Healthcare: Hampshire
Paul Holmes Excerpts(3 days, 14 hours ago)
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Dr Danny Chambers (Winchester) (LD)
Whether I am door-knocking at the general election or reading my inbox, the NHS and healthcare services are, by a long way, the single biggest worry that people talk about. After 14 years of Conservative mismanagement of both the economy and the NHS, I have heard from many people about how they are struggling to access NHS services not only for themselves but for their children, which causes huge stress for the family and friends of those involved.
In 2019, Boris Johnson announced that Hampshire would have one of 40 new hospitals. In 2024 the sitting Conservative MP I stood against repeated once again that there would be a new hospital in Hampshire. It was frustrating, although possibly not surprising, to find out after the general election that not only had there never been any money assigned to the new hospital in Hampshire but that there is a £22 billion deficit that we had not previously known about.
Hospital managers, along with the chief executives of hospital trusts and integrated care boards, are trying to plan the future of healthcare in Hampshire, which becomes difficult when the goalposts keep moving and when they do not know whether there will be a new hospital. It is also causing huge stress for the residents around Winchester, especially those south of Winchester, who have been told that they might lose their accident and emergency department and their consultant-led maternity services as part of the new hospital plan. I have heard from thousands of people, including up to 30,000 who signed a petition, about the importance of keeping our A&E and consultant-led maternity services in and around Winchester. I have heard from many people whose lives were saved at Winchester and who are worried that they might have to travel further.
There has been a public consultation on the location of a new hospital, and it is currently being reviewed. Winchester residents are very concerned that none of the suitable potential sites in Winchester was included as an option. People had to choose between north or south of Basingstoke. This is not only a concern for people in Winchester, who will have to travel further for emergency healthcare; it is also a concern for the management of Southampton hospital, who are concerned that the further north a new hospital is built, the more that people will go to Southampton because it is closer. At the moment, Southampton hospital is operating at capacity and would need significant new resources if the hospital were built too far north.
When we look at the future of healthcare in Hampshire, we should seriously consider why we would build a new hospital so close to Frimley Park, which is going to be rebuilt because it has reinforced autoclaved aerated concrete and is only 20 minutes away along the A3. Why would we have two new hospitals so close to each other? I would appreciate having a meeting with Minister to discuss the potential location of any new hospital, so that we can ensure everyone in Winchester can access healthcare in an appropriate place.
The location of any new hospital is key to the future of healthcare in Hampshire because it will provide healthcare for decades to come. However, we are aware that the proposed new hospital may not be included in the new hospital programme after the review, so we need to focus on our current hospital. The NHS staff at that hospital are fantastic, but we need to look at how we can support it now and in the decades to come.
Paul Holmes (Hamble Valley) (Con)
I apologise for intervening on the hon. Gentleman without notice; I appreciate him giving way. He outlined the case for a new hospital at junction 7 of the M3, but he is slightly muddling the argument. Clinical professionals recommended a location for that hospital, with replacement services that were being taken from Winchester hospital, while maintaining a Winchester hospital with certain services. Blue light times showed that there would be no significant difference in accessing healthcare for someone living in the north half of my old constituency of Eastleigh and someone living the part of his constituency that he mentioned. The hon. Gentleman and his hon. Friend, the new hon. Member for Eastleigh (Liz Jarvis), opposed the new hospital, so is it not a little bit awkward for him to say that the Government had no funding plans, when he opposed the location and that hospital being created? That meant there was a muddling of decision making because he and his colleague opposed that hospital being created in the first place.
Dr Chambers
We never opposed a new hospital—that was something the Conservatives were saying about us. We support a new hospital, we want a new hospital, and we want modern healthcare services in Hampshire. However, we were very concerned that the proposed location of the new hospital is not suitable when we look at how healthcare is delivered throughout Hampshire. Sites just north of Winchester were identified as suitable; when we look at a map of Hampshire, it is clear that those proposed locations would be much more suitable for people throughout Hampshire, including those in the hon. Gentleman’s constituency, to reach emergency services.
Our current A&E department, like other A&E departments, is hugely busy, especially as we head into winter. We know that many people attend A&E because they cannot get the primary care they need. Up to 20% of people who turn up at A&E are there because they cannot get a doctor’s appointment. People who are in a mental health crisis—many are often already on a waiting list—are going to A&E. They take up a huge amount of time and staff resources, often needing 15 to 18 hours of constant monitoring before they can be taken to a place of safety. We also have people turning up with dental issues because they cannot access an NHS dentist.
The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)
I congratulate the hon. Member for Winchester (Dr Chambers) on securing the debate, and echo his thanks to all health and social care staff who do incredible work in very difficult circumstances. We know that our NHS is broken. Whenever MPs from across the House come to me with issues affecting their constituencies, I repeat the same mantra: this Government will be honest about the issues facing our NHS, and serious about tackling them. Lord Darzi has already completed his review of the current state of the NHS, and his report laid bare the true scale of the challenges facing our health service.
We will not sugarcoat the problems faced by the health service in each and every part of the country, because colleagues from across the House are right to raise issues with me, and we will fix them together. We have already launched our national conversation on the future of the NHS, and we want patients, families and staff to join that conversation and make their voices heard. If Members have not already been to the website, the address is change.nhs.uk. Please let us have some sensible suggestions—not firing the Secretary of State out of a cannon.
In her spring Budget, the Chancellor of the Exchequer announced an extra £22.6 billion to protect NHS day-to-day spending. Every penny of that investment will come alongside vital health reforms; they are two sides of the same coin.
As the Secretary of State outlined last week, this Government intend to publish a league table of providers, allocating the best talent to the most challenging areas and ensuring that there are no rewards for failure. Where necessary, we will remove failing managers, and we will reward senior leaders who successfully improve performance.
Paul Holmes
On failing organisations, just before the general election a cross-party group of MPs, including Labour MPs, had a meeting with the then Secretary of State, my right hon. Friend the Member for Louth and Horncastle (Victoria Atkins), about the performance and management of Hampshire and Isle of Wight ICB. Members of Parliament from across the political divide have serious concerns about its leadership, communications and funding—not Government funding, and I welcome the increased funding, but the way that it is distributed to services in Hampshire. Frankly, I do not think the leadership is up to running that ICB. Will the Minister agree to meet me and other Members from across the House to discuss the urgency of the situation? Will he find out from his civil servants where the request for a two-week action plan went and come back to Hampshire MPs?
