NHS Winter Crisis

Debate between Norman Lamb and Philip Dunne

Monday 8th January 2018 Commons Chamber

[Mr Dunne]

I am very pleased to respond to my hon. Friend on a subject that is not always at the forefront of his mind. He is absolutely right to highlight the abuse of the health service by certain people—revellers—who turn up at hospitals in an unfit state to be treated. In some places, we have introduced holding areas to ensure that they do not disrupt the work of the hospital.

[Norman Lamb (North Norfolk) (LD)]

The Minister will be aware that the tragic case of the elderly lady who lost her life while waiting four hours for an ambulance is not an isolated one: there are constant failures of care across the country every day of the week. If he recognises that this is completely intolerable, will he not respond to the 90 MPs from across this House who have demanded that the Government get a grip and work, on a cross-party basis, to come up with a long-term solution?

[Mr Dunne]

I am always interested in what the former Health Minister has to say on these subjects, because he speaks with considerable authority. On ambulances, it is obviously unacceptable for there to be delays of that nature and leading to that kind of outcome, and we absolutely need to ensure that all trusts, when these incidents occur, look very carefully at trying to prevent them from occurring again. We have now—in part, in response to the pressures that the ambulance service has been under—set up a national ambulance control centre to try to help co-ordinate ambulance responses where services are not meeting the targets in certain parts of the country or our requirements in individual hospitals.

Drug Addiction

Debate between Norman Lamb and Philip Dunne

Wednesday 22nd November 2017 Westminster Hall

[Mr Dunne]

As I said, the Government published what we regard as an ambitious new drug strategy in July. As my right hon. Friend the Home Secretary compellingly set out in her foreword, the harms caused by drug misuse are far-reaching and affect lives at every level. I welcome the support of my hon. Friend the Member for South Thanet for the strategy. My hon. Friend the Member for Henley (John Howell) also made a powerful contribution to the debate, focusing on differentiating enforcement action between the different categories of drug users. Although, of course, some of that is already in force in the sanctions available to our criminal justice system, the point that he makes in relation to identifying those who use criminality to fund their addiction is important.

Crime committed to fuel drug dependence is one of the biggest challenges that society has to contend with as a result of drug abuse. That extends into organised criminality in this country and internationally. From the perspective of the individual, the physical and mental health harms suffered by those who misuse drugs and the irreparable damage and loss to the families and individuals whose lives they destroy were eloquently expressed by the hon. Member for Glasgow East (David Linden), who speaks for the Scottish National party. The constituent’s story that he told was harrowing. I think that we all share those concerns.

The drug strategy highlights the huge financial cost to society from illicit drugs. Each year, drugs cost the UK £10.7 billion in policing, healthcare and crime, with drug-fuelled theft alone costing £6 billion a year.

[Norman Lamb]

Will the Minister give way?

[Mr Dunne]

I am afraid not, because I have limited time.

As my hon. Friend the Member for South Thanet pointed out, research shows that for every £1 spent on treatment, an estimated £2.50 is saved. It remains essential for us to offer those with a drug dependency the optimal chance of recovery. Since the 2010 strategy was published, we have made significant progress, despite the comments from the hon. Member for Washington and Sunderland West. She did acknowledge that drug use in England and Wales is lower now than it was a decade ago. In 2016-17, 8.5% of adults had used a drug in the previous year, compared with 10.1% of adults back in 2006-07. More adults are leaving treatment successfully now than in 2009-10, and the average waiting time to access treatment is now two days.

The new strategy aims to reduce illicit drug use and to increase the rate at which people recover from their dependence. Action is being taken in four areas: reducing demand to prevent drug use and its escalation; restricting the supply of illegal drugs; building recovery; and a new strand focused on global action. At the centre of the strategy is a core message: no one organisation or group can tackle drug misuse alone. As my hon. Friend pointed out, a partnership approach is required across Government and involving the treatment system, education, employment, housing, mental and physical health and the criminal justice system.

To drive forward the partnership approach, we are setting up a new board, chaired by the Home Secretary, which is due to meet for the first time next month. My right hon. Friend the Secretary of State for Health will attend, along with Ministers from across Government and wider partners, including Public Health England. The aim is to hold all parts of the system to account on specific commitments in the strategy. We are also appointing a new “recovery champion”, who will have a national leadership role with a remit to advise the Home Secretary and the board. That individual will drive collaboration across sectors and give people with drug dependency a voice to address the stigma that can prevent them from accessing the support that they need.

