Oral Answers to Questions

Norman Lamb Excerpts

Tuesday 26th November 2013 Commons Chamber

[Duncan Hames (Chippenham) (LD)]

1. What steps he is taking to improve signposting to support and information for carers by health bodies and local authorities.

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

The Care Bill will require local authorities to ensure that information and advice is available to their local populations, including carers, and to co-operate with health bodies in fulfilling this function. The Bill will extend carers’ rights to an assessment of their needs so that carers receive appropriate support and signposting to local services.

[Duncan Hames]

I welcome those measures in the Care Bill to support carers, but for them to benefit from that support, they first need to be identified. It is estimated that only one in 20 carers of people with cancer, for example, receives a carer’s assessment. How does the Minister propose to get local authorities to work with the NHS and other health bodies to identify carers and ensure that their needs do not go unnoticed?

[Norman Lamb]

The Care Bill will introduce a right to an assessment for all carers, which I think is an incredibly important advance for them. We are also giving money—£1.5 million—to the Royal College of General Practitioners and other bodies, including nursing bodies, to raise awareness of the vital role of carers in working with GPs to improve the care of those who need it.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

I think the Minister is missing the point, though, in that carers of people with cancer do not have contact with local authorities. Macmillan Cancer Support found that half of those carers are not getting any support at all and do not know where to go for it. They do have contact, however, with GPs and hospital doctors, so what is the Minister going to do to make sure that GPs and hospital doctors identify carers and make sure that they get that support and advice?

[Norman Lamb]

First, I pay tribute to the work of Macmillan. It does brilliant work, and this is a really important campaign because it will raise awareness. I do not think I am missing the point, because raising awareness among front-line professionals is critical, and local authorities will also have a duty through the Care Bill to co-operate with the health service and, of course, to integrate or join up care, all of which is in the interests of carers.

[Alison McGovern (Wirral South) (Lab)]

Carers—and, I hope, the Minister—local authorities and GPs will be distressed by this week’s report of care companies being investigated by Her Majesty’s Revenue and Customs, almost half of which were found not to be paying the minimum wage. How does tackling that problem at the heart of our care system fit into the Minister’s plans to help support carers?

[Norman Lamb]

I completely share the hon. Lady’s concern about care companies that do not pay the minimum wage. All care companies should meet their obligations in law to pay the minimum wage. HMRC has done a lot of work, focusing on the care sector, and I have been absolutely clear that there is an obligation for those care companies to meet their requirements under the national minimum wage legislation. We cannot get good care on the back of exploiting low-paid workers.

[Alec Shelbrooke (Elmet and Rothwell) (Con)]

2. What steps he is taking to ensure that compassionate care is at the heart of the NHS.

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[Rosie Cooper (West Lancashire) (Lab)]

5. What recent assessment he has made of ambulance handover times at accident and emergency departments.

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

Patient handover is a key part of delivering good emergency care. Systems are in place to ensure efficient handover, but we recognise that it sometimes takes longer than the recommended 15 minutes, particularly during peaks of demand. We are taking the issue of handover delay seriously, which is why we have introduced financial sanctions for unacceptable delay.

[Rosie Cooper]

Southport and Ormskirk hospital in my constituency has one of the longest handover times in the north-west, with ambulances queuing outside the hospital and patients lying on stretchers for hours. How does that offer the patient-centred care and dignity that the Government keep promising but failing to deliver? What can the Minister do to make it better for my constituents?

[Norman Lamb]

That sort of experience is not acceptable and has to be addressed, and I am sure the hon. Lady will welcome the encouraging news that the sanctions in the national contracts that clinical commissioning groups enter into with hospitals have resulted in a 38% reduction in delays, comparing the first two weeks of last November with the first two weeks of this November, which is the first period during which we measure winter pressures on handovers. That sign of a significant increase is to be welcomed.

[Mr Simon Burns (Chelmsford) (Con)]

As an east of England MP, the Minister will be aware of the problems with the East of England ambulance service and handover times at Broomfield hospital. While I warmly welcome the initiative, through the contract, to bring pressure to bear to reduce handover times to 15 minutes, will he join me in paying tribute to the new management of the ambulance service for what it is doing, through its assessments and monitoring, to deal with this problem?

