Oral Answers to Questions

John Bercow Excerpts

Tuesday 20th March 2018 Commons Chamber

[Sir Roger Gale (North Thanet) (Con)]

Thanet enjoys an ageing population and I am pleased to be a part of it. We will be delighted to know that one of the five new medical schools designated by the Secretary of State today is going to be based in east Kent: the bid from the University of Kent and Canterbury Christ Church University was successful. It will not have escaped my right hon. Friend’s notice that the Christ Church campus is in close proximity to an A&E hospital— the Queen Elizabeth The Queen Mother Hospital—and we hope very much to see all the benefits very soon. Thank you.

[Mr Speaker]

May I just say to the hon. Gentleman that if memory serves me correctly, he was born on 20 August 1943, and therefore, he is really not very old at all?

[Mr Hunt]

I congratulate my hon. Friend on being born five years before the NHS was founded—a very short while ago. Kent is an area that, although it is the garden of England, has some profound challenges in its health economy. One of those challenges is attracting doctors to work in Kent and other more geographically remote areas, so I am very hopeful that this big new announcement for the University of Kent will be a big help.

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[Mr Hunt]

If these cases were decided on the persistence and strength of the lobbying of local Members, for sure my hon. Friend’s would be at the very top of the list. I have been to the hospital and heard about the issues from staff—it was a very good visit. She has campaigned persistently on this and I very much hope that we can give her good news because I am aware of how urgent the need is.

[Mr Speaker]

Not only was the hon. Lady present in Speaker’s House this morning, but her sister and distinguished speech and language therapist Rosalind Pow was present as well, so we had two doses of Pow in the course of a breakfast meeting. It was an unforgettable experience for all concerned.

[Tim Farron (Westmorland and Lonsdale) (LD)]

I cannot compete with that, Mr Speaker. Back in November, I wrote to the Secretary of State about the increased service charges on GP practices. Ambleside surgery in my constituency, which serves an increasingly ageing population, faces a huge increase of £25,000—more than double—and the staff there fear they cannot keep the surgery going long term with that kind of increase. A ministerial written response in November did not mention Ambleside once, so will the Secretary of State commit now to intervening directly to guarantee that Ambleside will not have to pay this unjustified additional £25,000 a year?

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[Steve Brine]

All trusts have been directed to get on with the review. The NHS England specialised commissioning team is in discussions with my hon. Friend’s local trust as it develops its five-year strategic plan for the cancer pathways. It is working with his local cancer alliance, including radiotherapy services. It is recognised that a more radical approach and a broader review of the radiotherapy options may be required in future. As my hon. Friend says, he and my right hon. and learned Friend the Member for North East Hertfordshire (Sir Oliver Heald) have that meeting later this week, and I hope the discussions are productive. I feel sure that my hon. Friend will come back to me if they are not.

[Mr Speaker]

Let us hear from the neighbour. I call Sir Oliver Heald.

[Sir Oliver Heald (North East Hertfordshire) (Con)]

Would my hon. Friend be prepared to highlight to the review team just how dreadful it is for somebody to have to travel day after day, for an hour and a half in each direction, to London for radiotherapy when they are already ill? I hope it might be possible for some action to be taken to resolve this issue in our area.

[Steve Brine]

Obviously my right hon. and learned Friend is right to speak up for services in his area. The review is not about cutting those services, but about making sure that they are in the right places. We have to be mindful that sometimes the services have to be centralised to be in the right place to deliver the right outcomes for cancer patients.

[Mr Speaker]

I will take the next question on condition that Members are exceptionally brief, as time is constrained.

[Royston Smith (Southampton, Itchen) (Con)]

14. What steps he is taking to increase the capacity and availability of GP services.

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[Steve Brine]

We need more GPs, which is why today’s announcement is very important. I am sure that the hon. Gentleman welcomes them.

[Mr Speaker]

Well, if there are to be more GPs, they will have to be paid.

[Bill Esterson (Sefton Central) (Lab)]

Patients at Hightown GP surgery were promised that their surgery would stay open, but, out of the blue, they were written to and told that the surgery would close on 8 June. The Government are belatedly taking action on the shortage of GPs, but will the Minister intervene to make sure that Hightown surgery is kept open and that a promise is kept to patients?

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[Several hon. Members rose—]

[Mr Speaker]

Order. I am about to call the shadow Secretary of State, but I say very gently to him that he needs to be brief because there is a lot of pressure on time. He would not want a situation in which those on the Front Bench dominated at the expense of those on the Back Benches, because that would be absolutely wrong, and the hon. Gentleman is always opposed to that which is wrong.

