(9 years, 1 month ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
I hope the hon. Gentleman will pass the message on to his constituents that we were doing the House a courtesy in explaining that we were making progress and outlining a consultation timetable, and that the substantive statement will come in due course owing to the amount of work needed to make sure it is as full and thorough as possible. That is why we made the written ministerial statement. We intend to move as quickly as possible, as we have promised to do.
With all due respect, that is not good enough. There should have been an oral statement in the Commons, which was what the House was led to believe would happen. The fact that there was not a lot to say was not a reason to put out a written statement in the Lords on a Friday afternoon.
Will the excellent Minister, whom I have a lot of time for, confirm the position on the drugs? I have constituents who need drugs that are available but that the NHS is not granting at the moment. There cannot be much money involved; there is just red tape. Can we clear the red tape and let constituents get those drugs?
I thank my hon. Friend, and I have taken note of his comments. NHS England has just announced an accelerated review into hep C drugs, and the Parliamentary Under-Secretary of State for Life Sciences will give my hon. Friend further details on that, but we are moving quickly to ensure that the new range of drugs for hepatitis C in particular is brought into service as quickly as possible.
(9 years, 1 month ago)
Commons ChamberThe integration of the health and social care systems, as talked about by the right hon. Member for Leigh (Andy Burnham), is a very big priority. It is a vision shared by all parties. That is part of delivering safe seven-day care. The consequences for the health and social care system if we do not have safe hospital care are people with much greater medical needs, creating much more pressure in the system, so it is part of the same picture.
I thank the Secretary of State for coming to the House and also, I think, for making two written statements. There are only 32 other written statements from Ministers. I remember that when I first got here, there would be 87 written statements on the last day of term, with no chance to scrutinise the Minister. Following what my hon. Friend the Member for Lewes (Maria Caulfield) said, has the Minister had a chance to look at my Ovarian Cancer (Information) Bill, which would help reduce the number of ovarian cancer deaths through earlier detection?
I thank my hon. Friend for his support for that Bill. I hope that plans that NHS England will announce shortly about how we can improve early cancer detection will give him much encouragement. He will see that some of the things that he is campaigning for are actually going to happen.
(9 years, 1 month ago)
Commons ChamberI gently say to the hon. Lady that we will not take any lessons in safe staffing from the party that left us with the tragedy of Mid Staffs. We have recruited 8,000 more nurses into our hospitals because we have learned the lessons of the Francis report. The important lesson in the report is that it is not simply about the number of nurses; it is about the culture in hospitals and making sure that nurses are supported to give the best care. We want to learn those lessons as well.
In reference to the “Five Year Forward View”, the Secretary of State talked about new modes of working. A very simple thing that could be done is for women’s smear test results to refer to the fact that it is not a test for ovarian cancer, and to then list the symptoms of that cancer. That would not cost any money, but it would save lives.
I am very happy to look into that. The general direction of travel my hon. Friend is talking about is right. We need to empower patients. We need patients to become expert patients, so that they take responsibility for their own healthcare. That means giving them much more information to help them to make the right decisions.
Order. The hon. Gentleman will resume his seat. It is a discourtesy to the House to be long-winded, especially when exhorted not to be. The hon. Gentleman has got—[Interruption.] Order. Do not argue the toss with the Chair, Mr Mulholland. Don’t shake your head, mate. I am telling you what the position is: you were too long. [Interruption.] Leave, that is fine—we can manage without you. [Interruption.] You were too long and you need to learn. That is the end of it. I call Mr Peter Bone.
Does the Secretary of State agree that hospital parking charges are unfair?
(9 years, 2 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
It might help the hon. Lady to know that I will come back to her for a few minutes once the winding-up speeches are finished.
It is a pleasure to serve under your chairmanship, Mr Bone. I pay tribute to the hon. Member for Glasgow Central (Alison Thewliss) for initiating the debate and for her leadership of it. I particularly commend her for tweeting a picture of herself breastfeeding to help launch and publicise the Breastfeeding Network and the campaign this week.
I commend the hon. Members for Dulwich and West Norwood (Helen Hayes), for Aberdeen North (Kirsty Blackman) and for Washington and Sunderland West (Mrs Hodgson) for raising in a short time a number of very important issues. They include issues about the importance of breastfeeding and about women in the workplace; issues, which we had all hoped would become legacy issues, about prejudice and discrimination; and important issues about geographic variation and inequality, including the importance of cultural leadership in changing attitudes.
