Oral Answers to Questions
Priti Patel Excerpts(2 months ago)
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Priti Patel (Witham) (Con)
Patient waiting times are reduced dramatically through the recruitment and retention of more GPs, so will the Secretary of State welcome the work of the Anglia Ruskin medical school in Essex, and perhaps have a conversation with myself and neighbouring MPs about how that medical school could be expanded to do much more to support the recruitment and training of more MPs—more GPs in Essex?
Wes Streeting
I am sure that the right hon. Lady does want more Conservative MPs in Essex. She has raised an entirely constructive point, which I strongly welcome. This Government are committed, as we were in opposition, to doubling the number of medical school places, and that means real opportunities for local medical schools such as hers. As ever, I would of course be delighted to meet her to talk about what more can do with her local university.
Oral Answers to Questions
Priti Patel Excerpts(4 months, 4 weeks ago)
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Karin Smyth
My hon. Friend makes an excellent point highlighting the challenges particularly around hospital capacity, something well-known on the Front Bench with my right hon. Friend the Health Secretary representing a nearby area. This type of patient experience is unacceptable, but it sadly became normal under the last Government of 14 years. My hon. Friend makes an excellent point about pharmacies: they will have a central role in our future system, and I would of course be happy to undertake a visit with her.
Priti Patel (Witham) (Con)
I welcome the new Front-Bench Members to their new portfolios and responsibilities. Essex has actually seen some improvements in emergency care services over the past 14 years, particularly in our ambulance trust, and that should be commended. One way in which pressure on emergency services can be reduced is by having community facilities in our towns and across our districts. Will the Minister commit to meeting me and working with my right hon. Friend the Member for Maldon (Sir John Whittingdale) on looking at ways in which we can safeguard community services at St Peter’s hospital in Maldon, which our communities absolutely need?
Karin Smyth
I thank the right hon. Lady because she again makes for us the excellent point about what has happened in the last 14 years under her Government: these situations have been allowed to get so much worse both in Essex and across the country. She should also welcome our mission to rebuild the broken front door to the NHS and have more neighbourhood services based in communities, bringing those services together where patients are; that is absolutely what we all want and I am very happy to discuss this with her.
Oral Answers to Questions
Priti Patel Excerpts(7 months, 4 weeks ago)
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Victoria Atkins
I am so glad that the hon. Gentleman has mentioned levelling up, because presumably he will know from his bid that the 12 levelling-up missions are mutually reinforcing. Conservative Members take the approach that in order to help people with their health—[Interruption.] The hon. Gentleman is shouting at me. I thought that this answer would be important to his constituents.
Levelling up is not just about health. It is about the impact of education, housing and other matters in our environment, which is why in the forthcoming major conditions strategy we will tie together the conditions that have the most impact on a healthy life. We will draw together a cross-Government strategy to help people who are living with those conditions to live longer but also healthier lives.
Priti Patel (Witham) (Con)
The Health Secretary will know about the health inequalities across the east of England, including in Maldon district, which will only be made worse if the NHS’s plans to close St Peter’s Hospital in Maldon proceed. Does she agree that the levelling-up funding that has been made available to Maldon District Council should be prioritised to facilitate investment in new localised health services, so that those inequalities can be tackled?
Victoria Atkins
My right hon. Friend makes an important point. The purpose of the levelling-up fund is to help local areas to address what they need locally, rather than respond to diktat from central London. I encourage her to work closely, as I know she will, with local agencies, the council and others making those important decisions, so that their levelling-up announcements include health, as an integral part of her mission to improve the lives of her constituents.
St Peter’s Hospital, Maldon
Priti Patel Excerpts(9 months, 1 week ago)
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Sir John Whittingdale (Maldon) (Con)
It is a pleasure to have a fellow Essex Member in the Chair, Madam Deputy Speaker. I also welcome my hon. Friend the Minister, and I am glad to see my constituency neighbours, my right hon. Friend the Member for Rayleigh and Wickford (Mr Francois)—on the opposite side of the River Crouch—and my right hon. Friend the Member for Witham (Priti Patel). She and I share the Maldon district between us, and we are working very closely on an issue that is of huge importance to both my constituents and hers.
St Peter’s Hospital in Maldon is a much-loved community hospital. It has been delivering care since the NHS was founded, but the building itself is a former workhouse and is more than 150 years old. We have known for some time that the building has significant problems, although, thanks to the dedication of the staff, the quality of care has been superb. There are significant challenges, which have become worse over time. The hallways are too narrow for stretchers, the floors have not been able to take the weight of the beds, the lift has repeatedly broken down, and there are leaking roofs, asbestos and potentially even a risk of legionnaires’ disease. While money has been spent over the years to maintain the building and keep it going, it has long been recognised that a new purpose-built facility is needed, either on the present site or in a different location. That has been the subject of debate and discussion for a number of years.
In 2003, the annual report of the Maldon and South Chelmsford Primary Care Trust stated that two preferred sites had been identified, that a provisional outline business case approval had been given, and that the new build was scheduled to open at some time towards the end of 2007. It never happened. There were difficulties with establishing ownership of part of the land off Limebrook Way, where it was due to be sited. Since then, we have had a succession of studies and debates about what a new hospital should offer and whether it should be a health hub. Most recently, plans were being drawn up for a new site to be developed to the west of Maldon, on Wycke Hill. However, this proposal became stuck due to the lack of sufficient funding for the access road, and a reduction in the contribution available from the developer and from the section 106 money for the housing being developed nearby.
