk around Capstone park in my constituency—one of a number of health walks supported by Medway Council. Will the Secretary of State join me in encouraging more GPs to prescribe walking as a gentle, low-impact form of exercise that is suitable for all ages and abilities?
Matt Hancock
With enthusiasm, I endorse the call from my hon. Friend, who did so much work on this at the Department for Digital, Culture, Media and Sport, both before I was in that Department and when I was Secretary of State there. She made the case brilliantly, and she continues to do so. She is absolutely right.
Stephen Gethins (North East Fife) (SNP)
Matt Hancock
Every EU worker across our health and social care system—whether in the NHS, or working in public health, in local authorities or in social care—is welcome here, and is supported to be welcome here, and we look forward to the settled status scheme rolling out. We are grateful for their service.
Theresa Villiers (Chipping Barnet) (Con)
GP appointments are vital for many to lead healthy lives, so will the Secretary of State give his strong personal support to the work of our fantastic GPs, and encourage the NHS to put general practice at the heart of the £20 billion future plan?
Matt Hancock
Yes. General practice will be at the heart of the long-term plan. GPs are the bedrock of the NHS. We will put an extra £3.5 billion, at least, into primary and community services to help keep people healthy and prevent them from going to hospital.
Jonathan Ashworth (Leicester South) (Lab/Co-op)
The Secretary of State got into a muddle last week with his GP figures, so may I suggest that he download an exciting new app to his phone? It is called a calculator. He has said that there will be more for community and primary care by 2024. Can he guarantee that there will be the extra GPs and district nurses to provide the services that he is promising?
Matt Hancock
Yes, I can; given that we have the money coming into the NHS, we are doing everything possible to ensure that we have the people to do the work. I am delighted to say that we have a record number of GPs in training right now.
Jonathan Ashworth
But GP numbers have gone down by 700 in the last year, have they not? There are 107,000 vacancies across the NHS, acute trusts are closing accident and emergency departments overnight, the closure of chemotherapy departments is being considered, and Health Education England’s training budget is the lowest that it has been for five years, with more cuts to come next year. Does the Secretary of State agree that if the long-term plan that he will publish next week is to be credible, he must reverse those training cuts and deliver the staff that our NHS needs?
Matt Hancock
That was a bit of a surprise, because the hon. Gentleman is normally such a reasonable fellow. I thought that he would welcome the record number of GPs in training, and the record number of nurses in the NHS. Because we love the NHS, of course we want to do more, and we will.
Marsha De Cordova (Battersea) (Lab)
Jack Brereton (Stoke-on-Trent South) (Con)
The Secretary of State for Health and Social Care (Matt Hancock)
We are increasing the NHS budget by £20.5 billion in real terms over the next five years. It is a major investment to make sure that the NHS is there for us all.
Jack Brereton
Royal Stoke University Hospital continues to be in financial special measures, and local clinical commissioning groups are now projecting significant overspends in their budgets. How will the Secretary of State ensure that stressed health economies such as those in Stoke-on-Trent and Staffordshire get a significant share of the additional £20.5 billion?
Matt Hancock
Clearly, part of the £20.5 billion of extra funding that taxpayers are putting into the NHS over the next five years is for ensuring that services can be put on a sustainable footing, and that includes some of the highly stressed services such as those in Stoke.
Dr Paul Williams (Stockton South) (Lab)
How do the Government plan to use funds to better identify perinatal mental health problems? Half of all women with perinatal mental health problems say that the current system does not identify their need.
Matt Hancock
I very much agree with the premise of the hon. Gentleman’s question. We need to do much more on this subject. It is incredibly important, and there will be more to hear in the long-term plan.
Mr Adrian Bailey (West Bromwich West) (Lab/Co-op)
Emma Reynolds (Wolverhampton North East) (Lab)
The Secretary of State for Health and Social Care (Matt Hancock)
The deal that the Prime Minister struck to leave the EU will ensure access to medicines and medical equipment, so it is another good reason to vote for the deal.
Matt Hancock
Well, of course, while voting for the deal is the best way to ensure the unhindered supply of medicines and medical devices, as a responsible Government we are also planning for the unlikely event of no deal, and that planning includes ensuring that we can continue to get unhindered access after the six weeks for which we are making sure that supplies are available.
Emma Reynolds
We are currently an influential member of the European Medicines Agency, which gives patients access to new medicines six months sooner than non-members. Given that the political declaration reduces us to exploring the possibility of co-operation with the EMA, will the Secretary of State admit that there are no guarantees for patients and that it is very likely that they will have to wait longer?
Matt Hancock
No, because in the event, under any circumstances, we will make sure that there are no further burdens on ensuring that medicines can get licensed here so that patients can use them, but it is another reason why the hon. Lady should vote for the deal.
Anna Soubry
Many people say that the much-heralded £20 billion extra for the NHS is some sort of Brexit dividend. In the event that our country remains in the European Union, will the Secretary of State confirm that that extra 3.4% a year will continue and that £20 billion will be made available to our NHS?
Matt Hancock
I am afraid that I will have to let my right hon. Friend know that we are leaving the European Union on 29 March.
David Tredinnick (Bosworth) (Con)
Luke Hall (Thornbury and Yate) (Con)
The Secretary of State for Health and Social Care (Matt Hancock)
This month, we launched our vision for the prevention of ill health that sets out measures to help increase life expectancy by at least five years because prevention is better than cure. We need to give people responsibility for their own health, while empowering them to make the right decisions in the right way. We are also saving more than £1 billion on the NHS drugs budget and committing more than £3.5 billion to primary and community care. Next month, we will publish the long-term plan for how we spend the extra £20 billion committed to the future of the NHS.
Luke Hall
19 November marked the three-year licence of the cystic fibrosis drug, Orkambi, in the UK, which is still not available on the NHS. Will the Secretary of State confirm whether there has been any further consideration to provide interim access to this treatment for patients, such as my constituents Annabelle Brennan and Cameron Jameson, while these negotiations continue?
Matt Hancock
The NHS and the National Institute for Health and Care Excellence have written to Vertex, the company involved. I am determined to see progress. We have made the largest ever proposal to Vertex, at half a billion pounds. It needs to engage with this very generous offer, which will mean that everyone wins, most of all those suffering from this awful condition. The ball is in Vertex’s court.
Barbara Keeley (Worsley and Eccles South) (Lab)
The learning disabilities mortality review—the LeDeR—investigated 1,000 early deaths of people with learning disabilities in hospital settings, but today major concerns have been raised by the parents of Oliver McGowan about the way in which some deaths have been investigated. The Secretary of State knows that 40 autistic people and people with learning disabilities died in assessment and treatment units, and he has called for a year-long review of the use of seclusion in ATUs. But that is not urgent action. Will he commit to stopping the use of ATUs immediately and to looking urgently at how early deaths are being investigated, particularly that of Oliver McGowan?
Matt Hancock
I can recommend to anybody spending the night with my hon. Friend in Derriford Hospital, where we learnt a huge amount. The team there were absolutely amazing and it was a brilliant experience. I also learnt a lot about the capital bid, which I have been keeping my eye on very closely. My hon. Friend should hear shortly.
Kerry McCarthy (Bristol East) (Lab)
Matt Hancock
I have a huge amount of sympathy for the hon. Lady’s point. We did act to ensure that the parties came together. The offer has been made and the response from the company has frankly not been good enough. It needs to come to the table; the ball is in its court.
Mr Philip Dunne (Ludlow) (Con)
Mr Ben Bradshaw (Exeter) (Lab)
Matt Hancock
I join the right hon. Gentleman in celebrating World Aids Day and ensuring that we redouble our commitment to making sure that we do everything we can. I will certainly look into the precise commitment that he asks for to make sure not only that it is deliverable but that we work not just here but around the world to end this scourge.
Kevin Hollinrake (Thirsk and Malton) (Con)
Everyone in this place has lost someone close to them to the terrible and terrifying disease that is cancer. How will the NHS 10-year plan help to improve detection rates?
Mrs Emma Lewell-Buck (South Shields) (Lab)
South Tyneside District Hospital recently surpassed targets for waiting times, yet this Government’s forced cuts under the guise of sustainability and transformation plans have left my constituents fundraising to fight the downgrading of key services in court next month. Why is the Secretary of State presiding over this destruction by stealth of our high-performing hospital and the NHS?
Matt Hancock
Of course, the STP proposals have to be clinically led and consulted on and discussed with local people. It is right that the allocation of services and exactly how they are configured locally is led locally, so that we can get the best services to people in Tyneside and across the country.
Tom Pursglove (Corby) (Con)
In England, over 80,000 people have a stroke each year and about 20% of them die within a year. Can my right hon. Friend reassure me, the House and my constituents in Corby and East Northamptonshire that he not only wants to drive down that figure but has a plan to do so?
Stephanie Peacock (Barnsley East) (Lab)
Despite the Government’s reassurances on the new NHS pay deal, it has left one of my constituents actually taking less money home at the end of the month and being required to pay money back. When I wrote to the Department, the Minister had the audacity to simply respond with a generic factsheet. Does he think this acceptable, and if not, will he give a meaningful reply to my constituent, who has done 30 years in the NHS?
Matt Hancock
Yes, of course. We value everybody who works in the NHS. I would love the hon. Lady to take up this individual case with me directly, and I am very happy to look into it.
Andrea Jenkyns (Morley and Outwood) (Con)
I have recently been contacted by a constituent who works as a paediatrician in a nearby hospital. Last Friday, tragically, a baby died in their ward. The cause of death is unknown. Owing to the lack of a coroner service at the weekend, the baby had to stay for three nights with breathing tubes fixed in. For the parents, these are the last memories of their child. What steps will the Minister be taking to guarantee that the seven days NHS requirement also applies to coroners and histopathologists?
Matt Hancock
My heart goes out to the parents of this child, my hon. Friend’s constituents, as I am sure it does from everybody in this House. Of course I will happily take up this individual case. But she raises the broader point, too. I am meeting the Justice Secretary on this topic to discuss what further we can do. It is technically a matter for the Ministry of Justice, but I understand entirely why we need to work together to make progress.
John Woodcock (Barrow and Furness) (Ind)
Is not the Secretary of State alarmed that fake psychiatrist Zholia Alemi was revalidated in 2013 under the supposedly strengthened revalidation process? Why did the Government not act on the findings of the Sir Keith Pearson report in January last year, which pointed out this exact weakness in the system?
Gosport Independent Panel
Matt Hancock Excerpts(5 years, 5 months ago)
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The Secretary of State for Health and Social Care (Matt Hancock)
In June this year, the Gosport Independent Panel published its report into what happened at Gosport War Memorial Hospital between 1987 and 2001. It found that 456 patients died sooner than they would have done after being given powerful opioid painkillers. As many as 200 other people may have had their lives shortened, but this could not be proved because medical records were missing.
The findings in the Gosport report are truly shocking, and we must not forget that every one of those people was a son or daughter, a mother or father, a sister or brother. I reiterate the profound and unambiguous apology on behalf of the Government and the NHS for the hurt and anguish that the families who lost loved ones have endured. These were not just preventable deaths, but deaths directly caused by the actions of others. The report is a deeply troubling account of people dying at the hands of those who were trusted to care for them. I pay tribute to the courage of the victims’ families and their local MP, my hon. Friend the Member for Gosport (Caroline Dinenage), in their work for and commitment to the truth. Without their persistence, the catalogue of failures may never have come to light.
Along with the Prime Minister, I have met Bishop James Jones, who chaired the panel. He made it absolutely clear that what happened at Gosport continues to have an impact and places a terrible burden on relatives to this day. The failures were made worse because whistleblowers were not listened to, investigations fell short and lessons failed to be learnt. We must all learn the right lessons from the panel’s report and apply them across the entire system.
As Bishop Jones writes in the report, relatives felt betrayed by those in authority and were made to feel like “troublemakers” for asking legitimate questions. The report states that
“when relatives complained about the safety of patients…they were consistently let down by those in authority—both individuals and institutions. These included the senior management of the hospital, healthcare organisations, Hampshire Constabulary, local politicians, the coronial system, the Crown Prosecution Service, the General Medical Council and the Nursing and Midwifery Council.”
The panel heard how nurses raised concerns as far back as 1988, but were ignored and sidelined. More than 100 families raised concerns over more than two decades, but they were ignored and patronised. Frail, elderly people were seen as problems to be managed, rather than patients to be helped. Perhaps the most harrowing part of the report is when it makes clear that if action had been taken when problems were first raised, hundreds fewer would have died at Gosport. People want to see that justice is done, policies are changed and that we learn the right lessons across the NHS. I will take each of those in turn.
First, on justice, between 1998 and 2010, Hampshire constabulary conducted three separate investigations. None of the investigations led to a prosecution. The panel criticised the police for their failings in the investigations and their failure to get to the truth. Families said that they felt police had not taken their concerns seriously enough or investigated fully. Because of Hampshire police’s failures, a different police force has been brought in. A new, external police team is now independently assessing the evidence and will decide whether to launch a full investigation. They must be allowed to complete that process and follow the evidence, so that justice is done. Much has improved in the NHS since the period covered by the panel’s report, but we cannot afford to be complacent. What happened at Gosport is both a warning and a challenge.
Let me turn to the reforms that have been made and the reforms that we plan to make. The Care Quality Commission has been established as an independent body that inspects all hospitals, GP surgeries and care homes to detect failings and identify what needs to be improved. We have set up the National Guardian’s Office to ensure that staff concerns are heard and addressed. Every NHS trust in England now has someone in place whom whistleblowers can speak to in confidence and without fear of being penalised. We have established NHS Improvement—a separate, dedicated organisation—to respond to failings and put things right, and the Healthcare Safety Investigation Branch now investigates safety breaches and uses them to learn lessons and spread best practice throughout the NHS.
Those are the reforms that the Government have already made, but we must go further, so motivated by this report we will bring forward new legislation that will compel NHS trusts to report annually on how concerns raised by staff have been addressed; and, we are working with our colleagues in the Department for Business, Energy and Industrial Strategy to see how we can strengthen protections for NHS whistleblowers, including changing the law and other options.
Next is the question of drug prescription. Central to the deaths at Gosport was the prescribing, dispensing and monitoring of controlled drugs. Since the period covered by the report, there have been significant changes in the way that controlled drugs are used and managed and these syringe drivers are no longer in use in the NHS. However, in the light of the panel’s findings, we are further reviewing how we can improve safety.
Further, from April next year, medical examiners will be introduced across England to ensure that every death is scrutinised by either a coroner or a medical examiner. Medical examiners are people bereaved families can talk to about their concerns to ensure that investigations take place when necessary, to help to detect and deter criminal activity and to promote good practice. The new system will be overseen by a new independent national medical examiner and training will take place to ensure a consistency of approach and a record of scrutiny.
The reforms that we have made since Gosport mean that staff can speak up with more confidence and that failings are identified earlier and responded to quicker. The reforms that we are making will mean greater transparency, stricter control of drugs and a full and thorough investigation of every hospital death. Taken together, they mean that warning signs about untypical patterns of death are more likely to be examined at the time, not 25 years later.
However, as well as these policy changes, there is a bigger change, too, which I turn to now. Just as with the reports into Mid Staffs and Morecambe Bay, the Gosport report will echo for years to come, and the culture change that these reports call for is as deep-rooted as it is vital. There has been a culture change within the NHS since Gosport, but the culture must change further still. One of the most important things that we learnt from the report is that we must create a culture where complaints are listened to and errors are learnt from, and that this must be embedded at every level in the NHS.
What happened at Gosport was not one individual error; it was a systemic failure to respond appropriately to terrible behaviour. To prevent that from happening again, we need to ensure that we respond appropriately to error—openly, honestly, taking concerns and complaints seriously and seeing them as an opportunity to learn and improve, not a need for cover-up and denial. I want to see a culture that starts by listening to patients and their relatives and by empowering staff to speak up. That starts with leaders creating a culture that is focused on learning not blaming—a culture that is less top-down and less hierarchical, with more autonomy for staff, and that is more open to challenge and change. We need to see better leadership at every level in the NHS to create that culture across the NHS.
Today marks an important moment. Lessons have been learned, will be learned and must be applied. The voices of the vulnerable will be heard. Those with the courage to speak up will be celebrated. Leaders must change the culture to learn from errors, and we must redouble our resolve to create a health service that will be a fitting testament to the Gosport patients and their families. I commend this statement to the House.
Jonathan Ashworth (Leicester South) (Lab/Co-op)
I thank the Secretary of State for an advance copy of his statement. I welcome the statement and the tone of his remarks, and I thank him for repeating the unambiguous and clear apology that the previous Secretary of State, the right hon. Member for South West Surrey (Mr Hunt), offered at the Dispatch Box before the summer—it is good to see the previous Secretary of State sitting on the Treasury Bench today.
We welcome the Secretary of State’s apology today. The whole House was shocked when the previous Secretary of State reported the findings of the Gosport inquiry to the House. This Secretary of State is right to remind us that everyone who lost a life was a son or daughter, a mother or father, a sister or brother. As he said, our thoughts are with the families of the 456 patients whose lives were shortened because of what happened at Gosport, and the families of the 200 others who may have suffered—whose lives may have been shortened; because of missing medical records, we will never know for sure. That lingering doubt—never knowing whether they were victims of what happened at Gosport—must be a particularly intolerable burden for those families affected.