Andrew Gwynne
I am sure the officials in the Box will have noted the concerns the hon. Gentleman rightly raised about his ICB. I will ensure that that is communicated back to the Minister for Secondary Care, my hon. Friend the Member for Bristol South (Karin Smyth), so she can look in more detail at those concerns and communicate with the Hampshire MPs. If a meeting is necessary at the end of that, I am sure she will be more than willing to meet him and his colleagues.
We want to ensure that every part of our NHS is working as well as it can and, as I say, good performance will be rewarded as part of our reforms. Alongside a college of executive and clinical leadership, that will ensure the NHS continues to develop and attract the best talent to top positions, bringing the best outcomes for patients and taxpayers alike.
Let me turn to some of the specific issues that the hon. Member for Winchester raised. On local hospital provision, patients deserve to have safe, compassionate and personalised care in a fit-for-purpose environment. That is why this Government have committed to building and refurbishing hospitals across the country. The new hospital programme includes a new hospital for north and mid Hampshire and a major refurbishment at Winchester to provide specialist and emergency care. As part of the proposal, I am aware that the local trust explored changes to the current obstetrician-led maternity services at the Winchester site. I know the hon. Member has been a strong champion of that, having raised it with the Prime Minister in October.
As announced in the Chancellor’s autumn Budget, my right hon. Friend the Secretary of State will set out further details of the review of the new hospital programme in the coming months, alongside a new and realistic schedule for delivery. The Hampshire hospitals scheme is in scope of the review, and I acknowledge the local concern over the proposal and the impact on the Winchester site and on maternity services.
Income Tax (Charge)
Paul Holmes Excerpts(2 weeks, 4 days ago)
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Wes Streeting
I will make some more progress.
Speaking of the Conservative party, I welcome the right hon. Member for Melton and Syston (Edward Argar) to his new position as the shadow Health and Social Care Secretary—the best job in the Opposition. In the two and a half years that I did his job, I faced five Health Secretaries. I am determined to make sure he faces only one. I had differing relationships with each of my predecessors. At best, we went hammer and tongs in this place, thrashing out our disagreements, but we would also get on the phone and work together in the national interest, particularly during covid when I had a particularly constructive working relationship with Sir Sajid Javid. I hope we can work together in that spirit. If he has any ideas to fix our broken NHS I am all ears—he just needs to go to change.nhs.uk, as hundreds of thousands of people across the country have already done. I must disappoint him, however: I will not be fired out of a cannon.
Choosing to serve is not always easy, especially in a job as thankless as being a member of His Majesty’s loyal Opposition. Let me applaud the right hon. Gentleman for stepping up to the plate. Having done his job until recently, I have some advice: first, it is easy to oppose for opposition’s sake, but the public will rightly expect him to have an alternative. The Leader of the Opposition refused to say at the weekend how Conservative Members will vote on the Budget. Apparently, whether they support or oppose £26 billion of investment in our NHS is, to quote her, “inside baseball”.
If the Conservatives finally decide to oppose the Chancellor’s measures, they will need to say what they would do instead. Would they keep our investment in the NHS? If so, how would they pay for it? Would they cancel our investment and the extra appointments, send doctors and nurses back out on strike or cause waiting lists to soar even higher? The Conservative party has to choose. At the moment, our only clue about the future of the party is the Leader of the Opposition’s comments about charging patients to use the NHS. She gave an interview to The Times just weeks ago in which, on the principle that the NHS should be free at the point of use, she said:
“we need to have a serious cross-party, national conversation.”
I am happy for the Conservative party to start that conversation any time. As far as I am concerned, it will be a short debate, and we will win: the answer is no. The Labour party will never surrender on the principle of the NHS being a public service, publicly funded and free at the point of use. It is time that the Leader of the Opposition made her position clear—although she has taken to opposition with such vigour, she tends to oppose things she said herself only days before.
I welcome the Leader of the Opposition’s call for honesty. The public have lost trust in politics, and we all have a responsibility to rebuild it. If we are not honest about the scale of the challenge and its causes, we have no hope of fixing them. Would it not be a welcome start to the role if the new shadow Secretary of State admitted what a mess his party made of our national health service and said sorry? It is not all the right hon. Gentleman’s fault; in fact, he and I have something in common. When he walked into the Department in 2019, he also inherited waiting lists already at record levels. It is true that waiting lists soared even further during the pandemic, but they were already at record levels before, and they continued to rise afterwards because of the damage that the Conservative party did to our NHS.
The Darzi investigation was clear about what is to blame: the top-down reorganisation, the chronic under-investment and the undoing of the last Labour Government’s reforms that saw NHS productivity fall off a cliff. Can the shadow Health and Social Care Secretary do what his predecessor could not, and accept the doctor’s diagnosis? Does this new Conservative leadership finally accept Lord Darzi’s findings? If the right hon. Gentleman cannot accept the work of an eminent cancer surgeon who has served both Labour and Conservative Governments, I wonder if he might agree with this damning assessment of his party’s record, made by one of his former colleagues:
“British citizens have the worst rate of life expectancy in western Europe. We have higher avoidable mortality rates than our neighbours. Survival rates for breast, cervical, rectal, lung, stomach and colon cancer are lower in the UK than in comparable jurisdictions. NHS patients who suffer heart attacks or strokes are more likely to die than in France, Spain, the Netherlands, Canada, Italy and New Zealand.
More than seven million people are on waiting lists...Every month, tens of thousands wait more than 12 hours for treatment after being admitted to accident and emergency wards. It is then no surprise that the number of (wealthier) patients opting to pay to be treated privately is at a record level...so we have a two-tier health system in this country in which the rich secure the best care, those in pain wait in agony and those with life-threatening conditions know their treatment would be better in Marseille or Madrid than in Manchester or Middlesbrough.”
The author of that quote was Michael Gove. If he can be honest about the mess the Conservatives made of the NHS, I hope the right hon. Gentleman can, too.
While the Conservatives work out what they stand for, we are getting on with cleaning up their mess, rebuilding our public services and reforming our NHS. As I said before the election, there is no point pouring more money into a broken system. Next week I will set out a package of reforms to make sure that every penny going into the NHS is well spent and benefits patients. Unless I am convinced that the money going in will deliver results, it will not get out the door.
