Oral Answers to Questions

Steve Barclay Excerpts

Tuesday 24th January 2023 Commons Chamber

[Jack Lopresti (Filton and Bradley Stoke) (Con)]

1. What steps he is taking to ensure that ambulance services continue to operate during strikes.

[The Secretary of State for Health and Social Care (Steve Barclay)]

We have introduced a range of contingency measures, such as the provision of military personnel, who are available to assist with the driving of ambulances, and community first responders, who can help before ambulances arrive on the scene.

[Jack Lopresti]

Will my right hon. Friend join me in thanking call handlers at the South Western Ambulance Service NHS Foundation Trust—and the public—for halving the number of 999 calls to the trust over the last month, and reducing average call answering times by 95%, to just three seconds? Will he also join me in expressing dismay at the approach taken by the Leader of the Opposition during the most recent session of Prime Minister’s Question Time in seeking to sow fear in the hearts of my constituents and others for his own narrow political gain?

[Steve Barclay]

I am happy to join my hon. Friend in paying tribute to the work of call handlers at the South Western Ambulance Service, and to the staff there as a whole. He is right to draw attention to the improved performance that we have seen in recent weeks, and also right to point out that all parts of the United Kingdom have faced considerable challenges, particularly over the Christmas period when we saw a significant spike in flu levels.

[Rachael Maskell (York Central) (Lab/Co-op)]

We have just heard in the Health and Social Care Committee that on strike days there was a drop in service demand, but also value added by the increased clinical support, resulting in better and more cost-effective decisions. Why does that happen on strike days rather than on every single day of the year?

[Steve Barclay]

We are taking a number of steps to improve performance, and not just on strike days—but I thought the hon. Lady was going to refer to the comment that she made about those on her own Front Bench, when she said:

“I think what our health team need to do is really spend more time in that environment with clinicians to really understand what drives them.”

We on this side of the House are spending a significant amount of time with clinicians, and it is important that those on the hon. Lady’s Front Bench do so as well.

[Janet Daby (Lewisham East) (Lab)]

2. If he will bring forward a plan to increase (a) retention and (b) recruitment of NHS staff.

[Karl MᶜCartney (Lincoln) (Con)]

21. What progress he has made on increasing the number of doctors and nurses in the NHS.

[The Secretary of State for Health and Social Care (Steve Barclay)]

The long-term workforce plan that is being developed by NHS England will help to ensure that we have the right staff numbers with the right skills to deliver high-quality services in the future.

[Janet Daby]

Is the Secretary of State fully aware that under this Government every part of the NHS is in crisis? Are the Government satisfied with the fact that, as medical students in their second year told me recently, the shortage of staff on hospital wards and the pressures on those wards are affecting their training? The students also told me that they had little aspiration to work as junior doctors in the UK after qualifying, because of the acute strain on the NHS and because they felt undervalued. Does the Secretary of State know about this, and what is he going to do about it?

[Steve Barclay]

We see a considerable number of applications for medical undergraduate places, far in excess of the number of places available. We have boosted the number of places—[Interruption.] The hon. Member for Ilford North (Wes Streeting) chunters from the Opposition Front Bench, but when I was last in the Department and the Chancellor had my role, we increased the number of medical undergraduate places by 25%. Indeed, we have more doctors and nurses than we had last year, and 3.5% more full-time equivalent staff: we have over 42,000 more people working in the NHS than we had last year.

[Jim Shannon]

The British Heart Foundation has reported that by the end of August 2022 a record 346,000 people were waiting for heart care. Despite the best efforts of NHS staff, workforce shortages are affecting primary and secondary care services. Can the Secretary of State explain how the Government’s comprehensive NHS workforce plan will address specific gaps in the workforce, especially those in cardiology services?

[Steve Barclay]

The hon. Gentleman has raised an important issue. I think that, in particular, we should look at our approach to major conditions, and I will say more about our thinking in that regard at the start of topical questions. I also think that we need to look at the issue of heart conditions in the context of the wider debate about excess deaths; we know that there is a particular issue in the 50 to 64-year-old cohort. As well as providing those extra doctors and clinicians—and from next autumn we will also have the additional medical doctor degree apprenticeship route—we need to look at methods of upstream testing, particularly in respect of heart conditions.

