Health and Care Bill

Debate between Matt Hancock and Justin Madders

Consideration of Lords amendments
Monday 25th April 2022 Commons Chamber

[Matt Hancock (West Suffolk) (Con)]

I rise to support the compromise measure on reconfigurations and to ask the Government to take forward the work on UK-wide statistics with vigour and gusto.

First, on reconfigurations, it is right and reasonable that the largest organisation in the country, which is funded by taxpayers through the taxes that every single citizen pays, should be accountable to Ministers who are in turn accountable to this House. Although that principle has been accepted in the Bill across the board and in general terms, the other place has decided that it should not apply in the specific circumstances of reconfigurations. It is vital that when a reconfiguration happens, not only the clinical voices but the voice of the local community should be heard. The two need to go together. The best way to make happen any reconfiguration that is needed on clinical grounds is to engage the local community and get it onside. If we are to save lives through a reconfiguration, we can win the argument, but only if we engage and make the argument. In my experience, too often a reconfiguration was put on the table, perhaps for good clinical reasons but without enough local engagement, and in practice the process just ran into the sand.

I welcome the six-month delay—I hope the Secretary of State will work quicker than six months most of the time, but it is a good backstop; I welcome the de minimis threshold, because relatively small reconfigurations happen all the time; and I welcome the removal of some of the bureaucracy in the amendment. To my hon. Friend the Minister, who has done a magnificent job on the Bill right from the start, before it even came to this House—I thank all his officials for their service—I say: let us take this compromise but say clearly to the other place, “Thus far and no further.” The principle of democratic responsibility for the NHS and for winning the argument with the public about its local design is at the heart of the Bill and it must stand.

In the final minute I have in which to speak, let me make a point about statistics. Those on the Treasury Bench have decided not to include in the Bill measures on the UK-wide measurement of health services and on the interoperability of data in the four nations of the UK, but I put on the record the importance—I hope the Minister reiterates this—of getting UK-wide measurements. In Wales, it was decided to discontinue the measurement of some aspects, especially in respect of A&E performance. A suspicion was raised—I am sure this could not possibly have been true—that those measurements were discontinued so that unfavourable comparisons with England could no longer be made. If that were true, it would be an outrage. I very much hope that it is not, but we should put it right anyway and measure NHS service delivery throughout the UK on the same basis, so that comparisons can be made, so that we can learn about and improve services across all four nations, and so that accountability can properly apply to the four different Governments who run the four parts of the one NHS, which operates across this United Kingdom.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

I rise to speak to the Lords amendment on workforce—probably for the dozenth time during the Bill’s passage. I make no apologies for repetition because some things are worth repeating and the importance of our workforce can never be understated. Everything comes back to workforce: the grandest plans, strategy documents, reorganisations, integrations and configurations will all count for very little if the fundamental cog in the machine and the glue that holds the whole thing together—the workforce—is not a central part of those plans. The consistent failure to invest in the workforce and to provide a plan for it so that it is able to meet demand over a sustained period is at the root of many of the challenges that the NHS faces today. We should correct that.

On Friday night, a constituent contacted me as he suspected he had dislocated his hip and had been told that his situation did not warrant an ambulance. Eventually, he managed to get to A&E, but in the end he went home without receiving treatment because it was so busy that people were standing outside the department. That is just one example, but there are countless others like it—the frustrated constituents who can never speak to their GP; the many people left in agony because waiting lists are at record levels; those whose teeth rot away because they cannot get dental treatment; and those who receive no help for their mental health issues because they do not reach the threshold for intervention. Every one of those examples arises because, to a greater or lesser extent—I would say to a greater extent most of the time—there simply are not enough staff to meet the demand.

There is a pattern of disconnection in respect of the action required to meet the Government’s ambitions, let alone getting the NHS to meet its constitutional targets. Unless workforce is addressed in a meaningful way as part of all the plans and strategies issued, the Government are just fooling themselves that their plans are credible and deliverable. Even if the Government wish to fool themselves, they are not fooling anyone else. They are certainly not fooling us Members on the Opposition Benches or the 100 or so health and social care organisations that support what we are trying to achieve with the workforce amendment.

