Oral Answers to Questions

Nic Dakin Excerpts

Tuesday 27th November 2018 Commons Chamber

[Steve Brine]

Through our work on parity of esteem for physical and mental health, we take eating disorders very seriously. That is not directly related to the child obesity plan, but we are absolutely determined to tackle weight challenges at either end of the scale, because I know that they affect a lot of people.

[Nic Dakin (Scunthorpe) (Lab)]

Obesity is now one of the biggest risks to health and a significant cause of cancer and other conditions. Is it not time to look at restricting the advertising of junk food up to 9 o’clock?

[Steve Brine]

I have a lot of time for the hon. Gentleman and do a lot of work with him. He knows that we published proposals in the child obesity plan to launch a consultation on a pre-9 pm watershed ban, and we will be bringing that forward before the end of the year as promised.

Dangerous Waste and Body Parts Disposal: NHS

Nic Dakin Excerpts

Tuesday 9th October 2018 Commons Chamber

[Stephen Barclay]

I very much share my hon. Friend’s desire for the backlog to be cleared as speedily as possible. As I referred to a moment ago, this is an area of scrutiny for the Environment Agency, and it is important that the company complies with its legal requirements and ensures that the level of waste is in line with its permits as soon as possible.

[Nic Dakin (Scunthorpe) (Lab)]

Hospitals such as Scunthorpe general cannot run effectively without the safe and secure disposal of clinical waste, which is exactly why it is important that the Minister has made the comments that he has today. Northern Lincolnshire and Goole trust quite properly put in place local contingencies, because obviously it could not rely on things being sorted out. It now looks as though contingencies are sorted nationally, so can he be very clear that local trusts will not face a penny more of extra costs as a result?

[Stephen Barclay]

The hon. Gentleman raises a fair point, and I want to be clear about the distinction. Additional cost arising from the contingency arrangement—for example, putting in place extra storage on the trust’s sites—will not be an additional cost on the trust. I hope that that will reassure him, although I do not want to suggest to him that there will be no financial impact on trusts, because the requirement to clear clinical waste sits with the trust. That is why the trusts themselves had contracts with the supplier. The ongoing arrangements are likely to mean some increased cost, as the new supplier comes on board. That will fall to the trust, but not the contingency element.

Oral Answers to Questions

Nic Dakin Excerpts

Tuesday 19th June 2018 Commons Chamber

[Mr Speaker]

Order. It is of the utmost importance that we are ready for the one-minute silence, so I shall take a brief inquiry from Mr Nic Dakin, and a brief reply.

[Nic Dakin (Scunthorpe) (Lab)]

There are homeless people in the Scunthorpe area who present with mental health problems. What are the Government doing to ensure that proper mental health support is there for people who present as homeless?

[Jackie Doyle-Price]

The hon. Gentleman is quite right. Mental health is both a symptom and a cause of homelessness, and we will tackle that as part of our work on rough sleepers.

--- Later in debate ---

[The Minister for Health (Stephen Barclay)]

I very much enjoyed visiting the trust with my hon. Friend. As he will be aware from our discussion during that visit a process for capital bids is under way. As my right hon. Friend the Secretary of State set out, the date for that is mid-July and I look forward to seeing the bid from my hon. Friend’s trust.

[Nic Dakin (Scunthorpe) (Lab)]

T3. NICE guide- lines on IVF seem to be largely honoured in the breach, leading to a postcode lottery across the country. Is it acceptable that women in North Lincolnshire who cannot conceive are being refused IVF if their partner has had children in another relationship?

[The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)]

I recently met the hon. Gentleman’s party colleague, the hon. Member for Birmingham, Selly Oak (Steve McCabe), to discuss this matter with the facility. We are very clear: we expect all clinical commissioning groups to honour the NICE guidelines. I am very cross that CCGs tend to view IVF services as low-hanging fruit with which to make cuts. That is totally unacceptable and I will be taking steps to remind them of that.