Every bit of investment announced by the Chancellor last week will be linked to reform. The Budget will fund 40,000 extra appointments a week, and the appointments will be delivered through reformed ways of working. They are already being used in hospital across the river from here, where operating theatres are run like Formula 1 pit-stops. We will get hospitals motoring right across the country using that reformed way of working. We are investing not just in new scanners but AI-enabled scanners that diagnose faster and more accurately, increasing productivity and busting the backlog of 1.5 million patients waiting for tests and scans.
The investments in the Budget have fired the starting pistol on the three shifts that our 10-year plan will deliver. It increased the disabled facilities grant, to help people stay well, independent and out of hospital, funding an extra 8,000 adaptations to people’s homes. We are raising the carer’s allowance, worth an extra £2,300 to family carers so that they can stay in work while looking after their loved ones. That is the biggest expansion of carer’s allowance since the 1970s. We are expanding NHS talking therapies to treat an extra 380,000 mental health patients. We are investing in bricks and mortar outside of hospitals, opening new mental health crisis centres and upgrading 200 GP surgeries.
Paul Holmes (Hamble Valley) (Con)
I congratulate the Secretary of State on the extra investment that he has secured for the national health service, in spite of the Chancellor. Does he agree that primary care needs to be diversified? Could he outline whether that includes walk-in centres? If it does, could I have a meeting to discuss a new walk-in centre at Fareham community hospital in my constituency?
Wes Streeting
I am not sure whether this is within the rules of the House—you will tell me if not, Madam Deputy Speaker—but I will do the hon. Member a deal: if he votes for the investment, he can have the meeting.
Turning to the second of the big shifts that we need, from analogue to digital, the Darzi investigation found that the Conservatives left the NHS 15 years behind the private sector on technology. This Budget invests £2 billion to arm the NHS with modern technology so that staff spend less time pushing paper and more time on the frontline. In 2024, that the NHS is still using paper records to store patients’ medical history is absurd and jeopardises patient safety. The investment in this Budget will provide every trust with electronic patient records, and upgrade the NHS app so that patients can access care with a few taps on their phone. We are backing British scientists and researchers to develop the treatments of the future, with record investment in the National Institute for Health and Care Research, support for life sciences innovation and strengthening the UK clinical trial network.
We are also shifting from sickness to prevention. Today, we have announced the biggest public sector health reform in a generation. We are raising the legal age at which people can buy tobacco by one year, every year, protecting children and people from the harmful effects of second-hand smoke outdoors as well as indoors. We are cracking down on the marketing and targeting of vapes at children, so that we can create the first ever smokefree generation. Unless we act on public health reform and public service reform, the demands and costs on the NHS will spiral and the service will become unsustainable. If we want the health service to survive, and we do not want to pay ever higher taxes to fund it, we have to help people stay healthy. Prevention is better than cure—that is why we are introducing the Bill. I hope it will continue to command cross-party support.
It is not just smoking; obesity costs the NHS almost £12 billion a year. That is why we have already introduced the motion to ban the targeting of junk food ads at kids. We are strengthening councils’ powers to stop fast-food shops setting up outside schools. In the Budget the Chancellor increased the soft drinks industry levy so that manufacturers continue to reduce their sugar content while we review the exemption for milk-based drinks.
Madam Deputy Speaker, as you know, it was a Conservative Chancellor who introduced the sugar tax and a Conservative Prime Minister who introduced the first Tobacco and Vapes Bill. Because he is sensible, I know the shadow Health and Social Care Secretary will support those measures, but I cannot say the same for the Leader of the Opposition, so trapped in the prison of ideological dogma is she, so scared is she of the Reform dog that is barking over their shoulders. I hope the shadow Health Secretary will continue to hold the torch for one nation conservatism, even as its light dims in his party. If we want to know when the Conservative party has changed, maybe we will know when they have learned once again to love George Osborne.
Fixing the foundations of the NHS starts with fixing its little foundations. Lord Darzi pointed to how the Conservatives raided capital budgets time and again to plug the gaps in day-to-day spending. Indeed, that is the position we found ourselves walking into this year. Lord Darzi called it a
“combination of austerity and capital starvation”.
The Budget will begin to rebuild our NHS with the biggest capital investment since Labour was last in office, including £1 billion to tackle dangerous RAAC—reinforced autoclaved aerated concrete—and the backlog of critical maintenance and repairs across the NHS estate, keeping staff and patients safe and boosting productivity.
In conclusion, we cannot fix 14 years of mismanagement and neglect in one go, but the Budget marked an historic turning point for our country. For years the Conservatives pretended that the problems facing Britain did not exist, leaving them to grow. This week, the Chancellor ran head first into those challenges, taking the tough, difficult decisions on tax, spending and welfare because the choice was stark: we could stick to the status quo of 14 years of underinvestment that has knee-capped our economy and crippled our NHS, or we could begin to fix the foundations, kick-start the economy and rebuild our health service. The choices the Chancellor made will give the NHS the investment and reform it desperately needs to cut waiting times, rebuild crumbling buildings, arm NHS staff with modern technology, get more out of the NHS for what we put in, and fix the foundations and rebuild Britain. That is the change the country voted for; that is the change this Labour Budget delivers.
Edward Argar
I am grateful to the hon. Gentleman. If he pauses for just a moment, I will turn to capital investment and seek to address his point.
Edward Argar
I will make a little progress, but then I will happily give way to my hon. Friend.
Apart from the press releases and the reviews, where is the action? We need to see where the £22 billion will be spent. What plans does the Secretary of State have for additional investment for the NHS this winter? He knows, as I knew when I was a Minister, that winter in the NHS is always challenging. I look forward to him setting out what additional investment he plans.
Edward Argar
I will give way to my hon. Friend the Member for Hamble Valley (Paul Holmes) in a second. Nice try, Secretary of State.
Is the right hon. Gentleman directing where that NHS funding goes himself, or will it be for his officials or NHS England to set the priorities for that, and who will be held accountable for ensuring that it is prioritised in the right places?
Paul Holmes
I thank my right hon. Friend for giving way and congratulate him on his appointment as shadow Secretary of State. Does he share my concern that, although the extra investment in the NHS is welcome, the lack of clarity from a Budget in which growth has actually been revised down means that in future years we could see additional investment in the NHS actually being cut back, because the Budget does not deliver the growth for public service investment?
Edward Argar
My hon. Friend is absolutely right. You cannot tax your way to growth and you cannot invest in public services without that growth. If the predictions we are seeing about growth are borne out, there is a real risk to our public services’ sustainability in future.
