Mental Health Taskforce Report

Oliver Colvile Excerpts

Wednesday 13th April 2016 Westminster Hall

[Oliver Colvile (Plymouth, Sutton and Devonport) (Con)]

I congratulate my hon. Friend on securing the debate. It is a pleasure to serve under your chairmanship, Mr Wilson.

Does my hon. Friend recognise that one of the key issues in constituencies such as mine, which is a low-wage, low-skill economy, is tackling depression? That is helping us get everybody into work. If we want growth, it is important that we deal with people who suffer from depression, which is, of course, another mental health problem.

[James Morris]

My hon. Friend is absolutely right. We need to support people with depression back into work. The report makes a number of recommendations, which he may be aware of, on the use of strategies such as individual placement and support to get people with mental health problems back into work.

The report also talks a lot about data, which underpin our decisions about where we should focus our efforts on mental health. It refers to a “black hole” of data and calls for a “transparency revolution” in mental health. As I said earlier, for a long time—probably 20 years or more—we have not been collecting sufficiently robust data about what is actually going on in mental health services. We need better data on what is going on to have a firm basis on which to understand what is working, what is not working and what is going on at local and national level. Recommendation 50 in the report—this pertains to what my hon. Friend the Member for Gillingham and Rainham (Rehman Chishti) said about accountability—is at the heart of the implementation challenges that we face. It states:

“The Department of Health and NHS England should require CCGs to publish data on levels of mental health spend in their Annual Report and Accounts, by condition and per capita, including for children and Adolescent Mental Health Services, from 2017/18 onwards. They should require CCGs to report on investment in mental health to demonstrate the commitment that commissioners must continue to increase investment in mental health services each year at a level which at least matches their overall allocation”

of funding. That goes to the heart of our data challenge.

For too long, mental health services have not been properly resourced because we do not have an effective data set on what is actually happening in the NHS or, as the report highlights, an effective model in the NHS for paying for mental health services. They tend to be commissioned on what is called a block contract basis, which often has the effect of focusing on the delivery of a low-cost service, rather than on quality outcomes. We certainly do not have a model of care that focuses on an individual care pathway or a cure for an individual patient.

We need a different model of payment for mental health services in the NHS that focuses on quality and outcomes and reflects our aspiration, which is written into the NHS’s operating mandate, for parity of esteem—the integration of physical and mental health. How can we express that aspiration? To give an example, if I suffer from diabetes and a serious mental health problem, my treatment in the national health service is effectively split in two: there is a physical health pathway, which is paid for in one way, and a mental health pathway, which is paid for in another way. I believe that we need to move towards a payment-by-activity model in the NHS that does not discriminate between physical and mental health. That will certainly not happen overnight, but the report goes some way towards arguing for it in recommendation 47, which states:

“NHS England and NHS Improvement should together lead on costing, developing and introducing a revised payment system by 2017/18 to drive the whole system to improve outcomes”.

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[The Minister for Community and Social Care (Alistair Burt)]

It is a pleasure to serve under your chairmanship, Mr Wilson. I thank my hon. Friend the Member for Halesowen and Rowley Regis (James Morris) for this debate.

Among several impossible jobs I have, responding to a debate of this quality in 10 minutes simply cannot be done, so in accordance with my normal practice, if I do not answer any question, I will write to the hon. Member and, with colleagues’ permission, I will link the questions so that everyone gets the same letter, so that virtually everyone who has spoken will get a letter. I will put a copy in the Library so that other colleagues can see it.

There are many things on which there is no disagreement. To give some one-liners, My hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter) said that we now deal with mental and physical illness in an holistic way; that is absolutely right and ensures that money goes to the right place. I will cover that later, but no one disagrees.

On psychiatric liaison, we are on to that. The importance of housing and so on is now understood as part of dealing with mental illness.

My hon. Friend the Member for Halesowen and Rowley Regis spoke about valuing the public sector; yes, that is not said often enough and it is vital to do. The right hon. Member for North Norfolk (Norman Lamb) spoke of the economic case for dealing with mental illness. No one now disagrees with that. The priority that the hon. Member for Coventry North East (Colleen Fletcher) mentioned is absolutely right, and when it comes to waiting times, we are on to those. We are funding waiting times differently from when the right hon. Gentleman set them up, but they are being funded and I am happy to write to him separately on that. His worry is not shared in the Department and I can clear that up.

We are accepting the taskforce’s recommendation that we act on out-of-area placements by 2021. I would like to do it sooner if possible. I am determined to do it, but it takes time and the attitude to tier 4 will need to change. My recent experience in Hull showed me how inept current NHS processes are in deciding where new tier 4 beds should be. The situation is unacceptable and they have got themselves into a complete mess. That must change and be done properly, and I am determined it will be.

