Access to GP Services and NHS Dentistry

Mike Amesbury Excerpts

Tuesday 21st June 2022 Commons Chamber

[Sajid Javid]

I am sorry to hear about the right hon. Gentleman’s constituent. If he will allow me, in a moment, I will come on to the pressures that dentistry is facing and, most importantly, what we are doing about them.

Those pressures have come about for two reasons. First, there was a fear of infection, which was understandable in a context where 10 minutes in a dentist’s chair during the pandemic could have meant 10 days in self-isolation or, perhaps, worse. Dental practices were almost uniquely at risk of spreading covid, so their activity was rightly severely constrained across the world—not just here in England and across the UK—by the infection prevention rules that were necessary at the time. Despite all the innovations in dentistry over the last few years, dental surgeries do not have a Zoom option.

Secondly, the British people stayed away because of their innate sense of responsibility during the pandemic. As all hon. Members saw in their constituencies, people understood our critical national mission. Our GPs were doing their duty vaccinating people in care homes and in thousands of vaccination centres up and down the country, protecting the most vulnerable and working hard to keep us all healthy and safe.

When omicron struck—we all remember that period, which was not that long ago—I stood before this House and asked GPs to stop all non-emergency work once again. I did not take that decision lightly, but we were faced with a stark choice of having more lockdowns or accelerating our vaccine programme. We chose to accelerate, with help from all corners of the NHS and with the backing, at that time, of the hon. Member for Ilford North. I remember him standing at the Dispatch Box pledging his full support for that effort and rightly stating that the Government were acting

“in the best interests of our NHS, our public health, and our nation.”—[Official Report, 13 December 2021; Vol. 705, c. 795.]

He recognised that it was the right thing to do then; he has now conveniently changed his mind. I wonder why.

[Mike Amesbury (Weaver Vale) (Lab)]

But people like Mark in my constituency cannot find an NHS dentist. This is not about covid; it was happening before covid. The investment just is not there. He is in pain; he is in agony. The Secretary of State needs to step up, step in and get things right.

Oral Answers to Questions

Mike Amesbury Excerpts

Tuesday 14th June 2022 Commons Chamber

[Maria Caulfield]

My hon. Friend is right that the issue is not just about the contract, although that is a key aspect of trying to get more dentists to take on NHS work. We are working on a number of incentives to increase recruitment, including working with Health Education England on centres for dental development to train more dentists in those hard-to-reach areas, which tend to be coastal and rural areas.

We are also looking at how we can reform the overseas dentist policy. We are working with the General Dental Council on that and may be bringing legislation forward towards the end of the year to improve that, too.

[Mike Amesbury (Weaver Vale) (Lab)]

Kathryn Townsend got in touch with me about her son Max, who has severe complex sensory issues and learning difficulties. He waited up to two years for an appointment. In that time, several rotten teeth have had to be removed. Conservative Governments have had 12 years now to get things right. When will the Minister get an urgent grip of the situation?

[Maria Caulfield]

The hon. Gentleman says that we have had 12 years, but he may recognise that, during the pandemic—two of the years that he talks about—routine dental appointments were not available because of the type of aspiration procedures that they involve. Only urgent appointments were available. We are now enabling 95% of the usual activity to take place, and that will soon be 100%. That means that there is still quite a backlog to get through, but we are in a better place than we were this time last year.

Future of the NHS

Mike Amesbury Excerpts

Monday 31st January 2022 Westminster Hall

[Matt Vickers (Stockton South) (Con)]

I beg to move,

That this House has considered e-petition 598732, relating to the future of the NHS.

It is an honour to serve under your chairmanship, Mr Gray. Today I have the privilege of bringing the petition to the House for debate. I congratulate Marcus Hynes, the writer of the petition and a proud Unite member, on achieving over 135,00 signatures. Marcus and other esteemed members of Unite shared their views ahead of the debate.

The NHS is a truly British innovation. It is there to help us in our hour of need, supporting us from cradle to grave. The NHS has an enormous role in the lives, health and welfare of British people. As a result, it is rightly at the centre of much debate in this place, as we constantly look at how it can be expanded, improved and made more efficient. I thank the NHS and all its amazing doctors, nurses, staff and volunteers for what they do. Throughout the past two years, they have been the crutch that has kept this country upright. No words will ever be able to articulate how thankful people across the UK are for the work that they do for us every day.

The NHS is a great British institution, founded in the wake of the war by a society that wanted better for everyone. It is, and always shall be, free at the point of use. The NHS carries the weight of our country’s health problems on its shoulders, which is why I am delighted to support the Government’s ongoing commitment to it.

[Mike Amesbury (Weaver Vale) (Lab)]

The hon. Member referred to the NHS being free at the point of delivery, but NHS dentistry is on its knees. In my constituency, Rachel Elizabeth has been waiting over two years to see a dentist. It is the same in Runcorn, Frodsham and so forth. There is a similar situation in the neighbouring constituency of my hon. Friend the Member for City of Chester (Christian Matheson), in Ellesmere Port and right across the country. Does the hon. Member for Stockton South (Matt Vickers) agree that NHS dentistry is in crisis?

[Matt Vickers]

I have shared concerns about NHS dentistry from my own part of the world, and I am fairly confident that the Minister will fill us in and give a more extensive response.

