Steve Barclay
Main Page: Steve Barclay (Conservative - North East Cambridgeshire)Department Debates - View all Steve Barclay's debates with the Department of Health and Social Care
(1 year, 7 months ago)
Commons ChamberThe Government are committed to our levelling-up mission to narrow the gap in healthy life expectancy by 2030. That is why, in October, we committed an additional £50 million to 13 local authorities to tackle inequalities and why we are also setting out our plans through the major conditions strategy.
Even in areas that people consider to be affluent, such as Buckinghamshire, health inequalities can be a serious concern. Figures from Opportunity Bucks show there is an eight-year difference in life expectancy between residents of the Aylesbury North West ward and the Ridgeway East ward, both of which are in my constituency, yet the funding for those areas is essentially the same. Will my right hon. Friend explain the steps he is taking to ensure that deprived communities, wherever they are in the country, get the additional help and support—not necessarily purely financial—that they need to address their needs?
My hon. Friend is absolutely right to highlight the importance of targeting health inequalities. Let me give the House a practical example. For lung cancer, patients are 20 times more likely to survive five years if we catch it early rather than late. Before the pandemic, those in the most deprived communities had the worst diagnosis. However, as a result of the targeted action we took with lung cancer check vans, they now have the best early diagnosis, which obviously has a big read-across for the five-year survival rate.
The UK ranks 29th in global life expectancy. Professor Martin McKee from the London School of Hygiene and Tropical Medicine notes that one reason why the overall increase in life expectancy has been so sluggish in the UK is that it has fallen for poorer groups. The Scottish Government are doing everything they can within devolved competencies to fight poverty—the Scottish child payment and so on—but Westminster controls 85% of social security. What representations has the Secretary of State made to Cabinet colleagues and the Department for Work and Pensions about the damaging effects of their policies on life expectancy?
The hon. Gentleman raises a very important point. He can see the success of the representations I made to Cabinet colleagues from the Chancellor’s Budget statement, when he announced additional funding to tackle, in particular, health impediments to access to the labour market. He will also have seen the recent announcement of targeted action on, for example, smoking cessation, which is a particular driver of health inequalities. That includes our financial incentive scheme to pregnant mums, which obviously has a big impact on both their health and the health of their baby.
It is becoming clear that in Cornwall the only way to get dental care is to go to a private dentist. In a deprived area, of which there are many across Cornwall, that is just not an option for people on low incomes. What can the Secretary of State do to increase the accessibility of NHS dentistry?
This issue concerns Members across the House. We have already started to reform the dental contract. We have introduced the £23 minimum value for units of dental activity and created more UDA bands, reflecting the fair cost. We are seeing more patients nationally—to March, up nearly a fifth on the year. But I recognise that there is more to do, and the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Harborough (Neil O’Brien), is undertaking that work as we speak.
Women in my constituency have a healthy life expectancy of only 56 years. Could the Minister explain why the difference between West Yorkshire and North Yorkshire—where the Prime Minister has his constituency—is 10 years? Why should women have to put up with that kind of experience? What is his explanation of how that has happened?
The hon. Gentleman is right that we should narrow the health inequalities gap, and we are committed to doing that. That is why in the women’s health strategy, which I set out in the summer, we committed to having women’s health hubs as one-stop shops to tackle some of the gender inequality. It is also why, whether on obesity, smoking or lung cancer, we are targeting our screening and public health interventions to close the gap, which he is quite right to highlight.
There is consensus in the House on our desire to close the health inequality gap—everyone agrees that is a key aim. The hon. Gentleman seems to have written the question before hearing my answer. I just gave a practical example of how we have transformed the early detection of lung cancer. He raised the public health grant, and I am happy to update the House that we are delivering 2.8% funding growth in the public health grant to help local authorities.
It is also about areas such as obesity and access to employment, which can have a big impact on mental health. The Chancellor announced specific funding—[Interruption.] The shadow Minister chunters away about children; I am conscious that one does not want too long an answer, but let me give the example of mental health. In the Budget we announced extra funding for a whole load of digital apps—[Interruption.] The shadow Minister keeps chuntering about children. Let me talk about the roll-out of our mental health support in schools, which is targeted at getting that early mental health intervention to school children.
