The National Health Service

Debate between Neil O'Brien and Jim Shannon

Wednesday 23rd October 2019 Commons Chamber

[Neil O’Brien (Harborough) (Con)]

I thank Ministers and everybody at University Hospitals of Leicester for the role they played in securing the fantastic £450 million investment in our local hospitals that was announced the other day. I also thank Ministers for the role they have played in today’s announcement that there will be a new £46 million investment in an urgent care hub at Kettering General. That means that constituents at both ends of my constituency will benefit from huge new investments. I am incredibly grateful.

Those are not the only pieces of good news my constituency has had recently. We have the gleaming new treatment centre at St Luke’s in Market Harborough. We have had the wonderful news that we will be keeping the world-leading children’s heart unit at Glenfield—a service that is not just brilliant for everybody in this country, but through the charity Healing Little Hearts provides help for people across the entire world. We also have the futuristic new A&E at Leicester Royal Infirmary. Those things are all great, but the investment we are about to receive will be even more transformational.

The Secretary of State came to the Royal Infirmary the other day. As we walked around, we heard about both the challenges and the opportunities that we have locally. We saw the difficulty of working in maternity when it is split across two sites. When my son was born just two weeks ago, I saw how having two different sites meant that the staff had to work all day without breaks to fit us in. Their lives and patients’ lives will be much better when we have a single new maternity hospital. As we walked around with the Secretary of State, we saw the brilliance of our intensive care staff, but we also saw that they were working in fundamentally out-of-date facilities. We saw the brilliant work that the A&E team were doing, particularly in enhancing data to improve services, but we also saw the incredible growth in demand for those services.

The investment we are about to get means a new maternity hospital, a new children’s hospital, two super-intensive care units with 100 beds in total and a planned new major treatment centre at Glenfield Hospital, as well as modernised wards, new operating theatres, new imaging facilities and, brilliantly, new additional car parking. Anybody who has ever tried to park at Leicester Royal Infirmary will realise that that is a huge boon. These local improvements are part of a wider series of improvements we are making across the NHS. It is great that we now have a long-term plan for the NHS, with a long-term budget for the NHS that allows NHS managers and staff to plan for the future.

[Jim Shannon]

I very much welcome the Government’s commitment and the money they have set aside, but is the hon. Gentleman aware that 16 million people in England live with the pain of a musculoskeletal condition? How will the Government ensure that people with arthritis are able to access the interventions that need to be in place—from joint replacement operations to physiotherapy—in a timely fashion? I think there is an opportunity to address those issues. I have the same problems in my constituency, but it is a devolved matter. I have been made aware of this issue in England. Does he agree that it is time for that?

[Neil O’Brien]

The hon. Gentleman raises an important point, and I was about to come on to it. It is great that we are making record investment in services such as mental health and spending more than we did before. It is great that we are introducing new targets, such as basic standards for help with eating disorders. It is great that we have more doctors, more nurses and more money. However, we are conscious, as we speak to people in the NHS, that unless we can deal with the sources of demand, fundamentally we will never be able to spend enough on all the priorities, including musculoskeletal services.

What do we need to tackle those causes of demand? We of course need the long-term plan for social care. The Minister needs to stick to his guns on public health: the sugar tax has worked. Things like the campaign against the anti-vaxxers and their pseudo-science are incredibly important, as is action on preventive social care. We should keep going with things such as the migrant health charge, which is raising money for the NHS; we could increase it. We should keep going on technology. It is so important for Ministers to help GPs to upgrade their telephone triage facilities, which would make the experience of using primary care so much better and reduce the burden.

Some of the things in the Queen’s Speech are incredibly important to help deal with these growing burdens. We need new technologies, which is why it is important to get more clinical trials going more quickly. That is why I welcome the measures in the Queen’s Speech. This is about building on the life sciences review—the Bell review—and it is very important to build on the work that the academic health science networks are doing. The potential advantage of our NHS is that it should be one of the best places in the world to do clinical trials—we have the scale—but at the moment there are too many gatekeepers and too many things stopping them.

Last but not least, there is the wonderful improvement in the NHS safety body that we are creating. From personal experience, I can say that when my daughter was born some things went wrong. We had a wonderful junior registrar who did lots of things right, but a few things went wrong, and my wife gave birth without anaesthetic. After that, unfortunately, her placenta did not deliver and the consultant—we never found out who this was—removed the placenta manually with no anaesthetic, and it was incredibly painful for my wife.