The NHS carries the weight of our country’s health problems on its shoulders, which is why I am delighted to support the Government’s ongoing commitment to it. The biggest cash boost in the history of the NHS is allowing us to put thousands more doctors and nurses into our hospitals, coupled with major capital investment programmes that have already benefited my local hospitals. I know that the Minister is only too aware of my ongoing campaign to secure more sizeable improvements at the University Hospital of North Tees. That said, I know from my constituency that there remain huge challenges for the NHS and its role in improving the health of the nation.

In 2018, Stockton was labelled England’s “most unequal town” by the BBC. It is a town where people born in one area can be expected to live 18 years fewer than those living just a few miles up the road. Such health inequalities are not acceptable in modern Britain. The NHS rightly looks to prevention as well as cures, and furthering this cause requires not just more resources and improved efficiency, but joined-up co-operation with other agencies, which lies at the heart of the reform agenda.

Putting my experiences and observations aside, the lead petitioner, Mr Hynes, and those from Unite wanted to let me know that they are fundamentally opposed to the Health and Care Bill. As part of their reasoning, petitioners cited concerns about the staffing crisis, overwhelmed human resource departments and the backlog as core reasons for their belief that the Bill should not be brought on to our statute book. Petitioners shared their concerns about staff shortages and worker fatigue in an NHS that already stretches itself to meet the needs of the UK’s ageing population and the exponential growth in the public’s health needs. They talked of how the pandemic has compounded this problem.

Moreover, the pandemic paused elective surgery, leaving the NHS to deal with backlogs and extended waiting lists. The view of the petitioners was that the NHS should be given time to stabilise and respond to those challenges before taking on the challenges of reform. On a more institutional level, Unite said that it fears that this Bill would open the NHS up to deregulation, worsening staff shortages, and create a pay-for-use system akin to America’s.

The petition states that

“The Government has no democratic mandate to privatise the NHS”.

I agree: the Government have no democratic mandate to privatise the NHS, which is why they are doing no such thing. Access to NHS services will continue to be based on clinical need, not an individual’s ability to pay.

Health and Social Care

Mike Amesbury Excerpts

Friday 3rd December 2021 Commons Chamber

[Edward Argar]

I can confirm that my hon. Friend is absolutely right in her assessment of the progress that we are making.

[Mike Amesbury (Weaver Vale) (Lab)]

When are Halton and Warrington going to get their new hospital campuses? We have waited for far too long.

[Edward Argar]

The hon. Gentleman showed admirable brevity in making his point very clearly, as ever—[Interruption.] I suspect he faces a bit of competition from his hon. Friend the Member for Wythenshawe and Sale East (Mike Kane) for the funding. In my recollection—forgive me if I am off on this—I think that Halton and Warrington have submitted a bid for funding as part of the next eight. There is considerable interest in this. We are evaluating all those at the moment and, in the coming months, we will work that down to a shortlist. It would be wrong for me to prejudge that process, but it is not wrong, of course, for the hon. Member for Weaver Vale (Mike Amesbury) to continue championing his local hospital and its cause.

Health and Care Bill

Mike Amesbury Excerpts

Report stage
Monday 22nd November 2021 Commons Chamber

[Alex Norris (Nottingham North) (Lab/Co-op)]

It is a pleasure to speak for the Opposition in this first part of the debate on the Bill.

A decade ago, virtually to the day, I was a young activist taking part in marches, protests, online campaigns, letter writing campaigns, petitions and much more in opposition to what would become the Health and Social Care Act 2012. We argued that it would lead to more fragmentation, less integration, confused decision making and more privatisation and that it would not make anybody any healthier.

Despite significant opposition to the legislation, the Government pushed on. But as campaigners, we were right, weren’t we? The 2012 Act created a fragmented system that did not promote health and care integration. Performance against NHS targets, even pre-pandemic, was dismal and now it is even worse. Waiting lists have grown extraordinarily, and staff vacancies have grown to crisis proportions.

We are here today and tomorrow to consign that legislation to history—perhaps less the end of an era and more the end of an error. But the same Government who broke the system now offer a new package of reforms, and that should really scare us. These are the wrong reforms at the wrong time. There are no answers in them to the waiting times crisis, no answers to the capacity issues in accident and emergency or our ambulance services, no answers to access issues for our GPs or dentists, and no answers to the environmental factors that make a country with so many assets so unhealthy.

[Mike Amesbury (Weaver Vale) (Lab)]

Does the shadow Minister agree that the Bill gives the green light to private profit making companies sitting on integrated care organisations?

[Alex Norris]

Yes. That was a strong theme in Committee that we on the Opposition Benches are very much against; it is likely to be a prominent theme during our discussion of upcoming amendments. Through what we are discussing now, we at least have the chance to put something in the Bill that might improve the public’s health.

--- Later in debate ---

[Justin Madders]

At the moment, ICBs are not a legal entity, so they do not own anything. When the Bill comes into force, they will effectively take over mainly administrative buildings from the CCGs, and the trust will hold ownership of most of the assets. We hope that there will not be the risks that my hon. Friend outlines, although it is not impossible for ICBs to set up their own trusts at some point in the future.

We do not believe that the question of private providers sitting on the place-based boards can be left open in this way, because this is really about who runs the NHS. There is a complete and utter incompatibility between the aims of private companies and what we say should be the aims of the NHS and the ICBs. I can do no better than refer to the evidence of Dr Chaand Nagpaul from the Bill Committee. He identified the concern perfectly:

“We forget at our peril the added value, the accountability, the loyalty and the good will that the NHS provides. We really do…I am saying that it does matter. Your local acute trust is not there on a 10-year contract, willing to walk away after two years. It is there for your population; it cannot walk away.”––[Official Report, Health and Care Public Bill Committee, 9 September 2021; c. 90, Q113.]

