Oral Answers to Questions

Rachel Maclean Excerpts

Tuesday 24th January 2023 Commons Chamber

[Neil O’Brien]

We are the first to say that the current situation is not satisfactory. That is why we invested an extra £50 million in the last quarter of last year, and it is why we are working at pace. Let us be clear: dentistry has not been right since Labour’s 2006 contract, and until we fix the fundamentals of that and the problems set up by the Opposition, we will not tackle the underlying problem.

[Rachel Maclean (Redditch) (Con)]

7. What steps his Department is taking to increase the number of NHS beds available in the Alexandra Hospital in Redditch.

[The Minister of State, Department of Health and Social Care (Helen Whately)]

Right now, we are putting an extra £750 million into our health and social care system to free up beds in hospitals. Looking ahead, we will shift the dial on the decades-old problem of delayed discharge by properly planning for discharge, making more care available at home, and joining up health and social care in a way that has never been done before. That is how we are freeing up beds in hospitals such as the Alexandra in Redditch.

[Rachel Maclean]

I thank the Minister for that answer. In Worcestershire, we warmly welcome the £2.6 million that has been allocated as our share of the discharge fund. Will the Minister set out when my constituents who use the Alexandra will start to see these changes flowing through? What practical changes will they see and what impact will there be on waiting times and waiting lists?

[Helen Whately]

I thank my hon. Friend for her excellent and important question about her local share of the £750 million of extra funding for discharge this winter. I can tell her that, in Worcestershire, money is already going into extra placements in homecare, community care and care homes, and into providing practical support to help people when they get home from hospital, in partnership with the voluntary sector. I assure her that we will publish the spending plans for her area and the rest of the country shortly.

Oral Answers to Questions

Rachel Maclean Excerpts

Tuesday 29th October 2019 Commons Chamber

[The Minister for Care (Caroline Dinenage)]

The hon. Lady will be aware that the Queen’s Speech announced a Bill to tackle the cost of adult social care. She will also know that the Prime Minister said on the steps of Downing Street that the Government will set out plans to fix the social care crisis once and for all. We need to get through Brexit, and Labour Members need to vote for the methods that will help us to deliver that, because we can then get on to the things in life that really matter, such as ensuring that no one will ever have to use their home to pay for their care.

[Rachel Maclean (Redditch) (Con)]

T9. I thank the Secretary of State very much for agreeing to increase the amount awarded to the Alex—Alexandra Hospital—to begin essential improvement works that the whole community in Redditch have been campaigning for for a very long time. Can he tell my constituents when we will finally see shovels in the ground?

[Matt Hancock]

We will see shovels in the ground, I very much hope, from next year. I pay tribute to my hon. Friend, who has campaigned endlessly for these improvements to the hospital in Redditch. There is no better supporter of Redditch than her. She has badgered me endlessly, met me formally and bumped into me on the campaign. Every time I see her, she says, “Can we have the improvement to the hospital?” and the answer is yes.

Oral Answers to Questions

Rachel Maclean Excerpts

Tuesday 23rd July 2019 Commons Chamber

[Matt Hancock]

Of course, in solving this problem, many of the changes can take place within the NHS, and we are working on that with the Treasury. I am happy to ensure that discussions take place with devolved colleagues, but of course, the NHS is devolved in Scotland.

[Rachel Maclean (Redditch) (Con)]

T2. Provision of in vitro fertilisation in Redditch has been reduced from two cycles to one. I warmly welcome the work that the Minister has done to increase equity across the country, but what more can she do to address the postcode lottery in this and other areas, such as hip and knee surgery?

[The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)]

My hon. Friend is right: the postcode lottery is not acceptable, and patients manage to get around it; my local clinical commissioning group, having funded three courses of IVF, has had to reduce that to two, because demand has doubled owing to the lack of provision in neighbouring CCGs. I have made it very clear that it is unacceptable for any CCG to offer no IVF cycles at all; I have given them that guidance.