The Chancellor said that the funding would help to deliver 40,000 more NHS appointments a week, but again we see no reference to specific actions by which that will be achieved. The Government seem not to know the difference between a target and a plan, and simply restating their ambition while throwing money at the challenge will not be enough to deliver on that commitment.
As I have said, elements of the Budget relating to the Department of Health and Social Care were welcome, one of them being the Secretary of State’s one-nil win over the Chief Secretary in respect of funding. An additional £2 billion to drive productivity is important. I fear that it is a slimmed-down version of the £3.4 billion NHS productivity plans that we announced and funded, but I will study it closely, and, similarly, the Secretary of State’s plan for mental health is deserving of serious study. On both sides of this Chamber, we recognise the importance in mental health investment of not only parity of esteem but parity of services, and it is therefore right for us to scrutinise very carefully how the right hon. Gentleman intends to build further on the success that we had in driving that agenda forward.
Let me now turn to the subject of capital investment, which was touched on by the hon. Member for Kensington and Bayswater (Joe Powell). It concerns me that, as far as I am aware, the Secretary of State has still not told us exactly when his review of the new hospital programme will report and set out the future for each and every one of the hospitals that he committed himself to delivering during the election campaign—the programme to which the previous Chancellor had committed funding, building on the original £3.7 billion allocated in 2019. The question for the Government, and the question for the Chief Secretary to answer when he winds up the debate, is: “When will that review report, and when will each and every one of those colleagues and communities who are looking forward to a new hospital know whether it will be delivered in line with the Secretary of State’s pledge, or whether the programme will be cut?”
Nearly a week after the Budget, Members will be familiar with the verdict of the Office for Budget Responsibility: namely, that the £25 billion assault on businesses risks lower wages, lower living standards and lower growth. And let us not forget what this tax hike will mean for those providing essential services across primary, secondary and social care—the general practices, care homes, adult social care providers, community pharmacists on our high streets, hospices and charities such as Marie Curie and Macmillan which provide additional care for patients alongside the NHS.
I was deeply disappointed that the Secretary of State did not take the opportunity offered by my hon. Friend the Member for Hinckley and Bosworth (Dr Evans) to state clearly that all those groups would be exempt and would not be hit by this hike, and I hope that when the Chief Secretary winds up the debate he will be able to give that reassurance. The Royal College of General Practitioners has warned that the extra costs of the employer’s national insurance hike could force GP surgeries to make redundancies or close altogether, and the Independent Pharmacies Association has warned that community pharmacies will have to find an extra £12,000 a year, on average, to pay for the hike.
Government Policy on Health
Paul Holmes Excerpts(2 months, 2 weeks ago)
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Wes Streeting
My hon. Friend is absolutely right. How fortunate we are to be able to turn to every living former Labour Health Secretary, from Alan Milburn to Andy Burnham, and in every single one of those cases be able to draw on people whose record of delivery led to the shortest waiting times and the highest patient satisfaction in history. I can confirm to my hon. Friend that, both in opposition and in government, I have been talking to the Mayor of Greater Manchester. He is doing some brilliant work on prevention. I am really looking forward to working with all our metro mayors to tackle health inequalities across the country and to improve the integration of health and care services across the land.
Paul Holmes (Hamble Valley) (Con)
I know it will be a novelty for the Secretary of State actually to answer a question during this urgent question, but maybe he will do the House a favour by answering this very simple question with a yes or no. He said that no pass was given to Alan Milburn, so will he guarantee that no confidential documents that could have been used for commercial purposes were accessed or left his Department? Will he take responsibility if any documents or data discussed at ministerial meetings with Alan Milburn leave the Department—yes or no?
Hospice Funding
Paul Holmes Excerpts(7 months ago)
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Paul Holmes (Eastleigh) (Con)
I congratulate my hon. Friends the Members for Hastings and Rye (Sally-Ann Hart) and for Darlington (Peter Gibson) on their hard work to secure the debate, and on their work on the all-party parliamentary group. I led a Westminster Hall debate on this subject on 14 June 2023. I am pleased that we are having this debate, but disappointed that no further progress has been made on the problems we expressed then, given the problems that hon. Members are expressing this evening.
As has been said, the hospice sector does a remarkable job and plays a pivotal role in our health system, providing care and the support needed to those who watch their loved ones pass away, and wonderful care in those weeks until that point. That happened to me and many of my dear friends upon the passing of my office manager Sue Hall on 30 March 2023. She passed away at the age of 57 from lymphoma, leaving her husband Jerry and her daughters Phoebe and Rosie. She was cared for fabulously by the team at Mountbatten hospice in my constituency. The family and I were able to count on the support of the fantastic staff at that hospice, who not only provided the best care that Sue wanted, needed and deserved, but gave us the wraparound support during and after that period.
Like many hospices, Mountbatten provides 24/7 in-patient and community domiciliary care to Southampton and large parts of Hampshire. It supports around 1,000 families every day. Demand for its services is expected to rise by 40% in the next 18 months. It costs £11.5 million to run every year and relies on fundraising, which equates to around 70% of its total budget. NHS contracting represents around 30% of services delivered. However, the funding models in place are inadequate, with the ICB giving only a 2.4% uplift in the contracting of services, when the real rise in costs requires an 8% uplift. For 2025-26, the Hampshire ICB has once again said that there will be no uplift, which means that Mountbatten will need to find an extra £750,000 just to provide the same services that it does today.
Simon Jupp (East Devon) (Con)
Strengthening our local hospices takes pressure off our NHS. My hon. Friend makes a good point that the benefits of fairer funding are plain to see, yet some hospices get no public funding at all from the local NHS. One such hospice is Sidmouth Hospice at Home in my constituency. Dr Sarah Wollaston, formerly of this place and chair of the NHS Devon ICB, still needs to provide a detailed idea of what funding Sidmouth Hospice at Home can get. It does not receive a penny from the NHS in Devon. That is wrong. Does my hon. Friend agree that it cannot be right that some hospice services and charities get funded from integrated care boards—something we should be proud of—while others get nothing at all?
Paul Holmes
I agree. In Hampshire we are lucky that 30% of Mountbatten’s services are contracted by the NHS. The ICB—which is in special measures, as my hon. Friend the Member for Isle of Wight (Bob Seely) said—is not doing a good enough job of providing those services. If a hospice wants to explore getting some of that funding from the national health service, it should be allowed to do so, while recognising the independence of spirit of many hospices that choose to go their own way. My hon. Friend is right to raise the work of the hospice in his constituency, and I hope that it will be able to acquire some ICB funding.