Those final words sum it up perfectly. Put a company on the board, and its interest lasts as long as the contract, and those interests will of course not be the same as the NHS’s anyway. A company’s primary concern is the shareholders, not the patients. With that clear and unanswerable concern about conflicts of interest, we invite the Government to withdraw their amendment and support ours.

We have already had some discussion of who goes on the ICB. Apparently, the answer is not the most appropriate people chosen by an independent external process or individuals directly accountable to the public; the answer is left to guidance that leaves open the risk that voices we think need to be heard will slip through the net. Our amendment 76 deals with that by setting out the requirements for ICB membership. Allocating scarce NHS resources should be robustly debated and will always be political. Tough choices have to be made, so we need people on the ICB who will be there to cover all the necessary interests for the wider good.

If Members look at what amendment 76 suggests, I hope nobody would argue that those interests do not have to have some voice. The public, patients, staff, social care, public health and mental health—which of those can be safely ignored and which has no part to play? As I have already mentioned, there is a major area of uncertainty because of the complete absence of anything that sets out how the much-vaunted place-based commissioning will work. Who will sit at the place-based table is, I am afraid, still completely opaque.

The next major area covered in the Bill is a further deconstruction of Lansley with the removal of compulsory competitive tendering for clinical services. We have seen the NHS proposals for a provider selection regime to replace the regulations under section 75 of the 2012 Act. That is to be regarded as a work in progress, so our amendment 72 covers the issue and would reintroduce some safeguards into how our money is spent. Since its inception, the NHS has always relied on some non-NHS providers, with the model developed for GPs being an obvious example. However, in recent decades there has been an increase in the use of private providers of acute care, most notably in diagnostics and surgery.

To be clear, we on the Opposition Benches believe that the NHS should be the default provider of clinical services. If it is not the only provider, it should be the predominant provider in geographical and services terms. Where a service cannot be provided by a public body because the capability or capacity is not there, there is still the option to go beyond the NHS itself, but that should be a last resort and never a permanent solution. Amendment 72 therefore sets out a clear framework for how we could achieve that. We hope that extra transparency and extra rigour would mean we avoid buying stuff that is unsuitable and sits in container mountains, stuff that does not meet specifications, and stuff made by companies that have no experience, but are owned by friends and family. In short, we would stop the covid crony gravy train.

The use of private sector capacity in the covid emergency turned out to be a farcical failure. It became very clear, very quickly that it was not there to support the NHS; it was there just to make profits. Use of private providers through dodgy deals during the PPE scandal has highlighted the need for greater transparency and greater capacity in the NHS. We can never allow a repeat of what we have seen there. We need the rigour set out in the amendment to be put into legislation, rather than left to guidance. We need to be able to challenge NHS bodies that do not comply, as well as Ministers who try to flout the rules.

I will now deal with new clause 49, saving the best—or more accurately, the worst—until last. Because of how Report stage works, it has fallen to me to express our opposition to this measure, rather than my expert colleague, my hon. Friend the Member for Leicester West (Liz Kendall), who shares my dismay at what has been produced and how it has been presented to us. Starting with the process, it is wholly wrong to bring such a fundamental change forward as a last-minute addition to this Bill. That means it cannot be debated properly today. There is no impact assessment and, as we have already heard, this change was not discussed in Committee at all. In fact, in 22 Committee sessions spanning some 50 hours, we never once heard mention of this amendment coming forward or discussion on the care cap. Indeed, when this Chamber was busy debating the social care levy, we were beavering away in Committee on the Bill, oblivious to the fact this measure was coming down the track. If the Government cannot even get their decision-making processes integrated, what hope is there for integrating health and social care?

As we know, the aim of the new clause is to remove means-tested benefits from the costs that count towards the care cap. As has been pointed out far and wide by Members from all parts of the House, that change adversely impacts some more than others. It is a wholly regressive measure, to say the least, to give support through means-testing, but then to penalise people later for receiving it in the first place. We will vote against this iniquity, and I hope many Conservative Members will vote with us. They should be used to the Prime Minister’s broken promises by now; this is their chance to make the point that he should stand by what he says.

[Mike Amesbury]

Does my hon. Friend agree that it is Robin Hood in reverse? I encourage Conservative Members who wax lyrical about levelling up, particularly in the north, to do the right thing.

[Justin Madders]

My hon. Friend must have sneaked a look at my speech, because I will say later that it is Robin Hood in reverse.

Chronic Obstructive Pulmonary Disease

Mike Amesbury Excerpts

Wednesday 17th November 2021 Westminster Hall

[Caroline Nokes (in the Chair)]

Before we begin, I remind Members that they are expected to wear face coverings when not speaking in the debate, in line with current Government and House of Commons Commission guidance. I remind Members that they are asked by the House to have a covid lateral flow test twice a week if coming on to the estate, which can be done either at the testing centre or at home. Please also give each other room when you leave the Chamber.

[Mike Amesbury (Weaver Vale) (Lab)]

I beg to move,

That this House has considered support for people with chronic obstructive pulmonary disease.