Genetic Haemochromatosis

Rachel Maclean Excerpts

Wednesday 3rd July 2019 Westminster Hall

[Mark Pawsey]

This is a genetic condition that becomes apparent in some people who possess the gene. People are affected to a variable degree. I will come on to some of the debilitating consequences of genetic haemochromatosis, which include arthritis, joint pain, diabetes, fatigue, psychological or cognitive difficulties, skin conditions, menstrual problems in women, impotence, breathing and heart problems, abdominal pain, liver problems and hair loss.

Just because the condition is not widely spoken about, in either medical or public life, that does not mean that it is not prevalent in the UK. The white UK population of north-European extraction, particularly people of Celtic extraction, gives the UK the highest prevalence anywhere in the world. The condition is found around the world wherever the Irish and Celtic population has migrated to, including Australia, the Americas and South Africa.

One in eight people in the UK carry a faulty copy of the GH gene. That faulty gene is known as HFE. One in 200 people carry two faulty copies of the HFE gene. Those are the people at risk of iron toxicity. In layman’s terms, people must have two copies of the gene in order to be affected by the condition. It is estimated that around 380,000 people worldwide have the genetic haemochromatosis mutation. Of those 380,000 people, 200,000 are under 40 years old, which is why early diagnosis is important. If we can diagnose the condition early, people will not be overlooked and can attend to their symptoms.

[Rachel Maclean (Redditch) (Con)]

I congratulate my hon. Friend on securing the debate. I thank him for outlining, for those of us who do not have as much knowledge, how prevalent the disease actually is and how important it is that we get services and treatment right. I thank my constituent Roger Keyte, who is a trustee of Haemochromatosis UK. He has done a good job educating me. I thank him and others who are working hard to help the many people who are affected.

[Mark Pawsey]

My hon. Friend is exactly right. That charity, which serves to raise awareness, has done a fantastic job, and that includes her constituent. I should point out that this is a condition rather than a disease, because a disease may be considered to be contagious.

I mentioned that the prevalence is higher in Ireland. According to the Irish Haemochromatosis Association, in Northern Ireland one in five people are carriers. The incidence among people of Celtic origin leads to some people referring to genetic haemochromatosis as the Celtic curse, a term that is not looked on favourably, but does underline the prevalence among Irish, Scottish and Welsh people, and the need for them and their doctors to be aware of the condition. I am delighted to see hon. Members representing Welsh and Scottish constituencies here, some of whom I know will contribute to the debate.

I have already mentioned that the condition is poorly diagnosed. Recent research shows that at least 45,000 people affected in the UK are loading iron as their bodies fail to control the absorption. Only 10% to 13% of these cases are diagnosed. For every patient diagnosed, between eight and 10 have the symptoms but have not been diagnosed. They are suffering unaware of what is happening to them.

Dr Ted Fitzsimons of the University of Glasgow has done a great deal of work in this area. He highlights that 80% to 90% of individuals who have this condition are unaware that they have it. They do not know what it is. They know the symptoms, which affect them, but they do not have an explanation for them.

Professor David Melzer, from Exeter University, and the Haemochromatosis Research Group have conducted a UK Biobank study of half a million patients, which was published in January 2019. They found that people with the double haemochromatosis mutation had four times the risk of liver disease, twice the risk of arthritis and frailty among older age groups, and a 50% higher risk of pneumonia and diabetes compared with those who do not suffer from the condition. In the UK, there are currently 136,000 people with the condition aged 40-plus. The study found that of that generation of 136,000, approximately 12,200 will have had a hip replacement, which they would not have needed if they had been diagnosed earlier and treated for iron overload. However, the study has a caveat, as there is uncertainty about whether all those operations would have been avoided by early diagnosis. But as with any condition, we know that early diagnosis is crucial.

Whorlton Hall

Rachel Maclean Excerpts

Thursday 23rd May 2019 Commons Chamber

[Caroline Dinenage]

The Secretary of State commissioned a report on exactly that—segregation and restrictive practice. It was published on Tuesday, and we have accepted all the recommendations. We are working very hard on this. There will be guidance, but it is more important than that. As shown in the TV programme last night, there was training and guidance on the restrictive practices to be implemented, but it was ignored, and restraint was recorded incorrectly. This is a much bigger issue than the one the hon. Gentleman highlights.