The urgent and emergency care recovery plan sets out how we will invest more than £1 billion in increasing capacity, including 800 new ambulances, an additional 5,000 core beds and a further 3,000 virtual wards, to provide more than 10,000 out-of-hospital care settings.
A key component of delivering better urgent care services will be expanding the network of urgent treatment centres across the country. Can my right hon. Friend assure me that a UTC in the major population centre of Northampton will be a high priority for the Department?
My hon. Friend is right to highlight the importance of UTCs. Nationally, they are above the national standard: 95.5% of patients are seen within four hours. He is a highly effective campaigner on health issues—he helped to secure the £2.8 million of investment for a new paediatric emergency department in his local area—and I know that he will be making a similar case to his local commissioners.
Ultimately, the best way to improve urgent and emergency care services is through new build, purpose-built hospitals. Can the Secretary of State confirm where we are with the Royal Berkshire Hospital and Frimley Park?
As the House knows, I am extremely committed to modern methods of construction and modular building capacity. We are using that as a central component of our new 40 hospitals programme. My hon. Friend will know that the RAAC—reinforced autoclaved aerated concrete—hospitals are very much part of that discussion, not just at Frimley but at King’s Lynn, at Hinchingbrooke and in a whole range of other settings. He will also know that we are in a purdah period, so we are constrained in what we can say, but we will have more to say on this very shortly.
We have had 13 years of Conservative government. There are record numbers of patients on waiting lists, record numbers of vacancies in the NHS, and a crisis of vacancies in social care. As for emergency care, the Government cannot meet their 18-minute target for category 2 ambulance responses. If the Conservatives were really concerned about the NHS, would we not be in a better position than this after 13 years?
The hon. Gentleman talks of 13 years. People are nearly twice as likely to be waiting for treatment in the Labour-run Welsh NHS as people seeking treatment in England, and, indeed, waits are longer in Wales: we have virtually eliminated two-year waits in England, whereas more than 41,000 people in Labour-run Wales are waiting more than two years.
I recently conducted a major surgery—[Laughter]—I mean a major survey of Rotherham residents to learn about their experiences of the NHS. A staggering 73% of respondents who had called ambulances needing a category 1 response had waited longer than the seven-minute target time. Given that minutes can mean the difference between life and death, what are the Government doing to ensure that my constituents receive the life-saving support that they need, when they need it?
I know we have clinicians in the House who do second jobs, but I did not know that the hon. Lady had expanded that definition to such an extent! She is right to highlight, through her survey, the importance of timely care. There is currently a range of initiatives, such as the development of the NHS app, the review of the 111 service, and the examination of innovations such as artificial intelligence. We are looking into how we can manage demand in the case of, in particular, frail elderly people by noting changes in behaviour patterns, which will allow us to ensure that, for example, someone who has a fall at home receives care much earlier before arriving in the accident and emergency department, because we know that once frail elderly people have been admitted they will often be in hospital for about 14 days. The hon. Lady has raised an extremely important issue through her survey, and one on which we are focusing in our urgent and emergency recovery plan.
That urgent and emergency care plan, which was announced in January, was received with acclaim by me and, indeed, with wide acclaim. It was described as a two-year plan to stabilise services by, for instance, returning to the A&E target that the Secretary of State has mentioned. What assessment has he made of the impact of the ongoing industrial dispute among the Agenda for Change cohort, and, of course, the junior doctors, on the delivery of the plan?
As a result of the fantastic work of Sir Jim Mackey and Professor Tim Briggs through the Getting It Right First Time programme, we have been making significant progress in respect of elective procedures. When it comes to urgent and emergency care, there are lessons coming out of the various strikes which we are keen to adopt, but this situation is also clearly having an impact on patients and the number of cancellations. As my hon. Friend well knows, we publish the figures.