It is a pleasure to serve under your chairmanship, Ms Nokes. I am grateful for the opportunity to lead the debate—and on World COPD Day itself, no less. Chronic obstructive pulmonary disease impacts many of our constituents, but it is simply not given the clinical priority in our health systems that it should have. I hope today, with the other parliamentarians present, to push the Government a step further and improve our fight against COPD on a few fronts: to push public health action to avoid our constituents contracting it; to improve diagnosis rates, so that it is caught at an earlier stage; to transform treatment to help patients manage their condition; and to invest in more research, so that we can develop groundbreaking diagnostics and treatments.

I am thankful for the hard work of the British Lung Foundation, which has campaigned tirelessly for better recognition and treatment of lung disease and which, ahead of World COPD Day, has highlighted the experiences of those living with COPD in their report “Failing on the fundamentals”, which I know some hon. Members in the room will have seen. I am also grateful to the all-party parliamentary group for respiratory health and those involved with the COPD national action plan for their work. I know that some Members present are involved in that APPG; I thank them sincerely. Many thanks also go to my constituent Sarah Jones, who has worked with the taskforce for lung health and pushed me to raise the fight against lung disease in Parliament after the sad loss of her father, John Jones, from idiopathic pulmonary fibrosis.

Chronic obstructive pulmonary disease is a group of lung conditions that cause breathing difficulties, including emphysema, which is a breakdown of lung tissue, and chronic bronchitis, the chronic inflammation of central airways. It is a disease chiefly caused by smoking, which causes nine out of 10 cases of COPD. Air pollution, childhood poverty and exposure to dust in workplaces are also contributing factors. I know that other Members in the Chamber will be very familiar with COPD and its constituent conditions. Many champion the cause of their constituents while others have direct experience.

In a case study provided by the British Lung Foundation, Chris highlights his desperation to breathe—something that many of us take for granted—the panic, the fear, the wheezing and in some cases the crushing sensation that he feels in depleted lungs. Those are just some of the facets of the debilitating disease known as COPD. Early signs are shortness of breath, a wheezing chest, tightness, chronic cough, lack of energy and weight loss. I encourage people with these signs to get an appointment with their GP.

According to the National Institute for Health and Care Excellence, 3 million people in the UK suffer from COPD. Shockingly, 2 million of are undiagnosed. As Sarah Woolnough, the chief executive of the British Lung Foundation stated:

“It is hard to imagine, for example, this proportion of cancer cases going undiagnosed”.

But that is the reality and it has to change. It is nothing short of a silent scandal.

To the Government’s credit, in response to campaigners and clinicians campaigning for respiratory disease, COPD is given priority in the NHS long-term plan. Yet, like all plans, the devil is in the detail and delivery on the ground is essential. It is vital to ensure that people with the disease are diagnosed early. Too often, diagnosis occurs only when the disease has considerably progressed, leading to greater risk of damaging flare-ups of COPD symptoms and greater risk of being one of the 30,000 people killed by the disease every year, making it Britain’s fifth biggest killer.

Of course, we encourage people to see GPs, but 9.8% of people in the north-west, for example, are struggling to get appointments. I am sure the Minister will refer to that in her reply. An important survey conducted by the British Lung Foundation—its largest ever of those suffering with COPD—found that 75% of those surveyed were missing out on the basic care recommended for the disease.

The theme of this year’s World COPD Day is “Healthy Lungs—Never More Important”. It aims to highlight the risk COPD poses against the backdrop of the pandemic, which has represented a higher risk for those suffering from lung disease and resulted in the additional demand on services created by the impact of covid-19. Even before the pandemic, it is clear that those with COPD experienced unacceptable delays in receiving a diagnosis—delays that can prove fatal.

Diagnosis rates, already far too low, plummeted further during the pandemic by 51%, meaning that nearly 50,000 of our constituents in England alone missed out on a diagnosis. Although the impact of covid-19 was widespread across our health service, this drop was more substantial than for comparable non-respiratory diseases, such as diabetes. Some GPs were advised during the pandemic to stop diagnosis breathing tests and they have yet to restart.

Does the Minister think that we should put in place a delivery plan with funding to get lung health strategies back on track and tackle the respiratory backlog so that another 50,000 people do not miss out on the diagnosis in the coming year? COPD already costs the health economy £1.9 billion. This could be an effective saving, not only of lives, but of essential financial resources.

Can the Minister confirm whether the new diagnostic hubs announced as part of the Budget will cover the tests needed to diagnose COPD and other pulmonary diseases? It would be useful to hear more detail on the part these hubs will play in the diagnosis of lung disease, and on an effective staffing and recruitment strategy.

The British Lung Foundation’s recent report on the experience of people with COPD also highlights shortcomings after diagnosis. It found that three quarters of people across the UK did not receive the five fundamentals of COPD care, as set out in the NICE guidelines. The problem is particularly severe in the north of England and in the devolved nations. Tackling this and ensuring that everyone is offered the five fundamentals of COPD care needs to be at the centre of the strategy. Those five fundamentals are a written management plan, access to pulmonary rehabilitation, help to stop smoking, management of co-existing medical conditions, and access to flu and pneumonia vaccinations.

As with many diseases, prevalence of COPD is linked with deprivation. Between 2019 and 2020 the life expectancy gap between the least and most deprived areas in England grew from 9.3 years to 10.3 years for men and 7.7 years to 8.3 years for women. Respiratory conditions are major contributors to widening health inequalities in the UK, with those living in the most socioeconomically deprived areas in England seven times more likely to die from respiratory disease compared with the least deprived areas.

