(4 years, 2 months ago)
Commons ChamberIt is a pleasure to follow the right hon. Member for South West Surrey (Jeremy Hunt), the Chair of the Health and Social Care Committee, who spoke incredibly powerfully.
I would like to begin by placing on the record my thanks to the doctors, nurses and staff at Barnsley Hospital, who have been working tirelessly to keep our community safe. These have been very difficult times, and my thoughts are with families who have lost loved ones, with NHS and care staff who risk their lives every day to look after patients, and with key workers who are making huge sacrifices to keep our country running.
As a community, we have come together in the face of huge adversity. Like my neighbours in Barnsley, I have clapped for our carers. As a community and a country, we have expressed our gratitude to our NHS heroes and all our key workers, and I hope that the Government have been listening. Our applause must be translated into action.
When I met representatives of Barnsley Hospital and Public Health England, they told me that coronavirus has changed how people see care. Fewer people are going to A&E and attending regular check-ups for existing illnesses. At the same time, millions of routine operations, screening tests and treatments have been cancelled or suspended. We need a strategy to deal with the backlog in non-coronavirus care. The motion calls for a fully functioning test and trace system for NHS staff. Without it, the NHS cannot return to offering non-urgent and routine care appointments for everyone, and existing health inequalities in the UK will only get worse.
In Barnsley, winter death rates from flu and respiratory diseases are higher than the national average. I represent a former mining community with a large ageing population of ex-miners. Underlying health conditions brought on by their time down the pits have made them more vulnerable to this deadly disease. A recent survey by the British Lung Foundation, which has already been highlighted, showed that one in four people suffering from COPD has had a regular GP or hospital appointment cancelled.
Last month, 20 coalfield Labour MPs wrote to the Secretary of State, voicing the concerns of former miners who fear that if they die during this outbreak, their death certificates will make no mention of the industrial diseases that have caused them decades of ill health. We are still waiting for the Government to reply. I have heard of former miners who tested negative for covid-19 but had it recorded on their death certificate, purely because that is policy for anyone who dies in a hospital. If a death certificate does not mention a miner’s underlying health condition, their grieving family will be denied the compensation they are entitled to.
Industrial diseases have cut short the lives of far too many miners over the years, so I ask one very simple thing of the Government: please change the advice to medical practitioners so that poor health prior to this outbreak is recorded on death certificates. Covid-19 is not some great leveller. It feeds off existing inequalities and it hits communities with vulnerable people hardest. That needs to change.
Like all other Members from all parts of the House and from all four nations, I add my thanks to all those in the NHS and across social care, although actually it is broader than that. There are those in primary care, our community health teams, those who have adapted the way they work in addiction services and so on, because all these things have had to change at pace.
When we started to get the news towards the end of January that this was a pandemic, we started to realise that we were dealing with a completely unprecedented time, and all those people stepped forward. We have heard repeatedly this afternoon that more people stepped forward to make this a journey of collaboration and innovation. We have seen changes right across the national health service and the services that we have had to build to make decisive changes.
I gently say that 12 weeks ago, as we went into lockdown, many of those services were very different: the delivery of PPE to just over 200 national health trusts has now ramped up to 58,000 providers; we have developed Clipper and local resilience forums to help us with the distribution of PPE throughout these extremely complex changes; and a large amount of work has been done on vaccines and testing. All these things are a tribute to collaboration and we need to thank the innovation of not only private industry, as my hon. Friend the Member for Witney (Robert Courts) mentioned, but the Army. This truly has been an effort of public service, and as we have come together—as we have done across the House—we have achieved so much more.
How do we carry on achieving more? There was a challenge before we went into the crisis, and the decision to postpone non-urgent elective treatment was the right one, because it allowed us to have the capacity required to help us to manage increased demand in the NHS. Throughout the outbreak, we have ensured that patients who require urgent treatment have been able to access it and, like many Members, we encourage people not to delay in coming forward for treatment as they normally would, should they require it. NHS has a firm “Help Us Help You” message.
We heard of how, as my hon. Friend the Member for North Devon (Selaine Saxby) put it—I do not think I can put it better—we achieve much more by working together and focusing on what we do best. How do we drive down waiting times and have routine services return as quickly as possible to their normal provision? We must ensure that that is done in a safe and managed way to maintain capacity but avoid any further surge in covid. As outlined in the guidance already issued to the NHS, the restarting of routine electives should prioritise long waiters first and make full use of all contracted independent-sector hospital and diagnostic capacity.
Cancer was mentioned by severable Members. Urgent cancer care and treatment has continued throughout the pandemic. We know how important it is that referrals, diagnostics and cancer treatment reach pre-pandemic levels as soon as possible. Urgent action should now be taken by hospitals on the two-week-wait referrals, and they should provide two-week-wait out-patient diagnostic appointments at pre-covid-19 levels. That is easy to say but really hard to achieve.