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

Thank you for your instructions, Mr Speaker. We have heard today more warnings that the winter crisis will stretch beyond Easter. We have seen the worst winter crisis for years. The Secretary of State will blame the flu and the weather, but patients are blaming years of underfunding, blaming years of social care cuts, and blaming years of cuts to acute beds, so will he now apologise for telling us that the NHS was better prepared than ever before this winter?

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[Mr Hunt]

Gratefully accepted.

[Mr Speaker]

Very wise.

[Frank Field (Birkenhead) (Lab)]

May I thank the Minister for his concern about what is going on at Arrowe Park Hospital? Will he meet Wirral Members shortly so that we can be assured that the existing governance is very short-term and that the issues of bullying and the way the hospital cripples primary care are dealt with effectively?

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[Steve Brine]

That is an excellent question. We are testing the new Accelerate, Co-ordinate, Evaluate programme—ACE—which I visited recently at the Churchill Hospital in Oxford. Patients with vague symptoms can be referred for multiple tests and often receive a diagnosis or an all-clear on the same day. I do not get excited very easily, but that promises great excitement.

[Mr Speaker]

It is a delight to see the Minister in a state of high excitement. We hope to see it repeated on innumerable occasions.

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[Several hon. Members rose—]

[Mr Speaker]

Order. In Question Time, as in the health service under all Governments, demand tends invariably to exceed supply. We have time only for two more—we do not really have time, but I am creating it.

[Henry Smith (Crawley) (Con)]

I would like to thank the Under-Secretary of State for Health, the hon. Member for Winchester (Steve Brine), for his response to the all-party parliamentary group on blood cancer report. Will he continue to ensure that cancer alliances and GPs are diagnosing early?

Mental Health Services: Children and Young People

John Bercow Excerpts

Thursday 8th March 2018 Commons Chamber

[Several hon. Members rose—]

[Mr Speaker]

Order. Many right hon. and hon. Members are seeking to catch my eye, but I remind Members that there are business questions immediately after these exchanges, followed by an important statement by the Home Secretary. Thereafter, the debate on International Women’s Day is heavily subscribed, so there is a premium on brevity from Back and Front Benchers alike, and I want to move on, whether we have incorporated everybody or not, no later than 11 o’clock. Single-sentence questions are much to be preferred.

[Fiona Bruce (Congleton) (Con)]

I commend the Government for promoting the Emotionally Healthy Schools project, which, in my constituency, is working well and engaging not just children who have challenges, but their families. Does the Minister agree that helping children with their mental health challenges needs to involve, wherever practical, their families, family relationships and inter-parental relationships, as recommended by the Early Intervention Foundation?

Points of Order

John Bercow Excerpts

Wednesday 7th March 2018 Commons Chamber

[Paul Farrelly (Newcastle-under-Lyme) (Lab)]

rose—

[Mr Speaker]

I will come to the hon. Gentleman, but I have another point of order first.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

On a point of order, Mr Speaker. In an oral statement on social care on 7 December 2017, the then care Minister, the hon. Member for Thurrock (Jackie Doyle-Price)—as it happens, she is in her place on the Front Bench at the moment—replied to a question I asked about the Government abandoning the carers strategy, which had been due to be published in summer 2017. Of the thousands of carers who had responded to a consultation and then been left waiting, the Minister said:

“We have listened to them, and we will consider what they have said in bringing forward the Green Paper. In the meantime, it is very important to pull together exactly what support there is at present and then respond to that, and we will publish our action plan in January.”—[Official Report, 7 December 2017; Vol. 632, c. 1238-39.]

It is now March, and this is the second time I have raised this on a point of order. Not only do we no longer have any prospect of a carers strategy from the Government, but they have not met their own target to publish an action plan. That is a shabby way to treat carers. Mr Speaker, have you had any indication that the current Minister for Care or, indeed, any Health Minister plans to come to the House to update us on what, if anything, the Government propose to do for carers?

[Mr Speaker]

I have certainly not been advised of any intention on the part of a Minister to make an oral or, indeed, written statement to the House. There is a Health Minister on the Treasury Bench, who has heard what the hon. Lady said. She is welcome to respond if she wishes, but is under no obligation to do so.

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

indicated dissent.

[Mr Speaker]

Not at this time. I say to the hon. Member for Worsley and Eccles South (Barbara Keeley), who is an experienced denizen of the House, that there will be opportunities through the business question and subsequently for her to draw the attention of the House again, and perhaps in more detail, to her concerns and to elicit a ministerial reply.

