The National Health Service
Debate between Sarah Wollaston and Lindsay Hoyle(4 years, 6 months ago)
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Dr Wollaston
On a point of order, Mr Deputy Speaker. Frankly, I am astonished that at such short notice the Prime Minister has sent a note to the Liaison Committee refusing to appear before us in the morning. This is the only Committee that can call the Prime Minister to account, and it allows us to ask detailed questions with follow up on behalf of the public. This is now the third occasion on which the Prime Minister has cancelled. May I seek your guidance, Mr Deputy Speaker, because this is entirely unacceptable?
Mr Deputy Speaker (Sir Lindsay Hoyle)
I recognise that three times is very difficult, and quite rightly we have to hold all officers, even the Prime Minister, to account. However, I also recognise that these are very difficult times at the moment, and I would hope that the point of order has been listened to by Ministers and that we can come forward with a date for the Prime Minister to appear, but, more importantly, that the Liaison Committee can get that meeting in—and, as Chair, I recognise the need to do so. So, both ways, there is a need to try to make sure we can make this happen.
Mr Deputy Speaker
Order. I have been down that road already, and I am not going to change what I have said.
Dr Wollaston
Further to the point of order made by the hon. Member for Wycombe (Mr Baker), Mr Deputy Speaker. May I seek your confirmation that Select Committee Chairs are elected by the whole House of Commons because they are trusted not to take a tribal party political viewpoint in their role as Select Committee Chairs?
NHS Sustainability and Transformation Plans
Debate between Sarah Wollaston and Lindsay Hoyle(7 years, 7 months ago)
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Dr Wollaston
Members on both sides of the House are aware of how valuable and important community hospitals are to our constituents. Taking that a step further, I would say that the best bed for any patient is their own bed, provided that they can be given the right package of care close to home. We know that there are many people even in community hospital beds who do not need to be there. They are there for want of the right social care package that could enable them to be at home.
In welcoming STPs, we should be realistic about the financial challenge that they also face and the costs sometimes of providing those services. That is a huge challenge for them. In my area alone the STP is facing a £572 million shortfall by 2021 if no action is taken. I can understand why, for example, it will look at the relative cost of providing care to people in acute hospitals, in community hospitals and at home, and make an argument that sounds very reasonable about how a larger number of people could be much better cared for at home.
I return to the point that the hon. Member for Central Ayrshire (Dr Whitford) made. Access to the transformation part of the sustainability and transformation plans is necessary to be able to put those services in place and very often to build the infrastructure that we need. For example, in Dartmouth in my area, the possibility of providing more care closer to home within a community hub will require the up-front funds to build a new centre that allows the workforce to be developed and more services to be provided closer to home. Unfortunately, what we often see is the closure of a much loved facility without the new service in place.
As the sustainability and transformation plans progress, I would like to see a genuine focus on the opportunities to provide more care closer to home. I fear that we will miss that opportunity because, as we have heard, £1.8 billion of the £2.1 billion sustainability and transformation fund is going towards the sustainability bit, for which read “plugging provider deficits”, and only £300 million is left nationally to put in place all these plans.
We know also that part of the way that the Government have managed to fulfil their promise to NHS England in respect of the funding that it asked for has been by taking funding out of capital budgets because those are essentially flat cash, and also by taking money out of Health Education England budgets and public health budgets. It concerns me that many of the principles behind the sustainability and transformation plans are put at risk by other parts of the system being squeezed. We have heard the point about prevention. Central to the achievements of the sustainability and transformation plans is the prevention piece—the public health piece. It is a great shame that public health budgets have been squeezed, limiting the ability of those aims to be achieved.
I know that many Members wish to speak so I shall move on and make some asks of the Minister, if I may. There is more that the Government can do. We on the Health Committee were very disappointed that none of the witnesses who came before us from NHS England, NHS Improvement or the Department of Health was able to set out the impact of cuts to social care on health planning. We need to do much better at quantifying the cost to the NHS of cuts to the social care budget.
The Minister needs to take the long view on prevention and help the service by implementing policies that could help local authorities to make changes. For example, I suggest making health a material consideration in planning and licensing, in order to provide the levers to make a difference. We need a much greater focus on workforce, because the STPs cannot achieve their aims if the workforce to achieve them is not in place. Finally, will the Minister kindly visit my area to look at the proposals in the sustainability and transformation plans in south Devon, and at the opportunities and how we would achieve them?
Mr Deputy Speaker (Mr Lindsay Hoyle)
Order. The next speech, in the same way, will not have a time limit, but after that it will be five minutes. Some people will not get in. Please explain to them why those who took advantage of the time did so—it is totally unfair.
NHS Funding
Debate between Sarah Wollaston and Lindsay Hoyle(11 years, 4 months ago)
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Dr Sarah Wollaston (Totnes) (Con)
I am very disappointed to hear the right hon. Gentleman talk down the NHS. As he has just acknowledged, before the election the NHS knew that it was facing an unprecedented efficiency challenge. He will also know that under Labour productivity in the NHS fell continuously. I wonder whether—[Interruption.] Okay, but for almost every year—
Mr Deputy Speaker (Mr Lindsay Hoyle)
Order. The hon. Lady needs to ask a sharp and punchy question as an intervention, and very quickly.
Dr Wollaston
Will the right hon. Gentleman acknowledge the NHS’s achievement in making a productivity gain?
Health and Social Care Bill
Debate between Sarah Wollaston and Lindsay Hoyle(13 years, 3 months ago)
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Dr Wollaston
I am confident that commissioners will consider the impact of those decisions across the health care spectrum, which is very important.
In the limited time I have left, I should like to ask the Secretary of State to consider how we will monitor the quality of primary care. Who will be responsible for performers’ lists, audit, and identifying poorly performing doctors? As I understand it, all GP contracts will be held with the NHS commissioning board. What powers will GPs within consortia have to deal with those whom they feel are underperforming if they have no control over their contracts? What will be done about the ongoing, disgraceful situation regarding doctors from the EU with poor English skills, over whom we have few powers to protect patients until there has been a problem?
Professionals are also concerned about the make-up of consortia. Will they have the flexibility to include consultants and other specialists—