There were specific questions on policy, which I will try to come to in a moment. I just want to take this opportunity to celebrate and promote National Breastfeeding Week, which runs from 20 to 28 June. It is an excellent initiative and it is particularly good to see it so active on Twitter, which may be to the credit of the hon. Member for Glasgow Central, and to see the plethora of activities going on around the country and the sharing of good practice and experiences by women and health professionals in place-based and virtual networks. That is genuinely inspirational, and the Department and I look forward to seeing other activities organised by local groups around the country this week.
It will not have escaped your beady eye, Mr Bone, that I am, on a gender basis, the least qualified person in the room to be responding to the debate, but I am pleased that the shadow Minister, the hon. Member for Washington and Sunderland West, highlighted the fact that I am the Minister responsible for life and health sciences. This issue goes to the heart of our thinking more broadly about how we unleash the power of the NHS and our health system more generally to support and drive public health.
Before coming to the House, I worked in biomedical research. I had the great privilege of working at the Institute of Child Health, which is doing extraordinary work on the importance of pre and post-natal nutrition for long-term health outcomes. Extraordinary data are beginning to appear on the importance of early nutrition in determining our long-term health. As the Minister responsible for the National Institute for Health Research, as well as the whizzy high science of tomorrow’s technologies, I can say that we also have at the heart of the NHS a commitment to ensure, through the institute, that we are constantly using the power of our health system to drive public health and to promote best practice.
The Department of Health is working closely with our partners at UNICEF, the Royal College of Midwives, the Institute of Health Visiting, NHS England and Public Health England to co-ordinate our awareness messaging this week. This debate provides an invaluable opportunity for Members of Parliament to discuss these important issues.
It may help if I begin by setting out the Department’s view on breastfeeding in England, which is the only place for which I can speak. It is widely agreed that breastfeeding delivers significant health benefits for both the mother and her baby and is more cost-effective for mothers than other methods of infant feeding. A mother’s milk provides a perfect balance of nutrients and vitamins for the first six months of a child’s life. That is why the World Health Organisation and the Department of Health encourage exclusive breastfeeding for the first six months.
The Department is aware, however, that infant feeding choices are complex and personal, based as they are on individual and family circumstances. That is right. Not all mothers choose to or are able to breastfeed. In line with UNICEF’s Baby Friendly guidelines, all mothers should be supported to make informed decisions and to develop a close relationship with their babies soon after birth.
The evidence shows that, in addition to providing all the nutrients and vitamins that a baby needs, breast milk also protects him or her from infections and diseases. Breastfed babies are less likely to develop diarrhoea, vomiting and chest infections, leading to fewer hospital visits; and they are less likely to become obese both as children and in later life. Breastfeeding can also reduce the chances for some women of getting diseases such as breast or ovarian cancer later in life. The evidence and data also show that breastfeeding as soon as possible following birth helps to start the bonding process between a mother and her baby. We know that secure parent-child attachment results in better social and emotional wellbeing among children. Furthermore, evidence shows that that, in turn, has important implications in terms of life prospects for the infant.
I am pleased that the breastfeeding initiation rate in England has increased from about 62% in 2005-06 to 73.9% in the third quarter of 2014-15. The Office for National Statistics will publish the full-year figures in a couple of weeks. However, breastfeeding initiation rates vary widely across clinical commissioning group areas, from 43.9% in NHS South Sefton to 93.4% in NHS Lambeth.
While we understand that cultural differences exist in different areas, it is important that all new mothers receive the best quality of care no matter who they are or where they live. We encourage local commissioners and services to use their resources, and opportunities such as National Breastfeeding Week, to reduce such variations and increase overall breastfeeding rates.
Increased awareness of the health risks associated with not breastfeeding has brought about a drive in recent years to improve breastfeeding support and increase breastfeeding prevalence rates. Support and information is currently available to health professionals and parents through a range of channels such as the NHS Choices website under the Start4Life banner; the national breastfeeding helpline; the UNICEF UK Baby Friendly initiative; and local peer support programmes.
