Health and Care Professions Council: Registration Fees

Rachael Maskell Excerpts

Thursday 14th March 2019 Westminster Hall

[Rachael Maskell (York Central) (Lab/Co-op)]

It is a pleasure to serve under you in the Chair, Mr McCabe. I was also registered with the HCPC and the preceding bodies. Although I am no longer registered, I recognise the impact this issue has on NHS staff.

There are nine different regulators in the NHS, regulating 32 different professions. They provide a very important function: this is about protecting not only the public, but health professionals themselves in the course of their practice. The regulators are there to set, maintain and raise standards and to give confidence to the public, as well as to hold a register and protect the title of a profession, so that other people cannot set up a business pretending that they hold the professional qualifications, which people across the NHS work hard for.

Increasingly, regulators also ensure continuing professional development. The most advanced programme of professional development has been put in place by the Nursing and Midwifery Council in recent times. The regulations around that ensure that registrants are compliant with continuing professional development. The function of regulators is to ensure that professionals who fail to uphold professional standards and their duty of care are called to account, so that sanction is applied where necessary and recourse is taken.

We have already heard that—thankfully—a miniscule number of professionals are taken through disciplinary processes. That is a tribute to the great professionalism across the NHS. However, such cases do occur, and it is appropriate that rigorous processes are in place so that individuals can defend their position and have recourse to justice before appropriate action is taken. To have someone practising who is not fit for practice risks the whole profession, so it is vital that that is put in place.

However, the cost of that process has escalated substantially, as hon. Members have mentioned. When I first registered as a physio, I had to pay only £17. In 2015, the last year that I was registered, there was a huge increase—from £80 to £90. The suggested increase to £106 is, quite frankly, unacceptable, particularly given the background, as set out by hon. Members, of a decade of pay regression, pension cuts and student loan repayments. In my time we had grants, so things have changed significantly.

More and more burdens are being placed on health professionals. That means that more risk is placed on health professionals. When we had adequate staffing in the NHS, mistakes were less frequent and caseloads were safer. Unfortunately, in many professions people’s caseloads are now too big. The pressure on those individuals increases.

I was formerly head of health at Unite. We focused on organisations’ duty of care. Managers in particular must say no to the organisation and argue the case for more staff, rather than increase the pressure on health professionals by making their caseloads unsafe—that would mean that managers were failing in their duty of care, in breach of their standards of professional conduct.

[Mike Hill]

I am also a former Unison official. In view of that, does my hon. Friend agree that, as my hon. Friend the Member for Heywood and Middleton (Liz McInnes) rightly pointed out, the professional bodies cover not only full-time and part-time staff, but student social workers and student nurses? They are under the same constraints.

[Rachael Maskell]

Students do have responsibility, but the registered health professional is responsible for ensuring that they are safe under their practice while they are training in their profession. Training the future workforce is an incredibly important additional function of health professionals.

The Law Commission came forward with a set of recommendations for registrant bodies in 2012. In 2019, we still have not seen the implementation of those recommendations in full. I would like the Minister to explain why that is the case. Implementing a substantial piece of work about ensuring patient safety should surely be at the forefront of the Minister’s agenda. I am interested to hear the reasons for the delay, and what plans there are to put those recommendations in place. Training programmes for health professionals need to focus on the ethics, behaviour and conduct of health professionals, if we want to see a reduction in the number of cases. Managing that risk is really important.

I want to raise a number of points to move this case forward. First, as we have heard, 38,000 people signed a petition to register their discontent with the fee rise. That cannot be ignored. These are valuable NHS workers. Their call must be heard and reflected on. However, the HCPC hardly seems to have taken that into consideration. As my hon. Friend the Member for Heywood and Middleton (Liz McInnes) said, the number of fitness-to-practise cases being taken forward—currently, 59% of them involve social workers—will disappear. Therefore, surely the registrant body’s costs will decrease. We want to hear how that will benefit health professionals.

This is a tax on professionals. Will the Minister consider funding that regulation fee through the NHS? It does not make sense for nurses, physios and speech therapists, for example, to pay a different amount. That is a tax on professionals who have put in the training and the hours, and go over and above the hours. Why can the Government not pay the amount for each health professional? More than a gesture, it is a responsibility of the NHS to ensure that its registrants, including part-time workers, have that support. I completely concur with the suggestion made by my hon. Friend the Member for Heywood and Middleton that there should be a part-time rate.