My hon. Friend the Member for Bexhill and Battle (Huw Merriman) rightly spoke about the importance of early intervention, as did the hon. Member for York Central (Rachael Maskell). I pay tribute to the knowledge and work of the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) in this area. Perinatal care is very much on everyone’s agenda.

My hon. Friend the Member for St Albans (Mrs Main) talked about the importance of work. There is now a joint unit between the Department of Health and the Department for Work and Pensions to do more of that. A White Paper or Green Paper is expected later this year and will show its importance.

On the importance of young people, the hon. Member for East Kilbride, Strathaven and Lesmahagow mentioned our work with the Department for Education on new technology, apps and earlier intervention. She is absolutely right.

I do not want to dwell on any of those matters, although I could spend 10 minutes on each, but we have all grasped how important they are. I would like to respond to the key issues raised by my hon. Friend the Member for Halesowen and Rowley Regis and the hon. Member for Liverpool, Wavertree (Luciana Berger). I can cover transparency and implementation right up front.

I thank Paul Farmer, Jacqui Dyer and colleagues for their very important report. I am determined that it will not gather dust and as a way forward I have suggested—and we will do it—that an implementation plan is published by the end of the summer. I am not sure whether that will be in August, but it will be by the end of the summer. It will detail how we intend to implement the recommendation. There will not be one response; there will be a series of responses, and there will be a website where people can see what is being done and monitor what is planned. It will be transparent. There will be monitoring by all those who have been engaged but there will be constant reference back to the taskforce’s work, so that people can see that what is being done is related to that. The Department is putting in place a robust process with people to monitor it. That is how we will do it.

I want to cover the cross-Government issues not by interministerial committee, but by way of bilaterals with colleagues to drive things forward. I think that is the right way to do that.

My hon. Friend the Member for Halesowen and Rowley Regis mentioned data, particularly in the context in which the hon. Member for Liverpool, Wavertree mentioned them. I think there is recognition that the way in which data have been collected in the past has not been good enough, and there is also recognition that we are trying to lever up standards in all places. The “Panorama” programme and the hon. Lady’s questions over a period exposed the difficulty of getting all the data in the right place. This needs a separate debate and a separate set of answers. I have put in place an investigation into where the deficiencies in the data are, and how data that are collected elsewhere but centrally can be brought together. That will not be necessary in some cases and a written question may not provide all the answers.

In relation to the matters raised in “Panorama” on Monday and the difficulty for the right hon. Member for North Norfolk, it should be possible to answer the question. The problem is in terminology and deciding at what point a young person might be in the mental health system. I have agreed to meet Deborah Coles of INQUEST to talk about the information they have gathered. Plainly, it cannot be right that one Minister says “none”, I say “one”, the NHS says “four” and INQUEST says “nine”. That cannot be fair to the people involved.

A lot of attention is paid to the death of any young person with mental health problems. My hon. Friend the Member for Derby North (Amanda Solloway) raised this in a personal context. I can reassure colleagues. There are serious incident reviews, a child death overview panel, and the Care Quality Commission is involved.

[Oliver Colvile]

Will my right hon. Friend give way?

[Alistair Burt]

If my hon. Friend will forgive me on this occasion, there is just too much to cover in a short period.

There is a national confidential inquiry into suicide and homicide by people with mental illness and the Office for National Statistics is involved. Unfortunately, there is a gap in the data between national and local sources due to commission arrangements changing. That is an explanation; it is not an excuse or an answer, so my officials are looking urgently into how we can make sure our data collection is more unified and that we are working collaboratively with INQUEST to make sure we get an accurate number and resolve any discrepancies. Most importantly, as my hon. Friend the Member for Halesowen and Rowley Regis said, we must make sure we learn from every tragedy so that we can apply the learning to make things better. We are on to that. I promise the hon. Member for Liverpool, Wavertree that I will find a way of responding to the House to put that right. I will be in touch with her further.

I thank my hon. Friend for his work with the all-party mental health group. He and other colleagues have been responsible for raising these issues over a period.

A figure from the National Institute of Health Research indicates that it spent £72.6 million on mental health research programmes in 2014-15, which in terms of particular research is £27.7 million higher than in any other disease area, including cancer. We are determined to do more research, but I am not convinced the figures are quite as bad as people say None the less, we need data and we need research. Again, the taskforce is right. The Department has accepted all the taskforce’s recommendations.

I agree with my hon. Friend that there is a need for better commissioning. We are changing the tariff terms. He said it could not be done from tomorrow, but it is being done from April 2017. To end the block payments, there will be two new payment approaches with two different tariffs. I agree with him on leadership.