[Karl MᶜCartney]

In reference to my right hon. Friend’s earlier answers, we are keen to see the success of the new Lincoln medical school leading to more locally trained NHS professionals working across Lincolnshire. What more can the Government do to remove barriers to entry to ensure that anyone who can do so is able to train to become a doctor, nurse, dentist or dental nurse in our NHS, specifically in Lincoln and Lincolnshire?

[Steve Barclay]

My hon. Friend raises an important point on two levels. The first relates to how we boost recruitment in areas such as Lincolnshire, and the new medical school in Lincoln will play a key part in that. The second relates to how we increase the retainability of staff in those parts of the country, and having more on-the-job training and apprenticeships is a key way of doing that. That is why things like the new medical doctor degree apprenticeship will be particularly relevant to cohorts of the population in areas such as Lincoln.

[Mr Louie French (Old Bexley and Sidcup) (Con)]

One of the biggest issues my local hospitals raise with me in outer London is the impact of Sadiq Khan’s ultra-low emission zone expansion, with nurses and other staff facing charges of £12.50 per shift or £25 if they are working nights. Given that 50% of London’s emergency service workers live outside the capital, does the Minister agree that the Mayor and the Labour party should stop ignoring Londoners and drop their ULEZ tax rate?

[Steve Barclay]

My hon. Friend raises an important point about the additional costs that the London Mayor is imposing not just on NHS staff but on all staff working in the capital, in contrast to the approach the Chancellor has taken to energy support to help staff across the workforce, including in the NHS, with the cost of living.

[Sir Gary Streeter (South West Devon) (Con)]

Most of the GP practices in South West Devon report to me that their biggest challenge is recruiting new doctors. Does my right hon. Friend have an estimate of the number of young doctors finishing their training this year who are likely to want to become GPs, and can he reassure us that that is a greater number than the number who are likely to retire in the next 12 months?

[Steve Barclay]

My hon. Friend raises two important themes. The first relates to how many are in training, and I think it is around 4,000. We have boosted the number of GP training places and we have looked at medical schools as a specific issue. Also, he will have seen some of the changes being made around pensions in order to better retain staff, mindful of those clinicians who are leaving the profession, and further discussions are taking place with Treasury colleagues in that regard.

[Helen Morgan (North Shropshire) (LD)]

In Shropshire there are 14% fewer GPs and 29% fewer GP partners than in 2019, yet in the period from April to November 2022, they provided 6% more appointments. It is this additional workload that is causing burnout in GP practices and a flight from the profession. What is the Secretary of State doing to improve the retention of GPs as well as recruitment?

[Steve Barclay]

It is important to look at the number of doctors in general practice, and those numbers are up. There are 2,298 more than there were in September 2019, so we are increasing the number of doctors. What is also important is getting the right care at the right time within primary care, which is about the wider workforce—the paramedics, the mental health support and others working in primary care—and there are an extra 21,000 there. This is enabling GPs to see more patients a day and allowing more patients to get the right primary care, perhaps not from a doctor but from others who can offer specialised support.

[Eddie Hughes (Walsall North) (Con)]

One of the best ways to improve recruitment and retention is to make sure that staff have an excellent working environment, which is why I campaigned for a new urgent and emergency care department at Walsall Manor Hospital. I was successful, and it is opening in March. Will one of the ministerial team join me to celebrate this success?

[Steve Barclay]

I welcome my hon. Friend’s drawing attention to the investment that has been made, which is in no small part due to his campaigning and championing his constituents, as he does so assiduously. I think the Minister of State, Department of Health and Social Care, my hon. Friend the Member for Colchester (Will Quince) has plans to join him to mark the opening of that important facility, which shows our investment in the estate within the NHS.

[Mr Speaker]

There will be a 24-hour service at Chorley as well, I hope.

[Gareth Thomas (Harrow West) (Lab/Co-op)]

One way to improve retention and recruitment of NHS staff at Northwick Park Hospital, which serves my constituency and which I believe the Secretary of State visited last Thursday, would be to invest in doubling its intensive care beds. Did the Secretary of State discuss that issue with the chief executive of Northwick Park when he visited last week? Will he tell us when he might be able to announce funding for the new 60-bed unit that Northwick Park needs?

