Oral Answers to Questions

Norman Lamb Excerpts

Tuesday 24th February 2015 Commons Chamber

[The Minister of State, Department of Health (Norman Lamb)]

HM Treasury’s costing demonstrates the limitations of data available nationally in estimating the potential costs of providing free personal care at the end of life. That is why the Department of Health is undertaking further work with stakeholders to develop an evidence base to inform the next spending review.

[Dr Wollaston]

I thank the Minister for that reply. He will know that most people want to be able to remain at home at the end of their lives, surrounded by the people they love, and I pay tribute to all the carers, volunteers and health professionals, including Rowcroft’s hospice at home, who help to make that possible. Sadly, he will also know that often the situation can break down because of the sheer exhaustion of caring for a loved one at the end of their life. Will he commit that the Government will consider the quality of care as well as the costs when considering introducing free end-of-life social care?

[Norman Lamb]

I thank my hon. Friend for that question and join her in paying tribute to the work of so many people: volunteers, loved ones and the professionals working in the community. The whole emphasis should be on ensuring that we respect people’s choice about where they want to be and that they get the best possible care. Later this week, the independent review of choice at the end of life will be published and I hope that it will inform discussions. I am completely with her in trying to ensure that we can achieve this.

[Lisa Nandy (Wigan) (Lab)]

One of my constituents recently went through a lengthy, distressing and difficult process to get NHS continuing care for his wife. If we remove the distinction between NHS and social care, many people across this country, including my constituent, will be spared this distress and difficulty at one of the hardest times in their lives. We know that funding should be put where it is needed and we know that that will be more cost-effective in the long run and will be better for patients, so why will the Minister not act?

[Norman Lamb]

Actually, we are all agreed on this. We all want free care at the end of life, but whoever is in power after the election in May will have to ensure that we understand fully the costs. There is a lot of evidence, and the evidence is growing. We are having very good discussions with groups involved in care at the end of life and we all want to achieve a solution. Of course, the truth is that very many people are receiving free care at the end of life, but they are in hospital, where they often do not want to be. I am completely with the hon. Lady in trying to achieve this.

[Paul Burstow (Sutton and Cheam) (LD)]

Eight out of 10 people say that they would prefer to die at home when their time comes. Since the Government published their White Paper and said that they saw merit in social care being free at the end of life, a succession of reports from Macmillan, Nuffield and others have shown that there are savings to be made and benefits in terms of more dignified deaths and compassion for families. Is it not time to act on the evidence and make social care free at the end of life?

[Norman Lamb]

We very much hope that the case will stack up. As I said earlier, we are in active discussions with these groups and I held a round table with them a few months ago to discuss how we can achieve this. Everyone is agreed on the objective, but we need to understand the full costs involved before any Government can make a commitment to it.

[Mr Frank Field (Birkenhead) (Lab)]

Is there not something deceitful about the Government’s promising major changes for the next Parliament when we do not know how they will be paid for? If we want improvements to the NHS and end-of-life care in the next Parliament, Members on both sides of the House need to put before the electorate how we will pay for those important long-term changes.

[Norman Lamb]

I am tempted to say that that is a bit rich coming from an Opposition Member. I am sure that he would agree that whatever commitments are made, we need to understand their cost. That work is under way and I hope that as soon as we achieve a full understanding we can proceed.

[James Morris (Halesowen and Rowley Regis) (Con)]

8. What assessment he has made of the potential of the genomics programme to improve cancer treatment.

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[Sir Bob Russell (Colchester) (LD)]

10. What guidance he has given to clinical commissioning groups and mental health trusts on jointly funding not-for-profit voluntary and charitable organisations providing support for people with mental health issues.

[The Minister of State, Department of Health (Norman Lamb)]

The Government are clear that voluntary organisations and charities make an important contribution to the delivery of local health and social care services, including services that support people’s mental health needs. However, it is the responsibility of local commissioners to commission appropriate services based on their local population’s needs.

[Sir Bob Russell]

The Minister will be aware that although the NHS is one organisation, trusts seem to operate as silos. Will he convene a meeting of all the trusts in the Colchester area to discuss the future of the Haven project?