To meet the anticipated winter pressures, it was announced in August last year that the in-patient beds would be relocated to Brentwood and Rochford, and the birthing unit transferred to St Michael’s Hospital in Braintree. We were told that these changes were only temporary while long-term solutions were found. Despite that, the Mid and South Essex integrated care board announced in January that it was proposing to make the changes permanent and that the out-patient services at St Peter’s would be relocated elsewhere, allowing the building to be eventually closed.
The proposals are subject to a consultation, which has recently been extended to 4 April. The ICB says that 2,600 of its surveys have already been returned. Over 400 people attended a public meeting that I organised with the mayor of Maldon, Councillor Andrew Lay, and another 100 had to be turned away. I have also received nearly 700 email responses to my own survey, and I am currently distributing across the constituency 25,000 leaflets containing a survey. It is already clear that my constituents are unanimous in wanting to see medical services continue in the town. They also believe that the consultation is a cosmetic exercise, with decisions already taken. I have to say that this belief is reinforced by the fact that the two alternative options presented for the in-patient beds currently in St Peter’s both involve closing the wards in the hospital and moving them elsewhere.
The Maldon district is growing steadily. We have something like 3,000 houses currently under construction in Maldon and Heybridge, with another 1,500 across the district. Demand for NHS services is rising steadily, with the GP to patient ratio already one of the worst in the country. Rather than closing NHS facilities, we need more. In addition, Maldon district is geographically spread, with some villages already half an hour’s travel time from Maldon. The travel time to Broomfield, Braintree or Brentwood can be up to an hour or more from villages such as Tillingham or Southminster in the Dengie peninsula, and the idea that an expectant mother in the early stages of giving birth should have to travel an hour is appalling.
The ICB suggested last year that there was an average of just six births per month at the maternity unit in St Peter’s, but the unit was actually closed for a large part of that time, because staff were sent to Chelmsford. Ten years ago, there were over 300 births per year, and the population has grown steadily since that time. As one of the midwives wrote in response to the survey that I am conducting:
“Our unit has seen 1000’s of births over its 75 years, over the past 5 years we have had over a 1000 postnatal stays, mothers who have birthed at Broomfield, then needed ongoing support coming to stay with us, we have taken readmissions from the community with baby’s not feeding well, which in turn warded off a remission to Broomfield where beds are always in short supply. We do in excess of 50 community visits weekly, 80+ clinic appointments weekly, over 20 new bookings a week, and anything between 5-10 appointments a day on our ward for anything extra…We are so much more than the ‘6 births a month’ that was widely reported and made us as a team so very angry and undervalued.”
The availability of in-patient services and a maternity unit are of huge importance to my constituents, but it is the out-patient services on which thousands depend. There are some 80,000 out-patient appointments each year, with a huge range of specialties such as X-rays, blood tests and ophthalmology. Although, unlike my right hon. Friend the Member for Witham, I have not used the birthing unit, I have received physiotherapy at the hospital and am due to have an abdominal aortic aneurysm screening there in the next few weeks.
I welcome the ICB’s assurance that out-patient services will be maintained at St Peter’s until alternative locations in the town are found, but it is essential that they are maintained in Maldon without a break or cessation of service. It is not good enough simply to divide up the different services and to try to slot them into buildings across the town. We need the new hospital or health hub that has been promised for so long. We have seen the new hospital at Braintree and the expansion of Broomfield and Southend, but Maldon has been consistently overlooked.
It was announced in last week’s Budget that the Maldon district is being allocated £5 million of levelling-up money for cultural projects, which I welcome, but what my constituents want is not cultural projects but a new hospital. Essex County Council and the district council have money set aside, but it is unlikely to be sufficient.
I applaud the Government’s continuing investment in the NHS, of which we saw further proof last week, but I ask the Minister to tell the Mid and South Essex ICB to think again and, rather than cutting services, to maintain and expand them so that my constituents have the high-quality, easily accessible healthcare they deserve.
Madam Deputy Speaker (Dame Eleanor Laing)
The right hon. Lady has not asked me, the Minister or the right hon. Member for Maldon (Sir John Whittingdale) whether she can take part in the debate, but she can ask now.
The Minister for Social Care (Helen Whately)
indicated assent.
Priti Patel (Witham) (Con)
Thank you, Madam Deputy Speaker.
I congratulate my right hon. Friend the Member for Maldon (Sir John Whittingdale) on securing the debate, and I echo everything he said in illustrating the sorry and sad situation in which our constituents find themselves with regard to what is a much-loved local hospital. Naturally, we both speak from our personal experience, but it is fair to say that both he and my right hon. Friend the Member for Rayleigh and Wickford (Mr Francois) will have received hefty mailbags of angry correspondence from our constituents who believe that the ICB’s consultation is effectively a slippery slope to permanent closure and the running down of services after last summer’s announcement, which we clearly do not support. It is right that we stand up for our constituents.
I reiterate and echo the points raised by my right hon. Friend the Member for Maldon, particularly on the incredible maternity and birthing facility. Nurses from the facility were present at the public meeting held in Witham on Monday evening, and I emphasise the due diligence, care and compassion they provide not just in the birthing unit but in the wider community. The support that the facility gives to new mothers was echoed by everyone in that public meeting.
The reality is that Essex is a very large county, and relocating these services is simply not good enough because of the time it takes to travel to the alternative facilities, and public transport is not available. I emphasise that Maldon is a growing district in both our constituencies; the Westcombe Park development in Heybridge straddles my right hon. Friend’s constituency and mine, and it now has more than 1,000 homes under development.The current local plan runs until 2029 and will see the development of another 5,000 homes. It is simply unsustainable that we have a proposal to close St Peter’s Hospital and relocate services elsewhere in Essex, because we can guarantee that in future years there will be calls to stand up those local medical facilities again. That is why, as my right hon. Friend the Member for Maldon said, we must have new facilities in Maldon town, and they have to be future-proofed to meet growing need.