[Paul Farrelly]

On a point of order, Mr Speaker. I ask your advice on how the House can put on the record its concern that the Conservative manifesto in 2017, with its promise to scrap Leveson 2 and section 40, pre-empted the results of a consultation that the Department for Culture, Media and Sport was carrying out. How can we be sure, particularly given the comments of Sir Brian Leveson, that that decision was reached fairly and reasonably and will not be subject to judicial review?

[Mr Speaker]

I will say two things in response to the hon. Gentleman. First, he seeks and perhaps over-generously expects from me a degree of reassurance and even of wisdom that it is not within the capacity of the Chair to provide. Secondly, in asking how we—meaning the House as a whole—can be sure, I simply say that the hon. Gentleman, who is no stranger to these matters, raises something of a philosophical question. Whether, when and to what degree Members can be confident of certainty are not matters that can be broached now from the Chair. However, in so far as he was seeking—as the puckish grin on his face suggests—to register his own concerns, he has found his own salvation.

[Karen Lee (Lincoln) (Lab)]

On a point of order, Mr Speaker. At Prime Minister’s Question Time on 31 January, I asked for a meeting with a Minister and was promised that I could have one. I received a letter two or three weeks ago saying that the matter had been passed to the Department of Health and Social Care. I seek your guidance—or anyone’s guidance, really—on how I can progress that, because I have had no meeting and no date so far. That was five weeks ago, so I think I have been fairly patient.

[Mr Speaker]

The hon. Lady has certainly been patient. Sometimes, raising a point of order in the Chamber and reminding those on the Treasury Bench of a promised meeting that has not yet been delivered can be a remarkably effective way of bringing about said meeting. The other device that I recommend to the hon. Lady, who is a new Member of the House, is the tabling of a written question. If she is interested in exploring historic copies of the Official Report, she will know that the former Member for Manchester, Gorton, our late and dear friend Sir Gerald Kaufman, was fond of highlighting unanswered correspondence to which he demanded a reply, unanswered questions to which he demanded a reply, or undelivered meetings that he had been promised and on which he still insisted by tabling written questions to remind Ministers of those matters and inquire when the promised reply or meeting would take place. In my experience, Sir Gerald was remarkably effective at obtaining such responses, as indeed was the former Member for Walsall North, Mr David Winnick. The hon. Lady may usefully learn from their and many other examples.

[Alex Cunningham (Stockton North) (Lab)]

On a point of order, Mr Speaker. In January, the Government announced plans to incentivise local communities to agree to explore the possibility of storing radioactive nuclear waste near their homes—an initiative that was widely reported in the media. I was anxious that it could revive proposals to store nuclear waste in the anhydrite mine under thousands of homes in Billingham in my constituency. I raised the issue at Prime Minister’s questions on 31 January. Sadly, the Prime Minister’s substitute that day, the Minister for the Cabinet Office, despite the publicity and it being Government policy, knew nothing about that initiative by his Government. However, he promised to investigate the matter and write to me. That was five weeks ago. Will you advise me whether it is unreasonable of me to have expected an answer by now?

[Mr Speaker]

I am grateful to the hon. Gentleman for his point of order and for his courtesy in giving me notice of it. It is not unreasonable for an hon. Member to expect a response from Ministers within five weeks. Ministerial correspondence is of course, as colleagues will know, the responsibility of the Minister concerned. The Minister for the Cabinet Office and Chancellor of the Duchy of Lancaster, the right hon. Member for Aylesbury (Mr Lidington), who happens to be my constituency neighbour, is normally most courteous. I am sure that his colleagues on the Treasury Bench, including the representatives of the Patronage Secretary, will swiftly alert the right hon. Gentleman to this outstanding action. The hon. Member for Stockton North (Alex Cunningham) certainly should have had a reply and he should now get one, sooner rather than later. Meanwhile, he has placed his concern on the record.

Mental Health Act: CQC Report

John Bercow Excerpts

Tuesday 27th February 2018 Commons Chamber

[Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)]

(Urgent Question): Thank you very much for granting this urgent question, Mr Speaker. This morning, the Care Quality Commission published—

[Mr Speaker]

Order. I am immensely grateful to the hon. Lady, but she needs to say, “To ask the Minister for a statement, etc.” She will get her full go—her full bite at the cherry—when the Minister has delivered the initial statement. That is the way it works.

[Luciana Berger]

To ask the Secretary of State for Health and Social Care to make a statement on the Care Quality Commission’s report, “Monitoring the Mental Health Act in 2016/17”.

Medicines and Medical Devices Safety Review

John Bercow Excerpts

Wednesday 21st February 2018 Commons Chamber

[Huw Merriman (Bexhill and Battle) (Con)]

Just an hour ago I met my constituent Carol Short and Emma Friedmann, a constituent of the hon. Member for Leicester South (Jonathan Ashworth), to discuss the next stage of the valproate campaign, but because of the statement, that meeting was adjourned. I am happy that they are now in the Chamber, and I am sure that they are pleased to hear about the review.