Parents-to-be and new mothers and fathers can also sign up to the Start4life information service for parents. Subscribers receive regular free emails, videos and text messages that offer high quality advice and information based on the stage of pregnancy and the age of the child. That service includes breastfeeding and signposts parents to other quality-assured information about parenting, relationship support and benefits advice.
In the past five years, I am delighted to say that we have recruited more than 2,100 more midwives into the NHS. We are training a further 6,400, who will provide women with the information, advice and support they need to breastfeed. In addition, appropriately trained and supervised maternity support workers play an important role in supporting women with breastfeeding and helping midwives to run parentcraft classes. In the past five years, 2,000 new health visitors have been recruited and we are on track to reach our target of 4,200 by the end of the year.
I will try to answer the important questions raised in the few minutes available; if I am beaten by the clock, perhaps I can write to hon. Members. The hon. Member for Glasgow Central mentioned the National Infant Feeding Network. In 2014, the Department of Health provided £30,000 to UNICEF UK to support the establishment of the network, which shares and promotes evidence-based practice on infant feeding and early childhood development to deliver optimum outcomes. It comprises 600 infant feeding specialists and supports 30,000 health professionals who, in turn, are responsible for caring for more than 650,000 mothers.
The network approached the Department for funding support in 2015. Unfortunately, its request could not be accommodated because it came in too late for the 2015-16 budget. However, we continue to work closely with the network co-ordinators on future funding.
The hon. Lady also raised the breastfeeding rights of women in the workplace. Specific health and safety requirements relating to new and expectant mothers at work are contained in regulations 16 to 18 of the Management of Health and Safety at Work Regulations 1999. A woman can ask her employer to provide a private, safe and healthy space to allow her to express milk and a fridge to store it in.
On the UNICEF UK Baby Friendly initiative, I repeat that we want to encourage more women to breastfeed. That is why we welcome the revised Baby Friendly standards that support feeding and relationship building. It is great to see that, across the UK, 91% of maternity services and 88% of health visiting services are working towards Baby Friendly accreditation. In the UK, 49% of maternity services, 51% of health visiting services, 37% of university midwifery courses and 9% of health visiting courses currently have full Baby Friendly accreditation.
On the infant feeding survey, I am happy to confirm that the Government’s policy is to improve outcomes for women and their babies. To do that, we need current information to inform policy and service delivery. The statistics that NHS England regularly gathers capture data from all women using NHS services, rather than from the periodic survey samples. From 2016, the maternity and children’s dataset will, for the first time, link a mother’s health and behaviours during pregnancy and post-natally to outcomes for herself. I will happily write with more details on that and on the issue of breast milk substitutes, since I am defeated by the clock.
The Minister is certainly not defeated by the clock; it is at 5.44 pm that the debate will now finish.
Thank you, Mr Bone. I apologise; I was merely stretching my legs as I saw the clock hit the 5.30 button. I was not expecting the vote. I am delighted that I have more time to finish dealing with the two questions. There was an important question on breast milk substitutes.
For mothers who choose to use formula milk, it is important that measures are in place to protect babies’ health and that all the parents have the information they need to make the right choice. The Government provide advice for parents on maternal and infant nutrition via NHS Choices and the NHS Start4life information service.
The international code of marketing of breast milk substitutes is an international health policy framework to regulate the marketing of breast milk substitutes. In view of the vulnerability of babies in the early months of life and the risks involved in inappropriate feeding, the marketing of breast milk substitutes requires special treatment. Baby Friendly accreditation requires services to implement the requirements of the code, which goes further than UK law in regulating marketing activity. To meet the Baby Friendly standards, services must ensure that there is no promotion of breast milk substitutes, bottles, teats or dummies in any part of the facility or by any of the staff.
The Infant Formula and Follow-on Formula (England) Regulations 2007 are designed to ensure that all types of infant formulae meet the nutritional needs of babies, while ensuring that breastfeeding is not undermined by the advertising, marketing and promotion of such products. The regulations include strict controls on the promotion, labelling and composition of infant and follow-on formula and set out clear guidance for infant formula manufacturers on how the regulations should be implemented.
Finally, there was a question about the National Infant Feeding Network, which I think I have dealt with. If there are any other issues, I will happily respond by letter. I shall leave enough time for the hon. Member for Glasgow Central to close the debate.
