Health Inequalities
Mike Amesbury Excerpts(4 years, 2 months ago)
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Jo Churchill
I appreciate that they need to know those figures, and they will know them extremely shortly.
I strongly believe that high-quality primary care is also crucial to early and preventive treatment, and key to reducing the health inequalities we are discussing. We are improving access to primary care by creating an extra 50 million appointments in general practice within the next five years, growing the workforce by 6,000 more doctors and 26,000 more wider primary care professionals. Within that, we want to target NHS resources, so that they can help their localities to level up. Through the targeted enhanced recruitment scheme, we are recruiting trainees to work in the areas of the country where we have had vacancies for years, particularly rural and coastal areas, such as Plymouth, and the coastal area of County Durham and North Yorkshire. It has already proved highly successful, with a fill rate of close to 100% last year, and over-subscription in many parts of the country. For that reason, we will increase the places on the TERS from 276 to 500 in 2021, and then up to 800 in 2020, to make sure that we get the skilled staff in the areas where they can do most good.
Practices, working together within primary care networks, will be asked to take action on health inequalities, to be agreed as part of the next 2021-22 GP contract. What happens in one’s early years, even before one pops out into the world, has an impact well into later life. Pregnancy and early years are therefore a key time to have an impact on inequalities. In particular, the fact that women’s life expectancy is so challenged is of acute importance to me. We have many challenges as we travel through life, and making sure that we are equipped to make the best of our lives, particularly as we often act as primary carers, is hugely important.
Pregnancy and early years are a key time to have an impact on inequalities. Many babies do get a fantastic start, but sadly it is not the case for everyone. Children in more deprived areas are more likely to be exposed to avoidable risks and have poorer outcomes by the time they start school. It is right that all universal support has a focus on reducing inequalities, and that it is targeting investment to meet higher needs. Many children are benefiting from investment in childcare and early years education. Fifteen hours of free early years education for disadvantaged two-year-olds and 15 hours of free early years education for all three and four-year-olds is key. We have also announced our commitment to modernise the healthy child programme to reflect the latest evidence to support families.
Jo Churchill
No, I am going to push on. I would particularly like to give those people making their maiden speech, which is hugely important, the time to do so.
For a good start in life, we need to do better in oral health. Tooth decay is the most common oral disease among children, affecting one in four by the time they start school, and it is the most common reason for admission to hospital for children aged five to nine. It is largely preventable. Improving the oral health of children is a Public Health England priority, and a number of actions are under way. Supervised tooth-brushing and water fluoridation are two evidence-based areas in which we want to go further. When I met a number of dentists recently and asked them what they would do if they had the key that would enable them to do anything, they said that water fluoridation would be one of the key measures to reduce childhood inequality across the country. In 2016-17, one in six children had tooth decay in the south-east compared with one in three in the north, and the variation is even greater among local authorities. I am delighted that two authorities, Durham and Northumberland County Councils, recently announced formal proposals to increase water fluoridation, and I hope to be able to facilitate that.
Obesity is a challenge. It is shocking that children in poorer parts of the country are more than twice as likely to be overweight or obese. Children who are overweight or obese are increasingly developing type 2 diabetes and liver problems, they are more likely to experience bullying, low esteem and a lower quality of life, and they are highly likely to become overweight adults with a higher risk of cancer and heart and liver disease. This is a huge cost to the health and wellbeing of the individual, but also to the NHS and the wider economy.
National cardiovascular disease and diabetes prevention programmes have already been introduced, but we want to go further. NHS England has delivered a diabetes treatment and care programme aimed at reducing variation and improving outcomes for people living with diabetes, thus reducing inequalities. We published the third chapter of the childhood obesity plan in July 2019, with further measures to help to meet our ambition to halve childhood obesity by 2030 and reduce the gap between the most and the least deprived. We have seen some important successes. The average sugar content of drinks subject to the soft drinks industry levy decreased by 28.8% between 2015 and 2018. Significant investment has been made in schools to promote physical activity and healthy eating. The childhood obesity trailblazer programme works with local authorities to address the issue at local level, and that really helps, with authorities working together to ensure that the messages sent to children are healthy food messages. The programme has a strong focus on inequalities and ethnic disparities in the context of childhood obesity, and is helping five local authorities to take innovative action. We have a lot to gain, particularly if we help parents, especially in the most deprived areas, to help their children.
