(5 years, 2 months ago)
Commons ChamberI am grateful to the hon. Lady for her continued interest in this matter. She will recognise the cultural challenge of encouraging all practitioners in the NHS to embrace the change, because we quite rightly have a culture in which discretion is paramount. Practices are in place to encourage information sharing, and I highlight our support for the Zero Suicide Alliance—£2 million was provided last October—and central to its work will be spreading understanding of the consensus statement throughout the NHS.
The interim people plan that we published this month puts the workforce at the heart of the future of the NHS and will ensure that we have the staff needed to deliver high-quality care.
The Secretary of State will be aware that recruitment and retention is particularly difficult for hospitals in special measures, such as the Worcestershire Acute Hospitals NHS Trust, which he recently visited. Such hospitals have to rely heavily on agency staff, which puts pressure on their finances. What specific steps is he taking to help those hospitals with their financial and recruiting pressures?
We are working closely with that trust, and it was good to visit and see just how hard working the staff are. They are dedicated to the cause and well supported by their MPs. My hon. Friend is quite right to make that case, and we have a direct package of support for the Worcestershire Royal Hospital and the trust more broadly because it faces unique challenges, some of which are not at all of its own making. The staff at Worcester are working incredibly hard to deliver for their local citizens.
(5 years, 2 months ago)
Commons ChamberMaking sure that there are enough nurses on wards is incredibly important for delivering good patient care not just in relation to food, but more broadly. My hon. Friend raises the question of price per meal. It is interesting that the hospitals that have brought food production in-house and source not necessarily locally distributed food but locally produced food, have often found that that reduces costs rather than raises them. This is a question not of resources, but of good practice.
I welcome the announcement of the root-and-branch review and I know that patient safety continues to be a top priority for the Secretary of State, but can he reassure me and my constituents that the overall risk of listeriosis remains low?
Yes, of course. Millions of meals are served in NHS hospitals each year. While we regret any death, especially a death that could have been avoided, the overall food in hospitals absolutely is safe.
(5 years, 3 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
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I do recognise what the hon. Lady is saying. It is difficult to know how best to analyse something as tragic as a death—how to bring forward all the relevant expertise. That is why NHS England works with the University of Bristol on this programme. It is a very new programme—the report to be published shortly will only be the third one—and we are always open to ways in which it can be improved and seen to be more independent, more thorough and to make more difference.
I welcome the review and understand the Minister’s reluctance to comment on rumours and leaks, but as a point of principle does she agree that access to specialist services and care, as well as early and accurate diagnosis, is really important and should be consistently applied across the country? Will she therefore assure me that people with learning disabilities in Worcestershire will receive the same good service as people elsewhere in the country—in Birmingham or London, for example?
My hon. Friend is absolutely right that nobody with a learning disability, autism or any other condition should expect to receive worse care. Everybody should expect the same level of quality care, no matter who they are or where in the country they live. That is what we are working towards, and learning from deaths is a key element of helping to deliver that aim.
(5 years, 3 months ago)
Commons ChamberI thank my Worcestershire colleague for his intervention. I think we are all on the same page. We all want to see better services across the whole of our county of Worcestershire.
Where I am going with this debate and the point I want to make is that the long-promised plan for the Alex to become a centre of excellence for planned surgery has not materialised, despite my pressing for it constantly and despite a £29.6 million funding pot. That funding is in the process of being delivered across the trust, and it was intended to help implement the new clinical model.
That is why I believe it is time to look again at where and how services are provided, and particularly to consider the return of a range of maternity and paediatric services to the Alex. We need to explore options for the local population to use services in Birmingham, which are more accessible than those in Worcester. We also need to continue investment in our communities and build a medical school in Worcester to create our own local NHS workforce, which would help to address the shortage of staff at the root.
The context has changed because the Prime Minister recently announced the Government’s intention to provide the NHS with an additional £20.5 billion by 2023-24—the largest, longest funding settlement in the history of the NHS. We hear that the four CCGs that cover our two counties could merge into one in the future. This is why I believe it is time to be honest with people and for bosses to say that plan A is not working.
My hon. Friend is an excellent champion for her constituents on this and many other issues. On the funding point, does she agree with me that those of us in Worcestershire are arguing not for special treatment, but for fair treatment? Particularly when it comes to funding, because we all know we are relatively underfunded at CCG level and elsewhere, we just want our fair share, not special treatment. We would just like a fair share of the cash, please. We know it is coming, and we would like our share of it.
