Social Care Funding

Debate between Norman Lamb and David Mowat

Monday 12th December 2016 Commons Chamber

[David Mowat]

I agree and I commend my hon. Friend for his work on the Morleigh homes in his constituency, which had significant issues and have now been substantially closed down. He is right that the issues there were not principally about money; they were about quality and about people doing their jobs properly.

[Norman Lamb (North Norfolk) (LD)]

Does the Minister share the view of the CQC that the system is close to tipping point, and does he understand the impact that has on many frail elderly people? Does he not agree that now is the time to bury our differences and work together to come up with a long-term settlement for the health and care system?

[David Mowat]

Today is not the day on which to announce a royal commission on the funding of care in the future, but I do agree that it is important that we put care funding on to a better structural footing for the future. The right hon. Gentleman is right to say that.

Oral Answers to Questions

Debate between Norman Lamb and David Mowat

Tuesday 15th November 2016 Commons Chamber

[David Mowat]

It is vital that every STP engages with all stakeholders, and that includes North Devon. The public and, indeed, MPs should engage in the process as critical friends to try to make these plans better.

[Norman Lamb (North Norfolk) (LD)]

Despite reassurances, there are still concerns that mental health remains peripheral to STPs in many areas. Will the Minister provide some further reassurance, because unless the Government absolutely insist that mental health is central and that resources are focused on prevention in mental health, these plans will simply fail?

[David Mowat]

I give the right hon. Gentleman the categorical assurance that better mental health is a fundamental part of what the STPs are trying to achieve, as are better cancer outcomes and better integration of adult social care. If an STP does not include those things, it will have to continue to evolve until it does.

Community Pharmacies

Debate between Norman Lamb and David Mowat

Wednesday 2nd November 2016 Commons Chamber

[David Mowat]

Before I give way, I should like to quote the chief pharmacist himself. Dr Keith Ridge has confirmed that the review

“will support community pharmacy to develop new clinical pharmacy services, working practices and online support to meet the public’s expectations for a modern NHS.”

Two weeks ago, I announced two initiatives that will proceed in advance of the King’s Fund report. From 1 December, phone calls made to NHS 111 for urgent repeat prescriptions will be directed not to an out-of-hours GP service as at present but to a community pharmacy. This will amount to some 200,000 calls a year, resulting in further revenue streams, for the consultations and for supplying the medicine. NHS England has also committed to encouraging national coverage of a locally commissioned NHS minor ailments service. Some areas, including West Yorkshire, already do this, and we will roll it out to the whole country by April 2018. Both those initiatives will relieve pressure on surgeries and emergency care centres. Both will result in additional incremental revenue for pharmacies, but they are very much only the start.

[Norman Lamb (North Norfolk) (LD)]

Does the Minister accept the view expressed in the impact assessment that independent pharmacies, which are often micro-businesses, and small chains of up to 20 pharmacies will be at a higher risk of closure than the larger chains?

[David Mowat]

In terms of these proposals, we have to be blind to the ownership of pharmacies. The fact is that the average pharmacy sells for something like £750,000. I do not accept that the proposals will cause closures in those segments, if that was the thrust of the right hon. Gentleman’s question.

--- Later in debate ---

[David Mowat]

I will continue to make some progress and then give way towards the end of my remarks.

I do not want to downplay the impact of the change on the private businesses that own and operate the network. The pharmacy sector is a mixed economy with 70% of the market made up of multiples and chains and 30% owned by independents. It is hard to accurately predict the impact of the changes on those individual business models. What I can say, however, is that the savings we are making will be entirely recycled back into the NHS. Every penny of the efficiency savings that we are asking of community pharmacies will be spent on better patient care, better drugs and better GP access.

[Norman Lamb]

I am grateful to the Minister for giving way. I totally understand the importance of trying to get as much bang for your buck from pharmacy services, but does this not actually amount to a significant cut in spending on preventive services? That seems completely counter to the Government’s aim.

[David Mowat]

When one takes into account the £112 million that we are spending on getting more pharmacists into GP practices, the right hon. Gentleman’s point is incorrect.

Community Pharmacy in 2016-17 and Beyond

Debate between Norman Lamb and David Mowat

1st reading: House of Commons
Thursday 20th October 2016 Commons Chamber

[David Mowat]

The access scheme to which I referred will apply to rural and urban pharmacies. Indeed, there is more urban than rural in it, but it will protect rural pharmacies in the way my right hon. Friend mentions.