It will cost Mountbatten an extra £750,000 just to provide the same services, while the number of people it supports will rise by 200%. The Minister will say that this Government awarded another £1.5 billion for hospice services through ICBs. That is entirely welcome, and I congratulated her on her announcement in my debate last year. But I say now what I said in that debate: the ICBs are not passing on the money for the purposes set out. ICBs—particularly mine in Hampshire—are riding roughshod over the Government’s wishes and are exacerbating a problem in a system that already fails to take into account the varying nature of needs across different parts of the country.
My hon. Friend the Member for Isle of Wight (Bob Seely) and I had a meeting last week with representatives from our ICB. I asked how much of that £1.5 billion had been awarded to the Hampshire ICB. They could not give an answer. I asked how much of that was allocated to hospices in the region. They could not give an answer. I say what I said last June to the Minister, who is doing an excellent job: that money was very welcome but I hope we can look at a better way of holding ICBs to account, to ensure that when the Government put hard-pressed money into our health system, ICBs deliver it to the frontline services for which it was intended. That is no different in Hampshire. The leadership of Hampshire ICB needs to look at that seriously.
Mountbatten also has to compete with the NHS for its workforce. It rightly chooses to pay and award its staff along the same pay guidelines as NHS staff. This year, that represented a 4.8% rise in costs, and will represent a further 5% next year. Again, I thank the Government for awarding an extra £450,000 to Mountbatten, but that will still leave a deficit of £1 million overall this year. It is right that it chooses to pay its staff adequately, but that will mean Mountbatten will have to lay off some of its workforce, harming outcomes for families in my constituency. That will be the case in the rest of the UK if other hospices have the same problem.
The funding instability—which in my case I blame on the ICB, which is leading a review into hospice care—seems entirely one-sided. It will end up costing the NHS more money, as hospitals will pick up the burden of care, and beds will be used by people who should be in hospices. We all know the impact that energy bills and covid had on the sector.
I do not mean to sound depressing to the House, but we must continue to look at this issue. The Government’s investment is extremely welcome, but we need more. I would like to hear from the Minister how the Government and the NHS nationally intend to work together to provide a sustainable long-term funding settlement for hospice care, while retaining that independence that hon. Members have outlined. We need the Minister to review how much money ICBs are passing on to hospices, and to take a stronger line in reviewing the role of ICBs and holding them to account if they are not giving that money to the frontline.
The Government, the hospice sector and the ICBs have a clear choice: a sustainable funding model for our hospices, or more pressure on an already stretched national health service. The hospice staff I have met care and want to deliver on the challenge that many of our constituents face across the United Kingdom, but they need a level playing field in order to provide that care. Let us help them do that and improve hospice care.
Several hon. Members rose—
Hospice Services: Support
Paul Holmes Excerpts(1 year, 5 months ago)
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Paul Holmes (Eastleigh) (Con)
I beg to move,
That this House has considered support for hospice services.
It is a pleasure to serve under your chairmanship, Ms Nokes. You are intrinsically linked to the Mountbatten hospice, which I will speak about this morning, in your role as the Member of Parliament for Romsey and Southampton North.
I thank the all-party parliamentary group on hospice and end of life care and its chair and co-chair, my hon. Friend the Member for Darlington (Peter Gibson), who is here today, and Baroness Finlay, for their work in promoting and championing the hospice sector. They have a lot of experience in the sector and I am grateful to them for lending me their support in this important debate.
The hospice sector in this country does incredible work for thousands of families and individuals every day. It is a fact of life that we all experience a bereavement at some point, and some of my colleagues know that we recently had the very sad task of saying goodbye to my office manager, Sue Hall. Sue was not just an employee of mine; she was my friend, confidante, an incredible wife and mum, and a friend to all. She was a magnificent woman—a local hero who helped people every day. She never baulked at a challenge or missed an opportunity to show people how much she cared. I am sure many, if not all, of those here have had that special support in their lives from someone they rely on. For me, that person was Sue. I never thought I would have to make do without her by my side.
Sue left us peacefully, surrounded by her family and friends on 30 March. She was comfortable and well looked after, and for that I will ever be grateful to Mountbatten hospice in my constituency, which cared for her at the end of her life. It made her final days and moments a special time for her family and friends. We can all hope at the end of our time on this earth to have an opportunity to say, “Thank you, I love you, and goodbye.” That is a truly special and incredible moment for everyone—one that the hospice Sue stayed in provides for people every day.
Sue’s journey had a profound impact on me as I spent time with her in the hospice learning about the work that it does and the struggles it faces. In a moment of weakness, her son-in-law, Miles Rogers—a good friend of mine—and I agreed to do a charity skydive for Mountbatten hospice on 24 June. The fundraising page is available on my Facebook page if anyone wants to contribute.
Mountbatten Hampshire is a hospice in my constituency that provides 24/7 in-patient and community domiciliary and palliative end of life care services to people across Southampton city and large parts of Hampshire. It also provides rehabilitation and enablement services, as well as psychological and bereavement support to parents and their families. Sue’s family and I will forever be grateful to it for its kindness during Sue’s last days. Having had the pleasure of meeting the hospice’s chief executive officer, Nigel Hartley, and the fantastic staff who work there, I know that their passion and commitment to providing the best possible care for all their patients is their top priority, and they give that care with skill, tact and grace every day.
Alan Mak (Havant) (Con)
I thank my hon. Friend for securing this debate. Rowans Hospice does great work in the Havant constituency, and as a result it engenders a lot of loyalty, including from fundraising and support groups. Will he join me in thanking such groups for their contribution alongside the full-time staff at hospices?
Paul Holmes
I pay tribute to Rowans Hospice and to all the hospices that we will no doubt hear about this morning, given the number of people attending this debate.
As I say, I had the pleasure of meeting the CEO of Mountbatten hospice. Its work does not come without cost, but, as a charity, its services are provided free of charge to all who need them, thanks to the generosity of its amazing community and incredible volunteers, who give their time to support the best possible care for local people during the last years and months of their lives. Mountbatten currently supports around 1,000 families every day, and demand for its services is predicted to rise by 40% in the next 18 months. It costs £11.5 million a year to keep the services running, and the hospice relies on charitable support to fund its 24/7, 365 days a year services to people who need them.