I thank the Minister and all the Members who have spoken today; the fact that they came along and participated is very much appreciated. I can see from Twitter that the debate has been getting a good and interesting response. I thank the hon. Member for Dulwich and West Norwood (Helen Hayes) for her contribution and for her support for the organisations in her area that clearly need it at this time. Where we have instances of good practice in breastfeeding in this country, we must absolutely support services in every way we can. It is absolutely true that if we lose the expertise and the service, that will set breastfeeding back hugely and it will be difficult to re-establish.
My hon. Friend the Member for Aberdeen North (Kirsty Blackman) spoke passionately about the support required, about the importance of the consistency of a network and about the importance of having experienced midwife support. Experienced professional advice must be given, and it can be given only, whatever the circumstances, by seeing somebody physically. The answer cannot always be to do things online.
The Minister made the point about follow-on milk, commercialisation and the implementation of the code. I still think that we have issues. We can go further to implement the code; it is clear that the implication of some of the adverts for follow-on milk is that if women breastfeed for a year or two, their milk might not contain enough nutrients for their child. The opposite is true—it contains all the nutrients that are needed. That is exactly and specifically how nature has designed it for the healthy development of children.
I thank the hon. Member for Washington and Sunderland West (Mrs Hodgson) for her contribution. She is hugely experienced and clearly very passionate about the subject, which is great. There are lots of obstacles in the way, not least women returning to work, and we need to be mindful of that and how best we can offer support. We need to make breastfeeding a normal process so that women do not feel embarrassed about asking to nip out to express milk or going to visit the nursery to feed their child.
I had a strange experience last summer as a volunteer at the Commonwealth games in Glasgow. It was the longest time I had been away from my baby at that point. I found it very difficult to explain to a room of strangers that I was nipping out for a couple of minutes to express milk and to ask whether I could hide it in the fridge somewhere. The situation is difficult and awkward; we need to be aware of that. Employers need to be aware of their obligations and how to make it easy for people, so that there is a private space where they will not be interrupted. People should not be offered a corner of a busy lunchroom and certainly never a toilet, because that is disgusting, frankly. We would not eat our lunch in the toilet, so we should not expect anyone else to.
The point about images and showing the world what breastfeeding looks like was interesting. The Minister commented that I had tweeted a picture at the weekend; someone came up to me yesterday and said, “That’s very daring of you!” and “That’s very brave of you!” To be honest, I did not think about it. I was holding a baby; there was nothing particularly to see in the picture other than me feeding my daughter. I thought, “What a strange reaction.” To me, it is completely natural; I do it almost without thinking.
I put the picture up to publicise the importance of the debate and National Breastfeeding Week. If we look at the hashtag, we will see women doing similar across the internet just now. It is a process of normalising the activity—perhaps making a breastfeeding selfie something that people do, rather than draw back from. The issue is about making breastfeeding part of everyday life that people see all the time. If people do not see women breastfeeding, do not know anyone who breastfeeds and all they see are women feeding children with bottles, they will think that breastfeeding is odd and may not feel brave enough—because it will feel brave—to attempt it themselves.
We need to think carefully about how we normalise breastfeeding and how families, extended families and friends can best support women when they are doing it. My neighbours in Glasgow were keen to help their daughters and daughters-in-law by taking their babies overnight when they were tiny to give the mother a break. Although that is a wonderful thing to do to help, it will not help breastfeeding at all and will make it all the more difficult. We all need to think about our roles as part of families, the things we say and the way in which we say them—not say, “You must be exhausted”, but rather, “Can I make you a wee cup of tea?” It is about finding ways to support people rather than passing comment or using phrases that almost feel undermining at every turn. We need to think about that as much as we can.
Order. We are all finding our way with the new system that we have only just implemented in Westminster Hall. The wind-up speech should really be very brief—probably about two minutes. I think the hon. Lady has been going for more than five minutes, so she might want to bring her contribution to an end.
Thank you, Mr Bone. I have found it difficult because the time is not what I expected it to be, so I was unsure about whether I was running out of time and how long I had. I thank the Minister for his contribution. I still think that there are lots of issues that we, as individual Members, ought to take up in this Parliament to support mothers in any way we can. I thank hon. Members again for attending.
Question put and agreed to.