Like the Secretary of State, I pay tribute to the victims’ families, who, as he says, have in the face of grief shown immense courage, fortitude and commitment to demand the truth. I think the whole House will pay tribute to them today. I also reiterate our gratitude to the former Bishop of Liverpool, James Jones, for his extraordinary dedication, persistence, compassion and leadership in uncovering this injustice. Finally, I applaud those hon. Members who played a central role in establishing this inquiry, not just the previous Secretary of State, but the right hon. Member for North Norfolk (Norman Lamb) and the Minister for Care, the hon. Member for Gosport (Caroline Dinenage), who in recent years has played an important role in her capacity as a constituency MP.
The Secretary of State is correct to say that lessons must be learned and applied across the whole system. We all understand that in the delivery of healthcare and the practice of medicine, sadly, tragically, things can and do sometimes go wrong, but we also understand, as Bishop Jones said in his report, that
“the handing over of a loved one to a hospital, to doctors and nurses is an act of trust”,
but that that trust was
“betrayed.”
I still believe that that betrayal was unforgivable. Patient safety must always be the priority, so when there are systemic failures, it is our duty to act, learn lessons and change policies.
I wish to respond to the Secretary of State’s announcements today. We welcome his commitment to legislation placing more transparency duties on trusts, and we will engage constructively with that legislation. Is it his intention to bring forward amendments to the Health Service Safety Investigations Bill, and if so when, or should we expect a new bill altogether? We look forward to his proposals on strengthening protection for whistleblowers, but he will know that the NHS has just spent £700,000 contesting the case of whistleblower Dr Chris Day, a junior doctor who raised safety concerns. He will also be aware of the British Medical Association survey showing that not even half of doctors feel they would have the confidence to raise concerns about safety. Moreover, he will be aware of how Dr Bawa-Garba’s case played out, with her personal reflections effectively used in evidence against her. Can he offer more details on how he will change the climate in the NHS so that clinicians feel they can speak out without being penalised?
I welcome the thrust of the Secretary of State’s remarks on medical examiners, and I agree they are a crucial reform, but can he offer us some more details? Is it still the Government’s intention that they will be employed directly by acute trusts? He will be aware that this has provoked questions about their independence. We would urge him to go further and base them in local authorities and extend their remit to primary care, nursing homes and mental health and community health trusts. If legislation is needed, we would work constructively with him.
We welcome the review into improving safety when prescribing and dispensing medicine. Clearly, one of the first questions that comes to mind when reading the Gosport report is: how were these prescriptions monitored? The Government’s own research indicates that more than 230 million medication errors take place a year, and it has been estimated that these errors and mix-ups could contribute to as many as 22,000 deaths a year, so this review is clearly urgent. Can the Secretary of State tell us whether it will be an independent review, who will lead it and when we can expect it to report?
Finally, patient safety is compromised when staff are overworked and overburdened with pressures. He will know that we have over 100,000 staff vacancies across the NHS. Some trusts are proposing closing A&E departments overnight because they do not have the staff, and some are even proposing closing chemotherapy wards because they believe that the lack of staffing means services are unsafe. How does the Secretary of State plan to recruit the staff our NHS desperately needs to provide the level of safe care patients deserve?
In conclusion, I offer to work constructively with the Secretary of State to improve patient safety across the NHS, and we support his statement today.
Matt Hancock
I appreciate the tone of the hon. Gentleman, who rightly focuses on the need to ensure that this never happens again, and I join him in thanking Bishop James Jones for his work on this and other inquiries. It was quite brilliant empathetic work. I also thank the right hon. Member for North Norfolk (Norman Lamb), for whom I have an awful lot of respect.
The core of the questions the hon. Gentleman raised, about the need to ensure that whistleblowers are listened to and that people are heard in the NHS, comes down to culture change. A whole series of policies underpins that culture change, and I will come to them, but ultimately it comes down to this: errors happen in medicine—it is a high-risk business—but what matters is behaviour, that everything is done to minimise errors and, when they are made, to learn from them, rather than try to cover them up. The culture change needs to be driven across the NHS. It has changed and improved in many areas, but there is still much more to do.
The hon. Gentleman asked whether amendments would be tabled to the Health Service Safety Investigations Bill or in separate legislation on whistleblowers. We are looking at both options. Partly it comes down to the technicalities of scope and the exact distinction and definition of the amendments, but I look forward to working with him on that legislation.
The hon. Gentleman asked why gagging clauses are still in use. I may well ask the very same question. They were deemed unacceptable by my predecessor—I join in the tributes to him—who did so much on this agenda. Gagging clauses have been unacceptable in the NHS since 2013. Trusts, which are independent, can legally use them, but I find them unacceptable, and I will do what it takes to stamp them out.
The hon. Gentleman said that too many people in the NHS feel unable to speak up. To ensure a route for this, we now have, in every single NHS trust, an individual separate from line management to whom staff can go to raise concerns. This is part of the culture change, but it is not the whole. Line management itself in every hospital should welcome challenge and concerns, because that is the way to improve practice. Challenges and concerns that are raised with managers should be deemed an opportunity to improve the service offered to patients, rather than a problem to be managed.
The hon. Gentleman also mentioned medication errors. Of course, this was not a case of medication error—it would have been far less bad had it been; it was a case of active mis-medication that led to deaths. Medication errors are an important issue, however, and we are bringing in e-prescribing across the board to allow much more accurate measurement, audit and analysis of medication.
Finally, the hon. Gentleman said that pressures often come from staff shortages. Again, that was emphatically not the concern here, and we absolutely must not muddle up the behaviour here with the issue of staff shortages. Nevertheless, I acknowledge the need for more staff in the NHS. Indeed, we are putting £20 billion into it over the next five years to make sure we have the people we need to deliver the NHS that everyone wants.
Dr Sarah Wollaston (Totnes) (Con)
I welcome the Secretary of State’s statement and commitment to introduce legislation to compel trusts to report on how they handle staff complaints and concerns, but will he assure the House that trusts will not be penalised if they have more staff concerns raised, because it might be an indicator that they have introduced the culture change necessary for staff to feel able to come forward? Will he also clarify how rapidly we will be rolling out the very welcome introduction of medical examiners?
Matt Hancock
My hon. Friend is absolutely right that the number of complaints and concerns raised is not the material factor. A complaint that is actively welcomed and then acted on by management is merely part of the improvement process of any organisation. We should be open to them, welcome them and see them as an important part of the continuous improvement of NHS trusts, which is how many successful organisations see them. As I set out in the statement, medical examiners will be introduced from next April, but I am happy to give her more details of that whole policy.
Dr Philippa Whitford (Central Ayrshire) (SNP)
I, too, welcome the Secretary of State’s statement and the proposals in it. As he says, these 450—possibly even 650— deaths were not accidental, but deliberate.
I welcomed the Secretary of State’s attendance at our event yesterday, when we discussed the need for a just and learning culture in the NHS. Obviously, he heard the stories that were related during the event: stories of patients who had lost their lives, and families who have ended up spending their entire lives fighting for justice or change, so they have suffered over and above their bereavement. Staff were obviously not listened to. One witness compared a whistleblower with someone reporting to the police, or a state witness, and pointed out how shocked we would be if the police tried to shut that case up. Whistleblowers should be welcomed as people giving evidence against wrongdoing or failure.
I particularly welcomed the Secretary of State’s comment about reform of the Public Interest Disclosure Act 1998, which I think needs to be replaced. I think we need legislation that gives definite protection to people who come forward. As one who has been a clinician for more than 30 years, I can tell the Secretary of State that the long trail of clinicians who have reported concerns and then had their careers ended lies there like a threat to every whistleblower who thinks of speaking up.
If patient safety and the ability of people to speak up in safety are not enshrined in the NHS, we are all under threat. I am sure that not just the hon. Member for Leicester South (Jonathan Ashworth) but Members in all parts of the House would work with the Secretary of State to reform the legislation here and inspire the culture change that is needed in the NHS itself. I certainly would.
Matt Hancock
I agree with an awful lot of what the hon. Lady has said, and I appreciate the wisdom that she brings to this issue with her clinical experience.
The need for a just culture in the NHS is very clear, and the Gosport report makes it clearer still. A just culture means that, yes, there is accountability, but the accountability is established with the intent that the system will improve and people will learn; that people can come forward with concerns rather than covering them up; and that when concerns are expressed, they are welcomed.
I am also pleased about the hon. Lady’s attitude to potential legislation. I look forward to working with her, and, indeed, learning from some of the improvements that have been made in Scotland, to try to ensure that we can get this right.
Alan Mak (Havant) (Con)
The events at Gosport are of substantial interest to my constituents in Havant and across the Solent region. I agree with the Secretary of State that lessons must be not only learned but applied. Will he confirm that ensuring patients’ safety will remain at the heart of all that the NHS does, including the development of its new 10-year plan, and will he confirm in particular that better medical records can be produced through, for instance, the use of new technologies?
Matt Hancock
Absolutely, and I pay tribute to my hon. Friend’s work. People from across the country, and certainly from across the region, were affected by this. The need for better medical records is underlined in the report. In the case of several hundred people, we do not know whether their lives were shortened or not. Of course technology has a huge part to play in this. From about 15 years ago onwards it is highly unlikely that medical records would have been lost or misplaced in this way, and therefore new technology has a role to play, but it needs to be improved so that access to those records can be made available to the right people at the right time.
Norman Lamb (North Norfolk) (LD)
I welcome the ambition in the statement for the culture change that is clearly still needed in the NHS. This is the most extraordinary scandal. The Secretary of State is right to highlight the extent to which loved ones were patronised and ignored and staff were often crushed, and how that facilitated the ongoing scandal at Gosport War Memorial Hospital. Clearly, the pursuit of justice is the most pressing priority for the relatives, given how long delayed that is, but may I specifically highlight the Secretary of State’s reference to working with the Business Secretary to establish whether reforms to the legislation are necessary? Does he agree that reformed legislation that allows staff to feel able to speak out—not just in the NHS, but in any occupation—can facilitate the very culture change that he needs so much?
Matt Hancock
Yes. I pay tribute to the right hon. Gentleman’s work, especially as a Minister in the Department, to make sure that people got to the bottom of this and that the truth was published and brought out in the way that it has been. He is right about the question of justice, but it is currently—rightly—a matter for the police, so I will go no further than that.
I strongly agree with the right hon. Gentleman that the legislative framework that we set here in Parliament leads to and underpins the culture that is critical. That is, of course, a matter for the whistleblowing legislation. There are also questions of legal liability. As the right hon. Gentleman well knows, often what patients who have been wronged—or the families of patients who have been wronged—want most of all is an apology, an explanation and a commitment that others will not be affected because the lessons will be learnt. Too often what has been offered instead is the phone number of a no-win, no-fee lawyer, and that is not the way to solve this problem.
Suella Braverman (Fareham) (Con)
I welcome the Secretary of State’s announcement and his plain and self-evident commitment to learning from this episode and righting the wrongs. The findings of the report are shocking and heartbreaking, and they affect some of my constituents whose families have suffered so much grief because of the life-shortening policy employed at Gosport War Memorial Hospital. Many of them still have questions many years on, about such matters as criminal investigations. I welcome the Secretary of State’s announcement that an external police team will be carrying out an investigation on whether to press charges, but can he provide some guidance on the timeline and whether the police can realistically expect justice to be done, and seen to be done, through the criminal courts?
Matt Hancock
My hon. Friend is right. The grief over the loss of a loved one whose life has been foreshortened is compounded if that is not acknowledged by the authorities, and we therefore acknowledge it once again today. As for the police investigation, the timings are of course a matter for the police themselves, who are rightly independent. The process currently under way is the reviewing of all the evidence to establish what and whether prosecutions should be brought forward. That will continue into the new year, and the police will then make a statement on the next stages of their investigation.
Ruth Cadbury (Brentford and Isleworth) (Lab)
On 10 October, my constituent Bridget Reeves submitted a petition with more than 100,000 signatures to the Government to trigger a parliamentary debate. Today is the anniversary of her grandmother Elsie Devine’s death at Gosport War Memorial Hospital. She died after concerns had emerged from staff at the hospital.
I thank the Secretary of State for his statement and for his commitment to addressing many of the problems that have already been identified and are emerging from the various inquiries. The families want justice, among other things, but they will not get it until the outcome of the fourth police investigation—and I welcome the fact that it is being carried out by a different police authority.
I have two questions. First, will the Secretary of State meet the families face to face? Secondly, while I acknowledge his points about concerns of culture in the NHS, I am concerned about the culture in the coroner service, in relation to not just this case but others, including one that I met constituents to discuss this morning. There is a governance issue relating to when the coroner service needs investigating in the case of some inquests. Will the Secretary of State work with the Attorney General and pick up the concerns that Members expressed about a number of inquests?
Matt Hancock
The point about coroners is a matter for the Ministry of Justice, but I am pleased to see that the Under-Secretary of State for Justice, my hon. Friend the Member for Charnwood (Edward Argar) is present. He would delighted to meet the hon. Lady to take up that point—
The Parliamentary Under-Secretary of State for Justice (Edward Argar)
indicated assent.
Matt Hancock
Yes: good.
I will, of course, be happy to meet the families, but the advice of Bishop James Jones is that that will be appropriate after this stage of the police investigation. I wrote to the families to explain the position before making my statement. It is important that we go through the process properly during the police investigation to ensure that justice can be done, but I shall be more than happy to meet the families at the appropriate moment.
Several hon. Members rose—
Mr Philip Dunne (Ludlow) (Con)
I join the cross-party support for my right hon. Friend’s statement and add my voice in commending the dedication and commitment of Bishop James Jones, who, I am pleased to say, is I think in the Chamber listening to the Government response to his report.
I am a great supporter of the National Guardian’s Office and the “freedom to speak up” guardians; in fact I am such a strong supporter that I wear its lanyard around my neck and have done ever since I was in the Health Department. But a number of people who make complaints either do not yet have sufficient confidence in these guardians or feel that their complaints are not properly addressed. There are however good examples of best practice, where some chief executives of trusts have a regular, routine meeting with guardians to make sure that complaints are brought directly to their attention. Will my right hon. Friend work with the senior leaders across the NHS and the National Guardian’s Office to ensure that best practice is used so we can give the most possible confidence to people with concerns about safety?
Matt Hancock
Yes, absolutely I am happy to do that, and I am happy to commend my hon. Friend’s lanyard, too. Ultimately culture change and having a good culture comes down to the leadership within the NHS and individual trusts. It has struck me in the four months that I have been doing this job that the trusts that have the best results in terms of outcomes for patients, waiting times and waiting lists and finances are also those that are hot on this subject; they listen to complaints and act on them, because they know that that is the way to improve their organisation. I want to see that sort of best practice right across the board.
Stephen Lloyd (Eastbourne) (LD)
Like colleagues, I welcome the Secretary of State’s statement. It was my constituent Gillian Mackenzie 21 years ago who was the first relative to raise concerns, and she has been battling ever since. She came to me 11 years ago and it was with pleasure that I introduced her and the other families to my colleague, my right hon. Friend the Member for North Norfolk (Norman Lamb). I am grateful for the changes in the health service that will hopefully prevent any such dreadful and shocking episode from happening again.
I must bring the Secretary of State back to the justice issue, however, as it is very important. I appreciate that it concerns a different Department, but the Secretary of State said in his statement that the police
“must be allowed to complete that process and follow the evidence, so that justice is done.”
A few weeks ago I had a constructive meeting with Assistant Chief Constable Downing, who is in charge of that. I would like a commitment from the Government that there will be sufficient funding for the full assessment, and, if it goes to investigation, sufficient funding in the budget for a proper investigation to be done so that relatives can get the justice they have been denied for so long.
Matt Hancock
Yes, of course that is the Government’s position, and I am very happy to reiterate it today. The police need to be able to follow the evidence without fear or favour.
Maria Caulfield (Lewes) (Con)
I declare an interest as a registered nurse and someone who has worked in areas using syringe drivers and controlled drugs. I welcome the measures announced today, but may I make two further suggestions? First, there are very strict guidelines for nurses on controlling the stock of controlled drugs, and wrongdoing is picked up very quickly. There is not, however, enough training in the use, the dosage, the method and the route of controlled drugs that would give nurses confidence to speak up. Secondly, this situation could have been picked up much sooner if we had a proper IT system that shares medical notes between hospitals and doctors.
Matt Hancock
My hon. Friend is right on both points, and I am very happy to work with her on them. On the latter point, there is still much more work to do to have a system that is fully interoperable between secondary and primary care. As she says, many patients’ GPs might have picked up on the unusual patterns if they had had access to hospital notes. That now does happen in a small number of hospitals, but it is central to improving the technological capability of the NHS.
Nigel Huddleston (Mid Worcestershire) (Con)
I welcome the Secretary of State’s statement and his overall approach on patient safety. We have talked a lot about the need to change the culture from one of blame to one of accountability and transparency. That is easy to say, but difficult to implement so, as well as the changes to the annual report and procedures and process changes, will there be additional training and practical support that can help embed this new culture?
Matt Hancock
Training has improved over the last couple of decades. The training programmes are independently devised for doctors by the royal colleges and are developed and implemented with the General Medical Council and the Nursing and Midwifery Council. There is still much to do to drive through the modern culture of inclusivity and bringing in ideas from all places and to remove some of the unnecessary hierarchies in the world of medicine, both within the NHS and without. I look forward to working with my hon. Friend on that.