[Dr Drew]

Forgive me if I am being simple, but do we know where the extra money is going and what the HCPC is doing with it? Can it explain that? Are the Government holding it accountable? Can my hon. Friend throw some light on that?

[Rachael Maskell]

My hon. Friend makes such a good point. I wish I could explain that, but to me it seems to be more money and less work. I am as baffled as he is about why health sector workers have to pay into this institution to do less work. I worked as a part-timer when I was head of health at Unite. Although I worked at weekends, I had to pay the full fee, so I certainly understand the frustration. Of course, that mainly affects women, who are more likely to work part time.

Finally, I ask that an expansion of the number of registered health professionals should be considered—after all, this is about keeping the public safe. We should know that the title under which the professional acts is secure and represents them. Certainly psychological services, such as psychotherapists, have requested to be registered, as have community nursery nurses. It is perplexing that the registration of nursing associates on a register—not this one—has been accelerated, but the registration of community nursery nurses, who have long asked for that, has not happened.

I would go further and say that, as we are looking at the future of the social care workforce across the country, we should also look at individuals who are singlehandedly going into people’s homes but who do not have the protection of being on a professional register. Ultimately, that is about keeping the public and our health professionals safe and secure. What steps is the Minister taking to ensure that a greater number of professionals are protected under the existing regulatory regimes?

Eating Disorders Awareness Week

Rachael Maskell Excerpts

Wednesday 27th February 2019 Westminster Hall

[Kirstene Hair]

My hon. Friend is absolutely right. The sufferer of course needs specialist support, but I will go on to speak about how I believe that we also desperately need to support families and, indeed, all those around them. This disease is so complex that it is often difficult to treat and, trapped in the disease, sufferers feel that there is simply no way out. Many believe that if the disease does not take them, they will take their own life, just to rid themselves of it. No matter how strong an individual is, an eating disorder is so all-consuming that once it has taken hold, some people believe that they will never live a normal life again, and many do not: the condition becomes chronic for about 20% of sufferers.

Normally, a series of events has encouraged the person’s mind to think differently about their body image. Perhaps they have decided that they are not good enough: one too many times, people or life events have created a narrative in their mind that they are inferior to those around them, or perhaps life is out of control in many aspects—nothing is going right. They compare themselves with others around them and see only the negatives in their own life and the positives in other lives, but they can take back control of one aspect of their life—control of what they eat. That may well start off as a diet, but not a diet that would be followed by a normal individual, which often fails. It soon becomes a focus and then a more extreme calorie-counting exercise that involves hiding food, burning off every calorie possible and social isolationism. Before they know it, the candle is burning at both ends. Before a sufferer has identified that they need help, the registered impact on their body is always perceived as being caused by some other reason. There is a voice inside a sufferer screaming that too much food is being consumed or not enough exercise is being done—praise when they miss a meal or hear the sound of a rumbling stomach. That voice inside a sufferer will not and cannot go away.

The loved ones around a sufferer see their daughter, son or friend fade into a shadow of their former self; they are helpless in every way. Parents struggle and are in emotional turmoil. They know that if their daughter falls and skins her knee, they can bathe it, put a plaster on it and make it better. If their son is upset because he is struggling at school, they can get him the support that he needs. We have solutions, and it is human nature to want to fix and help those we love. However, when it comes to eating disorders, everyone is helpless and feels hopeless. No one, unless they are trained, can provide support, other than the individual themselves. Many, if not all, sufferers who have managed to recover will say that it was the hardest journey that they have ever taken, but having spoken to some of Beat’s bravest ambassadors, we have seen at first hand the amazing, inspiring individuals they can become—but that is only if we help them.

As a result of the stigma attached to eating disorders, black, Asian and ethnic minority people, lesbian, gay, bisexual and transgender people and people from less affluent backgrounds are less likely to seek and get medical support. Research developed ahead of today’s debate showed that four in 10 people believe that eating disorders were more prevalent in white people than in other ethnicities, yet research shows that they are just as common or more common in the BAME community. Thirty per cent. thought eating disorders were more likely to affect the more affluent; in fact, they evolve at the same rate irrespective of education or income. Sixty per cent. of respondents believed that they affected only young people. That is having a significant impact on adults coming forward for support, and we see men and boys not being referred as soon as girls and females.