Resolved,
That this House has considered National Breastfeeding Week.
(9 years, 2 months ago)
Commons ChamberIt is a matter of fact that we increased nursing numbers. The hon. Lady will be well aware that when we came into office in 1997, we were training 15,000 nurses a year, and when we left office in 2010, we were training 20,000 nurses a year.
On social care, under this Government, 300,000 fewer older people are getting the care they need, with more and more people being forced to stay in hospital. But that is only part of the story. When someone who needs care cannot get the help they need, it increases the risk that they will struggle or fall ill and have to go to accident and emergency. That is clearly demonstrated in the increasing number of older people arriving at A&E by ambulance. Almost 100,000 extra patients over the age of 90 were brought to accident and emergency by ambulance last year. That is an indictment of Government policy towards older people, and the problem is further exacerbated when the true scale of the damage to social care is revealed.
Before the election, the National Audit Office published its report on the impact of Government cuts on local council budgets. The report found that 40% of the total savings between 2013-14 and 2014-15 were made through reducing adult social care services.
The Association of Directors of Adult Social Services has calculated that a further £1.1 billion will be cut from adult social care over this financial year, and the president of the association said:
“Short-changing social care is short-sighted and short-term.”
The number of patients ending up in A&E because they cannot get the care they need to help them stay healthy outside hospital is clear evidence of this short-termism.
Cutting the social care budget is clearly a false economy, as thousands turn to A&E as a result. That is bad not only for the patient, but for the taxpayer. If a patient is not getting the care they need, their condition will deteriorate, which means that more complex interventions will be needed. A recent poll commissioned by the Care and Support Alliance found that nine out of 10 GPs believe that deep social care cuts are responsible for the overcrowding in our accident and emergency departments. The Government need to get a grip and address the crisis in social care in order to relieve the pressure on A&E departments and GP surgeries. Instead, they have chosen to risk putting more pressure on the heath system at all levels by announcing further cuts of £200 million to the public health budgets of local authorities without any idea of whether they can be made without harming vital services—services that potentially save money.
Will the shadow Minister recognise the initiative that is happening in north Northamptonshire? Kettering general hospital will have not only an A&E, but urgent care, social care and mental health facilities and GPs all on the same site. People can go to the hospital and be dealt with there and then, correctly. I will also have an urgent care centre in my constituency. Is that not the way forward?
I am grateful to the hon. Gentleman for his intervention. I absolutely agree that models such as that and local best practice can exist in pockets all over the country. It is just a shame that so many health economies are getting cut to the bone, because that stops them developing such care models. He is right that it is precisely that kind of integration that points the way to the future. Have the effects of these public health budget cuts on primary care and accident and emergency been modelled by the Department, and will the Minister share that work with the House? If that work has not been done, will he explain why? Has the Department consulted on these latest cuts, and what was the response?
I now wish to turn to the situation in general practice. In the previous Parliament, we saw a marked increase in the number of people waiting longer for a GP appointment. By 2013-14, almost 6 million people could not get a GP appointment. If the trend continues, that figure could be around 10 million by the end of this Parliament. Those people are often left with little option but to turn to accident and emergency. The GP patient survey suggests that almost 1 million patients went to A&E last year because they could not get a convenient GP appointment. It is clear that the GP workforce crisis is a major driver of the issues under discussion today.
(9 years, 2 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
I welcome the hon. Lady to her place. We are now repeating discussions we had in the previous Parliament, because I am afraid that the Labour party still does not understand that these decisions are not being directed from Whitehall. I know that is uncomfortable for them, because what they want to do is pull a lever and hope that something happens at the other end, but that does not work. The only way to get success is by having local clinicians, supported by national bodies, providing the solutions that local people deserve.
In North Northamptonshire we had a problem with the A&E at Kettering hospital. Local commissioners and three hon. Members—my hon. Friends the Members for Kettering (Mr Hollobone) and for Corby (Tom Pursglove) and I—all worked together to produce a plan, which the Minister has taken up. That is a precursor to the success regime, and it shows that local commissioners, local hospitals and MPs can solve problems by working together. Will the Minister continue to look on that favourably?
The care of my hon. Friend’s constituents, including Mrs Bone, is always a prime consideration. He has shown what Opposition Front Benchers should understand, which is that working across parties, as he did in his part of the world, can bring about co-ordination and success. I only wish that those on the Opposition Front Bench, on what should be a clean slate, would do the same.