Finally, may I end by saying that there is still work to do, not least on the judicial element, and all of us should thank Bishop James Jones for how he has handled this process and made sure that people feel that justice can be done and that the learnings can be taken?
Bill Presented
Palestinian Statehood (Recognition) Bill
Presentation and First Reading (Standing Order No. 57)
Layla Moran, supported by Richard Burden, Sir Vince Cable, Mr Alistair Carmichael, Tim Farron, Wera Hobhouse, Ben Lake, Norman Lamb, Stephen Lloyd, Caroline Lucas, Jess Phillips and Dr Philippa Whitford, presented a Bill to make provision in connection with the recognition of the State of Palestine.
Bill read the First time; to be read a Second time on Friday 8 February 2019, and to be printed (Bill 295).
Prevention of Ill Health: Government Vision
Matt Hancock Excerpts(5 years, 6 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Secretary of State for Health and Social Care (Matt Hancock)
Last week, the Chancellor confirmed that the NHS budget would rise by £20.5 billion over the next five years, because we care about the NHS being there for everyone. As well as money, however, reform is crucial. Before Christmas, we will bring forward a long-term plan for the NHS. We know that so much of what contributes to good health comes not just from what happens when someone is in hospital but from what we do to stay out of hospital. Prevention is better than cure. Today I have laid before the House our vision for the prevention of ill health. It covers what the NHS needs to do, including more funding for community and primary care and the better use of technology. The plan also outlines what we need to see more broadly; everyone has a part to play.
As well as the rights we have as citizens to access NHS services free at the point of use, we all have responsibilities, too. Individuals have responsibilities, and we want to empower people to make the right choices. For instance, smoking costs the NHS £2.5 billion each year and contributes to 4% of hospital admissions. That is despite the massive reduction in smoking over the past 30 years. The next step to a smoke-free society is targeted anti-smoking interventions, especially in hospitals.
As well as stopping smoking, we must tackle excess salt. Salt intake has fallen 11% over just under a decade, but if it fell by a third, that would prevent 8,000 premature deaths and save the NHS over £500 million annually. We are working on new solutions to tackle salt, and we will set out more details by Easter and deliver on chapter 2 of our obesity plan, too.
Next, prevention can save money and eliminate waste. At the moment, it takes too long, with too many invasive tests, to diagnose some illnesses. Doctors often have to try several different treatments before they alight on what is right for a patient. However, two new technologies—artificial intelligence and genomics—have the potential to change that. I want predictive prevention to help prevent people from becoming patients and to deliver more targeted interventions, with better results, when people do fall ill. Instead of simply broadcasting messages to the nation, technology allows us to support much more targeted advice, messages and interventions for those most at risk.
Turning to environmental factors, our health is not determined only by what happens in hospitals. In fact, only a minority of the impact on anyone’s healthy lifespan is delivered by what hospitals do. The other factors include the air we breathe, whether someone has a job and the quality of our housing. That means our GP surgeries, our hospitals and our care homes all working more closely with local authorities, schools, businesses, charities and other parts of our communities. Of course, the record number of people in work is good news on that front, and employers have a big role in helping their staff to stay healthy and to return to health after illness. That is where we can learn from the excellent record of our brave armed services, which have an 85% return-to-work rate after serious injury, while the equivalent rate for civilians in only 35%. Building on all that, the Government will next year publish a Green Paper on prevention, which will set out the plans in greater detail. This is all part of our long-term plan for the future of the NHS.
If I may, Mr Speaker, I will now address two separate issues that I know are of interest across the House today: the treatment of those with learning difficulties and autism, and the medical use of cannabis. Since becoming Health and Social Care Secretary, I have been shocked by some of the care received by those with autism and learning difficulties. Where people deserve compassion and dignity, they have been treated like criminals, and that must stop. Like everyone across the House, I have been moved by the cases of Bethany, Stephen and so many others, whose stories have laid bare what is wrong with our system and what needs to change. I have instituted a serious incident review, but this is not just about individual cases; it is about the system.
Three years ago, the Government committed to reducing the number of people with learning disabilities or autism in secure mental health hospitals by at least a third. Currently, it is down by a fifth, but that still leaves 2,315 people with learning disabilities or autism in mental health hospitals. I want to see that number drastically reduce. I have asked the NHS to address that in the long-term plan, and I know that its leadership shares my determination to get this right. I have also instigated a Care Quality Commission review into the inappropriate use of prolonged seclusion and segregation. The long-term use of seclusion is unacceptable both medically and ethically. It must stop. The review will recommend how to protect vulnerable people better and how to ensure that everyone is cared for with the compassion, respect and dignity they deserve.
On the prescription of medicinal cannabis, I pay tribute to my right hon. Friend the Member for Hemel Hempstead (Sir Mike Penning), my hon. Friend the Member for Dover (Charlie Elphicke) and the hon. Member for Inverclyde (Ronnie Cowan) for their campaigning on this issue. We have changed the law to make it possible to prescribe medicinal cannabis where clinically appropriate. Urgent cases have been brought to my attention, including concerns that those who have received treatment on an exceptional basis are now being denied that treatment. There is no reason for that to happen. The treatment of each individual patient is and must be down to the decision of the specialist doctor, working with patients and their family to determine the best course of treatment for them.
I met the head of the NHS on that this morning, and I have immediately instigated a system of second opinions. We have put out a call for research to develop the evidence, and we have also commissioned the National Institute for Health and Care Excellence to produce further clinical guidance on this issue. No one who currently gets medicinal cannabis should be denied it, and there is a system in place now for those who need to get it in future.
We want to deliver the best possible care to the most vulnerable, and we want to help build a more sustainable health and care system for all. Today’s announcements will help to do that, and I commend this statement to the House.
Jonathan Ashworth (Leicester South) (Lab/Co-op)
I thank the Secretary of State for advance sight of his statement. We welcome his remarks on the use of medicinal cannabis and on the appalling, barbaric abuses of those with learning disabilities and autism, by which we have all been shocked. I understand his point about the review and about asking NHS England to carry out some work, but is it not time that these institutions were closed down and proper support provided in the community instead?
Of course we welcome the emphasis and focus on prevention, but these promises are not worth a candle if they are not backed up with real, substantive action. They come on the back of £700 million-worth of cuts to public health services, with more cuts to public health services pencilled in for next year, including £17 million-worth of cuts to sexual health services, £34 million-worth of cuts to drug and alcohol services, £3 million-worth of cuts to smoking cessation services and £1 million-worth of cuts to obesity services.
The Secretary of State did not mention childhood obesity in his remarks.
Jonathan Ashworth
I apologise if I missed it. Could the Secretary of State tell us when he plans to outlaw or ban the advertising of junk food on family television and when the consultation will end?
Immunisation rates for children have fallen for the fourth year in a row, so a big part of prevention should surely be a focus on investment in children’s and early years health services, yet Government cuts to those budgets and, indeed, the privatisation of many of those services in our communities have seen health visitor numbers fall by more than 2,000, school nurse numbers go down by 700 and 11% of babies miss out on mandated health checks. What is the Secretary of State’s plan to reverse those cuts to health visitors and school nurses?
All in all, alongside wider Department of Health and Social Care budgets, there will be £1 billion-worth of cuts to health services next year, with public health budgets taking considerable strain. Those £1 billion-worth of cuts should have been abandoned today, and it is a missed opportunity that the Secretary of State has not abandoned them. When he was asked about this in the Budget debate, he said it was a matter for the spending review. Well, today the Association of Directors of Public Health has said that the spending review should allocate an extra £3.2 billion for the public health grant next year. Does he accept that figure?
Of course prevention is about more than just public health; it is also about primary care. But GP numbers are down by 1,000 since 2015, and since 2010 district nurses have been cut by more than 3,000, so can the Secretary of State tell us what his plan is to increase the primary care workforce to support his wider ambitions on prevention? We know he wants a higher proportion of NHS spending to go to general practice, so does he agree with GPs that general practice should again receive around 11% of the overall NHS budget? If not, why not?
Of course, prevention is also about mental health services, but 30% of patients referred to IAPT—improving access to psychological therapies—services never receive treatment. What is his plan to ensure that everyone who needs IAPT services next year gets them?
Finally, on the wider social determinants of ill health, the shameful reality is that people in poorer areas die earlier and get sick quicker. Life expectancy has begun to stall, and has actually gone backwards in some of the poorest parts of the country. Rates of premature mortality are twice as high in the most deprived areas of England compared with the most affluent, and mortality rates for the very sickest of babies are increasing. As laudable as many of the aims that the Secretary of State has announced today are, this document does not even mention poverty or deprivation. It does not even recognise that some of the deepest cuts to public health grants have been in the areas of highest need and highest deprivation.
Yes, we welcome a focus on prevention—we have long called for such a focus—but a genuine commitment to prevention would go hand in hand with a genuine commitment to ending austerity. That must start with reversing the public health cuts and blocking the £1 billion of further cuts to health services to come next year. On that test, the Secretary of State has failed today.
Matt Hancock
Great, well I take that as a broadly positive response from the hon. Gentleman, and I will address the points he makes. He asked about money, and we are putting £20.5 billion extra into the NHS—this is the largest and longest financial commitment any Government have made to any public service ever. Of course, as well as the NHS budget, local authorities have budgets for public health; as he said, that will be addressed in the spending review. The increase in funding must ensure that we do more on prevention, which means more going into community services and into primary care, as well as making sure we get the appropriate level of spending into public health.
The hon. Gentleman asked about the consultation on advertising as part of the obesity plan. As he knows, that will be published before Christmas. He also asked about rates of immunisation. I want to see immunisation used right across the country. There is a campaign all of us can take part in to persuade people and ensure that immunisation takes place. We do not have compulsory immunisation in this country. I believe that is right, on civil liberties grounds, but by goodness it means it is incumbent on all of us to persuade everybody of the health benefits of immunisation.
The hon. Gentleman asked about GP numbers. We want 5,000 more GPs, and I am glad to report that we have got record numbers of GPs in training, thanks to action by this Government. Finally, he asked about the economic causes of ill health. The No. 1 economic cause of ill health is not having a job, and there are record numbers of jobs in this country. If he says that inequality has an impact on ill health, he should probably welcome the fall in inequality that we have seen under this Government.
Several hon. Members rose—
Dr Sarah Wollaston (Totnes) (Con)
In the Secretary of State’s vision for prevention he rightly points out that £14 of social benefit accrues from every £1 spent in public health. Therefore it is going to be much more challenging for him to deliver on his objectives if there is a further transfer from the public health budgets into NHS England budgets. However, I recognise that this requires action across all Departments, so will he set out what he is going to do to encourage cross-government action on physical activity, because we all know that that is a vital part of public health and prevention?
Matt Hancock
I agree with my hon. Friend the Chair of the Select Committee on that. Of course, the public health budgets for local authorities and Public Health England will be settled as part of the spending review, and there was no change to them in the Budget last week. There are also much wider responsibilities on activity—on cycling and walking—on which I am working with the Department for Transport. The document is all about the cross-government action, and the NHS will come forward with its long-term plan for the NHS-specific action. If there are aspects of cross-departmental working that she suggests we have not yet taken up, I will be looking forward to listening to her on that.
Stuart C. McDonald (Cumbernauld, Kilsyth and Kirkintilloch East) (SNP)
I thank the Secretary of State for advance sight of his statement and, in particular, I welcome his determination to reduce the inappropriate and sometimes disgraceful treatment of vulnerable people with autism and learning disabilities. He says that prevention is infinitely better than cure—nobody is going to disagree with that—and that the Government are encouraging people to make better choices, which is fine. However, that will ring hollow if the Government themselves duck difficult decisions that could help citizens to make better choices; we have heard about the example of junk food advertising already, but let me touch on the issue of alcohol. If he is serious about supporting healthy choices, surely he must bring to an end the free-for-all that sees supermarkets encouraging alcohol consumption by selling it at ludicrously discounted prices. Some estimate that in the first five years a 50p minimum unit price in England could save more than 1,000 lives, reduce hospital admissions by 75,000 and cut healthcare costs by £326 million. If the Secretary of State is serious about prevention, will he support minimum pricing?
Finally, I welcome the moves in respect of the prescription of medicinal cannabis, but too few are benefiting. My constituent Caroline was given months to live after being diagnosed with a brain tumour. Those treating her link her ongoing good standard of living with her use of cannabis oil from Canada, which comes at an enormous financial cost to her and her family. However, those treating her will not prescribe cannabis oil because there is no suitable medical research on which to base such a prescription. Why not let Caroline become part of that research by prescribing medicinal cannabis to her? We can then all learn from her experience.
Matt Hancock
On medicinal cannabis, I announced more research today and there is now a route in England. The hon. Gentleman will of course have to talk to the Scottish health service to ensure that a constituent in Scotland gets access, but I am very happy to look into specific English cases.
On the broader point about alcohol, it is important that we tackle alcohol abuse and it is vital that we do it in the right way. I do not want to punish people who drink responsibly at responsible levels, including myself. I occasionally drink at a responsible level, and I am sure that the hon. Gentleman does—certainly his colleagues enjoy a wee dram. Nevertheless, 5% of people in this country drink 30% of the alcohol. It is the small minority who present significant problems for the NHS and we need significant, targeted action.
Sir Desmond Swayne (New Forest West) (Con)
We have cut salt dramatically and the Secretary of State now wants to cut it further; life will certainly seem longer, will it not?
Matt Hancock
There are many ways to make one’s food taste good and make it healthy, too.
Dr Paul Williams (Stockton South) (Lab)
It is astonishing that there was no mention in the statement of poverty as a cause of ill health. Is the Secretary of State really so out of touch with communities in this country that he does not see how austerity is making people ill?
Matt Hancock
The statement talks all about the wider determinants of health. If the hon. Gentleman wishes to talk about poverty specifically, it is absolute poverty, not relative poverty, that has a link to ill health, and that has fallen.
David Tredinnick (Bosworth) (Con)
Is the Secretary of State aware that experts have warned that a million patients are getting useless drugs and injections for back pain, but his Department makes very little use of statutorily regulated osteopaths and chiropractors? Is he also aware that there is a Faculty of Homeopathy here and that the doctors are not employed enough, despite the fact that there are a quarter of a million homeopathic doctors in India?
Matt Hancock
I respect my hon. Friend’s understanding of these issues, not least because I am married to an osteopath, so my back is feeling okay and I hope that other people can access such services, too.
Mr Barry Sheerman (Huddersfield) (Lab/Co-op)
I very much welcome what the Secretary of State said about people on the autism and special educational needs spectrum. I also welcome his enthusiasm for the use of new technology, big data, data analytics and all that. Across party lines many of us see some real opportunities for delivering real public education in the health sector. When the Secretary of State makes good decisions and puts in the resources, he will have our support.
Matt Hancock
I am grateful for that. We put significant resources into the NHS last Monday. The hon. Gentleman makes an important point about the use of data. Instead of just targeting the average, it is about making sure that we get the public health messages to the people who really need to hear them. There is an argument that just broadly targeting public health messages actually exacerbates health inequalities, because people who are likely to listen to the messages tend to be people who are more likely to take responsibility for their own health in the first place. We need to be much more targeted and work is under way to make that happen.
Justine Greening (Putney) (Con)
I very much welcome the Secretary of State’s statement today. It is not only the right thing to do, but the smart thing to do for the NHS, and also a healthy economy needs healthy people. Communities such as my own have very many young people, who are often renting, do not necessarily stay very long and therefore do not register with a GP. Will he take that into account when he is looking at where investment in primary care flows to in the detailed strategy?
Matt Hancock
My right hon. Friend makes an incredibly important point. The way that money for primary care is allocated is being looked at right now, taking that and other things into account.
Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)
To really make a difference to keep our nation well, prevention has to be the preserve of both local and central Government. I note that the conclusion of the Secretary of State’s report says that he will be considering what a health-in-all-policies approach to policymaking could look like next year. Will he signal his support for the health-in-all-policies principle by supporting the Second Reading of my Health Impacts (Public Sector Duty) Bill on Friday 23 November?
Mrs Anne-Marie Trevelyan (Berwick-upon-Tweed) (Con)
We have a duty of care to support all our citizens to maintain good health by empowering employers in the private and the public sectors to motivate staff to invest time and commitment into their diet, fitness, and long-term health. How will the Secretary of State create that new ethos?
Matt Hancock
There is such an important role here for employers. It is not part of the culture of the UK, except in some excellent examples, that employers take a proactive view of the health of their employees. Other countries around Europe do that much, much more systematically. I am attracted to the Dutch model, but there are others, too, and I am grateful to my hon. Friend for her support in doing that.
Alison Thewliss (Glasgow Central) (SNP)
Breastfeeding has a significant preventive effect, and babies who are not breastfed are at greater risk of eczema, asthma, obesity, diabetes and sudden infant death syndrome, among other conditions. Scotland has invested in breastfeeding support and seen rates at six to eight weeks rise, whereas in England the rates have fallen for the second year running. Will the Secretary of State invest to bring all maternity and community services up to UNICEF’s baby-friendly standard, and will he act to make sure that women who wish to breastfeed are not being failed by the cuts in England?
Matt Hancock
The earlier that we can start with this sort of strategy of preventing ill health the better, and there is a lot of merit in a lot of what the hon. Lady said.
John Lamont (Berwickshire, Roxburgh and Selkirk) (Con)
I very much welcome the statement today. I also welcome the Government’s commitment to the daily mile in primary schools—I am a particular fan of it because it was invented by a Scottish headteacher in Stirlingshire. Does the Secretary of State agree that young people being fit and active is good for their mental, social and physical wellbeing?