It is clear that there is a great deal to do. Let me reiterate that the Government have made real commitments to real action, and that we will increase our focus on the real challenges that people experience in their lives every day. Reducing health inequalities is not an issue that truly divides the House, and I look forward to hearing the suggestions of Members on both sides of the House so that we can move forward. Their contributions will help to fuel our purpose. We share the common goal of reducing inequalities, and we can work together to achieve it.
Social Care
Mike Amesbury Excerpts(4 years, 2 months ago)
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Barbara Keeley
Once again, I absolutely agree. My hon. Friend is right to emphasise that point.
Last week I met home care support workers in my constituency who are campaigning to be paid a real living wage, and they told me about their struggles to manage financially. One staff member talked of working 90 hours for four consecutive weeks at an effective rate of £6.10 an hour. Others talked about being bitten or punched, yet still they continue to do the support job that they love. I pay tribute to their commitment; in the case of social care, doing a rewarding job does not pay the bills.
Mike Amesbury (Weaver Vale) (Lab)
Does my hon. Friend agree that far too many essential careworkers are employed on zero-hours contracts, which we really need to see kicked into history?
Barbara Keeley
I very much agree. We need to pay care staff the real living wage, provide them with training and end the use of zero-hours contracts.
I think it is clear enough that the Labour party believes that the current system is not working, and I am sure that the Secretary of State knows it too. Councils just do not have the funding required to deliver the care that people need, and they are faced with a stark choice—either they cut back on the quality of care, or even fewer people receive any help at all. Only a third of directors of adult social services think that their budget will be enough to meet their statutory duties this year, which means that thousands of people who approach their local authority for help with their care are turned down for support. Without investment and a plan, social care services will be pushed deeper and deeper into crisis. Expert report after expert report has pointed to social care being on the verge of collapse, and those reports make it clear that councils cannot deliver adequate adult social care provision without a sustainable, long-term funding strategy. Yet what we have seen from the Government, year after year, is short-term and piecemeal funding.
The Secretary of State may repeat, as his colleagues did yesterday, that the Government are allowing councils to raise council tax this year to fund social care services, but the Opposition know that council tax is a deeply unfair way to fund this vital public service. A 2% rise in council tax rates in Wokingham will raise twice as much money as it would in Knowsley. Even if we raised council tax by 2% every year, the Institute for Fiscal Studies says that by the end of the decade social care will make up over half of all local government spending. This means that other vital services will continue to be cut back. That is certainly the situation I see in my own local authority area.
Health and Social Care
Mike Amesbury Excerpts(4 years, 3 months ago)
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Matt Hancock
That is right, and of those 40 new hospitals over the next decade, one of the very first will be in Harlow. I pay tribute to my right hon. Friend, who has been a champion of Harlow for the last decade and has championed the need for a new hospital in Harlow. I am working very closely with the Harlow trust to make sure that that new hospital delivers what is needed for the people of Harlow. I very much look forward to working with him, and perhaps even being invited to cut a ribbon in due course.
Mike Amesbury (Weaver Vale) (Lab)
The reality on the ground in the Halton part of my Weaver Vale constituency is somewhat different. Twice the Halton hospital campus has been turned down for capital investment. If the Secretary of State is true to his word on delivery for northern constituencies such as mine, will he please meet me? Let us have some progress there.
Matt Hancock
I am very happy to meet the hon. Gentleman. As well as the new hospitals, we also have upgrades going on that are very important. Some hospitals need to be completely rebuilt, we need some that are completely new and we also need to upgrade some. I am very happy to take that forward.
Health Infrastructure Plan
Mike Amesbury Excerpts(4 years, 7 months ago)
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Edward Argar
I am grateful to the hon. Gentleman for attempting to pile a number of requests into his question. On where bids have come from for these moneys, they have come from those trusts and been worked up by those local trusts. On the specific requests he has and that he wants to raise with me about particular shovel-ready projects, I am very happy to look at those with him.
