Prostate Cancer

Simon Hoare Excerpts

Wednesday 6th February 2019 Commons Chamber

[Simon Hoare (North Dorset) (Con)]

I rise to open this five-hour Adjournment debate—that was a joke, Mr Deputy Speaker. This debate is certainly timely, given that on Monday this week we celebrated the 20th anniversary of World Cancer Day, and many Members will have attended the event held by Cancer Research UK in Portcullis House this morning. It is timely given the more than welcome announcement by the Treasury and the Department of Health and Social Care of record investment coming into the national health service. It is timely because we have the Government’s welcome and focused cancer strategy. It is timely because at no other time in our history have Government and health campaigners and providers had a greater communication platform to reach out to members of the public and explain, inform and educate. Finally, this debate is also timely because this week, under the auspices of my hon. Friend the Member for Lewes (Maria Caulfield), who has considerable nursing experience, we have seen the launch of the all-party parliamentary group on male cancers, including prostate cancer.

We need to recognise that cancer is still feared in this country. Terms such as “battle, “fight” and “lost the crusade” against cancer are used in countless obituaries, which testifies to that fear. I hope that we all take heart from the commitment in this important health area shown by my right hon. Friend the Secretary of State and the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Winchester (Steve Brine). That should provide us with a reservoir of optimism about the seriousness and determination of the Department on these issues.

It may just be something to do with my sex—I am not sure—but all the statistics and all the anecdotes tell us that men appear to have a greater aversion to going to the doctor and asking questions about their health than our female counterparts, and certainly anything below the waist is to be avoided at all costs because it is going to be painful, embarrassing and undignified.

I pause for a moment to reflect on the absolute honesty that we have heard from my hon. Friend the Member for Redditch (Rachel Maclean), and indeed the clarity of my right hon. Friend the Prime Minister at the Dispatch Box during a recent Prime Minister’s questions, about cervical cancer testing—admitting some of the inhibitions, but, given the importance, exhorting people to take those tests. I do not think that I hear such exhortations and frank honesty from men about this health issue.

[Nick Smith (Blaenau Gwent) (Lab)]

I commend the hon. Gentleman for his leadership and for securing this important debate. I have been along to the World Cancer Day event today, where I was told that more than a third of cancer cases can be prevented, and another third can be cured if detected early and treated properly. The message he is sending out today is really important for us to share across the whole country.

--- Later in debate ---

[Simon Hoare]

The hon. Gentleman is absolutely right, and I will turn to diagnosis in a moment.

Let me return to the point I made a moment or so ago about fear. We will all have had family and close friends experience being given a diagnosis of prostate cancer or, indeed, other cancers, and the first thing is always to face that in a very black mood and think that there is absolutely no cure. However, we know that there are scientists—clever men and women—striving every day to find such cures. Indeed, life expectancy post an early diagnosis is of course getting better and better. Rightly, we place huge emphasis on breast and cervical cancers, but I suggest to the Minister that, in the shape of male cancers, we need to up the game in communication and education as well.

Some statistics on prostate cancer, provided by Prostate Cancer UK, may be of help to the House. Prostate cancer is the most common male cancer in our country: 47,000 men are diagnosed each year. One in eight men will get prostate cancer, and every 45 minutes one man dies of it in our country. Men over 50—I turned 50 this year, so I do not know whether—[Hon. Members: “No.”] I know; it is almost impossible to believe. I am not sure whether I should therefore declare an interest, but men over 50 are more prone to it, particularly if they have a family history.

A statistic I have learned—I am yet to find any particular reason for it—is that black men are far more at risk of contracting prostate cancer: one in four will get it. Someone’s risk of prostate cancer is heightened—again, this was a new fact to me—if their mother or their sister has had breast cancer. I wonder how many people recognise that and see that, if a female in the family is diagnosed with breast cancer, that should act as a spur for them to go and have a test. In 2016, 11,631 men died of prostate cancer in the UK alone.

At our party conference last year, my right hon. Friend the Prime Minister said:

“The key to boosting your chance of surviving cancer is early diagnosis… Through our Cancer Strategy, we will increase the early detection rate… We will do it by…investing in the very latest scanners.”

[Mary Glindon (North Tyneside) (Lab)]

I congratulate the hon. Gentleman on securing this important Adjournment debate. As well as early diagnosis, this is about people’s awareness that they themselves may possibly have the symptoms. When my husband was diagnosed, he just thought he had a chill. Unfortunately, his is incurable, but he thought no more about it than that he had a chill. An even more important issue than having screening is that we should be aware of our bodies.

[Simon Hoare]

The hon. Lady makes an incredibly telling point, because unless people know what the full range of symptoms are, they do not really know what they should be thinking and whether one of those symptoms or a combination of them should actually trigger a visit to their doctor in the first instance. I think she is absolutely right that we need a better understanding.

This goes back to a point I made a moment or two ago. Because this is a below-the-waist issue and we men get frightfully embarrassed about those sorts of things, we are inclined to say that it might just be something else or that it will pass, and so on. However, for too many people, it is left too late to have any meaningful, beneficial outcome as and when they eventually go to see their GP and then trigger the referral process.

[Mark Tami (Alyn and Deeside) (Lab)]

Does the hon. Gentleman agree that we can concentrate on all the negatives, but we have to get across that people are surviving and, more than surviving, actually living well? We have to present that because, with some cancers, there is still the idea that if someone gets it, “Well, that’s it then”.