Ellie Reeves (Lewisham West and Penge) (Lab)
St Christopher’s Hospice in my constituency is widely regarded as the first modern hospice, and it is still pioneering today, but it has to fundraise £15 million a year. The cost of living crisis means that its costs are going up and its donations are at risk of going down. Does the hon. Member agree that the Government must review the current funding model?
Paul Holmes
The hon. Lady tempts me to come to content that I will cover later in my speech, but for now she can take it that I wholeheartedly agree, as do many Members here, I suspect.
No one will contest that our health and care staff deserve to be well paid for the incredible work they do, and in an ideal world we would see our life savers and carers never have to worry about their finances and pay, but it would be deeply irresponsible to facilitate pay rises without giving due consideration to the dramatic impact that rising wage costs have on these essential services. To give some specific context, Mountbatten Hampshire took over management of the hospice from the NHS in 2019. It has a contract with the NHS for roughly 35% of its costs, of which about £3.8 million comes from the local NHS commissioners in the form of an outcome-based contract. The hospice follows the NHS pay award each year to remain competitive and to retain and hire staff for its services, which means that the hospice has seen a 4.8% rise in costs this year and will see a further 5% next year, with no corresponding change in its NHS contract, leaving an increasing and worrying financial gap that the charity will find very hard to reconcile without public funding.
Dame Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)
Will the hon. Member give way?
Several hon. Members rose—
Paul Holmes
I am spoilt for choice! I give way to the hon. Member for Hackney South and Shoreditch (Dame Meg Hillier).
Dame Meg Hillier
It is interesting to hear about the Mountbatten, which I spent many years at when it opened, when I was a child. The hospice in my constituency, St. Joseph’s Hospice, is really cutting-edge, but the retrospective payment for nurses will cost it £470,000, and it cannot apply that yet because it has no certainty from commissioners about its funding. To keep it up will be another half a million a year, and it cannot afford that without certainty of funding. I am sure the hon. Member agrees that we need to press the Minister for some clarity on this.
Paul Holmes
I agree with the right hon. Lady; we do. In my experience, the uplift that has been given to local NHS commissioning groups is simply not making it through to those end of life services. I hope we will see some recognition of that from the Minister, and I am sure she will enforce this, to ensure that the funding to local commissioning groups gets through to these services.
Several hon. Members rose—
Paul Holmes
I do not want to be harsh, but I have been warned by the Chair that I should get through my speech. I will make some progress and then give way shortly.
Written evidence submitted to Parliament by Hospice UK records that hospices across the UK employ 12,000 nurses, with 8% of the nursing workforce drawn from bank or agency, which make up a 9,400 full-time equivalent nursing establishment, but they are struggling to recruit registered nurses. A clinical survey in 2021 found that there was an 11% vacancy rate in community-based hospices and a 7% vacancy rate in hospice-based nursing roles in adult hospices, with 16% vacancy rates for hospice-based nursing associate and community-based healthcare assistant roles. The written evidence states:
“Since this data was collected, between March and May 2021, the sense on the ground is that these figures have increased and workforce shortages in UK hospices and across other providers that deliver palliative and end of life care have worsened.”
This is clearly the tip of the iceberg, and further pressures are to follow. Hospices are desperate for more support from the Government. The Mountbatten will end the year with a £1.4 million deficit, with no foreseeable change in the financial forecast with the current funding arrangement. The impact will be felt not only in the care sector but throughout the whole NHS.
Mrs Flick Drummond (Meon Valley) (Con)
My hon. Friend paid a fantastic tribute to his office manager, Sue. Rowans Hospice in my constituency is thinking about increasing its number of beds from 19 to 22, but that will cost an extra £130,000 a year, and the trust is nervous about making that commitment. What he is saying is very important. Does he agree that the Government need to give more money to this valuable service?
Paul Holmes
I suspect that I will be in constant agreement with interventions this morning. My hon. Friend and constituency neighbour makes an astute point, as usual, and she is right to pay tribute to the hospice in her constituency.
Communities such as mine in Eastleigh will suffer as hospices such as Mountbatten have no choice but to reduce their services and the extraordinary high-quality care they offer, and this comes at a time when demand is only growing. As if that were not enough, staffing costs are but one consideration that care providers are having to take into account. As we all know, the soaring price of energy has hit businesses, families and individuals all over the country, and none more so than those in the charity care sector.
Wendy Morton (Aldridge-Brownhills) (Con)
Acorns Children’s Hospice in the Walsall borough supports families and children in my constituency. Does my hon. Friend agree that, in these challenging times when energy prices are on the rise, we want any additional help to include the hospice sector?
Paul Holmes
I thank my right hon. Friend for her intervention. She tempts me to talk about issues that I will come to later in my speech—it is only a couple of pages away, I assure you, Ms Nokes. She is right that hospices have not been included in the energy support given to other charities, even though their services are energy intensive due to the equipment they use. Her point is well made and will be recognised in her constituency.
The energy bill for Mountbatten has risen by an eye-watering £250,000—a fivefold increase—and there has been no additional financial support. One might think that that is surely as high as prices can go, but a London-based hospice has forecast that its energy costs will increase by almost £300,000 a year due to inflation pressures. A north London hospice told Civil Society Media that it faces an energy bill of £433,000 in 2023-24, based on predicted energy costs.
Adult hospices are not the only ones affected by this issue. As my hon. Friend the Member for Winchester (Steve Brine) said in his letters to the Department of Health and Social Care, there is also uncertainty about the children’s hospice grant—a vital source of funding that represented an average of 15% of children’s hospices’ income in 2021-22.
Stephen Hammond (Wimbledon) (Con)
My hon. Friend is absolutely right about the pressures on the sector, which also affect St Raphael’s in my constituency. The Government have been generous with the children’s hospice grant, but it runs out next year, and the lack of certainty is the problem. We would really like the Minister to stand up and say that she will renew the grant after 2023-24, which would provide a huge amount of certainty for the sector.
Paul Holmes
My hon. Friend, who is my past employer, makes a good point—although not as good as when I wrote his speeches. He is absolutely correct that there is uncertainty about that grant, and about how it is handed out by local commissioning groups. It is not getting through to children’s hospices, and I hope the Minister will have something to say about tweaking the way that grant is allocated to local areas.
Jim Shannon (Strangford) (DUP)
Sixty-six per cent. of adult hospice income and 80% of children’s hospice income is raised through fundraising—bake sales, charity shops and marathons—and Marie Curie depends on that more than others. Does the hon. Gentleman agree that we should put on the record our thanks to the volunteers who make the effort and get the money in?