Matt Hancock
Absolutely. I strongly support the daily mile and I try to do it myself. The key is that this is about activity. It is not necessarily about competitive sport, but about healthy activity that can help to prevent all manner of ills.
Norman Lamb (North Norfolk) (LD)
I welcome the Secretary of State’s focus on learning disability and autism. He will have seen the report in The Times today, which highlights the outrageous profiteering of a number of people in providing the wrong model of care—long-term institutional care—which frequently breaches people’s human rights. Will he commit to bringing an end to this profiteering and will he also look at including the endemic use of force—restraint—in these facilities along with seclusion in the Care Quality Commission’s investigation?
Matt Hancock
Yes, I will. I pay tribute to the work that the right hon. Gentleman did in the Department and the fact that he continues to champion this issue.
Several hon. Members rose—
Bim Afolami (Hitchin and Harpenden) (Con)
I welcome the Secretary of State’s statement. Will he outline what his views are for community pharmacy as part of the strategy of prevention?
Matt Hancock
Community pharmacies have a hugely important role to play in keeping people out of hospital and in supporting GP surgeries by doing more. Here, it is the French model that I look to for inspiration, but we should look all across the world to improve our health service.
Judith Cummins (Bradford South) (Lab)
Tooth decay is entirely preventable, so will the Secretary of State act now to address the concerns of the British Dental Association and others that the new dental contract will not go far enough in prioritising prevention?
Matt Hancock
We are trialling the new contract to get it right. We want to get it right, and I look forward to listening to the hon. Lady’s concerns in more detail.
Sir Paul Beresford (Mole Valley) (Con)
As my right hon. Friend is aware, I am a very part-time dentist and I am also a supporter of the British Fluoridation Society. Probably the very biggest reason for children attending hospital for general anaesthetic is to extract decayed, rotten, abscessing teeth caused by dental caries. Fluoridation of the water supplies is a very effective means of prevention. Does he support fluoridation of the water supplies, and what can he do to actively promote it, because, at the moment, it is in only 10% of our supplies?
Matt Hancock
My hon. Friend is of course a dentist, and I would love to listen to him speak in more detail about what we can do to get this right.
Louise Haigh (Sheffield, Heeley) (Lab)
If the Secretary of State does not think that poverty and deprivation are key factors in health inequality, can he explain why life expectancy for women in Sheffield has fallen by four years since 2009?
Matt Hancock
I said the opposite actually. There are environmental and economic factors, and they are very important. My point was that having a record level of jobs in this country is a benefit.
Mrs Pauline Latham (Mid Derbyshire) (Con)
In my constituency of Mid Derbyshire, there is an amazing group of community pharmacies that are saving people going into hospital and getting them out quicker. I invite my right hon. Friend to come and see them. He does not need to go to France; he can come to Mid Derbyshire instead.
Matt Hancock
I will actually be in Derbyshire later this month visiting a neighbouring constituency, but it looks like I have just put another stop on the itinerary.
Mr Speaker
I am quite certain that the Secretary of State will want to visit the hon. Lady’s constituency.
Christian Matheson (City of Chester) (Lab)
I welcome the focus on prevention. Of course, the next best thing is early diagnosis. Will the Secretary of State look again and remove the arbitrary age limit of 25 for women’s smear tests?
Matt Hancock
We are reviewing questions around that issue, because we want to ensure the best possible prevention and early diagnosis.
Rebecca Pow (Taunton Deane) (Con)
I welcome the focus on physical activity in the new prevention strategy. First, how will the Secretary of State work with the Department for Digital, Culture, Media and Sport on this? Secondly, would not travelling to work provide a great opportunity? Activities such as walking, cycling, tennis before work, Mr Speaker, and my eight minutes of pilates are all cheap or free. What does the Secretary of State have to say about that?
Matt Hancock
Well, I wish I had time for eight minutes of pilates with my hon. Friend. I cannot think of a better way to start the day. I am delighted that the Secretary of State for Digital, Culture, Media and Sport was here for the statement. We have been working with his Department on the strategy because it is so important to work across Government.
Stephen Doughty (Cardiff South and Penarth) (Lab/Co-op)
There is lots that we can agree on in this strategy but, as chair of the all-party parliamentary group on HIV and AIDS, I am genuinely disappointed to see that there is no mention of sexual health, HIV or crucial preventive measures such as PrEP. We have made huge progress in reducing new HIV infections in this country. Surely, we cannot risk the reversal of that progress now. Local services have been cut and the Health Foundation estimates that sexual health services in England will have been cut by a quarter by 2020. That means huge consequences for the individual and costs for the NHS. What is the Secretary of State going to do?
Matt Hancock
Public Health England is trialling PrEP, and I am willing to work with the hon. Gentleman and others to ensure that we do everything we can in this space. The truth is that outcomes are improving in many areas of sexual health, and we have to ensure that we get the right treatment to the right people at the right time.
Andrew Selous (South West Bedfordshire) (Con)
The Secretary of State’s focus on clean air and reducing childhood obesity is massively welcome. In the Netherlands, half of all children cycle to school. In the UK, it is 3%. What more will he do across Government to up that figure?
Matt Hancock
I am working with the Department for Transport. Transport Ministers feel very strongly about this question. The document details some of the things that we are going to do, but I am sure that there are a lot more.
Debbie Abrahams (Oldham East and Saddleworth) (Lab)
May I suggest that the Secretary of State has a look at the report, “Fair Society, Health Lives”, by Professor Sir Michael Marmot, particularly at his recommendation about a minimum income for healthy living? With this in mind, what assessment has the Secretary of State made of the impact of universal credit and cuts to that scheme on poverty and healthy life expectancy?
Matt Hancock
I have of course looked at that report. It is important, and it is important that we get the answers to it right.
John Howell (Henley) (Con)
Will the Secretary of State agree that more education should be spent on understanding the total role of sugars in combating diabetes, to go with the success that he has had with regards to the direct focus on sugars in drinks and food?
Matt Hancock
My hon. Friend is absolutely right; I strongly agree. Reformulation is critical. However, it is crucial to look not just at sugar, but at calorie count. Replacing sugars with higher calorie products is not necessarily the right way forward.
Wera Hobhouse (Bath) (LD)
Current average waiting times for eating disorders are 27 weeks, during which time the condition can become much worse. Will the prevention strategy look into concrete proposals to reduce waiting times, with, specifically, targets for waiting times for adult sufferers from eating disorders?
Matt Hancock
Yes, we are considering this as part of the long-term plan. We have already announced that more than £2 billion extra will be going into mental health services and services to tackle eating disorders, and there will be more to come on this very shortly.
Mr Marcus Jones (Nuneaton) (Con)
Will my right hon. Friend join me in congratulating Whitestone surgery and its patient participation group, who have brought forward a social prescribing model that has reduced the prevalence of early-onset dementia and reduced the number of anti-depressant drugs being prescribed at that surgery?
Matt Hancock
Yes, I absolutely will. I am a huge fan of social prescribing. I essentially think that because drugs companies have a big budget to try to market their drugs—and of course many drugs do wonders—there is not the equivalent level of organisation to drive up the use of social prescribing. Examples like the one that my hon. Friend mentions are incredibly important.
Rachael Maskell (York Central) (Lab/Co-op)
The half-a-million-pound cut in public health in York has had very serious consequences, while nationally, with regard to the Government’s flagship project of health visiting—the crucial profession in improving outcomes—the number of health visitors has plummeted by 23% from the previous figure of 10,309. Why?
Matt Hancock
We are increasing the budget in future and making sure that we target it more on community services and making sure that we get more prevention rather than cure. I can look at the case of York; I can look right across the country at what we need to do. Making sure that we get better prevention is all part of that.
Mr Philip Hollobone (Kettering) (Con)
Children’s dental health is shocking and child obesity levels are too high. Will the two words, “parental responsibility”, appear in the Secretary of State’s forthcoming Green Paper?
Matt Hancock
They will now. I believe very strongly in parental responsibility as well as personal responsibility and the responsibilities of employers. We all have a part to play. As parents, we have a very big responsibility to bring up our children in a heathy way, too.
James Cartlidge (South Suffolk) (Con)
As my right hon. Friend may be aware, one of the benefits of turning 40 is that we become entitled to an NHS MOT every five years. Has he, as part of his very welcome shift towards prevention, considered extending both the age range and frequency of these very important tests?
Matt Hancock
Well, you learn new things every day, Madam Deputy Speaker—as someone who only just turned 40, I had no idea. I think we should send everybody a 40th birthday card from the NHS saying, “You can now have these MOTs every five years.” [Interruption.] The shadow Secretary of State would like one, too. We will make sure that that is arranged right away.
Kevin Foster (Torbay) (Con)
As it is my 40th birthday next month, I will look forward to getting a card. The Croft Hall medical practice in Torquay has taken a bold step to use what was once just a derelict backyard as a community garden as part of its wellbeing hub. What role does my right hon. Friend see that type of work by local GP surgeries playing in this strategy?
Matt Hancock
That sort of work is absolutely brilliant. At one level, it is common sense, but it also needs to be a bigger part of the system. I congratulate my hon. Friend on bringing this to the House’s attention. Perhaps he should be the first recipient of one of the NHS’s 40th birthday cards.
Nigel Huddleston (Mid Worcestershire) (Con)
Are there any other international models inspiring the Secretary of State—in relation to prevention, of course?
Eddie Hughes (Walsall North) (Con)
The Secretary of State is obviously too young for it, but will he endorse the mile walk aimed at the over-50s that leaves the Stan Ball centre in my constituency at half-past 10 every Monday morning?
Matt Hancock
The daily mile—or, in this case, the mile walk once a week—is not just for children but for all of us who can make it. The example that my hon. Friend mentions is valuable to the community, and I am absolutely delighted that it is happening.
Matt Warman (Boston and Skegness) (Con)
I have a couple of years to go until I am 40, but one in four of my constituents is over 65. Lincolnshire has done great work on frailty and assessing the whole person. Does the Secretary of State agree that actually we need to look at the whole person in the round, and that, for older people, technology can also pay a huge role?
Matt Hancock
Perhaps by the time my hon. Friend becomes 40 it will be a birthday text rather than a birthday card, thus saving on postage costs within the NHS and moving on from the fax machines of old. In all seriousness, the point that he raises is incredibly important. The role of technology in this whole agenda is transforming what we can achieve for the over-65s and for the whole population, as in every other area of life. I know that he is a huge champion of technology, and I would like to think that I am, too. We have yet more to learn about what more we can do to improve people’s lives through technology within the prevention agenda.
Points of Order
Matt Hancock Excerpts(5 years, 6 months ago)
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Barbara Keeley (Worsley and Eccles South) (Lab)
On a point of order, Madam Deputy Speaker. The treatment of autistic people and people with learning disabilities in assessment and treatment units is nothing short of a national scandal. Seven years after the Winterbourne View scandal, the Government still have not got rid of these units or substantially cut their use. Now we get, with no notice, the whole issue rolled into another oral statement on public health. The shameful treatment of 2,300 people in Bedlam-like conditions is too important to be dealt with in this way. Can you advise on how to get the Secretary of State for Health and Social Care to take this issue more seriously in the way that he communicates to the House?
The Secretary of State for Health and Social Care (Matt Hancock)
Further to that point of order, Madam Deputy Speaker. I have come to the House at the first available opportunity to explain very clearly, and with some force, I hope, how strongly I feel about people with learning difficulties and autism being held in seclusion units. It is unacceptable morally and unacceptable medically. It has to stop, and it is going to stop.
Barbara Keeley
Further to that point of order, Madam Deputy Speaker. What I was complaining about was that this was done with no notice—no notice to the shadow Secretary of State, no notice to me or the team, and no notice to Members of this House who were not here to ask questions. We should have had notice that this important issue was being dealt with.
Government Vision on Prevention
Matt Hancock Excerpts(5 years, 6 months ago)
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The Secretary of State for Health and Social Care (Matt Hancock)
Today I am placing before the House the Government’s prevention vision, “Prevention is Better than Cure”.
This document sets out a cross-Government vision for stopping health problems from arising in the first place and, when they do, supporting people to manage them as effectively as possible. Our mission is to improve healthy life expectancy, so that, by 2035, we are enjoying at least five extra years of healthy, independent life, while closing the gap between the richest and poorest. When it comes to prevention, we all have a role to play: individuals, families, communities, employers, charities, the NHS, social care, and local and national Government. Only by working together can we make this vision a reality.
I am placing a copy of the prevention vision in the Libraries of both Houses.
[HCWS1063]
Budget Resolutions
Matt Hancock Excerpts(5 years, 6 months ago)
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The Secretary of State for Health and Social Care (Matt Hancock)
Yesterday’s Budget proved the time-honoured truth that careful stewardship of the economy, taking difficult decisions, creating the environment for enterprise and generating growth will lead to better days, not just for those with the dignity of employment, now in record numbers, who did not have it in the past, but for the provision of the public services on which we all depend. This Budget reported record jobs, unemployment lower than in a generation, more full-time jobs, the lowest proportion of low-paid jobs for two decades and rising real pay, with the fastest rises in real pay among the lowest paid in our society, thanks to our national living wage.
We have just seen the big difference between the two Front Benches. While we are delivering more jobs, more opportunity and more prosperity, those on the Opposition Front Bench promise more borrowing, more taxes and more debt. We have just heard it again from the shadow Chancellor: no ideas for the future; just talking Britain down. There is a big difference in this Parliament between a party that believes in the future and an Opposition Front Bench that would only take us back. Wherever it has been tried in the world, the programme that the right hon. Member for Hayes and Harlington (John McDonnell) proposes has led to bankruptcy and misery for millions, and we cannot fund public services on that. Without a strong economy, we cannot fund an NHS that everyone can turn to in their hour of need, whether that involves a life-threatening condition or falling over some fly-tipping. We are able to put record funding into our NHS only because there are millions more people in work who are earning more and paying their taxes.
James Morris (Halesowen and Rowley Regis) (Con)
On that point, may I thank the Secretary of State for his work on securing the public capital for the Midland Metropolitan Hospital in Sandwell, which had some difficulties following the collapse of Carillion? His work with the chief executive and the board of the trust has secured the future of that hospital, which is now on track to be built. It will be a vital resource for my local area of Rowley Regis.
Matt Hancock
I pay tribute to my hon. Friend, who has worked so hard to get that hospital back on track. It is now being built because we have put in the capital—it is in the NHS budget. We had to rescue it from the failed private finance initiative that was invented by the Labour party. It is only because we have a strong economy that we can give the NHS the longest and largest cash injection ever in its history—
Matt Hancock
If the right hon. Gentleman will welcome that injection, I will give way to him.
Sir Edward Davey
The right hon. Gentleman is talking about the rise in health spending. He is Secretary of State for Health and Social Care, so can he tell us by how much social care expenditure is going to rise over the next five years?
Matt Hancock
Yes, I am going to come on to social care. Yesterday, we put a further £650 million into social care, and we are coming forward with reforms to social care to put it on a sustainable footing for the long term.
Chris Bryant (Rhondda) (Lab)
I want to ask the Secretary of State about acquired brain injury. We save so many lives now, but if we put in significant investment up front to ensure that everyone got the right neuro-rehabilitation, we could save vast amounts of money for the taxpayer. Is that not rather a good model for us to pursue?
Matt Hancock
Yes, and the constructive approach that the hon. Gentleman has taken on this subject with me over many months, and for years before that, shows the progress that we can make. We are putting £20.5 billion extra into the NHS, and making an uplift like that means that we can turn resources towards preventing ill health in exactly the way that he describes. I pay tribute to the work that he has done on this subject.
Wes Streeting (Ilford North) (Lab)
Yesterday, the Chancellor boasted of a “jobs miracle”. If there is a jobs miracle, why is the chemotherapy unit at King George Hospital in my constituency closing because of a shortage of chemotherapy nurses?
Matt Hancock
We have a plan to improve the cancer workforce and to try to solve some of these problems. Maybe the hon. Gentleman should come over to this side and work with us to put record funding into the NHS. We can only have record funding for the NHS if we have a strong economy.
Mr Jayawardena
Is it not critical that every single penny put into the NHS is well spent if we are to tackle waste and bureaucracy, unlike what happened when Labour was in charge, when almost half was not spent on patient care?
Matt Hancock
My hon. Friend is absolutely right. People want to see more funding for our NHS, and they are going to get it, but they also want to see all the money being well spent.
The Budget confirms that the NHS is the Government’s No. 1 spending priority, just as it is the British people’s No.1 spending priority. This Budget places the Government four-square in the centre of British politics. It is progressive and optimistic and focused on the future, not just for the many but for the whole country that we serve.
Dr Sarah Wollaston (Totnes) (Con)
I absolutely welcome the uplift to NHS funding, but will the Secretary of State answer a small technical question, please? In the Red Book, there are separate entries for the increases in the resource departmental expenditure limits for health and for NHS England? Can he confirm that the difference—£6.3 billion versus £7.2 billion—will not result in a transfer from Public Health England, from Health Education England or from capital budgets to fund the discrepancy? That has happened in the past.
Matt Hancock
Yes, I can confirm that. The £20.5 billion real-terms funding for the NHS in the Budget is for the NHS itself and will be channelled through NHS England. Of course there are budgets in the Department that are outside the NHS envelope, and they will be settled in the spending review. This is exactly as has been planned, and it was made clear in June. I can tell the House that the £20.5 billion is both the longest and the largest settlement for any public service in the history of this country.
