Oral Answers to Questions
Rachael Maskell Excerpts(1 year, 1 month ago)
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Wes Streeting
I am very sympathetic to the argument that the right hon. Gentleman makes about the importance of neighbourhood health services in Borehamwood, and indeed in towns and communities across the country. What I am not sympathetic to is a former Deputy Prime Minister complaining about the state of the NHS, which he played a key part in creating when he sat around the Cabinet table.
Rachael Maskell (York Central) (Lab/Co-op)
One in three hospital admissions occurs in a person’s last year of life, and 43% of people will die in an NHS hospital. Clearly, that is not acceptable when people are at their frailest. What is my right hon. Friend doing to invest in virtual wards so that we can keep those people at home, and in the district nurse workforce to ensure that district nurses have a proper career structure and that theirs can be a profession of choice once again?
Wes Streeting
My hon. Friend is absolutely right about the innovation and the impact of virtual wards. I have seen at first hand the impact they can have—not just in providing better value for taxpayers and freeing up hospital beds for those who genuinely need to be in hospital, but in providing what everyone wants, which is to receive high-quality care in the comfort of their own home wherever possible. That will be a big part of our 10-year plan, and of course, it will be underpinned by really good community nursing and community healthcare teams.
Down’s Syndrome
Rachael Maskell Excerpts(1 year, 1 month ago)
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Rachael Maskell (York Central) (Lab/Co-op)
It is a pleasure to see you in the chair, Mr Turner. I congratulate the right hon. Member for Beverley and Holderness (Graham Stuart) on securing this debate. The Down Syndrome Act is simple, but brilliant—but it is powerless without the guidance to accompany it. That is why this debate is timely.
I also call it timely because the elements of the Act determine the very structure that can support a child through to adulthood, from birth through to work. The Act depends on three main pillars, the first of which is healthcare. At this time, we are putting in place a 10-year NHS plan, putting together the NHS of the future, and looking at how we can keep ourselves well; we are putting in early intervention measures and ensuring that we have the workforce needed in the future. If this guidance is to have effect, we need the workforce and the structures to support individuals and their families. Now is the time to look at that and to put in the additional screening and support that a person with Down syndrome needs to optimise their health and keep well throughout their life.
The second pillar is that we are having a massive review of the education system at the moment. We are looking at curriculum change, recognising that the broadening of the curriculum will be much more inclusive. As we review SEND and the whole education system, it is timely to bring in this guidance. It cannot just be guidance around Down syndrome looking in; it must be looking out at other Departments. Again, the time is now. Look at the data: the figure of 80% of children with Down syndrome attending primary school drops to between 25% and 37% in secondary school. That deficit in itself indicates that we need significant change in our education system. We need a schools system that is nurturing, therapeutic and integrated, so that no child feels on the outside of the education they are rightly entitled to.
The third pillar is the place of work. We need to ensure that there are more opportunities for people with Down syndrome to engage in the labour market. Just yesterday, the Government published their plan “Pathways to Work”, which I see as a plan in two halves. The first half will enable more people to access the labour market, to follow the career of their dreams, and to have their skills and talents recognised. We need to ensure that everybody with Down syndrome has that opportunity where it can be afforded—if not in a formal workplace, by volunteering in the community or being able to have the most life-enhancing opportunities available to them. When I talk about the second half of the plan, I have deep concern for people with Down syndrome, looking at the proposed thresholds for personal independence payment in which people will have to score at least four points to meet the threshold to access vital funding to keep them independent —the key word in personal independence payments. We need to ensure that we feed into that debate.