[Steve Barclay]

The hon. Gentleman is right to highlight the importance of bed capacity at Northwick Park, but my discussions with the chief executive were more in the context of how step-down capacity will relieve pressure on A&E. The hon. Gentleman will know that Northwick Park has one of the busiest, if not the busiest, A&Es in London on many days, and the chief executive spoke to me about the value of adding extra bed capacity from a step-down perspective, much more so than from an intensive-care perspective. If there are specific issues for intensive care, I am happy to follow them up with the hon. Gentleman.

[Mr Speaker]

I call the shadow Minister.

[Dr Rosena Allin-Khan (Tooting) (Lab)]

In mental health we rely on staff, not shiny machinery, so why is the Secretary of State rehashing old announcements and scrapping plans? It is because the Government have run out of ideas. Labour has a plan. We will recruit 8,500 more mental health professionals, ensuring a million more patients get treated every year. We will double the number of medical school places. We will train 10,000 extra nurses and midwives every year, and we will focus on retaining the fantastic staff we already have. Where is the Government’s plan? We have had our plan for two years, but they are binning theirs.

[Steve Barclay]

It is slightly odd for the hon. Lady to talk about a plan when she does not agree with the plan of the shadow Health Secretary, the hon. Member for Ilford North (Wes Streeting). He plans to use the private sector, which he describes as “effective and popular,” whereas the hon. Lady said:

“In my own brief in mental health we have use of the private sector, which ultimately often lets patients down.”

First, the hon. Lady does not agree with the shadow Secretary of State. [Interruption.] The hon. Lady chunters, but she asked about a plan when she does not agree with her own Secretary of State.

Secondly, the hon. Lady talked about shiny new equipment. I am delighted that she allows me to draw the House’s attention to yesterday’s announcement of a fleet of 100 new mental health ambulances, which will relieve pressure on A&E. I am delighted that she gave me an open door to highlight that investment, which is part of our £2.3 billion investment in mental health.

[Ellie Reeves (Lewisham West and Penge) (Lab)]

3. What recent steps he has taken to implement the women’s health strategy for England.

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[Mohammad Yasin (Bedford) (Lab)]

4. What steps he is taking to help improve access to GPs.

[The Secretary of State for Health and Social Care (Steve Barclay)]

We recognise that increased demand has had an impact on GP services. That is why we are investing at least £1.5 billion to create an additional 50 million GP appointments by 2024.

[Mohammad Yasin]

There is a clear failure to invest in critical infrastructure across the primary care estate, for example, in modernising in-patient mental health services and GP hubs. To make matters worse, Government bureaucracy is holding up capital funding allocations. My constituents deserve better community care and hospitals need relief, so when will the Government finally release the funding to build the facilities desperately needed in Bedford and Kempston?

[Steve Barclay]

We have literally just heard in this questions session from my hon. Friend the Member for Walsall North (Eddie Hughes) about the investment the Government are making in infrastructure across the NHS. That is why we have also, alongside the investment we are making in primary care, invested in the new hospitals programme, as part of this Government’s commitment to the NHS estate.

[Dame Caroline Dinenage (Gosport) (Con)]

Since the beginning of January, Gosport patients have learnt that one of our GP practices is threatened with closure, while another is about to merge with an already very subscribed group of practices. Partners are retiring, with no replacements. Will the Secretary of State confirm what he is doing to ensure that my constituents can access a GP? Will he please meet me to discuss this issue?

[Steve Barclay]

My hon. Friend raises an important point, and we are investing over a fifth more than in 2016, as part of our wider investment programme. I am very keen to work with her on the role of her ICB. It was set up operationally last summer, and its role is to commission primary care services for the community and to assess the needs of her Gosport constituents. I am very happy to work with her and her ICB on the issues she raises.

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

Hull has the second highest ratio of GPs to patients in the country. Even though GPs see 46 people a day on average, it is clear that demand for their services outstrips supply. Of course the Labour Government will have a plan to resolve this, but in the meantime will the Secretary of State look at giving women direct access to specialist nurses and services, such as endometriosis or menopause specialists, to prevent them from having to go via their GP each time they need renewed treatment and updated medication?