Grahame Morris
We need to be precise and accurate about this, and I have just googled the settlement. In fact, the biggest ever increase in NHS funding happened between 1997 and 2008 when the budget went up from £55 billion to £125.4 billion—
Grahame Morris
Well, I am talking about being factually correct. The biggest ever funding increase came under a Labour Government. Let us be honest about this.
Matt Hancock
This is a single settlement for a five-year period so that the NHS can plan again.
Several hon. Members rose—
Matt Hancock
I want to make some progress.
I received some representations about what we should do on NHS funding. One was from a John from Hillingdon, who called for a 2.2% increase in funding. John said that would make the NHS the “envy of the world”. Others may preach a gospel of envy, but we are getting on with building the NHS to be there for us all. The £20 billion increase I have talked about is not a 2.2% per year increase—it is 3.4% a year more over the next five years.
Mr Adrian Bailey (West Bromwich West) (Lab/Co-op)
I acknowledge the Secretary of State’s contribution to funding the Midland Metro Hospital, which is very important to people in the Black country. However, given that NHS hospital trusts have cumulative debts of around £7.5 billion plus a further £5 billion or so of other debts, can he reassure us that the £20.5 billion will be used not just to pay debts but to provide extra services?
Matt Hancock
The £20.5 billion is just for day-to-day running costs—the resource costs. Of course there is a capital budget, too, which includes £4 billion of taxpayers’ money. That goes towards ensuring that we can get the capital built. The critical point is that we have not only that £20.5 billion uplift in running costs but a capital budget. We will make further announcements on the allocation of the capital budget later in the autumn.
Karin Smyth (Bristol South) (Lab)
I am grateful to the Secretary of State for clarifying the £20.5 billion figure, which does not include training or capital. Of course, that contradicts the unhelpful briefing from Downing Street during the summer that it was something like £84 billion. Will he confirm that that £84 billion figure, which has been repeated in the media, is, as the Health Service Journal says, a fib, and that we are talking about £20.5 billion purely for resources in the NHS in England and Wales?
Matt Hancock
No. The £84 billion is the cash figure. The £20.5 billion is the real-terms increase by the end of the five years. If we add up all the extra money, we get £84 billion. It is there on page 36 of the Budget, if the hon. Lady wants to look. The biggest single cash increase comes next year, in 2019-20. It is all there in the Red Book.
Nicky Morgan (Loughborough) (Con)
I thank the Secretary of State for more good news for the midlands in the form of £70 million for the Defence and National Rehabilitation Centre just outside my constituency to help civilian rehabilitation. Can he share further details of that with us?
Matt Hancock
I pay tribute again to my right hon. Friend, who has worked tirelessly in support of that project. The Defence and National Rehabilitation Centre in Loughborough will link world-class military medical facilities with our NHS. That means lessons learned in the medical field from treating our brave troops who come back from the frontline can be brought into the NHS—for instance, surgical techniques that were learned in battle can be adapted to help civilians here. I pay tribute to her and others for the work they have done.
Jonathan Ashworth (Leicester South) (Lab/Co-op)
Here is a representation from a Jonathan from Leicester. Further to the question from the Chair of the Select Committee on Health and Social Care, the hon. Member for Totnes (Dr Wollaston), can the Secretary of State confirm that, in next year’s spending review, the cuts to capital budgets and the £700 million-worth of cuts to public health budgets will be reversed, and that there will be real-terms increases in funding for capital, training and public health? Can he guarantee that?
Matt Hancock
The spending review is next year. What I can guarantee is a £20.5 billion increase in NHS spending. That is the biggest increase in any spending commitment for any public service in the history of this country. [Interruption.] It is a pity that the Leader of the Opposition is not interested and does not want to hear about it. If he stayed, he could also hear about the reforms we are going to make. He should hear this more than anyone. We are acutely aware on the Conservative Benches that this is not Government money or NHS money but the hard-earned money of taxpayers, and we need to ensure that it is spent wisely. When he sprays his commitments around, Opposition Front Benchers would do well to remember that this is money from taxpayers.
Mr Jayawardena
I welcome the fact that taxpayers’ money will be spread across the whole country, including £10 million to support air ambulances, which provide vital services in rural areas.
Matt Hancock
So many of us know just how important air ambulance services are and the countless lives they save. I am delighted that, on top of the £20.5 billion for the NHS—the biggest ever, longest ever cash settlement for any public service in history—there was £10 million for air ambulances.
Neil O'Brien
If my right hon. Friend will excuse another Leicestershire-based health intervention, I am incredibly grateful for the creation of the new Cottage Hospital in Market Harborough, the gleaming new A&E ward at Leicester Royal Infirmary and the decision to save the brilliant children’s heart unit at Glenfield Hospital. Does he agree that that is a more welcome record than the Labour party’s record of bankrupting the country, giving us the biggest recession since the second world war and putting 1 million people on the dole?
Matt Hancock
It is true that the Labour party in office has always left unemployment higher than it found it; it is true that, while Labour left the deficit higher, we are bringing it down; and it is true that inequality, too, is coming down. Page 8 of the distributional analysis shows that, contrary to what we heard in that paean of gloom from the shadow Chancellor, the biggest rises in full-time employee gross weekly real earnings over the last three years have been among the 10% least well paid in our country. That is what this Conservative Government are doing—delivering for everybody in our country.
Debbie Abrahams (Oldham East and Saddleworth) (Lab)
On inequalities, does the Secretary of State recognise that life expectancy is stalling under his Government? In some regions it is getting worse. For women, it is getting worse. Perhaps he can answer the question he could not answer last week—why, for the first time in 100 years, do four babies in 1,000 not reach their first birthday?
Matt Hancock
As the hon. Lady knows, life expectancy is increasing, and we are forecast to see an increasing number of people live to a good old age. Indeed, the number of people aged 75 and over is set to double in the next 30 years. That is a brilliant achievement, which is in part down to the hard work of our NHS. Cancer survival rates are at a record high, strokes are down by a third and deaths from heart failure are down by a quarter. Of course, those successes have brought new challenges. The biggest health challenge we face is that people are living longer, often with multiple chronic conditions. The money is only one part of the plan to safeguard the NHS and ensure it is fit for the 21st century. The Budget delivers the funding, and later this year we will deliver the plan for how we will set the NHS fair for the future.
Rachael Maskell (York Central) (Lab/Co-op)
I have very little hope for the older people of our country given that the Government have cut £7 billion from the social care budget and replaced it with only £240 million. How is that safeguarding our old people for the future?
Matt Hancock
Of course, in Scotland social care is devolved, so—[Interruption.] And in York, the amount of money for social care is going up thanks to the decisions announced yesterday.
Mr Jayawardena
Is not it true that Labour talk the talk but do not walk the walk? They failed to deliver an effective long-term solution for social care when they were in government. They had 13 years to sort it and they did not. Is not it also true that, even though they said they would use the comprehensive spending review to address that, they left office without delivering? That is what they do time and again.
Matt Hancock
My hon. Friend is absolutely right. The long-term plan needs to ensure that we address the challenges of today and of tomorrow, including dementia, obesity and the rise in mental ill health. It will set out how we are going to address and deliver these changes. The Government believe in an NHS that is free at the point of use for everyone, for the long term.
Vicky Ford (Chelmsford) (Con)
The A&E in my local hospital is deeply loved and I am very grateful that it is staying, but it is still under huge pressure. When I have been out at night with the emergency services, I have seen that emergency services personnel have to stay with someone who has an acute mental illness and needs a mental health bed, which means that they cannot get on with other roles. Does the Secretary of State agree that the Government’s strong announcement of more funding for mental health will help the whole NHS to do more?
Matt Hancock
My hon. Friend is absolutely right, and we can only have a sustainable NHS if the social care system is also properly supported.
The social care Green Paper to be published later this year will set out the options to meet the unprecedented demographic challenge—and what a challenge. Some 70% of people in residential care homes now have dementia. The number of people with dementia is set to rise from 850,000 today to over 1 million in less than a decade. The number of people of working age in need of care is rising and is set to increase by almost half by 2035. Yet, despite these pressures, 83% of adult social care settings are now rated good or outstanding by the Care Quality Commission. That is the highest level since assessments began. As a society, we need to address the pressures on social care so that everyone can live in dignity and we can have a situation that is sustainable for the long term.
The Green Paper will bring forward a range of proposals to reform our social care system. I pay tribute to the excellent cross-party work of the Health and Social Care Committee and the Housing, Communities and Local Government Committee, which are helping to build a consensus behind potential solutions. This is exactly the sort of long-term cross-party work that we need to see, when fair-minded people from across the House come together to address the challenges of the future, and I will work with anyone from any party to get this right.
Sir Geoffrey Clifton-Brown (The Cotswolds) (Con)
I listened with care to my right hon. Friend’s very welcome remarks on yesterday’s “Today” programme about having parity of esteem between mental health and physical health, and I welcome the announcement in the Budget of £250,000 for children’s crisis centres. Sadly, people in society now have complex mental health problems at a younger and younger age. In order to make these policies work, will the Secretary of State ensure that there is a sufficient number of well trained staff in the NHS to deal with these mental health problems?
Matt Hancock
My hon. Friend is absolutely right; he has put his finger on an incredibly important point. As we spend £20 billion extra on the NHS, we are going to ensure that we train up and attract the people who are going to do the caring.
Emma Hardy (Kingston upon Hull West and Hessle) (Lab)
On the issue of mental health support and services for children, I was quite disappointed that mental health support for schools was missing from the Budget. A lot of money was promised for child and adolescent mental health services but, as the Secretary of State will know, the Education Committee produced a joint report with the Health and Social Care Committee entitled “The Government’s Green Paper on mental health: failing a generation”, in which we outlined that we were really keen to see additional funding for mental health support in schools. Is there anything that the Minister can do to look again at that issue?
Matt Hancock
Yes—part of the £2 billion of extra mental health funding that we announced yesterday is to ensure that there is support in schools, particularly for young people. That is one of the elements of the funding that we announced in the Budget yesterday, and I am very happy to talk to the hon. Lady about the details.
The social care Green Paper will address the question of long-term funding reform for social care and how we can help people to plan sensibly so they do not have to fear the risk of losing everything. But the Green Paper will not just look at funding; it will also look at the role of housing, at how we can combine a home with high-quality care, and at the links between the care of children and of the elderly. I have seen how such links can benefit both groups, helping children’s development and tackling the scourge of loneliness that elderly people too often face. The Green Paper will of course also look at how we can better integrate the NHS and the social care system. What matters is what works, so we will look at things such as auto-enrolment, and how and if reforms elsewhere can be applied to social care. Like the NHS, the future of our social care system rests not just on funding, but on reform, and we are determined to rise to this challenge.
Every Member of this House will have their own personal story of the NHS. Whether it was the first few breaths of a child or the final few moments of a loved one, from cradle to grave that care is ever present, whatever the shade of Government. This Government want to ensure that that care will always be there for whoever needs it, and that the NHS remains free at the point of delivery. That is why we are putting the extra £20 billion into the NHS. It is only because our economy is strong, employment is rising and we believe in a free market economy that we can fund this increase, for just as there can only be truth when there is freedom of speech, so can there only be prosperity to fund public services when there is freedom of enterprise. It is a great sadness that, in stark contrast with the greats of his party in the past, the shadow Chancellor opposes both. It is now a combination that we can only get under a progressive, optimistic, future-focused Conservative Government. That is what this Budget delivers. I commend it to the House.
Kirsty Blackman
Absolutely; it is clear that remaining part of the UK is bad for Scotland’s economy. The comparators in the Budget information documents show that the UK economy is growing slower than the EU economy is set to grow in every but one of the next five years.
Matt Hancock
May I just ask whether the hon. Lady has ever seen the result of a referendum that she likes?
Kirsty Blackman
Do you know what? The reality is that we have argued for a very long time—I have argued for my entire adult life—against the current democratic system, because it does not work for the people of Scotland. We do not get the Governments we vote for and we do not get the result that we voted for in the EU referendum. If the democratic system meant that Scotland’s votes were reflected in reality, we would be in a very different situation today.
On a serious note, every week in our communities and at our surgeries MPs from both sides of the House are faced with the consequences of Westminster’s poor decisions. We see working mothers forced to go to food banks. We see and hear about the Home Office-enforced separation of families. We meet young men struggling with mental health problems who have been sanctioned yet again because they are unable to jump through the unreasonable hoops put in their way by the Department for Work and Pensions. I do not know how anybody, even in this Westminster Government, can believe that their policies are having a positive benefit. The tears and desperation with which we are all faced on a regular basis give the lie to that notion.
The Chancellor has failed adequately to fund our public services in this Budget. He has failed to undo the devastating social security cuts, he has failed to legislate for a real living wage and he has failed to provide adequate support for businesses facing the impending cliff edge of Brexit.
The Budget should have included decisions to help support all those who have been hit by a decade of austerity, and all those who will be hit by the forthcoming Brexit. The roll-out of universal credit should have been halted. A third of working-age households will be entitled to some universal credit. Of those, around a third will be at least £1,000 a year worse off than under the legacy system.
Oral Answers to Questions
Matt Hancock Excerpts(5 years, 6 months ago)
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Julian Sturdy (York Outer) (Con)
The Secretary of State for Health and Social Care (Matt Hancock)
We are bringing a tech revolution to the NHS to improve patient outcomes and reduce waste. Today I am delighted to announce the selection of the first batch of products under the accelerated access collaborative, as well as funding for tech test beds to ensure that more patients get faster access to the most effective innovations.
Scott Mann
I am grateful to the Secretary of State for his answer. Will he expand further on the recent announcement of the wave 2 test beds project and how it could deliver better outcomes for my residents down in Cornwall?
Matt Hancock
The tech test beds programme is about ensuring that we have units around the country that will support local collaborations between the NHS, tech companies and academia to harness new technologies right across the land, including—and no doubt—in Cornwall.
Julian Sturdy
The National Institute for Health and Care Excellence has so far declined to recommend the new drug Spinraza, despite its ability to transform the lives of patients such as my young constituent Matilda Jamieson, who suffers from type 3 spinal muscular atrophy. As NICE meets today to finalise the guidance, will my right hon. Friend assure me that he will work with the manufacturers, NHS England and NICE to ensure that patients such as Matilda can benefit from that drug?
Matt Hancock
I pay tribute to my hon. Friend for making that case so powerfully. We work very closely with NICE, which is rightly the objective decision maker that makes recommendations for Ministers to follow about what drugs should and should not be accessed through the NHS. He makes the case very strongly.
Mr Barry Sheerman (Huddersfield) (Lab/Co-op)
This question is about innovative technology in the health service. What is the Secretary of State saying today to scientists? For example, 97% of people from the Francis Crick Institute say that our science and our bioscience are in danger because of Brexit. What is he going to do about technology that is suitable for the health service?
Matt Hancock
The scientists, like me, want a Brexit that is based on a good deal for the UK, and that is what we are seeking to deliver. In any case, we have put more money into the science budget than ever before, so no matter what the outcome of the negotiations, there will be more support for science in Britain.
Sir Vince Cable (Twickenham) (LD)
One of the innovative technologies is the new production and distribution system for flu jabs for the over-65s. Is the Secretary of State aware that this technology is breaking down? In my constituency and elsewhere, there are doctors and pharmacists who simply cannot get hold of stocks, which leads to potential pressures in hospitals. Will the Secretary of State investigate and take action if necessary?
Matt Hancock
Having a flu jab is incredibly important, and I hope that Members on both sides of the House have taken the opportunity to do so, including the right hon. Gentleman, with whom I enjoyed working for many years. We have a phased roll-out of the flu jab, making sure that we get the best flu jab most appropriately to the people who need it most, and of course we keep that under review.
Dr Sarah Wollaston (Totnes) (Con)
Digital health tools, including decision-support software, have a great potential to increase the quality, safety and cost-effectiveness of care for patients, and nowhere is that more important than in reducing antimicrobial resistance. Will my right hon. Friend respond to the points that we on the Health and Social Care Committee make in our report about the variation in roll-out, which is wholly unacceptable, and what measures will he take to make sure that it is clear where the responsibility for this lies?
Matt Hancock
I pay tribute to the Select Committee for the report on AMR that was published yesterday. Of course, digital tools such as the one that my hon. Friend mentions are important in making sure that we make the best use of antibiotics and counter antimicrobial resistance as much as possible.
Jonathan Ashworth (Leicester South) (Lab/Co-op)
If we have a “technological revolution”, in the words of the Secretary of State, surely that depends on capital investment, but that has been cut by £1 billion. For example, we have the lowest numbers of CT and MRI scanners on average in the OECD, hospitals are reliant on 1,700 pieces of out-of-date equipment, and the hospital repair bill now stands at £6 billion. If austerity has ended, can he tell us when this maintenance backlog will be cleared?
Matt Hancock
Unlike with the failed national programme for IT, we are delivering modern technology in the national health service. That is underpinned by a record commitment of £20 billion extra for the NHS over the next five years, accompanied by a long-term plan that will show how we will support the NHS and make sure that it is guaranteed to be there for the long term.
Jonathan Ashworth
But I asked the Secretary of State about capital budgets, not revenue budgets.
