Oral Answers to Questions

Steve Barclay Excerpts

Tuesday 17th October 2023 Commons Chamber

[Theo Clarke (Stafford) (Con)]

1. What steps his Department is taking to train more NHS staff.

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

The NHS long-term workforce plan sets out a path to double the number of medical school training places, increase GP training by 50% and double the number of adult nursing training places.

[Theo Clarke]

What steps are the Government taking to increase the recruitment of midwives, given the closure of Stafford County Hospital’s freestanding midwifery birthing unit due to shortages, and how is the Secretary of State going to ensure that all midwives are trained to deal with birth injuries to reduce risk?

[Steve Barclay]

My hon. Friend raises an important point, and I know she has secured a debate in the House this week to further explore these issues. She will be aware that there has been a 13% increase in the number of midwifery programme place starters since two years ago. That is alongside the £165 million added to the maternity budget since 2021 and the key increase in midwifery places in the long-term workforce plan.

[Derek Twigg (Halton) (Lab)]

It is obviously welcome to train and recruit as many staff as possible, but part of the problem is actually retaining the staff. We are increasingly seeing among the reasons given for leaving, particularly by nurses, their work-life balance. What is the Secretary of State doing to address that?

[Steve Barclay]

Just yesterday, I met leaders of the NHS Staff Council, who represent trade unions under Agenda for Change, as part of our ongoing discussions on the agreement we will reach with them, which includes working together on retention and how we address some of the challenges the workforce face.

[Matt Hancock (West Suffolk) (Ind)]

May I congratulate the Secretary of State on being ahead of track to hire 50,000 more nurses this Parliament, as we committed to in the 2019 manifesto? However, can I push him by asking him where he is up to on ensuring that enough staff are trained to do clinical trials, as set out in the excellent O’Shaughnessy review, and can he give us an update of where implementation of that review is up to?

[Steve Barclay]

I very much welcome my right hon. Friend signalling that we are ahead of the manifesto commitment not just in nurses being recruited, but in key additional roles in primary care, where the target was 26,000 and actually 31,000 have now been recruited. He is right about the importance of clinical research. The O’Shaughnessy review speeds that up and reduces the cost. It better leverages the taxpayer pound in investment from the private sector, and standardises contracts across NHS trusts to bring the time down. We are also looking at innovation in areas such as the NHS app to better empower patients to take part in clinical research trials. That ensures they are at the front of the queue in getting the latest medicine, which is exactly where we want the NHS to be.

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

The Secretary of State did not mention the increase planned in the number of physician associates. The Norfolk and Waveney integrated care system has posted:

“Got abdominal pain that isn’t going away? A Physician Associate based in your GP practice can help…They are highly skilled at diagnosing conditions”.

After the tragic case of Emily Chesterton, who was misdiagnosed after seeing a physician associate twice at a GP practice and no GP at any point, when will the lesson be learned that the NHS workforce cannot be safely expanded by this route of associates with only two years’ medical training?

[Steve Barclay]

All clinical roles need to have the right regulation around them, and we need to ensure that patient safety is to the fore. The hon. Lady gives a very good illustration of how the Labour party talks about reform, but not when it comes to the reform of new roles, having new roles in the NHS and having a ladder of opportunity for people to come into the NHS. Physician associates are people with masters’ degrees: these people are highly skilled. Of course, we need to get the regulation right. However, the Labour party talks about reform, but when it comes to standing up to the trade unions, it is not willing to do so, which is why, when there is an innovation such as physician associates, it wants to block it.

[Paul Howell (Sedgefield) (Con)]

3. What steps he is taking to help prevent suicide.

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[Ian Lavery (Wansbeck) (Lab)]

4. What steps his Department is taking to remediate hospital buildings with reinforced autoclaved aerated concrete.

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

We are determined to address the safety issues caused by RAAC. We are prioritising the seven worst-affected hospitals and have a fund of just under £700 million covering the four-year programme of replacement.