We will also take forward the drug strategy’s approach to prevention, because we know that we stand the best chance of preventing young people from misusing drugs by building their resilience and helping them to make good choices about their lives and their health. To achieve that, we will take forward evidence-based prevention measures, including developing the “Frank” drugs information service, to which my hon. Friend referred, so that it remains a credible and trusted source of information for young people. I note that the young people in the straw poll he did in his constituency had not heard of that service. I will ask officials to look at how we can raise awareness of that tool, but I point out gently to him that it is designed to be an information tool rather than a prevention tool in and of itself.

Other measures are promoting the online resilience-building resource, Rise Above, which helps teenagers to make positive choices for their health, and expanding the alcohol and drug education and prevention information service to give schools the tools and resources that they need to help to prevent drug misuse among teenagers.

The hon. Member for Washington and Sunderland West mentioned funding. Funding decisions on drug and alcohol treatment budgets have been devolved to local authorities, which are best placed to understand the support and treatment needs of their populations because they differ across the country, as we have heard today. We know that there are concerns about funding, and that local authorities are making difficult choices about their spending; we are not shying away from that. That is why we are extending the ring-fenced public health grant until April 2019 and retaining the specific criteria to improve drug and alcohol treatment uptake and outcomes. Although the intention remains to give local authorities more control over the money that they raise—like with business rates—we are actively considering the options for 2019 onwards. We remain committed to protecting and improving the outcomes from core services, including in respect of substance misuse, and will involve stakeholders in discussions about how we achieve that.

We know that drug misuse is both a cause and a result of wider social issues. That is why we are testing ways to improve employment support for people in recovery. We have accepted Dame Carol Black’s recommendation that we trial an “individual placement and support” approach to help people in drug and alcohol treatment to prepare for, find and maintain employment. In that context, I would like to give a quick plug to an outstanding charity in my constituency called Willowdene Farm, which provides very successful residential rehabilitation and training centres, historically for adult men with a history of substance addiction; it has just opened a residential facility for adult women as well. It is leading the way in encouraging those who have been through its programme into employment. Public Health England announced yesterday that the trial will go live in April 2018 in seven areas: Birmingham, Blackpool, Brighton and Hove, Derbyshire, Haringey, Sheffield and Staffordshire.

I shall briefly go through some of the emerging challenges. Since 2012, we have seen sharp increases in drug misuse deaths linked to an ageing group of older heroin users with multiple and complex needs. In response to drug-related deaths, Public Health England is looking at how we protect people from dying of overdoses. It has published updated guidance for mental health and substance misuse treatment services, to help them to work better with people who have co-existing mental health, alcohol and drug problems.

In addition, local authorities must ensure that treatment services respond to the changing patterns of drug use. Treatment has been demonstrated to have a significant protective effect, without which the recent rise in drug-related deaths is likely to have been higher. Drug treatment can also cut crime. Recent analysis by the Ministry of Justice and Public Health England showed that 44% of people in treatment had not offended again two years after starting treatment. In recent months, as we heard from my hon. Friend the Member for South Thanet, there have been deaths linked to fentanyl-contaminated heroin in parts of the UK. He gave us a graphic illustration of the impact in certain parts of the United States. I agree that that is extremely worrying. It underlines the importance of vigilance and strong enforcement action by the police and the National Crime Agency, as well as accessible treatment and the availability of life-saving interventions such as naloxone.

The use of synthetic cannabinoids, often called Spice, among the homeless and prison populations is a real concern for the Government. That was raised by a number of hon. Members. The Government have already taken action to classify third-generation synthetic cannabinoids, such as Spice, as class B drugs under the Misuse of Drugs Act 1971, giving the police the powers that they need to take action, making possession illegal and delivering longer sentences for dealers.

Valproate and Foetal Anticonvulsant Syndrome

Debate between Norman Lamb and Philip Dunne

Thursday 19th October 2017 Commons Chamber

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

I congratulate the right hon. Member for North Norfolk (Norman Lamb) on securing this debate through the good offices of the Backbench Business Committee. He has, as he indicated, taken a particular interest in this issue since it was brought to his attention during his time as a Minister in the Department of Health, and all tribute to him for being so persistent in that endeavour.

This is a very important issue. Members on both sides of the House have come together once again—for two weeks in a row, as the hon. Member for Central Ayrshire (Dr Whitford) pointed out—to demonstrate their concerns. Those are not party political; these issues affect all our constituents, irrespective of any party political alliance.