[Rachel Maclean (Redditch) (Con)]

I see more and more families in my surgery with loved ones who suffer from autism or learning difficulties being failed by the system. Will the Minister give an assurance to my constituents and their families that there will be a genuine focus in the NHS long-term plan on these vulnerable people?

[Caroline Dinenage]

I thank my hon. Friend for that question; she is right to raise it. Autism and learning disability are both mentioned as clinical priorities in the NHS long-term plan. That is absolutely right, and we must relentlessly continue that focus.

Alexandra Hospital, Redditch

Rachel Maclean Excerpts

Wednesday 15th May 2019 Commons Chamber

[Rachel Maclean (Redditch) (Con)]

I am glad to be able to raise in the Chamber the issue of services at the Alexandra Hospital in Redditch. I hear concerns time and again in public meetings, and I thank the local groups, such as Save the Alex, that are campaigning on this matter.

In short, services at the Alex are inadequate. That is not my word, but the one used by the independent Care Quality Commission. It inspected Worcestershire Acute Hospitals NHS Trust, which includes the Alex Hospital in Redditch, in June last year and again found it to be inadequate. That represents no change since the last inspection. Indeed, in 16 areas that the CQC inspects, only one was rated good, none was outstanding, and half were rated inadequate, with the remaining requiring improvement. That is not good enough.

On being elected in 2017, I inherited a situation where the trust had already approved a new clinical model for future acute services to which centralisation was key. As a result, regrettably, a number of services, including maternity and paediatric care, were removed from the Alex and relocated to Worcestershire Royal Hospital. Our maternity unit closed in November 2015, and paediatrics was “temporarily” transferred in September 2016. The new plan, which was rubber-stamped in 2017, is intended to relieve pressure on both hospitals, improve patient safety and address staff shortages, but almost two years on from the removal of services and the approval of the new plan, it is clear to me that it has not had the intended outcome. The hospital is still inadequate, and the trust remains in special measures. Some services have got worse. Patients cannot access services when they need them, waiting times are poor and promised investments are not coming to fruition quickly enough. Pressure has not been relieved. Patient safety is being called into question, and staff shortages persist at both sites.

Since my election, I have given NHS bosses and management time to demonstrate to me and my constituents that the new clinical model is beneficial. I have done my best to explain to constituents why services were transferred, and I have visited the hospital time and again—along with my fellow Worcestershire MPs, who are here tonight—to keep a close eye on developments.

We have thousands of dedicated and fantastic staff in our hospital. I have spoken to many of them, and my constituents report time and again that the care they receive is fantastic. I thank every single member of staff at the hospital for their work. However, I do not believe I can continue in good faith to defend the new clinical model. It is not delivering for the people of Redditch. I secured this debate to press my constituents’ concerns on the Minister and call for a fresh approach. All options must remain on the table.

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Lady for giving way; I spoke to her beforehand and explained the situation of some of my hospitals back home. I commend her efforts to retain services at the Alexandra Hospital. The recommendations of Redditch Borough Council health commission, which came out firmly against the clinical commissioning group proposals, must be given weight. The proposals must not progress to any lessening of services in the Alexandra. My own Ulster hospital is seeing proposals to redirect stroke services to a hospital that is over an hour away in traffic, which will certainly mean that damage cannot be fixed within the window of opportunity for recovery. Does she agree that money saving cannot trump life saving in any trust area?

[Rachel Maclean]

I thank the hon. Gentleman for his intervention. It sounds as though his experiences are very similar to ours in Worcestershire. I am sure he will continue to stand up for his constituents.

I have campaigned for improvements to local health services, and I welcome the investments coming on stream as a result. Upgrades in endoscopy, a new urgent care centre at the Alex and better infrastructure have all come on stream. A frailty unit has been transferred from Worcester, and a new ward has opened to improve the flow of patients in and out of A&E. Those are all making a difference.

[Mark Garnier (Wyre Forest) (Con)]

I echo my hon. Friend’s sentiment about the hard work of the stalwart staff of the Worcestershire Acute Hospitals NHS Trust. I can testify that, right now, my 11-year-old son is sitting in the A&E department having a sprained ankle attended to by nurses. I am sure he will be fine; he has obviously been hooning around when he should have been paying attention at school—I will talk to him when I get home.