Is it possible to ensure that GPs are giving out the excellent advice that the Medicines and Healthcare products Regulatory Agency has put together? I am sorry to say that it seems that far too many are not, and there appear to be no regulatory sanctions to ensure that they do.

[Mr Speaker]

Order. I mean no discourtesy to the hon. Gentleman, but I hope that the people whom he mentioned are in fact in the Gallery rather than in the Chamber. That would be greatly reassuring to us, and quite possibly to them.

[Mr Hunt]

I can give my hon. Friend the assurance for which he has asked. We have announced today that we are improving the system of alerting both general practices and community pharmacies to ensure that the right advice is given and the right safeguards are in place, so that people who are pregnant or might become pregnant do not take a medicine that is very powerful and very effective in the right circumstances, but incredibly dangerous in the wrong ones.

Acute and Community Health

John Bercow Excerpts

Thursday 8th February 2018 Commons Chamber

[Several hon. Members rose—]

[Mr Speaker]

Order. I remind the House that there is another ministerial statement to follow, and that although the debate on matters to be raised before the forthcoming Adjournment is not now intended to take place, no fewer than 19 Members wish to take part in the debate on community banking, so there is a premium on brevity. These important matters having been preliminarily aired, I now appeal to colleagues to ask single-sentence, pithy questions, without a great preamble, then we will progress towards other matters. I now call Sir Oliver Heald.

[Sir Oliver Heald (North East Hertfordshire) (Con)]

My hon. Friend will be aware, and indeed has said, how bad the situation was at Liverpool prison, where the trust had no understanding of what was required of it in its role as health provider. That put healthcare staff in a very difficult position. Does he feel that there is a need for better liaison between health and justice in relation to prison health facilities? Is the CQC really in a position to inspect them, or should there be joint inspections by Her Majesty’s inspectorate of prisons and the chief inspector of hospitals?

Oral Answers to Questions

John Bercow Excerpts

Tuesday 6th February 2018 Commons Chamber

[Fiona Bruce (Congleton) (Con)]

rose—

[Mr Speaker]

Order. We might hear from the hon. Member for Kingswood (Chris Skidmore) later, but I say to him in all friendly courtesy that while Kingswood no doubt has a great deal to be said for it, as does Congleton, both have one thing in common, and that is that they are a very long way from northern Lincolnshire.

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[Mr Hunt]

I am most grateful. That is a very rare compliment, so I shall savour it. I would gently say to her that the point about nurse degree apprenticeships is that it is possible to transition into nursing from being a healthcare assistant without any fees being paid at all. That is why it is a huge and highly significant change.

[Mr Speaker]

As the hon. Member for Wallasey (Ms Eagle) is sporting what appears to me to be a very fetching suffragette rosette, it is perhaps timely to record that in the great success our national health service has been under successive Governments, I think I am right in saying, as things stand, that well over 70% of the people who make it great are women.

[Dr Sarah Wollaston (Totnes) (Con)]

Following the recent inquiry by the Select Committee on Health into the nursing workforce, we absolutely welcome the new routes into nursing, including the new role of nursing associate. However, one of the issues highlighted strongly was the need to retain our existing nursing workforce as well as to recruit into it. Will the Secretary of State comment on that?

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[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

May I send a brief message of congratulation to the Secretary of State for his rapid response to President Trump’s remarks about the values of the NHS?

As chair of the Westminster Commission on Autism, let me now ask the Secretary of State a serious question. We are about to produce a report on the fake medicine that is sold to families with an autistic child. When the report is published, in the next few days, will the Secretary of State act very quickly to stop this dreadful trade?

[Mr Speaker]

I am not quite sure that that is altogether related to the main question.

[Mr Sheerman]

It is related to the Food Standards Agency.

[Mr Speaker]

Possibly. Anyway, it was a worthy effort, and I will give the hon. Gentleman the benefit of the doubt. Let us now hear from the Minister.

[Caroline Dinenage]

As the hon. Gentleman was so very charming to the Secretary of State, we will of course look into the issue.

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[Mr Speaker]

Dr Williams, you wanted to speak a moment ago; have you abandoned the idea?

[Dr Paul Williams (Stockton South) (Lab)]

indicated assent.

[Mr Speaker]

Very well.

[Bridget Phillipson (Houghton and Sunderland South) (Lab)]

NHS figures continue to show an alarming decline in the number of family doctors working across the north-east, which is why I am supporting the University of Sunderland bid to establish a new medical school. Does the Minister accept that prioritising training places in areas of greatest need is the best long-term solution to the crisis facing general practice?