The work done by protected hubs and to ensure that rapid diagnostic centres have been pushed out has been important. During the outbreak, the Secretary of State and I have regularly met the national cancer director, Dame Cally Palmer, to discuss progress not only on how we were dealing with cancer during the crisis, but on restoring cancer services as quickly as possible. We will keep a laser focus on that.
The NHS has continued to deliver over and above. Guidance has been issued and further guidance to restore urgent non-covid services in a safe way while ensuring that surge capacity can be stood up again, should it be needed, is already being planned. Preparations for going forward have already begun: we are learning lessons from where we have been but also driving ourselves to where we need to go. My hon. Friend the Member for Runnymede and Weybridge (Dr Spencer) said that we should think about what we can learn, how we can reset and how we can make sure that as we go forward we can take the best of what has changed, develop it and weave it in.
I really appreciate the Minister giving way. I just wondered whether she could respond to the question that I put in my contribution to the debate, which is around the relaxation of guidance on death certificates for those suffering from industrial diseases. I am just asking the Government to revise their guidance so that anyone who has an industrial disease has that recorded on their death certificate.
If the hon. Lady will forgive me, I will write to her on that exact point after the end of this debate. If I segway off, I will not make the points that I would like to make.
I was very grateful to my right hon. Friend the Member for South West Surrey (Jeremy Hunt), who said that the decision by the Secretary of State to put in a stretch target for testing was indeed courageous—something with which many hon. Members, I am sure, would agree. That dramatic expansion of testing has got us to where we are today.
My hon. Friend the Member for Peterborough (Paul Bristow) spoke of improving care pathways and the joint work between the private sector and the NHS, being ambitious and changing methods of working to meet demand. My hon. Friend the Member for Wimbledon (Stephen Hammond) spoke articulately about the issues, including the stretch target, but also about preparation and how we make sure that our hospitals are ready and fit for the future. My hon. Friend the Member for Moray (Douglas Ross) talked about how challenging it is but pointed out how the four nations have worked together. I join him in supporting the fact that we are stronger together. I have missed out my hon. Friend for—
(4 years, 5 months ago)
Commons ChamberThis is an issue that I discussed with the hon. Member for Leicester South, the shadow Health Secretary, earlier today. The package of measures in the Budget addresses it as much as is possible, and we are prepared to go further if that is what is needed.
I have been contacted by constituents concerned by the lack of health and safety and testing at our borders. Do the Government have plans to implement stricter measures at our airports, ports and rail terminals?
Now that there is onward transmission in the UK, those sorts of measures are less efficacious. Of course, we have been doing that all along and strengthening it, but there are also those who said, “Go further and stop all the flights.” Of course, the Italians were the ones whose who initially stopped flights from China and ended up as the European epicentre of this anyway.
(4 years, 5 months ago)
Commons ChamberI thoroughly enjoyed my visit to Blackpool. I cannot remember whether it was in November or in the first half of December, but it was very enjoyable. It was great to see what the trusts are planning to do with the extra investment that is coming their way. I also want to congratulate all those at the trust who have done such a fantastic job in deciding how best to ensure that people are treated as quickly as possible. They have improved their systems, they have learnt from what works, and they are doing brilliantly.
Research has shown that CT scans can diagnose covid-19 with 98% accuracy, taking less than 10 minutes. Have the Government any plans to use CT scans in diagnosis?
Yes, we are looking at all possible methods of diagnosis, and we have funding to ensure that we can improve the research. Diagnostics must be effective, but our goal is to for them to be done next to the patient and turned around rapidly, which, obviously, is what everyone the world over is seeking.
(4 years, 6 months ago)
Commons ChamberYes, absolutely; of course I will keep the House and the wider public updated. That is an incredibly important part of our work. Of course, for any colleague, my door, and that of the Minister for Public Health, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), is always open to answer any questions.
What steps are the Government taking, in partnership with tech companies, to battle fake news on coronavirus?
That is a very important subject. In fact, I have been working on that in the past 24 hours, to ensure that tech companies, social media companies, Google and others promote the right answers to questions about coronavirus. Most of the social media companies—we have been in contact with them—have behaved in an exemplary fashion, ensuring that information from, for example, the NHS gets promoted.
(4 years, 6 months ago)
Commons ChamberIt is absolutely true that handwashing and “catch it, bin it, kill it” are the right responses to flu as well as coronavirus. We are coming towards the end of the traditional flu season, which this year in England came early, in December, and thus far—touch wood—has thankfully been largely mitigated and gone away. Next year, of course, we will be even more vigilant than normal.