Mike Amesbury (Weaver Vale) (Lab)
May I welcome the new Minister to his place and give him the opportunity to make his mark? Halton Hospital has been turned down twice for much-needed capital investment. It is desperate for investment. Will he meet me and my neighbour, my hon. Friend the Member for Halton (Derek Twigg), and secure the future for Halton Hospital?
Edward Argar
As that is the final request for a meeting, it would be churlish of me to say no to the hon. Gentleman. I am very happy to meet him, as I am happy to meet any Member of this House to discuss this announcement and our commitment to funding the NHS because we are the party of the NHS.
NHS Long-Term Plan: Implementation
Mike Amesbury Excerpts(4 years, 10 months ago)
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Matt Hancock
Yes, I agree very strongly with that. When I said that my right hon. Friend the Member for Harlow (Robert Halfon) was one of the best constituency advocates, I forgot my hon. Friend the Member for Cheltenham (Alex Chalk), who is also one of the best, and certainly the best advocate for Cheltenham, that the House has ever seen. He is absolutely right in the substance of his question, which is that we must have the support for the workforce we need, including in emergency medicine, to ensure high-quality emergency facilities near to people—where they are needed—and he makes that case with respect to the expansion of services at Cheltenham Hospital, which he supports incredibly strongly.
Mike Amesbury (Weaver Vale) (Lab)
Is the privatisation of the urgent care centre in the Runcorn-Halton part of my constituency part of the Secretary of State’s NHS plan?
Matt Hancock
I am not sure what specific case the hon. Gentleman is referring to, but I will tell him this about privatisation: I support the NHS being free at the point of delivery so that everybody can use it, and the most important principle at stake is how to deliver the best possible services for our constituents. That is what I will keep doing.
Oral Answers to Questions
Mike Amesbury Excerpts(5 years, 5 months ago)
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Mike Amesbury (Weaver Vale) (Lab)
The Parliamentary Under-Secretary of State for Health and Social Care (Steve Brine)
We have had lots; it is just that none come with any idea of how that might be paid for. The Government have a strong track record on public health. Local authorities in England have received more than £16 billion in ring-fenced public health grants over the current spending period. Decisions on future funding for that area of spending are of course for the next spending review.
Mike Amesbury
On current projections, over £800 million will have been cut from public health budgets by 2021, £2 million of which has been cut from vital services in my constituency relating to sexual health, and to tackle obesity and smoking. Will the Minister guarantee that the new NHS long-term plan will reverse the cuts to public health budgets?
Steve Brine
I know that Opposition Members like to pretend that the past eight and a half years did not have to happen, but there is a reason why they had to happen—the economy was crashed—and eight and a half years is not a long time to clear up the mess of the last Government. But we are very clear, as the hon. Gentleman should know, that a focus on prevention will be central to the long-term plan. He mentions child obesity—[Interruption.] Opposition Members may wish to listen. The public health grant remains ring-fenced and protected for use exclusively on improving health, but local government spending on health is not just about the public health grant. The Government spend money on many other things, including around the child obesity plan and vaccinations, and that is all around prevention and public health.
Healthcare (International Arrangements) Bill
Mike Amesbury Excerpts(5 years, 6 months ago)
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Stephen Barclay
I am grateful to my hon. Friend for raising that. Understandably, much of the debate today has focused on the EU element of the Bill, but he is quite right to recognise that the reciprocal element extends beyond the EU and particularly to Crown dependencies, overseas territories and countries such as Australia, New Zealand and elsewhere. I am very happy to have those discussions with him.
My opposite number, the hon. Member for Ellesmere Port and Neston, raised a number of points, one of which was the impact on people with long-term conditions. I agree that, without reciprocal healthcare, people with long-term conditions, including those who need dialysis, may find it harder to travel, which is the very essence of why the Bill is necessary, so that we can implement a reciprocal arrangement with the EU or, failing that, with individual member states to support the travel arrangements of those with long-term conditions.