One of the hospitals run by the trust that is not talked about much is Kidderminster treatment centre. Does my hon. Friend agree that we have to think coherently about all the services across the three hospitals? If we bring more services back to Redditch, we can also bring more long-term treatment services back to Kidderminster Hospital and have a much better service for all our constituents in Worcestershire.

[Rachel Maclean]

I thank my Worcestershire colleague for his intervention. I think we are all on the same page. We all want to see better services across the whole of our county of Worcestershire.

Where I am going with this debate and the point I want to make is that the long-promised plan for the Alex to become a centre of excellence for planned surgery has not materialised, despite my pressing for it constantly and despite a £29.6 million funding pot. That funding is in the process of being delivered across the trust, and it was intended to help implement the new clinical model.

That is why I believe it is time to look again at where and how services are provided, and particularly to consider the return of a range of maternity and paediatric services to the Alex. We need to explore options for the local population to use services in Birmingham, which are more accessible than those in Worcester. We also need to continue investment in our communities and build a medical school in Worcester to create our own local NHS workforce, which would help to address the shortage of staff at the root.

The context has changed because the Prime Minister recently announced the Government’s intention to provide the NHS with an additional £20.5 billion by 2023-24—the largest, longest funding settlement in the history of the NHS. We hear that the four CCGs that cover our two counties could merge into one in the future. This is why I believe it is time to be honest with people and for bosses to say that plan A is not working.

[Nigel Huddleston (Mid Worcestershire) (Con)]

My hon. Friend is an excellent champion for her constituents on this and many other issues. On the funding point, does she agree with me that those of us in Worcestershire are arguing not for special treatment, but for fair treatment? Particularly when it comes to funding, because we all know we are relatively underfunded at CCG level and elsewhere, we just want our fair share, not special treatment. We would just like a fair share of the cash, please. We know it is coming, and we would like our share of it.

[Rachel Maclean]

My hon. Friend echoes my point. I absolutely agree. We know the NHS is world class and we know that more funding is coming on stream; we are just arguing for it to be distributed for our constituents’ benefit.

We need to act soon. Redditch is home to 85,000 people; the population has grown from 78,000 in 2001, and almost 90,000 people are expected to live locally by 2030. In neighbouring South Worcestershire, tens of thousands of new homes are planned and the population is going to grow rapidly. Redditch is a new town, and it has always attracted young families to move there and build a better life, away from the back streets of Birmingham and from all over the country. We are proud of our local environment and of much else, but I want to be able to promote the holistic experience of living in Redditch, and to say that this is a great place for people to come to and live, work, set up a business and raise their family. For that, we need to have all the facilities that young families expect, including excellent healthcare services. This is part of our campaign to unlock Redditch. It needs to be the best place in the midlands, and we deserve nothing less.

We were told that the reason for centralising maternity services away from Redditch is that the size of the population is not large enough to sustain a full maternity service safely, but that does not make sense to me and my constituents. I accept that safety has to be paramount and I know that the Meadow birth centre in Worcester does a brilliant job, but the truth is that we have a high proportion of young families, which is increasing the demand for maternity and children’s services. What the hon. Member for Strangford (Jim Shannon) said is the same for us: it can take over an hour to reach Worcester from some areas of the town, particularly in traffic. There is no direct bus or train link from Redditch, so my constituents who need to use public transport must travel to the hospital via Birmingham or Bromsgrove.

When we look around the other areas of the west midlands conurbation, we can see that there are maternity units with populations much smaller than Redditch’s: for example, in Oswestry, which has a population of 16,000; Bridgnorth, with 12,000; Burton-on-Trent, with 75,000; Hereford, with 63,000; and even Ludlow, with 11,000. I am calling on the CCG and the trust to publish those comparator statistics and justify why those towns should have their own maternity unit, but Redditch should not. Most people would understand that a higher risk birth would require more specialist services and that might not be possible in Redditch, but the vast majority of births can be catered for safely in a midwife-led maternity unit.