Paul Holmes
The hon. Gentleman is absolutely correct. I only have to see Mountbatten local networks of fundraising and charity supporters, whether in charity shops or in fundraising roles. I am honoured that I may become part of that community—if I land on the ground safety, alongside Miles—but it will not end there. I will carry on fundraising for a fantastic cause.
When Mountbatten hospice wrote to me in January to outline those extraordinary energy costs, I was happy to write on its behalf to the Secretary of State. Unfortunately, the energy bill relief scheme and the later energy bills discount scheme did not ease the pressures, as the hospice was not eligible. Mountbatten still faces unsustainable pressure, as do hospices across the United Kingdom.
Of course, there are some people who ask whether a charity should not take the majority of its funding from its local community—from donations and contributions, rather than from Government funding. That is a fair question, but unfortunately it does not provide a solution, especially considering that community donations already support 70% of Mountbatten’s funding, which it has calculated to be the limit of what it can ask from people.
Andy McDonald
The hon. Gentleman is making an excellent speech. He is right about donations, but my local hospice, Teesside Hospice, is really struggling. I congratulate the hon. Member for Darlington (Peter Gibson) on his work in that respect. Is the hon. Member for Eastleigh (Paul Holmes) not describing a perfect storm? There is a statutory obligation on the NHS to fund hospices for medical care, but the NHS is entirely strapped. Can I divert him away from the solution of asking members of staff to tighten their belts even further? That is not an option. When we cannot recruit and retain, that is not the solution. We need a fundamental reset of the economic settlement.
Paul Holmes
I hope the hon. Gentleman has not taken from my speech that I am suggesting that staff tighten their belts. In fact, I am advocating that hospices be allowed to follow the NHS pay settlement model, and be funded properly to so do. I would say to the hon. Gentleman that the Government have put their hand in their pocket through the £1.5 billion uplift, although that is simply not getting through from the Department of Health and Social Care and local commissioning boards to the hospices. That is where the Government need to step in to a greater extent. Therefore, I ask the Government to take the issue seriously and to continue to treat the charity care sector with the priority it deserves.
Hospices do incredible work, and they represent spectacular value owing to the services they provide. We cannot allow that vital link in the care chain to be broken, or even weakened, particularly at this time. Evidence submitted to the all-party parliamentary group on hospice and end of life care’s report detailed how the covid-19 pandemic made fundraising even more challenging for hospices. Hospices experienced a massive decrease in income while facing unprecedented demand for their services. One hospice’s overnight sitting service had to end due to lack of funding to sustain it, which highlights how dependent those services are on charitable donations.
It is important to highlight the fact that the sustainability of the hospice sector continues to be tested due to the cost of living crisis. Some sort of long-term funding settlement for hospices would be in the interests of all concerned because 160,000 more people each year are expected to require palliative care by the end of 2040. Having sufficient staff and volunteer resourcing in the specialist palliative care field is essential. An ideal outcome would be the Government and the NHS working with the hospice sector to provide an ongoing financial settlement, with regular contractual reviews to ensure that the support that hospices receive is at least the minimum they require to keep services running. That should be directed to cover both staffing and energy cost rises.
Doing that would be in the best interests not only of hospices, because hospices play a vital role in reducing pressure on NHS services by providing bed space and crucial care capacity. The NHS can scarce afford to lose such space and capacity, particularly in the light of the current waiting lists, but lose them it may if action is not taken.
Several hon. Members rose—
Helen Whately
That alludes to exactly the point I made a moment ago. As flagged in that 2022 Act, ICBs have responsibility for commissioning that care, using the budgets they receive through NHS England. I am working to ensure the visibility of the commissioning, to be assured that that is taking place, so that we can be assured about the availability of end of life and palliative care for our communities.
I want to make a final point as I close; I am looking at the clock ticking. Against the backdrop of financial concerns, which I of course recognise and which we are discussing, is the strength of hospices in their communities, and the importance, as mentioned by hon. Friends, that they are not solely financially dependent on the state and the NHS for funding. They receive some NHS funding, but it is important that hospices are successful in fundraising and gaining support from our communities. That is one of the strengths of their model, and I want to continue to support that.
I pay tribute to all the volunteers and those involved in fundraising, including many hon. Members this morning who mentioned the fundraising efforts that they are personally making for hospices in their communities. I wish very good luck to my hon. Friend the Member for Eastleigh for his forthcoming skydive. All credit to him for having the courage to jump out of an aeroplane. I sincerely hope that he is successful.
Helen Whately
I wish him very good luck; it is fabulous that he is doing that for his own hospice. I also commend the efforts of many other hon. Members. I conclude by thanking all hon. Members for coming today and for their contributions to this important debate.
Paul Holmes
Thank you, Ms Nokes. I will briefly wind up by saying thanks to all hon. Members for the heartfelt contributions that they have made. It has been incredibly humbling sitting here. If my career does end on 24 June with my skydive, and this is the one thing I have managed to do, it will be entirely worth it. I thank the Minister for responding. I also thank Sue’s family—her husband Jerry and her girls Rosie and Phoebe—who have been immensely strong over the past year or so.
I hope the Minister has recognised that there are serious concerns about the funding of hospices. In the environment she set out of the ICBs being given the money, she should take credit for the uplift they have been given. I hope that after this morning’s debate she will take a stronger line in holding those ICBs to account because, frankly, that money is not getting through when it should.
Question put and agreed to.
Resolved,
That this House has considered support for hospice services.
Oral Answers to Questions
Paul Holmes Excerpts(1 year, 10 months ago)
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Steve Barclay
I am not surprised that the hon. Gentleman wants to misrepresent the Government’s plan, not least because his own plan is disintegrating before his own Front Bench. The hon. Member for York Central (Rachael Maskell), who spoke earlier, contradicted his point. Not only have the hon. Gentleman’s Front-Bench colleagues contradicted it; even the deputy chair of the British Medical Association has said that Labour’s plan would create higher demand and longer waiting times. I am not surprised that the hon. Gentleman does not want to talk about his own plans anymore; that is why he has taken to distorting ours.
Paul Holmes (Eastleigh) (Con)
Eastleigh, Hedge End and the villages have many vibrant pharmacies, but it is disappointing that Lloyds has closed two branches in my constituency. I welcome the additional £100 million that this Government are investing in community pharmacies, but can my right hon. Friend confirm how that funding will cut NHS waiting times and, more importantly, reverse the trend of closures?