We have had some very constructive suggestions on both sides of the House, and we have heard a number of the personal cases that constituents have brought to the attention of Members, which has been very moving. Rather than rehearse them, I will just point to my hon. Friend the Member for Congleton (Fiona Bruce), who went into some detail, as the hon. Member for Washington and Sunderland West (Mrs Hodgson) said, about the particular circumstances of the two outstanding campaigners—I am pleased they are here to witness this debate—who have spoken so powerfully about the effects that valproate has had on their lives and those of their children. Like other hon. Members, I have very great sympathy for those families who have been affected by valproate use in pregnancy.

The Association of British Neurologists advises that valproate remains the most effective treatment for generalised epilepsy, and this is reflected in NICE guidelines. For some women with epilepsy, it may be the only effective treatment—the only thing that prevents a potentially life-threatening seizure. However, because of its risks, valproate should be used to treat women of child-bearing age only if other drugs are ineffective or not tolerated. This is not a clear case of use or no use, as was clearly pointed out by the hon. Member for Central Ayrshire, who speaks with authority on these matters.

The key challenge for clinicians is to ensure that the drug is used only by those who really need it, that they are fully informed about the risks and that their treatment is closely monitored.

[Norman Lamb]

Does the Minister share my aspiration that we should be aiming to ensure that every woman, wherever they live, has access to a specialist unit?

[Mr Dunne]

I will come on to how access—and monitoring—needs to be improved.

As my hon. Friend the Member for Eastleigh (Mims Davies) acknowledged, it is vital that no woman stops taking valproate, or any other anti-epileptic, without first discussing it with their doctor and, if necessary, with the relevant specialist. The Medicines and Healthcare Products Regulatory Agency is currently working with European regulators, and with experts and healthcare bodies, to decide what further action should be taken. Like many anti-epileptics, valproate has always been known to carry a risk if taken during pregnancy. However, as hon. Members have pointed out, important questions have been raised, here in the Chamber and elsewhere, about the extent to which women have been informed over the decades about the risks.

At the time that valproate was first marketed in 1974 for the treatment of epilepsy, animal studies had shown that there might be a risk of birth defects. Health professionals were made aware of this and were expected to weigh the benefits against the risks. Difficult prescribing decisions had to be made. Campaigners have highlighted, as did the right hon. Member for North Norfolk in his opening remarks, the minutes of a meeting of the Committee on Safety of Medicines in 1973 where the Committee concluded that it would be best not to mention the risk of birth defects in package inserts. As has been said today, this paternalistic attitude has no place in the NHS of today. Now, patients and doctors are expected to make decisions based on open communication on the risks and benefits of a treatment, which is underpinned by legislation. However, that was not always the case, and the views expressed by the CSM in 1973 were not unusual at that time, particularly in relation to life-saving medicines such as anti-epileptics.

I am pleased to say that medical practice has changed considerably since then. Comprehensive patient information leaflets have been a legal requirement since 1999, and warnings have been issued when new evidence on risks has become available. The MHRA issued bulletins in 1983 and 1993 to update prescribers on the risk of birth defects, and in 2003 warned about a possible risk of developmental delay in children exposed to valproate during pregnancy. Warnings were extended to include a risk of autism in 2010, and a reminder bulletin was issued in 2013. Information on the full magnitude and nature of the risks with valproate first became available in 2013, following a long term follow-up of children whose mothers had taken valproate and other anti-epileptics.

Given those concerns, the MHRA initiated and led a Europe-wide review which completed in November 2014. The review found that there was still a clinical need for valproate despite the significant risks to the child if taken in pregnancy, and that it should remain an option for women of childbearing potential only where other treatments had failed or were not tolerated. To mitigate the risks, the recommendation was that women should use effective contraception and treatment should be supervised by a specialist. In January 2015, the MHRA sent a letter to doctors and pharmacists about the strengthened restrictions. As well as updating statutory information, the MHRA has developed the valproate toolkit referred to by hon. Members.

Although I am not allowed, quite properly, to use props while I am at the Dispatch Box, I cannot resist pointing out to hon. Members that the warnings now on valproate packaging include the following very specific warning:

“Warning for women and girls: This medicine can seriously harm an unborn baby. Always use effective contraception during treatment. If you are thinking of becoming pregnant or you become pregnant, talk to your doctor straight away.”

In addition to that warning on the packaging, there are other elements in the toolkit. I will not trouble the House to read them out, but they include patient cards, information for patients, and information for prescribers and clinicians. The toolkit was distributed to doctors and pharmacists in February 2016. Messages sent through different channels then and subsequently have reinforced the recommendation of its use to support discussions with patients.