It is important, as my hon. Friend the Member for Harwich and North Essex (Sir Bernard Jenkin) said, that we learn lessons in the NHS without attributing blame. Not attributing blame was one of the fundamental recommendations following the Mid Staffs inquiry: we have got to be able to learn lessons. When we started to complain about what happened to my wife, people closed ranks. My wife is a doctor, and we would never in a million years have sued the NHS, but they did not know that. We never even found out who the consultant was who had got things wrong, so I do not know whether the lessons were learned from that mistake; I hope they were.

Having a no-blame culture, having this new body and learning from the experiences of painful things such as the Bawa-Garba case are the ways in which we can have truth and reconciliation, with a system that learns. One of the most important things we could ever do to improve the NHS is to make it a self-improving system that is constantly learning and constantly getting better.

Small and Village School Funding

Debate between Neil O'Brien and Jim Shannon

Wednesday 17th July 2019 Westminster Hall

[Neil O'Brien]

My hon. Friend is completely correct. However, rural schools, partly because they are small schools, have been much more likely to close in recent years. I thank the Department for Education for the historical data it provided to me on this, and Pippa Allen-Kinross at Schools Week for helping me to analyse it. Since 2010, 61% of schools that have closed and not reopened in another form have been rural schools, meaning that rural schools have been twice as likely to shut as urban ones. Since 2000, 150 rural primaries have closed.

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Gentleman for bringing the debate. What he outlines in his constituency and other parts of the United Kingdom mainland is replicated in Northern Ireland. I know that the Minister does not have responsibility for this, but for the record, is the hon. Gentleman aware that since September 2010, 98 of the 230 schools that closed in Northern Ireland—42%—were rural, according to Schools Week analysis? Does he recognise the difficulties that creates for rural dwellers and socially isolated children?

[Neil O'Brien]

The hon. Gentleman is completely correct. This challenge affects all of the United Kingdom. For rural schools that closed, the average walk to the next nearest school is 52 minutes, which in practice means driving or getting a bus. There is a cost to the taxpayer for this transport, and a cost to parents and children for driving a long way, so there are all kinds of reasons why we should want to preserve our village schools.

I will turn to small schools more generally, including those in urban areas. I am grateful to the House of Commons Library for digitising older data for me that revealed a dramatic transformation in the scale of our schools over recent decades, and a decline in the number of small schools. The number of pupils at state primary schools in England is roughly the same as in 1980, but the schools that they attend are completely different. In 1980 there were 11,464 small primary schools with fewer than 200 pupils, but in 2018 there were just 5,406. The number of such schools has halved over the decades.

In contrast, in 1980 there were 949 large primary schools with more than 400 pupils, but in 2018 there were more than 4,000, so the number of large schools has quadrupled. The number of really big primaries with more than 600 pupils increased from 49 to 780, while there are now more than 100 what I call “super jumbo” primary schools with more than 800 pupils, which often have playtimes in shifts and hundreds of staff. This is a huge change in the nature of our primary schools, and it is visible in Scotland, Wales and Northern Ireland too. In fact, since 2002 Wales has seen the most dramatic decline in the number of small schools, followed by the north-west and Yorkshire.

This huge change in our primary schools has come about without any real discussion or political choice. It seems to me a move away from the natural small scale for small children, and there is no obvious policy rationale for it. Small schools are not bad schools. Schools with 200 pupils or fewer are just as likely to be “good” or “outstanding” as other schools. In fact, schools with fewer than 100 pupils, which account for about one in eight schools, are more likely than average to be “good” or “outstanding”, so this is not about academic standards.

I think two different things are driving it. The first is planning, which is outside the DFE’s remit. We do not build new small schools, and we do not make developers pay enough for the infrastructure needed for new housing. Instead, our bitty, piecemeal development allows developers to get out of paying for new schools, and we cram more pupils into existing schools, building classrooms on playing fields. Secondly, wider catchment areas mean more car journeys to those schools, and because builders often put schools in residential areas, there are a lot of cars driving into streets that were never intended for them, leading to a lot of congestion. People tell me that makes their village no longer feel so much like a village.

However, the DFE could do some things about the declining number of small schools. We should increase the lump sum element of the national funding formula. Do not get me wrong: the national funding formula is extremely good and has meant that the funding rate per pupil in my constituency has gone up twice as fast as the national average. It helps underfunded areas such as mine to catch up with the national average, although there is still a long way to go. It would be very helpful to increase the lump sum—the part of the national funding formula intended to help small schools.