[Ian Lavery]

Can the Secretary of State tell the House how many of the hospitals where RAAC is an issue also have issues with asbestos being present? What assessment has his Department made of the impact should asbestos spores be released in a RAAC collapse?

[Steve Barclay]

The hon. Member raises an interesting point about asbestos, because much of the NHS estate dates from a time when asbestos was widely used. Of course, asbestos is considered safe if it is undisturbed. It is a similar issue with RAAC.

On RAAC, we are following the guidance from the Institution of Structural Engineers and monitoring it. The advice is not that all RAAC needs to be replaced; the point is that it needs to be monitored. Where there is deterioration, we have a fund of just under £700 million to tackle that. The asbestos is being monitored, as is the RAAC. We have been monitoring this since 2019 and have a four-year national programme backed up with £700 million to address issues as and when they arise.

[Jonathan Gullis (Stoke-on-Trent North) (Con)]

The residents of Stoke-on-Trent North, Kidsgrove and Talke would like me to place their thanks on the record to the Secretary of State for having ensured that the Haywood walk-in centre, which has RAAC present, has just received £26.5 million for a new build out-patient building, which will do a lot to improve the care of residents locally. As spades are already in the ground, will the Secretary of State commit to coming to visit so that we can show off this fantastic progress?

[Steve Barclay]

It is always a pleasure to visit my hon. Friend’s constituency. He highlights a good illustration of how the national programme is working, backed with that £700 million of funding. We are closely monitoring the estate and, where RAAC mitigation is required, that work is taking place. He brings a good example of that to the House’s attention.

[Mr Speaker]

I call the shadow Minister.

[Karin Smyth (Bristol South) (Lab)]

Not only are the hospital buildings crumbling after 13 years of neglect, creating huge capacity challenges; it seems that those still standing do not have enough beds. As we heard from The Times this morning, the number of

“hospital beds…has fallen by almost 3,000 since ministers promised 5,000 before winter”.

It feels pretty much like winter to me. Is that just another broken promise?

[Steve Barclay]

First, we have got more than £1 billion of investment in an additional 5,000 permanent beds going into the NHS estate as part of our urgent and emergency care recovery programme. More widely, the Government are committed to the biggest ever investment in the NHS estate, backed with more than £20 billion—the biggest of any Government. Of course, we will not take lectures from Labour, which bequeathed the NHS the consequence of expensive private finance initiative deals that many trusts are still paying for to this day.

[Patrick Grady (Glasgow North) (SNP)]

5. What recent assessment he has made of the impact of the UK’s departure from the EU on trends in the level of recruitment in the health and social care sector.

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[Suzanne Webb (Stourbridge) (Con)]

9. What steps he is taking to help prevent cardiovascular diseases.

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

We are making the most significant public health intervention in a generation by creating a smoke-free generation. To put that in context, every five cigarettes a day increases the risk of stroke by 12%. We are also rolling out free blood pressure checks to people over 40 in community pharmacies, which will help to detect much earlier thousands more people living with high blood pressure.

[Suzanne Webb]

I thank the Secretary of State for that answer. Many commercial infant and toddler foods are ultra-processed, which sets alarm bells ringing as ultra-processed food is strongly associated with cardiovascular diseases and 40% of 10 to 11-year-olds are obese. I strongly believe that parents are being misled by companies that put health claims on ultra-processed infant food, when in fact the food is anything but healthy—it is high in fat, salt and sugar. What steps are the Government taking to address the disingenuous and grossly misleading marketing and labelling of commercial infant and toddler food and drink?

[Steve Barclay]

As my hon. Friend knows, there is no agreed definition for ultra-high processed food. As a general principle, I do not think we should be taxing and banning things—smoking is an outlier. We have to empower the patient and recognise the pressures from the cost of living. We are also rolling out anti-obesity drugs to give patients access to the most innovative drugs as part of our wider response to the challenge of obesity.

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

What is the Secretary of State’s view of the worrying trend of increased cardiac-related deaths in the UK and around the world since 2021, which correlates closely with the roll-out of the experimental mRNA vaccines?