Acquired Brain Injury

Nic Dakin Excerpts

Monday 18th June 2018 Commons Chamber

[Steve Brine]

I do not know what you mean, Madam Deputy Speaker, but I will certainly be here until 11 pm.

The hon. Member for Strangford (Jim Shannon) makes a good point, which follows on neatly from the point made by the hon. Member for Brighton, Pavilion (Caroline Lucas). It also leads me neatly on to the point I was about to make. The all-party group on ABI is currently conducting a very broad inquiry into the condition—its causes, treatments and societal impact—and I am sure it will consider the wider family. When I say family, I do not just mean the nuclear family but society’s family and even the Church, which can embrace people suffering the life change the hon. Gentleman spoke about so well with regard to his brother. I want the all-party group to know that I will support its inquiry as best I can. They should know that that offer is there.

As a Health Minister, I will obviously focus on the health aspects of ABI, but I just want to highlight some of the other areas—this touches on one or two of the interventions—where its impact is felt and action is under way. On education, many children and young people with ABI are rightly in education and have special educational needs as a result of their injuries. The Government recently provided some £29 million to support local authorities with ongoing implementation of individual education, health and care plans to meet those needs. It is vital to us that health, social care and education services work jointly in developing these care plans. I know my colleagues in the Department for Education share that view.

On offending behaviour—ABI touches on a lot of different Government Departments—there is an increasing body of evidence suggesting that children and young people who survive traumatic brain injury are more likely to develop behavioural problems that can be linked to an increased vulnerability to offend. NHS England’s liaison and diversion service has collaborated with the charity Headway, which I mentioned at the start of my speech, to improve awareness of ABI in vulnerable offenders and the support available—the point raised by my hon. Friend the Member for Cheltenham (Alex Chalk). Further, the Ministry of Justice is piloting approaches to improve screening and support for prisoners with ABI to prevent a cycle of re-offending once they enter the secure estate. The Minister for Disabled People, Health and Work, my hon. Friend the Member for Truro and Falmouth (Sarah Newton), is very kindly on the Government Front Bench to listen to the debate and I am grateful to her. The Minister of State, Ministry of Justice, my hon. Friend the Member for Penrith and The Border (Rory Stewart), who has responsibility for prisons, had hoped to be here but was pulled away. I know he will be taking a close interest in what is said tonight, because this issue will come up again.

Sport is another area for which there is a growing body of evidence and concern about the levels of risk and response to injury. This is why the Government commissioned an independent review of the duty of care that sport has to its participants, which published its findings in April 2017, and we are now working to implement its recommendations, including around awareness and prevention of head injury while playing sport.

On trauma centres, it is vital that those with the most serious brain injuries receive the best care that our NHS —our birthday NHS—can offer. In 2012, 22 regional trauma networks were developed across England. Within those networks, major trauma centres provide specialised care for patients with multiple, complex and serious major trauma injuries, including brain injury. Two years after their introduction, an independent audit of the network, commissioned by NHS England, showed patients had a 30% improved chance of surviving severe injuries and that the networks had saved some 600 lives. There is a positive story there.

A vital part of the treatment pathway for people who have suffered ABI is neuro-rehabilitation that is timely and appropriate to their needs. There is good evidence that access to high quality rehabilitation both improves outcomes for patients and can save money.

[Nic Dakin (Scunthorpe) (Lab)]

The neuro-rehabilitation centre in Goole is an excellent example of such practice. It serves north Lincolnshire and the wider area. I commend that service, and others like it, to the Minister.

[Steve Brine]

I thank the hon. Gentleman for his intervention. I hope to get to his part of the world at some point while doing this job and it may be that I could visit it while I am up there.

The World Health Organisation states that rehabilitation intervention should be aimed at achieving the following five broad objectives: preventing the loss of function; slowing the rate of loss of function; improving or restoring function; compensating for lost function; and maintaining current function. NHS England’s Improving Rehabilitation programme applies those principles, rightly, in a holistic way to encompass both mental and physical health. In 2015, the programme published the “Principles and expectations for good adult rehabilitation” to support commissioners on delivering rehabilitation care locally in our constituencies. This document describes what good rehabilitation looks like and offers a national consensus on the services that we think people should expect.