In my constituency of Weaver Vale, 2.6% of residents are estimated to suffer from COPD, compared with 1.9% of people in England as a whole. Looking at the map of the prevalence in my constituency, we can clearly see that the most deprived areas have twice the proportion of COPD cases than the least deprived areas, and I know other hon. Members here will have the same experience. Eighteen of the 20 clinical commissioning groups in the worst areas for respiratory diseases and emergency responses are in the in the north of England.

If the Government are serious about tackling health inequalities and levelling up life chances, more work needs to be done to ensure that COPD is not overlooked as one of the major respiratory conditions driving health inequality in the UK. If this Government are really serious about levelling up, that should be a focus. Those living with COPD, as well as those living with other diseases, should have equal access to fast diagnosis, care and treatment, no matter who they are and where they live. I hope to hear from the Minister about how her Department plans to ensure that disparities in COPD prevalence, diagnosis and care are a major part of the national health inequalities strategy.

In most cases COPD is caused by smoking, so I would like the Minister to give an update on the new tobacco control plan, how it will focus on tackling health disparities and how she intends to plan and fund an effective, high-quality stop smoking service throughout the country. Over the past 11 years, many of those services have been cut, so I would be fascinated by her response.

Finally, I would like to raise the problem of awareness of COPD, lung disease more widely and the importance of lung health. Today’s debate has primarily focused on the lack of funding, the lack of real clinical and Government priority and the lack of awareness that extends beyond that. I would like the Minister to outline how, as part of getting lung disease the delivery prioritisation it desperately needs, her Department can promote greater public awareness of lung disease. Our shared interest must be to transform COPD care in the UK, while driving down the numbers who develop this condition in the first place. I look forward to this debate, and I certainly look forward to the Minister’s response.

--- Later in debate ---

[Mike Amesbury]

I thank the Minister for her detailed response and for taking a number of interventions—she was generous with her time. I also thank right hon. and hon. Members of different parties for championing the cause and for highlighting cases in their constituencies across the UK.

Some of the key asks on World COPD Day were for a dedicated, detailed and resourced plan. Everybody spoke about the need for early diagnosis and access to GPs. We all have examples in our constituencies, and it was interesting that the Minister talked about resources going forward in her response, but we know that COPD is a real issue here and now in our constituencies. The British Lung Foundation said that over 70% of those diagnosed with COPD were struggling to access services, particularly the NICE-recommended COPD five-point plan.

Regional disparities are a big issue. The Government talk about levelling up, and here is a real opportunity to level up the life chances and health chances of people right across the UK. COPD is particularly prevalent in the north, Scotland and Northern Ireland.

We mentioned other factors such as workplace, and the Minister spoke about some personal family experience in the industrialised north-west. We also spoke about the link with poverty.

The Government have to address these issues effectively, and we will continue to hold their feet to the fire. They have been in power for 11 years. It is right to say that this is a journey, and we are not where we need to be for the millions of constituents who face this awful, debilitating disease.

Question put and agreed to.

Resolved,

That this House has considered support for people with chronic obstructive pulmonary disease.

Covid-19 Update

Mike Amesbury Excerpts

Monday 15th November 2021 Commons Chamber

[Sajid Javid]

Yes, I happily join my hon. Friend in that. If you live in Stoke-on-Trent South, there is a great new walk-in centre, so please go on Friday, because the best way to protect yourself and your loved ones is to get vaccinated.

[Mike Amesbury (Weaver Vale) (Lab)]

John Fagan from the Runcorn part of my constituency did the right thing and went for his booster jab last week, but when he arrived he was told they had run out of supplies. What reassurance can the Secretary of State and the Department give to me, my constituents and the country more broadly that there will be sufficient supplies for the booster roll-out?

[Sajid Javid]

The hon. Gentleman will understand that I do not know the details of that particular situation, but I reassure him and the House that, whether for our boosters offer or the evergreen offer of vaccination, the country—the vaccines taskforce—has more than enough supply.

Hospital Building Programme

Mike Amesbury Excerpts

Wednesday 3rd November 2021 Westminster Hall

[Dr Mullan]

My hon. Friend is absolutely right. One of the great things about the plans for the new site is that they take into account those future projected increases in population. I do not know what we will do if the resources are not there to do that.

Going back to staffing, we have more nurses and doctors and more staff overall working in the NHS than ever before, but it remains a huge undertaking for the Government to continue to work on recruitment and retention to staff new facilities. I know a lot of the media and campaigning by Opposition parties has focused on pay. While it is important, my experience is that fixing staff shortages would be the priority for most staff. The obstacles for further recruitment will not simply be solved by higher pay; the challenges are more complicated than that.

Of course, buildings and facilities matter, but we have to remember that the material used to build Leighton was expected to last only 30 years. It might seem odd to us now to create a major public facility with that sort of life span, but that is the reality.

[Mike Amesbury (Weaver Vale) (Lab)]

The hon. Gentleman is a neighbouring MP. A reference was made to Northwich in my constituency. This proposal certainly has cross-party support. I support the hon. Gentleman and all Cheshire MPs in arguing this case with the Minister in front of us for much-needed investment in a first-class hospital facility in our patch.

[Dr Mullan]

It is great to get cross-party support to demonstrate to the Minister how important it is to all our local communities. I thank the hon. Gentleman for his support.