[Steve Barclay]

First, that is exactly what the women’s health strategy is doing through designing women’s health hubs. It is exactly why we are appointing a wider portfolio of roles into primary care. The hon. Lady says that Labour has a plan, but Labour’s plan is to divert £7 billion out of primary care property, which will not improve services for women and will actually impede the ability to deliver exactly the sort of services she is calling for.

[Paul Maynard (Blackpool North and Cleveleys) (Con)]

Thornton Cleveleys will see a 17% increase in new patients registering for primary care in the next five years, exceeding the physical capacity. Cost-effective solutions have been found, but the obstacle is the integrated care board, which keeps changing its mind as to whether money is or is not available. The clock is ticking on the need for this new capacity. Will the primary care Minister meet me to resolve this impasse and get the ICB to sort its act out?

[Steve Barclay]

My hon. Friend brings welcome transparency to the issue. The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Harborough (Neil O’Brien) was listening intently, and is nodding his head about meeting him to discuss it.

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[Justin Madders (Ellesmere Port and Neston) (Lab)]

T1. If he will make a statement on his departmental responsibilities.

[The Secretary of State for Health and Social Care (Steve Barclay)]

I am pleased to announce that we will be developing and publishing a major conditions strategy. Around 60% of disability-adjusted life years in England are accounted for by just six conditions: cancer, cardiovascular disease, chronic respiratory disease, dementia, musculoskeletal disease and mental health. An increasing number of us live with one or more of these conditions. Tackling them is a significant opportunity to improve the lives of millions of people and to support our goal to improve healthy life expectancy.

This work will bring together our existing commitments to develop plans for mental health, cancer, dementia and health disparities, and our new strategy will shift our focus on to integrated, whole-person care, with a focus on prevention, early detection and the use of innovative technology to improve patient outcomes. It will also improve how the NHS functions, relieving pressure on hospitals, promoting integration and putting us on a sustainable long-term footing.

We look forward to involving partners in the NHS, the charitable and voluntary sector and industry in developing this important work. Further detail about the strategy is included in my written statement published today. The statement also confirms that we will publish a suicide prevention plan this year, building on the important work of my predecessor, my right hon. Friend the Member for Bromsgrove (Sajid Javid), and I look forward to updating the House in due course.

[Justin Madders]

During the passage of the Health and Care Bill in 2021, safe staffing levels in the NHS came up, and the Government told us then that they

“do not believe that there is a single ratio or formula that could calculate what represents safe staffing.”––[Official Report, Health and Care Public Bill Committee, 27 October 2021; c. 773.]

Is the truth not that the Strikes (Minimum Service Levels) Bill is not about safe staffing levels, but about preventing nurses, doctors and paramedics from exercising their fundamental right to withdraw their labour, because they have lost all confidence in this Government?

[Steve Barclay]

The hon. Gentleman is right to say that it is a fundamental right that people are able to strike, and the legislation will balance that right, in the same way that other countries in Europe do, with minimum safe staffing levels. That is something that the French, the Italians and many other European countries have, and the Bill is simply bringing the NHS into line with other health systems.

[Sarah Atherton (Wrexham) (Con)]

T3. Wrexham Maelor Hospital was built in 1934 and is no longer fit for purpose. It has been divided and sub-divided with modular add-ons. It is a labyrinth of rooms, ageing departments and corridors. I trained there as a nurse in 1990 and returned during covid, and there has been little improvement. It is no longer fit for a new city. Healthcare is devolved in Wales. The Welsh Labour Government have received the largest funding settlement since devolution began, so will the Minister agree that Welsh Labour needs to listen to the people of Wrexham and build us a new hospital?

[Steve Barclay]

My hon. Friend makes an extremely powerful point. I hope the Labour-run NHS in Wales takes heed of her comments. She brings professional experience to this issue and is absolutely right that there needs to be investment in the NHS estate in Wales.

[Mr Speaker]

I call the shadow Secretary of State.

[Steve Barclay]

I can see from your reaction, Mr Speaker, and the reaction of colleagues in the House, that that is a misrepresentation of the Prime Minister’s position. For the majority of its existence, the NHS has been run by Conservative Governments. We remain committed to treatment free at the point of use. That is the Prime Minister’s position and the Government’s position.