NHS Long-Term Plan

Nic Dakin Excerpts

Monday 18th June 2018 Commons Chamber

[Mr Hunt]

My hon. Friend is absolutely right, and that is a big priority for us, which is why this year we will publish a final 10-year NHS workforce plan, at the same time as the NHS plan that Simon Stevens is putting together. Together they are designed precisely to avoid shortages in particular and very important specialties.

[Nic Dakin (Scunthorpe) (Lab)]

Community pharmacies feel stretched at the moment, yet they are well placed, at the heart of the community, to have a real impact by taking pressure off GPs. Will the Secretary of State give a commitment that some of this money will go to reinforce the strength of community pharmacies so that they can play their part in prevention as well as cure?

[Mr Hunt]

The hon. Gentleman is right that community pharmacies have a vital role to play. I do not think we use them enough. We need to find better ways for them to help us in the prevention agenda, and one way we are doing that is by integrating medical records so that they can be accessed by pharmacies, which will help them to give good advice to patients.

Breast Cancer Screening

Nic Dakin Excerpts

Wednesday 2nd May 2018 Commons Chamber

[Mr Hunt]

I thank my right hon. Friend for suggesting the Bishop of Norwich as a good person to help in the Paterson review, and the answer to her question is yes: if, because of a failing by the NHS, harm has happened, people will be eligible for compensation, and we will do all the necessary work to establish whether that is the case.

[Nic Dakin (Scunthorpe) (Lab)]

Breast cancer screening makes a real difference to outcomes for breast cancer patients by diagnosing early, so I applaud the Secretary of State for saying he will look at ways of improving performance in this area across the country, but what is he going to do to try to make women who have moved out of the UK who might be affected aware of what has happened?

[Mr Hunt]

We will look at whether we are able to get in contact with people and will get in contact whenever we can, but there is of course a helpline through which anyone can contact us. It is also important to say that, according to the advice I have received, missing the final screening will in many cases not make a difference to a patient’s cancer or the treatment they receive, but we will do everything we can to support everyone who thinks they might have been affected.

Cancer Targets

Nic Dakin Excerpts

Tuesday 1st May 2018 Westminster Hall

[Nic Dakin (Scunthorpe) (Lab)]

It is a real pleasure to serve under your chairmanship, Mr Streeter. I congratulate the hon. Member for Basildon and Billericay (Mr Baron) on securing this debate. It is a good opportunity for us in this House to recognise the excellent work and service that he has given in leading the all-party group over nine years. I am pleased that he is still in post. I suspect he will continue to serve the cancer community for ever, so we are grateful for that. I pay tribute to the courageous personal testament of my hon. Friend the Member for Lincoln (Karen Lee) and her role as a breast cancer champion, particularly in highlighting the need to do better on secondary breast cancer, which everybody wants us to deal with much better.

For all but one month since April 2014, the 62-day target for patients to have received their first treatment since initial referral has been missed, and 81 trusts failed to meet the 85% target last year. When we do not meet targets, we let patients down in one way or another. As has been said, the target is not perfect. It does, however, set our sights on what we are trying to achieve: securing treatments, reducing waiting lists and improving outcomes. The target is important because it helps to measure the patient pathway. It gives us a better understanding of what patients are going through and offers the opportunity to prevent unnecessarily long waits.

Waiting can be a very anxious time. While treatment is on hold, life carries on. Bills still need to be paid, the kids still need picking up from school and jobs still need to be done. Life does not stop, and cancer does not stop, so it is important that we have the 62-day target. It performs a function, but it is not everything. As the hon. Member for Basildon and Billericay has said, we need to move to outcome measures such as the one-year survival rate, or indeed the five-year survival rate. He spoke most eloquently about how that has the potential to change behaviours in a positive way. However, unless we have targets, we do not know how they impact on behaviours; they are always imperfect, but they are useful measures.