(9 years, 5 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
The hon. Gentleman is right, of course. He gives a tantalising flavour of the climax of my speech, which will be about the urgent care hub proposal for Kettering general hospital, on which he, I and my hon. Friend the Member for Wellingborough have been working together.
It is a pleasure to serve under your chairmanship, Mr Gray. I congratulate my hon. Friend on securing this important debate. Before he moves on to the climax, which we are all waiting to hear, may I mention, in addition to the work of the hospital and its staff, the contribution of support organisations? One of those is Crazy Hats, a local breast cancer charity run by Glennis Hooper, who is a remarkable lady. All three of us MPs took part in the charity walk on Sunday.
Yes—not only have we three north Northamptonshire Members worked on a cross-party basis to secure the future of our local hospital, but we all dressed up in funny outfits on Sunday to walk around Wicksteed park in Kettering in support of Glennis Hooper and the marvellous work she does for Crazy Hats, which raises money for cancer treatment and care for our constituents. I suppose that it is part of an MP’s job on occasion to dress up in a funny costume and look silly for the benefit of constituents, and we are all pleased to do that.
Some further good news about Kettering general hospital, from Department of Health statistics, is that finished consultant episodes when any procedure took place in the hospital—which I think is bureaucracy-speak for the number of operations—went up from 49,638 in 2010 to 53,869 in 2013. I am told that there are 43 more hospital doctors and 55 more nurses than in 2010 and there is a 24% increase in diagnostic tests, a one third increase in the number of people treated for cancer and a 71% increase in the number of MRI scans performed. Of course just two years ago the £30 million foundation wing was opened. It has a 16-bed intensive care unit, a 28-bed cardiac unit and a 32-bed children’s unit. That was massive new investment in our local hospital.
It should not be forgotten—and we three Members of Parliament for the area do not forget—that increasingly Kettering general hospital offers our constituents world-class health care. The latest example of that is the cardiac investigations department, which has received national recognition for its high standards in heart ultrasound scanning. Every year 8,000 of our constituents are patients through that unit, which provides ultrasound scans of the heart. Those can reveal diseases such as heart failure and valve diseases.
The hon. Gentleman is right. That is a good example of the way Kettering general hospital has raised its game to tackle local health needs. Increasingly, our constituents do not have to go to Glenfield, because they can get better care at their local hospital. In the case in question, that is because of the £300,000 investment in three state-of-the-art ultrasound scanners, which can show the heart in three dimensions. The 16-strong cardiac investigations team has been awarded accreditation by the British Society of Echocardiography, which is an affiliate of the British Cardiovascular Society. That accolade is not given lightly. Kettering hospital is one of only 38 in the country to have achieved that accreditation; some specialist centres, such as Glenfield, Papworth, John Radcliffe and Coventry, have not yet attained it.
The £4 million upgrade of the maternity department at Kettering general hospital started in December. An average of 10 babies per day are delivered at the hospital—including the babies of Members who are here today. It is part of an £18 million investment in the hospital.
In coming to the climax of my remarks, I want to talk about the innovative proposal for an urgent care hub at the hospital—my colleagues will appreciate this, because we have been working on it together. Over the past few months, the hospital has been liaising with partners and developing a strategic case for an urgent care hub on the hospital site to tackle long-term, urgent care pressure relating to population growth, about which we have spoken; age and acuity; and increasing public demand for prompt access to urgent care.
In December, the trust shared its strategic case with the foundation trust regulator, Monitor, which is currently considering the proposal. If Monitor approves the case, it will go on to an outline business case and finally a full business case for approval by Monitor, the Department of Health and the Treasury. The key to its success is that the hospital has been working in close collaboration with its health and social care partners. It is developing what is essentially a one-stop shop for our constituents who need urgent medical care.
The aim is to develop a £30 million urgent care hub on the hospital site that will combine secondary care, hospital A and E and urgent care assessment with primary care—in other words, GP services, minor injury care and social and community care services. The proposal has arisen because there has been significant growth in demand for that type of urgent care in the local health economy of our three constituencies, partly due to a 30% population growth over the past 19 years, with another 9% expected by 2020, and a rise in the population of older people, about which we have spoken. There has also been a massive 83% increase in the use of A and E over the past 20 years as a means of accessing urgent care.