[Simon Hoare]

rose—

[Mr Deputy Speaker (Sir Lindsay Hoyle)]

Order. May I just read out the deferred Division result?

[Simon Hoare]

We wait with bated breath.

[Mr Deputy Speaker]

Absolutely.

I have now to announce the result of today’s deferred Division. In respect of the question relating to long- term investment funds, the Ayes were 302 and the Noes were 262, so the Ayes have it.

[The Division list is published at the end of today’s debates.]

I must inform the House that there were errors in calculating the number of votes of Members for English and Welsh constituencies and for English constituencies in Divisions yesterday on the police grant and the local government finance report. On the police grant, the figures for the England and Wales-only vote should not have been announced as 289 for the Ayes and 242 for the Noes; they should have been announced as— Ayes 289 and Noes 244. On the local government finance report, the figures for the England-only vote should not have been announced as 270 for the Ayes and 208 for the Noes; they should have been announced as— Ayes 270 and Noes 206. The results are unaffected.

[Simon Hoare]

A restless nation will sit easier in their armchairs knowing that, and we are grateful to you, Mr Deputy Speaker, for your public service announcement.

To respond to the intervention from the right hon. Member for Alyn and Deeside (Mark Tami), I think he is absolutely right that we—not just Ministers, but health practitioners and all of us in our communities—need to stress again and again the widening range of treatments, the recovery rates and the extra lifespan one can have after early diagnosis and treatment. I suppose it is a perfectly legitimate historical response to have to such a diagnosis, but we need to end once and for all people saying, “Well, that’s it. I’ve had my chips.” To say, “You know, let’s see what we can do with the rest of it”, and in effect give up, is absolutely the worst thing that one could do.

May I raise the subject of diagnosis with the Minister? To pause there, I am not saying this to ingratiate myself with my hon. Friend, but the understanding and sensitivity that he brings to these issues and, indeed, to his wider portfolio commands respect across the House. I think we are very lucky to have him, and I am particularly pleased that my hon. Friend is the Minister replying to this debate.

[Mr Mark Francois (Rayleigh and Wickford) (Con)]

On that point, I had the privilege of attending an event that the Minister addressed a couple of weeks ago, and I was struck by the passion with which he spoke about this subject. I entirely endorse what my hon. Friend has said about the Minister’s commitment. In passing, I congratulate my hon. Friend on securing this very important Adjournment debate, and may I assure him that, when it comes to fighting prostate cancer, this is something on which he and I see absolutely eye to eye?

[Simon Hoare]

I am grateful to my right hon. Friend. I think we both stand at roughly 5 feet 6 or 7 inches, although I might be slightly taller than him when he is in his stocking feet. I get his reference and it is delightful to see eye to eye with him.

[Mr Jim Cunningham (Coventry South) (Lab)]

I wonder what you two want out of the Minister, given that you are giving him so much praise. Having said that, I am sure the hon. Member for North Dorset (Simon Hoare) will agree that the National Institute for Health and Care Excellence has sometimes been slow in making progress on treatments, as we have seen with other health problems. I echo his words that, simply put, men just do not like to tell anybody when they are not well. When people tell me that they have an illness like prostate cancer, they often say, “But don’t tell anybody.” The big problem is getting men to realise that they have to do something early, and the person who finds the answer to that very difficult issue will have done a great service.

[Simon Hoare]

I agree. In answer to the first part of the hon. Gentleman’s intervention, which I presume was rhetorical, I just want the Minister to carry on with the excellent work he is doing. The hon. Gentleman is right to say that we need to blow away the cloak of secrecy and, sometimes, shame and embarrassment. No family represented in this House will not have heard an aunt or an uncle say, in slightly hushed tones and that silent mouthed way, best exemplified by Les Dawson, that they have the big C. It is as though they cannot quite bring themselves to annunciate the word, in case it brings a plague upon their house. We have to brush all that away.

I am absolutely determined to get on to the issue that I want the Minister to address, which is what I was trying to do about 16 interventions ago. I urge him to grasp the opportunity—provided not least by the additional funding—for efficient, cost-effective and easier diagnosis. I appreciate that there is a whole range of things in the marketplace, but during my research I have been particularly struck by the opportunities presented by the pre-biopsy multiparametric MRI scan. We have a problem, because while demand for MRI scans rose by 30% between 2013 and 2016, this country still has fewer MRI scanners per head of the population than other countries with comparable populations. The additional moneys available provide a golden opportunity to do something about that.

Of course, it is never just a question of cash and kit, so allied with that are the people who can use the kit. The workforce are key. In addressing the issue of money and the benefits it can provide, we should note that we will not realise its full potential if we are short on workforce. The 10% vacancy rate in the national health service cannot be allowed to become the norm. Prostate cancer patients need and would like more clinical nurse specialists, who have the empathy and expertise to provide comfort, hope and a guiding hand. It is difficult to recruit in any specialist nurse area, but that should not put us off the endeavour.

Likewise, we need a recruitment drive for more radiologists. Prostate Cancer UK estimates that an additional 23 to 31 radiologists are needed in the UK. The Royal College of Radiologists estimates that in the financial year 2016-17, a whopping £116 million was spent on the outsourcing and insourcing of radiological skills additional to core contracted hours. To put that in perspective, £116 million would buy about 1,300 full-time consultant radiologists.