The most recent Department-commissioned NHS workforce strategy, the People Plan, did not include a forecast on staffing numbers. When asked about it, Baroness Harding, who authored the plan, said that the strategy did not include staff numbers not because

“the Government disagreed with the numbers”

but

“because we could not get approval to publish the document with any forecasts in it.”—[Official Report, House of Lords, 7 December 2021; Vol. 816, c. 1814.]

Perhaps that means the Government do have figures but just do not want us to see them. If that is right, perhaps the Minister could let us in on the secret when he responds. If that is not right, will he tell us what other organisation with more than a million staff manages to operate successfully without accurate figures on workforce projection?

In addition to the obvious arguments about why we need accurate information on workforce requirements, it is important that we collect such information for existing staff, because they need hope that help is on the way. We need to show that those claps on a Thursday night were not an empty gesture and that there is a determination to do something about the persistent rota gaps that mean staff are both exhausted and demoralised. Just look at some of the challenges we face: 93,000 vacancies; a £6 billion annual spend on agency staff; staff working extra unpaid hours; and some 40% off with work-related stress at some point or other. With all those things conspiring together, it is little wonder that retention is an issue, so we need to give staff hope that we have an answer—that we have a plan. As the Select Committee report on workforce burnout said:

“The way that the NHS does workforce planning is at best opaque and at worst responsible for the unacceptable pressure on the current workforce which existed even before the pandemic.”

With so many challenges currently facing the NHS, why do we want to make it worse by refusing to accept the evidence before our eyes? It is no coincidence that NHS satisfaction ratings are reported to be at a 25-year low at the same time as record numbers of NHS staff say they would not recommend working at their own trust. Those issues are not disconnected in any way, which is why we need to support the workforce amendment.

Oral Answers to Questions

Debate between Matt Hancock and Justin Madders

Tuesday 13th April 2021 Commons Chamber

[Mr Speaker]

This is Mrs Hoyle’s effort, but there we are.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

Congratulations to Mrs Hoyle on a job well done.

New investment is welcome, but it is no consolation to those patients missing out because the rest of the NHS estate is being starved of investment. We have seen a 23% increase in treatments being delayed or cancelled in the last year because of infrastructure failures, and the maintenance backlog went up by another 50% last year. We are not going to see those record waiting lists drop if operations are cancelled because basic repairs are not done, so will the Secretary of State tell us by what date we will see no more delays to treatment because of crumbling buildings?

[Matt Hancock]

We are putting a record amount of investment into the infrastructure of the NHS. That is evidenced by the questions that we have had already, with the improvements in Stoke, Scunthorpe and across the rest of the country. It is about not just the physical investment, but making sure that we support staff to be able to deliver and making sure that the NHS gets the support that it needs to tackle this backlog. We have a very significant backlog because of the pandemic and we are working incredibly hard to tackle it.

Public Health: Coronavirus Regulations

Debate between Matt Hancock and Justin Madders

Tuesday 13th October 2020 Commons Chamber

[Dr Luke Evans (Bosworth) (Con)]

On buying-in the local community, would the Secretary of State consider having a Government postcode checker so that people know exactly where they should be, in having the three tiers?

[Justin Madders (Ellesmere Port and Neston) (Lab)]

That was my idea.

[Matt Hancock]

My friend, the hon. Member for Ellesmere Port and Neston (Justin Madders), says from a sedentary position that that was his idea, but success has many fathers and I can tell my hon. Friend the Member for Bosworth (Dr Evans) that such a postcode checker was launched this morning. I will send him the link. It is still in beta, so it will be constantly improved, not least to ensure that, if a postcode covers an area that is in two different levels, that is clear. That is being sorted at the moment. A postcode checker is a great idea. It tells you the level of local risk. Furthermore, the NHS covid app, which has now been downloaded by over 17 million people, has a link to the local alert level as well.