The statistics might not be surprising, but we have to challenge them continually. They are preventing certain groups in society from appealing for help, and creating an inequality in support. As a result, people are more ill by the time they are referred, making the recovery process much more difficult and sometimes impossible. We have seen fantastic work by members of the royal family as well as other notable figures, who have raised awareness of mental health disorders and who seek to break down the barriers to people speaking out, but also recognise that it is okay to talk and okay for someone to say that they need help.

When sufferers reach out for help, they have often been suffering for years. They need urgent specialist help immediately. The average cycle of relapse and recovery lasts six years, and there must be constant efforts to reduce that. To undo months and years of torture, specialists need time and resources to allow a patient to open up, to analyse, to find out the root causes, to get under the skin of the issues and to develop the mind to fundamentally change—a long-term approach, but a life-changing one.

Families, too, need guidance and support on how to deal with this troubling time. Many do not know where to go for support. This was one comment from the social media campaign that I ran before the debate:

“When anorexia arrives in a family it is like throwing a grenade into a home and watching it explode...caring for my daughter has impacted on the mental health of all those in my family.”

That is why I agree with my hon. Friend the Member for Henley (John Howell) that family-based therapy would provide a much-needed support base throughout the recovery process.

Without the investment of time, those patients will be back in our GP surgeries and hospitals time and again. We must look beyond weight. This is an issue of the mind, so whether it is a case of referral or recovery, it cannot be determined by the number on the scales. As a result of the digital campaign that I ran, I heard from many people up and down the country, and I thank them for coming forward with their stories. One person, who wished to remain anonymous, said that

“my granddaughter never got so thin but she died nearly 7 years ago at the age of 19 and I feel that if there had been some positive help she would have been alive today.”

She had been disregarded simply because her weight was not low enough. Recent research shows that GPs do not have adequate training for supporting individuals who have an eating disorder, with three in 10 sufferers not being referred when required.

[Rachael Maskell (York Central) (Lab/Co-op)]

rose—

[Mr Adrian Bailey (in the Chair)]

I call Louise Haigh.

[Rachael Maskell]

The hon. Lady is making an excellent speech. I am troubled by the fact that, a year on, services in York are still completely inadequate. On Friday, I spoke to GPs who are trying to manage individuals with eating disorders. They have been instructed to take patients’ blood, to monitor the electrolytes, and to weigh them frequently, without the psychological support and clinical competencies that are necessary. Is it not absolutely essential that GPs receive the training that they need, so that we can put in place the holistic services that patients need?

[Kirstene Hair]

The hon. Lady is absolutely correct. I will come on to speak about that in detail. I hope the Minister will give further detail on how she is approaching that with other Departments.

In any five-year medical degree at UK medical schools the average amount of training in eating disorders was 1.8 hours, and one in five gave no training at all. The concern is not confined to one part of the United Kingdom; it is a widespread issue across all nations. That seems absolutely extraordinary, given that this is one of the most fatal mental health disorders, affecting 1.25 million people. GPs must be able to tell the difference between a healthy exercise routine and a compulsive one, low body-mass index and lack of nutrition, and going through a diet phase and the beginning of an eating disorder. They must recognise the clear indicators and how eating disorders manifest in order to deliver the right treatment plan, but to do that they need training.

I would like to see further encouragement of self-referrals and more work with schools, where many members of staff may be able to identify unusual behaviour. I warmly welcome the approach taken by my secondary school, Brechin High School, which has appointed a member of staff to lead on mental health who has a support base within the school and is linked up with the local primary schools, so that at the end of primary school, when an eating disorder—or any mental health disorder—may begin to develop, that support is monitored and continued as pupils enter secondary school and progress their education. I am keen to hear from the Minister how the training aspect can be addressed. I would like to hear from the Scottish National party spokesperson how the Scottish Government could do more to include training within university tuition, and how they will address the role that schools can play in early intervention.

When help is needed, how long do we have to wait? Waiting time targets have been a focal part of the campaigns run by many charities for years. In England and Wales, by 2021, 95% of eating disorder referrals for those under-19 are due to reach a specialist within four weeks, and within one week for urgent cases. Will the Minister confirm that the Government are on track to deliver that target, which is already making a huge impact? Along with the charities, I warmly welcome the ambition shown by this Government.