We have been working constructively with the NHS Staff Council. Unison voted by a majority of 74% to support the deal, there will be further votes this week from other key trade unions, and there will be a decision from the staff council on 2 May. Obviously, that will be extremely important when it comes to addressing the concern highlighted by my hon. Friend.
According to figures that I obtained recently from the House of Commons Library, in January 2023 54.4% of patients who were treated after an urgent referral received their first treatment within 62 days of that referral. The target is 85%. The figure for performance in January 2020, before covid, was 73.6%. Why has there been such a deterioration?
To be honest, I think the position is mixed. In certain areas we have seen significant improvements in performance: the faster diagnosis standard, for example, was hit for the first time this month. Purdah prevents me from going into the details of the 78-week wait, but I expect to be able to update the House very soon on the progress that has been made. As the hon. Gentleman says, there are still challenges as a consequence of the pandemic, but we are seeing much more progress than the NHS in Wales, and it is also worth reminding the House that, through Barnett consequentials, the Welsh NHS receives more funding that the NHS in England.
This may surprise you, Mr Speaker, but I have found evidence that the Health Secretary has got something right. He recently hailed the power of local news outlets, and he was spot on. I have here a story from his local paper, exposing the shocking length of waits in A&E for those in a mental health crisis: 5.4 million hours across England in just one year. He is very welcome to have a look if he would like to. Given his admiration for local journalism, does he feel embarrassed for his Government’s failings and will he apologise to all the people across the country who are stuck waiting in A&E?
There are two separate issues there: what we are doing for mental health in-patients and the point we just touched on about A&E. On mental health, it is good of the hon. Lady to give me the opportunity to remind the House of the significant increase in funding we are making to mental health. In the long-term plan, the former Prime Minister, my right hon. Friend the Member for Maidenhead (Mrs May), made a major strategic choice to invest more in mental health—an extra £2.3 billion per year. The hon. Lady is right to highlight the need for more capacity for mental health in-patients—[Interruption.] She asked a question on what we are doing on mental health. I am able to tell her that we are spending far more and investing far more in it, but it seems that she does not want to hear that answer.
In February, the faster diagnosis standard was met for the first time. In addition, we are investing in additional screening, testing and tech in order to detect cancer much earlier.
Recent data for the Buckinghamshire, Oxfordshire and Berkshire West ICB shows that 42.6% of cancer patients are waiting more than 62 days for treatment. That will only get worse without a significant programme of upgrading radiotherapy equipment and ensuring that there is a skilled workforce of radiographers. So what steps is my right hon. Friend taking to ensure that new, cutting-edge radiotherapy equipment is making it to the frontline, coupled with a fully staffed workforce to operate it and save those lives?
My hon. Friend is right to highlight the interaction of workforce and capacity in equipment. That is why we have 810 more consultant training places over three years, and we have grants to enable more than 1,000 nurses to train, for example, in chemotherapy and 1,400 new recruits to the cancer diagnostic workforce. Obviously, that sits alongside the expansion in capacity, including both in our surgical hubs and our expanded diagnostic centres.
My constituent had emergency surgery for a brain tumour, but this was after six months of going to the doctor repeatedly with problem headaches. Brain cancer causes 9% of cancer deaths but accounts for only 1% of cases. Sadly, my constituent is terminally ill, but he is in a position to explain his experiences. He has asked me to raise with the Secretary of State the issue of what work is being undertaken on genome sequencing, which could have a major impact on better treatment for brain cancers. It would be helpful if the Secretary of State not only answered this today but wrote to me in more detail on it.
The whole House will send their best wishes to the hon. Lady’s constituent. She raises an important point about genomics, which is why we have invested in Genomics England and 100,000 babies are being screened—that is a key programme of work. The Minister for Health and Secondary Care, my hon. Friend the Member for Colchester (Will Quince) recently hosted a roundtable with key stakeholders on that, but I am happy to write to her with more detail, because the prevention and capability that is offered through screening is a great way of getting early treatment to people.