[Anna Soubry (Broxtowe) (Con)]

T1. If he will make a statement on his departmental responsibilities. And you wear it well, Mr Speaker.

[Mr Speaker]

I do not know whether the right hon. Lady is referring to my age, a proposition on which I think the House would have to divide, or the rosette. [Interruption.] Yes, I thought she meant the rosette.

[The Secretary of State for Health and Social Care (Mr Jeremy Hunt)]

On the day that we mark the 100th anniversary of giving a voice to women, I want to update the House on concerns in the medical profession that we may not be giving a voice to doctors and other clinicians who want the freedom to be able to learn from mistakes. The House will know that, as a Government Minister, I cannot comment on a court ruling, but it is fair to say that the recent Dr Bawa-Garba case has caused huge concern, so today I can announce that I have asked Professor Sir Norman Williams, former president of the Royal College of Surgeons and my senior clinical adviser, to conduct a rapid review into the application of gross negligence manslaughter in healthcare.

Working with senior lawyers, Sir Norman will review how we ensure the vital role of reflective learning, openness and transparency is protected so that mistakes are learned from and not covered up, how we ensure that there is clarity about where the line is drawn between gross negligence manslaughter and ordinary human error in medical practice so that doctors and other health professionals know where they stand in respect of criminal liability or professional misconduct, and any lessons that need to be learned by the General Medical Council and other professional regulators. I will engage the devolved Administrations, the Justice Secretary and the Professional Standards Authority for Health and Social Care in this vital review, which will report to me before the end of April 2018.

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[Several hon. Members rose—]

[Mr Speaker]

There really is a magnificent array of rosettes on both sides of the Chamber, which today—today only—I will allow to influence me.

[Vicky Ford (Chelmsford) (Con)]

This is a very proud day to be a woman in this House. In mid and south Essex there are plans for a hyper-acute stroke unit at Basildon Hospital. Will the Secretary of State or one of the Ministers confirm that that will be an improvement of services for my constituents in Chelmsford, and not a downgrade?

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[Several hon. Members rose—]

[Mr Speaker]

I will call the hon. Member for East Worthing and Shoreham (Tim Loughton) if his question is shorter than his tie.

[Tim Loughton]

Lipoedema affects 10% of women in this country, many without a diagnosis, so why are an increasing number of my constituents saying they cannot get any therapeutic interventions funded by the CCG? Will the Minister meet a delegation of those people and other hon. Members similarly affected?

[Several hon. Members rose—]

[Mr Speaker]

We are well over time, but I do not want the hon. Member for Strangford (Jim Shannon) to feel isolated or excluded. Let us hear it.

[Jim Shannon (Strangford) (DUP)]

Child suicide calls to Childline are at a record high among girls—it is at 68%. Despite that, the NHS spends only 11% of its budget on mental health issues. Will the Minister indicate what he is going to do to prevent child suicides?

[Mr Hunt]

We are very focused on reducing all suicides. As the hon. Gentleman will know, we have a plan to reduce suicide rates by 10%, and last week we announced a plan to reduce in-patient suicides to zero, which is a big aspiration to which the NHS in England is certainly committed. We are very committed to this agenda.

[Mr Speaker]

Thank you, colleagues.

[Emma Hardy (Kingston upon Hull West and Hessle) (Lab)]

On a point of order, Mr Speaker.

[Mr Speaker]

Order. I think this appertains to the exchanges we have just had and relates to a ministerial answer. If the Secretary of State would be kind enough to wait a moment to hear it, we would be grateful.

[Emma Hardy]

I seek your advice, Mr Speaker, on something that is very important to my constituents. In my question earlier, I asked about pain infusions and highlighted a letter from consultants saying that the withdrawal of such treatment would increase the risk of mortality. The Under-Secretary of State for Health, the hon. Member for Winchester (Steve Brine), had previously agreed by email to meet me and said that he would answer my question today, if I was called to speak, yet a different Minister answered my question and there was no promise to meet. My office called the Department of Health and Social Care and was told that my case was labelled as “no further action”. What steps are available to me, Mr Speaker, to ensure that the Minister sticks to his word and agrees to meet me?