As I was saying, the building was not designed to last this long or to serve the size of population that it serves. My view is clear that we can be more efficient and do more in the community, but an aging population will have an ever-increasing demand for healthcare. We can delay the need for the most specialist hospital care in a population, but we can almost never remove it and stop the demand increasing overall.

How has Leighton managed this challenge over recent years? Rightly, it has benefited from major investment, as mentioned by my hon. Friend the Member for Eddisbury (Edward Timpson) who is working closely with me on this campaign alongside my hon. Friend the Member for Congleton (Fiona Bruce). I remember his excellent work in helping to secure funding for brand new theatres and a brand new ITU.

My first campaign after becoming the candidate for Crewe and Nantwich was to reverse the decision to turn down a request for an emergency department extension, which was ultimately funded in 2019. More recently, Leighton received £15 million to build a brand-new emergency department. As the Government understand the necessity, Leighton has had funding to tackle the parts of the original building that are simply not fit for use in the short term. However, there comes a point where the costs of one-off investments, accumulated maintenance and the need to replace the original building structures become a cost that cannot be borne by the ordinary capital spending, and when a whole new building becomes the best option financially and for patient care. That is where Leighton is at.

The life span of the original building is coming to an end. I suggest to the Department of Health and Social Care and the Treasury that they view the funding committed to the hospital building programme as a unique opportunity to look at estates that are winding down towards the end of their life span and address that now.

Under the leadership of the chief executive officer, James Sumner, Leighton has done an enormous amount of work for many months to develop its plans for a new hospital. The team sought expert advice on the life span of the current estate and, importantly, the cost of maintaining it and to keep the existing original buildings in use. I know the Minister will scrutinise the figures and see for himself the financial sense in the case that has been made. Independent analysis demonstrates that the ongoing refurbishment of the present failing infrastructure over the next 15 years will cost substantially more than projected new build costs.

Importantly, the plans are ambitious in ensuring better healthcare is delivered in a better environment for patients and staff. As well as providing the mentioned much-needed bed capacity to meet the projected demand later in the decade, the new facilities will deliver single rooms to improve privacy, dignity and infection control. The new layout will incorporate the latest design advice for supporting patients with conditions such as dementia.

The site as a whole will be reorganised some of the long journeys from key locations, such as the emergency department, to other parts of the hospital that have grown as a result of sporadic development to date. They will future proof the hospital with the most up-to-date digital infrastructure which is becoming increasingly important for delivering the best possible care and doing so efficiently. A new site will enable Leighton to play its part in the race to net zero with more energy efficient buildings and solar power and even, potentially, a geothermal heat source, which is a technology I am campaigning for the Government to support to get off the ground across the country.

The team at Leighton have a track record of delivering improved and innovative care to back up their pledges. For example, the trust recently received an award for its same-day emergency care programme, led by surgeons David Corless and Ali Kazem. I am sure that, with improved facilities, they will continue to find new and better ways to care for their patients.

--- Later in debate ---

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

It is a pleasure to see you in the Chair, Mr Sharma. I congratulate the hon. Member for Crewe and Nantwich (Dr Mullan) on securing the debate. As a fellow Cheshire Member, our paths will no doubt cross as we get involved in the megalithic integrated care system that covers our area, and it is good to see healthy representation from Cheshire Members, which shows the interest and passion that we have for improved health services in our area. He mentioned that he volunteered to use his medical skills on the frontline during the pandemic, and we thank him for his efforts, just as we thank everyone who contributed to the fight against covid, be it in the NHS, in social care or in any of the other many sectors that played their part. We recognise and value the commitment that was made by so many people over such a long period of time.

As the hon. Member for Crewe and Nantwich set out, hospitals are more than the buildings themselves. It is the staff who make hospitals, and he brought that to the fore in his comments. He said that the site of Leighton Hospital has exceeded its original lifespan—I think it is as old as I am, which is a concern. Hopefully, I will not be up for a rebuild any time soon. It was a common theme of contributions to the debate that a lot of the buildings in Members’ constituencies have reached the end of their natural lifespans. It would be useful to hear from the Minister whether any assessment has been made of how many hospital buildings, and buildings across the wider NHS, have already exceeded their original lifespans. The hon. Gentleman made a compelling case for why a new hospital needs to be built in Crewe, and he mentioned that the local population has grown considerably.

[Mike Amesbury]

I thank my hon. Friend and constituency neighbour for giving way. Of course, Leighton Hospital is part of the Mid Cheshire Hospitals NHS Foundation Trust, which also includes Victoria Infirmary in Northwich. This would be a real opportunity to capture investment across the campuses, which serve a number of our constituents, and I would certainly welcome my hon. Friend’s support on that. As a Cheshire MP, it would certainly be very welcome indeed.

[Justin Madders]

My hon. Friend probably needs to direct his pleas to the Minister more than me—at this stage, of course—but I would be delighted to visit the facility with him. I am sure that he will make a strong case for investment, as other Members have done. There is an issue with how the interplay works between some of the competing bids for what is obviously a very competitive process, which I will return to later. Like the hon. Member for Eddisbury (Edward Timpson), my hon. Friend the Member for Weaver Vale (Mike Amesbury) has shown that there is cross-party support for the case for a new hospital that was made by the hon. Member for Crewe and Nantwich, who also set out why this is good for patients. He talked about some of the issues around privacy, dignity and infection control, and he said that a new build gives us an opportunity to invest in modern digital infrastructure. Of course, he also mentioned important stuff to do with COP26 and the energy efficiency of a new build. Those were all well-made points.