As I have said, raising public awareness of prostate cancer—its signs, symptoms, diagnosis and treatment—is pivotal, but so too is the reinforcement of messages from the Department, NHS England and others to our general practitioners. We all know that there is a growing problem of finding people who are interested in and prepared to enter general practice. The myriad drugs that come on to market and myriad other conditions make the already demanding life of a GP ever more so.

I recently met Jim Davis, the chairman of the Dorset branch of the Prostate Cancer Support Organisation, a charity that covers Hampshire, Dorset and Sussex. It is run for men diagnosed with prostate cancer, by patients with prostate cancer. Last year, they held 23 free prostate-specific antigen testing events, which delivered those tests for 4,813 men. They have found that people are more inclined to go into that sort of environment than to their GP surgery. Their work involves—as a Hampshire Member of Parliament, the Minister may already know this—raising money, advertising the tests and hiring village halls and other places. Men then come and have the test, which is sent—in effect, the work is subcontracted—to the local hospital, which analyses it and sends back the results. I will not detain the Minister, but I could read out a whole legion of extracts from letters from grateful men who availed themselves of that opportunity and found their life chances and health much improved.

Although the national health service says that any man over 50 is entitled to a free PSA test, evidence suggests that some GPs—I stress the word “some”, but one is too many—are either unaware of that entitlement or express and demonstrate an unwillingness to refer. Last May, David Radbourne, the director of commissioning operations at NHS England South East, wrote in response to a letter from Jim, who had produced a list of affected patients:

“If there are individuals who feel they are being refused legitimate access to this test…please ask them to file a complaint through the appropriate NHS complaints process.”

I say to my hon. Friend the Minister that in those circumstances, people should not be forced to go through an NHS complaints process. Like other campaigners, I see a lacuna, or an information gap—call it what you will—among certain GPs, and I urge the Department to consider ways in which to plug it. That issue needs to be addressed quickly. The official in the Box is waving a piece of paper and the Parliamentary Private Secretary, my hon. Friend the Member for Erewash (Maggie Throup), is up on her feet with alacrity, as always.

The Public Health England advisory note, “Advising well men aged 50 and over about the PSA test for prostate cancer”, needs to be reviewed and updated. It states:

“GPs should use their clinical judgement”.

That is a pejorative term—it is an open term—so perhaps that language should be revisited. The approach needs to be a little more robust.

[Nick Smith]

The hon. Gentleman is making a really important point. I am over 50, but I did not know about the test. Does he know how many men over 50 as a proportion of the population have had the test?

[Simon Hoare]

I am sure that I have come across that figure in my research, but I do not have it to hand. However, as I mentioned in my introductory remarks, the platforms to inform, encourage and educate us all as health citizens, for want of a better phrase, that we seem to avail ourselves of very much relate to—this is not a criticism; it is perfectly correct—cervical cancer, breast cancer and other cancers. The opportunity presented by additional funding and by the very welcome cancer strategy should now allow us all to give—I do not know whether this is quite the right phrase—parity of esteem between male and female cancers. Cancer has a devastating effect on family irrespective of which member has it. I am afraid I cannot answer that query, but the Minister may have that figure. As it is an entitlement, I urge as many men over 50 as possible to see it as routine and regular as going to the optician or the dentist.

In conclusion, with the cancer strategy, fantastic levels of funding and the active commitment, energy and understanding shown by Ministers in the Department, now is the time to make positive progress.

--- Later in debate ---

[Simon Hoare]

I am very grateful that the Minister is setting this out in his customary detail. In a circumstance in which all those conversations have taken place, if the patient says, “Thank you doctor, I hear what you say, but I am entitled to have this test, and I want to have this test done,” will the Minister confirm that GPs are obliged to make the referral, rather than saying, “Well, I’ve heard what you said, but I am your doctor and I am not going to let you have it done”?

[Steve Brine]

We do not often use the term, “No decision about me, without me” any more, but I always remember the former Health Secretary—now Lord Lansley—using that a lot, and that is still very true. A patient over that age has every right to request a PSA test, and certainly even more so if they believe that they have symptoms. I would be very concerned about a GP refusing it—I think it would be extremely unlikely for one to do so in such instances—but any patient has the right of travel. Every patient has the right to change GP if they are not satisfied with the relationship that they have. If my hon. Friend did know of an instance of that, I would be very interested to hear about it—as, I suspect, would the Royal College of General Practitioners —but I would be very surprised.

I want to touch on screening, which we talk about a lot at the moment, and I will come on to why. Because of the limitations of the PSA test, there is currently no national screening programme for prostate cancer. In 2016, Prostate Cancer UK, which has been rightly lauded this afternoon, began work to help to develop tests that could form part of a national screening programme. This would potentially involve better blood tests, which are currently in development, combined with more advanced scanning. It is hoping to make that happen in the next five years—nothing happens quickly in this space unfortunately—and I am sure that we all welcome their efforts.

Members will be aware—I have spoken about this quite a lot in the House recently; we have had a number of cancer debates since Christmas—that Sir Mike Richards is leading a review for the Secretary of State of our current screening programmes. As part of that—I met Sir Mike last month—we will consider how we can make screening smarter, targeting those most at risk. We expect that Sir Mike’s work will have positive implications for future programmes. He is an incredibly experienced and respected figure in this space, and I hope that his work will enable us to roll screening out faster when the evidence base is there to support it. I am very hopeful and ambitious about that work, as I know Sir Mike is.