As the all-party group’s December report said, we need to break the link between the 62-day performance target and access to transformation funds. As the exchange between my hon. Friend the Member for Lincoln and the hon. Member for Basildon and Billericay demonstrates, unfortunately that can have iniquitous consequences and the areas that most need support get least support. Of course, the support needs to go where it can be most effective. I think we all have confidence in the Minister. Like many other people who work to help tackle cancer up and down the land and for whom we can have only the greatest admiration, he is fighting every day to try to make things better for cancer patients, cancer survivors and their families.

As the hon. Member for Basildon and Billericay has said, early diagnosis is the key. It is the magic wand, the holy grail, the silver button, but if it was easy to achieve it would have been achieved by now. Rarer cancers make up more than 50% of cancer cases, so we need to provide transformation funding for cancer alliances so that it can help drive early diagnosis and achieve NHS targets. It is crucial that the less survivable cancers benefit from allocation of transformation funding. The funding must continue to be used to tackle hard-to-treat cancers such as pancreatic cancer. I speak as chair of the all-party group on pancreatic cancer. It has the lowest survival rates of the 20 most common cancers. Its one-year survival rate is sadly still 24%, far behind the 75% one-year survival target set in the cancer strategy. So there is still a long way to go and we know that it is a massive challenge. Things are moving in the right direction, and we are right to be impatient, but we need to use our impatience to help us to work with the Government to bring about the positive changes we all want.

As an example of what is being done to tackle pancreatic cancer, and the need to get the transformation funding in the right place, Mr Keith Roberts and his team in Birmingham have created a faster pathway to surgery for pancreatic cancer patients by redesigning services. With the fast-track pathway, a patient receives surgery for a tumour quickly, avoiding the need for a separate procedure for jaundice. A patient not on the fast-track pathway would have a procedure for jaundice followed by a separate surgery, which could take two months on average. Going straight to resection cuts out the delay. At present, surgery is the only treatment that can save lives, yet fewer than one in 10 people with pancreatic cancer have access to it. The pathway is achieved in part through the use of a dedicated clinical nurse specialist, who is appointed to support and prepare patients to receive surgery within 16 days of referral. The results of the fast-track surgery pathway have been quite compelling. It has increased the number of patients whose surgery was successful by 22%, and patients received surgery within 16 days as opposed to two months from referral. It has saved the NHS an average of £3,200 per patient, and we would expect those savings to have reached £100,000 within a year.

The initial fast-track findings were so successful that the NICE guidelines on pancreatic cancer, which were published in February, now recommend the fast-track pathway, unless the person is taking part in a clinical trial requiring other treatment. However, despite all those benefits, the savings to the NHS and the fact that the pathway is recommended by NICE, Mr. Roberts’ team is still struggling to secure funding for a full-time clinical nurse specialist, which means it has one fewer than a year ago. That does not make logical sense, but sometimes in the real world things that make no logical sense happen because of the other pressures on people. The fast-track pathway and its patients are being challenged. That situation is a good example of the need to get transformation funding to the right places, and is probably one of many around the country. It is not because people do not want them that the things in question do not happen; it is because the system does not work as everyone wants it to. One of our jobs is to use our voice here to help to unlock the barriers, so that the things we want can happen, and so that patients are seen faster and have the transformational treatments that are needed.

The all-party parliamentary group on cancer has called on the NHS to ensure that the cancer alliances are given the necessary transformation funding and support, and it is crucial that the NHS delivers that. Cancer alliances everywhere need to be able to use their funding to implement the NICE guidelines, including those on pancreatic cancer. Fast-track surgery is recommended for certain patients with jaundice. Yet it will not be available to most patients because the pathway is not in their area. We need to make sure that it is accessible. Cancer alliances must prioritise innovations for less survivable cancers and ensure that opportunities are provided, because, as the hon. Member for Basildon and Billericay reminded us, 50% of cancers are rarer ones that are more difficult to address.