[Mr Speaker]

I think that the explanation of the situation is innocent and that I can probably reassure the hon. Lady. She came in on a question that was being answered by another Minister. On the whole, it is deprecated if Ministers play musical chairs in answer to the same question, even when supplementaries come. It tends to be expected that one Minister will deal with, to put it bluntly or in the vernacular, the whole caboodle. I think that was why the hon. Lady lost out. However, I just asked the Under-Secretary of State for Health, the hon. Member for Winchester (Steve Brine), who is a very agreeable fellow, whether he stood by his commitment to meet, and he gave a nod of assent. He is very happy to meet the hon. Lady to discuss the matter. They may or may not end up agreeing, but of one thing she can rest assured: there is no conspiracy to exclude her. I hope that the hon. Lady will now go about her business with an additional glint in her eye and spring in her step, confident in the knowledge that she shall shortly meet the hon. Member for Winchester.

NHS Winter Crisis

John Bercow Excerpts

Wednesday 10th January 2018 Commons Chamber

[Peter Kyle]

My hon. Friend is being very generous in giving way. Down in Sussex, patient transport was privatised and given to a company called Coperforma. Seven months after the contract was awarded, the company was stripped of it for its appalling practices and for completely underperforming in every way, shape and form. It now transpires that Coperforma has been given more money for seven months than it would have received if it had performed properly for a full year. Is that not indicative of the way in which the NHS is being run?

[Mr Speaker]

Order. May I appeal for brief interventions? I would just point out to the House that no fewer than 38 Back Benchers wish to speak, and even if the debate is allowed to run on beyond 4 o’clock, which is in the hands of the usual channels, probably half of them will not be able to do so. I say now that they will just have to sit, wait and hope—I am not publishing a list; we do not do so—but long interventions do not help.

[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.

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[Several hon. Members rose—]

[Mr Speaker]

Order. We are grateful to the hon. Lady for her contribution. I must advise the House that, on account of the large number of Members interested in contributing to the debate, there will be a four-minute limit on Back-Bench speeches with immediate effect.

NHS Winter Crisis

John Bercow Excerpts

Monday 8th January 2018 Commons Chamber

[The Minister of State, Department of Health (Mr Philip Dunne)]

I thank the hon. Gentleman for applying to ask the urgent question as I agree that it is helpful for colleagues in the House to be updated on the current performance of the NHS during this challenging time.

We all know that winter is the most difficult time of the year for the NHS, and I start by saying a heartfelt thank you to all staff across the health and care system who work tirelessly through the winter, routinely going above and beyond the call of duty to keep our patients safe. They give up their family celebrations over the holiday period to put the needs of patients first. Those dedicated people make the NHS truly great.

Winter places additional pressure on the NHS and this year is no exception. The NHS saw 59,000 patients every day within four hours in November. That is 2,800 more every day compared with the previous year. The figures for December will be published on Thursday. We have done more this year in preparing and planning earlier than ever before. That means that the NHS is better able to respond to pressure when it arises. In the words of Professor Sir Bruce Keogh, the national medical director:

“I think it’s the one”

winter

“that we’re best prepared for. Historically we begin preparing in July/August. This year we started preparing last winter. We have, I think, a good plan.”

Let me tell the House about some of the things that have been done differently this year. We further strengthened the NHS’s ability to respond to risk, and the NHS set up the clinically-led national emergency pressures panel to advise on measures to reduce the level of clinical system risk.

We are supporting hospital flow and discharge. We allocated £1 billion for social care this year, meaning that local authorities have funded more care packages. Delayed transfers of care have been reduced, freeing up 1,100 hospital beds by the onset of winter. Additional capacity has been made possible through the extra £337 million we invested at the Budget, helping 2,705 more acute beds to open since the end of November.

We have also ensured that more people have better access to GPs. We allocated £100 million to roll out GP streaming in A&E departments and I am pleased that 91% of hospitals with A&E departments had this in place by the end of November. For the first time, people could access GPs nationally for urgent appointments from 8 am to 8 pm, seven days a week, over the holiday period. In the week to new year’s eve, the number of 111 calls dealt with by a clinician more than doubled compared with the equivalent week last year, to 39.5%, thereby reducing additional pressures on A&E.

We extended our flu vaccination programme, already the most comprehensive in Europe, even further. Vaccination remains the best line of defence against flu and this year an estimated 1,175,000 more people have been vaccinated, including the highest ever uptake among healthcare workers, which had reached 59.3% by the end of November.

We all accept that winter is challenging for health services, not just in this country but worldwide. The preparations made by the NHS are among the most comprehensive, and we are lucky to be able to depend on the extraordinary dedication of frontline staff at this highly challenging time.

[Mr Speaker]

Order. For a moment I thought that the Minister intended to treat this as though it were an oral statement, to judge by the length. I think it is fair and correct for those following our proceedings to point out that this is not an oral statement offered by the Government: it is a response to an urgent question applied for to, and granted by, me.