I think the question is about GPs and workforce capability, and that is why we are investing in more doctors. We have recruited over 5,000 more doctors, including an additional 2,000 doctors in primary care.
An increasing number of my constituents are having difficulties obtaining appointments in GP surgeries. However, I was pleased to learn that the GP workforce in my constituency of Bexleyheath and Crayford has increased by an estimated 75% since September 2019. Will my right hon. Friend confirm what further steps he is taking to continue growing the workforce in general practice, which is so crucial to increasing the number of appointments available?
Now that I have found the right page in my notes I can be precise in telling my right hon. Friend that it is a 75.7% increase in his constituency, so he is absolutely right about that. Nationally, we have recruited an additional 25,262 full-time equivalent primary care professionals, so that is expanding the workforce capability in primary care. As my hon. Friend the Minister for Health and Secondary Care said a moment ago, it is part of our £1.5 billion investment in the workforce in primary care.
As the House will know, this week is MS Awareness Week. Early diagnosis and treatment of MS are vital to delay disability progression and help those with the condition to manage it, yet, currently, 13,000 people have been waiting more than a year for a neurology appointment after GP referral. A recent study suggested that the UK comes a shameful 44th out of 45 European countries for neurologists per head of population. When will the Government bring forward a strategy to attract, recruit and retain the neurology workforce?
The hon. Lady raises an important issue related to MS. I am happy to write to her with a more detailed answer about the capability and the plan. There is always a tendency within government to lurch to a strategy rather than to look at what is needed for immediate delivery. I will happily set out what steps we are taking now as part of our pandemic recovery in order to target the workforce within the constraints that she raises.
The Government support the right to take industrial action within the law, but equally the law is there to protect patients and NHS staff alike. Following legal advice, NHS Employers and my Department are confident that the proposed strike action by the Royal College of Nursing goes beyond the mandate it secured from its members, which expires on 1 May at midnight. While NHS Employers has sought to resolve the issue through dialogue, the RCN’s failure to amend its planned action has led NHS Employers to request my intervention. Even as we work to resolve those issues through dialogue, I can tell the House that I have regretfully provided notice of my intent to pursue legal action. None the less, I am hopeful that discussions can still be productive, especially those between the RCN and NHS England on patient safety, and that they will continue to be guided by the imperative to keep people who use the NHS safe.
The right to choose sounds attractive, but when diabetic eye disease and glaucoma seriously threaten the sight of millions, the fact that any qualified provider can and does cherry-pick reversible cataract work leaves the NHS with astronomical bills and all the complex cases. Will the Secretary of State praise award-winning clinicians Christiana and Evie at Central Middlesex Hospital and visit to see for himself how effectively writing a blank cheque for private treatment is destabilising NHS budgets and jeopardising the NHS’s ability to do award-winning research and to train junior doctors, who need routine work?
I am always happy to praise the brilliant work of clinicians up and down the NHS, who do a formidable job. Given the huge scale of the backlogs we face as a consequence of the pandemic, it is important that we not only use the full capacity available within the NHS, empowering patients through patient choice and technologies such as the NHS app to better enable that, but maximise the capacity in the independent sector.
My hon. Friend makes a brilliant point, and that is something that we are committed to doing. There is a huge amount of expertise within the pharmacy network, which is why we are looking, through technology such as the NHS app, at how we can better enable people to get the right care from the right place at the right time. Quite often, that is not by seeing the GP, but it might be by seeing those in additional roles in primary care or going to a pharmacist who can offer the right services.
A 13-year-old girl who has already waited more than a year for spinal surgery has seen her operation cancelled twice because of the Government’s failure to negotiate an end to the junior doctors’ strike. Why on earth is the Secretary of State still refusing to sit down and negotiate with junior doctors?
Like others in the House, my heart goes out to any 13- year-old girl in that situation. As the parent of a 12-year-old girl, I can only imagine how distressing it is to the family concerned to see that operation cancelled. That is why it is important that we have dialogue. The hon. Gentleman has said that the demands of the British Medical Association are unaffordable and unrealistic at 35%, as has the Leader of the Opposition. We have been clear on that, but the House saw that in our negotiation with the Agenda for Change staff unions we had meaningful, constructive engagement; that was how we reached an agreement with the NHS Staff Council, and we stand ready to have similar discussions with the junior doctors.