My hon. Friend echoes my point. I absolutely agree. We know the NHS is world class and we know that more funding is coming on stream; we are just arguing for it to be distributed for our constituents’ benefit.
We need to act soon. Redditch is home to 85,000 people; the population has grown from 78,000 in 2001, and almost 90,000 people are expected to live locally by 2030. In neighbouring South Worcestershire, tens of thousands of new homes are planned and the population is going to grow rapidly. Redditch is a new town, and it has always attracted young families to move there and build a better life, away from the back streets of Birmingham and from all over the country. We are proud of our local environment and of much else, but I want to be able to promote the holistic experience of living in Redditch, and to say that this is a great place for people to come to and live, work, set up a business and raise their family. For that, we need to have all the facilities that young families expect, including excellent healthcare services. This is part of our campaign to unlock Redditch. It needs to be the best place in the midlands, and we deserve nothing less.
We were told that the reason for centralising maternity services away from Redditch is that the size of the population is not large enough to sustain a full maternity service safely, but that does not make sense to me and my constituents. I accept that safety has to be paramount and I know that the Meadow birth centre in Worcester does a brilliant job, but the truth is that we have a high proportion of young families, which is increasing the demand for maternity and children’s services. What the hon. Member for Strangford (Jim Shannon) said is the same for us: it can take over an hour to reach Worcester from some areas of the town, particularly in traffic. There is no direct bus or train link from Redditch, so my constituents who need to use public transport must travel to the hospital via Birmingham or Bromsgrove.
When we look around the other areas of the west midlands conurbation, we can see that there are maternity units with populations much smaller than Redditch’s: for example, in Oswestry, which has a population of 16,000; Bridgnorth, with 12,000; Burton-on-Trent, with 75,000; Hereford, with 63,000; and even Ludlow, with 11,000. I am calling on the CCG and the trust to publish those comparator statistics and justify why those towns should have their own maternity unit, but Redditch should not. Most people would understand that a higher risk birth would require more specialist services and that might not be possible in Redditch, but the vast majority of births can be catered for safely in a midwife-led maternity unit.
The centralisation has piled pressure on to Worcester. It cannot withstand that pressure and we have all voiced concerns in this Chamber. I talked about the ambulance handover delays at the Worcestershire Royal just before Christmas—they are amongst the worst in the country, with ambulances waiting for over an hour. I am very grateful that the Secretary of State visited Worcestershire Acute. He saw for himself—
(5 years, 3 months ago)
Commons ChamberThe Chair of the Select Committee is right: the vacancies are not evenly spread and are of particular concern in learning difficulties and a number of other areas. Of course we want to ensure that mature students come back to and stay within the health service. That is why a number of incentives are being put in place to encourage, recruit and retain mature students. I would, of course, be happy to meet her to discuss this matter in more depth.
I appreciate the Minister’s comments about the need for retention and morale-boosting in the NHS. Does he agree that constantly going around fabricating threats of closures when no such threats exist, or talking down the NHS—as some politicians do—does not exactly help recruitment and retention either?
My hon. Friend is completely right. One would have hoped that all Members on both sides of the House celebrate the fact that the number of nurses and the number of doctors in the NHS are now higher than they have ever been in its 70-year history, and that the Government are backing that up with a commitment to invest £33.9 billion.
(5 years, 6 months ago)
Commons ChamberIf we are asking the NHS to be speedy and agile, I am sure we in the House can be.
I am glad to stand here today to talk about the great British institution that is the NHS and about how we can improve and protect it under this plan. Of course, we need to constantly transform and improve the NHS as our population grows and ages, and as treatment costs soar as we discover new but ever more expensive ways to treat previously untreatable diseases.
In Worcestershire, our acute hospitals are under immense pressure, with 10,500 A&E visits in January alone and an overnight bed occupancy rate of 93.7%. That fits into a wider national trend, with a 28% increase in hospital admissions over the past decade and an NHS in England that deals with 1.4 million patients every 24 hours.
That is where the 10-year plan really comes in, with a £20.5 million cash increase, funding for primary and community care increasing by £4.5 billion a year by 2023-24 and an ambitious target to make sure that, in 10 years’ time, 55,000 more people will survive cancer each year. My ask of the Minister is that, as we increase this funding, Worcestershire also gets its fair share.
Of course, it is not all about hospitals and it is not all about funding, so I welcome the renewed focus on prevention, which we all need to take some personal responsibility for, as do the food and drink manufacturers and the advertisers. I also welcome the renewed focus on mental health and the parity of mental health. The £2.3 billion in extra funding will give 350,000 more children and 370,000 more adults the support they so desperately need.