The funding will be there, but it must build up over time. The money is being delivered through the spending review and how we intend to fund the national health service generally. The commitment for the £1 billion of extra funding the taskforce asked for is very important and I believe it will make a significant difference.

Commitment, money and determination from the whole of Parliament will be of huge importance in this area and I thank colleagues for their engagement.

Junior Doctors: Industrial Action

Oliver Colvile Excerpts

Thursday 24th March 2016 Commons Chamber

[Ben Gummer]

The point of the new contract has, in part, been to try to achieve fairer rostering through the week and weekend. It is in response to the doctors and dentists pay review body, which took evidence from managers and senior clinicians within the service. It is their judgment that we, as Ministers, have to respect. It is not for us to make up new terms; it is to listen to those who have experience. We have been talking for three and a half years. Part of those talks were led by Sir David Dalton, who is one of the most respected people in the NHS. If he could not achieve a conclusion, I doubt very much that I, or any other Minister, would be able to do so.

[Oliver Colvile (Plymouth, Sutton and Devonport) (Con)]

How many junior doctors are members of the BMA? If the BMA is set on this activity, I encourage my hon. Friend to start talking to those who are not members. Perhaps he could talk to other health workers, too, including pharmacists, and get them involved in trying to deal with this.

[Ben Gummer]

My hon. Friend is right to point out that not all junior doctors are members of the BMA. In fact, a significant minority are not, which is why fewer than half have been turning out for industrial action. The number has been decreasing with each successive strike, and I have no doubt that as we move to the withdrawal of emergency cover, most junior doctors will say, “This is not something I went into medicine to do”, and will want to show their support for patients, rather than an increasingly militant junior doctors committee.

Community Pharmacies

Oliver Colvile Excerpts

Tuesday 23rd February 2016 Westminster Hall

[Derek Thomas]

I thank the right hon. Gentleman for that intervention. What I have learned from many patients and from the pharmacists themselves is that patients see pharmacists as the first port of call for health, so there is no doubt that there will be times when pharmacists are picking up things that otherwise would have to be picked up in A&E.

[Oliver Colvile (Plymouth, Sutton and Devonport) (Con)]

Does my hon. Friend agree that it is important not to confuse the role of pharmacists with the number of pharmacies? It is vital that we protect the pharmacists, who are very important in delivering in the national health service.

[Derek Thomas]

That is exactly right: it is pharmacists’ skills that we must be careful to maintain and develop.

I know that you have concerns about this matter as well, Mr Streeter, especially concerning the pharmacy in Modbury in your constituency, so I appreciate your support on this issue and the way you are chairing this wonderful Westminster Hall debate.

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[Oliver Colvile (Plymouth, Sutton and Devonport) (Con)]

May I say what a pleasure it is to serve under your chairmanship, Mr Streeter. I have been involved in the whole business of pharmacies since 10 to 15 years ago, when I worked commercially on the campaign for resale price maintenance. Members may remember that the then Government were seeking to get rid of resale price maintenance on many prescription medicines. So I have been following the area closely.

I congratulate my hon. Friend the Member for St Ives (Derek Thomas) on securing the debate. Members should be aware that I am the Government’s pharmacy champion, as well as the vice-chairman of the all-party pharmacy group. The right hon. Member for Rother Valley (Kevin Barron) is the chairman.

Just before Christmas, the Government announced that they wanted to review community pharmacies, and I very much welcomed that. The Government’s consultation process on community pharmacies needs to ensure that health service money is targeted better on where it can deliver the best results. The consultation process has highlighted that there is an oversupply or clustering of pharmacies in specific locations. The other day, I was driving back to London from my constituency, and I noticed that there were three or four pharmacies within two or three minutes’ walk of each other. To my mind, that has to be looked at.

The issue is how we ensure that the changes to the funding mechanism ensure the desired results, namely, the reduction of clusters while ensuring that we do not damage key parts of the pharmacy network. Using funding to make the changes is potentially a blunt instrument, and it will impact on smaller volume pharmacies in rural areas in particular. They are a part of the network that is desperately needed. What mechanisms are envisaged to achieve those goals? I understand that some large pharmacy groups might be willing to give up the leases on some of their shops, but they want to know whether the Government will give them an assurance that the leases will not be handed over to another chain of pharmacies. Perhaps my right hon. Friend the Minister will explain what approach the Government will take to ensure that that does not happen.