So why is the Secretary of State not sat down with them today? He says that he cannot negotiate because the BMA will not budge on 35%, but that is not true, is it? He says that the junior doctors have to drop their preconditions; they do not have any, do they? And he says that strike action will have to be called off before he can sit down; there are no strike days planned, are there? So is it not the case that he is quite happy to see hundreds of thousands of operations cancelled so that he can blame the junior doctors for the NHS waiting lists rather than 13 years of staggering Conservative incompetence?
It is slightly odd that the hon. Gentleman talks about 13 years when we are actually talking about a current industrial dispute. We have shown, through our negotiation with the NHS Staff Council, our willingness to engage and to reach a settlement. Indeed, the general secretary of the RCN recommended the deal from the AfC unions to her members. Unison—the union of which the hon. Gentleman is a member—voted for the deal by a margin of 74%. We stand ready to have engagement with the junior doctors, but 35% is not reasonable. He himself has said—[Interruption.]
Order. I do not need the Minister for Social Care, the hon. Member for Faversham and Mid Kent (Helen Whately), shouting from the end of the Treasury Bench. Okay? I call Henry Smith.
First, I very much welcome the good care that the hon. Gentleman received, and it is great to see him back in the Chamber. On the wider issue, that is why we have an elective recovery plan, in which we have applied a boost in capacity, particularly through the surgical hubs. We are looking at how we build greater resilience, especially in winter, when elective beds are often under pressure. We are also investing in areas such as eye treatment, and we are rolling out through Getting It Right First Time a programme of improvement in a range of areas, including that one.
Provision for special educational needs and child and adolescent mental health services is one of the biggest issues in my inbox in Leicestershire, particularly in respect of delays in assessment and diagnosis. One of the Government’s plans was to introduce school mental health support teams. The Health and Social Care Committee heard that the aim was that 35% of pupils should be covered by 2023. May we have an update on progress and on when we are likely to reach 100%?
My hon. Friend makes an important point, and I am happy to update the House, as we have already achieved 35% coverage. By the end of the month, we expect to have 399 operational mental health support teams, covering 3 million children and young people. We plan to go further, with over 500 such teams by spring 2024.
Yesterday, when the Prime Minister met business, the huge value of the NHS database was highlighted. Unfortunately, the previous occasions on which the NHS has tried to open its database have been unmitigated disasters. Will the Secretary of State give an undertaking to stick closely to the recommendations of the Goldacre report so that we can deliver the database while protecting the privacy of patients?
It is a huge opportunity. My right hon. Friend and I have discussed this matter outside the Chamber, and I met Ben Goldacre in the summer to discuss his fantastic work in the context of covid. It is absolutely right that, given the potential of artificial intelligence, there are huge opportunities in relation to health inequalities and allowing us to better target provision. I think my right hon. Friend would agree that we should do that through the prism of patient consent. One thing that we are trying to build into the NHS app is the ability to better empower the patient to decide what they wish to sign up to and what they would like their data shared with.
We are committed to a major conditions paper, not least because many people with cancer have multiple conditions; that is why it is important that we look at these issues in the round. With the Minister for Social Care, I had a very useful roundtable with key stakeholders, including the cancer charities. The key issue is that as part of our work on cancer checks, over 320,000 more people are receiving treatment for cancer compared with last year—that is around fifth higher—and we are expanding our capacity through the diagnostic centres, the surgical hubs and the expansion of the workforce. All of that fits within the strategy we have through the major conditions paper.
St Rocco’s Hospice in Warrington provides invaluable palliative and end-of-life care for families. However, the charities that run hospices around the UK are finding it incredibly difficult to raise funds. Will the Minister give us an assurance that she is working very closely with the sector to ensure that those services continue to be provided?