Finally, it is vital that we recognise the overall impact of an ageing and growing population. We have to provide the right kind of medical facilities and give our constituents the assurance that whatever happens with their health, they can have health provision on their doorstep.
Health and Wellbeing Services: Essex
Priti Patel Excerpts(9 months, 1 week ago)
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Priti Patel (Witham) (Con)
I beg to move,
That this House has considered health and wellbeing services in Essex.
I am grateful that you are chairing the debate, Mr Henderson, and pleased to see that my right hon. Friend the Member for Pendle (Andrew Stephenson) is the Minister responding. He has been very good on many issues that I have taken to him thus far. I will cover a wide and diverse range of health-related issues affecting my constituents and people across Essex. I appreciate that some of those issues fall outside of the Minister’s portfolio, but I know he will take them on board and will feed back to colleagues. He is an excellent Minister, and I know he will respond in a helpful way. I am particularly pleased to welcome to the debate colleagues from neighbouring constituencies, my right hon. Friend the Member for Maldon (Sir John Whittingdale) and my hon. Friend the Member for Colchester (Will Quince), because we care about the provision and quality of health and wellbeing services. It is important to our constituents, and it is important that our constituents know we will work together as neighbouring MPs on some of the issues.
As the Minister and colleagues will be aware, just over a year ago, in March 2023, we were in this very Chamber having a similar debate with a similar title—I think we stretched it to the east of England last time round—and this debate follows on from that one. Everyone here will know that Essex is an amazing county. Our residents, businesses and communities are hard-working, resilient, entrepreneurial, ambitious and aspirational. They obviously back all the Conservative values around lower taxes, being a county of entrepreneurs and the engine of economic growth. We are net contributors to the Exchequer. I never tire of saying that because, as net contributors, we in Essex do not always get our pound of flesh back from the Exchequer when it comes to investment in our public services. It is fair to say that our constituents expect that from the Exchequer, particularly the fact that we should be supported when it comes to our public services, including the NHS, but also wider health and wellbeing services that do not always require medical interventions or diagnostics.
Parts of our county—mid-Essex in particular—have experienced considerable population growth and demographic changes, and that covers the constituencies of Colchester and Maldon. For clarification, we share district boundaries, so our council boundaries are intertwined—we are effectively three integrated MPs, I think it is fair to say, on many of the issues that we stand up and speak for. Those living within Essex County Council’s boundary totalled more than 1.5 million at the 2021 census, up by more than 100,000 people on the 2011 census, which is more than 7% and above England’s average of 6.6% at the time. That includes areas such as Southend and Thurrock. When we include those areas, our county population totals just under two million, at 1.9 million. We are one of the fastest-growing counties in the country, and growth in the city of Colchester, which covers parts of my constituency, continues to grow. With that, demand on public services continues to grow. We see from the census that we have over 300,000 people aged 65 or over, which is 21% of our population. That is higher than the average in England of 18.6% and, by 2035, that number will grow by up to 27%, so just under 400,000 people in Essex. The number of those over 85 will rise by 60%, so we can see that the numbers are growing. We are an ageing not just county but country and, that impacts on the working-age population of 18 to 65-year-olds which, by contrast, is set to rise by only 4%.
We can see the counter-cyclical issues resulting from the fact that a greater part of our population will be elderly. Interestingly enough, with that ageing population we are seeing increasing numbers of young families coming to Essex, which will mean more house building. Our schools are rated good and outstanding, and we are commutable territory, so our towns are thriving and growing.
As I said in the debate last year, there are pressures on social care which have had a very significant impact on the integrated care systems that have been introduced, with further integration taking place. In particular, those pressures have had an impact on spending at the county, district and city council level. We have a number of integrated care boards that cover Essex: NHS Hertfordshire and West Essex; NHS Mid and South Essex, which predominantly covers mid-Essex; and NHS Suffolk and North East Essex, covering Colchester and Tendring.
We also have a number of hospitals, the biggest being Broomfield Hospital, Colchester Hospital, the Princess Alexandra Hospital, Basildon University Hospital and Southend University Hospital. Our emergency services are provided by the East of England Ambulance Service NHS Trust, and the South Essex Partnership NHS Foundation Trust provides mental health services. I am shortly going to discuss those areas, and those trusts in particular.
As hon. Members have heard, we have a range of trusts, hospitals and challenges in Essex. When I was first elected we had the old-fashioned primary care trusts and strategic health authorities. Those were deeply unpopular, hugely problematic and bureaucratic and massively resource-intensive, and the changes in structures we have seen now provide greater integration. What really matters to all my constituents and residents across Essex is not so much the configuration and structure of services, but how those services work together effectively to deliver what those people and their families need: primary care, appointments and access to health services.
Jim Shannon (Strangford) (DUP)
I commend the right hon. Lady on the debate. It is clearly about health services in Essex, and is therefore not to do with Strangford. However, to add my support to what the right hon. Lady is saying, I note that the problems in Essex she has outlined are replicated across my constituency as well. They include the closure of the local minor injuries unit, which is integral to the local community. That means that constituents have to travel further to get their healthcare—the very thing that the right hon. Lady is referring to. Does she agree that health bodies must focus more on community health and wellbeing to ensure that all constituents have the local access they deserve to efficient health and care services? Again, I commend the right hon. Lady on introducing the debate.
Priti Patel
The hon. Gentleman is absolutely right, and he has teed up the issue I wanted to raise—community healthcare provision and localised services. I have just mentioned our big hospitals in Essex, but it is absolutely vital that we have localised healthcare provision.