Let us talk about public awareness campaigns, which my hon. Friend mentioned in opening the debate. The Government have to do all that they can to raise awareness of prostate cancer and target high-risk groups, while recognising that there are limitations on how much the public will listen to public health messages from Ministers at the Dispatch Box—I know that it is hard to believe that people do not take this all to heart, but they do not, so we work with our partners.

In 2014, along with Public Health England, we worked on the phenomenally successful “Be Clear on Cancer” campaign, which has had a number of iterations, on prostate cancer in black men. The campaign messaging included:

“1 in 4 black men will get prostate cancer”,

which was one of its tag lines. It urged black men over 45 who were concerned about their risk of prostate cancer to visit their GPs. The campaign evaluation showed that it had stimulated new conversations about prostate cancer among families and the black community. Public Health England has made all the materials developed for the campaign available online, so that groups and other organisations can use them locally if they wish. They are very striking and powerful, and we believe that they were very successful.

We also welcome the work that Prostate Cancer UK is doing with the Football Association to raise awareness through their “relegate prostate cancer” campaign. It is fronted by high-profile celebrity football figures, including the England football manager, Gareth Southgate, and includes the slogan:

“One man dies every 45 minutes of prostate cancer”.

Anyone who can stay awake for “Match of the Day” on a Saturday night—thank goodness for the repeat on a Sunday morning—will see very many people, including the pundits and the managers interviewed afterwards, wearing the badge that I am wearing today. Members will be very familiar with that badge, which demonstrates the widespread support that Prostate Cancer UK has in continuing to raise awareness of this disease.

Let me turn to research, as I come to a conclusion. Research has played a crucial part in the advances that we have made in cancer survival over the past four decades. More than 15 years ago, the Department identified the need for further research into prostate cancer, and we have since worked closely with Cancer Research UK—it was here this morning; I was pleased to pop into its drop-in—Prostate Cancer UK, the Medical Research Council and others, through the National Cancer Research Institute, which is a strategic partnership of the major UK funders of cancer research. NCRI spend specifically on prostate cancer research increased from £17.1 million in 2011-12 to £26.5 million in 2015-16.

NHS Long-Term Plan

Simon Hoare Excerpts

Monday 18th June 2018 Commons Chamber

[Mr Hunt]

I thank the hon. Lady for asking that important question. We have introduced a £10,000 golden hello for postgraduates who go into the learning disability field. She is right that we have had particular pressure on the learning disability workforce. In the aftermath of Mid Staffs, there has been a whole range of measures to improve hospital ward staffing ratios for nurses and that has had an impact on learning disability nurses. That is absolutely something we hope to address with this new funding.

[Simon Hoare (North Dorset) (Con)]

I echo the thoughts of my hon. Friend the Member for South Dorset (Richard Drax) on the role of community hospitals as the segue between the acute sector and patients going home. Will my right hon. Friend confirm that, with this very welcome new money coming into the health service, the drive for efficiencies and increases in productivity will continue and indeed be increased to ensure that the biggest bung—the biggest bang is felt for those bucks?

[Mr Hunt]

My hon. Friend is absolutely right not to use the word “bung” in his question and to correct that very quickly indeed. He is also right to talk about productivity. The last Labour Government made important progress in bringing down waiting times. That required significant extra resources. When Alan Milburn had a 10-year plan, there was not a big productivity element to it. This time, when resources are much tighter, we have to make sure that productivity and efficiency gains are at the heart of the progress we make.

Breast Cancer Screening

Simon Hoare Excerpts

Wednesday 2nd May 2018 Commons Chamber

[Hon. Members]

Hear, hear.

[Simon Hoare (North Dorset) (Con)]

As I understand it, Public Health England, which is of course operationally independent of Ministers, runs the screening programme, so what assurances have the chair and chief executive of that important organisation given my right hon. Friend that the actions that he has usefully set out today will be completed within the required deadlines to meet the obvious and legitimate demands of patients?

[Mr Hunt]

PHE has given clear assurances that the problem has been fixed, but it is open to any suggestions that the review makes as to how things could have been handled better.

Medicines and Medical Devices Safety Review

Simon Hoare Excerpts

Wednesday 21st February 2018 Commons Chamber

[Mr Hunt]

Those words about the patronising disposition of unaccountable power came from Bishop James Jones, who has made an extraordinary contribution as a voice for people whose voices have been ignored for too long. The House will have every opportunity to debate Baroness Cumberlege’s report. The Government will decide their actions and we will put them to the House, which will have every opportunity to listen, make suggestions for improvements, and to become involved at every stage of the process as we take this forward.

[Simon Hoare (North Dorset) (Con)]

With their incredibly moving stories, my constituents Karen, a victim of vaginal mesh, and Angie, with Primodos, will have listened intently to what my right hon. Friend has said. May I underscore a point made by colleagues on both sides of the House? There are two key issues apart from the Cumberlege review. First, we must ensure that our medics, from med school up, realise that they are not gods, because that is how many patients feel when they have to deal with them and their concerns are too easily dismissed. That needs to change from the bottom up. Secondly, my right hon. Friend made the point that this is an issue not just for the NHS but for private health care too. It involves patients living in all quarters of the United Kingdom. How will this learning, and the learning of the review, spread, while respecting the devolved Assemblies, in those regions where the health service is not under the control of my right hon. Friend?

