Oral Answers to Questions

Neil O'Brien Excerpts

Tuesday 11th July 2023 Commons Chamber

[Daisy Cooper (St Albans) (LD)]

6. What assessment he has made of the potential impact of guidance issued by District Valuer Services on the availability of city-centre GP premises.

[The Parliamentary Under-Secretary of State for Health and Social Care (Neil O'Brien)]

While it is a very long-standing system, we keep the approach to funding for GP premises under review. We have taken action in the primary care recovery plan to improve access to section 106 funds, so that new homes always come with the GP infrastructure that is needed.

[Daisy Cooper]

The Secretary of State and his Ministers will know that I first raised this issue in the Chamber on 6 June this year. Integrated care boards, GPs, and now the medical property sector are all telling me that the Treasury rules are out of date and are a massive block to securing much-needed primary care premises in the right places, particularly in city centres such as St Albans. When I have asked the Department via written parliamentary questions for its assessment of how much of a problem this issue is, the Department has told me that it just does not know. Could the Minister please tell us when he will be speaking to colleagues in the Treasury to resolve this issue, so that we can make sure that GP premises are secured where people need them most?

[Neil O'Brien]

We talk all the time. I am conscious that there are 60% more full-time patient-facing staff in the hon. Lady’s constituency than there were in 2019, which of course puts pressure on premises. The capital allocation for her local ICB between 2022-23 and 2024-25 was £200 million, so the money is there, but I am happy to continue the conversation about how we get the premises in the places where we need them.

[Chris Green (Bolton West) (Con)]

7. What recent progress he has made on increasing the range of services in pharmacies.

[The Parliamentary Under-Secretary of State for Health and Social Care (Neil O'Brien)]

We have already been growing the range of NHS services available in pharmacies: we have set up the community pharmacist consultation service, the discharge medicines service, the new medicine service, the blood pressure check service, smoking-cessation services and the contraception service. We are now investing £645 million to go further through the new Pharmacy First scheme for common conditions.

[Chris Green]

I thank my hon. Friend for his answer, but does he agree that the services offered by pharmacies can be made more efficient? For example, 62 million prescription items are subject to “split and snip” per year. That is where, to get the right number of pills, a pack has to be manually opened up for a couple of pills to be snipped out, then repackaged and relabelled before being reissued. The spare pills are often thrown away. Can that system not be better?

[Neil O'Brien]

My hon. Friend is completely correct. That is why at the end of last month we laid a statutory instrument before the House to fix the system, so that pharmacists can spend more time using their skills to provide high-end clinical services and less time snipping blister packs.

[John Cryer (Leyton and Wanstead) (Lab)]

Given the national shortage of GPs, does the Minister recognise that there is a potential danger in asking pharmacists to take on the duties of GPs—duties that they are not necessarily qualified to undertake—especially given the already large workload undertaken by pharmacists?

[Neil O'Brien]

We absolutely recognise the need for patient safety, which is why there will be clear patient group directions and clear pathways about what pharmacists do. They are not taking on the role of GPs, but are providing additional services that will make things more convenient for all of our constituents.

[Dame Maria Miller (Basingstoke) (Con)]

I warmly welcome the Government’s commitment to investing £645 million to enable pharmacists to provide for far more common conditions. I have already visited one of my own local surgeries, the Shakespeare Road medical practice, and seen at first hand how pharmacists are already working in GP surgeries to try to reduce waiting times. Surely, more surgeries should be doing the same, involving pharmacists with enhanced roles in order to cut waiting times in a manner that is safe.

[Neil O'Brien]

My right hon. Friend is completely correct. That £645 million, of course, comes on top of the £100 million that we have already put in. We have grown the pharmacy workforce hugely—there are 82% more pharmacists now than in 2010—and we are also enabling those people with their high-end skills to do more by reforming regulations. That is not just the blister packs issue; we are enabling them to do convenient things such as hand out bagged medicines even if the pharmacist is not present.

[Mr Gregory Campbell (East Londonderry) (DUP)]

Will the Minister undertake to liaise closely with local community pharmacy representative groups to ensure that the excellent work they have been doing can be maximised, particularly given that the NHS is under severe pressure at the moment?

[Neil O’Brien]

Absolutely, and I always try to learn lessons from right across the UK. In fact, some of the ideas for reforms have come from listening to local partners. For example, our reforms to enable modern ways of working, hub-and-spoke dispensing and empowering pharmacy technicians have come from talking to those local partners.

[Mr Speaker]

I call the shadow Minister.

[Karin Smyth (Bristol South) (Lab)]

People across the country rely on local, accessible pharmacies, but whether it is high street closures or supply problems leading to the absurd situation where women are phoning or visiting multiple pharmacies for a prescribed dose of hormone replacement therapy and other drugs, the Government are again letting people down. They have repeatedly announced plans to expand the role of community pharmacies, but have failed to update legislation that could possibly help. They keep collapsing the business in this place, so we have time to sort it. Why will they not do so?