With regard to the capital facility that has been announced, can the Secretary of State outline the total amount of funding allocated to the NHS and can he say whether this is new money or a loan that will have to be paid back?
This will be new money to those NHS organisations bidding for it, and we have not put a cap on it. We are inviting bids from NHS organisations and will very rapidly assess those bids.
(4 years, 6 months ago)
Commons ChamberIt is a great pleasure to follow the hon. Member for Ellesmere Port and Neston (Justin Madders). We were on opposite Front Benches for many years, but I always had great respect for his detailed understanding of healthcare issues and the integrity of his approach. He once wrote me a private letter. I will not divulge its contents; suffice it to say that it demonstrated his recognition that we are human beings on this side of the House. That was a rare admission from a member of the Labour party, and I am very grateful to him for it.
I will not be supporting the hon. Gentleman’s amendments and new clauses, but I think he is right to raise the issues that he has raised, and I want to propose some different ways of achieving his objectives. I am very pleased that he has raised the issue of mental health and mental health funding, and I therefore wish to speak to amendments 1 and 2 and new clauses 1, 2 and 3.
I think that all hon Members have knocked on the doors of constituents—I did as Health Secretary—and been confronted by people who have been given a totally inadequate service in relation to their mental health or that of their children. One person I met, who was not a constituent, was a very remarkable gentleman called Steve Mallen. He had a son, Edward, who had an extraordinarily promising life in front of him. Edward had secured a place at Cambridge, he was very musical, he had friends; and then, in the year before he was due to go up to Cambridge, he had a six-month period of severe mental illness and ended up killing himself, five years ago this Sunday. I think that all of us have to have people like Edward Mallen at the back of our minds, and to remember, as we enjoy a normal weekend, that for Edward’s family Sunday will be a very, very challenging day.
I believe we could all come up with stories like that. I mentioned Steve Mallen because he has chosen to relive the grief that he feels for his son Edward. He made a promise at Edward’s funeral that he would campaign to ensure that other people received the mental health provision that Edward did not receive. He subsequently set up the Zero Suicide Alliance with an inspirational NHS chief executive called Jo Rafferty, who runs Mersey Care. It is a fantastic project, and I am pleased to say that the Health Secretary has agreed to a meeting to discuss continued funds for the alliance. As we think about people like Edward, it is important to understand just why funding for mental health has not increased at the rate at which it should have, and why we do not have the service provision that we should have.
Does the right hon. Gentleman share my concern about the fact that the mental health charity Combat Stress has said it is unable to accept any more new cases? Support for the charity, which helps military veterans, has fallen in the last few years, and 90% of its income consists of public donations.
I am well aware of the fantastic work done by Combat Stress, and I think it is important for it to receive the funds that it needs. However, when we look at the root cause of the problems in mental health funding, we see that on both sides of the Committee there is some culpability, and that on both sides it was completely unintentional. I hope that the shadow Secretary of State, the hon. Member for Leicester South (Jonathan Ashworth), will forgive me if I start with the other side.
The truth is that when targets were introduced in the 2000s for A&E and elective care waiting times they were hugely effective, but they were introduced only for physical healthcare. As a result, during the austerity period when the budgets of clinical commissioning groups or primary care trusts were under pressure, money was sucked out of community and mental health services. That is at the heart of the problem that has bedevilled mental health care. The position changed in 2012, because a Labour amendment to the Bill that became the Health and Social Care Act 2012 instituted parity of esteem between mental and physical health. We were the first country in the world to do that.
As a Conservative, I am always deeply sceptical about legislating for principles, because I am not totally convinced that it ever changes anything, but that amendment did bring about a significant and very practical change, which I discovered myself as Health Secretary. No Health Secretary and no NHS chief executive ever wants to have to say publicly that the proportion of funding going to mental health has fallen on his or her watch, because that would be a direct contradiction of the principle of parity of esteem. That is why, since this became law, we have seen the proportion of funding of the entire NHS budget going into mental health either stabilised or starting to go up. That should put to rest some of the Opposition’s concerns about the risk of a decreasing proportion of NHS funding going into mental health, but it does not solve the problem.
