Drug Treatment Services

Debate between Philip Hollobone and Dan Poulter

Tuesday 16th July 2019 Westminster Hall

[Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)]

I congratulate the hon. Member for Manchester, Withington (Jeff Smith) on securing the debate. I agree with everything he said. I draw the attention of Members to my declaration of interest as a practising NHS psychiatrist and as someone who has worked in drug addiction, or drug treatment, services.

I do not intend to rehearse the discussion on the lack of, or reduction in, funding for the treatment of addiction services since the commissioning moved to local authorities, because that argument has been well established. The challenge we face is how to encourage more people to engage with addiction services and how to improve the quality of care available to those who are drug and alcohol-dependent. In my view—this is increasingly the consensus—commissioning by local authorities has probably been the single biggest failure of health legislation under our Government, and we need to revisit that if we want to improve the quality of care available to the patients we are looking after.

Between 2009-10 and 2016-17, the number of people with opiate addiction who access services has reduced by about 16%. Heroin deaths are on the rise; the number of people presenting with alcohol-related illness, pathology and morbidity is rising; and alcohol-related deaths are rising. Our current approach to additions is not working, which appears to be that the NHS will patch you up as best it can. We are not doing a good job of preventing people from appearing in A&E or in the acute hospital because the commissioning of addiction service is not right. While I do not believe that local authorities are in the right place to commission services, the lack of funding they receive has been a contributing factor.

There are five key challenges and problems with commissioning by local authorities. The first is the quality of patient care delivered. There is poor integration of services between the NHS and the providers that often are commissioned by the local authority, be they in the private sector or the charitable sector. Historically, NHS services have had a good integrated approach between physical healthcare and addictions care. NHS providers have a joined-up approach to treating people with hepatitis, HIV and other physical health problems, or older addicts who may need support for physical health needs, such as cardiac or respiratory problems they may develop as a result of their addictions, particularly if they smoke heroin. That does not happen when there is fragmented commissioning by private-sector providers and local authorities. That needs to change for the benefit of many patients.

Secondly, all private sector providers operate under their own IT systems that have no integration with the NHS whatsoever, so an NHS doctor does not know necessarily what care those private providers are giving. That is dangerous because there is no continuity of healthcare and it is fragmented, to the extent that one part of a supposed health system cannot see what is happening elsewhere.

[Mr Philip Hollobone (in the Chair)]

Order.

Oral Answers to Questions

Debate between Philip Hollobone and Dan Poulter

Tuesday 24th February 2015 Commons Chamber

[Dr Poulter]

It has always been the case—it was certainly the case among many of my medical contemporaries—that many people from our NHS go and work overseas for some time. They often come back to the NHS, bringing broader experience and skills. As I outlined earlier, there are now 1,000 more GPs working and training in our NHS than there were five years ago.

[Mr Philip Hollobone (Kettering) (Con)]

Following the retirement of a senior partner whom it has been impossible to replace, Dr Hadrian Moss of the Dryland GP surgery in Kettering has followed the advice of the British Medical Association and informally closed his expanded list of 2,500 patients on the ground of patient safety. He has now been taken to task by NHS England for a potential breach of contract. What is the Minister’s opinion on reconciling the views of the BMA on patient safety guidelines and those of NHS England on a potential breach of contract?

[Dr Poulter]

I am sure that my hon. Friend will understand that it is difficult for me to comment on an individual case, but I am very happy to look into the matter and get back to him about it.

General Dental Council

Debate between Philip Hollobone and Dan Poulter

Tuesday 9th December 2014 Westminster Hall

[Dr Poulter]

If we look at similar organisations, we see that the GMC, for example, has similar practices and processes. The Nursing and Midwifery Council has a very small fee rise, but has seen a similar section 60 process take place. All those regulators, in my view, have taken every step possible to look at their annual fee in the context of the section 60 orders, and with the mindset that any fee rise needs to be fully evidence based and appropriately proportionate. From my conversations, and from the practice of other health care regulators, I think that there is very good evidence that that is a consistent pattern of behaviour. As I said, the GDC’s fee rise is unprecedentedly large, and its behaviour is not consistent or in keeping with that of any of the other health care regulators, from what I can see.

In addition to the GDC-related section 60 order, the Government are taking forward a number of key pieces of secondary legislation in this Parliament to address priority areas that we have identified after discussion with the regulatory bodies and other stakeholders; I mentioned other section 60 orders. We are also working on a response to the Law Commission’s valuable work on proposals for more wide-ranging reforms.