This is not a political debate and I do not wish to make it one. However, once again, when I wrote to the Scottish Government asking why they refused to equalise that target for young people, no substantive reason was given. I have also asked the Scottish Minister for Mental Health about that, and I look forward to her response. The UK Government have stepped up to treat under-19s. I encourage work so that those targets continue to be ambitious. We know that the sooner patients are seen, the higher the chance of recovery and the lower the long-term cost to the NHS. The current 18-week target in Scotland simply has to be addressed. When sufferers determine they need help, their illness is more likely to be treatable, but by the time they may be seen, the likely outcome is much more negative and potentially fatal. I want my constituents to have the same opportunity for early intervention as people south of the border. I want the Scottish Government urgently to address this needless inequality.

As we know, those with an eating disorder often take up to three years to identify that they have such a disorder. Sufferers must do two things: realise something is wrong and wish to make themselves better. When a sufferer comes forward, given their scepticism about all those trying to help them, we have a moral responsibility to grasp their ask for help and support them as a matter of urgency. That requires step-by-step help, to nurture these fragile but wonderful people and not let any of them fall out of the system.

I want to conclude with a point about social media, which is a force for good in many ways, but a stain on the life of many families, which recognise it as the tool that tore them apart. All age groups regularly browse online to determine what everyone else is up to or to catch up on the news, but they normally see only positive news. I have not seen one Instagram image of anyone in this room getting up in the morning, doing mundane things, such as washing the dishes, or having a bad day at work, because we submit only positive images. However, if we also put out negative images, things might feel slightly more normal.

Social media is a platform for showcasing the positive aspect of our lives, with no balance of the negative aspect that we encounter every day. For someone with an eating disorder, or any mental health disorder, that only accentuates their problems. Recent cases have made us all stop and think. There is so much pro-ana and pro-mia material promoting a harmful mindset, which forms or heightens an eating disorder. We must not forget that this material is often put up by sufferers themselves, so we must push supportive materials towards those who promote such images and material.

I do not believe that that is above any of the social media companies. The Secretary of State for Digital, Culture, Media and Sport made a hugely positive step forward in that respect earlier this month. Will the Minister explain the conversations that her Department has had with the Department for Digital, Culture, Media and Sport? Social media platforms cannot take all the positives of social media, but refuse to take responsibility for some of the damage it causes.

In summary, I would like to thank all hon. Members for supporting this debate. I know that it is close to the hearts of many in this place. I hope that the Minister will show those who have suffered, those who are suffering and those who do not yet know that they will suffer that this Government are on their side. I hope the Minister will show that we will never rest on our laurels, but will continue to address the flaws and increase our ambition, reduce waiting times, develop support and facilities for all who need it, wherever they live in the country, intervene early and offer the right support throughout the whole process, expel the postcode lottery of support, encourage our world-class universities to improve teaching programmes, so that they are in line with the impact this disease has on so many, and ensure that social media companies play their part in bucking this trend. We have to help those who are, through no fault of their own, helpless about their own aid. For many it will be the first time in their lives, because that is what Government is here to do: help you when you cannot help yourself.

Orkambi

Rachael Maskell Excerpts

Monday 4th February 2019 Commons Chamber

[Bill Wiggin]

I am sure that the hon. Gentleman’s constituents will be grateful to him for raising the issue in the House this evening.

Every week, five babies are born with the disease, according to Great Ormond Street Hospital, and every week two young people die as a result of cystic fibrosis. The disease accounts for 9,500 hospital admissions and over 100,000 hospital bed days a year. There are two main ways to treat cystic fibrosis: conventional treatments target the symptoms, and precision medicines such as Orkambi tackle the cause of the condition. For conventional treatment on the NHS, the average waiting time to be admitted to hospital is 45 days.

Orkambi presents a relatively safer, more effective and clinically meaningful alternative. In treating the root causes, it reduces lung damage and cystic fibrosis-related diabetes, and improves pancreatic function. The drug has been approved by the European Medical Association, and the Food and Drug Administration in the United States. It avoids the high risk associated with organ transplants.