In view of the importance of the issue, in the autumn of 2015 the former Minister for Life Sciences brought together healthcare bodies to support the promotion of the toolkit and ensure that there was co-ordinated messaging to health professionals and patients. The MHRA further developed that group into a 39-strong stakeholder network of health system organisations, health professional bodies, charities and campaign groups, which include In-FACT, FACS-Aware, the Organisation for Anti-Convulsant Syndrome, Epilepsy Action, the Epilepsy Society, the Royal College of General Practitioners and the Royal Pharmaceutical Society.

Our communications strategy has been informed at every step by the valproate stakeholder network, including NHS England. In response to concerns about gaps in awareness that have been identified by several Members in today’s debate, in July of this year the toolkit was redistributed to GPs and specialist prescribers, and additional materials were distributed to pharmacies. More than 100,000 healthcare professionals received the toolkit this year.

What are we doing beyond that? We are tracking changes in prescribing. Data show that between 2012 and 2017, there has been a decline of approximately 26% in the number of women of childbearing age treated with valproate. The decline is sharper among 10 to 17-year-olds. Although usage is declining, there has not been the step change that we would want, and, as has been mentioned today, the results of surveys of patient awareness of the risk clearly indicate that more needs to be done.

I am aware that campaigners have called for the use of the toolkit to be made mandatory. The MHRA and NHS Improvement sent out a patient safety alert in April 2017, which directs organisations systematically to identify women and girls taking valproate and to support them to make informed choices. MHRA and NHS Improvement are monitoring the implementation of the alert and are following up directly with relevant organisations. That action has been taken consistently across the UK and through the devolved Administrations.

The MHRA is fully involved in the new Europe-wide review to look into whether further restrictions are needed. An expert working group of the Commission on Human Medicines, a committee of the MHRA, has been convened to inform the UK’s position during the EU review, which is expected to conclude early in the new year. This review is also looking carefully at whether there is any evidence of adverse effects in babies whose father took valproate. I am sure the whole House was moved by the personal testimony of the hon. Member for Bury North (James Frith) about the consequences of childhood meningitis and his six years on valproate to control epilepsy.

I hope I have made it clear that we are taking the matter seriously. I have enormous sympathy for those families who have been affected by valproate use in pregnancy. In the short time that I have available, I want to touch on a couple of the issues raised by the right hon. Member for North Norfolk. He talked about support, and we have an established system, reinforced by the Children and Families Act 2014, to establish a new framework for local authorities and CCGs to secure services for children and young people who have special educational needs or disabilities.

I will not get into the question of compensation or an inquiry here. What I will say to the right hon. Gentleman is that a meeting has been arranged for the chair of the all-party group with my Lords colleague the Under-Secretary of State for Health, and the issues that the right hon. Gentleman has raised should be brought up at that meeting. I encourage other members of the all-party group to join him in that meeting at the Department.

I will look at the feasibility of extending the yellow card system, as hon. Members have described. I think it is right that we shine the spotlight of transparency to improve patient safety. No Government have done more than we have to make that happen in other areas, and the victims of valproate deserve nothing less.

Contaminated Blood

Debate between Norman Lamb and Philip Dunne

Tuesday 11th July 2017 Commons Chamber

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

I thank you, Mr Speaker, for explaining to the House the sequence in which we are speaking today in this very important debate.

I wish to start by offering my personal apology to all those who have been affected by the tragedy of infected NHS-supplied blood or blood products. This has had a terrible impact on so many individuals and families. I know that, quite rightly, there have been many debates on the subject in this Chamber, which have been prompted by the quite proper concern of Members on both sides of this House over many years.

There have been two previous inquiries on this issue: the privately funded Archer report, which was published in 2009, and the Scottish Government-funded Penrose inquiry report, which was published in 2015. However, I am aware that, over the years, there have been several calls for a full independent inquiry.

In addition to those reports, the Department of Health has worked to bring greater transparency to the events. Many documents relating to blood safety, covering the period from 1970 to 1995, have been published and are available on The National Archives website. Those documents provide a comprehensive picture of events and decisions, many of which were included in the documents reviewed by the Penrose inquiry. However, I recognise that, for those affected, these steps do not go far enough to provide the answers that they want or to get to the truth of what happened.