To turn back to the measures before us, we will keep the measures under constant review. The overarching regulations sunset after six months, but regulation 8(1) of statutory instrument 1105 makes clear that the allocation of a particular area to local alert level 3 will automatically expire after 28 days. We will work with local areas on the level they need to be at and that work continues at pace. Decisions to move local areas between the levels will be considered by the JBC, working across Government and with local government on the normal weekly cycle. While, of course, there will be times when we need to act quickly to contain the virus, we want to give the House the opportunity to consider the measures on the medium and high local alert levels, and the baseline measures for the very high alert level. I urge the House to support the measures set out today.

Oral Answers to Questions

Debate between Matt Hancock and Justin Madders

Tuesday 1st September 2020 Commons Chamber

[Matt Hancock]

The answer to the first part of the hon. Lady’s question is that when we are trying to reach scale fast, we use the national system. That then engages with the local system—for instance, in Croydon, as we just heard—so that we can get the boots on the ground to find those contacts who cannot be contacted through the national system. It is the combination of the two that works best. As for making sure that our systems are in the best possible place to tackle coronavirus going forward, I absolutely think that it is right constantly to be seeking to make improvements to how things operate, which is why I announced the changes that I did.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

In some areas, the private companies involved in test and trace have been reaching less than half the contacts they are supposed to reach, not the 80% that the Secretary of State has claimed. We do not need an algorithm to work out that those companies’ performance, compared with that of local public health teams, is where test and trace is failing. Why, then, are the Government rewarding private sector failure by extending the contracts?

[Matt Hancock]

As I have just explained, the test and trace system at the national level makes the immediate and rapid first attempt at contact. If no contact is made, the local teams can then go in. It is the combination of the two that works best. I really think that the Opposition —especially coming from the Front-Bench team—are making a mistake in trying to divide people between public and private. Actually, everybody is working very hard together to deliver the control of this virus.

Oral Answers to Questions

Debate between Matt Hancock and Justin Madders

Tuesday 23rd June 2020 Commons Chamber

[Matt Hancock]

It is very strange taking these questions from the SNP spokesman, given that I am working with the SNP Government on resolving exactly these problems in Scotland, and maybe the SNP would do better to focus there. In response to the second question, honestly, we have put £300 million of support into local directors of public health to tackle this pandemic, and I know that her colleagues in the Scottish Government are working hard with local authorities in Scotland as well in exactly the same way.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

The Prime Minister promised that 100,000 people a day would be tested by the end of April, so since that date, on how many occasions have more than 100,000 people been tested on any single day?

NHS Long-Term Plan: Implementation

Debate between Matt Hancock and Justin Madders

Monday 1st July 2019 Commons Chamber

[Matt Hancock]

NHS dentistry is incredibly important. Ultimately, dentistry is part of prevention; it prevents oral ill health. We are doing a lot of work on what further we can do to support oral health. In fact, I had a meeting with the Minister with responsibility for public health on that subject this morning. I would love to meet my hon. Friend to discuss it further.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

The Secretary of State clearly identified three critical areas for improvement to cancer survival rates. He is absolutely right about early diagnosis. I do not want to make my hon. Friend the Member for Rhondda (Chris Bryant) any more sweaty than he already is, but it cannot be repeated enough times that spotting these issues early on is critical to improving survival rates. The Secretary of State is also right about the importance of mental health. The third point he touched on was that the workforce is key to underpinning all this. In that regard, does he know how many specialist mental health and specialist cancer nurses we will have at the end of the 10-year period?

[Matt Hancock]

The answer to that question is being worked on as part of the people plan, which Baroness Dido Harding is putting together. We published the interim plan last month. The full people plan will be available after we have settled, in the spending review, the budget of Health Education England. The hon. Gentleman raises an incredibly important point.