The hon. Gentleman also questioned the £66 million figure that I referenced in my speech, and I am happy to point out that that was in relation to the 2016-17 value of claims made by the UK to EU member states. He also asked about cost recovery more generally and, since 2015, we have increased identified income for the NHS under reciprocal arrangements by 40%, and directly charged income has increased by 86% over the same period. I mentioned the increased focus on that to my hon. Friend the Member for Crawley (Henry Smith), which I hope gives a signal of intent as to the direction of travel on cost recovery.
The hon. Member for Ellesmere Port and Neston also mentioned the role of NHS Improvement, and I am happy to clarify that it is now working with more than 50 NHS trusts to improve their practices further, with a bespoke improvement team in place to provide on-the-ground support and challenge in identifying and sharing best practice.
The hon. Gentleman also mentioned an important point, and one that we will probably go into in more detail in Committee, on data. Again, the policy intent is continuity, rather than a change in our approach to data. Clause 4 expressly contains a safeguard for personal data, which can be processed only where necessary for limited purposes or funding arrangements. That covers, for example, where someone is injured while abroad, where personal data of a medical nature often needs to be shared to allow treatment to take place. At the same time, there are safeguards in the Bill, which I am sure we will explore.
My hon. Friend the Member for North Thanet expressed concern about cherry-picking, and I recognise his point. That is why we are looking for the reciprocal arrangements to continue, although even in the event of no deal and no bilateral deal, local arrangements often apply for healthcare, such as on the basis of long-term residency or previous employment. Those would be local factors, but obviously the policy intent is to have an arrangement with countries across the EU.
The hon. Member for Linlithgow and East Falkirk (Martyn Day) and my hon. Friend the Member for East Renfrewshire (Paul Masterton) spoke about the work of the devolved Assemblies and how we liaise with them. Indeed, I spoke with my Welsh counterpart just yesterday. In the other place, the Parliamentary Under-Secretary of State for Health has been working closely with the devolved Assemblies, as have colleagues and officials in our Department. How we work with the devolved Assemblies is a pertinent point, and we are keen to continue that active dialogue.
My hon. Friend the Member for Poole (Sir Robert Syms) correctly identified the importance of the EHIC card and of inward tourism to the UK. The point about continuity was reinforced by my hon. Friends the Members for Chichester (Gillian Keegan) and for Chelmsford (Vicky Ford) in their thoughtful contributions. It was also echoed by my hon. Friend the Member for Walsall North (Eddie Hughes) when he highlighted the importance of taking a practical approach to how these arrangements apply.
My hon. Friend the Member for Totnes (Dr Wollaston) raised a number of detailed points, and I am happy to have continued dialogue with her on them, although I hope she will draw some comfort from recent quotes and legislative developments in a number of EU27 states. For example, the French Minister for European Affairs said, “France will do as much for British citizens in France as the British authorities do for our citizens.” France has legislation under way. The Spanish Prime Minister said, “I appreciate, and thank very much, Prime Minister May’s commitment to safeguarding those rights. We will do the same with the 300,000 Britons who are in Spain.”
Again, I hope the fact that we actually pay out more to the EU than we currently receive, and the fact that both nations benefit from a reciprocal arrangement, gives an idea of the starting point of the discussions. Like my hon. Friend, I would welcome it if that were done across the EU27 as a whole.
My hon. Friend also raised the issue of dispute resolution, and the current arrangements between the UK and other member states require states to resolve differences, in the first instance, between themselves. That is the existing position that applies, but clearly it would be a matter for negotiation as to how a future UK-EU agreement might be governed. That is a cross-cutting issue; it is not one pertaining solely to this Bill.
It is clearly in the interests of the British public to ensure reciprocal healthcare, arrangements, similar to those currently in place, continue when we leave the EU, whether that happens through an agreement with the EU itself, as we very much want, or through individual arrangements with EU member states.
Mike Amesbury (Weaver Vale) (Lab)
Just for clarification, is the jurisdiction of the European Court of Justice still a red line in the sand?
Stephen Barclay
The issue in terms of the ECJ will be dealt with in other areas of the withdrawal agreement discussions. In the event of a deal, and in the event of no deal, it will be governed by the bilateral arrangements.
