Oral Answers to Questions

Meg Hillier Excerpts

Tuesday 11th July 2023 Commons Chamber

[Neil O’Brien]

I have given a flavour of the four different reforms we are making. To give the wider picture, there are more pharmacies in England than there were in 2010, there are 24,000 more pharmacists in England than there were in 2010 and we are putting in £645 million to provide a bunch of services that were not there when Labour was in office. We are very happy to take lessons from the pharmacy sector, but not from the Labour party.

[Dame Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

8. What steps he is taking to help improve the effectiveness of brain cancer treatments.

[The Minister for Health and Secondary Care (Will Quince)]

We are working closely with research partners, and although I am pleased to say that more research is being funded, we want to see more research in brain cancer treatments. We continue to encourage more researchers to become involved in what remains a challenging scientific area, with a relatively small research community, but I am confident that the Government’s continued commitment to funding will help us make progress towards effective treatments.

[Dame Meg Hillier]

I thank the Minister for that answer, and I am sure—and I know—he will take this very seriously. I have had three constituents in the last year come to see me who have suffered serious brain tumours, and they have had a very similar pathway, which is basically that after a certain point there is little the NHS can do for them. In particular, there is a shortage of neuro-oncologists, and one has spent their life savings on private treatment, even though that was difficult to find. Is there any hope, in the NHS workforce plan, that there will be more oncology training and more support for neuro-oncology, because the survival rate for this cancer is still woefully low?

[Will Quince]

I thank the hon. Lady for her question, and I am sorry to hear of the experience of her three constituents. There certainly is hope within the long-term workforce plan. As she rightly alludes to, we are reliant on researchers to submit high-quality research proposals, and that requires clinicians specialising in this area. It is something I take very seriously, and I would be very happy to work with her on it.

Hospice Services: Support

Meg Hillier Excerpts

Wednesday 14th June 2023 Westminster Hall

[Paul Holmes]

The hon. Lady tempts me to come to content that I will cover later in my speech, but for now she can take it that I wholeheartedly agree, as do many Members here, I suspect.

No one will contest that our health and care staff deserve to be well paid for the incredible work they do, and in an ideal world we would see our life savers and carers never have to worry about their finances and pay, but it would be deeply irresponsible to facilitate pay rises without giving due consideration to the dramatic impact that rising wage costs have on these essential services. To give some specific context, Mountbatten Hampshire took over management of the hospice from the NHS in 2019. It has a contract with the NHS for roughly 35% of its costs, of which about £3.8 million comes from the local NHS commissioners in the form of an outcome-based contract. The hospice follows the NHS pay award each year to remain competitive and to retain and hire staff for its services, which means that the hospice has seen a 4.8% rise in costs this year and will see a further 5% next year, with no corresponding change in its NHS contract, leaving an increasing and worrying financial gap that the charity will find very hard to reconcile without public funding.

[Dame Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

Will the hon. Member give way?

[Several hon. Members rose—]

[Paul Holmes]

I am spoilt for choice! I give way to the hon. Member for Hackney South and Shoreditch (Dame Meg Hillier).

[Dame Meg Hillier]

It is interesting to hear about the Mountbatten, which I spent many years at when it opened, when I was a child. The hospice in my constituency, St. Joseph’s Hospice, is really cutting-edge, but the retrospective payment for nurses will cost it £470,000, and it cannot apply that yet because it has no certainty from commissioners about its funding. To keep it up will be another half a million a year, and it cannot afford that without certainty of funding. I am sure the hon. Member agrees that we need to press the Minister for some clarity on this.

[Paul Holmes]

I agree with the right hon. Lady; we do. In my experience, the uplift that has been given to local NHS commissioning groups is simply not making it through to those end of life services. I hope we will see some recognition of that from the Minister, and I am sure she will enforce this, to ensure that the funding to local commissioning groups gets through to these services.

Oral Answers

Meg Hillier Excerpts

Tuesday 25th April 2023 Commons Chamber

[Dame Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

My constituent had emergency surgery for a brain tumour, but this was after six months of going to the doctor repeatedly with problem headaches. Brain cancer causes 9% of cancer deaths but accounts for only 1% of cases. Sadly, my constituent is terminally ill, but he is in a position to explain his experiences. He has asked me to raise with the Secretary of State the issue of what work is being undertaken on genome sequencing, which could have a major impact on better treatment for brain cancers. It would be helpful if the Secretary of State not only answered this today but wrote to me in more detail on it.