Orkambi treats the F508del mutation, which around 50% of people with CF in the UK carry. Essentially, the drug permits more chloride ions to pass into and out of the cells. This helps to keep a balance of salt and water in affected organs. Ivacaftor is one of the active substances in Orkambi. It increases the activity of the defective cystic fibrosis transmembrane conductance regulator protein, thereby making the mucus less thick. Decline in lung function is the most common cause of death for people with cystic fibrosis and, although not a cure, Orkambi has been found to slow the decline in lung function by 42% and reduce hospitalisations by 61%.

[Rachael Maskell (York Central) (Lab/Co-op)]

Before coming to this place, I was a respiratory physio and worked with many people with cystic fibrosis. The cost of hospitalisation and treatment far outstrips the cost of this drug for many people with cystic fibrosis. Should not the National Institute for Health and Care Excellence change its criteria and look at the value of life, instead of only the day-to-day cost of this drug?

[Bill Wiggin]

No, I do not agree. The purpose of this debate is to a show an alternative that allows NICE to spend taxpayers’ money on drugs for other conditions while still allowing cystic fibrosis sufferers to have access to this vital drug—and not just to Orkambi, but to the next generation of the same sort of drugs. Bear with me because we have not got to the good bit yet.

In July 2016, NICE recognised Orkambi as an important treatment, yet was unable to recommend the drug for use within the NHS on grounds of cost-effectiveness. The drug is estimated to cost around £104,000 per patient per year and must be taken for life. Orkambi is not provided by the NHS, except in rare cases on compassionate grounds. It remains patent to its manufacturer, Vertex Pharmaceuticals, under UK patent law. In July 2018, NHS England made what it said was its best and final offer to Vertex of £500 million over five years. This was described by the NHS as the “largest ever financial commitment” in its 70-year history. Tragically, Vertex rejected the offer.

We all know that it is essential that a solution is found as soon as possible to make the drug available, as every day counts in slowing the progress of the disease. In an email to me, Vertex states that it

“is committed to finding a sustainable solution for access to our medicines for Cystic Fibrosis patients, including Orkambi”.

That is not quite the impression I have received so far. I sincerely hope that that is indeed its highest priority.

The drugs that constitute Orkambi—Ivacaftor and Lumacaftor—can be synthetically developed at low cost, yet their price remains inaccessibly high.

NHS Long-term Plan

Rachael Maskell Excerpts

Monday 7th January 2019 Commons Chamber

[Matt Hancock]

Yes. I have discussed the proposals made by my hon. Friend and his Northamptonshire colleagues with the Secretary of State for Housing, Communities and Local Government. We are both enthusiastic to see what can be done, and I invite my hon. Friend into the Department to speak to my officials about how this could be done. His proposals are, by design, entirely consistent with the proposals in paragraph 1.58 of the long-term plan, and I very much look forward to working with him and his Northamptonshire colleagues on making it happen.

[Rachael Maskell (York Central) (Lab/Co-op)]

Health visitors are vital to delivering early intervention and prevention, yet their numbers are in freefall—falling by 23.5%, or 2,425 health visitors, since October 2015. Health visitors are now working with dangerous caseloads, so when will the Secretary of State ensure that we have safe delivery of health visiting services?

[Matt Hancock]

The hon. Lady is dead right. Of course, health visitor numbers went up very sharply between 2010 and 2015. In fact there is a proposal in the plan, and the NHS will be discussing with Government the best way to commission health visitors. Health visitors are clearly a health service but, at the moment, they are commissioned by local authorities. We look forward to working with the NHS and with the Ministry of Housing, Communities and Local Government on how best we can commission health visitors in future, because they are a critical part of maternity services.

NHS: Staffing Levels

Rachael Maskell Excerpts

Tuesday 11th December 2018 Westminster Hall

[Rachael Maskell (York Central) (Lab/Co-op)]

I congratulate my hon. Friend the Member for Batley and Spen (Tracy Brabin) on calling this vital debate.

I remember the challenging years of the mid-1990s, when I was working as a physio in the NHS. During that crisis time, I never knew when I would get home. Today’s scenario reminds me of the dying years of a Tory Government—the parallels are so strong.