That brings me on to a local issue that affects my right hon. Friend the Member for Maldon and me—the future of St Peter’s Hospital. I raised this issue in the House last week in Health questions, and my right hon. Friend the Member for Maldon has secured an Adjournment debate on Thursday to discuss it further. Last night I attended a public meeting hosted and organised in Witham by Witham Town Council on this matter.
I know that colleagues will say more about this issue later in this debate, but for context, to say that my right hon. Friend and I are receiving hefty mailbags on this issue would be an understatement. We are receiving unprecedented levels of correspondence and communication —emails and phone calls—from concerned and angry residents who are frustrated by the plans put forward by the integrated care board to remove services from St Peter’s hospital, which could lead to its closure under the proposed consultation. The Minister will know that the plans are subject to consultation; my right hon. Friend and I have called for it to be extended, and yesterday we were given confirmation that it has been.
The measures that we are discussing include the removal of stroke rehabilitation in-patient beds to Brentwood and Rochford, which are not local areas and require considerable travel, and making permanent the temporary removal of a midwife-led birthing unit. The ICB is also seeking views on the future removal of other services from the site, including out-patient services covering blood tests, ultrasound scans, X-rays, podiatry clinics and services to support mental health patients, with an average total of around 300 patients a day using the particular site.
I should add that this is a much-loved community site, and it is fair to say that across the generations everyone in our district would have had some kind of interaction or engagement with it. I myself have used St Peter’s and its maternity facilities. Last night, I met some of its maternity nurses, who kindly came to our public debate. They are remarkable ladies, who are wonderful in the care and compassion that they give to mothers, particularly new mothers who, quite frankly, struggle after the birth of their first child to adapt to some of the post-maternity services. The nurses are wonderful.
The hospital serves the town of Maldon and the wider rural area, including people in Maldon district who live in the Witham constituency. This part of Essex has experienced very considerable economic growth, particularly housing growth. My right hon. Friend the Member for Maldon cannot speak about small housing developments—we have significant housing developments in our constituencies. I will refer to the Westcombe Park development in Heybridge, which straddles both our constituencies. It is a development of over 1,000 homes, which speaks to the type of developments that we have locally. The current local plan runs up to 2029, and we will see the development of another 5,000 homes in that time. I recognise that we need more homes—people need homes to live in and we aspire to own our homes—but we also need to know that new housing and population growth will attract the infrastructure and public services to support them in the long run.
The consultation about St Peter’s is very important. The document covers a range of issues, but I have to say that it is not acceptable for us to say, “It’s fine for the services to go elsewhere and be relocated.” Our constituents would experience considerable travel times if services were relocated and there are issues with local public transport as well. I am afraid to say that trying to park a car at Broomfield Hospital is nigh-on impossible. We want to those services to remain local; that is absolutely pivotal. Importantly, they should remain within Maldon town and Maldon district.
Our constituents have serious reservations about these proposals and it is right that we, as local MPs, continue to support, champion and work with the integrated care board, and work with local authorities, Ministers and the Government to secure these services in Maldon town. We have to keep these services in our district. I know that the Minister cannot specifically intervene in matters being considered by the ICB, but I would welcome his views, and I think this issue is going to be very important going forward. This consultation also sets a benchmark for engagement with ICBs and future-proofing localised healthcare services, which we all want to see in our constituencies.
I have mentioned the need to enhance services and safeguard them in Maldon and Maldon district. The Department is very familiar with communication around Witham town and my calls over 14 years for a new health centre there. My correspondence file in the Department is large; I know that, and I thank Ministers for their forbearance and all the responses that they have sent to me. However, like Maldon, Witham has experienced huge amounts of housing growth, which means that the demand for primary care is outstripping supply.
We have four GP practices in the town and I will name them all: Fern House surgery has 16,500 patients; Douglas Grove surgery has 6,500 patients; Witham practice has 6,500 patients; and Collingwood Road practice, which I visited recently, has 2,500 patients. That is a total patient list of about 32,000 just in the town itself. The national patient to GP ratio average is around 1,700 patients per GP, but across those four surgeries there are around 13 full-time equivalent GPs, which means that the local patient to GP ratio is closer to 2,500. That is the tense situation that we have and the challenge that we face.
We also have the incredible Anglia Ruskin University medical facility. Many of us were part of the group making the business case that was made for that and we are very proud of it. In September 2023, we saw the first cohort of medical practitioners from that facility. We are desperate to make sure that we keep them all local; we absolutely want them to remain local.
However, we need to discuss the practicalities and how hard it is to get a GP appointment. That is why we need new facilities, more support for GPs and more primary care staff to improve health services in Witham. I am consistent in my campaigning for all of that.
I pay tribute to Braintree District Council, which has been on this journey with us. We have capital funding for a service, but the Minister will recognise that we need the GP practices to make the business case on how they can work together. I pay tribute also to the work of the local ICB and the NHS Alliance director for mid-Essex, Dan Doherty, who has undertaken to pursue this project with local councillors. For the first time in a decade, I feel that we have better collaboration and a stronger commitment to making this happen.
We have opportunities to redevelop locations. I cannot speak about them because some are commercially sensitive and are subject to the local councils and the ICB working together. We need the critical mass of our GPs to commit firmly to driving this proposal forward. The Minister knows that it cannot be achieved without them. We want to ensure that there is sustainability and a future business for them. For example, we are protecting prescribing, because one of the practices is a prescribing pharmacy. It is important that we give them the approach to do this.
With the game-changing dialogue that we hear in Government about localised health services, community pharmacies, and my right hon. Friend the Chancellor’s focus on improving efficiency in the NHS, if we can knit those strands together, this could develop and lead to great outcomes for Witham town. The frustration of my constituents in Witham town is palpable; they have been waiting decades for this. We as a Government must deliver for them, and I will continue to press the Government on this.
