Oral Answers to Questions
Debate between Philippa Whitford and David Rutley(5 years, 10 months ago)
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David Rutley
The Secretary of State has made it clear in his contributions here and at the recent farming conference in Oxford that there could be significant disruption for the farming sector, which is why we are working very hard to make sure that Staffordshire NFU members and farmers across the country get the best possible protection. I meet the NFU every week to listen to and work through its concerns and, of course, the No. 1 priority is to make sure we get this deal. Again, I am grateful to those parties that have sought to become part of that process and dialogue.
Dr Philippa Whitford (Central Ayrshire) (SNP)
David Rutley
I can assure the hon. Lady that I am not the future Prime Minister. That will not happen. She does not have to worry about that. [Interruption.] Well, I am certainly not. I am merely filling in for him while he is not here.
The hon. Lady asks an important question, which other hon. Members have also asked. We want to make sure that protections are in place, and we want to get this deal in place, because a no deal would potentially have a disruptive effect on farmers. We will work together closely to ensure a deal happens.
Improving Air Quality
Debate between Philippa Whitford and David Rutley(6 years, 4 months ago)
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David Rutley
If the hon. Lady will let me, I would like to answer her question. Only six other countries in the world are moving more quickly than the UK on ending petrol and diesel, and the UK is moving faster than almost every other country in the EU, as well as many other countries such as the US and Australia.
The £3.5 billion investment also includes £1.2 billion of available funding for the first ever statutory cycling and walking investment strategy. I know that that has been raised by a number of Members who have talked about what we can do to improve the take-up of cycling and walking. I think that, perhaps, there has been an over representation of the cycling lobby today. As a former member of the mountaineering all-party parliamentary group, the pinnacle of APPGs, we need to speak up for walkers as well. I know that the hon. Member for Nottingham South (Lilian Greenwood) fully agrees with me on that important point.
Dr Whitford
Does the Minister recognise, however, the disparity between the cost to the Government through ill health and the amount that is being spent on active transport, be it cycling or walking?
David Rutley
There is more that we need to do, but the £1.2 billion funding in the cycling and walking investment strategy is a first important step, and we need to build on that—no question.
A number of important issues have been raised throughout the debate, and I will address some of them in the time remaining. One issue that has been highlighted is that of what we can do to help raise people’s awareness of the health challenges around air quality. There were important contributions on this topic from my hon. Friends the Members for Erewash (Maggie Throup) and for South West Bedfordshire, the right hon. Member for Exeter (Mr Bradshaw), and the hon. Members for Wakefield, for Brentford and Isleworth (Ruth Cadbury) and for Strangford (Jim Shannon). Through the clean air strategy, we are committed to a national information campaign to raise awareness of the dangers of air pollution. We will introduce a personal messaging system to ensure that those who are most at risk receive the information that they need about pollution risks. Public Health England is currently reviewing evidence of the effectiveness of different interventions, and will report its findings to Ministers later this year. This will include advice on the factors affecting behaviour change around air quality.
The Committees have called for a new clean air Act. As announced in our clean air strategy, we will set out new primary legislation to secure a more coherent legislative framework for action to tackle air pollution.
NHS and Social Care Funding
Debate between Philippa Whitford and David Rutley(7 years, 10 months ago)
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Dr Whitford
The whole issue comes down to sustainability, which is obviously the idea behind the sustainability and transformation plans. As those who have heard me speak about STPs will know, I support the idea in principle. The idea is to go back to place-based planning on an integrated basis for a community. The difference in Scotland is that we have focused on integration. We got rid of hospital trusts in 2004, and we got rid of primary care trusts in the late 2000s—in 2009 or 2010. Since April 2014, we have set up integration joint boards, where a bag of money from the NHS and a bag of money from the local authority are put on the table and a group sit around it and work out the best way to deal with the interface and to support social care. Anyone in the Chamber or elsewhere with family members who have been stuck in hospital will know that people get into a bickering situation: Mrs Bloggs is in a bed so the local authority is not interested, because she is safe there, and the local authority is instead busy with Mrs Smith, who has fallen off a ladder trying to put up her curtains and who is not considered safe because she is leaving the gas on. Such boards get rid of all that perverse obstruction.
David Rutley (Macclesfield) (Con)
The hon. Lady is making an important point, and I welcome the tone that she, unlike the shadow Secretary of State, has brought to this debate. She makes the point that the integration of care—social and health—is important, but does she agree that, with further devolution to the sub-regions and major cities in England, there is a huge opportunity to move forward that agenda south of the border?
Dr Whitford
The whole idea of STPs is to go back to areas. We simply have geographical health boards—the only layer we have—so we are not wasting huge amounts of money on having layers and layers, which could be integrated. For an STP to work it must make sense geographically, which might be a county or something bigger or smaller. I think that they should be put on a statutory footing. We have 211 CCGs. There will be an average of six CCGs for every STP, so that is a waste of layers, and it will be very difficult to integrate.
One of the biggest differences is that, in 2004, we got rid of the purchaser-provider split. In the past 25 years, there has been no evidence of any clinical benefit from the purchaser-provider split, the internal market or, as it now is, the external market. It is estimated that the costs of running that market are between £5 billion and £10 billion a year. That money does not actually go to healthcare, but on bidding, tendering, administration or profits. We cannot have an overnight change, but if we simply made a principled decision to work our way back to having the NHS as the main provider of public health treatment and to integrate care through the STPs, we could reach a point of sustainability.
As I said earlier, we must protect things such as community hospitals and community services and, indeed, invest in them. Our health board has rebuilt three cottage hospitals as modern hospitals, because that is where we should put an older person who is on their own and has a chest infection, who just needs a few days of antibiotics, TLC and decent feeding. We do not want them in big acute hospitals; we want them to be close to home. The danger is that under the STPs people will see community hospitals as easy to get rid of, but that is an efficiency saving only if it gets rid of inefficiency. If we slash and burn, we will end up spending more money in the end.