[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.

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[Kate Osborne (Jarrow) (Lab)]

10. What steps he is taking to help tackle health inequalities.

[The Parliamentary Under-Secretary of State for Health and Social Care (Neil O’Brien)]

We are tackling the root causes of health inequalities. We have doubled the duty on cigarettes and brought in a minimum excise tax on the cheapest cigarettes. That has helped to drive down smoking rates from 21% to a record low of 13%. We are going further, helping a million smokers with our scheme to get people to stop smoking and start vaping. We have provided £40 million to start rolling out new weight-loss drugs and, in the major conditions strategy, we will talk further about how we will tackle health inequalities.

[Kate Osborne]

People in the north-east die younger than people in the rest of England and spend more years in ill health. Increased NHS waiting times leaves them on medication for longer. The north-east has the highest level of people living in poverty, leaving many of my constituents unable to afford prescription charges. Some have told me that they are taking paracetamol instead of prescribed medication, worsening health inequalities. Will the Minister commit to scrapping these unfair prescription charges?

[Neil O’Brien]

Nine out of 10 prescriptions are not paid for, but free at the point of delivery. On the various important points that the hon. Lady makes, tackling health inequalities is hugely important to us. That is why we are creating 160 extra community diagnostic centres, which are targeted at areas of the highest deprivation. It is why we are rolling out targeted lung health checks in 43 areas of the most deprivation. It is also why we are providing cost of living support worth about £3,300 for the average household in this country. It is one of the most generous schemes anywhere in Europe, exactly to tackle those cost of living pressures and health inequalities.

[Mr Louie French (Old Bexley and Sidcup) (Con)]

My hon. Friend will be aware that health inequalities can also be geographical within the south-east, with boroughs such as Bexley having historically received less funding than other parts of London. Does he therefore agree that further investment in the fantastic Queen Mary’s Hospital Sidcup would address that issue and improve health outcomes for people in south-east London?

[Neil O’Brien]

My hon. Friend is assiduous in making the case for his constituency. Ministers of course will meet him to discuss this matter. I know he is closely following the progress of the CDC bid, which we have been talking about. Those diagnostic centres are doing fantastic work to get earlier diagnosis and save more lives, particularly in areas of deprivation.

[Mr Speaker]

I call the shadow Minister.

[Andrew Gwynne (Denton and Reddish) (Lab)]

From this complacent Minister’s replies already, one would think that health inequalities in England were improving, not widening. Last year, 11,000 people, including 312 children, were hospitalised for malnutrition in the United Kingdom. That is the highest number since comparable records began. Why are so many people in Britain going hungry under the Tories?

[Neil O’Brien]

We need to have care in discussing these subjects. Eating disorders are a sensitive subject and the statistics the hon. Gentleman is quoting are a mix of different things. I have already talked about the £3,300 of cost of living support that this Government are providing to the average UK household, with more targeted help for more vulnerable households. It is something we are seized of and are working on.

[Mr Speaker]

I call the SNP spokesperson.

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

Millions of people with disabilities or serious medical conditions rely on specialist equipment, such as ventilators or home dialysis, which personally costs them more money to run, while giving considerable savings to NHS hospitals. Will the Minister urge Cabinet colleagues in the Department for Work and Pensions to help to tackle health inequalities by ensuring that those people receive a fair and timely reimbursement for those additional costs, which are essential to run the equipment to help keep them alive?

[Neil O’Brien]

Absolutely. We are conscious of the additional needs of people who have equipment like that. By the end of June, the Government had covered nearly half of a typical household’s energy bill through the support schemes we put in place, but we are always looking at what more we can do to help vulnerable households.

[Ian Byrne (Liverpool, West Derby) (Lab)]

11. What assessment his Department has made of the potential impact of primary care service closures on public health.

[The Parliamentary Under-Secretary of State for Health and Social Care (Neil O’Brien)]

Each integrated care board is required to ensure access to GP services for all. Overall, more people are being seen in general practice than ever before—about 10% more than before the pandemic—but where some practices close, the local ICB has to ensure that patients are transferred smoothly to other practices.

[Ian Byrne]

Park View medical centre in West Derby, one of the most deprived areas of my city, is facing imminent closure, and there has been a lack of transparency and accountability throughout the process when dealing with the ICB to get the decision reversed. In the Minister’s reply to my letter, he said it was essential that, if a GP surgery closes, it does not lead to a reduction in the quality of care for patients in the locality. Park View patients have been clear that dispersal to other surgeries would be catastrophic, especially when all GPs are already facing huge pressures. Will the Minister urgently intervene to halt the closure due to the legal insufficiency of the consultation process and meet me and patients?

[Neil O’Brien]

I have looked carefully at that case, on which the hon. Gentleman has been campaigning. The incumbent provider chose not to bid for the future contract for Park View medical centre, and NHS Cheshire and Merseyside decided that the best thing was to help patients to transfer to neighbouring practices. Patients will only be transferred to practices rated as good, and there are 10 other practices rated as good within a 1-mile radius of Park View. Since 2019, there has been an increase in the number of patient-facing staff of about 50% in the constituency. That means there are more people in his GP surgeries. We are working hard to ensure high-quality GP services in his constituency.