In addition to the growing demands in Witham, we have growing demand for primary care and GP services in other parts of my constituency. These are theoretically villages but their growth means they are not analogous with the old view of what a village looks like; they include Kelvedon and Feering. Stanway in its own right is no longer a village; it has become a town within the Colchester city footprint. The beautiful village of Tiptree is famous for Wilkin & Sons and some other wonderful businesses. The Tiptree medical centre now has 12,000 patients on its books, and there are concerns that that is too many for one practice to handle. I recently received a letter from the practice explaining that their clinical rooms are full to capacity, and that they may consider options to close their patient list to new patients, formally or informally, and to reduce their patient catchment area significantly, so as not to include patients who are registered in the CM postcode area.
That is worrying and deeply concerning. Action is needed to address concerns about the impact of population growth. That is something our local authorities should be doing as they develop their local plans—they have to be much more strategic. Six years ago, a very unpopular planning application was submitted for 200 dwellings in Tiptree. It was widely opposed, including on the basis of pressures on the local health services, the Tiptree medical practice in particular. Initially the application put aside land for a new medical facility; despite local opposition, the application was granted on appeal, but in the end no site for a medical facility was included, according to the decision issued. That said that the application originally included the provision of land for a medical facility but that that was removed from the proposal because Tiptree medical centre and North East Essex clinical commissioning group no longer required the land on the site, and instead requested a financial contribution towards the provision of medical facilities. That contribution has been incorporated into the section 106 agreement. As we can see from the correspondence I referred to from the medical practice, the new capacity is now not sufficient.
What we now have in Tiptree is an unwelcome development: a growing population but no significant new investment to meet the demands. Again, across Essex, planning contributions to health facilities are inadequate. They are not delivering on the improvements that have been promised, and that is totally unsustainable. I would like the Minister and the Department to review this and, in particular, look into the provision of GP services in Tiptree, and with the CCG look at how developer contributions are secured and issued.
As well as protecting and enhancing primary care facilities, we need to talk about GP training. I have already mentioned the facility at Anglia Ruskin University, which we are thrilled to have. I think that the Minister himself may have recently visited, and I will be heading there this week as well. It is an incredible facility that we need to grow at some stage, which I am already hinting to the Minister basically means expansion. We can then grow its capacity and have more locally trained medical practitioners.
On the subject of healthcare in our community, I thank the Minister and the Government for empowering pharmacies to deliver more services, which was long overdue. I have raised that issue in previous debates and I spoke about it when we had the announcement in January that pharmacies can now support patients with seven common conditions. That reportedly frees up something like an incredible 10 million GP appointments a year, while providing pharmacies with new business activities that importantly keep their footfall going.
Our local pharmacies are at the heart of our communities. That is pivotal, which is particularly in constituencies like mine and that that of my right hon. Friend the Member for Maldon, which as hon. Members will know, touch the coast. I urge the Minister to consider empowering pharmacies by giving them the opportunity to grow that provision around the wider conditions that they can treat. I am a great believer in social prescribing as well, and some of those pharmacies could even utilise their own buildings as social prescribing hubs, which we should all collectively look to expand.
The Minister has heard me touch on the importance of investment in primary care services, but the statistics I referenced in my opening remarks demonstrate the importance of prevention and social care services. I have to say that Essex County Council is blessed with the high-calibre leadership of Councillor Kevin Bentley and Councillor John Spence, who is the portfolio holder for health, adult social care and integrated care systems integration, and it has a strong record in supporting investment and service area improvements. I do not say that lightly because we were not there a decade ago, when none of us wanted to use the infamous term “bed-blocking” or say that it would take place in our hospitals, the implications of which we all know.
At any one time, the council is supporting around 16,000 people with social care, and 40,000 during the course of the year. Over 90% of people who use its services say that they are safe and secure, and the council is supporting increasing numbers with hospital discharges and reablement services. I visited an organisation called Medequip on Friday, based in Braintree district, that is contracted by Essex County Council. The innovation and the quality of care and equipment that it is providing for reablement services is phenomenal, and we really have to do much more to support that. For example, the Essex Wellbeing Service has helped 73% of people in Essex to quit smoking, which is an important intervention using preventative care, and it also supported the provision of 42,000 NHS health checks. We need to do much more on health checks, particularly cancer checks.
I will not repeat the numbers on the elderly population, but the population with learning disabilities and autism is also increasing. It is expected to grow by 3% by 2025—just next year—and the population of working-age adults with sensory impairments will grow by 5%. The council is spending around £500,000 a year on adult social care services, just over £200 million on people aged over 65 and just under £300 million on working age adults between 18 and 64. I welcome the funding that we have, but we definitely need much more.
I met parents yesterday in my constituency who are fighting for education, health and care plans—a common experience for all of us now. Since 2019, under Essex County Council, the number of EHCPs has increased from just under 9,000 to over 11,600 in 2023—a 29% increase in four years. Essex is doing very well at this compared with many authorities, but we are struggling to get these plans for children. That is a long-standing issue. The Minister will recognise that we are seeing greater demand from parents and that schools are raising this issue.
Another area of frontline health provision that will be familiar to the Minister is dentistry. In the east of England in particular—not just Essex—we have long-standing problems. The Library has shown that, in 2023, around 52.2% of children in Essex had seen a dentist in the past two years, which is just under the English average of 53%. Our figures are not good, and I would like to hear from the Minister how we are going to make progress in this area.