[Steve Barclay]

The whole House will send their best wishes to the hon. Lady’s constituent. She raises an important point about genomics, which is why we have invested in Genomics England and 100,000 babies are being screened—that is a key programme of work. The Minister for Health and Secondary Care, my hon. Friend the Member for Colchester (Will Quince) recently hosted a roundtable with key stakeholders on that, but I am happy to write to her with more detail, because the prevention and capability that is offered through screening is a great way of getting early treatment to people.

NHS Winter Pressures

Meg Hillier Excerpts

Monday 9th January 2023 Commons Chamber

[Steve Barclay]

My hon. Friend raises an important issue about getting flow into the system, not least because delays in ambulance handovers lead to the highest risk in what is a whole-of-system issue where the patient is not seen and treatment is delayed. That is why flow through discharge is so important, because, while that often concerns the back door of the hospital, it is actually the pressure at the front door that is most acute. The Government recognised that in the autumn statement and that is why there was additional funding with the £500 million for delayed discharge. That has taken some time to ramp up, but we recognise that because of the flu there is an immediacy in the pressure on A&E that we need to address.

My hon. Friend’s point speaks to one of the key lessons from the covid period. It is not simply about releasing patients from hospitals who are fit to discharge; it is also about the wraparound services provided for those patients so that they do not get stuck in residential care for longer, and they are still able to go home and get the domiciliary care packages. NHS England is focused on that so that they have the wraparound services alongside that discharge.

[Dame Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

We have seen this year in, year out: money thrown into the NHS at a winter crisis point, too late to spend it sensibly, yet this Government have been in power for nearly 13 years. I could not identify anything new in the Secretary of State’s speech. We have talked about discharge before, and picking up on the point made by the Select Committee Chair the hon. Member for Winchester (Steve Brine), without proper funding for local councils for domiciliary care and for funding care homes, this will never work.

Government PPE Contracts

Meg Hillier Excerpts

Tuesday 6th December 2022 Commons Chamber

[Angela Rayner]

I thank the hon. Member for his point, and he is absolutely right. The Fire Brigades Union members were in Parliament and outside it today. They are frustrated, like many others who have been told that there is not money to give them a pay rise and that, actually, they are going to get a real-terms pay cut. But at the same time, billions of pounds has been wasted. As I said in my opening remarks, £770,000 a day has gone on storing this equipment. It is not acceptable to most people and most members of the public.

[Dame Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

My right hon. Friend has highlighted one particular legal situation, but I am sure she is aware that the Department of Health and Social Care remains in dispute on 176 contracts for PPE worth £2.7 billion. I wonder whether she has any thoughts about that.

[Angela Rayner]

The Chair of the Public Accounts Committee is absolutely right. It is absolutely eye-watering and astonishing that 176 contracts remain in this situation. The public can see that and they are frustrated, because it is not acceptable and not okay to govern in that way. The public rightly want answers, and they want them now.

The links between the company Medpro and the Tory peer in question were never publicly disclosed. In fact, they were denied repeatedly by the lawyers acting for those involved. We now know that the money ended up in offshore accounts directly linked to those individuals. By their own admission, this was for so-called tax efficiency. It seems that they even dodged paying their own taxes on the profits they made from ours. Only after a long legal battle was it revealed that there was active lobbying from ministerial colleagues for access to the VIP lane and substantial contracts were won by those companies. They said that the peer in question did not benefit from these contracts. That denial has been rather undermined by the latest revelations of The Guardian, rather than any disclosure of Ministers. It was only some time after The Guardian exposed those links that a Minister, the right hon. Member for Charnwood (Edward Argar), finally told me in answer to a parliamentary question:

“Departmental records reflect that a link between Baroness Mone and PPE Medpro was clear prior to contracts being awarded.”

But Ministers have, for months, refused to show us those records or tell us the nature of that link and whether it was declared or discovered in due diligence.

This was the subject of an investigation by the Standards Commissioners in the other place, yet it appears that Ministers sat on the information that they had. The question is very simple: what have Ministers got to hide? Did they know all along who was behind PPE Medpro, or was due diligence so poor that they did not realise the problem? If they had nothing to hide and no rules or laws were broken, Ministers will surely be happy to make the details of the meetings and correspondence available. While they are at it, will the Minister give us clarity about allegations made by the former Health Secretary in his new book about a separate bid for business connected to Baroness Mone?