Pharmacies, particularly community pharmacies, are undergoing unprecedented changes. They want to expand and to assist in meeting primary care demand, diverting activity from A&E to support more patients with self-care and in the prevention of ill health. Pharmacy is increasingly seen as a large part of the solution to the shortage of doctors and nurses in primary care. We are watching the spiralling demand for practices and community pharmacies, which are about delivering that patient care.

We need to support the innovation in roles to facilitate change in the infrastructure: information exchange, organisation, and working practices. Current investment in the innovation fund will probably not provide the level of investment needed, and access to transformation funds for this purpose seems unlikely. The change is needed to manage demand more effectively, but, unless supported, we place the system and the patients it serves at high risk. Can we therefore ensure that higher priority is given to ensuring that the changes are effectively supported?

[Stephen Pound]

On the subject of changes, and bearing in mind that the increase in prescribing is about 2.5% per annum, does the hon. Gentleman honestly believe that the Government’s proposal for a hub-and-spoke prescribing model, breaking the link between the patient and the pharmacist, represents value for money, or even sanity?

[Oliver Colvile]

There are two things. First, it is important that the consultation process reaches a conclusion. For us to try to premeditate on that would be unhelpful. Secondly, there are examples of where the Government have been able to make sure that money is better focused and better used. They can make budgets sweat quite well, and we should certainly take that into account.

I very much welcome the review, as I believe that community pharmacies should have a much wider role than simply dispensing prescriptions. They can take the pressure off hectic GP surgeries and our hard-pressed accident and emergency units. Such venues should provide alternative services such as help with mental health conditions, smoking cessation and suchlike. The Government need to ensure that pharmacies are the first point of contact when patients are looking for minor help, such as flu jabs. We also need to make sure that patients in our rural villages have access to pharmacies, although in urban conurbations, such as my Plymouth, Sutton and Devonport inner city constituency, there should not be a plethora of chemists just for the sake of having them. We need to make sure that patients’ safety is paramount when pharmacies are dispensing medicines.

Over the past five years I have consistently campaigned for the Government to decriminalise dispensing errors made by pharmacies. At present, GPs can only be struck off if they make a prescription error, whereas pharmacists can be sent to prison for exactly the same thing. We need a level playing field. Despite being the Government’s pharmacy champion, I am going to be slightly critical of the Government over this issue. We hoped that it would be sorted through secondary legislation before the general election. During a debate on the Access to Medical Treatments (Innovation) Bill, which was promoted by my hon. Friend the Member for Daventry (Chris Heaton-Harris), I questioned the Department of Health’s decision to delay the necessary legislation until after the devolved Assembly elections and the new Executives and Governments had had a chance to introduce their own legislation. This means it is unlikely to be introduced before the summer, so English pharmacists are now dependent on legislation being passed for other pharmacists. So much for fair devolution. When my right hon. Friend the Minister sums up, will he explain why English pharmacies have to wait until the Welsh, Scottish and Northern Irish Assemblies have passed the necessary legislation?

I understand that the Government are keen for pharmacies to be able to share summary care records to ensure that they are fully informed of patients’ medical history when giving medical advice. What progress is my right hon. Friend’s Department making?

Yesterday, I met the General Pharmaceutical Council, the pharmacy regulator since 2010. Various issues were raised by the GPC, especially the Pharmacy (Premises Standards, Information Obligations, etc.) Order 2016, which was in its Grand Committee stage in the House of Lords yesterday. I welcome this section 60 order, as it will bring much-needed transparency to the GPC’s reporting on inspections. There must be transparency. The section 60 would also allow the GPC to take proportionate action when pharmacies fail to meet essential standards. This is just one of the reasons why I support the section 60 order.

Pharmacy has the potential to play a huge part in community healthcare in Britain. However, we need to address the fundamental flaws in the system so that our communities are better served by pharmacy and our healthcare system is used responsibly.

[Mr Mark Williams (Ceredigion) (LD)]

I note the time, Mr Streeter, and your stipulation about when Front-Bench speeches will start. I thank the hon. Member for St Ives (Derek Thomas) for initiating this important debate. As I look around the Chamber today, I see that Members from Wales, Scotland and Northern Ireland are outnumbered, which is appropriate, given the letter that was sent and the cuts that pharmacists might endure. In Wales, the issue of health is almost entirely devolved, so much of what is being discussed today will be different in Wales from in England. However, the community pharmacy contractual framework is an England and Wales arrangement, so what happens in England could impact on Wales.

The hon. Member for Plymouth, Sutton and Devonport (Oliver Colvile) mentioned the issue of devolved Administrations and delays. Our understanding is that the consultation will conclude, the Minister will reflect, and an announcement will be made during the Assembly election campaign period. We will not have a health Minister in Wales if decisions made in Whitehall impact on the delivery of services in Wales. I think that it has something to do with the respect agenda and waiting for a health Minister to be in place.