I have one or two other points to make. The cancer dashboard has been helpful in driving improvements in cancer treatment. It might be worth looking at whether blood cancer could be included, as I think it would be of assistance. I very much support what the hon. Member for Basildon and Billericay, the chair of the all-party group, said about the HPV vaccine. It seems like an opportunity for prevention, which is always better than cure, particularly if it is reasonably cost-effective, as I believe that vaccine is. There are opportunities to raise awareness, such as the Be Clear on Cancer campaign on difficult abdominal pains, which was piloted in the west midlands. Such things help to increase patient and GP awareness, and the chance that people will go to their GP at the right time and get an assessment. That can drive them into early diagnosis, so that things can be moved forward. Such things, which I know the Minister is keen on, are opportunities that can help, and are to be applauded and encouraged.

It is estimated that by 2020 2.4 million people in England will have had a cancer diagnosis at some point in their lives. We cannot let them down. Our job is to do the best by them. We need to do the best with the 62-day target, but also to continue the debate on whether process targets take us where we need to be or whether we should look more carefully at outcome targets. We must use whatever means we can to improve early diagnosis, and do all we can to support patients from the day they receive the news no one wants to hear to the day they receive the all clear. If we achieve those things, not only will we improve the NHS but we will save hundreds of lives every day of the year.

Cancer Strategy

Nic Dakin Excerpts

Thursday 22nd February 2018 Commons Chamber

[Nic Dakin (Scunthorpe) (Lab)]

It is a pleasure to follow the hon. Member for North Warwickshire (Craig Tracey), who reminds us of the importance of using the expertise and knowledge we have in the system to accelerate improvements in outcomes.

I thank the hon. Member for Basildon and Billericay (Mr Baron), who I know is disappointed not to be here, for securing the debate and for his time and dedication in chairing the all-party parliamentary group on cancer so well and so impressively over the past nine years.

This debate focuses on the cancer strategy and the current challenges it faces. It is important to reflect on the positives, too. In the space of my lifetime, the progress on understanding, diagnosing and treating cancer has been remarkable. In the 1950s, there was limited knowledge of cancer and of the associated risk factors, the NHS had only recently emerged and there was no co-ordinated plan to treat cancer. We have come a very long way since those early days.

Cancer survival rates have doubled in the UK since the 1970s, which is a real credit to the countless health professionals, researchers, volunteers, charities and, of course, patients who have pioneered progress and who continue to do so every day. It is because of them that we are where we are today, where a person in the UK is more likely to survive cancer than to die from it.

However, massive challenges remain. My constituent Maggie Watts came to see me after losing her husband, Kevin, to pancreatic cancer in 2009. It is her fault that I have ended up as chair of the all-party parliamentary group on pancreatic cancer—thank you, Maggie. Kevin’s mother died of pancreatic cancer 40 years earlier, and the shocking thing is that Kevin’s chances of survival were no better than his mother’s. In most parts of life, the world has moved on rapidly in 40 years, but it has not done so in that part. In fact, at less than 7% in the UK, pancreatic cancer has the worst five-year survival rate of the 20 most common cancers, with the UK ranked 26th out of the 27 EU countries, according to the Association of the British Pharmaceutical Industry. Sadly, pancreatic cancer is on course to become the fourth biggest cancer killer by 2026, so action is needed now.

[George Freeman]

Does the hon. Gentleman agree that, if we are to tackle such cancer outliers, it is vital that, as well as the great research we do in the UK, we make sure that the NHS is better at adopting and taking up innovative medicines? A large part of the accelerated access review, the genomics programme and the informatics programme is about making sure that the NHS is capable not just of doing the research but of enlightened procurement to take up more quickly the drugs that work.

[Nic Dakin]

Absolutely, and I will come on to that later.

As the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron), who introduced the debate so well, pointed out, we are now almost halfway into the five-year implementation plan of the Government’s cancer strategy for England. At this mid-point, there are concerns about the rate of progress being made, and the workforce plan is not yet as effective as we would wish.

For example, as the Royal College of Pathologists has said, it can take up to 15 years to train a pathologist. Pathology services are unable to recruit to vacant posts today, and it is anticipated that a third of consultant histopathologists will retire in the next five years, which is just one example of the challenges we face.