The issue when it comes to mental health services for our constituencies is not about political will or funding; it is about capacity. We have an enormous number of ambitious plans on mental health. I unveiled one—in 2016, from memory—that said we would treat 1 million more people by 2020 and increase spending by several billion pounds. The mental health “Forward View” had some very ambitious plans, and we had the children and young people’s Green Paper. There are also targets to increase access to talking therapies, which are essential for people with anxiety and depression. But if we do not increase the capacity of the system to deliver these services, in the end we will miss the targets. For example, the children and young people’s Green Paper is an incredibly important programme, with a plan for every secondary school in the country to have a mental health lead among the teaching staff who would have some of the basic training that a GP would have to spot a mild mental health illness, anxiety or depression, or a severe one such as OCD or bipolar, and therefore know to refer it—[Interruption.] I am getting a look. I understand, and I will draw my comments to a close—
(4 years, 6 months ago)
Commons ChamberOne part of that is true and another is sadly not, in that it is no longer “if” it comes to this country—it is here. However, the thrust of what my hon. Friend says is absolutely right: the current rate of mortality—those who die having contracted the disease—is around 2%, which is significantly lower than other recent diseases of this type, such as SARS, and a lot lower than Ebola. However, as the shadow Secretary of State said, the rate of transmission appears to be higher, and the number of cases appears to be doubling around every five days. We have the challenge of a disease that is transmitting relatively quickly, but the vast majority of people who have it survive.
In answer to my written question from 27 January, the Government said that funding is in place to deal with this public health challenge. Will the Secretary of State outline exactly how much contingency funding has been allocated, further to the £20 million in his statement, and is that just to the Department of Health and Social Care or across Government?
Currently, there is no further need for the draw-down of funding. However, conversations with the Treasury have taken place to ensure that all the funding that is necessary will be available, if it is needed outside existing departmental budgets.
(4 years, 7 months ago)
Commons ChamberOrder. I am sure the Secretary of State would acknowledge that I am trying to get the last few questions in, and I think we can speed up rather than trying to make any last final points.
May I ask the Secretary of State what screening plans are in place for those arriving in the UK from China, and has a contingency fund been established to tackle the potential effects of the coronavirus?
Of course, it is incredibly important that we have appropriate measures in place for those who return from China—not only those returning from outside Wuhan, but those returning from Wuhan should they do so. Those are being put in place, and of course we are making budgets available to ensure that all support necessary is given.
(4 years, 10 months ago)
Commons ChamberWith one in three arthritis sufferers missing out on at least one prescription due to cost, what can the Minister say to the pensioner in Barnsley who has had their pension cut, lost their local bus service and now lost out on the treatment that enables them to simply walk down the street? Is it not time the Government matched Labour’s promise, and invested in pensions, services and free prescriptions on the NHS?
I simply say to the hon. Lady that people over the age of 60 qualify for free prescriptions.
(5 years, 8 months ago)
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Certainly, funding and support should be given to frontline staffing. I will go on to talk about how I see that playing out.
The Mid Yorkshire trust is a major employer of about 8,000 members of staff who operate across three hospital sites: Pinderfields Hospital, Pontefract Hospital and Dewsbury and District Hospital, which is in my constituency. Like many trusts across the country, the trust is feeling the pressure on recruitment. In the most up-to-date figures, which were given to me directly by the trust this week, there is a 10% vacancy rate. That includes 95 full-time-equivalent posts for medical staff, 209 vacancies for full-time registered nurses, and vacancies for all other posts covered by the trust. The trust tells me that its key workforce challenge remains recruiting registered nurses and junior doctors in training. Those staff shortages lead to expensive cover being required— a bill that is ultimately paid by the taxpayer.
I am pleased that the trust has taken steps to mitigate against staffing shortages, including an extensive recruitment programme where vacancies across the trust are advertised and marketed widely. It has introduced a new associate nurse role in partnership with a local university, and expanded and increased the number of apprenticeship opportunities to offer different routes into careers in the NHS. It has held open theatre days to promote particularly difficult roles to recruit for, such as operating department practitioners. Finally, it has increased the number of nurses and doctors on the local temporary staff bank, which reduces its reliance on, and the cost of, commercial agency staff. I am sure that all hon. Members agree that that is all great.
Despite that work, problems remain. I must put on record my concern that staffing shortages can lead to problems for patients. The ambulatory emergency care unit at Dewsbury and District Hospital opened in 2015 to care for patients who needed a quick diagnosis and treatment, and who could be treated without the need for admission to a hospital bed. Since July, it has been closed because of staff shortages and it will remain closed for the foreseeable future. It had also been closed from the end of December last year to early March. Patients now face the lengthy and expensive trip to Pinderfields Hospital.
In the most recent inspection at Mid Yorks, the results of which were announced last week, the safety of services was deemed to require improvement, which will cause deep concern to my constituents. We are now told that the harsh funding climate for our NHS, which has existed since 2010, is coming to an end—austerity is over.
As the daughter of a nurse, I congratulate my hon. Friend on securing this important debate. I know she is a proud member of the GMB, like me, so I declare an interest in highlighting its survey, which showed that 78% of NHS and ambulance workers are incredibly concerned about staffing levels. Does she agree with a nurse from Barnsley who said that we need more registered nurses and trained support staff, not untrained volunteers, who are sometimes being used?