The centralisation has piled pressure on to Worcester. It cannot withstand that pressure and we have all voiced concerns in this Chamber. I talked about the ambulance handover delays at the Worcestershire Royal just before Christmas—they are amongst the worst in the country, with ambulances waiting for over an hour. I am very grateful that the Secretary of State visited Worcestershire Acute. He saw for himself—

--- Later in debate ---

Motion made, and Question proposed, That this House do now adjourn.—(Mike Freer.)

[Rachel Maclean]

As I was saying, the Secretary of State visited Worcestershire Acute and saw the size of the emergency department, which constrains patient flow. Despite the incredible efforts of the staff triage and consultants, and even with the welcome recent investments and improvements, it is difficult to see how those problems can be solved in the short term. Surely, the answer is to let Redditch take some of the strain, particularly with paediatrics.

I appreciate that changes such as this will take time and involve many layers of management, but it is my job to ensure that the people who are making these decisions take into account the experience of my constituents. We are lucky to live in a country with free healthcare, free at the point of use. Investment in health pays off multiple times in both financial and wellbeing terms. Other trusts in the country have managed to recover from poor performance, but we in Worcestershire seem to be struggling on with one of the worst trusts in the country, and it is my constituents who pay the price. I am extremely frustrated that we are no closer to the green shoots of improvement than when I was elected, and there has been a high turnover of people in senior positions, which does not help.

I think that a practical solution to relieve pressure on the overloaded site at Worcester is to provide more care for children and families at Redditch, so I would really like to hear from the Minister what other plans there are to turn this around. What evidence does she have that improvements will take place under the current structure? How long are we expected to wait? What options are there for working more closely with the University Hospitals Birmingham NHS Foundation Trust, for example—a high-performing trust, which is rated “good” by the Care Quality Commission, with much better transport and strong historical links to Redditch?

I thank the Minister for coming here to reply to the debate. I very much look forward to hearing her response.

[The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)]

I really thank my hon. Friend the Member for Redditch (Rachel Maclean) for the passionate, articulate pitch she made on behalf of her constituents and the health services that they deserve, because obviously we all deserve good-quality health services. As the Minister responsible, it is my job to give challenge to ensure that we are delivering the best services we can. Obviously, they are not always as good as we would like them to be, but I can reassure my hon. Friend of my determination to make sure that we continue with the constant campaign for improvements, and for the best possible services. All our constituents, as taxpayers, are paying for those services, and they all deserve an equivalent service.

I thank my other hon. Friends from Worcestershire—my hon. Friends the Members for Wyre Forest (Mark Garnier) and for Mid Worcestershire (Nigel Huddleston)—for showing their support. The issues that my hon. Friend the Member for Redditch raises are clearly of concern across the wider area. Indeed, my right hon. Friend the Member for Bromsgrove (Sajid Javid) has also lobbied me about this, notwithstanding the wider interests that he has in this place.

My hon. Friend the Member for Redditch raised several important points and areas of concern, which I will seek to address. She raised a number of points about maternity services. She is absolutely right that we must ensure that we have the safest possible environment in which people have their children. Obviously, having safer births is very much a national priority, so that issue is of particular concern to me. As my hon. Friend is aware, the decision to move maternity and children’s services from the Princess Alexandra Hospital to the Worcestershire Royal was implemented in 2017, and it was clearly controversial—many changes are, and this is no exception. That is why we need to continue to give appropriate scrutiny—my hon. Friend is absolutely right to do that—to ensure that we are serving all our constituents as well as we possibly can. She is also right to say that challenges remain. The trust continues to be scrutinised closely by the Care Quality Commission and in this House.

My hon. Friend asks how long we have to wait. Quite often, changes can be achieved very quickly. Sometimes, however, whether cultural or behavioural changes, they take much longer than any of us are happy with. I say to her that in my experience, constant scrutiny by the CQC does deliver results. I encourage her to continue her discussions with local interest groups and the CQC to ensure that all the constant scrutiny and challenge drives improvement. I do not know how many times I have said it in this place, but sunlight is the best disinfectant. Accountability will drive improvement and change.