[Norman Lamb]

I visited the Haven last week with my hon. Friend, and I was enormously impressed by everything I heard, including the extraordinary testimonies of people with personality disorders who had benefited so much from the Haven’s service. In my view, it would be incredibly sad and very worrying if that service were to be lost. I am happy to invite the clinical commissioning group and the mental health trust to a meeting in the Department to discuss how it can be saved.

[Kevin Barron (Rother Valley) (Lab)]

I recently met the five UK Youth Parliament Members from Rotherham, who talked about the lack of facilities for mental health help in education, both further education and state education. May I say to the Minister that it is all right saying that it is up to local commissioning groups, but where is the leadership, when our young people are being left in extremely difficult situations and are seen by some professionals but, sadly, not health professionals?

[Norman Lamb]

The local Members of the Youth Parliament the right hon. Gentleman met make an incredibly important point. I refer him to the children and young people’s mental health and well-being taskforce, which will report very soon. I think that the role of schools will be crucial in its conclusions, and I encourage him to look at the report when it emerges.

[Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)]

The latest figures show a huge rise in the number of young people with a mental illness turning up at A and E. Young people not getting the help they need early on and becoming so ill that they need hospital care shows that the system is failing. Does the Minister accept that this Government’s decision to cut children’s mental health services at the same time as wasting £3 billion on a reorganisation has been a key factor in that failure?

[Norman Lamb]

This Government have absolutely not made any decision to cut children’s mental health services, and the hon. Lady knows it is misleading to suggest otherwise. These decisions are taken by local commissioners in local authorities and CCGs. Indeed, we have legislated for parity of esteem for mental health. I urge her to look at the outcome of the work of the children and young people’s mental health and well-being taskforce, which I think gives us a real opportunity to improve the way in which services operate.

[Steve McCabe (Birmingham, Selly Oak) (Lab)]

11. How many nurses per million population were working in the NHS in each of the last five years.

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[Mr Bernard Jenkin (Harwich and North Essex) (Con)]

12. What discussions he has had with (a) the Haven project in Colchester and (b) NHS bodies in north Essex on the need for continuing funding for support for people with moderate to severe personality disorder.

[The Minister of State, Department of Health (Norman Lamb)]

My right hon. and noble Friend the Under-Secretary of State with responsibility for quality responded in February 2014 to correspondence from the client chair of the Haven project about its funding. As I said a few minutes ago, decisions on NHS funding are a matter for local commissioners, but I will invite North East Essex clinical commissioning group to meet to discuss the issue in more detail.

[Mr Jenkin]

I am grateful to my right hon. Friend for taking such a close interest in the matter, and for the visit paid by the Under-Secretary of State for Health, my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter). Although I understand the huge cost pressures on the CCG, may I invite my right hon. Friend to study the Enable East report, which made a different recommendation on how the unit should be treated? It would be sad to close the leading example among 11 Department of Health pilots, when all the other 10 are being kept open as the lessons learned are so valuable.

[Norman Lamb]

I am very much aware of the work that my right hon. Friend and my hon. Friend the Member for Colchester (Sir Bob Russell) have done on this. It is interesting that all the other 10 pilots have continued. They are part of NHS trusts. This is the only one run by a voluntary sector organisation. It is an incredibly valuable service. I was struck by the extent to which people said how much they had reduced their hospital in-patient admissions as a result of the incredibly impressive preventive work that this service provides, and I want to look into it further.

[Andrew Griffiths (Burton) (Con)]

14. What support the Government are giving to people with Ehlers-Danlos syndrome.

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[Philip Davies (Shipley) (Con)]

15. What estimate he has made of the number of admissions to A & E in the last three years for patients with palliative care needs in (a) areas with a 24-hour palliative care helpline or palliative co-ordination centre and (b) areas that do not offer such services; and if he will make a statement.

[The Minister of State, Department of Health (Norman Lamb)]

We know from local examples that areas that offer 24/7 community palliative care services have been able to reduce the number of A and E attendances and inappropriate hospital admissions, including emergency admissions, for people with palliative care needs. I would encourage all areas to offer these services in line with the NICE quality standard.