[Steve Barclay]

It is always important to follow the science. That is why, at the G20, Health Ministers agreed to look at the various research being done in multiple countries, particularly on long covid but also on the lessons from that period, to ensure that research from that period is shared internationally so we can learn best practice from other countries as well as within the NHS.

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

10. How many and what proportion of NHS radiotherapy linear accelerator (LINAC) machines will reach the end of their recommended lifespan in 2024.

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

Our primary care recovery plan supports GP practices in addressing the 8 am rush for appointments, cutting bureaucracy for GPs and expanding community pharmacy services. We have recruited over 31,000 additional primary care staff and have over 2,000 more doctors working in general practice, compared with before the pandemic.

[Mr Dhesi]

People are finding it nigh-on impossible to see their GP when they need to. Labour has pledged to guarantee face-to-face appointments when people want them by training more NHS GPs but, as my constituents point out to me, under the Tories, a two-tier healthcare system is emerging where some are forced to pay to be seen quicker while those that cannot afford it are left behind in agony. Why have the Conservatives broken their promise, made in 2019, to deliver 6,000 more GPs, and when will this GP crisis finally be resolved?

[Steve Barclay]

There is a two-tier approach within the UK, between what is going on with the NHS in Wales and what is going on in England. We have more appointments, more staff—over 2,000 more doctors and over 31,000 additional roles—and more tech, with £240 million invested in delivering the digital telephony and the online booking system so that we can get patients to the right level of care with an appointment as part of our commitment to 50 million more appointments in primary care.

[Rob Butler]

In my constituency of Aylesbury we have some absolutely fantastic GPs and some brilliant services being delivered, thanks in part to many of the policies that have been introduced under this Government. I thank my right hon. Friend for continuing with that. However, there are still challenges for constituents to get through to their GP surgery to make an appointment in the first place. He has just mentioned digital telephony. Could he update the House on the progress that is being made on rolling out this technology to health centres to end the incredibly frustrating waits that people have, sometimes being on hold on the phone for hours at a time?

[Steve Barclay]

Through that £240 million, we have 100% adoption from GP practices that want to take part in receiving those funds and putting digital telephony in place if they have not already done so. This includes call-back, which allows people to know where they are in the queue, and links to online booking, which allows us to maximise the 31,000 additional roles that we have put into primary care so that people can see the specialist that they need. In my hon. Friend’s own integrated care board, appointments for July increased from 768,000 last July to 816,000 this July, so more patients are being seen, more appointments are taking place and more tech investment is going into the practices in his area.

[Mr Speaker]

I call the shadow Secretary of State.

[Wes Streeting (Ilford North) (Lab)]

To listen to the Secretary of State, you would think it was all going so well, so let me give him a reality check. In Tamworth last year, only a third of patients said it was easy to get through to their doctor on the phone, one in three GP appointments were not conducted face to face and fewer than half of patients were offered a choice of appointment. The Government are not listening to the people of Tamworth. Perhaps the Secretary of State would like to explain to the people of Tamworth why, after 13 years of Conservative Government, this is the case, and better still, adopt Labour’s plan to cut red tape, incentivise continuity of care and bring back the family doctor.

[Steve Barclay]

I am glad that the hon. Gentleman raised GPs in Tamworth. The GP lead for the Doctors Association said that his plans for general practice filled them with despair, and his proposal for GP nationalisation was mocked by the Nuffield Trust, one of the respected think-tanks. The reality is that this Government are investing in more tech in primary care, have recruited 31,000 additional roles into primary care and have over 2,000 more doctors working in primary care than before the pandemic. Those are the facts. His plans have been mocked by respected think-tanks because he talks a good game on reform but we know that he will never stand up to the trade unions.

