Oral Answers to Questions

Philip Dunne Excerpts

Tuesday 15th November 2016 Commons Chamber

[Dan Jarvis (Barnsley Central) (Lab)]

1. What plans he has to prevent excess deaths in the winter of 2016-17.

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

Last week, NHS England and Public Health England launched the Stay Well This Winter campaign, which last year reached 98% of the over 65s. This year, for the first time, children in year 3 will be offered free flu vaccine, which means that an additional 600,000 children will be protected this winter, making this the largest children’s flu vaccination programme to date. The Government also provide practical support for those most at risk, including winter fuel payments and the warm home discount scheme. We are also working with the NHS and local authorities to implement our cold weather plan, which is poised to respond to pressures on vital health and social care services this winter.

[Dan Jarvis]

It is a national disgrace that so many people die needlessly in this country as a result of the cold each year—43,900 people died over the winter of 2014-15. When will somebody in Government accept some responsibility, show some leadership and act decisively to reduce the appalling number of people who die each winter as a result of the cold?

[Mr Dunne]

I congratulate the hon. Gentleman on the interest that he takes in this subject. I know that he has a petition currently running in his local area. We do take very seriously the additional pressures placed on the NHS primarily by the winter weather but also by disease prevalence, particularly flu. We started winter planning for this coming winter early in the summer. We have regular updates, which I run, and I report to the Secretary of State on how those plans are going. I can assure him that we are taking as many steps as we can to ensure that we are on top of this issue this winter.

[Sir Simon Burns (Chelmsford) (Con)]

As part of the plans to reduce and prevent deaths during the winter, what changes have been made with regard to the winter fuel payments for those eligible residents living in the Mediterranean?

[Mr Dunne]

My right hon. Friend refers to the changes that we introduced under this Government with effect from last year, 2015-16, to reduce the eligibility for those British citizens living in warmer climates around the Mediterranean, which I know caused him considerable concern. I am pleased to be able to tell him that the change in policy last year reduced the amount paid under the winter fuel payments by 70% compared with the previous year to those people living in the European economic area.

[Ian Austin (Dudley North) (Lab)]

One way of preventing excess winter deaths would be to ensure that people can go to their local pharmacy for advice, essential medicines and flu vaccines. Plans to cut pharmacy budgets will hit Dudley hard, with just 1%—one out of Dudley’s 100 pharmacies—getting extra support, compared with 40% in places such as Chesham and Hampshire. Of the thousands of local residents who completed my survey, 97% said that they opposed these cuts. Why will the Minister not listen to the people of Dudley and sort this out?

[Mr Dunne]

I wonder whether the hon. Gentleman included in his survey the fact that the reduction in the establishment payment to each pharmacy will be of the order of £200 a week from 1 December, and £400 a week from 1 April. How many of those pharmacies in Dudley will not be able to sustain that reduction in Government subsidy? We use community pharmacies to undertake flu vaccinations for which they will be paid.

[Dr Andrew Murrison (South West Wiltshire) (Con)]

What can be done to reduce the effect of winter pressures on the bed state of our acute hospitals and thus reduce the awful phenomenon of bed blocking this winter?

[Mr Dunne]

As my hon. Friend knows, we are taking steps, in particular through the sustainable transformation plans, to increase the integration of social care and the health sector. For this winter, we are working hard on delayed transfers of care, to try to ensure that there is more rapid patient flow through our hospitals. That involves closer integration with social care professionals to encourage quicker discharges from the hospitals.

[Mr Dennis Skinner (Bolsover) (Lab)]

One way of making sure that people do not die in the winter or at any other time is for this Government to concentrate on keeping hospitals open, thereby saving the beds. In that context, why does the Secretary of State refuse to answer the question why hospitals such as Bolsover and another half a dozen in Derbyshire are secretly being closed and Ministers are doing nothing about it?

[Mr Dunne]

The question is about flu vaccinations and I strongly encourage the hon. Gentleman to join me in having a flu vaccination, as I believe he is one of the eligible individuals. In relation to Derbyshire, the local health services there are working together to identify the best pattern of provision for a sustainable health service for the future.

[Mr Speaker]

The question was about the prevention of excess deaths, so the hon. Member for Bolsover (Mr Skinner) was entirely in order in his interpretation of the question. It was not about flu vaccinations, and nobody should mislead the House, however inadvertently.