[Oliver Colvile]

Does the hon. Gentleman recognise that if there were delays in Wales, Scotland or Northern Ireland, the English pharmacies would end up waiting behind that queue?

[Mr Williams]

The hon. Gentleman should address that question to the Minister. The timing represents an unfortunate mismatch, for which pharmacists in England might pay the price. The timetable is of the Government’s making, not mine, so the Minister needs to reflect on that.

I want to talk about two facets of this debate that have been touched on by the hon. Members for St Ives and for Bexhill and Battle (Huw Merriman): the issue of rurality and the impact of the cuts. The consultation document stated:

“40% of pharmacies are in clusters of 3 or more meaning that two-fifths of pharmacies are within 10 minutes walk of 2 or more other pharmacies”.

Junior Doctors Contracts

Oliver Colvile Excerpts

Thursday 11th February 2016 Commons Chamber

[Mr Hunt]

We have no plans to do so, but I cannot be drawn any further, except to say that we do have to deliver our manifesto commitments. The specific issues that we have identified with respect to seven-day working relate to consultant and junior doctor presence, and that is what we are focused on putting right.

[Oliver Colvile (Plymouth, Sutton and Devonport) (Con)]

I thank my right hon. Friend for the very clear way in which he has kept the House up to date on the progress of all this. It is very important not only that we free up beds in hospitals, most certainly at weekends, but that we should be making much greater use of our pharmacies to deliver better healthcare within the community. Will he explain how that might happen?

[Mr Hunt]

I believe my right hon. Friend the Minister of State is with the pharmacists now discussing that precise issue. My hon. Friend raises this issue regularly and rightly: pharmacists have a very important part in the future of the NHS.

Oral Answers to Questions

Oliver Colvile Excerpts

Tuesday 9th February 2016 Commons Chamber

[Mr Jeremy Hunt]

The only reason we do not have a solution on the junior doctors is the BMA saying in December that it would negotiate on the one outstanding issue—pay on Saturdays—but last month refusing to negotiate. If the BMA is prepared to negotiate and be flexible on that, so are we. It is noticeable that despite 3,000 cancelled operations, no one in the Labour party is condemning the strikes.

[Oliver Colvile (Plymouth, Sutton and Devonport) (Con)]

T6. Will my right hon. Friend update us on the progress in decriminalising dispensing errors for pharmacists?

[Alistair Burt]

I am aware of my hon. Friend’s keen interest in the rebalancing programme of work, and particularly the work on dispensing errors. We are fully committed to making that change. There are a number of stages to amending primary legislation through a section 60 order. Given the timetable, it is likely that the order will be laid before the Westminster and Scottish Parliaments in the autumn.

Access to Medical Treatments (Innovation) Bill

Oliver Colvile Excerpts

Friday 29th January 2016 Commons Chamber

[Anne Marie Morris]

I will speak first to amendments 8 and 9 and then turn my attention to amendment 15. As the hon. Member for Lewisham East (Heidi Alexander) explained, amendments 8 and 9 would add a whole host of bodies—I think that I counted eight—that the Secretary of State must consult before making regulations under subsection (1). This relates to the conferring of functions on the Health and Social Care Information Centre in connection with the establishment, maintenance and operation of a database. The hon. Lady has talked articulately about why the two amendments should be made, but I have some concerns.

My main concern, despite everything the hon. Lady said, is that adding all these organisations that the Secretary of State must consult will just add to the complication of the database. The amendments not only ask the Secretary of State to consult, but ask that all these organisations approve the regulations. Adding these extra organisations will just add to the confusion about who is policing the system. Is the consent of all those organisations needed before a treatment can be removed, or can it be removed just by the Health and Social Care Information Centre? If a complaint is made about what is on the database, does it go to the Secretary of State, the NHS or the Health and Social Care Information Centre, or does it have to be put in front of all those organisations again?

I understand that the hon. Lady might not have all the answers to my questions and that these issues go deeper than just her amendments, but I do not think that adding extra layers of consultation will help to simplify the Bill or make it any easier to implement the database, which, if put together correctly, could do much good and help many people across the country and, potentially, the world. I do not support amendments 8 and 9, because I believe that they will add unnecessary complications to the database and impede the good work that it could well achieve.