We also heard from the right hon. Member for Hemel Hempstead (Sir Mike Penning), who made a persuasive and passionate case as to why the current plans need to be reconsidered. He made a very interesting point about the accountability of trusts. He is probably not aware that the Minister and I have been debating this issue in Committee for a number of weeks, and it is fair to say that we have differing views as to how accountable the current system is and whether it will actually change at all when the Health and Care Bill receives Royal Assent. There is an issue with how large trusts have their own priorities, which are not necessarily in tune with the rest of the wider population and healthcare system.

The hon. Member for North West Norfolk (James Wild) made a very strong case for the Queen Elizabeth Hospital in King’s Lynn; he highlighted the critical nature of the maintenance issues there, which are clearly having an effect on patient care now. The Minister will not be surprised to know that I will be referring to the maintenance backlog during my comments today. The hon. Member also set out very well how new builds can not only improve infection control, but enhance the patient experience. We should always remember that the patient journey is central to these things. A new hospital always has to have the interests of patients, and their perspective, at the heart of its plans.

The hon. Member for Keighley (Robbie Moore) made a strong case for why a new hospital is needed in Airedale. Again, it is a building that is past its original lifespan; it has critical infrastructure issues. Describing it as the “leakiest hospital is the UK” is not something the hon. Member will want to repeat for much longer. It shows again that many of these issues have been building up for some time.

I was very interested in what the hon. Member for Hartlepool (Jill Mortimer) said about health inequalities; it was an important point, and perhaps a broader one than some of the others that have been made. She is absolutely right that the pandemic has shone a light on the existing health inequalities in this country. I agree that if we are serious about levelling up, reducing health inequalities has to be central to any policy.

The right hon. Member for Basingstoke (Mrs Miller) made a compelling case about how investment is needed for her new hospital, and how the change and growth in local population has created additional demand. It is an important point that, because of the way that her town has built up, there is more demand from an increasingly ageing population.

All the Members have made very good cases today; if it was based on the commitment and passion of individual Members, the Minister’s job would be quite straightforward. However, I know there will be many other demands on the departmental budget. There is a serious point here. We need to have transparency on the criteria that will be applied when the decisions are made. It would be fair to say, if we look at levelling-up bids, there has been some consternation that the decisions are not always made on the merits of the case. It is important that the Department is crystal clear on why particular projects are getting the go-ahead, and why others may have to wait a little longer.

I am sure that the Minister would be disappointed if I did not make a reference to whether the Prime Minister’s claim to be building 48 new hospitals is in fact an accurate one. We take with a large pinch of salt the definitions from the Department’s playbook that the following count as a new hospital: they say this includes

“a new wing of an existing hospital (provided it contains a whole clinical service, such as maternity or children’s services).”

They also say this includes

“A major refurbishment and alteration of all but the building frame or main structure, delivering a significant extension to useful life which includes major or visible changes to the external structure.”

That may well be investment in buildings—which is of course welcome—but it stretches credibility to say that those are new hospitals. I will not repeat the whole debate again on whether those descriptions can be classed as new hospitals, except to say that the Minister will no doubt rely on his VAT notices to reach that figure of 48: we will rely on the good sense of the British public to judge whether a new hospital is indeed a new hospital. When we get to 2030, we will see how many new hospitals we actually have—although it is possible that both the Minister and I will have moved on by that point.

Let us return to the present day, move away from the headlines and the spin, and ask some specific questions about the programme. I will start with the cost issue. It is my understanding that the projects identified in phase 1 have been promised a total of £2.7 billion, although some reports suggest that a £400 million price cap is being applied to each scheme, even though some of the published plans for those schemes have exceeded that limit already. Could the Minister comment on whether there is in fact an upper cash limit on particular projects, and whether it is indeed £400 million?

Almost exactly a month ago, the Prime Minister made an announcement on round 2 of the health infrastructure plan, in which, incidentally, only three out of the 25 hospitals are in the whole of the north of England. I think that says something about the Government’s commitment to levelling up and bolsters the case made by the hon. Member for Crewe and Nantwich to push forward for a new building in Crewe. Could the Minister advise what period and how much of the total programme the £3.7 billion mentioned in that announcement covers? Could the Minister also advise if the £4.2 billion, announced in the spending review last week in relation to new hospitals, is the same money as the Prime Minister announced on 2 October or is in addition to that? If it is additional, what period does that £4.2 billion cover? We want a little clarity on how much has actually been allocated and the period that it covers. I am sure the Minister realises that, even if we add up all those figures, it would not be the total cost of all those projects moving forward to 2030.

We have had three separate announcements over the last year. I make that point because the foreword to the health infrastructure plan talks about ending the “piecemeal and uncoordinated approach”. We have an investment plan spanning a decade, but the necessary investment has been announced for only the first half of that decade, at best, to come out in dribs and drabs. I suggest that the Minister might need to read the foreword to the plan again to see whether the ambitions set out there are being met.

NHS Providers has said that the actual cost of the planned building projects would be around £20 billion, most of which will need to be found in the next few years. Even building an average-sized new hospital costs around £500 million, which rather puts the spotlight on the supposed £400 million cost limit I referred to earlier. I wonder if the Minister could put a total cost—

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[Mike Amesbury]

One such scheme, for which I and my hon. Friends the Members for Warrington North (Charlotte Nichols) and for Halton (Derek Twigg) and the hon. Member for Warrington South (Andy Carter) have been campaigning, is two campuses for Warrington and Halton trust. They seem to meet those criteria, so I look forward to an assessment and conclusion in the not too distant future.