Innovative technology can play a role in prevention, but so do public health budgets. With health inequalities widening, infant mortality rising in the most deprived parts of the population, rates of smoking in pregnancy remaining higher than the EU average and child obesity levels getting worse, will the Secretary of State commit, alongside an investment in technology, to reversing the £700 million of cuts to public health, or is the reality that his promises on prevention are entirely hollow?
Matt Hancock
I am afraid that the hon. Gentleman has it slightly muddled up, because technology does involve capital investment, but it also includes revenue investment to ensure that the service element of any technology can continue to be delivered. Maybe he should have another look at how technology is delivered these days. Alongside the capital budget, we have record spending on the NHS to ensure that it is there for the long term. Of course public health is an important element of that, and there has been £16 billion for public health over this spending review period because it really matters.
Peter Aldous (Waveney) (Con)
Adam Afriyie (Windsor) (Con)
The Secretary of State for Health and Social Care (Matt Hancock)
This month, we hosted the world’s first ever global ministerial mental health summit. Over 60 countries were represented, and they were united in the ambition to achieve equality for mental and physical health. The legacy of the summit will continue, with the baton now passed to the Netherlands, which has committed to host next year.
Richard Benyon
At the summit, I hope that the Government were applauded for appointing a Minister for suicide prevention. Will my right hon. Friend reflect on the fact that many people contemplating taking their life end up in A&E or in police stations, and will he look at James’ Place in Liverpool? That non-clinical centre catches young men in particular, who are very often the victims of this problem, and deals with their mental health issues.
Matt Hancock
Part of the purpose of having a cross-Government suicide prevention Minister is to bring together all these issues. I pay tribute to the work of James’ Place and its founder, Clare Milford Haven. We are spending £30 million of taxpayers’ money to increase the number of health-based places of safety for people experiencing a crisis, and I look forward to working with my hon. Friend on that.
Matt Hancock
I very much agree with my hon. Friend. The role will be cross-governmental. It will involve working not only across national Government, convening the policies that need to be pulled together from various Departments’ responses to support people in crisis and to reduce suicide, but with local government, which has responsibilities here.
Helen Jones (Warrington North) (Lab)
Suicide prevention plans have to be a key element of any mental health strategy, yet the Government are not monitoring the effectiveness of those plans or ensuring that they are fully funded. Will the Secretary of State commit to ensuring that the plans that are put in place are effective and that local authorities have sufficient funds to implement them properly?
Matt Hancock
The hon. Lady is right to draw attention to the need to ensure that funding for mental health services has parity with that for physical health services. Getting there is the work of a generation. We did not even measure access to mental health services until this Government brought that in, and we are working towards parity.
Paula Sherriff (Dewsbury) (Lab)
The Secretary of State boasted to the global ministerial mental health summit about the Government’s plans to recruit 21,000 more staff to the mental health workforce by 2021, but he did not tell the summit that by the end of May this year, nearly 25,000 mental health staff—one in eight of the workforce—had left the NHS and that fewer than 1,000 extra staff had been recruited by March, equating to just 0.5% of his target. Does he really think that he is in a position to lecture the rest of the world?
Matt Hancock
I welcome the hon. Lady’s commitment to this area. Clearly it is very important to have the workforce in place. As she said, we are making progress, but we still have more to do. As far as the international approach is concerned, the response to the summit was that many countries came together, because collectively we all face the same sorts of challenges. I am in absolutely no doubt that the leadership shown by some countries, including the UK, is warmly welcomed.
Andrew Selous (South West Bedfordshire) (Con)
The links between poor mental health, suicide and gambling addiction have been made clear to the Health and Social Care Committee. In that regard, will the Secretary of State make it clear to the Treasury that many across the House want to make sure that action on fixed odds betting terminals is taken forward so that we can have good results in the areas of mental health and suicide prevention?
Matt Hancock
My hon. Friend knows my personal strength of feeling about tackling the scourge of fixed odds betting terminals. The links between gambling addiction and mental health issues—and indeed, directly to suicide—are clear in the evidence, and we must address them.
Helen Hayes (Dulwich and West Norwood) (Lab)
My constituent David contacted me after his 18-year-old son became severely mentally unwell and needed emergency treatment. His son spent four days in A&E at the local hospital because no in-patient beds were available. This is not a one-off case: on a daily basis, mentally unwell people are being failed by our health service. When will the Secretary of State take meaningful action to fund mental health services properly and stop this scandal?
Matt Hancock
I am glad that, like me, the hon. Lady cares so much about getting this right. The long-term plan, which we are writing with the NHS, for how we will spend the £20 billion funding increase is where we can get these details right. Access to mental health services was not even measured before. The first step was to put the measurement in place, and now we can act on that measurement with the huge increase in funding coming to the NHS.
Grahame Morris (Easington) (Lab)
Kwasi Kwarteng (Spelthorne) (Con)
The Secretary of State for Health and Social Care (Matt Hancock)
Britain is world leading at treating cancer when it is discovered, but we do not diagnose it early enough, so we will radically overhaul our screening programmes, roll out rapid diagnostic centres for people with early symptoms, and expand mobile lung screening units. Our ambition is to ensure that three quarters of cancers are diagnosed at stage 1 or 2 by 2028, up from half today.
Sir David Evennett
May I first highlight the excellent Guy’s Cancer Centre at Queen Mary’s hospital in Sidcup, a state-of-the-art facility which offers local cancer patients treatment closer to home? Secondly, can my right hon. Friend provide any detail on how the NHS long-term plan will improve cancer services?
Matt Hancock
Yes. Focusing on early diagnosis will help to save lives. Indeed, the cancer survival rates have never been higher than they are now. About 7,000 people who are alive today would not have been had mortality rates stayed the same as they were in 2010. However, we want to use the most cutting-edge technologies in order to save more lives.
Kwasi Kwarteng
In respect of early screening, how does my right hon. Friend expect the measures that he has introduced to move the service forward in the way that we want to see?
Matt Hancock
Absolutely central to this is ensuring that we address cancer at the earliest possible opportunity. The earlier the diagnosis is made, the greater is the likelihood of survival, so we want to see more cancers diagnosed earlier across the board.
Ruth George (High Peak) (Lab)
Matt Hancock
The announcement the details of which I have just set out comes with £1.6 billion of the £20 billion uplift we are putting into the NHS written into the long-term plan, so the funding is there to deliver on this policy, too.
Tim Farron (Westmorland and Lonsdale) (LD)
The Secretary of State is right to say that early diagnosis provides more opportunity to cure and treat cancers. Some 60% of those treated for cancer will receive radiotherapy, and nearly every radiotherapy centre in the country has linear accelerators that are enabled to provide the advanced SABR, or stereotactic ablative body radiotherapy, technology, but Government—NHS England—contracts mean that out of the 52 centres in England no more than 20 are contracted to actually use this technology. That means that either patients are not receiving the highest quality life-saving standard of treatment that they could be or that trusts are providing it anyway but are not being paid and valuable data on mistreatment are being completely lost. Will the right hon. Gentleman order NHS England to stop this recklessness, and frankly lethal, nonsense and agree to every—
Mr Speaker
Order. [Interruption.] Order. The thrust of the question is entirely clear. I was going to offer the hon. Gentleman an Adjournment debate on the subject until I realised that he had in fact just conducted it.
Matt Hancock
And also, Mr Speaker, the hon. Gentleman’s all-party group is meeting my Minister, the Under-Secretary of State for Health and Social Care, my hon. Friend the hon. Member for Winchester (Steve Brine), on this very matter. Since 2016 we have put £130 million of funding in to try to resolve the issue that the hon. Gentleman talks about: to make sure that all new equipment is capable of delivering advanced radiotherapy. Work on this is ongoing.
Several hon. Members rose—
Jim Shannon (Strangford) (DUP)
Mr Speaker, you had a broader smile on your face this morning than my friend the hon. Member for Scunthorpe (Nic Dakin) and I. We still support Leicester and hope we will pay you back some day.
An important aspect of diagnosing cancer is to find the drugs that address it. What has been done to ensure the partnerships between universities and the NHS can continue, so that they can find new drugs and therefore address cancers at a very early stage?
Matt Hancock
There are deepening relationships between universities and the NHS right across the country, especially in this field of the combination of diagnosis and early treatment. Some of the most advanced technology and research in the world is happening in universities in the UK in order to save lives, which is such an important issue here.
Alan Brown (Kilmarnock and Loudoun) (SNP)
The Secretary of State for Health and Social Care (Matt Hancock)
We will continue to have access to new medicines through the deal we expect to negotiate with the EU. In the unlikely event of no deal, we will directly recognise batch testing of medicines done in the EU. We are currently consulting on the approach to licensing medicines in a no-deal scenario, but I am clear that patients should not be disadvantaged and should continue to have timely access to new medicines.
Alan Brown
The reality is that Brexit uncertainty about future medicine approvals and unresolved issues with the European Medicines Agency have caused research firm Recardio to suspend UK recruitment to a drug trial, posing a risk to its business and interrupting the research. As the EMA has no associate membership for third countries, how does the Secretary of State plan to avoid the UK being left out of future clinical trials despite his bluster?
Matt Hancock
Not only does the UK bring a huge amount to the table in terms of research, but we fully intend to make sure that we have a robust and seamless system in place. A consultation is out at the moment and we will respond to it very shortly.
Martyn Day
The Government have stated that the new EU clinical trials regulations will not be in place before March, but have committed to aligning with it where possible. What progress has been made regarding data sharing to ensure that clinical trials continue and pharmaceutical and research firms do not leave the UK after Brexit?
Matt Hancock
As part of the EU deal we are negotiating, the relationship with the EMA will be extremely close, so I am sure that that will be a part of our agreement.
Mr Philip Hollobone (Kettering) (Con)
Will the Health Secretary confirm that since the referendum the number of EU nationals working in our NHS has actually risen by 4,000, and that regardless of the state of the negotiations their rights will be protected and they will continue to be able to work in the NHS after we leave?
Matt Hancock
Yes, my hon. Friend is absolutely right. In fact, the number of EU nationals working in the NHS has now risen by more than 4,000 since the referendum, and we welcome them all.
Mr Stephen Hepburn (Jarrow) (Lab)
Huw Merriman (Bexhill and Battle) (Con)
The Secretary of State for Health and Social Care (Matt Hancock)
The Department is working with the NHS to ensure that the £20 billion of extra taxpayers’ money is well spent: supporting social care, backing the workforce, using the best modern technology and strengthening prevention. On that note, I can tell the House that we now have a record number of GPs in training: 3,473—10% up on last year.
Huw Merriman
I thank the Secretary of State for so promptly accepting our invitation to visit us in East Sussex in January. He will be warmly welcomed. With that season in mind, what assessment has he made of the NHS’s resilience with winter approaching?
Matt Hancock
Of course winter always challenges the NHS, and this year will be no different. We have put in extra funding, including more capital funding, to ensure that we get the best possible flow through A&E and to ensure there is further funding for social care so that people who do not need to be in hospital can leave hospital.
Barbara Keeley (Worsley and Eccles South) (Lab)
Last week, The Times reported that a young autistic woman with severe learning disabilities and an IQ of 52 was sexually exploited for months after her care provider had a court accept a plan for her to have sexual relations with men at her home. It is unacceptable that the agency charged with the care of this young woman decided that unsupervised contact with men for sex was in her best interest, yet the Government would give all such care providers a role in assessing the mental capacity of the people for whom they care. Will the Secretary of State urgently investigate this case? Given that the case illustrates the conflict of interest that arises from involving care providers in mental capacity assessments, will he pause the Mental Capacity (Amendment) Bill to allow time to make it fit for purpose?
Boris Johnson (Uxbridge and South Ruislip) (Con)
Matt Hancock
My right hon. Friend is an assiduous supporter of his constituents. I look forward very much to taking up his invitation to visit. I have looked into some of the details of the proposal on the table and, indeed, at some of the other proposals that may benefit the Hillingdon area. I look forward to discussing them with him.
Emma Reynolds (Wolverhampton North East) (Lab)
Matt Hancock
Yes, of course I will make sure the appropriate action is taken in this case. It is a sensitive matter, and I look forward to discussing it with the hon. Lady.
James Duddridge (Rochford and Southend East) (Con)
Sir Nicholas Soames (Mid Sussex) (Con)
Matt Hancock
My right hon. Friend identifies a critical factor in improving the future of the NHS, which is to have stronger leadership at all levels, to be able to support innovation and to find out the best that is happening elsewhere and bring it to trusts. I know he has a particular interest in that, and I look forward to working with him on it.
Bill Esterson (Sefton Central) (Lab)
Foetal alcohol spectrum disorders mean permanent brain damage. In the United States, studies show that one in 20 children are affected. So when will this Government carry out their own prevalence study, so that we can confirm the extent of this entirely preventable disability in the UK?
Anna Soubry (Broxtowe) (Con)
I thank the Secretary of State for the extra £5 million for East Midlands ambulance service and for the £4.5 million extra for Nottingham University Hospitals Trust, which will mean at least 150 more beds this winter, all of which will help with winter planning, but does he agree that it behoves us all to play our own part in keeping fit and healthy and to use the NHS services responsibly?
Matt Hancock
My right hon. Friend makes a very important point, which is that, while we drive to ensure that the NHS is prepared as possible for this winter, it is incumbent on everybody to exercise their judgment, yes, to access the NHS where it is needed and important, but also to make sure that they bear a personal responsibility, too.
Yvette Cooper (Normanton, Pontefract and Castleford) (Lab)
The Mid Yorkshire Hospitals Trust is proposing to close our midwife-led maternity unit, telling me that, while it is safe, unless it has 500 births a year, it is not value for money. Is that a new national standard for midwife maternity units, because if so it would close 90% of free-standing units? Will a Minister meet me on this matter, because it is unfair on local parents, and, frankly, we are sick and tired of losing services from our towns?
Mr Ben Bradshaw (Exeter) (Lab)
Is it true that the Secretary of State is now so worried about the supply of vital medicines in the event of a no deal or a hard Brexit that he has asked the pharmaceutical industry to extend the period of stockpiling from six weeks to 20 weeks?
Matt Hancock
No, that is not true. We are working very closely with the pharmaceutical industry to make sure that, in the event of a no-deal Brexit, which I regard as unlikely, we mitigate as much as possible the impact on the supply of medicines and that the supply of medicines can be unhindered.
Kevin Hollinrake (Thirsk and Malton) (Con)
Will my hon. Friend, the Minister with responsibility for antimicrobial resistance, consider a 10% levy on antibiotics? If such a levy were applied globally, it would raise £3 billion a year, which is the amount specified in the O’Neill review to fund research into this area properly.
Robert Courts (Witney) (Con)
Will the Minister please provide an update to the House on work to ensure that we train more GPs for England, particularly for west Oxfordshire?
Matt Hancock
Yes. My hon. Friend will have heard that we have record numbers of GPs in training— 10% up on last year. I want to see more GPs—5,000 more across the country—and, no doubt, some of those in west Oxfordshire.
Eleanor Smith (Wolverhampton South West) (Lab)
I have a constituent who has Turner syndrome, a female-only genetic disorder that affects one in every 2,000 baby girls. Owing to this, she has to take several medications every day of her life, and this is mounting up as she gets older. She works so she is not on any benefits and has to pay for her medications herself. Will the Minister consider exempting those who suffer from lifelong conditions such as Turner syndrome from paying for their prescriptions? Surely, it cannot be right that people in England should be treated differently from those in Scotland, Wales and Northern Ireland, where such prescription charges have been abolished.
Daniel Zeichner (Cambridge) (Lab)
Last week, the chief executive of the Association of the British Pharmaceutical Industry warned that even associate membership of the European Medicines Agency would not do for our life sciences sector, so can the Secretary of State tell us how much longer we will have to wait and how much more we will have to pay for new medicines if we are outside the European medicines market?
Matt Hancock
We will not have to wait longer; we will ensure that we get the best medicines to the people of Britain long after we are members of the European Union, as we did before we were members of the European Union.
Several hon. Members rose—
Debbie Abrahams (Oldham East and Saddleworth) (Lab)
Last week, the Royal College of Paediatrics and Child Health revealed that there has been an increase in infant mortality for the first time in 100 years. Four in every 1,000 babies will not reach their first birthday, compared with 2.8 in every 1,000 babies in Europe. This was warned against as an effect of austerity. What assessment has the Health Secretary done on the effects of next week’s Budget on child health and the longevity of our children?
Matt Hancock
I saw that report and we are analysing it. Last week was Baby Loss Awareness Week, and I am glad that there is more awareness of the issue now than there was previously. It is a very important issue that we are looking at right across the board.
Mr Dennis Skinner (Bolsover) (Lab)
About two hours ago, I rang to book a flu jab less than a mile away from here. Unfortunately, staff said that they had run out and will not be able to do it until 2 November. The Secretary of State is nodding. He seems to know the answer to everything. What is the issue? Will he give me the answer? This never happened under Labour.
Matt Hancock
If the hon. Gentleman is claiming that there were not enough flu jabs under Labour, I might agree with him, because there are now more flu jabs. More than 4 million flu jabs have already taken place. I am delighted that lots of people want flu jabs because everybody who needs one should get one. The arrival of the flu jab medicine is phased, because we have to ensure that we get the right flu jabs. If the hon. Gentleman could carry on promoting flu jabs for the elderly, I would be delighted.