All that said, we should recognise that there has been some important progress in the service at the trust. The CQC looked at the maternity in-patient survey for February 2017, which found that the Worcestershire Royal rated well against other maternity services in all aspects of care and scored among the best in the country in partner engagement and involvement in the appropriate length of stay in hospital. In addition, following the reconfiguration of services the neonatal rota is now fully staffed and recruitment is going in the right direction; the maternity doctors’ rota is fully staffed; and the trust has avoided a lot of the cancellation of antenatal or gynaecology clinics that was previously seen. I know that people will be concerned because of the historical record, but the scrutiny of the CQC shows that there are improvements.

According to the most recent CQC report, maternity and gynaecology services at the Alex are rated “good” for caring and “responsive” and “requires improvement” for other domains. Worcestershire Royal is rated “requires improvement” for safety and “good” in all other categories. The CQC recognised that the Worcestershire Royal’s maternity service was especially caring and responsive to parents who had suffered a pregnancy loss, such as miscarriage, stillbirth or neonatal death, and was committed to continually improving the care and services it provided for bereaved parents. That shows that there are some areas where the leadership are making an impact, but we clearly need to keep the situation under review.

In October 2018, the trust’s professional development team won the workforce team of the year award at the prestigious Nursing Times awards, which celebrate excellence in supporting the nursing and midwifery workforce. We congratulate them on that award. We should not be complacent, however. There is still very much more to do. I look forward to further discussions with my hon. Friend in the light of further investigations. We will do our best to support the entire community by making sure that performance is improved.

My hon. Friend raised the wider challenges facing the trust. It has been in special measures since December 2015. The latest CQC inspection judged the hospital as inadequate, with key concerns in urgent and emergency care, surgery and outpatients. I say again that scrutiny is the first catalyst to achieving improvement. It is worth noting that the trust achieved a “good” rating for the caring inspection domain in the latest CQC report, so in terms of patient experience there is clearly some improvement. However, nobody should be complacent about the scale of the task. As she says, her constituents really should not be expected to wait an undue length of time to achieve the quality of service that patients in other parts of the country receive.

I assure my hon. Friend that both the Government and national NHS bodies are committed to providing both the support and investment needed to help the trust make progress. I will be ensuring that we use our levers at a national level to give that appropriate challenge and support. Support currently in place for the trust includes a support package focusing on culture, risk and governance. That is very important. We always find, when a trust is going through the journey from requiring improvement to good, that leadership is crucial. I cannot overstate the importance of making sure that we are getting the right leaders in and mentoring them to deliver that. That support is crucial.

There is a quality improvement director, and there is a nurse retention collaborative programme to reduce turnover. There is a suggestion that that is starting to bear fruit. There will be emergency care support from the emergency care intensive support team and a peer support buddying arrangement with the Royal Wolverhampton NHS Trust. We have seen such buddying arrangements achieve real change, more than anything else by giving local leaders the confidence to be innovative and imaginative and really give additional challenge.

Local commissioners are closely involved in working with the trust to ensure that the quality of children’s and maternity services improves. Given the concerns my hon. Friend has expressed, I encourage her to engage with local commissioners to discuss how they are interpreting reviews of monthly divisional data and what they are doing to assure themselves of the quality of service. As a Minister, I can stand at the Dispatch Box and make promises, but ultimately I rely on local commissioners to do their bit to give challenge too. In giving me challenge, I encourage her also to give them challenge and have those discussions. The spirit of co-operation across the whole system is there to achieve improvements.

My hon. Friend rightly made her pitch for her constituents’ share of the increased funding for the NHS. While improvement is about more than just money, investment is clearly part of the picture. We will make the appropriate investments to support the trust. Recent examples of investments we have made are an award of £3.96 million for a breast imaging improvement plan, which will improve breast screening at the Alex; the development of a maternity hub to serve the Redditch area; and £3 million for a link bridge between the main hospital building and an outer building to be in place for the winter to assist with winter pressures.