[Norman Lamb]

I have had a similar experience at the Norfolk and Norwich hospital. It is clear that the number of delays in the east of England has reduced substantially, and I pay tribute to everyone involved. Getting urgent care right requires collaboration between ambulance trusts, acute care and GPs and social care workers on the ground. Significant improvements have been made in the east of England, as well as across the rest of the country.

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

The Minister surely knows that deteriorating ambulance handover times are just one of a growing number of signs highlighting what is going wrong with A and E on this Government’s watch. Now we see the Secretary of State and his Ministers in full panic mode after denying for months that there was a problem. The question is: why was the Health Secretary the last person in the entire NHS to realise that there was an A and E crisis?

[Norman Lamb]

It seems as if Labour is always desperately in search of a crisis, even if there is none to be found. If the hon. Gentleman had listened to the answer that I gave to the hon. Member for West Lancashire (Rosie Cooper), he would have heard me say that there had been a 38% improvement in waiting times for ambulance handovers between last November and this November. I am sure that he will welcome that.

[George Freeman (Mid Norfolk) (Con)]

I congratulate the Minister and the Government on the work that is being done to integrate social and NHS care. Does my hon. Friend agree that, for the many elderly patients moving between hospital care and community social care, integrated patient records across the two areas will significantly improve elderly care? Will he meet me and campaigners following Health questions to discuss my ten-minute rule Bill?

[Norman Lamb]

My hon. Friend deserves credit for that one. Of course I would be happy to have a chat with him. He makes a point about integrated care records. We should be focusing on ensuring that we do much more to keep frail and elderly people out of hospital in the first place. The system that we have inherited is dysfunctional, and the shift towards integrated care is exactly what needs to be done.

[Mark Menzies (Fylde) (Con)]

6. What progress his Department has made on improving out-of-hospital care for frail elderly people.

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[Mrs Mary Glindon (North Tyneside) (Lab)]

8. What assessment he has made of the effects of social care budget changes on attendances at accident and emergency departments.

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

Joining up health and social care is an absolute priority for this Government. The NHS will provide £900 million this year and £1.1 billion next year to support social care services with a health benefit and to promote joint working. In 2015-16, we will introduce a £3.8 billion pooled budget for health and social care. The number of bed days lost because of delays attributable to social care was nearly 50,000 lower in 2012-13 than it was in 2011-12.

[Mrs Glindon]

In the first two years of this Government, there was a frightening 66% increase in the number of people aged 90 and over coming into accident and emergency in a blue-light ambulance. When will the Minister accept that cuts to elderly care have increased pressure on the NHS, and are a major cause of the A and E crisis?

[Norman Lamb]

First, it is worth us all recognising that there is an increase in the number of frail elderly people in our society living with chronic conditions and that that is putting additional pressure on accident and emergency departments. The numbers have increased by over a million a year since 2010. However, the fact that there has been a reduction of 50,000 in the number of delayed discharges demonstrates that the social care system is doing incredibly well, and we should pay tribute to social care workers across the system who are doing so well to ensure that that improvement is taking place.[Official Report, 4 December 2013, Vol. 571, c. 13MC.]

[Andrew George (St Ives) (LD)]

Bottlenecks in A and E are certainly not new, and they are not aided by the mantra that acute hospitals should be able to manage with fewer acute beds. On my hon. Friend’s point about shared and integrated planning, is he prepared to go further and push the Government in the direction of shared and integrated budgets as between health and social care?

[Norman Lamb]

I thank my hon. Friend for that question. We are creating a pooled budget in 2015-16 with this £3.8 billion fund. I can remember in opposition frequently making the case for integrated care and not really getting much of a positive response from the then Government. As the Chair of the Select Committee, my right hon. Friend the Member for Charnwood (Mr Dorrell), said, the great thing is that this Government are actually doing it.