My hon. Friend is outlining an exciting new project. The scheme will include a minor injuries and accidents unit at the Isebrook hospital, which will relieve up to 40% of my constituents from having to go to Kettering. It is bang next to a 24-hour GP service, so that is exciting for my constituents, too.
My hon. Friend has rightly made that issue a priority for his constituents, and he has led an effective campaign on it. That facility will be similar to the facility currently in operation in Corby. The idea is to treat people as locally as possible so they do not have to present themselves at Kettering’s A and E department. It is all part of making local health care delivery more efficient and effective, and my hon. Friend is right to highlight it.
(9 years, 6 months ago)
Commons ChamberI thank the hon. Gentleman for that intervention. It was clear last night when we heard from the affected families that they wanted that choice, and these regulations very specifically only apply to those families that are affected by mitochondrial disease.
I am going to finish my point, if I may.
In the intervening years the science and ethics of these techniques have been extensively debated. The Nuffield Council on Bioethics and the HFEA held extensive public consultations in 2012 and identified broad public support for the use of these techniques. There have been three expert scientific review panels—in April 2011, March 2013 and June 2014—all of which found no evidence to suggest that the techniques are unsafe for clinical use, and only last week a group of eminent scientists and experts in medical ethics, including Professor Sir John Sulston, Baroness Warnock and Sir Paul Nurse, wrote to The Times urging Parliament to approve the new regulations. They argued that the question parliamentarians must consider is not whether we would want to use this technique ourselves, but whether there are grounds to prevent affected families from doing so. I again reiterate what we have heard in the representations from families, and particularly women of child-bearing age: they want the opportunity to use these techniques.
The hon. Lady is making a very good speech and is trying to make it balanced. She talked about last night’s meeting, which I understand went on for quite some time, and there has been a lot of debate outside this Chamber, but is she satisfied that we come here to the Chamber this afternoon with only 90 minutes to discuss this? Would it not be better if we were to withdraw this motion today and come back with more time to debate it next week?
Unfortunately, it is not in the Opposition’s gift to determine the time allocated for these debates. I would have welcomed further debate, and we had an opportunity in a previous Backbench Business Committee-initiated debate to discuss these matters.
It is simply that this legislation will open up research that is illegal, as I shall describe in a moment. I also think there are greater concerns about generations down the line.
The EU clinical trials directive, which applies to all clinical work, states:
“No gene therapy trials may be carried out that result in modification to the subject’s germline genetic identity.”
The HFEA itself has said that this procedure does. In the legal opinion on the regulations, Lord Brennan QC has said that they are caught by the directive and that they are
“likely to be in breach of EU law”
on clinical trials.
The Department of Health examined the legal opinion but rejected it, saying that the licence will not be granted for clinical trial but for treatment and therefore will not be caught by that law. Apparently, this is not about clinical trials and furthering the science but about going straight for treatment.
Lord Brennan’s opinion anticipated that. He set out the relevant paragraphs from the 2011 report on safety from the review panel set up by the Secretary of State to monitor the procedures to the HFEA, which said:
“Once assessed as safe to use in clinical practice, the panel strongly recommends that permission is sought from the parents of the children born from MST and PNT to be followed up for an extensive period”
and that such permission should be sought from the children themselves once they are old enough. In the case of females, that should ideally be to the next generation. Those recommendations should also apply to pre-implantation genetic diagnosis for mitochondrial DNA genetic disease.
I think they are doing that because the legislation on the EU clinical trials directive will be tightened up even more next year.
Until knowledge has built up that says otherwise, the panel recommends that any female born following MST or PNT should be advised, when old enough, that she herself might be at risk of having a child with a significant level of mutant mitochondrial DNA. The HFEA is putting that child and, if they are female, subsequent generations at risk.