When we get this right, it will be for the benefit of the whole of society. In York, I think of those people who work in West Offices, where the café is run by United Response and provides real work opportunities, and of the Once Seen theatre company, where I see such talent on display. We must get this guidance—
NHS England Update
Rachael Maskell Excerpts(1 year, 1 month ago)
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Rachael Maskell (York Central) (Lab/Co-op)
We must remember that NHS England came out of the Tory Government’s reforms that were intended to privatise the NHS. I want to thank NHS England staff for their work. I am sorry about the way in which they have heard this announcement, because it is their jobs that are being put at risk. We have to ensure, however, that we are not replicating NHS England across the ICBs of our country, and that ICBs are also reformed to transform the NHS through the three shifts that will be placed on them with the publication of the 10-year plan. How will my right hon. Friend ensure that we have the machinery to hold the system to account, but also to put those reforms in place?
Wes Streeting
My hon. Friend is absolutely right: if we just replicate NHS England as it is with all the challenges in its set-up in ICBs across the land, we will have failed. Frankly, if we replicate NHS England and the Department as they are today just in one organisation, we will have failed to meet the challenge of change. It needs to feel and act like a completely new organisation, culture and way of working to modernise the state, so that if Disraeli, Gladstone, Churchill or Attlee walked into Whitehall at the end of this Government, it would not look so much like the Government they worked in during the 19th and 20th centuries. That is the reality of Whitehall today; it is not a reflection on the people who work in it, but it shows why it needs to change, and that is also true of the NHS. I look forward to working with ICB leaders to reform their ways of working, clarify their priorities, give them clearer marching orders and ensure that they can deliver.
Finally, my hon. Friend mentions the staff of NHS England—indeed, this affects staff in my Department, too—and I thank her for the care she has shown. Change is always disruptive and it can be scary, and of course that is particularly the case when job losses are involved. I want to acknowledge that on the Floor of the House, as I have to staff across both organisations this morning. I know that the Permanent Secretary and the chief executive of NHS England have done so in recent days, and I will be holding a town hall with staff next week. This really is not a reflection on them. In fact, I think they will recognise in my description of our ways of working the many things that frustrate them. None the less, they are dedicated and talented people, and some of the best people I have ever worked with in any walk of life or career work in this system. I look forward to working with them in the coming weeks and months with the same dedication and professionalism they have always shown, so that we can all look back on this time with pride, knowing that we were part of the team that took the NHS from the worst crisis in its history to getting it back on its feet and making it fit for the future.
New Hospital Programme Review
Rachael Maskell Excerpts(1 year, 3 months ago)
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Rachael Maskell (York Central) (Lab/Co-op)
I am really glad that my right hon. Friend has a grip on the hospital building programme and has developed a pipeline for scheduling the new hospitals. York is not on the list, but given that it was one of the cheapest hospitals to build, it will certainly need to be there in 10 to 15 years. How will my right hon. Friend review hospitals that are not on the list and schedule them into future programmes?
Wes Streeting
We keep a regular eye on the capital needs of the NHS across the board. Subject to the usual constraints on resources, supply chain construction industry capacity and so on, we will continue to do so. We are determined not to repeat the mistakes of our predecessors, but to ensure that the promises we make are promises we can keep.
Health and Social Care: Winter Update
Rachael Maskell Excerpts(1 year, 3 months ago)
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Madam Deputy Speaker (Judith Cummins)
Order. Members will be aware that we have pressure on time today, so I will finish this statement at around 3.15 pm.
Rachael Maskell (York Central) (Lab/Co-op)
Triaging patients into virtual wards will not only protect the front door of the NHS, but be far better for patients. What is the Secretary of State doing to hold integrated care boards to account and ensure that they are putting money into primary care, as opposed to where everyone always looks, which is secondary care?
Wes Streeting
That is an excellent question from my hon. Friend. This Government have been walking the talk on primary care since we came into office. There was an immediate release of funding, within weeks, for 1,000 GPs, who are to be employed on the frontline by this April, and an £889 million uplift in funding for general practice that we announced prior to Christmas. I think that care in the home and care closer to home will be how we not only get the NHS back on its feet, but make sure it is fit for the future. That shift from hospital to community is one of the three big shifts that will lie at the heart of our 10-year plan for the national health service.