I am aware that the decision not to progress a professional regulation Bill in the current Session has come as a disappointment to interested parties. However, that decision provides an opportunity to invest time in ensuring that that important legislative change is got right, for the benefit of those who will ultimately be affected by it. My hon. Friend outlined very articulately some of the challenges that need to be considered in putting together the Bill. We are committed—I would like to put this on the record again—to bringing forward primary legislation to address wider reforms to the system of professional regulation when parliamentary time allows, but in the meantime, working with the regulators, we have put in place, or have in train, a number of section 60 orders. They are about streamlining processes, providing efficiencies to the regulators and, most important of all, protecting patients and the public.

Let me say a quick word about the GDC’s general performance. It is very important that the GDC manages its rising volumes of complaints as well as the other issues raised by the Professional Standards Authority as part of its annual performance review. In due course, the GDC will need to demonstrate what it has done to address the recommendations made.

Hon. Members may be aware that the Professional Standards Authority is also conducting an investigation of the GDC after claims were made by a whistleblower about the management and support processes of the GDC’s investigating committee. I understand that the Professional Standards Authority has concluded the evidence-gathering phase of the investigation, is in the process of compiling the investigation report, and will provide that report to the Select Committee on Health and publish it on its website in due course.

I have outlined a number of issues and concerns about the unprecedentedly high rise in the GDC fee. As we have discussed, it is out of keeping and inconsistent with the behaviour of many other health care regulators. I am not convinced, from the evidence that I have been presented with, that there is a strongly evidenced case to support that fee rise, and it goes against Government policy, which is to encourage regulators to set appropriate and proportionate fee rises, to show restraint where appropriate and to be mindful of the effects of fees on registrants.

I want to make it clear, in drawing to a conclusion, that I am not raising any doubt about the fact that the GDC continues to fulfil its statutory duties. However, it will need to make significant improvements to meet the challenges set out in the annual performance review undertaken by the Professional Standards Authority. Registrants, patients and the public need to be able to have confidence in the performance of the GDC and to see improvements in its operation, effectiveness and efficiency. I hope that I have answered all the points raised in the debate, and I again thank my hon. Friend the Member for Mole Valley for raising a very important issue that I am sure is filling many MPs’ postbags.

[Mr Philip Hollobone (in the Chair)]

I thank all hon. Members who took part in the debate.

Oral Answers to Questions

Debate between Philip Hollobone and Dan Poulter

Tuesday 25th November 2014 Commons Chamber

[Mr Philip Hollobone (Kettering) (Con)]

4. How many patient episodes there were at Kettering General Hospital in (a) 2010 and (b) the last year for which figures are available; and what assessment he has made of the reasons for the change in the number of such episodes.

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

In 2012-13 there were 85,497 in-patient finished consultant episodes at Kettering General Hospital NHS Foundation Trust, compared to 84,602 in 2011-12. There has also been an increase in the number of accident and emergency attendances, from 76,099 in 2010-11 to 84,055 in 2012-13. That increase is largely attributable to a high demand for services from a growing, ageing population.

[Mr Hollobone]

Kettering general hospital serves one of the areas with the fastest population growth and greatest ageing in the whole country. Today’s report from the Care Quality Commission shows that, while the hospital has some of the most caring staff in the whole of the NHS, many areas of the hospital require considerable improvement. Will the Minister ensure that future NHS funding decisions are better targeted at areas such as Kettering which have such costly demographics?

[Dr Poulter]

My hon. Friend will be aware that the NHS funding formula is set independently, free from political interference. It is reviewed annually. I should like to reassure him that the Nene and Corby clinical commissioning groups have both received higher than real terms growth in their funding allocations and will do so again next year, to move them closer to their target allocations.

Oral Answers to Questions

Debate between Philip Hollobone and Dan Poulter

Tuesday 1st April 2014 Commons Chamber

[Mr Philip Hollobone (Kettering) (Con)]

Ten babies a day are born at Kettering general hospital. May I welcome the recent award of £400,000 of NHS modernisation funds to the hospital’s 33-bed maternity unit and urge the Minister to encourage NHS England to prioritise areas of high population growth such as Kettering for future funding?

[Dr Poulter]

I know that the staff at my hon. Friend’s maternity unit work tremendously hard to look after patients, and it is important that we gave them the right facilities in order to do so. I am delighted that, like over 100 other birthing units in the country, they have received money to make sure that women are treated with greater dignity and that the quality of care is as high as it can be.