[Luke Hall (Thornbury and Yate) (Con)]

14. What steps his Department is taking to provide a new health centre in Thornbury.

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[Aaron Bell (Newcastle-under-Lyme) (Con)]

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

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

First, may I welcome Opposition Front-Bench Members to their new roles, as there have been changes since we last met? Since then, we have launched a new £30 million fund to speed up the adoption of tech across the NHS. Even when local pilots prove their effectiveness, it often takes too long for those innovations to be rolled out nationally. This fund can change that, giving integrated care systems across England the chance to invest in tech that is proven to improve care, for instance in detecting cancer sooner. These investments will be made this financial year, getting patients care faster. We are also making more than 200 more medical school places available for universities from next September, accelerating a commitment that we made in the NHS long-term workforce plan and delivering more doctors to areas that need them most.

This Government are listening to patient voices too, particularly on the importance of biological sex in healthcare. That is why, following a consultation later this year, we will amend the NHS constitution to make sure that we respect the privacy, dignity and safety of all patients. The Prime Minister has also unveiled plans to introduce a new law to prevent children who turn 14 this year from ever legally being sold cigarettes, creating the first smokefree generation. Last week, my Department launched an expedited consultation to crack down on youth vaping.

[Aaron Bell]

I thank the Secretary of State for his statement, particularly what he said about tech. On dental provision, I recently met with Dr Khan of Westbury Park dental practice in my constituency to discuss access to NHS dentistry, which is becoming more difficult for many of my constituents. I welcome the plans we have to increase the number of dentists and I reiterate my support for a dental school at Keele University, but those plans will take time. In the short term, there is a huge backlog of overseas clinicians waiting to take the registration exam so that they can practise here. What steps is the Secretary of State taking to expedite this?

[Steve Barclay]

He is right that we are taking both long-term and short-term actions. A key part of the long-term workforce plan is to boost the number of dentists being trained. In the more immediate term, earlier this year we made legislative changes that give the General Dental Council the flexibility to improve the way professionals are registered, giving more flexibility in terms of the skills mix and, for example, tripling the number of people sitting part 1 this year, so that more overseas professionals can be recognised and qualified to practise in the UK.

[Mr Speaker]

I call the shadow Secretary of State.

[Wes Streeting (Ilford North) (Lab)]

In Mid Bedfordshire last year, 165 children—[Interruption.] I do not know why Government Members are laughing; perhaps they should listen, as it is not our party that has let down the people of Mid Bedfordshire. Last year, 165 children in Mid Bedfordshire had teeth removed due to tooth decay. Some 800 patients were forced into A&E for the same reason and 100,000 people across the region cannot get access to an NHS dentist. Instead of laughing, the Government might like to adopt Labour’s plan to provide 700,000 extra dentistry appointments every year.

[Steve Barclay]

Since 2010, we have had 6.5% more dentists, a quarter more appointments and, as we have just touched on, increasing flexibility in regulation and boosting overseas recruitment. It is striking that one area of the country that the shadow Secretary of State does not want to talk about is Wales, which has a record of what a Labour Government will deliver. Indeed, the Leader of the Opposition says that he wants Wales to be the “blueprint” for what the NHS would be in England. There, this week, we have seen a fiddling of the figures on health. Even without that fiddling, we know people are twice as likely to be on a waiting list in Wales as in England—

[Mr Speaker]

Order. One of us has got to sit down and it is not going to be me. I let you have a good crack at the beginning, Secretary of State. Your opening statement took quite a long time, which I do not mind. I do not mind your having a go about Wales, but I am certainly not going to open up a debate between the Government and Opposition Front Benches. Topical questions are for Back Benchers and about short questions with short answers. I want it to be kept that way, so please understand that. There must be too many by-elections, because Members are getting carried away.

[Wes Streeting]

It is not just Mid Bedfordshire. Across the country, the No.1 reason children aged six to 10 are admitted to hospital is tooth decay. Given that, will the Secretary of State at least adopt the modest measure that Labour has proposed to introduce national supervised tooth brushing for small children—low cost, high impact—to keep their teeth clean and keep children out of hospital?