[Wes Streeting]

I note that the Secretary of State did not rule out any future extension of user charging, and I am sure that patients will have noticed too. Given that the chief executive of NHS England has said that the NHS needs to expand training; that many of the Secretary of State’s own Back Benchers are echoing Labour’s calls to double the number of medical school places; and that he has no plan whatsoever to expand NHS medical school training places, nursing and midwifery clinical training places, to double the number of district nurses qualifying, or to provide 5,000 more health visitors, is it not time for the Conservatives to swallow their pride, admit that they have no plan and adopt Labour’s workforce plan instead?

[Steve Barclay]

I am not surprised that the hon. Gentleman wants to misrepresent the Government’s plan, not least because his own plan is disintegrating before his own Front Bench. The hon. Member for York Central (Rachael Maskell), who spoke earlier, contradicted his point. Not only have the hon. Gentleman’s Front-Bench colleagues contradicted it; even the deputy chair of the British Medical Association has said that Labour’s plan would create higher demand and longer waiting times. I am not surprised that the hon. Gentleman does not want to talk about his own plans anymore; that is why he has taken to distorting ours.

[Paul Holmes (Eastleigh) (Con)]

Eastleigh, Hedge End and the villages have many vibrant pharmacies, but it is disappointing that Lloyds has closed two branches in my constituency. I welcome the additional £100 million that this Government are investing in community pharmacies, but can my right hon. Friend confirm how that funding will cut NHS waiting times and, more importantly, reverse the trend of closures?

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[Steve Barclay]

Those discussions are ongoing with my right hon. Friend the Chancellor. The hon. Gentleman will know that we made progress in the summer on a couple of areas in relation to pensions, and my right hon. Friend is having further discussions with us in that context.

[Dr Luke Evans (Bosworth) (Con)]

I declare an interest as a GP and the immediate family of a GP and doctors. GPs are working incredibly hard in tough times. It is true that supply has gone up, but so too has demand. Change needs to happen in primary care, but one of the bedrocks is the GP partnership model. Does this Government agree?

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[Priti Patel (Witham) (Con)]

The Secretary of State is well aware of the challenges facing Essex mental health care and the independent inquiry there into so many patients who have died. Can he tell the House and my constituents what steps he is taking to make this a statutory inquiry?

[Steve Barclay]

My right hon. Friend raises an extremely grave and serious issue that I know is of concern to a number of colleagues. Following representations from parliamentary colleagues, I had discussions with the chair of the inquiry, and I then with the chief executive and leadership team, in terms of the level of engagement with the inquiry. The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield), and I are closely involved in that issue, and I am happy to have further discussions with my right hon. Friend.

[Stephen Morgan (Portsmouth South) (Lab)]

T4. While the Government have slashed medical school places by a third, Labour is committed to doubling the number of places in order to train a new generation of NHS staff. Will the Minister support me in backing the University of Portsmouth’s bid for a much-needed medical school for my city?

[Steve Barclay]

The hon. Gentleman is just factually wrong. We have increased medical undergraduate places by a quarter—I was in the Department at the time the decision was taken—so he is wrong on the facts. We also need to look at new ways of getting medics in and having more diverse recruitment in relation to social profile. That is why the apprenticeship route is an extremely important one that I am keen to expand.

[Mr Speaker]

I call the Chair of the Select Committee.

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[Kelly Tolhurst (Rochester and Strood) (Con)]

The Kent and Medway integrated care board reported that we had an increase of over 230,000 in the number of GP appointments offered to patients between September 2020 and September 2022. However, Medway has some of the lowest numbers of GPs per head in the country, and demand has increased. What support is the Department giving to the ICB to further increase access to GP appointments in Medway?

[Steve Barclay]

I welcome the increase in appointments and the numbers that my hon. Friend has drawn to the House’s attention. There is targeted funding of up to £20,000 for areas that are having difficulty recruiting; I am happy to discuss with her how we ensure that Medway can adequately access that fund.

[Jessica Morden (Newport East) (Lab)]

T6.   Why are the Government continuing to delay their consultation on the regulation of physician associates? Constituents who are physician associates point out that they could be doing much more to perform vital duties and relieve pressure in our hospitals, which, I am sure the Secretary of State would agree, we desperately need.