Amendment 15 has been tabled by the Minister, who has spoken eloquently throughout these debates. Including references to treatments carried out for the purposes of medical research will enhance the database, because it will allow the inclusion of clinical trials and other forms of medical research. Including medical research in the Bill will hopefully help to address the UK DUETS database. Mr Deputy Speaker, you will be glad to hear that that is not a database of UK singers who perform together; it is the database of uncertainties about the effects of treatment. It publishes treatment uncertainties from a wide range of people, including patients, clinicians and research recommendations, among others. By including medical research on the database, hopefully we can remove a few more treatment uncertainties from the database or, on the flip side, identify treatment uncertainties with greater ease and therefore tackle them head-on.

Clinical trials are vital if we are to put our NHS resources into the right treatments. They can help find out how to prevent illnesses, detect and diagnose illnesses or treat illnesses. The earlier we can do that, the more lives we can save, so I support any move to increase clinical trials, which I believe this amendment will do. It is my belief—I am sure that my hon. Friend the Minister will correct me if I am wrong—that his amendment will also increase knowledge of clinical trials among clinicians by adding them to the database. Sir Francis Bacon said that “knowledge is power”, and I do not believe that is any less true when it comes to medicine and saving lives. I fully support the Minister’s amendment.

[Oliver Colvile (Plymouth, Sutton and Devonport) (Con)]

I congratulate my hon. Friend the Member for Daventry (Chris Heaton-Harris) on introducing this Bill. Let us hope that it has a successful outcome later. I should remind you, Mr Deputy Speaker, that I am the Government’s pharmacy champion and vice-chairman of the all-party pharmacy group. Consequently, the majority of my comments will be based very much on pharmacists as dispensers of medicines that will include off-label ones.

I enter into the debate with some trepidation having listened to the hon. Member for Central Ayrshire (Dr Whitford), who was incredibly well-informed and very persuasive. I hope that my comments will be practical and constructive. I want to concentrate on the data-sharing of summary care records, as well as information to do with these medicines, and the decriminalisation of pharmacists for dispensing errors. I hope that the Minister can clarify his position on some of this stuff when he winds up.

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[Chris Heaton-Harris]

The hon. Lady speaks with way more experience and knowledge than I do, but from everything I found out during my research for the Bill, I completely concur.

[Oliver Colvile]

rose—

[Chris Heaton-Harris]

I give way to my hon. Friend the guinea pig.

[Oliver Colvile]

Does my hon. Friend also recognise that an enormous amount of research is taking place in many of our medical schools, especially Peninsula medical school in my constituency and the one in Exeter?

[Chris Heaton-Harris]

Clinical research and innovation is happening across our NHS every day. Would it not be wonderful if every registered medical practitioner could see what was going on, without too much effort or work, by tapping into a database and getting a better understanding of the picture around them?

This is the crux of the matter. Treatments are not what they used to be; there is not a one-size-fits-all policy. As medicine progresses and personalises even further, the mind boggles trying to imagine the sheer number of treatments that will be available in our NHS in the future. How can we expect every clinician to know about all the possible treatment routes? How can we not, therefore, provide them with somewhere to record them and their outcomes?

As Lord Giddens stated in the debate I mentioned earlier, we are experiencing a digital revolution. Given how far technology has come in our lifetimes and what is now possible, we can truly say we are living through a different age of digital capability. It is moving at such a pace that we struggle to keep up with it ourselves. It is not unfounded to say we might be living through a period of unparalleled innovation in medicine and other frontier areas of science more generally. Thanks to the strides in treatment and the speed of technological development, we have an opportunity to create and record life-saving data like never before. It is surprising that we do not have such a database already. The Bill sends an unambiguous political signal to the Government that we would like them to get on with it.

The Bill defines innovation as a situation where a doctor departs from the existing range of accepted medical treatments for a condition. This will be well understood by doctors, who are best placed to know whether treatments are acceptable and responsible. The definition of what can go on the database is deliberately wide because I want the Minister to have as wide an ambit as possible.

I want quickly to mention another stakeholder I met, Nutricia, a company dealing with advanced medical nutrition. It kindly welcomed the Bill:

“This Bill marks an opportunity for patients managing a range of diseases and conditions to get access to the most innovative medical care, and to actively support their inclusion in patient pathways in an on-going manner. This should not simply be confined to pharmaceuticals, as patients can benefit from innovation across a range of sectors, for example medical nutrition.”

Medical nutrition—otherwise known as medical foods—describes a special category of foods designed to meet the needs of patients whose disease or health concern requires medically determined nutritional support. Medical nutrition is a scientifically formulated food that is available in many different formats. Applications can range from those with rare conditions, such a child who inherits a metabolic condition meaning that the consumption of a specific amino acid commonly found in normal foods can lead to brain damage, right through to people with common cancers who may as a consequence lose weight rapidly and be at risk of malnutrition for a period of time. Nutricia was therefore keen that we maintained the widest possible definition for how the database could be used.