[Steve Barclay]

We are reforming the NHS workforce more fundamentally, looking at how we expand the roles that dental hygienists and dental therapists can perform. We are looking at how we can boost training, which is why we have made the commitment for more dentists in the long-term workforce plan, backed by £2.4 billion. How does that help? It increases the number of dentists being trained and we have a quarter more activity compared with last year.

[Philip Dunne (Ludlow) (Con)]

T2.   Can the Minister confirm that the £312 million capital investment to transform the Shrewsbury and Telford Hospital NHS Trust acute hospitals is on track through the NHS approval process, with its outline business case, to enable a full business case to be concluded in the coming months so that construction can commence during this financial year?

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[Amy Callaghan (East Dunbartonshire) (SNP)]

New research by UNICEF UK has made clear how badly the cost of living crisis has hit the mental health of families with young children. Rising prices and services gutted by austerity have left 60% of parents feeling overwhelmed, anxious, unsupported and lonely all or most of the time. What representations has the Secretary of State made to his Cabinet colleagues ahead of the upcoming autumn statement to support families and to improve health outcomes?

[Steve Barclay]

That shows just how divorced the SNP line of questioning is from the reality of funding. The funding for mental health is £2.3 billion more this year than it was four years ago. We are funding 160 mental health crisis cafés and we have a programme of mental health support teams being rolled out in our schools, all of which is subject to Barnett consequentials on which the Scottish Government receive money. This Government are committed to investing in mental health. That is what we are doing. The question for the Scottish Government is why they are not getting the same results that we are.

[Suzanne Webb (Stourbridge) (Con)]

T3. Most supermarkets practise place-based and price promotions mainly on ultra processed food—food that plays a key part in feeding the obesity crisis. How can the Government best ensure that supermarkets promote affordable, unprocessed and sustainable foods, not foods high in fat, sugar and salt, and, importantly how can we ensure that supermarkets comply with the regulations?

[Clive Lewis (Norwich South) (Lab)]

I was going to ask a question about the shocking statistic of 85,000 people on the waiting list at Norfolk and Norwich University Hospital, but so poor was the Secretary of State’s response to the question of my hon. Friend the Member for Ilford North (Wes Streeting) about the dental desert that I will tell him a quick story. Ukrainian refugees who come to my constituency are travelling back to war-torn Ukraine to have their teeth seen to because there is a better dental service there than in Norfolk and Norwich. What does he have to say to that?

[Steve Barclay]

As I have said, we have 6.5% more dentists now than when we came to power. There is also a quarter more dental activity this year compared with last year. I understand why the hon. Gentleman does not want to talk about the investment that we are making on the elective programme in Norfolk, because it includes funding for two new hospitals in Norfolk through our new hospitals programme and significant funding into diagnostic capacity, with a number of diagnostic centres being opened in Norfolk, which he does not want to mention.

[Matt Vickers (Stockton South) (Con)]

T4. My local hospital, North Tees, is tired, dated and well beyond its life expectancy, with operating theatres too small to meet modern requirements, so I was hugely disappointed that my NHS trust failed even to apply for Government funding that could have built a new state-of-the-art surgical hub on the site. Will my hon. Friend work with me to ensure that the people of Stockton get the healthcare facilities that they need?

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

Ten years on from the Francis report, the National Guardian’s Office—for freedom to speak up—reports that last year there were 937 cases where whistleblowers were not listened to and experienced detriment. If we add that to 170,000 complaints, with 30,000 reaching the Parliamentary and Health Service Ombudsman, we can see that the complaints system across the NHS is defensive and dangerous. Will the Secretary of State review the NHS complaints system, and embed a listening and learning culture and early intervention?

[Steve Barclay]

I discussed this with Henrietta Hughes, the patient safety champion, just yesterday as part of the sprint that we have commissioned in the Department in response to Martha’s rule. We are doing considerable work with NHSE colleagues on how we better respond to the concerns of patients, whether it is through the work on Martha’s rule or the complaints process, and a significant amount of work is ongoing as part of that.