[Jonathan Ashworth]

It is always a delight to see the Minister, but the Secretary of State for Health should be here to defend his handling of the crisis, not pleading for a promotion in Downing Street as we speak.

I join the Minister in paying tribute to all those NHS staff working flat out. Many of them have said that this winter crisis was entirely predictable and preventable. When you starve the NHS of resources, when you cut beds by 15,000, when you cut district nurses, when walk-in centres are closed, when we have vacancies for 40,000 nurses, when you fragment the NHS at a local level and drive privatisation and when social care is savaged, is it any surprise that we have a winter crisis of this severity?

More than 75,000 patients, including many elderly and frail, were stuck in the back of ambulances for over 30 minutes in the winter cold this December and January. A&Es were so logjammed that they were forced to turn away patients 150 times. In the week before new year’s eve, 22 trusts were completely full for up to five days. The blanket cancellation of elective operations means that people will wait longer in pain, distress and discomfort. Children’s wards have been handed over to the treatment of adults. Of course, we do not know the full scale of the crisis, because NHS England refuses to publish the operational pressures escalation levels alerts revealing hospital pressures. Given Ministers’ keenness on duty of candour, why are OPEL alerts data not being collected and published nationally for England?

The Minister mentioned the winter pressures funding, but that money was announced in the Budget on 22 November. Why were trusts not informed of allocations until a month later? That is not planning for the winter: it is more like a wing and prayer. He will know that cancelling elective operations has an impact on hospital finances. What assessment has he made of the anticipated loss of revenue for trusts from cancelling electives? Will he compensate hospitals for that loss of revenue, or should we expect deficits to worsen? Can he tell us when those cancelled operations will be rescheduled?

The Prime Minister defends this crisis by saying nothing is perfect. Patients do not want perfection: they just want an NHS which is properly funded and properly staffed without the indignity of 560,000 people waiting on trolleys in the last year, in which operations are not cancelled on this scale, and in which ambulances are not backed up outside overcrowded hospitals. Patients do not just need a change of Ministers today: they need a change of Government.

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[Several hon. Members rose—]

[Mr Speaker]

Order. It might be helpful to the House if I inform Members that I am looking to move on to the second urgent question at no later than 4.30 pm, so inevitably some people will be disappointed on this question. The longer each question and answer takes, sadly, the more people will be disappointed. I am in favour of fewer disappointments. I am sure that colleagues share that ambition with me, not just in general, but including in terms of its implications for their own question.

[Mr Peter Bone (Wellingborough) (Con)]

Does the Minister agree that the social care system is broken and that the leader of the Liberal Democrats is right that we are not going to solve the problem unless we all work together?

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[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.

[Lilian Greenwood (Nottingham South) (Lab)]

Nottingham University Hospitals NHS Trust and the East Midlands Ambulance Service have both declared the highest level of alert in recent days. Despite the heroic efforts of NHS staff, emergency patients’ care, safety and dignity have been put at risk, and of course other patients have had their operations cancelled. Does this not confirm that the Government’s preparations and resourcing were too little and too late?

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[Andrew Bridgen (North West Leicestershire) (Con)]

On my behalf and that, I hope, of the hon. Member for Leicester South (Jonathan Ashworth), may I welcome the £4.2 million of additional winter funding for the University Hospitals of Leicester NHS Trust? To remind the Labour party what an NHS crisis really is, will my hon. Friend tell the House who was in charge at the time of the Mid Staffs crisis—

[Mr Speaker]

Order. I have tried over a period of seven and a half years to educate the hon. Gentleman, and I am afraid that on the whole my efforts have been unavailing. I have tried to explain to him that his responsibility is to ask questions about the policy of the Government, for which it is the responsibility of the Government to answer; it is not the occasion for asking questions about the policy of the Opposition or the opposing party when in government. It is a point that is so blindingly obvious that only an extraordinarily sophisticated person could fail to grasp it.

[Gareth Snell (Stoke-on-Trent Central) (Lab/Co-op)]

Royal Stoke University Hospital in my constituency faces a double whammy during this winter crisis: an estimated net cost of £8 million even with the Government’s investment of this period and the loss of income as a result of the cancelation of elective surgery where income has been put to one side. How does the Minister expect the Royal Stoke and the University Hospitals of North Midlands NHS Trust to meet that cost? Given that CCGs will now have a windfall because of cancelled operations, how will he make sure that that money is reinvested in community and acute services?

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[Several hon. Members rose—]

[Mr Speaker]

Order. I am sorry, but we must now move on.