The lack of workforce capacity must be addressed to change survival outcomes for pancreatic cancer patients. It would be good if the Minister were able to update us on what his Department is doing to prioritise workforce planning and to provide the funding needed, based on England’s cancer workforce plan.

Fast access to quick and accurate diagnostic tests is also crucial. Many pancreatic cancer patients are diagnosed too late, when surgery—the only curative option—is no longer available. The early diagnosis inquiry by the all-party parliamentary group on pancreatic cancer, “Time to Change the Story,” heard anecdotal evidence from a healthcare professional that a CT scan can be done quite quickly but that the report can sometimes take 10 weeks. It would be helpful if the Department were able to respond to the recommendations of the all-party group’s report and to update us on the progress being made in that area.

The diagnosis of not only pancreatic cancer but other cancers, such as blood cancer, can be complex because symptoms such as back pain or tiredness are often misunderstood or misdiagnosed. Delays in blood cancer diagnosis can have a major impact on a patient’s quality of life and overall outcome, and earlier diagnosis would make a difference for many, but not all, blood cancers. To change this, recommendations for early diagnosis in the cancer strategy should be reviewed to ensure that all people with blood cancer are benefiting from early, accurate diagnosis. GPs could be encouraged to ask for a simple blood test for people displaying one or more blood cancer symptoms.

Diagnostic techniques also have the potential to guide what treatment options are likely to be effective. Last month, NICE provisionally rejected the use of five tumour profiling tests to guide treatment decisions on whether patients with a particular type of early breast cancer should also receive chemotherapy following surgery, reversing its previous guidance recommending Oncotype DX as an option. This goes to the heart of the point made by the hon. Member for Mid Norfolk (George Freeman) about using genomics effectively and precisely. Breast Cancer Now is concerned that this could be a backwards step for some breast cancer patients, especially in the context of the current cancer strategy’s welcome ambition to enable more personalised treatment.

[George Freeman]

Does the hon. Gentleman agree that on this subject of accelerated, earlier diagnosis and treatment, the work of the Institute of Translational Medicine in Birmingham, led by Professor Charlie Craddock, and the Cure Leukaemia team, working on blood cancers, has written the playbook on how we do early diagnosis? They have pulled in £200 million of free drugs for NHS patients by doing accelerated access.

[Nic Dakin]

There is some wonderful work going on, and this goes back to what the hon. Member for North Warwickshire said about the need to grab this wonderful work and move it forward, and not be held back by frameworks that are not quick enough to move with the times.

The ability to personalise treatment based on tumour profiling, which would allow many women to avoid the gruelling side effects of chemotherapy, is an essential part of improving patient care and has the potential to reduce costs associated with chemotherapy—that is a win-win. It can also give both clinicians and patients invaluable reassurance that they may safely not have chemotherapy, thus reducing overtreatment. NICE has not communicated clearly enough the reasons behind provisionally rejecting the future use of the Oncotype DX tumour profiling test, as it is unclear whether this is a result of additional clinical evidence, the cost or a combination of both. Will the Minister ask NICE to clarify the clinical and economic drivers behind the recent provisional rejection of tumour profiling tests to guide treatment decisions in a specific group of breast cancer patients?

The cancer strategy calls on Public Health England to continue to invest in “Be Clear on Cancer” campaigns to raise awareness of possible symptoms of cancer. Symptom awareness is a big challenge in terms of pancreatic cancer, as well as other cancers. A ComRes poll carried out by Pancreatic Cancer UK in 2017 found that 35% of adults in the UK would not be worried if they had a few of the potential symptoms of pancreatic cancer. Last year, Public Health England launched an exciting regional pilot on vague abdominal symptoms, including persistent diarrhoea, bloating and discomfort. Although the results for the campaign were positive, it has not yet been rolled out nationally. I would be keen to know when the Minister plans a national roll-out of the vague abdominal symptoms “Be Clear on Cancer” campaign.