I am confident that this will not be the last discussion my hon. Friend and I have about her local health services. I am grateful to her for bringing her concerns to me and putting them on the record. As I say, sunlight is the best disinfectant when it comes to inspection and challenge on the ground, but the opportunity to raise things here on the Floor of the House gives a signal to the entire health system that where we think things are not good enough and need to improve, we will not be shy in our determination to achieve that improvement.

[Rachel Maclean]

I thank the Minister for her comments and share her view that sunlight is a great disinfectant. May I press her? We have been undergoing this journey for four years, which is a long time. I had not been a Member of Parliament before and have never seen a trust turn around, so I would be grateful for some indication of how long she thinks it is reasonable for us to wait, with me as the local MP explaining to people, “You have to keep waiting.” Has she any examples of how it can happen and at what pace?

[Jackie Doyle-Price]

I will answer my hon. Friend’s question, but I will answer a different one too. She asks how long it is reasonable to wait. It is not reasonable to have to wait at all, because we should be delivering services of an appropriate quality. How long will people have to wait? We should be entirely honest when an institution requires improvement. She is right that four years seems like a long time. When my local trust went into special measures, it came out within two years, and the crucial ingredient was getting the right leader in at the top. Other trusts wait longer because other challenges can come into play that mean they are judged to require improvement—some trusts still struggle to get the right personnel, for example. We need to look in detail at exactly where the weaknesses are. My challenge to the system is to come up with a good plan to help get out of it. I would expect the buddying system with the Wolverhampton trust to start to deliver that more effectively, because there is no better driver of speed than external challenge.

With that in mind, I would like to close this excellent debate. The points made here should be considered very seriously by the local health system.

Question put and agreed to.

Health

Rachel Maclean Excerpts

Tuesday 14th May 2019 Commons Chamber

[Rachel Maclean (Redditch) (Con)]

It is a pleasure to follow the hon. Member for Stockton South (Dr Williams), but I want to put it on the record that Conservative Members understand and appreciate the importance of public health. I have heard several contributions from hon. Friends about exactly that. I am grateful that public health is at the heart of the long-term plan for the national health service and that investment is already going into it.

My constituents would not forgive me if I did not start by talking about the Alex Hospital in Redditch, which is the No. 1 concern for me and my constituents. Yes, we are having a debate about public health, but this takes its place at the heart of that. It is not just about funding—a lot of money has been invested in the Alex for wards, infrastructure and facilities thanks to all our lobbying, but that is not enough; it is about how that money is managed across the trust. Unfortunately, services were centralised in Worcester, and that is not working for my constituents. I welcome the Minister to her place, but she will definitely receive more visits and correspondence from me on this issue. I have an Adjournment debate tomorrow night, so I will not steal my own thunder, but I want to place it on the record that it is very much about leadership, making services work across a county and getting the right outcomes for patients and my constituents.

One of the causes close to my heart is the menopause. Anyone who has been watching BBC’s “Breakfast” programme this week will know it is featuring it as part of its menopause week. It is brilliant that people are brave enough to talk about their experiences. This is a taboo subject, but we are starting to talk about it in this Chamber, and I have received cross-party support, which is fantastic. This goes to the heart of what we are talking about: prevention and public health. It is about educating primary care providers and GPs to do the right thing when prescribing for women entering the perimenopause and the menopause and to understand that it is not just about having hot flushes and those other stereotypical symptoms but that there can be hundreds of different symptoms. Every woman is different. There is widespread ignorance, but when women visit their GPs, very simple treatment should be available. This does not cost money. It is just a question of ensuring that GPs are in the right place to prescribe what those women need: treatment that will make a transformative difference to their lives, and will enable them to continue to contribute at work as well as in their families and communities. I hope that the Minister will recognise the importance of this issue, because it affects not only women; it affects every man who has to work with a woman or is related to a woman. That fact is often hidden, and we need to break down the stigma to an even greater extent.

My third point concerns technology. We are talking about prevention, and technology plays an important role in that. I have been a tech entrepreneur, and I was delighted to learn about a service called GP at Hand, which was released recently. I have been using it, and it has made a massive difference to me. We are all stuck here, and I do not know about other Members, but I find it very hard to make an appointment to see my GP. However, I have an app on my phone. I need only log on, and I can secure an appointment within five or 10 minutes.