Social Care Funding
Matt Hancock Excerpts(5 years, 6 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Barbara Keeley
The hon. Gentleman asked me the same question six months ago, on our last Opposition day debate on this subject, and I will give him the answer I gave him then: he should really be trying to influence his own party. I thank those Committees for the work they did, as the Prime Minister did today. Labour has got as far as producing a White Paper—not a Green Paper. We have a 2010 White Paper, and I have a copy with me. I recommend that Conservative Members who keep asking about this look at the extensive proposals in that White Paper, which followed a Green Paper and an extensive consultation. The party being left behind is the Conservative party.
The Secretary of State for Health and Social Care (Matt Hancock)
For the information of the House, will the hon. Lady answer the question from my hon. Friend the Member for Thirsk and Malton (Kevin Hollinrake)? Does she support the measures recommended by the Select Committees—yes or no?
The Secretary of State for Health and Social Care (Matt Hancock)
Each and every one of us in this House recognises and values those who care, from care workers to nurses to the millions of unpaid carers who look after loved ones. I think the whole House can unite behind the statement that how we care for the most vulnerable is a mark of our civility as a society. Across our country, in our NHS and in our care homes, so many people dedicate their lives to caring for others. I want to address the pressures we face in our social care system in the short term, as well as the long-term reforms we must take to ensure that our social care system is sustainable and fit for the future.
Right at the start, I want to address the individual case of Bethany, which the hon. Member for Worsley and Eccles South (Barbara Keeley) rightly raised. On seeing the reports of the case in the media, I immediately asked for an investigation inside the Department, along with NHS England and the Care Quality Commission. This is clearly a distressing case—it was initially brought to my attention by Ian Birrell—and we will get to the bottom of it. More broadly, the number of in-patients is now down to 2,375, a fall of 17% from March 2015, including 600 who had previously been in hospital for five years or more. So there has been some progress, but there is clearly more to do and the hon. Lady was right to raise the issue.
Barbara Keeley
I gave the House a statistic of 2,600. Bethany’s dad, who is campaigning on her behalf, wants to see her in a proper community placement, but there are thousands of Bethanys. This is a serious matter. We had a debate here on transforming care a few months ago, but very little has happened since.
Matt Hancock
As I said, progress has been made. There has been a reduction of 17% in the number of in-patients—down from 2,875 in March 2015 to 2,375 on the latest figures—but I would fully acknowledge that there is more to do and I am determined to see that happen.
Our population is ageing. More people are living longer and, as a society, we must address the challenge that that creates for social care. To put that into context, over the next 25 years, the number of people aged 75 and over is set to double and the number of people aged 85 will rise by more still. Of course, this is good news. It is down in part to the hard work of our NHS. Cancer survival rates are at a record high and strokes are down by a third, but with such successes come new challenges. For instance, we are seeing a rise in dementia and in age-related conditions, with 70% of people in residential care homes now suffering with dementia.
Debbie Abrahams
Will the Secretary of State agree to support a dedicated dementia fund, as proposed by the Alzheimer’s Society, to recognise the inequity given the additional care costs that such people would be paying?
Matt Hancock
I have seen that proposal from the Alzheimer’s Society and we are looking at it now. At the same time, we are working on both the Green Paper for the future of social care, which will come before the end of the year, and the long-term plan for the future of the NHS. The interaction between the two is important.
Andrew Selous (South West Bedfordshire) (Con)
Does the Secretary of State accept that there is actually a lot of support on the Government Benches, the Opposition Benches and, indeed, across the country for the Joint Select Committee’s proposals. The concept is that, if everyone who can afford it pays something, that means that no one has to lose everything, and that is not only worth while, but urgent.
Matt Hancock
I will come on to the proposed funding reforms. My hon. Friend is right that there is support for reform across the House, but there is support for different types of reform in different parts of the House. I respect the shadow Opposition spokeswoman, but it would help if she could bring more clarity to the Opposition’s position, updating the proposal that they put forward in 2010, which I will come on to in some detail. That will help if they want to genuinely contribute to this debate.
Of course, social care is not only a challenge of old age. The number of people of working age with care needs is also growing. Many of us in this House will know the pain and difficulty of helping a loved one who needs constant care or faces dementia. Such pressures bring long-term challenges, and we must ensure that both the NHS and our social care system can respond to the challenges we face.
Janet Daby (Lewisham East) (Lab)
There is an acute nursing shortage in this country. According to the CQC, nursing homes may need to re-register as residential homes, possibly due to the difficulty in recruiting enough nurses, which would have disastrous consequences for some of the country’s most vulnerable old people. With the looming prospect that Brexit will further restrict our ability to recruit nurses from Europe with the necessary skills and talent, does the Secretary of State agree that he needs to do everything he can to ensure that the nursing home sector does not collapse?
Matt Hancock
There are more nurses on our wards than in 2010, but it is important that we have more in the future, and a whole run of work is going on to ensure that we can get more nurses right across the NHS and the social care system, including community nurses. As we put £20 billion extra into the NHS, we are going to need more nurses as a result. The nursing associate route is now available in social care, and there is a policy programme to try to ensure that we answer the exact question that the hon. Lady rightly identifies.
Damian Green (Ashford) (Con)
In the light of what my right hon. Friend just said about the long-term nature of the challenges, may I put to him the question that the Chair of the Health and Social Care Committee put to the Opposition spokeswoman? Does my right hon. Friend agree that the only way to get a decent long-term solution for all the people who will need social care is by doing so on a cross-party basis with a wide degree of consensus?
Matt Hancock
I pay tribute to my right hon. Friend’s work in this area. He is incredibly thoughtful and has been prepared to ask some of the difficult questions and give his answers to them. I agree that this is something that we should take forward on a cross-party basis wherever possible. I will come on to the long-term funding in a moment, but I just want to address directly the question of short-term funding.
I query the Labour party’s motion because 80% of local authority funding was reliant on the central Government grant in 2010, and that is no longer the case. Looking only at the central Government grant is an inaccurate way of assessing the question. For instance, we introduced the social care precept directly to address some of these costs. It would be far better if this debate took place in the context of the available budget for social care, which is increasing by 8% in real terms over the four years from 2015-16 to 2019-20. The debate should be based on facts rather than partial facts, and that is how I will seek to proceed.
Quality is important, too, and 83% of adult social care settings are now rated good or outstanding by the CQC. The figure has risen from 79% in just the last year, and it is the highest since measurement started in 2014, but I want to see it rise further still.
The links between the social care system and the NHS are important, too. No one should stay in hospital longer than necessary.
Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)
My right hon. Friend is right to highlight the link between healthcare and social care. If we are to care properly for people with the long-term conditions he has outlined, we need to have a more joined up and integrated system. It is hard to deliver that when we have a taxpayer-funded NHS and a social care system in which many people now have to pay for their own care. In looking for a cross-party solution, which he is open to, will he consider that we may need to look at a taxpayer-funded solution for funding social care so that we can deliver the transformative integrated care we want for older people?
Matt Hancock
Part of the social care system is, of course, tax payer-funded, but I also value the contributions that people make to social care. They are an important part of keeping the system strong. We dismiss those contributions at our peril, but I agree with my hon. Friend that we need to make sure we get more funding and better integration between the healthcare and social care systems. We can do that with different funding sources, as long as we have better organisation on the ground.
We must make sure we have the appropriate amount of care available so that people can leave hospital at the right time; people should not have to stay in hospital longer than necessary, as it reduces their dignity and quality of life and leads to poorer health outcomes, as well as putting unnecessary pressure on the NHS.
Since February 2017, more than 1,900 beds have been freed up in hospitals by reducing NHS and social care delays, yet we know that the winter months bring increasing pressure on adult social care services, which can have a knock-on impact on hospitals. On top of the rising social care budget, we are providing an additional £240 million for adult social care capacity this winter, which will help councils to get patients home quicker and free up hospital beds for more urgent and acute cases.
Today I have published the allocation for every local authority in England, and the Barnett formula will apply to allocations in Scotland, Wales and Northern Ireland. Individual allocations include, for example, £1.3 million in Salford and £1.5 million in Leicester.
Julian Knight (Solihull) (Con)
My constituents and my local council are thankful for the funding increase of £870,356, which will help the adult social care situation in Solihull. We have a lot of people over the age of 65, including 40% of the Silhill ward alone.
Matt Hancock
I am grateful for my hon. Friend’s work in making the case for more support for adult social care in Solihull, and to support the NHS in Solihull through that. I hope the funding we have announced today will help in Solihull, and the people of Solihull should know they have an excellent champion who has helped them to get that funding.
Rachael Maskell (York Central) (Lab/Co-op)
To address delayed discharges, it is crucial that we have transitional care and extra care in place. Will the Secretary of State look at York’s proposal for building facilities on an adjacent site to make that happen?
Matt Hancock
That is an interesting proposal, and I have seen others similar to it. We are looking at the link with housing as part of the Green Paper, and I have been discussing that with the Department concerned. The point the hon. Lady raises is important. I note that £731,800 has been allocated today to improved adult social care in York, to take the pressure off the NHS in York this winter. I hope that she will acknowledge that fact.
Hugh Gaffney (Coatbridge, Chryston and Bellshill) (Lab)
In Scotland, like in England, Wales and Northern Ireland, we have seen unbearable cuts to councils, which have made the problems of funding social care get worse. Does the Secretary of State agree that the Tories and the Scottish National party have to get a grip of the situation and give the councils more resources? They have given out figures for the Barnett formula. What is Scotland actually getting?
Matt Hancock
Through the Barnett formula, we have made available funding for Scotland today, which in England we are spending on adult social care. I very much hope the SNP Government in Holyrood will make sure they do the right thing by this funding and ensure that it goes to helping people get out of hospital when they medically can leave hospital but need care once they get out. I think we are agreed between us that the SNP Government in Holyrood should spend this money wisely.
Melanie Onn
I am keen to learn how much extra my constituency is getting, given that the Secretary of State is doing a roll call of all that. I also wish to ask him about the comments he made about the streams of funding for social care and healthcare. Is he proposing that funding would be ring-fenced? There is a concern that when we try to integrate the two, urgent healthcare will always come before social care.
Matt Hancock
That need not necessarily be the case. It was slightly disappointing that the hon. Lady, who is normally a great champion of cross-party working, did not welcome the £780,000 extra for Grimsby, but you can’t win them all. The people of Grimsby need to know that we are there to support them and to support their local NHS.
I now turn to the long-term funding pressures. The lifetime care costs of a 65-year-old today are about £45,000 on average, but those total average costs that people face are not distributed evenly. Some people face no care costs at all, whereas the care costs for someone with dementia who lives into their 90s can run into hundreds of thousands of pounds. As a society, that is the challenge we face, yet right now there is no way to predict or insure this potential financial burden. We are committed to ensuring that everyone has access to the care and support they need. However, as has always been the case, that must be based on the principle of shared responsibility. With sensible planning, people should not have to fear the risk of losing everything. The adult social care Green Paper, which will be published later this year, will bring forward a range of ideas to address the long-term challenge. We want to learn from what has been proven to work, with one example being the auto-enrolment pension reforms, which have been taken forward on a cross-party basis over a decade. The rate of opting out has been remarkably low, and this has put in place the foundations for the strengthening of our pensions system over time. The Green Paper will propose a range of options and ideas, learning from both the UK and from around the world.
Andrew Lewer (Northampton South) (Con)
The Secretary of State has said that he wants this debate to be based on fact, not partial fact, so may I have his assurance that research behind the Green Paper has taken full account of overseas options, which provide insurance models and choice, taking us well beyond these simplistic more tax solutions to address this complex problem?
Matt Hancock
Yes; I enjoyed reading that report on my summer holidays and thought the research that underpinned it was very interesting. Of course, the taxpayer does contribute to the system, but we cannot rely only on the taxpayer to support the growing cost. Some people propose the answer that the taxpayer should simply fund everything, but I do not think that that is a valid solution.
Alongside the reforms to the funding, we need to transform our care system, so we will look into how the Government can support innovation and encourage new models of care provision. That will include looking at the role of housing and how we can replicate the very best models that combine a home with quality of care. For instance, I love the examples of combing care provision for the young and the old. I pay tribute to the doctors behind the “Old People’s Home for 4 Year Olds” project, which is good viewing on Channel 4. We also need to better support people through well-designed aids and adaptations, and we must ensure better support for carers, too.
Kevin Hollinrake
The Secretary of State is making some good points, but may I press him on the point made by my hon. Friend the Member for Northampton South (Andrew Lewer) about the social insurance recommendation in the Select Committee report? The shadow Minister refused to confirm whether she would consider the findings in that report; will the Secretary of State agree at least to consider the proposals and recommendations that were delivered on a unanimous cross-party basis?
Matt Hancock
Yes, absolutely. I am considering them. In fact, I shall go further and say that I am attracted to the insurance and contribution model. There are many different potential details in how such a model can be delivered, but I am very much taking that Select Committee report into consideration as we draft the Green Paper.
Alongside ensuring that the funding is in place, we need to make sure that we support carers. In June, we published the carers action plan, a two-year package of support for carers to ensure that they are properly recognised, helped and valued in a way that supports their health and wellbeing. The Green Paper will go further and propose how society can strengthen support for carers as a vital part of a sustainable health and social care system.
The guiding principles behind the Green Paper will be sevenfold: first, improving the quality and safety of care; secondly, integrated care, with the NHS and social care systems operating as one; thirdly, giving the highest possible control to those receiving support; fourthly, better practical support for families and carers; fifthly, a sustainable funding model supported by a diverse, vibrant and stable market; sixthly, greater security for those born with care needs or who develop those needs in later life; and seventhly, a valued NHS and social care workforce. Those will be the principles behind the Green Paper, and I hope that we can build cross-party support for it.
As a society, we need to rise to the unprecedented social care challenge that our generation faces. For the sake of future generations, we must act now to build a better and more sustainable social care system, in the short term and the long term, that ensures that people are properly valued: a system both for those in need of care and for their carers, a system that supports carers—not only those who work in care homes but those who care for loved ones at home—and with the goal of building a sustainable health and social care system of which we can all be proud.
Several hon. Members rose—
Oral Answers to Questions
Matt Hancock Excerpts(5 years, 9 months ago)
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Alan Mak (Havant) (Con)
The Secretary of State for Health and Social Care (Matt Hancock)
It is a great honour to be here, Mr Speaker.
There is good progress in patients using online services in the NHS—about a quarter of patients are now registered to access general practitioner online services, up from about a fifth a year ago—but there is much more to be done to use technology in the NHS for the benefit of patients and clinicians alike.
Alan Mak
I congratulate my right hon. Friend on his appointment. Healthcare delivered by app is increasingly popular with patients in Havant and across the country. Will my right hon. Friend reconfirm his Department’s commitment to the first ever NHS patient app, and update the House on the timetable for its roll-out?
Matt Hancock
The roll-out of technology right across the NHS and, indeed, social care is good for patients and good for clinicians. I have seen countless examples of that in just my first two weeks in this job. I pay tribute to the Centre for Policy Studies report, which was launched by my predecessor and authored by my hon. Friend, which demonstrates how apps can be useful for making healthcare easier to access for patients. Apps are popular with patients, and I cannot wait to drive that forward.
Helen Goodman (Bishop Auckland) (Lab)
Matt Hancock
Yes, of course I will. I pay tribute to the hon. Lady for her work to raise funds for the MRI scanner in Bishop Auckland, which benefits from great levels of philanthropy in some areas. The whole purpose of having a national health service is that, wherever people live in the country, they can get high-quality healthcare, free at the point of delivery, according to need. I stand by that principle, and I honour it.
Dr Sarah Wollaston (Totnes) (Con)
I welcome the Secretary of State to his post. He will know that no regulator is prospectively examining the safety and effectiveness of diagnostic apps in use in the NHS. I wrote to his predecessor recently following concerns that were raised with me about Babylon’s apps, which could be missing symptoms of meningitis and heart attack, for example. What steps will the Secretary of State take to ensure that, as these technologies are rolled out, patients have can have absolute confidence that they have been properly evaluated for safety and effectiveness? Will he set out how he will take that forward?
Matt Hancock
The Chair of the Health and Social Care Committee makes a really important point. There is no greater enthusiast for technology than me—as you well know, Mr Speaker—but the thing about new technology is that the rules sometimes need to be updated to take changes in technology into account. The response when there are challenges such as the one my hon. Friend raises is not to reject the technology, but the opposite: to keep improving the technology so that it gets better and better, and to make sure that the rules keep up to pace. I spoke to Simon Stevens at NHS England about this only this morning—we have had a series of conversations in the past couple of weeks since I have been in post—and he is reviewing this exact question. I am absolutely sure that we will get to the right answer.
Andy Slaughter (Hammersmith) (Lab)
Is the Secretary of State familiar with the “GP at hand” online service? It is a partnership between a private company and a Fulham GP surgery, and it has poached thousands of profitable patients from GPs all over London, to the alarm of the British Medical Association and of GPs generally. My clinical commissioning group is investigating it, and in the meantime CCGs have blocked Babylon’s expansion to Birmingham on safety grounds. This is creating a two-tier system for GPs, so will the Secretary of State investigate it?
Matt Hancock
I am acutely aware of the question that the hon. Gentleman raises, not least because I am a user of the Babylon service myself—it is my GP. The important thing is to ensure that the rules are kept up to date so that we can get the benefits of the new technology, but make sure that it works in a way that ensures everybody gets high-quality primary care.
Theresa Villiers (Chipping Barnet) (Con)
Warm congratulations to the Secretary of State.