[Norman Lamb (North Norfolk) (LD)]

There is no escaping the fact that this amounts to a significant cut in prevention services, which is what always happens when the finances of the NHS are under pressure. I absolutely accept the need for reform of the financial incentives involved, to ensure that we get the best outcomes from the money being spent, but surely we should be investing more in prevention in order to ensure that the NHS is sustainable.

[David Mowat]

The quality system that I have mentioned is about potentially investing more in prevention and linking the best pharmacies—the high quality pharmacies—more closely to local authorities, public health schemes and all that goes with that. I make the point again that there is a requirement for efficiency savings, but we do not believe that they will affect access overall. We do not believe that this will affect the public’s ability to use pharmacies as they do now. This will be part of modernising and digitising the service and providing resources for other parts of the NHS that need them very much.

NHS Sustainability and Transformation Plans

Debate between Norman Lamb and David Mowat

Wednesday 14th September 2016 Commons Chamber

[Norman Lamb (North Norfolk) (LD)]

I want to start by saying that I very much agree with the point made by the hon. Member for Central Ayrshire (Dr Whitford) that this ought to present a real opportunity. It has brought people together, and discussions have started across organisations that in the past have not talked to each other nearly enough—both across the health and social care divide, and also bringing in people from outside the health service and social care system—but I fear that the opportunity will be fatally undermined for three central reasons.

First, there is the point that I made in my challenge to the Minister, on mental health: unless every STP addresses the burden of mental ill health in every community centrally as part of its plan, it will fail. There is no doubt about that. I noted the Minister’s attempt to reassure me, but the parliamentary answer I received recently did not reassure me, because it appears that it is not going to be a requirement that every plan must centrally address this problem. I understand that the more developed plans will do so, but if this is not done, it will absolutely fail. We are dealing often with some of the people who are failed most by the system, and who use A&E departments more than any other people, yet my fear is this will be a massive missed opportunity in that regard.

[The Parliamentary Under-Secretary of State for Health (David Mowat)]

I thank the right hon. Gentleman for giving way, because I want to make the point again—I will say it very clearly—that if an STP does not come forward with very clear plans as to how the mental health and dementia programmes are going to move forward quickly, it will not go ahead. That cannot be clearer.

[Norman Lamb]

I am grateful to the Minister for that, and I hope that that message goes out across the country, because Andy Bell from the Centre for Mental Health today has again raised concern about the process in many parts of the country.

The second issue that causes me very real concern is the financial backdrop and the ability to deliver on the plans given the finances that are available. We have already heard that the bulk of the money that is available is going into clearing the deficits of providers, rather than into the transformation that is so necessary in order, as the hon. Member for Spelthorne (Kwasi Kwarteng) made clear, to spend money more efficiently and effectively in delivering care for our communities.

Chris Ham, chief executive of the King’s Fund and a well-respected commentator, says that its assessment of the draft plans

“shows that, in the absence of eye-watering efficiency improvements, there will be a financial gap running into hundreds of millions of pounds by 2020/21 in most of the footprints”—

not across the country, but in most footprints. This is completely unachievable, and he questions the deliverability of plans which include the closure of cottage hospitals in many areas—the very things that can keep people out of acute hospitals, yet we are planning in many areas to close them down. This seems to me to make no sense at all.

There is a related concern about governance. Currently in the NHS we regulate organisations, not systems, so within an STP footprint every organisation still has to focus on its own financial survival, rather than looking at the best approach for the entire health and care system in that locality. I fear that that in itself will be a central flaw.

Finally, there is the question of openness and transparency. I note the point that there will be a consultation process, but let me just tell the Government that if they really think that a formal consultation process after full draft plans have been produced in a secret process will in any way convince the public that they are being properly involved, it will fail. It is inevitable that it will fail. People are so suspicious of consultation processes that they simply do not believe that they are being properly engaged in them.