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[Stephen Gilbert (St Austell and Newquay) (LD)]

10. What assessment he has made of the effectiveness of section 64 grants in supporting children’s hospices.

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

We are aware how vital the annual grant of more than £10 million is to children’s hospices and we have pledged to continue it while we work with hospices to develop a per patient funding system to ensure that hospice services from 2015 can be funded locally and on an equitable and transparent basis.

[Stephen Gilbert]

I am grateful to my hon. Friend for that answer. Since the introduction of the grant in 2006, children’s hospices now reach 75% more children and families and provide vital services. Can he assure me that the funding agreement will be in place by 2015?

[Norman Lamb]

Let me first pay tribute to the amazing work of so many children’s hospices around the country. I know that Little Harbour in St Austell in my hon. Friend’s constituency has benefited from the grant and, indeed, from the increase in the grant last year. It is absolutely the intention both to work with hospices to get this right and to introduce the new system in 2015.

[Mr Andrew Turner (Isle of Wight) (Con)]

Will the Minister join me in sending condolences to Gemma and Aaron Rolf and Jack, the parents and brother of six-year-old Sophie Rolf, who had an inoperable brain tumour and died, sadly, yesterday? Sophie and her family raised thousands of pounds to bring children’s facilities to the Earl Mountbatten hospice on the island. Those facilities were recently opened and will be a lasting tribute to a very special little girl.

[Norman Lamb]

Absolutely. I offer my condolences to the family of Sophie. The remarkable selfless fundraising done by such families does much to provide care for others and that will be a remarkable legacy for a fine young girl.

[Glyn Davies (Montgomeryshire) (Con)]

11. What discussions he has had with NHS hospital trusts on taking account of the interests of patients in Wales who depend on hospitals in England.

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[Helen Jones (Warrington North) (Lab)]

When the Government decided to slash council budgets and, therefore, adult social services, did they know what effect that would have on hospitals, particularly A and E, and decide to carry on anyway, in which case they are too callous to be running the NHS, or did they not know, in which case they are too stupid to be running the NHS?

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

Throughout this Parliament we have ensured that extra funding has gone into social care to recognise the fact that council budgets have been under strain. The point that I made earlier—that there has been a 50,000 reduction in delayed discharges to social care—demonstrates just how well they are doing under significant pressure.

[Andrew Stephenson (Pendle) (Con)]

T9. What progress have the Government made in driving up standards and transparency in hospitals, social care and general practice?

[Norman Lamb]

The Government’s response to the Francis report demonstrated that openness and transparency are critical. As a result of the steps that we have proposed, this will be the most open health system anywhere in the world. That is something we should be very proud of.

[Robert Flello (Stoke-on-Trent South) (Lab)]

I need to press the Minister on this. Does he really expect people to believe that cutting £1.8 billion from local authority care budgets—Stoke-on-Trent has lost a third of its overall funding—will have no impact on the A and E crisis?

[Norman Lamb]

Labour still seems to be in complete denial about the crisis in public finances that we inherited in 2010 owing to failures by the Government whom the hon. Gentleman supported in managing public finances. What we are doing is introducing a £3.8 billion fund to pool health and social care. It amounts to a substantial shift of resources to preventing ill health and it will do exactly what we need to do for social care.

[David Morris (Morecambe and Lunesdale) (Con)]

May I thank the Under-Secretary of State for Health, my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter), for recently opening a walk-in centre in Morecambe? May I also set the record straight, because the centre had been closed under the previous Government? Does he not think that it is a shocking indictment that in 2006 the NHS was cut by 9% in the region—

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

The Minister will know that following the neuromuscular services review an explicit commitment was made to fund a care adviser and paediatric consultant post for the west midlands. Is he willing to meet me, patients and representatives of the Muscular Dystrophy Campaign to discuss the service and that commitment?

[Norman Lamb]

I would be happy to do so. I understand that NHS England is scheduling a meeting with Birmingham Children’s Hospital NHS Foundation Trust, which I hope will make some progress in ensuring that there is sufficient co-ordinated care for people with muscular dystrophy in the west midlands.

[Several hon. Members]

rose—