Oral Answers to Questions
Rachael Maskell Excerpts(1 year, 4 months ago)
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Andrew Gwynne
Social prescribing is one of the tools, and it is an important one in addressing public health concerns in each of our constituencies. This Government are committed to ensuring that we get those shifts from sickness to prevention. We will be ensuring that local areas have public health funding in reasonable time. We are about to announce, in due course, this year’s allocations. We need to make sure that local systems maximise the use of their money, and that certainly includes social prescribing.
Rachael Maskell (York Central) (Lab/Co-op)
In 2022, there were more than 10,000 deaths from alcohol use. We know that more than 600,000 people have an alcohol dependency. We need to focus not just on treatment services and their funding, but on prevention. The last Government failed to bring forward a timely alcohol strategy. Will the Minister update the House on what he is doing to ensure that we are tackling this massive situation in our communities?
Andrew Gwynne
My hon. Friend raises an important point. As part of the Government’s health mission, we are producing a five-point plan for prevention, and alcohol harms is one of those areas. I hope to be able to update her and the House in due course on the actions we will be taking to drive down the prevalence of alcohol harms and other addictions, because they are costing lives and causing misery in communities. That is why this Government are determined to tackle these public health problems.
Health and Adult Social Care Reform
Rachael Maskell Excerpts(1 year, 4 months ago)
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Mr Speaker
We are going to finish at about 10 to 5, so the speedier we go, the more that will help.
Rachael Maskell (York Central) (Lab/Co-op)
I thank NHS staff for working under severe duress over this winter. One way of ensuring better patient flows is to have better rehabilitation, so will my right hon. Friend say what he is doing to improve rehabilitation access not only in acute sectors but out in the community?
Wes Streeting
Further to the previous question, we will be refreshing and updating the NHS workforce plan alongside the long-term plan that we will publish in May, and my hon. Friend is right that rehab is key not just to good recovery but to prevention of future demand on the NHS. I saw a great example of that rehabilitation delivered in social care settings only last week. Whether in the NHS or in social care, we definitely need to do more on rehabilitation, because rehabilitation is often secondary prevention.
Winter Preparedness
Rachael Maskell Excerpts(1 year, 4 months ago)
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Karin Smyth
I will do my best to address that range of questions. First, as even a stopped clock is right once—[Interruption.] Yes, twice. On that basis, I agree with the right hon. Gentleman. On correspondence and answers to parliamentary questions, again, the situation we inherited is not satisfactory. I apologise to all Members who are waiting for correspondence—it is something we are taking a grip of. We want to respond positively to questions. The Conservatives did not; we will make sure that starts to happen.
On capacity in the system, again, I remind Members that we came into office in July, which is one quarter of the way through the planning and financial year. We very rapidly looked at the plans that were baked in by the previous Government—I appreciate that the right hon. Gentleman was in the Ministry of Justice at the time, not the Health and Social Care Department—to see whether they were fit for purpose. We wanted to make sure we brought stability to the system. There are, in fact, more beds currently available in the system than last year. If there is a need to increase capacity due to a likely cold snap, the system is absolutely ready to respond in its usual way. That is why we are meeting weekly.
On meetings with clinical and managerial colleagues at NHS England—who, frankly, I see more often than many members of my own family—I can tell the right hon. Gentleman that we started those meetings immediately. I would have to check the exact date, but it was certainly in the summer. I have had fortnightly meetings since September, which, as I said, we can move to monthly meetings, chaired by the Secretary of State. We began getting a grip from day one, knowing that winter was coming, which is why I am monitoring the situation weekly. It is also why we visited the operational centre, to understand in real time what is happening across every single system and every single trust—be that ambulance issues or problems at the front end and in A&E. The one question I do not directly have the answer to is what the daily figures are; I will try to get those figures to the right hon. Gentleman later.