In conclusion, much has been done and much is happening, but there is much more to do. Cancer alliances have a significant role to play in delivering effective change, and many are clearly making a difference. Workforce planning, early diagnosis and greater symptom awareness are key areas where we need to up our game as we move into the second half of this five-year cancer strategy.

Patient Transport Services: Northern Lincolnshire

Nic Dakin Excerpts

Tuesday 16th January 2018 Commons Chamber

[Andrew Percy]

I am sorry to learn that the experiences extend also to County Durham, because going to hospital is stressful enough in and of itself, particularly if one is very elderly or very vulnerable, as many people who use these services are, but especially so if one is not sure whether one will get home at the end of one’s treatment or after an appointment.

This is not, of course, a reflection on the frontline staff of Thames Ambulance Service, who are doing their very best in very difficult circumstances. I will come on to what some of the whistleblowers who have contacted us from that service have told us.

[Nic Dakin (Scunthorpe) (Lab)]

rose—

[Andrew Percy]

Of course I will give way to my neighbour in Scunthorpe.

[Nic Dakin]

I congratulate the hon. Gentleman on securing this debate. I have regularly had messages commenting about patient transport arriving late to pick people up, sometimes too late to get to appointments in time; patient transport sending unsuitable vehicles, so that disabled patients cannot access the transport; transport arriving late to a pick-up from hospital. That is a consistent theme. I have met with Thames. They held their hands up and said they had got problems. They said they were going to sort them out, but sadly, a month later, the problem is not getting any better.

[Andrew Percy]

I thank my hon. Friend and neighbour for that intervention. This is the problem. In many ways, it is nice that Thames Ambulance Service have met him. The correspondence that I have repeatedly sent them, chased by their official complaints procedure, by their chief executive, has not been responded to. So constituents who have not had a response have come to me, and I have then gone to Thames Ambulance Service, which has not responded to me. The service has not got any better. I will cite a few of the examples that my constituents have given, which are similar to my hon. Friend’s experience.

These experiences are being wrought on very vulnerable people. I want to go through a number of examples from my constituency. I will not name patients.

--- Later in debate ---

[Andrew Percy]

It has a whole knock-on effect, whether it be individuals having to find their own transport, missed appointments or rescheduled appointments—it is all incredibly expensive—and it is not just patients who have these terrible experiences, of course; it is also the drivers. I have had whistleblowers from the service contact my office. One said they come on duty at 12 o’clock and are expected at the same time to be at Castle Hill Hospital in Hull with patients. They have described themselves as being at their wits’ end and thoroughly stressed. One contacted me recently about a 100-year-old lady who had to wait three and a half hours to get home.

[Nic Dakin]

It is interesting to reflect that back before Thames took over the contract we did not have these problems. When we, as northern Lincolnshire MPs, met the hospital trust, it confirmed that these problems were related to how Thames was operating the contract and that it was adding to their problems trying to deliver high-quality care.

[Andrew Percy]

That is absolutely right. There is an argument for saying that those who provide the emergency services—East Midlands Ambulance Service in the case of Scunthorpe—are better able to provide the patient transport services, just as in Goole we would want Yorkshire Ambulance Service to provide the patient transport. There seems to be some sense in that, unless it is a very strong local community transport organisation that we know we can trust. Yes, there are always examples of failure, but we did not have this recurrent theme of failure under the previous system.

--- Later in debate ---

[The Minister of State, Department of Health and Social Care (Caroline Dinenage)]

I congratulate my hon. Friend the Member for Brigg and Goole (Andrew Percy) on securing the debate. As he has so elegantly articulated, the provision of patient transport services is important to many people throughout the country.

Let me take this opportunity to give heartfelt thanks to all the staff in the health and care system. They work tirelessly in often difficult circumstances, routinely going above and beyond the call of duty to keep patients safe. Those dedicated people make our NHS truly great. No one knows that better than my hon. Friend, who spends weekends volunteering as a first responder with the Yorkshire Ambulance Service. He deserves massive thanks for everything that he does in that role, as do all first responders up and down the country.