Oral Answers to Questions

John Bercow Excerpts

Tuesday 19th December 2017 Commons Chamber

[Mr Hunt]

What I want to ask the hon. Gentleman requires a one-word answer. Is he happy—

[Mr Speaker]

Order. We must observe the terms of debate. It is not for the Secretary of State to ask questions. He has been in the House long enough to know that. Please do not play games with the traditional and established procedures of the House, Secretary of State. You can do better than that.

[Mr Hunt]

Yes, I am delighted that the local hospital of the hon. Member for Ellesmere Port and Neston (Justin Madders) got £2.8 million in the Budget, but I am disappointed that he did not feel able to issue a press release to his local press. I have much enjoyed debating with the hon. Gentleman over the years, but the difference between me and him is that although we both want to find extra money for the NHS, he would do so by hiking corporation tax, which would destroy jobs, whereas Government Members want to get money into the NHS by creating jobs, which is what we are doing.

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[Several hon. Members rose—]

[Mr Speaker]

Order. I want to take one last grouping. We are out of time, but I want to accommodate the Questions on mental health services—brief questions, brief answers.

[Mr Steve Reed (Croydon North) (Lab/Co-op)]

15. What assessment he has made of the adequacy of access to mental health services for children and young people.

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[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

rose—

[Mr Speaker]

Order. I am sure that the shadow Secretary of State will be brief, in recognition of the enormous demand from Members wishing to contribute in this session.

[Jonathan Ashworth]

May I join the Secretary of State in wishing all our NHS and social care staff a very merry Christmas, and in thanking them for their commitment this winter?

Virgin Care recently won a £100 million contract for children’s health services in Lancashire, but in the Secretary of State’s own backyard of Surrey, Virgin Care recently took legal action against the NHS, forcing it to settle out of court. This money should be going to patient care, not the coffers of Virgin Care, so why will he not step in and fix this scandal so that his Surrey constituents and the NHS do not lose out?

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[Steve Brine]

There is huge interest in this subject in the House. Over the past three years, there has been extensive work to communicate advice on the risks of valproate in pregnancy, through a huge number of channels, to help professionals and patients. It is evident from monitoring activities that providing health professionals with information, even when repeated constantly through multiple sources, is not changing prescribing behaviour sufficiently to minimise harm to children exposed to valproate in pregnancy. The expert working group of the Commission on Human Medicines is informing the UK position in European negotiations and advising on the national action required within the UK health system. [Interruption.] Sorry, Mr Speaker.

[Mr Speaker]

Forgive me. I did not mean to be unkind to the Minister who was attending closely to his answer. It is just that we want the whole House to get the benefit of it.

[Nigel Huddleston (Mid Worcestershire) (Con)]

Will the Minister provide an update on efforts to move Worcestershire Acute Hospitals NHS Trust out of special measures, and on the status of the promised £29 million for much needed capital improvement programmes?

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[Mr Dunne]

My hon. Friend will be aware that the Chancellor provided a package of £10 billion in the Budget last month to be invested in the NHS, of which £3.9 billion will come from the Treasury. All bids for capital are being assessed through the STP prism. The proposal that his area will be making will be assessed against others. As far as I am aware, no such proposal has yet been made to NHS England, but it will obviously be looked at in due course.

[Mr Speaker]

The challenge is of single-sentence questions and answers.

[Louise Haigh (Sheffield, Heeley) (Lab)]

You may recall, Mr Speaker, that I raised earlier in the year the issue of a private mental health hospital in my constituency where a young woman had MRSA and was infecting staff and patients. Since then, there have been numerous inspections in relation to children having access to ligatures and medicines in order to overdose. Will the Secretary of State commit to a policy to ensure that no child or young person is placed in a mental health facility that is deemed unsafe?

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[Several hon. Members rose—]

[Mr Speaker]

Order. I appreciate the commitment of colleagues. The session has overrun, but I feel that colleagues will go home for Christmas content only if they have asked their questions and they have been answered. I am extremely grateful to the Front-Bench teams on both sides of the House.

[Mr Dennis Skinner (Bolsover) (Lab)]

Is the Secretary of State aware that in the course of this hour there have been more questions about hospital closures than about almost anything else, covering East Yorkshire, Berwick on his own side, Warwickshire on our side, and High Peak in Derbyshire, including Bolsover and Bakewell Hospitals? There is a growing suspicion that what this Secretary of State is up to is leaving those hospitals and losing all the beds in them forever so that the private sector can move in and take the lot. That is what is going to happen.

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[Several hon. Members rose—]

[Mr Speaker]

Order. Members can ask questions consisting of no more than one sentence each.

[Liz McInnes (Heywood and Middleton) (Lab)]

What funds are being made available to our mental health services to meet the additional demands placed on them by changes in the Mental Health Act 1983, which came into force on 11 December this year?