Whether it is online consultations or more traditional, face-to-face ones, will the Secretary of State join me in thanking all the NHS staff who do fantastic work in taking care of my constituents in Chipping Barnet?
Matt Hancock
I certainly will. I pay tribute to the NHS workforce and the social care workforce who, every day of their working lives, give up their time to serve their community, to serve their fellow man and woman, and to ensure that we have the healthiest nation we possibly can. I love the NHS, as does everybody in the House. Almost everyone is touched by the NHS at some of the most difficult times in their lives. I pay tribute to the workforce.
Julie Cooper (Burnley) (Lab)
I, too, welcome the Secretary of State to his new position. I note his intention to extend online NHS services, but I hope that he will provide more detail about how he intends to guarantee patient safety, given that the Care Quality Commission reported this year that 43% of online GP and pharmacy services are currently unsafe. Will he reverse the cuts to capital funding so that safe technology can be installed? Furthermore, what steps will he take to ensure that elderly and vulnerable patients, who find it difficult to access online services, will still have the certainty of sustainable community surgeries?
Matt Hancock
Those are really important questions. On funding, I announced only last week £487 million to improve technology and technology services to ensure that they can be as high quality as possible. On patient safety, the key is to keep improving technology so that it gets better and better. On universal access, we must use technology in such a way that patients who want to access services through technology can do so, as that frees up resources so that more can be done for those who do not want to use technology, meaning that we preserve universal access.
Ronnie Cowan (Inverclyde) (SNP)
Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
The Secretary of State for Health and Social Care (Matt Hancock)
We published the second chapter of our world-leading childhood obesity plan on 25 June. It builds on the progress we made since the publication of chapter 1 in 2016, particularly on the reformulation of products that our children eat and drink most. We will continue to take an approach that is based on evidence and we are determined to act.
Nigel Huddleston
I warmly welcome the Secretary of State to his post. I am sure that he was as alarmed as I was to learn that the proportion of 11-year-old children who are obese is now greater in the UK than the US. What more can we do to educate children and their parents about the benefit of a balanced diet and healthy life start?
Matt Hancock
I pay tribute to my hon. Friend’s work at the Department for Digital, Culture, Media and Sport on this matter. It is critical that we have a cross-Government approach. The obesity plan is led by the Department of Health and Social Care, but it is a cross-Government plan. There is a whole range of actions we need to take—from education through to culture and broadcasting—to make sure we get it right.
Dr Johnson
One of the reasons why tackling obesity in children is so important is the fact that it has such long-term detrimental effects on health. Now that the Government have published chapter 2 of their childhood obesity strategy, will the Secretary of State outline how it will have a long-term impact on children’s health and tackle issues such as diabetes and heart disease?
Matt Hancock
My hon. Friend is absolutely right that obesity, especially in children, is one of the underlying conditions that often leads to much worse long-term health conditions. Some 22% of children aged four and five in reception are overweight or obese; that number is too high and we have to act.
Mr Barry Sheerman (Huddersfield) (Lab/Co-op)
I welcome the Secretary of State to his new post, which is one of the toughest jobs in Parliament. Having worked with him on other things in the past, I am sure that his energy will come through in the Department.
I have a vested interest in the welfare of young children as we are expecting our 11th grandchild in October. Will the Secretary of State look closely at the relationship between obesity in later childhood and the diet of mothers during pregnancy? Early research shows that there is a link, so will he look at it carefully?
Matt Hancock
I am sure that they will grow into that, Mr Speaker.
I pay tribute to the work that the hon. Gentleman has done, which I have watched with admiration from elsewhere. I will certainly look at the point that he raises, which is very important, and we will take a fully evidence-based approach.
Nick Smith (Blaenau Gwent) (Lab)
I, too, welcome the Secretary of State to his new job. Today’s figures show that levels of severe obesity in children are at a record high, so will the Government speed up their childhood obesity strategy to tackle this urgent public health challenge?
Matt Hancock
We published chapter 2 less than a month ago. There is further work to do, because that sets out a whole series of areas in which we are going to take action, and I am already working on pushing it faster.
Philip Davies (Shipley) (Con)
I know that the Secretary of State has a track record of evidence-free, nanny-state policies from his time in DCMS. Can we expect more of the same in his new Department, or is he going to try out some Conservative principles, such as individual freedom, and individual and parental responsibility?
Matt Hancock
I am delighted to see that the teamwork between my hon. Friend and I is going to continue. You might be surprised to know, Mr Speaker, that there are some things on which my hon. Friend and I agree. One is the importance of individuals taking responsibility—a critical part of public health and tackling obesity—supported by an enabling state.
Mr Speaker
The Secretary of State is working extremely hard. I hope that he will take it in the right spirit if I say that I do not think he has yet quite secured the Shipley vote.
Luke Pollard (Plymouth, Sutton and Devonport) (Lab/Co-op)
Sarah, who runs the Devonport Live café in Devonport, one of the poorest parts of the country, used to provide cookery classes for local young mums, but she cannot do that anymore because of a lack of funding to provide the support, facilities and food to help young mums—especially those on low incomes—to get the skills that they need to cook healthy meals for their children. What support can the Secretary of State give to young mums and to people such as Sarah who want to provide cookery lessons to support tackling childhood obesity?
Matt Hancock
The hon. Gentleman makes an important point. Funding is available from lots of sources, not just taxpayers. Nevertheless, he will have noted that I have already started talking about the importance of getting funding out into the community, whether that is through social prescribing or wider public health efforts, to make sure that we try to tackle health problems at source and keep people out of hospital as much as possible, rather than spending all the money on sorting things out later in hospital.
Sir Paul Beresford (Mole Valley) (Con)
Patrick Grady (Glasgow North) (SNP)
The Secretary of State for Health and Social Care (Matt Hancock)
We now have more professionally qualified clinical staff working in the NHS: over 41,000 more since 2010, including over 14,000 more doctors and over 13,000 more nurses on our wards.
Peter Grant
The majority of NHS staff in Scotland will benefit from a 9% pay rise over the next three years; their equivalents in England will get a much lower increase, and we do not even know if the funding for that is secured. Does the Minister have any concerns that nurses in England may choose to relocate to Scotland where they could be paid almost £1,000 more and work for a health service whose Government actually value its work?
Matt Hancock
It is interesting that the hon. Gentleman asks that question, because it is worth looking at some of the facts. Over the five years to 2017 health spending increased by 20% in England but by only 14% in Scotland. As a consequence, people are 30% more likely to wait 18 weeks for treatment in Scotland than in England, and the increase in the number of nurses and doctors in England has been higher than in Scotland. Perhaps the SNP should look at how we have been performing in the NHS in England and learn from that.
Patrick Grady
In that case, perhaps the Secretary of State will join the Royal College of Nursing in welcoming the action by the Scottish Government to enshrine safe staffing levels and ratios in law. Given that there are over 36,000 vacant nursing posts in the NHS in England, when will he follow the Scottish Government’s lead and bring forward legislation on safe staffing levels?
Matt Hancock
I have seen what has happened, and maybe the reason why the SNP has had to do that is that in England we have increased the medical workforce faster than in Scotland. When the performances improve in the Scottish NHS, we in England will start to take lessons, but until then I will concentrate on making sure we get the very best NHS right across the country.
Robert Courts (Witney) (Con)
Barely two years after the shock closure of Deer Park medical centre in Witney, the people of Witney are now deeply concerned over the future of Cogges medical centre. Please will Ministers explain what they are doing to help with recruitment and retention of GPs in rural areas, and will the Secretary of State meet me to discuss the provision of GP services in our market towns?
Matt Hancock
I or the Minister of State would be delighted to meet my hon. Friend. Making sure that our GP services are of high quality and can respond to the health needs in the local community is absolutely mission-critical to getting prevention right, and I hope that my hon. Friend’s insights will feed into the long-term plan to guarantee the future of the NHS.
David Tredinnick (Bosworth) (Con)
I congratulate the Secretary of State and remind him that when he tours the high streets of Britain he will find an increasing number of acupuncturists, herbal medicine practitioners, reflexologists, yoga practitioners and many more, and they all have one thing in common: none of them is available on the health service. Will he introduce a review that takes into account patient experience and practitioner experience?
Matt Hancock
I pay tribute to my hon. Friend’s long campaign in this area, and I very much look forward to working with him on it to ensure that we get the right evidence-based approach to using all kinds of medicines and technologies for the benefit of patients.
Barbara Keeley (Worsley and Eccles South) (Lab)
I welcome the new Secretary of State to his post. He has said that the whole workforce of the NHS and social care should have the chance to fulfil their potential, but the care workforce has an annual turnover of 27% and a vacancy rate of 7%, and, sadly, care staff learned last week that they would not even be paid the national minimum wage for sleep-in shifts, which will potentially drive even more people away from working in social care. Will the Secretary of State demonstrate the leadership that this Government have lacked on this issue and ask the Chancellor to change the regulations on the national minimum wage for sleep-in shifts, to show care staff that they matter?
Matt Hancock
I value every person who works in the NHS and in social care, because everybody plays a part in improving the wellbeing and the health of the nation. I care deeply about that. On the question of sleep-in shifts, I saw the decision by the court and I have already had conversations with the Department for Business, Energy and Industrial Strategy, which leads on this regulation, to ensure that we can get the rules right for the future.
Kwasi Kwarteng (Spelthorne) (Con)
Mr Philip Dunne (Ludlow) (Con)
The Secretary of State for Health and Social Care (Matt Hancock)
The Government believe that artificial intelligence and other digital technologies have the potential to transform health and care services. Our work on that includes investing over £400 million in tech transformation, which I announced last week. There is much more to do.
Mr Dunne
I also welcome my right hon. Friend to his new role. He will bring tremendous energy and enthusiasm, particularly into the information advantage that we know is needed to transform the NHS. Does he share my view that not only will this transform patient outcomes but we can use artificial intelligence to improve patient treatments? What are his initial views of the obstacles standing in the way of rapid uptake of such technologies?
Matt Hancock
There are huge opportunities for AI to improve patient outcomes and to make life easier for staff. In answer to the second part of my hon. Friend’s question, it is all about getting interoperable data rules and standards in place so that different systems can talk to each other in a secure, safe and innovative way.
Mr Speaker
As the Clerk advises—his is the intellectual copyright—the hon. Gentleman has used his intelligence artificially to shoehorn his preoccupation into a question to which it has no other relation. But he has got away with it on this occasion, as it is the last day and we are all in a summer mood.
Matt Hancock
I welcome the power of new technologies to bring new drugs to the table. NHS England has made a very generous final offer to the manufacturer of Orkambi. Having spoken to those involved again over the past couple of days, I understand that a meeting has been offered to the company but not taken up. The company can break this impasse by accepting the very generous offer on the table.
Mary Robinson (Cheadle) (Con)
Patrick Grady (Glasgow North) (SNP)
The Secretary of State for Health and Social Care (Matt Hancock)
We have proposed £20 billion more funding for the NHS to guarantee its future, and I am looking forward to working with everyone in the NHS and the social care system on a long-term plan to ensure that that money is well spent. Today, we have published for the House the 2018-19 pay settlement for doctors and dentists. It represents the highest pay settlement since 2008. I regard it as a first step and look forward to a wider conversation on pay and improvements to help to make the NHS the best employer in the world.
Patrick Grady
Will the Secretary of State update the House on the progress of Baroness Cumberlege’s review of the use of mesh implants? Will he confirm whether the inquiry will liaise with the Scottish Government and whether it will hold any evidence sessions in Scotland? There are plenty of women, including some in my constituency, who had operations in England but now live in Scotland. Their voices must be heard in the inquiry.
Matt Hancock
Yes, the hon. Gentleman is absolutely right. We published information on this issue just last week. We absolutely will consult the Scottish Government and all interested stakeholders. It is a very important matter to get right.
Tim Loughton (East Worthing and Shoreham) (Con)
Matt Hancock
I would be absolutely thrilled to. I have previously participated in mindfulness training. In fact, the former chairman of my local Conservative association became a mindfulness instructor, which shows how much we take it seriously locally. I pay tribute to my hon. Friend’s work on this issue. He will have seen that, even in my first two weeks in this role I have already spoken out in favour of moves towards social prescribing and the broader prescribing of less intervention and less medicinal methods, where possible, because medicines do of course have their place. The work that he has done on this issue over many years is to be applauded.
Jonathan Ashworth (Leicester South) (Lab/Co-op)
I welcome the Secretary of State to his post. May I take a moment to thank all the NHS and social care staff who are caring for vulnerable patients in this intense summer heat?
The new Secretary of State inherits waiting lists at 4.3 million, with more than 3,000 patients waiting more than a year for an operation. He inherits a situation in which 1,700 patient requests for hip and knee operations have been refused, and in which patients in Sussex are now expected to endure “Uncontrolled, intense, persistent pain” for six months before they receive hip or knee treatment. Does he consider such increased rationing to be fair?
Matt Hancock
I am grateful to the hon. Gentleman for his welcome. Like him, I pay tribute to the work of NHS and social care staff in this summer heat. There are of course pressures on the NHS—I fully acknowledge that—and he raises a couple that I have already raised with NHS England. What he did not mention was that since 2010 there are 6,000 more operations every day and 1,800 more emergency admissions every day.
Jonathan Ashworth
Since 2010, the NHS has suffered the biggest financial squeeze in its history, and the rationing that I referred to is a consequence of that squeeze.
Let me ask the Secretary of State about general practice, which he will know is facing a severe workforce crisis, with GP numbers down by 1,000 and many GPs worried about the patient safety implications of the Babylon app, which we have already discussed this morning, and its funding implications for their model of practice. When Babylon itself admits that it is still testing it out, when Hammersmith and Fulham CCG says that
“there is evidence of concern regarding the risk to patient safety”
of expanding the service, and when Birmingham and Solihull CCG questions whether Babylon can operate in an effective and safe manner, why does the Secretary of State dismiss concerns about patient safety and say that the rules simply need to be updated? Will he tell us what specific rules will be updated to allay concerns about patient safety?
Matt Hancock
It is almost as if it was not just my hon. Friend the Member for Hitchin and Harpenden (Bim Afolami) who popped out, but the shadow Secretary of State, who obviously was not here for the earlier discussion. Getting more resources and increased resources into primary care and to GPs in particular is absolutely mission critical to the long-term sustainability of the NHS. I am delighted that there is record GP recruitment at the moment and that the work that has been done to increase GP training is bearing fruit. On the question of new technology, as we discussed over a series of questions earlier, yes, it is important to make sure that it works well and that the rules are right but, if we turn our backs on new technology, we are turning our backs on better care.
Robert Halfon (Harlow) (Con)
I congratulate my right hon. Friend on his new position. Despite having incredible NHS staff, our hospital in Harlow, the Princess Alexandra Hospital, is not fit for purpose in terms of its building. We desperately need a new hospital. Will he visit Princess Alexandra Hospital as Secretary of State and will he please make sure that we get the new hospital that we urgently need in the constituency of Harlow?
Matt Hancock
I pay tribute to the work that my right hon. Friend has done over many years making the case for his hospital, which I have heard loud and clear. I always enjoy visiting Harlow, especially when I am his guest. I hear the case that he puts and look forward to visiting soon.
Lilian Greenwood (Nottingham South) (Lab)
Chris Green (Bolton West) (Con)
I welcome the Secretary of State to his position, especially given his background in data and digital. What is he going to do to improve NHS data management to enable its use to develop the next generation of drugs and medical technologies to deliver better health outcomes?
Matt Hancock
That is a great question. Not only can technology improve in health settings; there are even greater opportunities on the research side. Getting the data structures right is mission critical, but there is so much more that we can do.
Nick Smith (Blaenau Gwent) (Lab)
Matt Hancock
We announced that we will be consulting less than a month ago. I have been closely involved in this in my previous role, as well as in this one. We will ensure that we take an evidence-based approach, but I am determined that we proceed.
Huw Merriman (Bexhill and Battle) (Con)
Will the Secretary of State come down to East Sussex to view the Better Together partnership, which puts health and social care together?
Matt Hancock
How could I say no? The integration of health and social care is vital and long awaited, and there is so much to do.
Ann Clwyd (Cynon Valley) (Lab)
As someone who is about to have a knee operation, may I tell the Secretary of State that it is a painful thing to wait for and that people should not have to stay on waiting lists for long periods of time? My question is about hospital medical staff. Western Mail carried out a survey to look at the effect of EU nationals leaving the national health service because of Brexit. It found one health board saying that there were 1,200 more nurses than there were four years ago, and another saying that there were 1,400 fewer. No one seems to be able to tell us with absolute certainty the numbers of these staff in the health service.
Matt Hancock
I listened carefully to the right hon. Lady because she has long been a campaigner on health issues, and I very much take her point about knee operations. Of course, the number of EU nationals working in the NHS in England has risen by over 4,000 since the referendum. I know that there are concerns in specific areas, but I hope that we can all take reassurance from the fact that that number has continued to rise. We are determined to ensure that the NHS has the workforce that it needs.
Mrs Anne-Marie Trevelyan (Berwick-upon-Tweed) (Con)
I welcome the Secretary of State to his place. I encourage him to visit the most rural part of England, up in Northumberland, to see for himself the challenges to healthcare provision due to the lack of a real rural financial formula. Will he update my constituents and the Save Rothbury Hospital campaign on how the review for that community hospital is going? That sort of low-level care is what makes the difference.