I thank the Minister for the time he gave us last week to discuss the mental health statutory inquiry. Colleagues in Essex are familiar with the concerns about this issue. When we debated health and wellbeing services last year, the inquiry was on a non-statutory footing. It was established back in 2021 to investigate 2,000 in-patient deaths that had occurred since 2000. I pay tribute to Geraldine Strathdee for her work in chairing that inquiry and for doing all she could to gather evidence and see the witnesses that participated in that work. She, families and colleagues in this place were frustrated that not enough progress was being made and, importantly, that not enough evidence was coming forward. Colleagues pressed for the inquiry to be converted to a statutory inquiry, and we now have Baroness Kate Lampard chairing it. Over the past few months, she has been consulting on the terms of reference. I thank Kate for the work that she is doing. Obviously, the Minister is familiar with this. We are waiting for the terms of reference to be finalised.
Our constituents have been incredible in their dignity, their courage and their bravery but also in their resilience. As human beings, they have been through a terrible ordeal—they really have. They want to see the statutory inquiry progress at pace. I pay tribute to my constituent Melanie Leahy, whose son Matthew died in 2012 while a patient in the Linden centre. My right hon. Friend the Member for Maldon will speak to this as well, as Melanie Leahy was at one stage his constituent. She is remarkable for the way in which she tackled what I call the institutional state failure of her son’s treatment. Importantly, she helped to get a statutory inquiry. The families must all get the answers that they need and see lessons learned from what happened. We owe it to those who lost their lives and to their families to change the system and to get answers. I look forward to the Minister’s comments on this in particular and on how we will come together to make time to meet the families and to work with them.
My final comments speak to the future of the NHS—the workforce plan, the growing demand for services and work on recruitment. I spoke about this in my last dialogue with the chief executive of Broomfield Hospital. I am interested in this, and I ask questions all the time. The House has heard the numbers and the statistics I put forward on how difficult it is to get an appointment and how pressed we are in terms of medical practitioners.
We should also recognise that we have an incredible international workforce locally. Our NHS would be in a much more difficult position if it was not for the staff from Botswana, India, Pakistan, Nigeria, Nepal, Sudan, India and Egypt who are working in our health and social care services and contributing to our public services, our economy and our tax system. They care for elderly and vulnerable residents across our constituencies, and they should be thanked for that.
There have been interesting debates on migration, immigration and on the skills and contributions of those coming to our country. Of course there is a need to control numbers, but we have to recognise that we rely on those skills and contributions because of workforce pressures and the fact that we have not done enough as an economy and a country to grow skillsets here. I encourage the Minister to ensure that, as part of the NHS long-term workforce plan, we do much more. We have Anglia Ruskin University and other universities across the country, but we must do more.
I want the Government to recognise that we need a wider labour market strategy that addresses these issues, which sometimes unnecessarily inflame debates around immigration. They must also recognise that many of those who come to our country through a skilled worker route pay thousands of pounds in immigration health surcharges, which contributes to the finances of the NHS. Many of them are also higher-rate taxpayers and contribute to our economy, our country and important sectors.
Of course, technology also has a role to play—it really does. We can do so much more using technology, and we must make sure that we absolutely grow the workforce locally going forward.
I have presented the Minister with a long list of health and wellbeing issues across Essex, and I thank him and his team for their patience—he is a great Minister, who is very considered, and I know he will respond accordingly. With investment, innovation and support, our health and wellbeing services across Essex could be so much better. Importantly, they could meet the needs of our constituents and ensure that we have not just a sustainable NHS service that meets the needs of our population, but a happier and healthier population.
Priti Patel
I am grateful for the opportunity to discuss these important health issues across Essex. I pay tribute to my right hon. Friend the Member for Maldon (Sir John Whittingdale) and my hon. Friend the Member for Colchester (Will Quince) for joining the debate, and to the Minister for a concise series of well-considered remarks. We have touched on a range of issues, including the challenging demographics of the county of Essex and the needs of populations, and key areas covering primary care services, GP-patient ratios, our hospitals, the need to safeguard the facilities of Maldon St Peter’s Hospital, the need to secure a health centre in Witham town, the growing needs in Tiptree itself and the significant demands on social care.
I thank everybody for their comments on the EPUT statutory mental health inquiry, which is particularly sensitive, difficult and challenging. I pay tribute to the Minister for meeting us last week, and his comments on meeting the families are crystal clear. I thank his private office, which contacted us MPs today—in less than a week—to ask for the specifics that we have discussed. It is important that we can go back to those families with the information that a meeting with the Secretary of State will take place very soon.
My final comment is to echo my right hon. Friend the Member for Maldon: the inquiry has been going on for too long. We need to find the right balance of redress and parity of esteem in the whole mental health debate. However, while the inquiry takes place, we also need to find the right services and support for the families and the lawyers in particular.
It has been a pleasure to secure this debate and raise these issues. I thank all hon, and right hon. Members for their important contributions. There is more to do, and we will be back to discuss the same issues again.
Question put and agreed to.
Resolved,
That this House has considered health and wellbeing services in Essex.
Oral Answers to Questions
Priti Patel Excerpts(9 months, 2 weeks ago)
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Maria Caulfield
I have a news flash for the hon. Lady: we are already doing all that work. Mental health support teams are being rolled out in schools—44% of pupils now have access to a mental health support team, rising to 50% shortly. Over 13,800 schools and colleges now have a trained senior mental health lead. Only last week we announced 24 early support hubs for 11 to 25-year-olds—they will not need a referral; they can drop in. There are 24/7 helplines available that can be accessed through 111. That is what we are doing.
Priti Patel (Witham) (Con)
Mid and South Essex integrated care board is seeking to remove vital community health services from St Peter’s Hospital in Maldon. Will the Minister meet me and our right hon. Friend the Member for Maldon (Sir John Whittingdale) to discuss the proposals? They will affect both our constituencies and are causing a great deal of concern.