[Mr Hunt]

Those are both important points. I will make one comment about the second one. The spreading of best practice is central. We must ensure that we do not just have a system where we have new NICE guidelines, but that we have confidence that it is being implemented across 30,000 GPs in 250 NHS trusts and so on, and I know Baroness Cumberlege will be thinking about that.

NHS Winter Crisis

Simon Hoare Excerpts

Monday 5th February 2018 Commons Chamber

[Stephen Barclay]

I thought the hon. Lady was going to stand up to reflect on the fact that her trust got £2.9 million of additional funding from what the Chancellor set about doing. The reality is that this Government are putting more money into the NHS and addressing the demands on the system.

[Simon Hoare (North Dorset) (Con)]

May I ask my hon. Friend what scope there is as we go forward for conversations between his Department, NHS England and NHS trusts about maximising staff numbers in acute settings in our hospitals during the winter months?

[Stephen Barclay]

We are in discussion with Health Education England on workforce planning and ensuring that we address concerns about retention and training, part of which is the fact that the Chancellor has lifted the 1% cap as it applies within the health service, and we are of course in active discussions with the trade unions on that point.

NHS Winter Crisis

Simon Hoare Excerpts

Wednesday 10th January 2018 Commons Chamber

[Jonathan Ashworth]

I will take that as my second telling off from you today, Mr Speaker. Given your guidance, I will try not to take any more interventions, but on the particular point raised by my hon. Friend the Member for Hove (Peter Kyle), the privatisation of patient transport services to Coperforma in his area of Sussex was an absolute disaster for patients and for the ambulance drivers, who I met—they went for eight weeks, as I recall, without pay. He has been campaigning on the issue, as has the GMB trade union, which I congratulate on the campaign it has run. We now learn that, having ended the contract, money is still going to that firm, which is an absolute scandal. I hope there can be a full inquiry into what has gone on, and I praise my hon. Friend for leading the campaign.

I have talked about the real impact of cancelled operations—for example, on someone waiting for a hip replacement who is forced to stay at home, unable to walk properly, and who, due to the pain, will no doubt at some point need to see a GP again in an emergency, which again adds to the pressures on the service. Perhaps someone in need of a cataract operation has had that operation cancelled and is now at risk of falls because they cannot see. Such a person could well end up in A&E, again needing a hospital bed. These are real people who rely on the NHS and whom the Government are letting down. The domino effect of not providing proper, timely care increases the crisis and pressures on the wider NHS.

[Simon Hoare (North Dorset) (Con)]

Will the hon. Gentleman give way?

[Rebecca Pow]

rose—

--- Later in debate ---

[Jonathan Ashworth]

I will make some progress.

The hon. Member for Banbury (Victoria Prentis) rightly said that we do not want to make this more of a crisis, but the Secretary of State knows that cancelling elective operations as an impact on hospital finances. It means a loss of revenue for trusts that are already struggling to meet their deficit targets. Rather than allowing waiting times—

[Simon Hoare]

Will the hon. Gentleman give way?

[Jonathan Ashworth]

I am not going to take any more interventions, I am afraid.

Rather than allowing waiting times to escalate further, why will the Secretary of State not commit today to giving hospitals emergency funds, so those cancelled operations can be rescheduled as soon as is reasonably possible and hospitals do not lose revenue and get further into problems with their deficits?

The Secretary of State knows that cancelling electives impacts on training of the next generation of surgeons and junior doctors, who are warning that they could lose out on as much as a sixth of their six-month training because the operations are not there for them to do. Will he tell us, if these cancelled electives continue, what is his plan to ensure that our junior doctors and surgeons can catch up on the training they need? Our patients deserve the best-trained surgeons and junior doctors in the world. Cancelling those electives impacts on their training. Will he tell us his plan for dealing with that?

We all agree that every penny counts in rising to the challenge of the winter crisis caused by Downing Street. I know the Secretary of State will tell us that we have had the—

[Simon Hoare]

Will the hon. Gentleman give way?

[Jonathan Ashworth]

I said that I would not take any more interventions.

The Secretary of State will tell us about the winter funding, but we also know that the winter funding came far too late. NHS Providers has warned that it came far too late in December, and I am sure that many hospital trusts will be telling him privately in his morning phone calls that it came too late. Hospital trusts have to turn to expensive private staffing agencies to get through this winter due to the Government’s failure to invest in an adequate workforce to enable the NHS to deliver the care the nation needs. In many places, NHS trusts are effectively held to ransom by staffing agencies.

Last month, NHS Improvement refused a freedom of information request to publish how much these private agencies are costing individual trusts. Does the Secretary of State agree that that is unacceptable and that we should know how much extra money set aside for winter is going to private agencies? Will he undertake to produce a league table naming and shaming every single agency and stating how much they have been getting from each and every trust, so that we can have clarity on this matter?

The Secretary of State will no doubt tell us that the problems we are experiencing have arisen because we have an ageing society. Of course, we see pressures on the service because of the demographics not just in winter, but all year round. Patients with less acuity, often with sometimes three or four comorbidities—in particular, those being treated at this time of year—put huge pressure on the service throughout the year.