In contrast to the hon. Member for Central Ayrshire (Dr Whitford), I welcome all the changes we will have as a result of digital and technology investment, which is meant not to replace humans, but to enhance their productivity. That is a fantastic improvement, which we should all welcome.
I will keep my comments short. I have further comments to make, but I am sure I can write to the Minister. I am confident that, as always, he will respond. I really welcome these plans and the focus today.
(5 years, 9 months ago)
Commons ChamberMy hon. Friend is right on both points, and I am very happy to work with her on them. On the latter point, there is still much more work to do to have a system that is fully interoperable between secondary and primary care. As she says, many patients’ GPs might have picked up on the unusual patterns if they had had access to hospital notes. That now does happen in a small number of hospitals, but it is central to improving the technological capability of the NHS.
I welcome the Secretary of State’s statement and his overall approach on patient safety. We have talked a lot about the need to change the culture from one of blame to one of accountability and transparency. That is easy to say, but difficult to implement so, as well as the changes to the annual report and procedures and process changes, will there be additional training and practical support that can help embed this new culture?
Training has improved over the last couple of decades. The training programmes are independently devised for doctors by the royal colleges and are developed and implemented with the General Medical Council and the Nursing and Midwifery Council. There is still much to do to drive through the modern culture of inclusivity and bringing in ideas from all places and to remove some of the unnecessary hierarchies in the world of medicine, both within the NHS and without. I look forward to working with my hon. Friend on that.
Finally, may I end by saying that there is still work to do, not least on the judicial element, and all of us should thank Bishop James Jones for how he has handled this process and made sure that people feel that justice can be done and that the learnings can be taken?
Bill Presented
Palestinian Statehood (Recognition) Bill
Presentation and First Reading (Standing Order No. 57)
Layla Moran, supported by Richard Burden, Sir Vince Cable, Mr Alistair Carmichael, Tim Farron, Wera Hobhouse, Ben Lake, Norman Lamb, Stephen Lloyd, Caroline Lucas, Jess Phillips and Dr Philippa Whitford, presented a Bill to make provision in connection with the recognition of the State of Palestine.
Bill read the First time; to be read a Second time on Friday 8 February 2019, and to be printed (Bill 295).
(5 years, 9 months ago)
Commons ChamberThat sort of work is absolutely brilliant. At one level, it is common sense, but it also needs to be a bigger part of the system. I congratulate my hon. Friend on bringing this to the House’s attention. Perhaps he should be the first recipient of one of the NHS’s 40th birthday cards.
Are there any other international models inspiring the Secretary of State—in relation to prevention, of course?
(6 years, 1 month ago)
Commons ChamberThere are in fact 2,300 more midwives in the NHS than there were in 2010, but the hon. Gentleman makes a very good point. We want to continue to attract the best people into midwifery, which is why we are providing an extra £500,000 to the NHS to cover the clinical placement costs for 650 additional students in 2019-20.
We published the second chapter of our world-leading childhood obesity plan on 25 June. It builds on the progress we made since the publication of chapter 1 in 2016, particularly on the reformulation of products that our children eat and drink most. We will continue to take an approach that is based on evidence and we are determined to act.
I warmly welcome the Secretary of State to his post. I am sure that he was as alarmed as I was to learn that the proportion of 11-year-old children who are obese is now greater in the UK than the US. What more can we do to educate children and their parents about the benefit of a balanced diet and healthy life start?
I pay tribute to my hon. Friend’s work at the Department for Digital, Culture, Media and Sport on this matter. It is critical that we have a cross-Government approach. The obesity plan is led by the Department of Health and Social Care, but it is a cross-Government plan. There is a whole range of actions we need to take—from education through to culture and broadcasting—to make sure we get it right.
(6 years, 1 month ago)
Commons ChamberIt is a pleasure to follow the hon. Member for Bristol South (Karin Smyth). In fact, all the speakers so far this evening command the respect of both sides of the Chamber for obvious reasons given what they have said. I, too, agree with a large amount of what has been said. It is also a pleasure to speak in this very week of the 70th anniversary of the NHS.