Helen Whately
I would be very happy to meet my right hon. Friends to discuss those concerns.
Pharmacy First
Priti Patel Excerpts(10 months, 3 weeks ago)
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Dame Andrea Leadsom
There has been a 61% increase in registered pharmacists since 2010, with plans to increase that number by 50% in the next few years.
Priti Patel (Witham) (Con)
I commend my right hon. Friend for her excellent statement, but how will she tackle the issue of funding for prescriptions? Community pharmacies are struggling, and she will understand that the NHS tariff does not pay them the full price of products. Will she look at that as she rolls out the scheme?
Dame Andrea Leadsom
The Government currently contribute £2.6 billion to community pharmacy, quite apart from the £645 million addition for Pharmacy First. We are about to start negotiations for the 2024-25 period.
Oral Answers to Questions
Priti Patel Excerpts(1 year ago)
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Dame Andrea Leadsom
My hon. Friend is right; it is appalling that people book an appointment and then do not show up. In many GP surgeries now they post the numbers of patients who do not turn up for their appointments and urge people to make the effort to cancel. As part of our access to primary care, we are creating digital tools so that GP surgeries can notify patients that they have an upcoming appointment and say, “If you don’t need it, press here and it will cancel the appointment.” Measures such as that make it easier for people to cancel, but he is quite right that it is incumbent on us all, if we book that appointment, to turn up for it.
Priti Patel (Witham) (Con)
Debbie Abrahams (Oldham East and Saddleworth) (Lab)
The Secretary of State for Health and Social Care (Victoria Atkins)
I am pleased to reiterate to my right hon. Friend the Member for Witham (Priti Patel) that Essex is receiving funding from the National Institute for Health and Care Research, which is funded by the Department of Health and Social Care, to promote research into health inequalities and support better health outcomes for her constituents and all residents in Essex.
Priti Patel
I thank the Secretary of State for her response and welcome her to her new role; it is a real pleasure to see her in her position today. My Witham constituents have one of the highest patient-GP ratios in the country. That brings many challenges in accessing the NHS, from primary care to dentistry, social care and hospital appointments, some of which have been exacerbated by industrial action. Will she give an update on the work she is leading to address some of those issues and will she support my work and campaign locally to get a new primary health centre in Witham town?
Victoria Atkins
I thank my right hon. Friend very much for her kind words. She will remember how much I enjoyed sitting on the Front Bench alongside her when we were in the Home Office. In terms of her work in Essex, she is a formidable campaigner and she will know that the decision on such a healthcare centre lies with her integrated care board, to which the Government have given some £183 million of capital funding between 2022 and 2025. I am sure she will make a compelling case to the ICB for such a centre in her constituency. Interestingly, the Mid and South Essex integrated care board is one of seven sites receiving additional support and funding from NHS England to address health inequalities, and I know she will pay close attention to how that is spent.
Victoria Atkins
As I said earlier, careful thought has gone into the announcements that were made in the autumn statement, and of course I will work with the Secretary of State and the Chancellor to ensure that the commitments we already have to people living with disabilities are maintained, and that we have their wellbeing at the heart of all our policy making.
Priti Patel (Witham) (Con)
Victoria Atkins
I would be very pleased to meet my right hon. Friend, the families and other Essex MPs to discuss that important inquiry.
Countess of Chester Hospital Inquiry
Priti Patel Excerpts(1 year, 3 months ago)
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Steve Barclay
The hon. Gentleman raises an extremely important point. It is right that we focus on that and ensure that the concerns about the revolving door are addressed. On the decision taken by my predecessor, my understanding is that the recommendations accepted from Kark were viewed as effective in addressing that—obviously, the events to which this statement relates have happened since—but I have asked NHS England colleagues in the Department to look again at testing them further in the light of the evidence that has come through from the court case in particular.
Priti Patel (Witham) (Con)
My heartfelt prayers and thoughts are rightly with the families, whose heartbreak and suffering is just unimaginable. I really welcome the tone that the Secretary of State has taken on ensuring that no stone is unturned in the quest for justice. Likewise, I thank him for the support that he has given us in Essex through the Essex mental health trust statutory inquiry that he announced just before recess—we look forward to working with Baroness Lampard on the terms of reference. Can he some provide some assurance so that the 80-plus families who did not engage with the inquiry previously come forward, give evidence and have confidence that their evidence will lead to justice for the loved ones they are missing because of what happened at the mental health trust?
Steve Barclay
I am keen to give my right hon. Friend that assurance. I know that she has personally championed —as have a number of colleagues across the House—the interests of families in Essex to ensure that they get the answers they need. Indeed, she very effectively conveyed to me the concerns about the inquiry in Essex hitherto. Our focus—I think this is an area of consensus across the House—has to be on ensuring that families get the answers that they legitimately deserve. The reason that it was proportionate to shift the Essex inquiry from a non-statutory footing to a statutory footing was the concern of the chair that there was insufficient engagement, particularly from staff but also, as my right hon. Friend just said, from families who did not have confidence in the inquiry as it was. That is why that inquiry has been strengthened and we have put in a very senior chair with experience of the Savile inquiry. I know that my right hon. Friend will be at the forefront in ensuring that the families’ voices are heard moving forward.
Mental Health In-patient Services: Improving Safety
Priti Patel Excerpts(1 year, 5 months ago)
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Steve Barclay
It is a shame that the hon. Lady chose to conclude her remarks in such a way. Let me address that head-on. It is bizarre to accuse a Minister who is literally at the Dispatch Box of being missing, particularly when the shadow Health Secretary, having managed to turn up for Prime Minister’s Question Time, has failed to turn up for this statement. It is even more bizarre that, although we are constantly told that the Labour party sees parity between mental health and physical health as a key priority, when it actually comes to debating the issue, the contrary is clearly on show.