In York, I read the Care Quality Commission reports in detail, and although the care given by our NHS staff is excellent, the real challenge that I pull out of the results of CQC reports is the staffing crisis. My local hospital currently has 59 doctor vacancies, and there are 580 nursing vacancies in bands 4 to 7, 312 of which are in bands 5 to 7. The trust has done everything it can to recruit. It went to Spain and recruited 40 Spanish nurses, 37 of whom left after a very short period. The reality is that NHS staffing is in crisis and that affects patient care.

Last year, the trust had to spend £8.5 million on agency staff. That pushed a trust that is already struggling because the funding formula does not work for York into further deficit, which has an impact on its control and on the resources it can get for the winter crisis—York had some of the highest levels of influenza last year. The Minister, therefore, must ensure that the money works, as well as addressing staffing.

I want briefly to look at primary care because, as we have heard, we need early intervention across all ages to keep people out of hospital. Rightly, the Government looked to increase the number of health visitors, and by 2015 the figure was up to 10,309, but since then we have seen a 23.8% fall, down to 7,852, meaning that young people are not getting the input they need. School nursing figures have also fallen by 25% since 2010. So we have a real crisis in our primary care workforce, and also in mental health, as the hon. Member for Central Suffolk and North Ipswich (Dr Poulter) said. Certainly we feel that in York, whether in the community or the hospital environment.

[Paula Sherriff]

Will my hon. Friend give way?

[Rachael Maskell]

I am going to continue.

The trust is doing everything it can to recruit, but it is impossible to recruit because the national pool of mental health staff is far too small. Therefore, it is vital that we consider the solution, which comes down, as has been said, to workforce planning. We need a partnership approach to planning the workforce. We need to understand the changing demographics and the increasing mental health challenges in order to put the right planning in place, but trusts will not be able to recruit unless the staffing framework is right. The removal of the bursary scheme has been seriously detrimental, particularly to the recruitment of mature students into nursing. People are giving up a job, but their staying in the profession for longer will pay dividends. Students have to pay to travel to placements, and I remember what that was like, so it is really important that they have bursaries.

Secondly on workforce planning, we need to look at how we educate healthcare professionals across the board. I remember discussions at a national level with the trade unions on that very issue, about needing to find a different way. In some countries they bring a real foundation into NHS training so that everyone works together in the first 18 months or two years of their training and has a breadth of understanding of medicine before going off to specialise. We, instead, train in traditional old silos of jobs that have clearly blended over the years, and we must look once again at how we structure that.

Thirdly, we need to look at the “Agenda for Change” package. There is no doubt that it is hard to recruit because people are poorly paid in the NHS and can be better paid elsewhere. Given the stress levels and the antisocial hours that people work, we need to look once again at the remuneration of our NHS workforce. Finally, the knowledge and skills framework has consistently been underutilised by the Government and NHS employers, and it is vital that we go back to that framework of professional development in the NHS.

Nursing: Higher Education Investment

Rachael Maskell Excerpts

Wednesday 21st November 2018 Westminster Hall

[Eleanor Smith]

I do, and I will talk about that in my speech and touch on the lack of nursing students coming into those particular areas because of the bursary’s disappearance.

[Rachael Maskell (York Central) (Lab/Co-op)]

My hon. Friend is making a very sound speech. Does she agree that it is a completely false economy that, as a student nurse told me just today, of the 45 recruits to mental health nursing in his cohort, under the new financial regime only 18 remain on the course in its second year? We desperately need those nurses—what a price to pay!

[Eleanor Smith]

My hon. Friend is totally right. Again, I will address that point in my speech, but it is noted. I am glad that my hon. Friends are intervening, because it shows the importance of this debate on nursing and the lack of it. I am glad the nurses came to my hon. Friend and told her what it is like. The situation is beyond shocking. There are almost 42,000 vacant nursing posts in the national health service in England. Without policy and funding intervention, that will grow to almost 43,000 by 2023.

Prevention of Ill Health: Government Vision

Rachael Maskell Excerpts

Monday 5th November 2018 Commons Chamber

[Matt Hancock]

Yes, I absolutely will. I am a huge fan of social prescribing. I essentially think that because drugs companies have a big budget to try to market their drugs—and of course many drugs do wonders—there is not the equivalent level of organisation to drive up the use of social prescribing. Examples like the one that my hon. Friend mentions are incredibly important.