In the light of those concerns and of reports of new evidence and of allegations of potential criminality, we think that it is important to understand the extent of what is claimed and the wider issues that arise. I am pleased to be able to confirm to the House that the Government intend to call an inquiry into the events that led to so many people being infected with HIV and/or hepatitis C through NHS-supplied blood or blood products.

[Norman Lamb]

I am very pleased with the news that the Minister has just confirmed. Will he ensure that the process that is followed—I very much support a Hillsborough-style inquiry—facilitates the ability to bring criminal charges so that the full force of the law can be applied to anyone who may be guilty of criminal wrongdoing?

[Mr Dunne]

I shall come on directly to the form that the independent inquiry should take, and I hope that that will help to address the right hon. Gentleman’s question.

We have heard calls for an inquiry based on the model that was used to investigate the Hillsborough tragedy—the so-called Hillsborough-style panel—which would allow for a sensitive investigation of the issues, allowing those affected and their families close personal engagement with an independent and trusted panel. There have also been suggestions that only a formal statutory inquiry led by a senior judge under the Inquiries Act 2005 will provide the answers that those affected want. Such an inquiry would have the power to compel witnesses and written evidence—an apparent shortcoming in previous reports. The Government can see that there are merits in both approaches, and to ensure that whatever is established is in the interests of those affected we will engage with the affected groups and interested parties, including the all-party parliamentary group, before taking a final decision on the type of inquiry.

Health and Social Care Budgets

Debate between Norman Lamb and Philip Dunne

Tuesday 14th March 2017 Westminster Hall

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

I congratulate you on chairing this substantial debate so efficiently, Mr Bailey. Some 31 colleagues were present—that is a very high turnout for Westminster Hall—of whom 18 spoke, including three distinguished Select Committee Chairs and two Opposition spokesmen. Certainly I have not attended such a significant debate in Westminster Hall, and it reflects our common interest in ensuring that the NHS and social care services in this country provide as high-quality a service to the public as possible.

Virtually all speakers welcomed the developments in last week’s Budget, and I welcome that broad consensus across the Chamber. Only one discordant note was struck—reference was made to a march in the streets of London led by the shadow Chancellor, the right hon. Member for Hayes and Harlington (John McDonnell). That march obviously demonstrated a degree of concern, but it happened before the Budget, which, as I shall touch on, responded to many of the concerns that have been raised.

We all recognise that the NHS faces a significant challenge, given the increasing demand for health services as a consequence of our ageing and growing population, new drugs and treatments, and safer staffing requirements, and that in turn is increasing the pressure on social care services. We know that finances are challenging for both areas, which is why we have ensured that spending on the NHS has increased as a proportion of total Government spending each year since 2010.

We backed the “Five Year Forward View” as part of the spending review in late 2015. That ensured that real-terms NHS funding will increase by £10 billion by 2020-21 compared with the year before the spending review. Some hon. Members said that they wanted to see a plan. We have supported the NHS’s own plan—the “Five Year Forward View”—and announced that we will publish a Green Paper this summer looking at how social care is funded in the long term, which hon. Members have welcomed, so it is churlish to deny that this Government are providing long-term strategic thinking about the way we fund both those services. I remind colleagues that the NHS budget was £98 billion in 2014-15 and will be £119.9 billion in 2020-21. That is a £21.8 billion increase in cash terms, which seems to get lost from time to time in these discussions.

We are almost at the end of the financial year. The NHS received a cash increase of more than £5 billion in 2016-17. That was front-loaded, as NHS chief executive Simon Stevens requested. For the year that starts on 1 April, there will be another significant increase in funding once the mandate is settled. The hon. Member for Bristol South (Karin Smyth), who is a member of the Public Accounts Committee, asked when we will see that document. It has to be published by the end of this month, and I assure her that it will be.

The measures announced last week, which many hon. Members referred to, have three features. I will not go into them in detail, because they have all been covered. Much of the focus has been on the additional £2 billion that we will provide for social care over the next three years, half of which will start to come in next month, when the new financial year begins.

Some hon. Members are aware of the numbers for their areas and some are not, and one colleague came up with a slightly incorrect figure. I will not go through every area, but I applaud the presence of Devon MPs in particular, given the manner in which they have massed themselves with colleagues from across the House. Devon will get a £30.3 million increase in its social care budget over the next three years and will receive half of that in the year that is about to start. My hon. Friend the Member for Thirsk and Malton (Kevin Hollinrake) referred to an £18 million increase for North Yorkshire. I can give him a bit of good news: it will actually be £19.6 million over the next three years. I am grateful to the Chair of the Public Accounts Committee, the hon. Member for Hackney South and Shoreditch (Meg Hillier), for her support for the Budget measures. Hackney will receive £12.8 million, as she acknowledged. Like many colleagues, she sought a long-term funding settlement.