The hon. Member for Spelthorne made a good point: people are often prepared to go on a journey. They are prepared to listen to potentially radical changes and potentially to use money more effectively, but the only way they will do that is if they are involved from the start—involved in shaping the proposals, rather than responding to something that has been fixed behind closed doors. The hon. Member for Bedford (Richard Fuller) knows full well how the public react when they are presented with what looks like a fait accompli. If the public are not involved in the development of plans to close cottage hospitals, to slim down acute hospitals and to merge hospitals around the country, we should be in no doubt that those plans will be rejected. The Government will be facing a political disaster if they plough on in this way. They must, for example, open up and involve the non-executive directors, who have been told that they cannot even be part of the discussions. That is ridiculous. For goodness’ sake, if we are to take people with us, we have to take them on a journey, engage with them and involve them in the plans.

Oral Answers to Questions

Debate between Norman Lamb and David Mowat

Tuesday 23rd October 2012 Commons Chamber

[Norman Lamb]

It is absolutely essential that users of services know exactly who the staff are who are caring for them, and the issue of uniform is something that I would be happy to discuss further with the hon. Gentleman.

[David Mowat (Warrington South) (Con)]

8. What plans he has to review the health allocation formula.

Oral Answers to Questions

Debate between Norman Lamb and David Mowat

Thursday 24th May 2012 Commons Chamber

[David Mowat (Warrington South) (Con)]

16. What discussions he has had with the Secretary of State for Energy and Climate Change on the potential effect on process manufacturing of the Government’s policy on energy pricing.

[The Parliamentary Under-Secretary of State for Business, Innovation and Skills (Norman Lamb)]

The Secretary of State regularly meets the Secretary of State for Energy and Climate Change to discuss energy and climate change policies, including their impact on manufacturing. We are committed to ensuring that manufacturing remains competitive, and in the autumn statement we announced a package worth £250 million to reduce the impact of policies affecting the cost of electricity for electricity-intensive industries most at risk of carbon leakage.

[David Mowat]

In January, the Department of Energy and Climate Change published figures showing that 18% of electricity costs for business go towards supporting the renewables industry. Last week, in the Financial Times, the chief executive officer of Solvay said that high energy prices are a bigger issue for his business in the UK than the eurozone crisis. What assurance can the Minister give us that as we decarbonise, we do it as cheaply as possible to ensure that we minimise value destruction and the number of jobs lost?

[Norman Lamb]

I give the hon. Gentleman that absolute reassurance. In terms of global carbon emissions, it makes no sense for a business to relocate to another country, so we will do everything we can to ensure that businesses remain competitive.

Energy and Climate Change

Debate between Norman Lamb and David Mowat

Tuesday 20th December 2011 Commons Chamber

[Norman Lamb]

Absolutely, I do. I accept that completely, and that is why the Government are determined to take decisive action.

The consequences, however, of a 3.5° C to 4° C rise would be devastating, including a 2 metre rise in sea levels, a massive impact on food production and so on, but to hit the 2° C target we need global emissions to peak by 2020 and, after that, to reduce by 4% annually. That target is achievable if decisive action is taken by both the developed and the developing worlds, and this Government are determined to take a lead internationally —one of the things that the hon. Lady raised specifically —in seeking to achieve it.

Developing countries on their own are likely to account for 60% of emissions by 2020 owing to rapid development, and the Government recognise that the European Union must show leadership, so we are pressing for a 30% 2020 emissions reduction target, rather than the current 20%.

To answer the hon. Lady’s specific question about whether we need to review the target level, I note that the Cancun conference agreed to a review of the science to see whether to adjust the target and whether the 2° C target is adequate to prevent the disastrous consequences of climate change. I acknowledge what she said about the outcome of the recent Durban conference, but it did make progress on the design of that review and on the steps, including negotiating a new global agreement, to get the global community back on track to achieve at least the 2° C goal. I pay tribute to my right hon. Friend the Secretary of State for Energy and Climate Change for playing a key role in the Durban negotiations, which have taken things forward.

All that sets the context—the imperative of building a low-carbon economy—for dealing with the contributions from the hon. Members for Warrington South (David Mowat), for Daventry (Chris Heaton-Harris) and for Montgomeryshire (Glyn Davies). Not only do we need to reduce carbon emissions because of the imperative of tackling climate change, but we face the massive challenge of energy security.