[Steve Barclay]

I agree that that is an important issue and I am keen to expedite it; we are having urgent discussions about how we maximise the use of physician associates. The hon. Lady raises an important point that we are discussing with the devolved Administrations, because it applies across the United Kingdom. I am keen to move quickly on that important area.

[Anna Firth (Southend West) (Con)]

“The Future of Pharmacy” report was published yesterday and highlighted again the funding pressures on the sector, including for the brilliant Belfairs Pharmacy in Leigh-on-Sea, which asks whether the Minister will urgently consider writing off the £370 million of covid loans given to pharmacies during covid-19.

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[Lucy Allan (Telford) (Con)]

In today’s Shropshire Star, my local paper, there is an eight-page spread on what is happening to healthcare in Shropshire, which is described as a war zone. Will the Secretary of State meet me and other Shropshire MPs to discuss the challenges we face?

[Steve Barclay]

I am happy to meet my hon. Friend to discuss the issues in Shropshire. I draw her attention to the fact that we have more doctors, more nurses and more funding going into the NHS, and more people are being treated.

[Dr Rupa Huq (Ealing Central and Acton) (Ind)]

T9. In the light of the Government’s welcome announcement of the Strathdee rapid review of in-patient mental health services, can we revisit West London NHS Trust’s decision to make the covid closure of the Wolsey wing permanent, which leaves Ealing, the third biggest borough in London, with no acute mental health beds for under-65s?

[James Morris (Halesowen and Rowley Regis) (Con)]

Although I welcome the new investment in emergency mental health services that was announced this week, does the Secretary of State agree that we must not lose sight of the fact that we need a long-term plan for the transformation of mental health services so that we achieve parity of esteem between mental and physical health in the NHS?

[Steve Barclay]

I do agree. That is why the long-term plan signalled the importance of mental health and the parity of which my hon. Friend speaks. It is also why, as the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield), has said, additional funding is being targeted at mental health—the extra £2.3 billion a year from 2024—signalling this Government’s commitment to mental health, as he will have seen with the announcement on mental health ambulances this week.

[Liz Twist (Blaydon) (Lab)]

T10. Suicide rates in England are as high now as they were 20 years ago, yet the written ministerial statement today simply says that a strategy will be published later this year. Saving deaths by suicide cannot wait. When exactly will the suicide prevention strategy be produced?

[Steve Barclay]

What we have signalled, and I agree with the hon. Member on this, is the importance of the suicide prevention plan. It is something my predecessor, my right hon. Friend the Member for Bromsgrove (Sajid Javid), highlighted. I am keen to work with him and Members across the House on that. I set out in the written ministerial statement today not a specific date, but our commitment to a bespoke plan, and I am very happy to work with her and other Members on that.

[Jack Brereton (Stoke-on-Trent South) (Con)]

Current plans for community diagnostic hubs in North Staffordshire would see only a single facility, which is meant to serve over half a million people. That is totally insufficient, so will the Secretary of State look at my suggestion that there should be two of these facilities in North Staffordshire?

[Richard Burgon (Leeds East) (Lab)]

Will the Secretary of State for Health—today, on the record—condemn the call from his predecessor to impose charges on visits to the GP or to A&E?

[Steve Barclay]

I am not sure how many times one needs to say the same point. The Government’s position on this is clear: we are committed to treatment free at the point of use. That is the Government’s position, and it has been throughout the NHS’s history, the majority of which has been under Conservative Governments.

[Mr Philip Hollobone (Kettering) (Con)]

How many operations have been lost to strike action in the NHS so far?

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[Maggie Throup (Erewash) (Con)]

The all-party group for diagnostics will hold its inaugural meeting on 8 February, and plans to conduct a short inquiry with the aim of providing a blueprint for how community diagnostic centres should operate in the longer term. As part of the inquiry, will my right hon. Friend commit to meeting members of the group to discuss what more the Government can do to maximise the role of diagnostics in addressing the pressures on the NHS?

[Steve Barclay]

I am very happy to give my hon. Friend that commitment. She is absolutely right to highlight the centrality of diagnostics and its importance in our overall plan to get elective numbers down.