[Edward Argar]

I am grateful to the hon. Gentleman, who quite rightly never misses an opportunity to champion his constituents’ interests.

Hon. Members will be aware that the interest around the country is significant. A significant number of expressions of interest have been submitted, so whittling them down will be a competitive and challenging process, but we undertake to be as clear and transparent about that as we can be. I suspect that, when the final list is announced, if I do not come to the House with a statement, the shadow Minister may well UQ me, to give colleagues an opportunity to say they are very pleased or to ask why their hospital is not on the list.

Let me turn to points made by other hon. and right hon. Members. My right hon. Friend the Member for Hemel Hempstead (Sir Mike Penning) will not be surprised that I will not be drawn on the specifics of the internal politics and the plans for his trust at this point. However, he quite rightly made the extremely important point that when trusts develop their plans and bring them forward, they need to carry the communities they serve with them and genuinely reflect on stakeholder input from elected Members and others, rather than—I am not saying that this is or is not the case with this trust—automatically having a preconceived idea of what the right answer is.

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[Mrs Miller]

rose—

[Mike Amesbury]

rose—

[Edward Argar]

Let me just finish this point before I take interventions from my right hon. Friend the Member for Basingstoke and then the hon. Member for Weaver Vale.

Our investment in new hospitals will also significantly reduce the backlog maintenance, because it will take out of the total a number of hospitals, some of which have been mentioned, that are being propped up day after day, with money being spent just to patch up and mend.

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[Edward Argar]

Let me take the hon. Member for Weaver Vale first, because I promised him that I would give way. I also want to leave a few minutes at the end for my hon. Friend the Member for Crewe and Nantwich to wind up.

[Mike Amesbury]

On the point about maintenance, several hospital buildings built in the 1970s have used Grenfell-style aluminium composite material cladding and high pressure laminate, so I assume that is part of the assessment criteria. Some have roof systems that are in a critical state.

[Edward Argar]

I am grateful to the hon. Gentleman, who raises a couple of points. Yes, roofs are a factor. In some cases—my hon. Friend the Member for Keighley talked about Airedale—there is a flat roof, which is vulnerable to heat and water, and aerated concrete planks, which is extremely challenging.

The hon. Gentleman mentioned cladding. I might be slightly out, but from memory I think that there are no hospitals with cladding in need of remediation. We put a programme in place following the Grenfell findings. Off the top of my head, I think every hospital trust has either had it removed or been assessed by the fire brigade as not having a risk. If I am wrong about that, I will of course write to him to correct the record.

Covid-19 Update

Mike Amesbury Excerpts

Monday 12th July 2021 Commons Chamber

[Mike Amesbury (Weaver Vale) (Lab) [V]]

What assessment have the Secretary of State and his Department made of the number of children with long covid, and when will children get vaccinated?

[Sajid Javid]

On children and covid—the hon. Gentleman asked about long covid—a huge amount of research is being done both in the NHS and in my Department. I mentioned, for example, the extra £50 million of funding that we are providing to do even more research and to step this up. As he knows, long covid is a problem the world over, and I hope that the UK can become a world leader in trying to help with this problem and share the research that it does with other countries. On the vaccination of children, as I said in response to a similar question, the JCVI is actively looking at this issue. Once we have its final advice, we will set out our plans.

Covid-Secure Borders

Mike Amesbury Excerpts

Tuesday 15th June 2021 Commons Chamber

[Mike Amesbury (Weaver Vale) (Lab)]

The delta variant, commonly known as the Indian variant, did not just miraculously appear on our shores via an act of God. It arrived because our borders were open to hundreds of people infected with it. That is a fact. We only had to switch on the TV to see the horrendous tragedy unfolding in India for all the world to see, yet despite the scientific advice—and, indeed, the call from those on our Front Bench way back in February—the closure of that border and those restrictions were not introduced until 23 April. Curiously, as has been mentioned in this Chamber over and over again today, both Pakistan and Bangladesh were put on the red list some two weeks earlier. That timeframe counts and that decision counts.

The Indian variant is now our variant, accounting for over 90% of cases. A strain identified in an outbreak in the Northwich part of my constituency is now spreading at an alarming rate throughout Cheshire, the north-west and our nation. Hospitalisations have now started to creep up, and we are in a race against time to jab to save lives, while local leaders in Cheshire, Merseyside, Halton and Warrington are pleading for more vaccine supplies. The right hon. Member for Bournemouth East (Mr Ellwood) referred to teenagers now being a priority, and I concur with that plea.

This did not, of course, have to be the case, and the finger should be pointed firmly at the door of No. 10 and the Prime Minister. It was his desperation to secure a trade deal on his planned trip to India that meant this followed the photo opportunity, not the data. Not only has this incompetence thrown us off track, but it could cost even more lives and livelihoods. The hospitality sector in my constituency is clinging on by its fingertips, with pubs, restaurants and the night-time economy having that hope upon the horizon shattered by the gross incompetence of this Prime Minister and Government. To add insult to injury, the Prime Minister and the Chancellor are now refusing to extend targeted support to the sector. These callous decisions are putting people out of business and out of jobs.

In conclusion, from Northwich to Runcorn and from Frodsham to Helsby, people in my constituency will remember, and the judgment day will come. No more benefit of the doubt—the truth will truly set us free about this absolute shower of a Government.