I shall deal first with the hon. Member for Warrington South, who criticised the focus on renewables and sought to concentrate on the optimisation of decarbonisation, arguing for the importance of nuclear and gas in the short term. We face the immediate and remarkable challenge that nearly one third of our energy supplies will be going off-grid in the next decade. That is because of decisions already taken. Nuclear cannot deliver in that time frame. There are disadvantages in relying heavily on imported gas because it makes us more vulnerable to risks with regard to security of supply, fluctuating and volatile cost, and availability of supply. To replace the lost capacity and to hit challenging emissions targets, we need a new supply quickly, and wind and other renewables are a crucial part of that. Over the longer term, the Government have no intention of favouring one form of low-carbon energy production over another. Our intention is to secure a level playing field for low-carbon technologies competing with one another. Tidal power, which was mentioned by the hon. Member for Montgomeryshire, should be given its chance along with other technologies.

The Government have already issued a White Paper on electricity market reform. That is an important way to deliver the change that we need to secure proper competition between low-carbon technologies. It will mean that a level playing field is introduced by 2020, and it covers nuclear, carbon capture and storage, and renewables. The carbon plan published on 1 December, which sets out how we will meet the requirements of the fourth carbon budget—between 2022 and 2027—does not favour one form of production over another but offers different scenarios and different combinations within the whole mix. We are not looking to lock in any one form of production. The Government have stressed the importance of reducing energy demand and of improved energy conservation. That is why our green deal is so important, as is the radical step of introducing smart electricity and gas meters across every home. We do, however, stress the need for immediate and decisive action.

[David Mowat]

Will the hon. Gentleman give way?

[Norman Lamb]

I will not, because I am conscious of time constraints and think that I must press on.

The hon. Members for Daventry and for Montgomeryshire discussed wind energy. First, it is important to recognise that this does cause concern for many people; we are all familiar with that in our own constituencies. Those concerns cannot just be dismissed. There are inevitably tensions between the absolute imperative of reducing carbon in our economy and the concerns of local people. It is important to recognise, though, that applications are turned down on landscape grounds. The key is to find appropriate locations in terms of landscape and wind speed.

The hon. Member for Daventry raised concerns about the efficiency and effectiveness of wind energy. Wind energy is generated for between 70% and 80% of the time. It is already providing about 2.9% of total energy generation—that was the figure for the second quarter of 2011—and it represented approximately 31% of the overall renewable electricity generated in that period. It is already delivering results. The costs of onshore wind are expected to come down by about 8% to 9% between now and 2030. That will result in support for onshore wind reducing by 10% from April 2013. The hon. Gentleman also raised concerns about the proximity of wind turbines to where people live and the importance of local decision making. The Government, through the Localism Act 2011, want to give people in their communities a greater say in the decisions that are taken.

The hon. Member for Montgomeryshire raised particular concerns about what is happening in his own community. I pay tribute to the passion and commitment that he has demonstrated on this issue over a long period. He will be aware that the location of wind farms in mid-Wales is down to TAN 8—technical advice note 8—which is the responsibility of the Welsh Assembly Government. Any changes or variations to TAN 8 are their responsibility rather than that of the UK Government. Six applications for developments of over 50 MW are currently in train in mid-Wales, and we are waiting on the response of the local authority, Powys county council, which is due by the end of March next year. The Minister of State, Department of Energy and Climate Change, the hon. Member for Wealden (Charles Hendry) has written to the authority recently—last week, I think—to extend the deadline to the end of September so that it can conduct its assessment properly and respond fully to the proposals. That extension is subject to approval by the applicants.

I should also mention the Localism Act 2011, which has removed decision making powers from the Infrastructure Planning Commission. That body has dealt with applications for developments of more than 50 MW since April 2010. It was introduced by the previous Government and it was an appointed, unaccountable quango. This Government have returned responsibility to Ministers, thereby reinstating clear accountability.

I want to reiterate the value and importance of wind in meeting climate change targets, for the reasons that I have already expressed. It has to be part of the mix. I stress its economic benefits in Wales and elsewhere. Wind energy contributes £158 million directly to the Welsh economy every year in turnover, employment and expenditure. It is responsible for more than 800 full- time jobs in Wales, and that is expected to rise to 1,000 next year. That must be considered.

Finally, I will deal with the contribution of the hon. Member for South West Bedfordshire (Andrew Selous). I am grateful to him for raising the concerns brought to his attention by Mrs Lorraine Bond. The amount that she and others have to pay over the winter just to heat their homes should concern us all. He is right that the recent Office of Fair Trading report highlighted that cylinder liquefied petroleum gas—