We are talking this evening—it is in the Order Paper—about NHS expenditure summing to greater than £120 billion. That is a staggering sum and it just shows how important the NHS is not only to the Treasury and the Government, but, perhaps most importantly, to the public. Certainly, this is the top topic of interaction for my constituents. It is very, very important to them. The NHS is right up there with the royal family and the armed forces in making the Brits proud to be British, and for understandable reasons. I therefore very much welcome the £20.5 billion increase in real terms spending on the NHS. It is not only obviously needed because the population is ageing and the cost of healthcare is growing, but also desired by the British public. Some 86% of the British public say that they feel the NHS needs more spending. They are also willing to pay for it. It is very important that we listen to the public very carefully when they say that they need more spending on the NHS and that they are willing to pay for it. We will come in a moment to how they should pay for it. The British public are not stupid. They are fully and well aware that Government expenditure all comes from taxation, either now, immediately, or in the future in terms of debt. That is important, as they recognise that we cannot magic money out of thin air. We must also be very responsible and careful as politicians that we respect the fact that, whenever we decide that we wish to increase Government expenditure, what we are effectively doing is reaching into the pockets of hard-working people in this country and saying, “We’ll take some of that out, thank you very much.” We have to be really respectful of that and explain why we are doing it and what we are doing it for. The laziest thing to do in politics is pretend that other people are going to pay for all this and to promise the world to everybody. It is a dangerous route to go down and the British public will eventually see through that approach.
If we are going to be straight with the British public, how will we achieve this increased expenditure? I am sceptical, but not as sceptical as my hon. Friend the Member for Totnes (Dr Wollaston), about the Brexit dividend. I do, however, like to talk about a deficit dividend; as we reduce the massive amounts of interest that we are paying over time, there will be a benefit to the UK population. We have to be honest about where the money could come from, and hon. Members have mentioned other ideas about how it could be generated, including by looking at council tax, tax-free allowances and the pension age.
We do need to look at the pension age very carefully again. We have already increased the pension age to 67 and 68, but as the population ages and we all live longer, it is not unreasonable to expect us all to work longer. As we work longer, we generate more taxes during our lifetime, and that is pretty important. We have to consider whether it is reasonable that we should all be living 15 or more years after we have retired without paying more tax.
Is the hon. Gentleman aware that the increase in life expectancy is actually stalling and not continuing to soar? Unfortunately, it is another inequality between richer areas and poorer areas, and the danger is that people in deprived areas will get no retirement at all.
The hon. Lady makes a perfectly valid point. The differentials in life expectancy concern me greatly, but we have come such a long way. Pensions were first introduced in 1908 for people aged 70, when the average life expectancy was 48 for men and 52 for women. Life expectancy increased slowly as the century went on, but I believe that it is now—quite staggeringly—78 for men and 82 for women. This is well beyond the average age at which we retire, so we have to look at the situation carefully.
Rather than directly tax people more, I would like to see economic growth, which was mentioned earlier. Every 1% increase in economic growth adds £7 billion to the economy, whereas every 1p increase in income tax raises just £5 billion. We have to look at having a good mix. The more that we can grow the economy the better. Owing to the growth in the economy, HMRC receipts actually increased from £414 billion in 2010-11 to £594 billion last year, so the more that we can do for economic growth, the better for us all.
Alternatively, we could shift Government expenditure from one Department to another, but that is very difficult to do in the age of austerity and perceived austerity. As a Conservative, I believe in Government spending that is as small as it can be, but as large as it needs to be. The message that I heard from my constituents at the last election is that they believe that it probably needs to be just that little bit bigger, particularly for health, social care and education.
The British public are now respecting and accepting the fact that Conservatives are very careful with their money and are respectful of taking tax and money out of their pockets. They know that we are not going to spend money willy-nilly. More than 60% of the British population—across all demographics, including party political persuasions, age groups and income groups—support a taxation increase to spend more money on the NHS, and we need to listen to that.
But we need to move the conversation away from being all about inputs. Everyone in this House needs to commit to avoiding this kind of arms war, whereby there is always a debate and a fight about who can spend most. Instead, we need to put much more focus on the outputs, such as improving diagnoses, treatments, survival rates and other matters in the NHS. That is part of the debate. I was glad that the Health Secretary focused on that while introducing the additional spending. It is an important factor to consider; productivity very much needs to be part of the deal.
We need to continue focusing on an NHS that is free at the point of need, but we need to be clear with people that it is not free. The NHS never has been free and never will be free. It comes at a cost and we all have to pay for it. We need to ensure that we keep focusing on cost, look at other areas of savings and educate the public that there is a cost when they miss an appointment, when an ambulance goes out unnecessarily and when people go to A&E but do not really need to do so. We should all play our part in ensuring that NHS money is spent as wisely and carefully as possible.
There is still a lot of work to do on social care and public health, as my hon. Friend the Member for Totnes said. We should try to put together a cross-party royal commission, as other have said, and investigate moving the NHS out of party politics as much as possible, but that is a debate for another day.