However, these demographic changes in society did not just drop out of the blue sky in the last few weeks. We have known about these trends for years and years, which makes it even more criminal that the Government have presided over eight years of underfunding in the NHS—£6 billion of cuts to social care—and have acquiesced in a reduction of 14,000 beds. We will probably see more bed reductions if we pursue the sustainability and transformation plans across the country. We have seen delayed transfers of care increase by 50% these last years.

On social care, the Secretary of State may have those words in his title now, but he has no plan to deal with the severe £6 billion cut we have had to social care in recent years.

--- Later in debate ---

[Simon Hoare (North Dorset) (Con)]

It is a pleasure to follow the hon. Member for Tooting (Dr Allin-Khan). For what it is worth, I thank her, my hon. Friends the Members for Lewes (Maria Caulfield) and for Sleaford and North Hykeham (Dr Johnson) and other medical colleagues who have spent time working in our service over this period, looking after constituents. Their public service is second to none. I also thank my hon. Friend the Member for Ludlow (Mr Dunne) for the work that he has done within the Department, and I welcome the new team. I also echo many colleagues from around the Chamber—across parties and from all geographies of the country—in thanking NHS staff, ambulance drivers, paramedics and those who work in our county social services, all of whom are trying to play a part.

I am going to be distracted slightly, because I am going to take strong issue with the peroration of the hon. Member for Wirral West (Margaret Greenwood), who said with full Momentum fury, “The NHS is a political entity.” I say to the hon. Lady, with the greatest of respect, that it is not. The national health service is a publicly funded service, free at the point of use, which is populated and staffed by publicly motivated and qualified public service medics and others, who look after our constituents and their health needs. They are not politicised; they are motivated by care. [Interruption.] Rather than chuntering from a sedentary position, I urge the hon. Lady to sit and reflect on her words, because her comment was one of the most dispiriting remarks that I have heard during my time in this House. While she is reflecting on her comments, she might also wish to reflect on the fact that, whenever the Treasury writes another cheque for the national health service—I am sure that practitioners will appreciate this—it always has to take into account the £2 billion a year private finance initiative albatross bequeathed by the Labour party.

I want to draw the attention of the House, as I did during the statement on Monday by my hon. Friend the Member for Ludlow, to the importance of bedded community hospitals. Dorset CCG, under the leadership of Tim Goodson, has listened to our community campaign and has saved the beds in Westminster Memorial Hospital in Shaftesbury. In my judgment, the provision of those beds is absolutely pivotal in providing the link between the acute sector and people making their journey to recovery and then being on their way home. The collaborative work between the NHS and Dorset County Council—where there are social care officers with computers that are interlinked with and embedded within Westminster Memorial Hospital, working out the discharge care programmes—is pivotal. I appreciate that what we are doing in Dorset is not unique, but I also appreciate that it is not replicated everywhere; it does merit attention.

We should be focusing on far better advertisements for the use of our pharmacies, and we should ensure that community pharmacies are a much more collegiate network of service provision, taking pressure off GPs and A&E departments. I urge the Minister to ensure that CCGs are better encouraged to make sure that their boards include a representative from the pharmacy community. This siloed approach does not help the provision of care for our constituents.

NHS Winter Crisis

Simon Hoare Excerpts

Monday 8th January 2018 Commons Chamber

[Mr Dunne]

I visited the A&E department at St Mary’s for a night shift a few months ago. I was not aware of the incident of ceiling damage that the hon. Lady referred to, but I would be very happy to meet her to discuss it.

[Simon Hoare (North Dorset) (Con)]

As my hon. Friend and his colleagues continue to wrestle with the conundrum of the merging of social care and healthcare, I urge him to keep at the front of his mind in his discussions with healthcare providers the importance of beds in community, district and cottage hospitals in providing a segue between acute settings and returning home.

[Mr Dunne]

My hon. Friend is a lively champion of the community hospitals in his area, which I know provide an important service, but I am afraid that I must again refer to the STP proposals and say that it is for local clinicians and health and local authority leaders to decide what is best in their area.

[Mr Speaker]

The hon. Member for North Dorset (Simon Hoare) should be doubly gratified to be acknowledged not merely as champion of the said hospitals but as a lively champion at that.

[Simon Hoare]

It is better than the alternative.

[Mr Speaker]

It is better than the alternative.

Surgical Mesh Implants

Simon Hoare Excerpts

Wednesday 18th October 2017 Westminster Hall

[Emma Hardy]

I absolutely and completely agree. One consultant has written to explain the problems with mesh removal, stating:

“Once stuck the mesh is never fully removed and failure of implanting means that mesh will fuse, erode, stick and adhere to organs, nerves and blood vessels—creating life long…injuries.”

She argues that patients were never clearly told of the risks of mesh fused to organs. She stated further that the

“mesh weave that is stuck will become a perfect breeding ground for bacteria”,

and unless it is completely removed, the patient will remain continually infected and fatigued forever.

[Simon Hoare (North Dorset) (Con)]

I apologise, Mr Owen, for arriving a little late. I know that the hon. Lady is talking about consultant surgeons, but does she agree with my constituent, Karen, who has corresponded with me to say that there is also a lack of awareness among the general practice community? The procedures are taking place and are deemed to be a success, but these other problems then present themselves and GPs are just not aware of the causal link and how to diagnose it.