Oral Answers to Questions

Debate between Matt Hancock and Justin Madders

Tuesday 18th June 2019 Commons Chamber

[Justin Madders (Ellesmere Port and Neston) (Lab)]

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

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

This week is Children’s Hospice Week, Loneliness Awareness Week, National Breastfeeding Week and Learning Disability Week, and today is International Fathers Mental Health Day. The Government have made plans to more than double funding for children’s palliative care and end-of-life care services, developed a loneliness strategy and launched a consultation on folic acid in flour to support expectant mothers, and yesterday the Prime Minister announced a package of further work to support people from all backgrounds in the UK with their mental health. I and my brilliant ministerial team will continue to drive forward the health of the nation.

--- Later in debate ---

[Justin Madders]

I want to bring to the Secretary of State’s attention some mental health waiting times that my constituents have recently come to me with. Someone with an urgent referral for trauma counselling is looking at a minimum six-month wait. A teenager who has attempted to take her own life is waiting over a year to see a psychiatrist. Several adults have been told there is a three-year wait just to get a diagnosis of attention deficit hyperactivity disorder. These waits are appalling. The Secretary of State billed himself as the leadership candidate for the future, but he is the Secretary of State for Health now. What is he going to do to address this appalling waiting system?

[Matt Hancock]

The hon. Gentleman is right that we need to ensure that access to mental health services improves. As part of the increase in funding we are putting into the NHS, the biggest increase is in mental health services, and it is a critical part of what we need to do to address the sorts of problems he rightly raises.

Oral Answers to Questions

Debate between Matt Hancock and Justin Madders

Tuesday 26th March 2019 Commons Chamber

[Justin Madders (Ellesmere Port and Neston) (Lab)]

10. What assessment he has made of the implications for his Department’s policies of the conclusions of the “Clinically-led review of NHS access standards: interim report from the NHS national medical director”; and if he will make a statement.

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

It is a great pity to see the hon. Gentleman back up there on the Back Benches as he was such a force—and a rare force—for reason and progress on the Opposition Front Bench until recently.

Standards in the NHS should be based on clinical evidence, and NHS England’s proposals will be rigorously field-tested to gather further evidence on clinical, operational, workforce and financial implications, all with the goal of improving the quality of care.

[Justin Madders]

I thank the Secretary of State for his tribute—although it is not going to change the question I am going to ask. He will be aware that since July 2015 the four-hour A&E target has not been met and last month saw the worst performance on record, so regardless of any clinical reviews, is it not time that Ministers admitted that the four-hour A&E target has effectively been abandoned?

[Matt Hancock]

Of course, we are aiming to meet and improve against the targets, including with the injection of the extra money—£34 billion extra in cash terms over the next five years. At the same time, we must make sure that the standards to which we hold the NHS are the right ones clinically for the times, and that is what this review of standards is all about.

Eurotunnel: Payment

Debate between Matt Hancock and Justin Madders

Monday 4th March 2019 Commons Chamber

[Matt Hancock]

Yes, my hon. Friend is correct. He makes a broader point: people watching these proceedings, people who have serious illnesses, and people who rely on medicines every day to keep them alive will be amazed by those Members who will not vote for the deal and therefore make a no-deal exit more likely, and by those Members who just cause political noise rather than admitting that, in the circumstances, they too would have settled this case. We are hearing a lot of that from those on the Opposition Benches. On the Government Benches, however, we are hearing from Members who care deeply about making sure that people get the medicines that they need.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

Does the £33 million include all the possible expenditure under this agreement, or are there any additional costs, such as legal fees, that need to be added on top? If there are, how much are they?

[Matt Hancock]

The settlement is £33 million. Of course, there are lawyers, and legal time was also needed inside the Department. That happens all the time in order to try to make sure that we can keep people safe, which is the whole purpose of this exercise.

Oral Answers to Questions

Debate between Matt Hancock and Justin Madders

Wednesday 27th January 2016 Commons Chamber

[Matthew Hancock]

Right across the public sector, thousands of public appointments are made each year. It is vital that people from all backgrounds, from all ethnicities, and both men and women, from all parts of our country, put their names forward so that they can help in our great mission of improving the lives of the citizens of the UK.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

T4. In the past year, one in seven peers did not speak at all in the other place, despite many of them claiming allowances. If the Government are so keen to reduce the cost of politics, why are they not doing anything about this?