Oral Answers to Questions

Debate between Philip Hollobone and Dan Poulter

Tuesday 14th January 2014 Commons Chamber

[Mr Philip Hollobone (Kettering) (Con)]

Would the Minister like to congratulate the Northamptonshire Healthcare NHS Foundation Trust, Kettering general hospital and the Northampton General Hospital NHS Trust for coming together to form the frail and elderly crisis hub in Northamptonshire, to prevent unnecessary admissions of elderly people to local accident and emergency departments?

[Dr Poulter]

I would very much like to do that. It is important, given that we sometimes have adversarial discussions on these matters, to highlight the examples of good practice. The example in my hon. Friend’s local area of Kettering is exactly the sort of initiative that we need to see elsewhere in the country. That is why we have given £3.8 billion to better support the integration of health and care.

Oral Answers to Questions

Debate between Philip Hollobone and Dan Poulter

Tuesday 16th July 2013 Commons Chamber

[Mr Philip Hollobone (Kettering) (Con)]

8. What assessment he has made of recent improvements in services to patients at Kettering general hospital.

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

Monitor, as the regulator of foundation trusts, is working with NHS England, the Care Quality Commission and local commissioners to ensure that the trust has robust plans to make the necessary improvements. The emergency care intensive support team has given the trust advice and support to help it to develop plans to improve its A and E performance.

[Mr Hollobone]

Will the Minister congratulate all those at Kettering general hospital who have been involved in various recent developments? For instance, urology patients are being given the anti-cancer drug mitomycin C, which halves the risk of a recurrence; a CT scanner that is 10 times more powerful than its predecessor is facilitating CT angiography; and 44% of colorectal operations—twice the national average—are being performed on a keyhole basis.

[Dr Poulter]

I am happy to commend Kettering general hospital for some of the improvements in care that have been made recently. My hon. Friend will, of course, want to ensure that that progress is sustained during the weeks and months ahead. As he will know, Monitor is still overseeing the trust to ensure that patient care and performance remain up to standard.

Oral Answers to Questions

Debate between Philip Hollobone and Dan Poulter

Tuesday 11th June 2013 Commons Chamber

[Dr Poulter]

We had this debate last week. The long-term pressures on the NHS, as we know, are the result of an aging population, with increasing numbers of older people arriving in A and E with complex needs, so the challenge is to ensure that they are better treated in the community. That is why my hon. Friend the Minister of State launched the integrated care pilots last month. We are also seeing more patients treated as day cases than ever before. About 80% of elective admissions are now treated as day cases, which shows a massive improvement in the speed and quality of care in the NHS.

[Mr Philip Hollobone (Kettering) (Con)]

Kettering general hospital is located in an area that has one of the fastest growing populations in the country and above-average growth in the number of patients aged 80 or over. What more can be done to send the correct signals to local authorities that they need to act quicker to get elderly patients out of hospital once they have been treated so that they can have the care they need in the community, thus freeing up hospital beds?

[Dr Poulter]

My hon. Friend is absolutely right that local authorities have a key role to play in integrated care. That is why in April this year the Government set up local health and wellbeing boards, which will bring about greater integration of care between the NHS, housing providers and social care locally. That will hopefully ensure that across the country we have a much greater focus on local health care needs and, in particular, on better supporting older people and people with long-term disabilities at home and keeping them out of hospital.

Oral Answers to Questions

Debate between Philip Hollobone and Dan Poulter

Tuesday 16th April 2013 Commons Chamber

[Dr Poulter]

My hon. Friend is right to highlight the fact that it is wrong of any political party—in this case, the Labour party—to focus on scaremongering when there is no basis in truth. At no point have there been plans to close Royal Lancaster Infirmary.

[Mr Philip Hollobone (Kettering) (Con)]

18. What assessment he has made of (a) the pressures faced by Kettering general hospital’s accident and emergency department and (b) what can be done by Kettering general hospital to achieve national accident and emergency transition time targets.

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

Local health care commissioners have worked with the trust, Monitor and NHS England’s Hertfordshire and South Midlands local area team to ensure that robust plans are in place to improve the trust’s performance against accident and emergency waiting time performance indicators.

[Mr Hollobone]

The greatest difficulty for Kettering is that it has the sixth fastest household growth rate in the country, and A and E admissions are up 12% year on year. Will the Minister ensure that the NHS Commissioning Board makes sure that population estimates are put into its funding formula?

[Dr Poulter]

My hon. Friend makes a very good point. I will take up the matter further with the NHS Commissioning Board because it is important that when we are commissioning services we take into account future population growth.