[Emma Hardy]

Absolutely; I will talk about that later. One of the women who wrote to me this week explained that her surgeon was worried about trying to remove a small piece of mesh from the heart of her vital organs, near her bowel and bladder, which he could not actually see by visual examination, ultrasound or X-ray. She explained that, since having the mesh fitted five and a half years ago, it has prevented her body from healing, causing ongoing problems ever since.

This is not an effort to scaremonger. For most, the surgery is successful, but we have estimates from the Medicines and Healthcare Products Regulatory Agency that about 1% to 3% of women suffer complications. A recent report in the scientific journal Nature showed evidence of about 10% of women suffering complications after surgery, and another research study estimates that the figure could be 15% to 20% or even higher.

NHS Pay

Simon Hoare Excerpts

Wednesday 13th September 2017 Commons Chamber

[Dr Allin-Khan]

I agree 100% with my hon. Friend’s argument, which was most eloquently put. While those on the frontline work so hard, they are on the breadline. Our firefighters, teaching assistants, council officers, nurses, policemen and women, prison guards and hospital porters—the list is endless—are the glue that binds our country together. The services in which they work are vital, because they allow people in every part of the country to live their lives, feel safe and have opportunity. Those workers—I have the pleasure of working alongside many of them at St George’s hospital in Tooting—do not seek recognition; they serve our country selflessly on a daily basis. They are simply seeking a decent day’s pay for a decent, hard day’s work. That is why the Labour party would scrap the NHS pay cap and give our hard-working NHS staff pay that recognises the skill and dedication that they bring to their working lives.

[Simon Hoare (North Dorset) (Con)]

Will the hon. Lady give way?

[Dr Allin-Khan]

No, I am going to make some progress.

The quality of NHS services depends on the skill and talent of the people in them. Those in our NHS facing the everyday challenge of treating our most vulnerable should not be worrying about how they will put food on the table for their children—the very children who are having to accompany them to food banks.

Let us be clear: lifting the pay cap is not about recognition. It is about removing a cap that actively degrades our public services, weakening the foundations under our feet. Let us stop this demonisation of a workforce who hold this country together. We need an independent pay body to negotiate public service pay. Our services have been gutted by seven years of ideological austerity.

[Simon Hoare]

Will the hon. Lady give way?

[Dr Allin-Khan]

I will give way—this will be interesting.

[Simon Hoare]

I will let you work out whether it is an interesting intervention, Madam Deputy Speaker.

I am listening carefully to what the hon. Lady says. She speaks with passion and from chalk-face experience. I was interested to hear her make an open-ended pledge that her party would raise public sector pay in the national health service, but she has not said by how much, at what rate, on what timetable or how it would be funded. Can we have some detail?

[Dr Allin-Khan]

The hon. Gentleman heard the eloquent contribution from the Opposition spokesman today, and I would ask him where the £350 million a week is that we expected to see as a result of leaving the European Union. If his party has its way, we will have even less money for the NHS, so we will not only lose our valuable workforce who have come here from Europe but we will be further underfunded.

Lifting the public service pay cap would enhance the capacity and skill of each of our public services. In such high-pressure, stressful places of work, we demand that our nurses, police officers and firefighters make life or death decisions with a clear mind. How will they do that if, at the back of their mind they are worrying about how they will be able to feed their children or care for their parents? They will burn out—it is a recipe for disaster, and we are already seeing it happen. How long do we expect those public sector workers to carry on like that?

There are times when we in the House divide and times when we unite. This debate reaches far beyond a percentage increase on a payslip. It is about not just pay but the knock-on effect on lives. I implore the Government to look at the issue again and pay our public service heroes a decent wage.

--- Later in debate ---

[Simon Hoare (North Dorset) (Con)]

I will not take that personally, Mr Deputy Speaker.

I thank the Labour party for giving the Conservative side of the House, and me in particular, the opportunity to put on the record the grateful thanks of all our constituents to public sector workers for their fantastic work in hospitals in places such as Blandford, Shaftesbury, Poole, Dorchester, Salisbury, Southampton and Bournemouth, all of which will have served my constituents over the years. We are all grateful to them.

I want to make two points to the Labour party. I entirely endorse what my right hon. Friend the Member for Broxtowe (Anna Soubry) had to say, because this is not a bidding war over which party loves the NHS more; it is about all of us trying to come together to ensure that the NHS is fit for purpose for the next 70 years, delivering quality care that is free at the point of use in the face of ever-increasing demand in the ever-more competitive space of medical advancement. At the heart of that, I am afraid to say, is cruelty from the Labour party, which makes huge promises about raising this, doing that or scrapping the other without saying how, by how much, or how it is going to be paid for. Labour raises expectations only for them to be dashed, as always, on the rocks of what would ultimately be the folly of a Labour Government. Labour’s childish approach to economic management defines what it is to be a Conservative. Broadly, being a Conservative in public life is to be the man or woman with the bucket, the brush and the shovel following behind the horse of Labour Government and picking up the mess.

[Margaret Greenwood (Wirral West) (Lab)]

I wonder whether the hon. Gentleman is aware of how his Government are reducing supply in the national health service, creating demand for private healthcare. People outside the Chamber are fully aware of the Conservative Government’s privatisation agenda and their agenda of selling off buildings—

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. It is not normal to intervene just after coming into the Chamber. The fact is that Members who have been here all day are desperate to get in, and I am worried that they may not.