We all know that waiting for discharge to assess is a massive problem. That is why, as I said in my statement, we want to take a grip of the better care fund, to ensure it works better and to stabilise the social care system. I am not particularly versed in issues on supply, so I apologise if that is wrong. We will certainly get back to the right hon. Gentleman on that matter, because we want people to be taking the vaccinations where necessary.
I can confirm that we want an announcement on hospices before Christmas. On winter fuel and its impact, as Opposition Members know, we will continue to monitor the impact of all situations on individuals to ensure they are supported in the community. We urge people to make sure they access pension credit. [Interruption.] I have just addressed that, but if I have missed anything, I will come back to it.
Rachael Maskell (York Central) (Lab/Co-op)
Despite York’s new emergency department, a consultant has described to me the situation in emergency medicine, where patients are waiting for days to be discharged and 50 patients are waiting to be placed on wards. We know we have inherited a broken NHS. Will the Minister say what she is doing first to enable primary care to pull more patients out of emergency medicine, in order to see people in the community, and secondly to invest in social care, which will clearly address some of the backlog and the logjam in patient flows?
Karin Smyth
My hon. Friend’s comments reinforce how much pressure, we understand, is front facing. A&E is demonstrative of the overall pressure in the system, not just at discharge but, as she rightly says, in primary care. We took action in the summer to improve primary care, increasing the number of GPs available in the system. It is absolutely critical that primary care community services are integral to winter planning at a local level. That is what we expect from every single system. We will continue to monitor that over the winter period and into the spring. If those services are not involved in planning for any particular systems, enabling them to monitor the surge and flow of people, we very much want to understand how that is working.
Oral Answers to Questions
Rachael Maskell Excerpts(1 year, 5 months ago)
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Wes Streeting
It is because the Chancellor took the decisions that she did in the Budget that my Department has received £26 billion to reform and improve health and social care. As I said before the general election, all parts of the United Kingdom suffered under the previous Conservative Government, which is why I am sure that Members from across Scotland will welcome the extra £1.5 billion this year and £3.4 billion next year—the biggest funding increase since devolution. I am sure that the SNP Government will welcome the increase, and they certainly have no excuses now for not acting.
Rachael Maskell (York Central) (Lab/Co-op)
Fourteen years of neglect have left hospices in a perilous condition. They are dealing with the rise in national insurance contributions, pay and other cost pressures, so I welcome the fact that the Secretary of State is putting in place measures to ensure that the funding recovers. Will he assure me that integrated care boards not only will pass on that recovery from the increased costs to hospices, but will help them catch up from the Tory years of neglect of the whole sector?
National Insurance Contributions: Healthcare
Rachael Maskell Excerpts(1 year, 5 months ago)
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Karin Smyth
The hon. Lady makes an excellent point about the importance of GPs and primary care to the wider sector. Immediately after taking office this summer, we freed up the system to employ 1,000 extra GPs through the additional roles reimbursement scheme—which the previous Government refused to implement—because we recognised the need for that extra capacity. We will be talking to general practice as part of the contract reforms over the next few months, following the normal process, to determine allocations for next year.
Rachael Maskell (York Central) (Lab/Co-op)
If this Government’s ambition, stemming from Lord Darzi’s report, is to be realised, significant investment is required not only in primary care but in third sector organisations. However, these organisations are concerned about the increased cost pressures on their services. Will the Minister ensure that there is sufficient support within the trickle-down approach, which the Department will now have to apply, to maintain current service levels and facilitate the urgently needed transition across health services?
Karin Smyth
I respect my hon. Friend’s expertise in this area. She is right, and we understand that the pressures are real, which is why we have committed to supporting the NHS and the social care system with the additional funding that my right hon. Friend the Secretary of State for Health and Social Care secured as part of the Budget settlement.
We are also working closely with the NHS, in a new relationship, to understand its needs. That is a dynamic conversation, because we want to understand what is happening in local systems as we continue to invest in them.