We recognise that effective patient transport services are vitally important, not only to ensure the provision of high-quality, safe services for patients, but to ensure that patient flow through hospitals is not slowed by missed medical appointments or delayed patient discharges. We are clear that local NHS CCGs must ensure that reliable, safe and comfortable patient transport services are delivered and maintained.

Patient transport services, like almost all other health services, are locally commissioned and provided to ensure that they are well adapted to local conditions. It is for local CCGs to set appropriate expectations of service with their providers and to take swift action where they fall short. However, that is not to say that the Government have no expectations of how these services should be delivered and should function. There is well-established national guidance on who is eligible to use patient transport services which makes it very clear that patients should reach appointments in reasonable time and comfort without detriment to their medical condition. NHS England has also communicated with the CCGs about their responsibilities when commissioning patient transport services via its CCG bulletin.

[Nic Dakin]

I congratulate the Minister on taking up her new post, which I am sure she will do very well. She said that CCGs should take swift action when things are not working. What does swift action look like? This has been going on for some time now; how quickly should the people of northern Lincolnshire expect to have the patient transport service they deserve?

[Caroline Dinenage]

Of course, we have devolved this matter locally and it is up to the local CCG to take action. I know that a recovery plan is in place and the delivery of the plan is now being monitored weekly, but the hon. Gentleman is right, and, like my hon. Friend the Member for Brigg and Goole, he has kept on articulating this issue and asking these questions on behalf of his constituents, to try to find out when they will see a visible difference to the service, because it is currently not good enough.

Patient transport providers are also required to be registered and inspected by the Care Quality Commission, the independent regulator of health services. This Government have given the CQC more powers, and it is now able to rate independent healthcare transport providers in the same way as NHS ambulance services. We fully support the CQC in its work to ensure that users of patient transport services are protected, and where services are not good enough and the necessary improvements have not been made, it can take further action, including issuing fines, service restrictions, and ultimately the cancellation of a provider’s registration.

Additionally, we are very supportive of the Department for Transport-led total transport initiative, which I think was what my hon. Friend the Member for Brigg and Goole was referring to, and which is currently piloting the joint commissioning of public sector-funded transport in order to reduce the risk of services overlapping, improve efficiency, and provide a better overall service to passengers.

From the local work carried out so far, it has become clear there are a range of potential benefits for the NHS, including helping to avoid bed blocking—where patients sometimes cannot go home because non-emergency patient transport is not available—and improving access to NHS services by reducing missed appointments due to late or unavailable transport. We have asked NHS England to ensure that CCGs are all engaging in this important work.

Oral Answers to Questions

Nic Dakin Excerpts

Tuesday 4th July 2017 Commons Chamber

[Jackie Doyle-Price]

I thank the right hon. Gentleman for his question. I would be grateful to receive more details so that we can make sure that such support is going where it is needed. I advise him that, certainly in the case of the too-frequent disasters that we have had recently, we have been relying on more intervention on the ground. In our work on mental health first aid we are prioritising exactly those areas.

[Nic Dakin (Scunthorpe) (Lab)]

15. What steps are being taken to ensure that NHS Improvement provides timely and effective support to health communities to deliver consistently high-quality care.

[The Minister of State, Department of Health (Mr Philip Dunne)]

NHS Improvement offers tailored support to the organisations it oversees, particularly those that have gone into special measures as a result of a Care Quality Commission review. The Department, of course, has responsibility for holding NHS Improvement to account, and it does that through me.

[Nic Dakin]

Northern Lincolnshire and Goole NHS Foundation Trust is in special measures for both financial and quality reasons, but the support given to date by NHSI has been neither timely nor effective. What are the Government going to do about that?

[Mr Dunne]

We are clearly disappointed that Northern Lincolnshire and Goole NHS Foundation Trust has gone back into special measures. It is one of a very small number of trusts that have emerged from special measures and then reverted, so this is something in which we are taking a lot of interest. NHS Improvement has appointed an improvement director and is in the process of arranging for a nearby buddy trust to provide some support. I assure the hon. Gentleman that the Department is receiving weekly updates.