--- Later in debate ---

[Will Quince]

I am pleased that the hon. Lady made that intervention, because it is the first I have heard of such an accusation being made. If she has evidence of such, I suggest that she presents it.

It might be helpful if I just talk through the process. Thousands of companies made offers; around 430 were prioritised through the high-priority lane; only 12% of those resulted in a contract; and due diligence was carried out on all companies by civil servants. Financial accountability sat with a senior civil servant, and Ministers—this is important—were not involved in the decision-making process. A team of more than 400 civil servants processed referrals and undertook due diligence tests.

On that basis, we will make no apology for procuring PPE at the pace and volume we did. Now that the global market for PPE has stabilised, it is easy for some people to point to the value of goods that are inevitably now sold at a much lower price than we paid, but that is a cheap shot, and one that entirely misses the point. We adjusted down the value of our PPE holding as market prices have changed—that is just standard accounting practice—and even then, we are still putting large quantities of it to use. Our successes should be judged on the conditions we faced at the height of the pandemic, not with the convenient benefit of hindsight.

Let me come to civil servants. If I may, I will give the right hon. Member for Ashton-under-Lyne (Angela Rayner) the benefit of my fast-approaching four years’ experience as a Minister. We rely on hard-working civil servants; they are the backbone of our state and it is my privilege to work with them. She knows that Ministers were not involved in the decision-making process for PPE procurement, and the due diligence, as I have said, was undertaken by a team of more than 400 civil servants. Although I am a Health Minister now, I was not at the time; I was a Minister at the Department for Work and Pensions. I recall how hard civil servants worked, under the most trying conditions, during the pandemic.

[Dame Meg Hillier]

rose—

[Will Quince]

I promise I will come to the hon. Lady.

Those 400 civil servants working on PPE and a senior accounting officer took decisions at pace and under huge pressure, as lives depended on them. Did they get everything right? No, they did not. But they did try their best in a highly competitive global market, with significant challenges in sourcing, procuring and distributing PPE. [Interruption.] Yes, they absolutely did. I gently say to the right hon. Member for Ashton-under-Lyne that her implied criticism of their professionalism, integrity and independence at a time of crisis, with the convenience and luxury now of hindsight, is deeply regrettable.

[Will Quince]

I will come to that. As I said, due diligence was carried out on all companies. Procurement decisions were taken by civil servants. Financial accountability sat with a senior civil servant. I thank and applaud our hard-working civil servants, and I humbly suggest that someone aspiring to be our Deputy Prime Minister should do the same and not seek to throw them under the metaphorical bus.

[Dame Meg Hillier]

Very early on, the Public Accounts Committee and the National Audit Office were looking into the issue. We know that it was a rush at the beginning, but we were warning about the problems early on, and still they persisted. There was poor record keeping—frankly, it was a lack of record keeping in many cases. This House gave the Government permission to act fast, but not to act fast and loose, and the Minister just needs to acknowledge that.

[Will Quince]

I thank the hon. Lady for her intervention, and I will come on to some of the action that we will take. She rightly mentions accountability. Details of the high-priority lane were published on 17 November 2021 and updated in February 2022. This is an important point, because the right hon. Lady, the deputy Leader of the Opposition, suggests that there is some kind of cover-up. If there is, Madam Deputy Speaker, listen to this, because this is some kind of cover up! As I have said, high-priority lane details were published on 17 November and updated in February this year. The National Audit Office has written three reports specifically about PPE. The Public Accounts Committee has held a number of evidence sessions. The Boardman review of procurement has taken place and we are implementing its findings in full. The independent public inquiry into the Government’s handling of the pandemic is ongoing. Of course there are lessons that we have to learn, and that we can and should learn, but there is clear accountability in this process.

As I have mentioned civil servants, I want to put on the record my thanks to the 400 civil servants who worked tirelessly to source deals from around the globe, buying PPE to the highest standards and quality and, yes, for the best value at the time. It was not only them; it was a true team effort—one that was made possible through some incredible collaborations, including everyone from industry to the NHS, and from social care providers to our armed forces. They all played their part and they played it well.