[Rachael Maskell (York Central) (Lab/Co-op)]

The half-a-million-pound cut in public health in York has had very serious consequences, while nationally, with regard to the Government’s flagship project of health visiting—the crucial profession in improving outcomes—the number of health visitors has plummeted by 23% from the previous figure of 10,309. Why?

[Matt Hancock]

We are increasing the budget in future and making sure that we target it more on community services and making sure that we get more prevention rather than cure. I can look at the case of York; I can look right across the country at what we need to do. Making sure that we get better prevention is all part of that.

Budget Resolutions

Rachael Maskell Excerpts

Tuesday 30th October 2018 Commons Chamber

[Matt Hancock]

As the hon. Lady knows, life expectancy is increasing, and we are forecast to see an increasing number of people live to a good old age. Indeed, the number of people aged 75 and over is set to double in the next 30 years. That is a brilliant achievement, which is in part down to the hard work of our NHS. Cancer survival rates are at a record high, strokes are down by a third and deaths from heart failure are down by a quarter. Of course, those successes have brought new challenges. The biggest health challenge we face is that people are living longer, often with multiple chronic conditions. The money is only one part of the plan to safeguard the NHS and ensure it is fit for the 21st century. The Budget delivers the funding, and later this year we will deliver the plan for how we will set the NHS fair for the future.

[Rachael Maskell (York Central) (Lab/Co-op)]

I have very little hope for the older people of our country given that the Government have cut £7 billion from the social care budget and replaced it with only £240 million. How is that safeguarding our old people for the future?

[Matt Hancock]

Of course, in Scotland social care is devolved, so—[Interruption.] And in York, the amount of money for social care is going up thanks to the decisions announced yesterday.

Social Care Funding

Rachael Maskell Excerpts

Wednesday 17th October 2018 Commons Chamber

[Matt Hancock]

I am grateful for my hon. Friend’s work in making the case for more support for adult social care in Solihull, and to support the NHS in Solihull through that. I hope the funding we have announced today will help in Solihull, and the people of Solihull should know they have an excellent champion who has helped them to get that funding.

[Rachael Maskell (York Central) (Lab/Co-op)]

To address delayed discharges, it is crucial that we have transitional care and extra care in place. Will the Secretary of State look at York’s proposal for building facilities on an adjacent site to make that happen?

[Matt Hancock]

That is an interesting proposal, and I have seen others similar to it. We are looking at the link with housing as part of the Green Paper, and I have been discussing that with the Department concerned. The point the hon. Lady raises is important. I note that £731,800 has been allocated today to improved adult social care in York, to take the pressure off the NHS in York this winter. I hope that she will acknowledge that fact.

Access to Orkambi

Rachael Maskell Excerpts

Tuesday 17th July 2018 Commons Chamber

[Mr Lewis]

I think that most people would accept that now is the time for a review of the criteria that are applied and the processes that are undertaken. Any organisation needs to be continually improving. We do not condemn NICE. In fact, we acknowledge that it has got many difficult decisions right, but it has also got some wrong. Time and again, the reason that it has got those decisions wrong—arguably—is that the criteria it is applying and the criteria it has been given by the Department of Health are out of date and flawed. I think we would all want to see a review of NICE’s remit and the way in which it carries out its work over a reasonable period of time. It would be helpful if the Minister would respond to that point when he concludes the debate.

[Rachael Maskell (York Central) (Lab/Co-op)]

My hon. Friend is making a very important speech. As I know from being a physio who worked with cystic fibrosis patients, when making an assessment of the cost of treating cystic fibrosis, we must look at the social cost, the economic cost and the immense cost of keeping somebody alive. Does he agree that Orkambi would be a solution to that, let alone addressing the human cost?

[Mr Lewis]

I entirely agree—my hon. Friend makes absolutely the right point. When there is an incomplete assessment in looking at value for money versus outcomes, that will lead to flawed decisions that are incredibly difficult to justify. We have a mismatch between the basis on which NICE is expected to make these decisions and appropriate processes. Instead of everybody hinting, “Yes, of course there’s a need to review NICE—of course that would be a good thing”, we would like to hear from the Minister a timescale as part of the response to the specific issue of Orkambi in terms of NICE’s roles and responsibilities.