[Mr Philip Hollobone (Kettering) (Con)]

Kettering general hospital would be better able to deal with winter pressures were it given permission to develop its urgent care hub. The hospital tells me that its application has been with NHS Improvement for nine months now. Will the Minister prod NHS Improvement to get a move on in approving this application?

[Mr Dunne]

My hon. Friend held an Adjournment debate recently which I was pleased to respond to. We discussed the status of Kettering general hospital and the foundation trust that runs it. He is correct that it is discussing with NHS Improvement the development of a business case for an urgent care hub, and this is being considered in the context of the wider sustainability and transformation plan. Mr Speaker, I accept your admonishment in respect of my answer to the previous question. Of course, one of the primary solutions to winter excess deaths is the flu vaccination programme.

[Mr Speaker]

Or even admonition.

--- Later in debate ---

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

Last year, the NHS in England handled 2.4 million more A&E attendances than when this Government took office. There has been a 4.6% increase in attendances, compared with only a 1.2% increase in Scotland. Despite that significant increase in demand the NHS has coped well, with nine out of 10 patients still seen within four hours.

[Alan Brown]

I thank the Minister for that answer, but the truth is it must do better and needs more support. In September, only 86% of patients were treated within the four hour target time in English A&E departments; by contrast, in Scotland it was 95%, for a record consecutive period. Given that winter is coming, what will the Minister do to ensure the service copes?

[Mr Dunne]

The hon. Gentleman should know that, according to figures for the most recent month available, 90.6% of A&E attendances were seen within the four hours. We are aware that the system remains under pressure, and are putting efforts into identifying steps through the A&E improvement plan, with five specific measures to improve front-door streaming, back-door discharge and patient pathways through hospitals to improve that performance.

[Anne Marie Morris (Newton Abbot) (Con)]

19. Rural areas have high demand for primary and social care that increases the pressure on A&E if it is not met. Given the relationship between primary, secondary, A&E and social care, does the Minister also measure waiting times in primary and social care in the same way? That would give him a fuller picture of the demands on the system that need addressing.

[Mr Dunne]

The short answer is that at present we do not record waiting times in the same way. Tests are being undertaken in relation to waiting times for GPs, but at this point I do not have access to the data.

[Sir Edward Leigh (Gainsborough) (Con)]

22. As we are unlikely to reach my question on the Order Paper, perhaps the Minister could now direct his attention to the east midlands where we have problems with A&E, particularly for people in rural areas. For those of us who rely completely on the NHS, this is obviously a matter of vital concern. I just wonder whether we should not have an honest debate about this and recognise that we have an ageing population. Our A&E times are stressed and we may have to either tax people more or even think the unthinkable and charge people for—[Interruption.] See, it is unthinkable, but we have to concentrate on the essentials. Let us have an honest debate about the finances of the NHS.

[Mr Dunne]

My hon. Friend will be aware that the sustainability and transformation plans discussed earlier today are designed to bring closer integration of health providers and commissioners within a health system area, such as the east midlands. The ambition is to integrate better health and social care provision to avoid some of the challenges he identifies.

[Dr Philippa Whitford (Central Ayrshire) (SNP)]

The A&E target the Minister mentions is actually a measure of the entire acute system. Important in that is the flow of patients from admission through treatment to discharge. In Scotland, delayed discharges have fallen 9% since health and social care were integrated. In England, they have gone up 30%. Does the Minister accept the need to fund social care properly to relieve the back pressure on A&E?

[Mr Dunne]

I listen with great interest to what the hon. Lady says, but I gently remind her of two things. First, as the result of the generosity of the Barnett formula, Scotland receives £1,500 per capita more to spend on health than England. Secondly, the Auditor General for Scotland recently reported that NHS Scotland was failing to meet seven out of eight key targets, including waiting times for A&E.

[Dr Whitford]

I wonder how many targets are being missed in England. The Royal College of Emergency Medicine report demonstrates that in the 176 emergency departments in England there are only enough consultants to provide the cover of one for 16 hours a day. On top of that, rota gaps among junior doctors are causing safety concerns. What exactly is the Minister going to do this winter and will he agree to lift his ban on locum agency staff to help to keep A&Es functioning?