The Parliamentary Under-Secretary of State for Health and Social Care (Neil O’Brien)
My hon. Friend is right. Although pharmacies are private businesses, we invest £2.5 billion in the clinical services they provide. We put in another £100 million in September so that they can provide more services. The number of community pharmacists is up by 18% since 2017, and we have introduced the pharmacy access scheme to ensure that we support pharmacies in areas where there are fewer of them. Clearly, the solution is for pharmacies to do more clinical work, take the burden off GPs and provide accessible services. That is exactly what we will keep growing.
Covid-19 Update
Paul Holmes Excerpts(3 years, 2 months ago)
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Sajid Javid
I was not sure from my hon. Friend’s question whether she was referring only to her own area or more generally in terms of local restrictions. In terms of the plans I announced today, the Government will retain some powers for local restrictions, working with local authorities, if absolutely necessary. If she is interested more in the current situation in her own area, I or other Ministers will be happy to talk with her.
Paul Holmes (Eastleigh) (Con)
Like my hon. Friend the Member for Watford (Dean Russell), may I emphasise to the Secretary of State the amount of anger there is in Eastleigh about not being able to get a face-to-face appointment with a GP? He stood at the Dispatch Box and encouraged GPs to get back to work. If necessary, and if that uptake has not happened, will he instruct them to get back to work, so we can at least have face-to-face appointments for my constituents?
Sajid Javid
I agree with my hon. Friend about the importance of giving patients the choice. Some patients actually prefer not to have a face-to-face appointment. They may be at work and they might like that kind of technology, and that is fine, but the important thing is that for those who want to have a face-to-face appointment it should be made available. The Department and the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Bury St Edmunds (Jo Churchill) are looking at what measures can be taken. My hon. Friend will be more than happy to meet him to take him through some of those initiatives.
Oral Answers to Questions
Paul Holmes Excerpts(3 years, 4 months ago)
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Sajid Javid
The hon. Lady is right to raise this issue. As she has rightly explained, there will be a number of people who, understandably, will be concerned about the move away from regulations to guidance. None the less, there must come a point when we start to remove the restrictions slowly, in a measured way, as we are doing—not least because we want to be able to start dealing much more with all the non-covid health problems that have been created as well. We have provided very clear guidance on masks and it was published yesterday. I hope that the hon. Lady can share that with people who are concerned.
Paul Holmes (Eastleigh) (Con) [V]
Sajid Javid
Yes, I can confirm that. Removing restrictions is not without risk—I accept that—but keeping restrictions is not without cost. As my hon. Friend points out, the restrictions have led to increased domestic violence, child abuse, mental health issues and undiagnosed cancer, which we have heard about today, to name but a few. As we start lifting restrictions, that means that we can better deal with all these major non-covid health problems.
Oral Answers to Questions
Paul Holmes Excerpts(3 years, 7 months ago)
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Ms Dorries
I pay tribute to my hon. Friend and her brave words about her much missed father. Politics divides us, but grief, for many reasons, unites us across this House. I have personally declared to my hon. Friend that I am here should she need me. I pay tribute to her for her bravery, being here today so soon after the loss of her wonderful father. I hear her request; it is constantly under review. Bereavement services are incredibly important to me personally and to many of us. She mentioned the £10.2 million. There are 700 bereavement charities, including the Good Grief Trust. We monitor carefully how people access bereavement services. We know that there is an increased need at the moment and that is being watched very carefully. My hon. Friend is incredibly brave.
Paul Holmes (Eastleigh) (Con)
The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)
We are continuing to work with the NHS and the wider scientific community to understand better the long-lasting effects of covid-19 infection and the potential treatments. We are committed to supporting patients suffering from long covid. Specialist NHS assessment services have opened across England, and the “Your COVID Recovery” website contains support and provides a personalised programme for people recovering from covid-19, following a clinical consultation. More than £30 million of funding has already been committed to research projects and a further £20 million was made available on 25 March.
Paul Holmes [V]
I pay tribute to all NHS and military staff who are administering vaccines across the UK, including to my mum and dad last week. The Minister knows of the debilitating and lasting effects of long covid. She has just outlined the funding elements that she proposes to put forward. Will she tell us whether she might set up a specific taskforce to look at more research into the damage that long covid causes and the effects that it has on so many people?
Jo Churchill
We are already taking strong action in this area; we have already worked hard and are taking long covid seriously. We are listening to patients, taking a patient-first approach, working with the NHS and the wider scientific community, and engaging with the Royal College of General Practitioners to better understand the disease, which is physiological and neurological. It is different for different people, and therefore treatments need to be different for different people. We are working on ensuring that we have the best post-covid assessment care and the best pathways.
Oral Answers to Questions
Paul Holmes Excerpts(4 years, 5 months ago)
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Jo Churchill
There are lessons to be learned; that is essence of my hon. Friend’s question. I have met both Cally Palmer and Professor Peter Johnson throughout the crisis, and our focus on cancer has remained. Ensuring that we deliver on the long-term plan is a key objective, and I am sure that my hon. Friend will work with me on that.
Paul Holmes (Eastleigh) (Con)
The Minister for Care (Helen Whately)
Our health and social care workforce are at the frontline in fighting this cruel disease. I would particularly like to talk about social care workers, who in the past have not had the same recognition as NHS workers. Let this pandemic be the moment when that changed and when we, as a society, recognise the skills, compassion and commitment of our entire care workforce. We have sought to put in place the same support for social care workers as there is for NHS workers and funding to local authorities to pass on to care providers, so that they can pay social care staff full wages for isolating due to covid-19.
Paul Holmes
I wish the Minister a happy birthday. The coronavirus pandemic has highlighted how vital social care workers are to our nation, and we as a House should thank them for the job that they do. Unpaid carers in particular have borne a huge weight throughout this pandemic, so will my hon. Friend tell the House what steps she has taken to support unpaid carers during this period?
Helen Whately
Unpaid carers are vital in our society. Being an unpaid carer is hard at the best of times, but even harder during this pandemic, and my hon. Friend is right to draw attention to that. During the pandemic, we have published guidance specifically for carers. We provided funding to extend the Carers UK helpline, we made unpaid carers a priority group for testing, and we are working with local government to support the reopening of day care services as soon as it is safe to do so.