[Mr Philip Hollobone (Kettering) (Con)]

T5. The Secretary of State has seen for himself the dilapidated steam generators at Kettering General Hospital. The new £34 million net zero energy plant designed to replace them faces challenges from rising costs and new design requirements. Will he ensure that the final business case approval process for this new power plant is completed as soon as possible, so that spades can hit the ground on time in spring 2024?

[Steve Barclay]

Yes I will. I pay tribute to my hon. Friend for the way he has championed this issue. I have visited the hospital; I have seen it for myself. As he will be aware, the full business case was received by the Department this morning. While the cost has increased, it is still within the wider funding envelope for the scheme on that site and I will do everything I can to expedite the process as he asks.

[Paula Barker (Liverpool, Wavertree) (Lab)]

In recent months, there was a concerted campaign from the public to prevent the closure of Park View Medical Centre in Liverpool, which was subsequently closed by the Merseyside and Cheshire integrated care board. Not long after the conclusion of the campaign, during which members of the public were turning up to board meetings, the ICB announced that 50% of its meetings would now be held exclusively in private. I for one do not believe that that is a coincidence. What would the Secretary of State’s advice be to Merseyside and Cheshire ICB on transparency and accountability, and is it not time we looked at strengthening the guidance?

[Steve Barclay]

The hon. Lady raises an important point. I was not aware of that decision by the local ICB. As a principle, I think we can agree across the House that greater transparency on such meetings is important, so I will follow up on that. The Government are making significant investment into Merseyside; both Alder Hey Children’s Hospital and the Royal Liverpool University Hospital have been rebuilt at significant cost as part of this Government’s commitment to investing in the NHS estate in that area.

[Chris Loder (West Dorset) (Con)]

T6. Will the Secretary of State join me in thanking the outgoing chief executive of the South Western Ambulance Service, Will Warrender? He came to join the service in the middle of covid, during very difficult times, and did a lot of work to help, and that comes after his 32 years of public service in the Royal Navy.

[Steve Barclay]

I am happy to join my hon. Friend; indeed, I am sure the whole House is happy to pay tribute to the exemplary public service Mr Warrender has provided, both in the Royal Navy and with the ambulance trust, and to wish him a very happy retirement.

[Daisy Cooper (St Albans) (LD)]

Immunocompromised patients are facing their fourth winter without adequate protection from covid, despite a new study showing that they now comprise approximately 25% of all covid hospitalisations, intensive care unit admissions and deaths. In the last few days, some hospitals have been giving guidance to their staff that they should not even test for covid unless they are working on specific wards. After three and a half years, what are the Government going to do to put an end to this appalling situation, where some of the most clinically vulnerable patients are scared of accessing the healthcare they need for fear it could literally be a death sentence?

[Steve Barclay]

During the pandemic, as the hon. Lady knows, the Government prioritised the clinically extremely vulnerable and significant investment went in there. We follow the guidance from the UK Health Security Agency about the right level of infection control. More widely, we need to look at what medicine is effective. If it relates to immunosuppressants, there was a big debate in summer 2022 about that issue and we keep the science under active review.

[John Penrose (Weston-super-Mare) (Con)]

T7. I thank Ministers for their earlier helpful replies about NHS dentistry, but I am afraid the situation in Weston-super-Mare remains extremely worrying. Local residents regularly say there is not a single local dentist accepting new adult NHS patients, and many practices have actively reduced NHS work since the pandemic. I have pushed both NHS England and the local integrated care board, but all we have so far are PowerPoint presentations rather than bookable appointments. What hope can the Secretary of State offer to Westonians who have paid their taxes, but are not getting any NHS dentistry in exchange?

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[Judith Cummins (Bradford South) (Lab)]

Having 100% fracture liaison services coverage in England would prevent an estimated 74,000 fractures, including 31,000 hip fractures, over five years. Will the Minister finally commit to 100% FLS coverage across England?

[Steve Barclay]

In the interests of brevity, I will actively look at that issue and write to the hon. Lady about it.