Turning now to unsuitable PPE or potential fraud, it is a simple truth that 97% of all PPE that we ordered was suitable and fit for use, with only a small proportion of the billions of items procured deemed unsuitable. Where that has been the case, we are actively seeking to recover costs from suppliers and we are working to maximise the value from our stockpiles, including using PPE in other settings outside of our NHS. Equally, in those rare instances where there have been allegations of fraud, my Department’s anti-fraud unit has worked quickly to investigate and move to recover costs.

With respect to some of the specific points raised in today’s motion, of the thousands of companies that made offers, around 430, as I have said, were processed through the high-priority lane, and only 12% of them resulted in a contract award. The right hon. Member for Ashton-under-Lyne knows that all contracts went through the same due diligence process regardless of the source of the offer. She also knows that the NAO has written three reports about PPE, and the Public Accounts Committee has held a number of hearings. I know that she would like me to go into the detail of individual contracts, but she knows—she even alluded to it—that my Department is engaged in commercially sensitive mediation with the relevant companies with a view to resolving the issue without recourse to formal legal action.

Responding specifically to the terms of the motion, the Government are committed to releasing information when all investigations are concluded. Our response will necessarily take into account the wider public interest and the commercially sensitive nature of the material. It is only right that we work with the Public Accounts Committee on the terms on which information might be shared. I understand that the Chancellor of the Duchy of Lancaster will soon begin a dialogue with the Chair of the PAC on how we enact those information-sharing arrangements.

[Dame Meg Hillier]

I thank the Minister for giving way again. I reassure him and the House that the Public Accounts Committee is responsible, not reckless. We have previously received papers from this House and we have a well-established protocol for receiving and dealing with such papers. The Committee is trusted—we never leak. If we decide to publish, that is a choice that we would make, but it is a responsible decision that we would take.

[Will Quince]

I thank the hon. Lady for that response, and I know the Chancellor of the Duchy of Lancaster will soon begin that dialogue with her.

Oral Answers to Questions

Meg Hillier Excerpts

Tuesday 6th December 2022 Commons Chamber

[Maria Caulfield]

May I thank my hon. Friend for all her hard work during her time as a Health Minister? We are going through the responses to the call for evidence right now; as I have indicated, we will update the House shortly. I will very much take her points on board.

[Dame Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

My constituent Jesse, who is 24, was diagnosed with grade 4 glioblastoma multiforme, a type of brain cancer. It has been devastating to her. She has had a very difficult year of treatment; crucially, after her initial round of treatment, there were delays in accessing a scan because of the backlogs in the NHS. There is a real need for a proper cancer care plan to make sure that she gets her scans as regularly as necessary. Other patients need them as well, but her scan was two months later than it should have been under the standard of care, leaving her in absolute terror that her cancer would come back. The fear is almost as bad as the disease itself. What plans does the Minister have to make sure that the 10-year cancer plan really gets to grips to the backlog, which is devastating people’s lives?

[Maria Caulfield]

I am sorry to hear about the experience of the hon. Lady’s constituent. I am sure that she will welcome the 91 community diagnostic centres that have already been set up to provide a range of tests, including CTs, ultrasounds and MRIs. We are expecting to deliver up to 160 community diagnostic centres in total, with the capacity for up to 9 million more scans per year when they are fully operational. That will not just deal with the backlog, but future-proof our diagnostic services.

Oral Answers to Questions

Meg Hillier Excerpts

Tuesday 19th July 2022 Commons Chamber

[Steve Barclay]

This is an important issue, and it affects different parts of the workforce in different ways. The 56p is higher than the rate approved by Her Majesty’s Revenue and Customs, and, as the hon. Lady said, it drops to 20p after 3,500 miles have been travelled. Of course, the Government are taking other measures more widely in their fiscal response to the cost of living, such as cutting fuel duty, but there is a review mechanism in respect of the NHS specifically, which involves looking at these issues in the round.

[Dame Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

5. What steps he is taking to encourage covid-19 vaccine uptake in adults.

[The Parliamentary Under-Secretary of State for Health and Social Care (Maggie Throup)]

Vaccines continue to be the best line of defence against covid-19, and about 94% of those aged over 12 in England have come forward for their first dose. We are continuing to make vaccinations as accessible and convenient as possible, with thousands of sites operational, including targeted mobile vaccination clinics. Throughout the roll-out, we have monitored data and shared it with local NHS systems to support tailored interventions and outreach. That includes providing bespoke messages from the trusted community and faith leaders who know their communities best.