[Philip Davies]

A poll conducted by Sue Ryder shows that 82% of people expect advice to be available 24/7, yet only 8% of CCG areas have a dedicated around-the-clock palliative care helpline and co-ordination centre. As I am sure we all agree, carers do wonderful work and need as much support as possible. Will my right hon. Friend’s Department work with Sue Ryder and others to ensure that there is a dedicated 24/7 palliative care service, which would certainly help to take the strain away from A and E, which is already under great pressure?

[Norman Lamb]

I pay tribute to the professionals in my hon. Friend’s area, which is one of the leading areas for providing strong support in the community, which prevents unnecessary hospital admissions. I am very happy to work with Sue Ryder and others to try to get the message across that if this can be provided throughout the country we will improve the experience of people at the end of life, but critically also save costs further down the line by stopping inappropriate hospital admissions.

[Mary Macleod (Brentford and Isleworth) (Con)]

16. What his priorities are for improving mental health care.

[Mr Speaker]

Minister Lamb.

[The Minister of State, Department of Health (Norman Lamb)]

Mr Speaker, you sounded a note of tedium in calling my name again.

[Mr Speaker]

I feel no sense of tedium but almost a state of ecstasy upon calling the right hon. Gentleman. If I gave any other impression, I most heartily apologise to him. I hope that he is now assured of his status in the affections of the Chair, if, possibly, also of the House? There might have to be a Division on that proposition. I do not know.

[Norman Lamb]

I am so grateful to be reassured, Mr Speaker.

Mental health is a priority for this Government. We have legislated for parity of esteem between mental and physical health, invested £400 million in talking therapies, significantly reduced the numbers of people who are placed in police cells during mental health crises and are introducing the first waiting times standards for mental health services from April this year.

[Mary Macleod]

I recently met a constituent at one of my advice surgeries who had been refused NHS mental health care because she was told that she was entitled to only one batch of free support. Considering how complicated and varied mental health issues can be, is there anything we can do for people who need more support after a relapse of mental ill health?

[Norman Lamb]

If that was the advice the hon. Lady’s constituent received, it is complete and utter nonsense. The idea that someone can have only one episode of care under the NHS is so ridiculous that it hardly merits a proper response. I urge her to encourage her constituent, with her support, to go back to those local services and ensure that she gets further support if she needs it, as she is entitled to it.

[Neil Parish (Tiverton and Honiton) (Con)]

17. What assessment his Department has made of the future role of community hospitals.

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[Annette Brooke (Mid Dorset and North Poole) (LD)]

T5. I have previously made Ministers aware that there are no beds for females in Dorset who need intensive psychiatric care. Our local newspaper, the Daily Echo, reports that such places will not be provided in Dorset for another three years. Meanwhile, patients are being sent as far away as Bradford. Do Ministers regard that as satisfactory? Are there enough resources coming to Dorset, or is it a local organisational issue?

[The Minister of State, Department of Health (Norman Lamb)]

No, I do not regard that as satisfactory and I am happy to talk to the local commissioners. We have ensured that there will be real-terms increases in mental health funding for 2015-16, and that should be regarded locally as a matter of urgency.

[Mr David Crausby (Bolton North East) (Lab)]

T6. Bolton’s accident and emergency department has been in crisis recently, partly because the clinical commissioning group closed the town’s walk-in centre. Will the Secretary of State support my petition calling for its reinstatement, or will he say, more predictably, “It’s not me, guv; I’m just the Secretary of State for Health”?

[Duncan Hames (Chippenham) (LD)]

What alternatives do clinical commissioning groups have to a full-scale commercial procurement when their existing contracts for community health services approach the time when they have run their course?

[Norman Lamb]

That is a matter for local commissioners. There is no requirement on them to tender competitively if their judgment is that it is right for the local community that services remain with the existing provider. We have been very clear that that is a matter for local commissioners.

[Graeme Morrice (Livingston) (Lab)]

T7. My constituent Wilma Ord was prescribed Primodos in the 1970s, an oral hormone pregnancy testing pill that she blames for her daughter’s birth defects. As the Secretary of State is aware, it was announced back in October that an inquiry would be established to look into the whole issue. What progress has been made in setting up the inquiry and what assurances can he give my constituent, and the many other women and families affected throughout the country, that the inquiry will be fully comprehensive, transparent and independent?