I have only a minute left but my speech would cover more than that time. It is nonsense to try to ram through this statutory instrument in no time at all. This is not about whether we should be helping families afflicted by this appalling disease but about saying we should get things right. We should ensure that this is done properly, with proper parliamentary scrutiny. The ultimate role of Government is to protect the safety of the citizens of this country and the regulations do not do that. They open the gates to a procedure that is completely untested, with no pre-clinical trials or clinical trials. The regulations talk about going straight to treatment and that has all been done so that the Department of Health can wangle its way around the legislation, or so it thinks. This is terrible. It is not good for the families with this chronic, horrible disease. We need proper and considered research. If these regulations were on genetically modified crops, we would all be up in arms. That is what is happening here.
(9 years, 6 months ago)
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That advice was issued in the west midlands, and not in Salford. The hon. Lady talked about the reorganisation. Well, that reorganisation means that we have been able to afford 82 more hospital doctors and 589 more nurses in her area, which is helping her constituents. Salford is one of the best examples of integrated care in the country, which is why any hospital declaring a major incident should think about the impact on the rest of the NHS locally. That is what the guidance says.
The shadow Secretary of State is a very honourable gentleman, but he might live to regret this political football stuff. In north Northamptonshire, my hon. Friend the Member for Kettering (Mr Hollobone), the hon. Member for Corby (Andy Sawford) and I are working together on local decisions about our A and E. Surely that, and not political football, is the way forward.
My hon. Friend is absolutely right. I have spoken to the chief executive of Northamptonshire county council and I have heard about the excellent integration of services that is now starting to happen between the local authority and the local hospital. That is the way forward. The guidance simply says that trusts must pay attention to the impact on the local health economy before they make a local decision. It is time that Labour stopped playing politics with something that they know is a disgrace.
(9 years, 7 months ago)
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That is a legitimate concern and fear, but the arrangements have the potential to avoid that risk, so that those concerns and fears are not realised; I will expand on that in a moment.
Guidance will be issued later this month setting out the detail of the proposed changes, alongside the criteria that determines which service is commissioned at which level. The engagement programme will include a number of patient and public engagement events and workshops in February, led by regional and area teams, to help to co-design the process for implementing the changes with CCGs. I encourage involvement with that programme, and as part of it NHS England will seek views on the criteria to decide which service is best commissioned at which level.
NHS England acknowledges that people are concerned about the re-emergence of a “postcode lottery”—the hon. Member for Alyn and Deeside specifically mentioned that point—as a result of a more collaborative approach. In particular, people are concerned that specialised services could once again be commissioned in a variety of ways across the country, resulting in patients experiencing difficulties in accessing services.
I totally understand why people have that anxiety, but let me be clear that NHS England would remain the accountable commissioner for any services commissioned collaboratively with CCGs. My hon. Friend the Member for St Austell and Newquay referred to the Health Committee’s concerns about the previous arrangements. However, because NHS England would remain the accountable commissioner and because commissioning would be done collaboratively, I think that concern has been sufficiently addressed.
Since April 2013, NHS England has achieved significant progress in developing a set of nationally consistent service standards and commissioning policies, which have been widely welcomed. They ensure equity of access to high quality services; the point about access was referred to by a number of hon. Members. These standards and policies will still apply for specialised services that are jointly commissioned by NHS England and CCGs, and NHS England will continue to improve on those in the years to come. I think that the shadow Minister, the hon. Member for Copeland (Mr Reed), also raised concerns about access and I hope that he finds what I have said about it reassuring.
For any services that are fully devolved to CCGs, allocations will be made on the basis of activity. Data from NHS England area teams would be used to trace historical activity levels and CCG funding allocations would be based on those, with adequate adjustments for population increase.
The purpose of the move to collaborative commissioning is to support more effective joint working and to allow discussions about service redesign to take place across the local health economy, engaging both national level and local level to try to build capacity.
In the short term, patients should not notice any difference to the service they receive, and in the medium to long term NHS England is confident that these changes should result in improvements, rather than a deterioration—including improved outcomes for patients, more integrated pathways and a better patient experience. We continue to work closely with NHS England as it develops these proposals and engages with all those involved in the commissioning of specialised services, including CCGs, individual patients and—critically—patient groups, area team commissioners and providers of services.
I thank all hon. Members and the sole right hon. Member here today, the right hon. Member for Wolverhampton South East, for contributing to this debate in a constructive way. The issues that have been discussed are of real concern, and it is right that they should have been raised. However, I think we have the potential to improve the way in which the system operates.
I thank all right hon. and hon. Members for this excellent debate.
Question put and agreed to.