[Dame Meg Hillier]

As the Public Accounts Committee reported last week, there are still 3 million people who have not been vaccinated, and we hope that the Government will give as much support as they can to increase the take-up among that group. However, I am particularly concerned about people with black, black British and Pakistani backgrounds, who are far less likely to have had their first booster. There is a real inequality issue here. Can the Minister give us any further indication of how she will ensure that, on her watch, we do not see that inequality embed itself?

[Maggie Throup]

I have read the hon. Lady’s Committee’s report with interest and I recognise the points she has raised. We know that vaccine hesitancy among ethnic minority groups has reduced over the course of the covid-19 vaccination programme, but we will not rest on our laurels. We continue to work closely with our valued communities and community leaders to provide advice and information at every opportunity, and we have materials translated into 28 different languages. There have been many ways in which we have reached out to those communities. For example, we have had vaccination sites in mosques—I visited one in Small Heath in Birmingham—and the Bangladeshi community have come together and encouraged people to get a “jab with your jalfrezi”. We are looking at every different way of reaching out to ensure that we reach all those communities.

Access to GP Services and NHS Dentistry

Meg Hillier Excerpts

Tuesday 21st June 2022 Commons Chamber

[Wes Streeting]

My hon. Friend is absolutely right about the state of dentistry. It is not alliterative, but I suspect that my hon. Friend the Member for Hackney South and Shoreditch has similar points to make.

[Dame Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

A constituent of mine told me that she had a terrible toothache, rang 111 and was assigned to an emergency dentist. The system worked, but does my hon. Friend agree that that that costs the taxpayer so much more money? My hon. Friend talks about overpromising and underdelivering, but with dentistry the Government have not even promised anything and they are underdelivering.

[Wes Streeting]

My hon. Friend knows exactly what she is talking about. Of course, there is no one better in this House to make the point about the waste of public money. That is the outrageous thing about all of this. People are paying more and getting less. Their taxes have been put up, justified in the name of the NHS, but the money is not being directed in the right way to deliver better care. In fact, the Government admit that even with the investment they are putting in, people will be waiting longer for care and that is a disgrace.

Oral Answers to Questions

Meg Hillier Excerpts

Tuesday 14th June 2022 Commons Chamber

[Maria Caulfield]

My hon. Friend is absolutely right that the nub of the problem is the dental contract. Negotiations have started and the details are with the British Dental Association as we speak. We expect to make an announcement before the summer recess.

[Dame Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

Like the hon. Member for Weston-super-Mare (John Penrose), I have a number of constituents who have had real problems reaching dentists before and since covid, but there have been some particularly distressing cases since covid. There has never been the right package to pay dentists to do the work, which is driving them out of the business, but the inefficiencies of having to go through the central NHS systems for an emergency appointment are costing the taxpayer dear. When will we see proper certainty around the measures that the Minister just described, so that dentists know that it is worth their while sticking with NHS patients?

[Maria Caulfield]

As I said, the contract is the nub of the problem; it is currently a perverse disincentive for dentists to take on NHS work. We are serious about reforming it, we are in discussions with the BDA, and we will make the announcements before the summer recess.

Oral Answers to Questions

Meg Hillier Excerpts

Tuesday 18th January 2022 Commons Chamber

[Edward Argar]

I am always happy to take the opportunity, as I know the Opposition Front-Bench team and my colleagues are, to thank the amazing NHS workforce for the work they have done. I pay tribute to the work of the teams at Mount Vernon and Watford General and, in the context of the pandemic, I pay tribute to my hon. Friend the Member for Watford (Dean Russell), who volunteered to help out at the hospital.

[Dame Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

The Minister highlighted the use of independent care providers. Last week, the Department announced that 150 hospitals would be on standby for three months to provide additional resource. Can the Minister tell the House when he or his Secretary of State asked NHS England to investigate standing up the 150 hospitals, which will receive a minimum income guarantee of £75 million to £90 million a month?

[Edward Argar]

I think I heard the hon. Lady correctly and she asked when those discussions began. That was last year, prior to the peak of this wave. We believe that the use of the independent sector to assist our NHS and provide additional capacity is absolutely the right thing to do. Thus far, during the course of the pandemic, it has provided, I believe, over 5 million procedures to patients. Therefore, we think this is a valuable and important addition to our capacity, and it is right that we have this surge capacity insurance policy in place to help to meet further demand.