Medical nutrition also provides benefits in the treatment pathways of other diseases, including various cancers, strokes, cerebral palsy and pressure ulcers. Nutricia has stated that,

“we must seek to streamline the adoption of innovative care of all kinds—not just pharmaceuticals—so that clinicians have a resource which will mean that there are no more missed opportunities, and patients have every available chance to manage their condition.”

Oral Answers to Questions

Oliver Colvile Excerpts

Tuesday 17th November 2015 Commons Chamber

[George Freeman]

The hon. Gentleman makes an excellent point. Genome editing is the latest in a suite of technologies that is rapidly emerging in genomics. Through the Genomics England programme, we are actively supporting those tools and intermediate technologies, and through the accelerated access review that I have launched, we are looking to harness those breakthroughs to support new treatments and new flexibilities for the National Institute for Health and Care Excellence and NHS England on targeted treatments.

[Oliver Colvile (Plymouth, Sutton and Devonport) (Con)]

8. What progress he has made on implementing a new contract for junior doctors; and if he will make a statement.

[Caroline Lucas (Brighton, Pavilion) (Green)]

9. What plans he has to introduce a new contract for junior doctors.

[The Secretary of State for Health (Mr Jeremy Hunt)]

Junior doctors are the backbone of the NHS. It is highly regrettable that their union has let them down by refusing to negotiate a new contract that will be fairer for doctors and safer for patients, and deliver the truly seven-day services we all want.

[Oliver Colvile]

I thank my right hon. Friend for that answer, but has he had an opportunity to speak to medical schools about the new contract for junior doctors, especially the Peninsula medical school in my Plymouth, Sutton and Devonport constituency?

[Mr Hunt]

NHS Employers has regular discussions with the Medical Schools Council, which represents the Peninsula medical school. Although the training of doctors is not the specific contractual dispute that is in the headlines, it is something on which we could make significant improvements. We want to use this opportunity to work with medical schools and the royal colleges to see whether we can bring back some of the continuity of training that used to be such an important feature of junior doctors’ training.

NHS Success Regime

Oliver Colvile Excerpts

Thursday 4th June 2015 Commons Chamber

[Ben Gummer]

I am so glad that the hon. Lady welcomes the success regime and the potential it might have. I spoke to one of her colleagues the other day about the troubled hospitals that she mentioned and I was about to invite her in to have a discussion about them, as we must try to find out what the core issues are with Barts Health NHS Trust. She raises an interesting point about PFI, however. One reason we are struggling in some cases, and why we have struggled over the past five years to provide the funding within the NHS that it requires, is the enormous NHS PFI debt that was loaded on to it by the previous Government and that has cost it billions of pounds over the past 10 years.

[Oliver Colvile (Plymouth, Sutton and Devonport) (Con)]

I thank my hon. Friend for his very thoughtful comments and replies. Does he recognise that one of the problems for the Devon clinical commissioning group is that it covers a large rural community and also Plymouth, the largest conurbation west of Bristol? We need to find a way in which this can all work to ensure that the city of Plymouth gets looked after and that levels of deprivation and so on are considered.

[Ben Gummer]

My hon. Friend makes the point better than I did. How do we sort these problems out using the local knowledge that he has just demonstrated rather than having a Minister in Whitehall with a map thinking that he or she can make the decision themselves? The success regime seeks to harness that local knowledge and the local solutions.

National Health Service

Oliver Colvile Excerpts

Wednesday 21st January 2015 Commons Chamber

[Richard Harrington (Watford) (Con)]

I will do my best, Madam Deputy Speaker, to stick to the eight-minute guideline—without casting any aspersion on the previous speaker, the illustrious former Secretary of State. I shall be watching the clock.

So much has been said about the situation nationally, and I found the speech by the shadow Secretary of State, which I listened to carefully, very political, controversial and adversarial. I shall do my best not to speak in that manner. Instead, I would like Members to listen to my personal experiences in the Watford area, from speaking to people and visiting, several times, the A and E department, the general hospital, the clinical commissioning group, and so on. As a Back-Bench Member, that is about the best I can do. It is very confusing watching these tennis matches—as soon as the Secretary of State says something, the shadow Secretary of State is on television saying completely the opposite. It is confusing for people who work in the NHS and the rest of our constituents.

As the Secretary of State said, there is unquestionably pressure on the NHS. Everybody knows that. We all know the statistics about people getting older and needing more medical care. I frequently have to ask my mother, when she phones the GP every other day, “Is it necessary?”, and I am sure she thinks it is always necessary, because when people get older, they need care, and the Government have to respond to that. However, these insinuations and open statements by the Opposition that NHS spending has been cut are untrue, and they frighten people. It is a fact—it cannot be disputed—that spending has increased in cash terms every year since the coalition came to power and by £13 billion overall, and will increase by £2 billion alone next year.