Let me add, before Members jump up and say it, that we all know that that service will not work for everyone. Of course it will not work for complex patients and vulnerable people who are not able to use technology. However, if it can work for people who are confident and comfortable with technology and can embrace it, it will make a huge difference in freeing up more resources for the patients who need more care and support in the GP’s surgery. I think that the two services can work side by side. What we need to do in the long-term plan for the future is embrace what technology can do and spread that across the country. There needs to be a real impetus behind solutions such as GP at Hand which provide more time for talking to people who need a lot of support, including mental health support. It really is a brilliant service, and it is free to use in London. I believe that it is being piloted, and I very much hope that it will extend across the country.

I commend the Government’s efforts, and their focus on public health. Let us not forget that if it were not for a Government who sorted out the economy and enabled it to grow, we would not have this multi-billion-pound investment. I believe that £157 billion of public money will have been invested in the NHS by 2023.

Oral Answers to Questions

Rachel Maclean Excerpts

Tuesday 7th May 2019 Commons Chamber

[Jackie Doyle-Price]

I am grateful to the hon. Lady for raising that. She is right to do so. We are aware of some of the specific issues in her constituency, and I look forward to visiting and taking up some of the discussions directly.

[Rachel Maclean (Redditch) (Con)]

The Secretary of State has been kind enough to visit Worcestershire Royal Hospital, which serves people in my constituency. He saw for himself how small the emergency department is there. With £20 billion going into the NHS, does he agree that there is a good opportunity to look again at returning services to Redditch—in particular, the maternity and A&E departments, which have been removed?

[Matt Hancock]

It was brilliant to visit Worcester hospital—another medium-sized hospital, but with a small A&E department that was working incredibly hard given the facilities. I pay tribute to all the work of staff there and very much take on board the points that my hon. Friend has made.

Social Media and Health

Rachel Maclean Excerpts

Tuesday 30th April 2019 Commons Chamber

[Matt Hancock]

We have proposed fines as called for by the hon. Lady, and of course this is a cross-Government effort. My responsibilities are the health impacts, but technology has an impact right across the board, including on the quality of debate in our democracy, which is a Cabinet Office issue, and with regard to terrorism content, which is a Home Office issue. The Department for Digital, Culture, Media and Sport leads across the board and the Prime Minister herself has led global debates on this. The hon. Lady is quite right to point out that there is a broad range of impacts, and we work together to tackle them.

[Rachel Maclean (Redditch) (Con)]

The shadow Secretary of State referred to the proliferation of pro-anorexia content online. Is the Secretary of State aware that tech giant, Amazon, sells books under the category of “pro-ana”, which purports to show anorexia as a healthy lifestyle? Does he share my revulsion that those books are available online, and will he call on Amazon to take this content down immediately? Will he look at whether tech giants such as Amazon can be brought into the remit of the online harms White Paper?

[Matt Hancock]

I will absolutely look at the matter raised by my hon. Friend, as it is alarming and distressing to hear about it. Amazon sells physical goods for the most part and surely has a duty of care to those who buy them, in the same way that a shop has a responsibility for what it sells. My hon. Friend makes an important point, which I will follow up. I will write to her with more details.

Access to Medical Cannabis

Rachel Maclean Excerpts

Monday 8th April 2019 Commons Chamber

[Matt Hancock]

I am sure that the BPNA will have heard that testimony from the right hon. Gentleman. Of course, the BPNA is independent of Government, and we have to follow the clinical judgments made by the relevant organisations, whether a royal college or, as in this case, an association. What I have done is ensure that a second opinion is available, because the BPNA guidance is merely guidance; it is not absolute. A clinician on the specialist register can make a decision according to what they think is best for the patient in front of them.

[Rachel Maclean (Redditch) (Con)]

Can the Secretary of State give some more detail on the time line for this very welcome review? I am sure that we all sympathise with parents such as Mrs Appleby, who is doing everything she can for her daughter.

[Matt Hancock]

Yes, the call for randomised control trials and the process evaluation are both being conducted very urgently by NHS England.