[Norman Lamb]

rose—

[Mr Dunne]

I am afraid I cannot take interventions, as we have very little time.

The spending review provided a settlement for the NHS. The Chancellor indicated that there will be a social care Green Paper this summer. Several colleagues called for a cross-party consensus. The Green Paper will provide an opportunity for debate and consultation, and such discussions should focus on that.

The second Budget measure was a £100 million increase in funding for A&E services, so that people who present at A&E who do not need intense or urgent care can be diverted to GPs or clinics run by nurse practitioners. That best practice has been proven to work in A&Es that have such a streaming service, so we are looking to provide facilities for basic capital spend to ensure that every A&E hospital across the country has streaming in place by next winter. I am pleased that that has been welcomed by hon. Members from across the House.

The third measure—this was touched on in the debate, albeit not in such detail—is the £325 million capital investment in the first set of sustainability and transformation plans. Those who make the strongest case for investment and can deliver better, more joined-up services, which can bring real improvements to patient care, will benefit from the funding. We look to that to be an exemplar for other areas whose plans are less well developed, to encourage them to develop a better, more integrated approach to patient care for the future, including closer working with local authorities for the provision of social care. That should encourage areas to bring forward more comprehensive plans for the next wave of STPs, which will be supported. As hon. Members have said, we look forward to explaining more about that at the time of the next Budget.

Oral Answers to Questions

Debate between Norman Lamb and Philip Dunne

Tuesday 20th December 2016 Commons Chamber

[Mr Dunne]

I join my right hon. Friend in congratulating her chief executive on her commitment to the NHS. As I said in answer to a previous question about the STP for my right hon. Friend’s area, the issue is being reviewed at the moment by NHS England, and I am afraid that I am not in a position to give her any advance notice of the outcome.

[Norman Lamb (North Norfolk) (LD)]

The Secretary of State will be aware of the horrifying case of Fiona Hollings, a 19-year-old with anorexia who for the past four months has been nearly 400 miles away from home, in a bed in Glasgow. Her family have travelled 8,000 miles in that time to see her. The Government commit to ending this horrific practice by 2020, but do families really have to put up with it until then? How would he feel if it was his child?

Oral Answers to Questions

Debate between Norman Lamb and Philip Dunne

Tuesday 11th October 2016 Commons Chamber

[Mr Dunne]

The hon. Gentleman has a consistent track record in opposing PFI, even when the vast majority of the schemes were put under contract by the Government of which he was a member—so I will not take any lectures from him about how to deal with PFI. We will continue to use the new stricter terms as and when appropriate.

[Norman Lamb (North Norfolk) (LD)]

The National Audit Office concluded that the PFI contract for the Norfolk and Norwich hospital was a bad deal for the taxpayer and for the NHS, yet last year Octagon Healthcare made a record profit as the Norfolk and Norwich’s finances sank ever further into the red. Will the Minister consider making a formal approach to Octagon Healthcare to ask it to forgo part of its profit to help confront the enormous financial black hole that the trust faces?

[Mr Dunne]

We have provided access for seven of the worst affected trusts with obligations under PFI to a support fund of some £1.5 billion to help them with those obligations. I am not sure whether Norfolk is one of them; I suspect that it is not. I would be happy to talk to the right hon. Gentleman about this, but rather than raising his hopes inappropriately I have to say to him that many of the schemes are too costly to divert resource to pay them off completely.

NHS Sustainability and Transformation Plans

Debate between Norman Lamb and Philip Dunne

Wednesday 14th September 2016 Commons Chamber

[Mr Dunne]

I am delighted to accept that invitation from my neighbour and friend, not least because many of my constituents look to Hereford County hospital for their acute care, but also because it is one of the hospital trusts that are in special measures, which is my specific responsibility. I look forward to seeing my hon. Friend there, perhaps even during the coming recess.

[Norman Lamb]

I wish the Minister all the best in his new role. Does he share my concern about the evidence from around the country that in many areas mental health is peripheral to the STP process? Will he ensure that no STP plan will be accepted unless mental health is central to it?

[Mr Dunne]

I am grateful for that intervention from the right hon. Gentleman, who has taken such a personal interest in this subject. I can confirm that mental health is one of the issues that will be addressed in each of the plans that will be taken forward. I hope that reassurance helps.