Healthcare: East Midlands

Debate between Stephen Hammond and Ruth George

Tuesday 30th April 2019 Westminster Hall

[The Minister for Health (Stephen Hammond)]

It is a pleasure to serve under your chairmanship, Mr Hollobone. As you know, I have met the chief executive of the team from Kettering, I have visited Kettering and I have responded to you on the Floor of the House about Kettering. Kettering and its requirements for the A&E are therefore not far from the forefront of my mind.

I congratulate the hon. Member for Lincoln (Karen Lee) on securing the debate and I thank all hon. Members for their contributions. I intend to spend some time going through a number of the areas raised this morning. I am bound to say that the long-term plan, which a number of Members welcomed, is a substantial step forward, and the funding commitment—the biggest ever in peacetime—is a key to ensuring that that can be delivered. The number 100,000 has been trotted out, but clearly that does not represent posts unfilled, nor does it take any account of the actions that the Government are undertaking. More than that, the simple fact is that, compared with eight years ago, there are 14,700—over 15%—more doctors, 10,300 more nurses, midwives and health visitors and, in addition, over 15,900 more nurses on our wards.

I also point out that of those vacancies that several hon. Members mentioned, well over 80% are being filled by a combination of bank and agency nurses. Of course no one wants that situation to persist, but there has been a consistent decline in the number of agency staff, and since the transfer from the bursary to the loan system, much has been done working with nurses to ensure that courses are filled. We are seeing more applications than previously: this time around UCAS reported over 4,000 more applicants. Last year, my predecessor announced a fund to provide an increased package for postgraduate nursing students starting courses in 2018-19 in terms of employment in learning disability, mental health and district nursing roles, which are the key vacancies that need to be filled.

I will try to answer a couple of specific points raised by the hon. Member for Lincoln. She rightly voiced concerns about the closure of Skellingthorpe health centre in her constituency. As she pointed out, were there to be a closure, the CCG would be required to conduct a proper consultation. I spoke to the CCG yesterday and I understand that as yet—she may wish to correct me—there has been no formal request for closure. Equally, the CCG tells me—I hope this is right—that it will meet the hon. Lady later in May to discuss this matter, and that, were there to be a request, it would immediately inform her and offer her a meeting with it and the lead GP at Skellingthorpe to see what action could be undertaken. The CCG has also confirmed —she will understand this—that it appreciates that this is a rural community, and that there are additional challenges for local residents, so it is working not only with Skellingthorpe to understand the challenges and how they may be met, but to ensure that the rural network of GPs might work together.

The hon. Lady rightly expressed concern about CQC inspections, and I will go on to speak about those if I have time. She mentioned the recent inspection that took place on 25 February at Pilgrim Hospital, with a report published on 3 April. Although “requires improvement” remains the rating, there were marked improvements in certain areas, including in the standard of care, numbers of staff and nursing provision for children, and a real improvement in the triage time. She will appreciate that the trust is receiving substantial support from NHS England, including to help the hospital get out of special measures.

My hon. Friend the Member for Bosworth (David Tredinnick), chair of the all-party parliamentary group for integrated healthcare, spoke passionately about the health and wellbeing partnership. He is absolutely right, and the Government support the integration of healthcare services and recognise the good work being done by that partnership in Hinckley and Bosworth. The Secretary of State enjoyed his visit to Hinckley, and was particularly pleased to get a real impression on the ground of the improvement in services that will come from the £8 million investment. My hon. Friend reminded me of his Christmas present to me, and I was pleased to read some—although not all—of his report over the Christmas period. You will not be surprised to hear, Mr Hollobone, that I was also intrigued to hear his comments about India. I sometimes think that the “Ministry of Calm” in India could benefit many people in this place.

The hon. Member for High Peak (Ruth George) spoke about “Better Care Closer to Home”. That reminded me of when I was a councillor 18 years ago and a different Government wanted to do to local services in my area the things that she described. The issue was only resolved some years later, in 2015, when a new medical centre was built. She rightly mentioned the East Midlands ambulance service and—most importantly —its paramedics. I visited that service earlier this year, and spoke not only to the management but to the medics who deliver those services. There are clearly challenges regarding location, and not all the standards have been met. It is also true, however, that there are 67 new ambulances—an increase of 27—and response times have improved, which is to be welcomed. I recognise the problems with CAMHS that the hon. Lady raised. That is clearly an issue nationally as well as in the east midlands, and it is right for the long-term plan to recognise that. The commitment to mental health diagnosis and treatment times is a significant change from the previous situation.

[Ruth George]

Mental health services were allocated £1.2 billion, but that money was not ring-fenced. That is the problem that CAMHS has had with the cuts. Will the Minister commit that any additional funding for mental health services will be ring-fenced, so that it goes where it is needed?

[Stephen Hammond]

There is a commitment to treatment and the funding that backs it in the long-term plan, and that money is dedicated to that commitment. That is pretty clear.

[Ruth George]

indicated dissent.

[Stephen Hammond]

The hon. Lady is asking me to use the word “ring-fenced”, but if I say that the money is there and allocated for that matter, then it is specifically ring-fenced for it.

My hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson) gave us a valuable insight into the NHS, given her experience as a consultant. She is right to say that we must tackle a number of workforce issues, and morale is undoubtedly key to that. I was pleased to see that set out in the initial workforce plan; and Baroness Harding, chair of NHS Improvement, has been asked to consider a stream of work about making the NHS the best employer. That work will consider a number of issues about retention and the culture and morale of staff. I look forward to the publication of that report, and I hope my hon. Friend will join me in welcoming the new ideas it contains.

My hon. Friend was right to mention the pensions of a number of GPs and other NHS staff. She will not be surprised to hear that I am continuing to persuade Treasury colleagues to accept the Department’s proposed solution for that issue, and I hope we can make progress and make an announcement on that soon, which will be reassuring to many. I encourage my hon. Friend to write to me about the dispensing service she mentioned, and I will consider what issues we can take up. Finally, she was right to talk about the orthopaedic services at Grantham. “Getting It Right First Time”—GIRFT—is led nationally by Professor Tim Briggs, who was lead clinician at the Royal National Orthopaedic Hospital. That is making a huge difference, not only to the concentration, specialisation and number of operations being undertaken, but—equally importantly—the great improvement in safety and reduction in infections is leading to hugely better care for patients.

The hon. Member for Washington and Sunderland West (Mrs Hodgson) mentioned A&E performance, and she is right to say that it fails to meet the target. However, she is wrong to say that this year has seen the worst performance ever, as there has been an improvement on last year. Over the past months, United Lincolnshire Hospitals NHS Trust has seen a huge increase in attendances compared with the previous year. That reflects the wider NHS, where demand is up by 6%, yet more than 4,700 patients per day are treated within the four-hour waiting limit. The hon. Lady mentioned Public Health England and Health Education England, but funding for those bodies was designed to be dealt with in the comprehensive spending review that will take place in the autumn. It was never intended to be tackled inside the long-term plan and spending commitment.

The hon. Lady mentioned money, but this is a transitional year for funding. The funding provided is enough to work on the deficit, and given the analysis being done, the Government’s commitments, and the work on efficiency in the health service, it is surprising that Labour Members who recognise the benefits of much of the long-term plan are not prepared to welcome the financial settlement that backs it up and will deliver it.

Briefly, let me mention another east midlands MP, my hon. Friend the Member for Erewash (Maggie Throup). She was not able to speak today as she is my Parliamentary Private Secretary, but she has done great work in pointing out the benefits of Ilkestone Community Hospital, which I intend to visit in the near future. May I just say that—