[Mr Dunne]

We recognise that there have been pressures on emergency departments for some years, which is why we have put particular effort into recruiting more consultants. There are, I believe, 50% more consultants working in emergency departments in England than there were in 2010, and 25% more doctors.

[Henry Smith (Crawley) (Con)]

10. What steps his Department is taking to improve the safety of maternity care.

--- Later in debate ---

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

It was this Government who first introduced key tests for service change, giving local people a say. We need an NHS that is ready for the future, and sustainability and transformation plans will help to ensure the best standards of care, with local doctors, hospitals and councils working together in conjunction with local communities for the first time. No decisions about service reconfigurations, including A&E units, will be made without local consultation, as is currently the case.

[Jason McCartney]

How can it be right that the disastrous private finance initiative deal at Calderdale is dictating that Huddersfield royal infirmary be bulldozed, leaving Huddersfield as the largest town in England without an A&E unit?

[Mr Dunne]

I am familiar with my hon. Friend’s concern for the hospital in Huddersfield. We have discussed it previously. Calderdale royal hospital was an early PFI and is halfway to paying off its liabilities. The present proposal, put forward by the local CCGs, for moving to a full outlined business case would involve an A&E trauma centre on a single site, but there would continue to be emergency care in Huddersfield 24 hours a day, seven days a week, and it would maintain the capability to assess and initiate treatment of all patients, if it were to proceed.

[Mr Speaker]

Hoping for an un-lawyerlike brevity, I call Mr Alistair Carmichael.

[Mr Alistair Carmichael (Orkney and Shetland) (LD)]

13. What recent assessment his Department has made of the effect of the vote for the UK to leave the EU on future recruitment of nurses to the NHS.

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

The NHS currently employs 21,030 nurses from the EU—6.6% of the total number of nurses in the workforce—while a further almost 90,000 EU citizens work in the social care sector across the UK. They all do a fantastic job, and we have been clear that we want them to be able to stay post-Brexit.

[Mr Carmichael]

What is the Minister going to do to achieve that then?

[Mr Dunne]

My right hon. Friend the Secretary of State has discussions with Cabinet colleagues handling the negotiations, and I am sure that his messages are being well heard across Government.

[Mr Speaker]

The right hon. Member for Orkney and Shetland (Mr Carmichael) is in line for an award.

--- Later in debate ---

[Tom Pursglove (Corby) (Con)]

T4. Across north Northamptonshire there is an enormous appetite for the new urgent care hub to be built at the site of Kettering general hospital, relieving pressure on A&E and improving services for patients. Will the Minister update us on progress?

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

As I said to my hon. Friend’s parliamentary neighbour, my hon. Friend the Member for Kettering (Mr Hollobone), we are aware that Kettering hospital has put forward a proposal. The outline business case is due to be discussed with NHS England in the coming weeks. In the meantime, we are looking at an interim solution for relieving pressure on A&E services in the area.

[Mr Virendra Sharma (Ealing, Southall) (Lab)]

T2. Diabetes is a big problem in my constituency, and the number of unnecessary lower limb amputations due to diabetes is on the rise. Will the Minister ask clinical commissioning groups to provide fully staffed community podiatry foot protection services to avoid amputations, keep people in work and make huge cost savings?

--- Later in debate ---

[Danny Kinahan (South Antrim) (UUP)]

In Northern Ireland in 2014-15, 870 deaths were due to the cold weather. Will the Minister engage with other Ministers to ensure that fuel poverty is looked at by all Departments, so that the pensioners who raised this in Parliament do not suffer from the health matters that are killing them off?

[Mr Dunne]

I thank the hon. Gentleman for making that point. We do of course have the cold weather payment system in force across the UK, and later this week I will attend a meeting with other Government Ministers to look at winter preparedness across the board.

[Kevin Foster (Torbay) (Con)]

The Minister will be aware of the concerns in Torbay about the impact on accident and emergency services from the potential loss of the minor injuries unit at Paignton hospital. Does he agree that it is vital that MIU services are kept within Paignton given that it is the second biggest town in Devon?

[Mr Dunne]

My hon. Friend is aware that a consultation is going on regarding services in south Devon. The point he makes has been well made and I am sure it will be taken into account by the clinical commissioning group and the local community hospital trust.

[Several hon. Members rose—]