I commend this Second Reading to the House, and I look forward to working with colleagues on both sides of the House in Committee.
Question put and agreed to.
Bill accordingly read a Second time.
Oral Answers to Questions
Mike Amesbury Excerpts(5 years, 6 months ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Steve Brine)
We certainly will. I do not wish to pre-empt what the long-term plan will say, but it is an excellent opportunity for us to look at how the NHS can best support people who have or are at risk of developing diabetes, and that includes transformation funding beyond next spring and how technology can be used to help people better manage that long-term condition.
Mike Amesbury (Weaver Vale) (Lab)
Stephen Barclay
I am not aware of the specific details of that, but I am happy to meet the hon. Gentleman to discuss it if he has particular concerns he wishes to raise.
Learning Disabilities Mortality Review
Mike Amesbury Excerpts(6 years ago)
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Caroline Dinenage
This is something that my hon. Friend, as a healthcare professional, obviously knows an awful lot about. She is right that a person having the ability to communicate, understand and identify when they do not feel well is important. These annual health checks, which are available to children from the age of 14 and into adulthood, are important because they enable any healthcare issues to be disseminated and communicated much more effectively between different healthcare and other providers.
Mike Amesbury (Weaver Vale) (Lab)
Can the Minister guarantee that future publications of such sensitive reports will be done in a timely manner and given proper parliamentary scrutiny?
Caroline Dinenage
I will certainly put that request to NHS England. It was not in our interest for the report to be published on Friday. This is an independent review, but it would have been much better for us to have had foreknowledge of its publication. We would then have brought a statement to the House. We will pass on the hon. Gentleman’s comments to NHS England.
Social Care
Mike Amesbury Excerpts(6 years ago)
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Mike Amesbury (Weaver Vale) (Lab)
It is a pleasure to follow the hon. Member for South West Bedfordshire (Andrew Selous), who is very knowledgeable on these issues.
In October last year, we sat in the Chamber and conducted an Opposition day debate on this crucial issue of social care. Today, six months later, we are doing exactly the same thing, not because there has been any major policy change or even any significant ideas from the Government, but because, six months on from the Government being told that there was a social care crisis, they have taken no concrete action to solve it. In fact, rather than tackle it head on, all they have done is shift the responsibility further on to hard-pressed councils and devolved the funding burden and pain on to individual taxpayers in my constituency and throughout England.
Social care faces a deficit of £2.5 billion by the end of the decade. That is not a Labour party figure, and it is not fake news; it is from the reputable King’s Fund. Cuts of £6.3 billion have been made to adult social care since 2010. As a result, there has been a 26% fall in the number of people accessing care, meaning that 400,000 fewer people are able to get the support they need and deserve.
My constituency of Weaver Vale is served by two councils: Halton, and Cheshire West and Chester. Both have fought a valiant battle against Tory austerity, doing all they can to protect the most vulnerable, but things are now at crisis point. Figures show that since 2011-12, external funding for Cheshire West and Chester Council and Houlton Council has been cut by 38.1% and 43.7% respectively. That situation is unsustainable. The care sector says so, the charities that support our vulnerable people say so, and even the Tory-led Local Government Association says so, yet still the Government do not listen. If they do not listen to the experts, or even to their own Tory councillors, perhaps they will listen to those at the sharp end on the frontline of social care: our staff.
On Saturday, I spoke to Paula, who represents thousands of local government workers in Unison in my constituency. She had a message for the Secretary of State:
“Do the right thing. Invest in our valuable public services. Invest in our amazing workers”.
This touches on some of the points made by Conservative Members. I agree with some of my hon. Friends who have said decent, quality social care costs money and that we need to put our money where our mouth is. We need to have an honest conversation about this. Let us finally take the bull by the horns and establish a national health and social care service. The Government must listen to public sector workers like Paula, and the millions of people like her, as well as to unions such as Unison. Only then will our communities and our councils have the funding that meets their needs, and which is stable and fair. Only then will we begin to tackle the crisis in social care.