I have spoken to consultants and nurses at Watford A and E—I have been there nearly every week since the beginning of the year—and I have seen ambulances backing up, and all the things that people on both sides of the House have mentioned. When I ask the A and E consultants why, they say, “These are not people with trivial illnesses, but people with serious concerns.” It is not a question of people with sore thumbs phoning the national number and being sent to A and E—I am certain of that, having spoken to many people in reception. We are not talking about people who should be going to see a nurse or a walk-in centre; these are serious matters, and there are a lot more of them. The extra GP hours will help, but I will come to that later.

The Watford area is making progress, however. Northwick Park hospital has just opened a big A and E, which I am sure will take off some of the pressure; the Herts Valley CCG has had a 5.5% increase; and there are more than 1,000 extra doctors in the region since 2010—I have seen them; they are not just a statistic. I have spoken to them and the management. They are real people. Similarly at Watford general, we have 142 more full-time nurses. I opened a new ward last week at Watford general, and there is a £1.6 million ambulatory care unit. There are lots and lots of new things, yet Labour did a party political broadcast from Watford hospital that really annoyed the staff, the management and my constituents, because it frightened people and gave the impression that the service was disintegrating and disappearing.

On the important subject of GPs, there is no question but that it was a mistake by previous Governments to restrict GP working hours. I commend the Watford Care Alliance for being among the first to get money under the Prime Minister’s fund to finance seven-day opening for GP services till 8 o’clock, which has made a significant difference. In Watford alone, there will be 16,000 extra appointments this year, which is a lot.

I am delighted that the Health Secretary came to visit Dr Mark Semler, whom I hope he will agree was inspirational in the way he spoke about the programme. He is a local GP who has taken this challenge on. Of course, there are big challenges with IT and explaining it to other staff in the area, but he is an inspirational man, and I think we had a constructive conversation with all the doctors about the implications of this policy. They have taken on the extra hours, and they know it is providing a service. In time, it will help significantly in providing a service to my constituents and taking some of the pressure off A and E.

I am pleased that Watford was one of the first in the country to do that, and I think it has been a success. I know the Government’s ambition is to roll it out to the rest of the country, which would be a major step forward. The actual infrastructure—the offices, the surgeries, the premises—are there, and to anyone from a background outside the public service, it would seem strange to have all those assets and not to use them for the benefit of the customers, who, in this case, are the patients. I commend the Government for that and I thank the Secretary of State that Watford was one of the first places in the country to do this.

Finally, I want to comment on the air ambulance service, which, as he often does, my hon. Friend the Member for Bedford (Richard Fuller) mentioned earlier. I have seen it and think the service is very impressive, and I hope the Government will consider giving it some of the LIBOR funding—it would be an excellent use of that money.

[Oliver Colvile (Plymouth, Sutton and Devonport) (Con)]

I thank my hon. Friend for his constructive speech. It is incredibly helpful, because a lot of people get very concerned when we play “Punch and Judy” occasionally. Does he recognise the role of pharmacies, which are a key part of our NHS that we need to make greater use of?

[Richard Harrington]

My hon. Friend makes a good point. Some pharmacists feels under threat from internet pharmacists—not illegal ones abroad, but proper ones—but the personal contact with pharmacists and the advice they offer can provide them with an enhanced role in the internet era. So I agree with him totally.

And that, Madam Deputy Speaker, concludes my comments.

Oral Answers to Questions

Oliver Colvile Excerpts

Tuesday 25th November 2014 Commons Chamber

[Dr Poulter]

This is an incredibly important area of health care. How do we support young people through periods of transition? We know that people with long-term illnesses may struggle particularly, and diabetes and epilepsy are two of the conditions that have been identified. NHS England is currently examining transitional care tariffs to support people during the transition between children’s and adult health services, and educational support is part of that ongoing work.

[Oliver Colvile (Plymouth, Sutton and Devonport) (Con)]

My right hon. Friend the Minister for Universities, Science and Cities recently announced that there would be no cap on the number of students wishing to study pharmacy. Does my hon. Friend agree that Plymouth university should now press ahead with the setting up of a pharmacy school given that it is the Peninsula medical school?

[Dr Poulter]

My hon. Friend makes an important point. I visited the Peninsula medical school and his local university to highlight some of their excellent work in training medical and dental students. I believe that there is ample scope to expand provision to train other health care professionals in what is becoming an outstanding medical and health care training facility.