This debate is not about the issues normally raised during Prime Minister’s questions about the politics of the day; it is about the families who have tragically lost loved ones, about how we can learn the lessons from that, and about how we can ensure that we get the data right, get the support for staff right, and get the procedures right so that other families do not suffer loss. We have responded to the excellent points made by Dr Strathdee through her rapid review about data. There are two elements to that: there is data that is collected that does not add value, is often duplicative and takes staff away from giving care—that is somewhere that we can free up staff—but there is other data that is needed to better identify issues early, and we need to look at how we improve that data. Specific issues arose in respect of engagement by staff, and we have actively listened and responded to the concerns raised by families and by many Members of the House, particularly about the Essex inquiry. I will come on to those as I go through the wider issues.
The shadow Minister mentioned speed. Of course, there is a balance to be struck between the completeness of a statutory inquiry and the greater speed that is often offered by other independent inquiries. Indeed, the Paterson inquiry was a non-statutory inquiry commissioned through the Department, and that is another vehicle that is often successfully used. There are also inquiries commissioned through NHS England, such as the Donna Ockenden review. There is often a balance to be struck between those inquiries, given the speed at which they can proceed, and a statutory inquiry, which has wider powers but often takes longer.
It was because of our desire to move at pace to get answers to families that we initially commissioned a non-statutory inquiry, in common with Bill Kirkup’s inquiry into Morecambe Bay and inquiries into many other instances in the NHS. However, we have listened to families and to right hon. and hon. Members who have raised concerns about the process and, in particular, the engagement by staff, and decided to make it a statutory inquiry.
The shadow Minister asked about our commitment to transparency. The very reason that we set up the rapid review in January was to bring greater transparency to the data. That is why I will be placing in the Libraries of both Houses the outcome of the rapid review. That speaks to the importance of transparency as we learn the lessons of what went wrong in Essex and in other mental health in-patient facilities.
The shadow Minister made a fair point about waiting times. We are committed to cutting waiting times, including in mental health. That is why we are spending £2.3 billion more on mental health this year than four years ago, we have commissioned 100 mental health ambulances, we have 160 different schemes looking at things such as crisis cafés to support people in A&E, and we have schemes such as the review through 111 and the funding the Chancellor announced in the Budget for mental health digital apps to give people early support. Of course, that sits alongside other mental health interventions, such as our programme to train more people to give mental health support in schools.
The shadow Minister made an important point about working with families. I agree with her about that. HSIB will be meeting families—indeed, Ministers have been doing likewise—and we are keen that that should feed into the terms of reference, both for the statutory inquiry and for the HSIB review.
We have touched on consultants, but let me make a final point on that. As far as I am aware, the Opposition do not support a 35% pay rise, whether for junior doctors or for consultants, but if that is their position, perhaps they will tell us whether this is yet another area that the stretchable non-dom contribution will reach to. Exactly how will it be funded?
This is a serious issue. The measures that we are taking address the concerns of families who have suffered the most tragic loss. It is important that we learn the lessons, both in Essex and more widely. We have actively listened to the points raised by Dr Strathdee, who has done a fantastic job. It is right that the work moves on to a statutory footing, but it is also right that we look more widely at the lessons from other mental health in-patient facilities. That is exactly what we intend to do.
Priti Patel (Witham) (Con)
First, let me put on the record my personal thanks to the Secretary of State and Ministers for their honest and frank engagement with colleagues and with bereaved families, whose concerns they have listened to. It was my constituent Melanie Leahy, who was at one stage a constituent of my right hon. Friend the Member for Maldon (Sir John Whittingdale), who brought the issue to our attention and to the attention of the Secretary of State. She deserves a lot of support for the way she has conducted herself. None of us would want to go through the sheer anguish and personal trauma that she has experienced. We owe a lot to her and to others who have come forward.
There are still 80-plus families who did not engage with the inquiry led by Dr Strathdee, to whom I pay tribute. The statutory inquiry will give them the confidence and courage to come forward, speak up and share what will be—we should be frank about this—deeply harrowing evidence. Will the Secretary of State expand on how evidence received by Dr Strathdee’s inquiry will be treated? I know that he said he will come back to the House on the processes. We are interested, in particular, in the inquiry’s terms of reference. Importantly for bereaved families, what measures will be in place to support people to come forward and give evidence? There have been too many barriers in that regard for families and, if I may say so, those who have been employed by EPUT. What involvement will the families have in drawing up the terms of reference? They are the ones that need confidence in the process. Again, I thank Dr Strathdee, and I thank the Secretary of State and Ministers for their engagement.
Steve Barclay
In my discussions with my right hon. Friend and colleagues, I found the compassion that they showed and the way they championed the family voice compelling. I absolutely agree that it is important that families take confidence from the decision to move the inquiry on to a statutory footing and come forward with their evidence. I know that she plays an active part in that. Of course, we want families to be part of the discussion on the terms of reference. I know that, with her significant experience, my right hon. Friend is keen to be part of that too, and we are keen to engage with her on it.
My right hon. Friend is right to highlight the evidence that has already been gathered through the excellent work of Dr Strathdee. I had a meeting with her yesterday to ensure that we capture that as part of the work that is moving forward. I hope—I reinforce my right hon. Friend’s point—that families will take confidence from today’s announcement and that those families who have not come forward to date will be able to do so. I know that in my right hon. Friend they will have a resolute champion supporting them to do so.