[Simon Hoare]

The hon. Lady has burnished her reselection credentials among the Corbynistas in Momentum as Labour approaches its party conference, and she will be grateful for that.

There is another great elephant that needs to be put out of its misery. It has been perpetuated by socialists down the decades, usually at public meetings and the like, that my party wants to privatise the national health service. Let me say in all candour that the Labour party misses the fundamental fact that the Conservatives have been in government for longer than Labour during the existence of the NHS. We have had majorities in three figures and two figures and we have had minorities, so if it was a deep-rooted Tory secret that we wanted to privatise the NHS, having privatised everything else we would have jolly well done it by now. We have no intention of doing so. I was born in an NHS hospital, as were my three daughters.

[Anna Soubry]

Will my hon. Friend confirm that the biggest increase in NHS privatisation—5%—occurred under a Labour Government? The Conservatives’ record is 1%.

[Simon Hoare]

My right hon. Friend is correct, but the Labour party does not like truth spoken unto opposition. Let us hope that we never have to speak truth unto Labour in power, because that would be even worse.

There is a false debate where GPs and pharmacists are in essence private businesses delivering healthcare and advice to our constituents free at the point of use. I think the mindset in the national debate has moved on beyond the cosy intellectual rigour of north Islington, and most people are just keen to enjoy a quality service that is delivered by motivated people in a safe and secure environment. That is at the heart of our policies.

There is clearly fluidity and movement on the pay cap, which is welcome. I used the word “cruelty” a moment ago. When its economy came under pressure, Ireland coped with the management of its health budget by making a vast number of health service workers unemployed. That is one way of dealing with it, but it is not the right way. We have done it the right way, and we are grateful for the forbearance of those at the sharp end. It has not been done out of cruelty or out of intellectual or ideological purity; it has been done out of financial and economic necessity.

As our economy grows, so will the pay packets of those working in our vital public services. I know it is boring, and I know it is an inconvenient truth for the Opposition, but without a strong economy, without people in work, without business confidence and without people paying taxes, it would be an absolute sham to continue funding unsustainable pay increases and the like through borrowing, because that would just lead to cuts and further ruin.

--- Later in debate ---

[Peter Dowd]

I will come back to the hon. Lady in a moment.

NHS workers are the subject of today’s debate, but we must not forget workers in the rest of the public sector. In fact, I believe that NHS workers would be dismayed if we focused only on their pay situation. Why would they be? Because they spend their professional lives looking after others. I take NHS workers’ commitment incredibly seriously, unlike that hon. Member on the Government Benches who laughs at nurses, doctors and allied professionals. That is the sort of thing we get from the Tories.

[Simon Hoare]

Will the hon. Gentleman give way?

[Anna Soubry]

Will the hon. Gentleman give way?

Contaminated Blood

Simon Hoare Excerpts

Tuesday 11th July 2017 Commons Chamber

[Simon Hoare (North Dorset) (Con)]

I, too, welcome you to your place, Madam Deputy Speaker. I have a confession, or an apology, to make: when I was first briefed on this issue, I put it into the “too difficult to deal with” category—perhaps it was too niche, too much of the past. It lacked a contemporary feel to it. I was wrong and the hon. Member for Kingston upon Hull North (Diana Johnson) has proved the point today, and she is to be congratulated on that.

Listening to this debate, I have been reflecting on the fact that so many of our constituents view this place through that very narrow prism of 30 minutes or so on a Wednesday. This debate has shown Parliament at its best—Members from across the parties with an interest in an issue coming together to try to find a solution. I welcome the words of the hon. Lady in relation to my right hon. Friend, the Prime Minister. As a number of hon. Members have pointed out, many Ministers have listened, and just as many Ministers listened to the tragedy of Hillsborough. My right hon. Friend the Prime Minister seems to have something in her essence, as she does not listen but decides to act in a fair, calm and sensible way, always in the pursuit of justice for our constituents and fellow citizens.

This issue speaks to a time long past—a different time for procedures, practices and medical processes. It certainly predates patients’ rights and, as a number of hon. Members have said, the devolution settlement, which will doubtless throw up challenges for the inquiry. However, it is also a contemporary issue, as it causes pain, suffering and anxiety, as many colleagues across the House have referenced. I strongly welcome the Government’s decision to move towards a single payment scheme. Having five silos to which people can try to apply and have to justify their needs to—my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi) alluded to such cases—has added indignity to injustice.

Money is not everything, as a number of colleagues have said. Yes, the ill health unnecessarily—and probably avoidably—experienced by sufferers as a result of contaminated blood means that they must bear greater medical costs as well as greater social and lifestyle costs. But the inquiry is crucial. I confess that I am sanguine, on a personal level, as to whether there should be a panel or a judge-led inquiry. If the latter—I agree entirely with the Minister that this has to be done in concert with the survivors to identify the best way—I hope that we can rally around the authenticity of the judge and not question their motivation or bona fides. The sufferers do not have time on their side, and we must move forward quickly. This is a campaign that has festered too long.

I conclude by congratulating again the hon. Member for Kingston upon Hull North. I hope that people who are suffering, who are bereaved, who are in pain, or who are anxious today are in some way sustained and comforted by a brighter glimmer of the hope of justice at the end of the tunnel.