[Virginia Crosbie (Ynys Môn) (Con)]

Health is devolved to Labour in Cardiff. Ynys Môn is represented by five Members of the Senedd, yet health represents a third of my postbag, particularly relating to access to primary care in Holyhead. Does the Minister agree that families in Holyhead are not getting the healthcare they need and deserve?

[Neil O’Brien]

Yes, it is true, I am afraid. People are about twice as likely to be waiting for treatment in the Welsh NHS. Waits are also longer in Wales, with 30,000 people waiting more than two years for treatment, even though those have been eliminated in England. England spends more on general practice than Scotland or Wales, despite the fact that Wales has 20% more funding, and England has also grown spending on general practice faster than either Scotland or Wales. We are highly focused on getting good primary care services in England. There are always lessons that we can learn from each other, but there are definitely lessons that Welsh Labour can learn from the English NHS.

[Neale Hanvey (Kirkcaldy and Cowdenbeath) (Alba)]

12. What steps his Department is taking to create a vaccine development and evaluation centre.

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[David Johnston (Wantage) (Con)]

T2.   I have campaigned for more health services for my constituents since I was elected, and 97% of those who responded to my recent health services survey felt that we did not have enough doctors for the number of people in the constituency. Will my hon. Friend meet me to discuss how to sort this out and get my constituents the health services that they deserve?

[The Parliamentary Under-Secretary of State for Health and Social Care (Neil O’Brien)]

We are conscious that more is going on in general practice than ever before. There are 10% more appointments than before the pandemic, as well as 29,000 extra clinicians and nearly 2,000 more doctors, but we are conscious of the pressures that puts on the estate locally. I would be very happy to meet and have further conversations with my hon. Friend.

[Kirsten Oswald (East Renfrewshire) (SNP)]

T3. I am sure that the Secretary of State shares my concern that school nurses report increasing rates of children presenting with health issues resulting from poor nutrition. In Scotland, the SNP Government have rolled out universal free school meals for all pupils in primary years 1 to 5 and special schools, and the expansion of the programme continues. What discussion has the Secretary of State had with Cabinet colleagues about following Scotland’s lead and expanding free school meal provision in England to improve children’s health and wellbeing?

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[Steven Bonnar (Coatbridge, Chryston and Bellshill) (SNP)]

A recent report by the Trussell Trust warns that people facing hunger are more likely to be affected by spiralling debt and a decline in their physical and mental health. The same report shows that one in seven people in the UK faced hunger in the last year due to a lack of money. Will the Minister make representations to his colleagues at the Department for Work and Pensions about increasing support for low-income households, thereby improving public health outcomes for all?

[Neil O’Brien]

It is to protect public health that we have provided cost of living support worth £3,300 on average per household, and that is why we have been paying about half of people’s average electricity and other energy bills. However, we always look at further things we can do to drive improvements in public health.

[Andrew Lewer (Northampton South) (Con)]

T7. What steps is the Department taking to prevent chronic kidney disease, given that the recent report published by Kidney Research UK predicts a significant rise in cases of kidney failure in 10 years’ time?

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[Jason McCartney (Colne Valley) (Con)]

T8. Many of my constituents are still struggling to get NHS dental appointments, so what is happening right now—this week, this month—to increase the availability of NHS dental appointments for them?

[Neil O’Brien]

I know how intensely my hon. Friend is campaigning on this issue. The amount of NHS dentistry being delivered has gone up by a fifth over the last year, partly as a result of the reforms we are already rolling out. He will have seen in the workforce plan that we are going to increase training places for dentists by 40% so that we have the NHS dentists we need. However, that is not all we will do, and our forthcoming dental plan will take further steps.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

We have known for a while that our life expectancy is shorter than it was in 2010. However, we are now seeing impacts on children in the UK, who are about 7 cm shorter at five compared, for example, with the children of our neighbours in Holland. What is the Secretary of State doing on this issue, and will he support the all-party parliamentary group on health in all policies in assessing the impacts on health and health inequalities?

[Neil O’Brien]

Of course we are taking action to improve public health, and that includes children’s nutrition. That is why we are spending £150 million on healthy food schemes, such as the school fruit and vegetable scheme, the nursery milk scheme and Healthy Start. It is also why we are investing £330 million a year in school sport and the PE premium and a further £300 million through the youth investment fund. We will continue to take action on this key issue.

[Mr Jonathan Lord (Woking) (Con)]

I am delighted that a new diagnostic centre is shortly to be built at our terrific Woking Community Hospital, very close to Woking town centre. Does the Minister agree that providing state-of-the-art diagnostic care right in the heart of the community can cut NHS waiting lists, reduce carbon emissions and, most importantly, help to optimise health outcomes for patients?