Oral Answers to Questions

Debate between Steve Barclay and Baroness Keeley

Tuesday 17th October 2023 Commons Chamber

[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.

Countess of Chester Hospital Inquiry

Debate between Steve Barclay and Baroness Keeley

Monday 4th September 2023 Commons Chamber

[Steve Barclay]

A number of steps have already been taken; I am thinking, for example, of the role of medical examiners working in conjunction with the role of the coroner. Those are the sort of areas that the inquiry will look at: the roles of the coroner, the medical director, the Royal College of Paediatrics and Child Health report in 2016, who had sight of that and what action was taken, and the role of the board, including the non-exec lead, in terms of issues around patient safety. So a range of areas will be looked at, which is the whole purpose of having this inquiry. A number of steps have already been put in place, but it is important that we learn the lesson where clinicians have raised concerns and those concerns were not acted on.

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

I co-signed a letter to the Health Secretary from Salford MPs and the Salford City Mayor detailing that two senior managers from the Countess of Chester Hospital who were accused, as we have been discussing, of repeatedly ignoring warnings about Ms Letby’s actions then left that hospital and were employed or seconded to NHS trusts in Greater Manchester, including Salford Royal NHS Foundation Trust and the Northern Care Alliance. The two managers were re-employed well after the police had launched their investigation into Lucy Letby. This raises serious questions about NHS governance, HR processes, safety, risk assessment and the role of regulators, as already raised by the Labour Front Bench and my hon. Friend the Member for Weaver Vale (Mike Amesbury). I want to join our concerns from Salford with the concerns the Health Secretary says are already being expressed about the governance issues raised by the re-employment of managers at that time and ask for assurances that this will be fully explored in Justice Thirlwall’s inquiry.

[Steve Barclay]

The hon. Lady raises extremely important issues and I am happy to give her the assurance that these issues will be explored. NHS England is looking at that. On the concerns expressed around the regulation of managers, the chief exec of NHS England hosted a meeting last week with key stakeholders to discuss these very issues and I will of course relay to the chief exec the points she has raised.

Oral Answers to Questions

Debate between Steve Barclay and Baroness Keeley

Tuesday 11th July 2023 Commons Chamber

[Steve Barclay]

It is characteristically astute of my hon. Friend to zero in on the tie-in, which is an important part of the long-term workforce plan. Around two thirds of dentists do not go into NHS work after training, so having a tie-in is more pertinent there than it might be elsewhere in the NHS workforce. I look forward to the Select Committee’s report but, with some of the reforms already in place, we are boosting the number of patients treated. There were a fifth more dental treatments in 2022 than in the previous year. We are also making NHS dentistry more attractive with some of the changes to the previous 2006 contract, but we recognise that there is more to do, which is why we will shortly set out our dental recovery plan.

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

I have received a wave of concern from clinicians on the safety of using physician associates, following my Adjournment debate last week in which I raised the death of Emily Chesterton, the 30-year-old daughter of my constituents Marion and Brendan. Emily died of a pulmonary embolism after being seen twice by the same physician associate at her GP practice. The physician associate failed to refer her to a doctor or to a hospital emergency unit for tests, which the coroner concluded could have prevented her death.

Yesterday, on “Good Morning Britain”, the Secretary of State boasted of increasing the number of people working in primary care, presumably including the workforce plan proposal to triple the use of physician associates. Will he look urgently at the details of Emily Chesterton’s case and ask himself whether lessons can be learned to avoid other preventable deaths?

Urgent and Emergency Care Recovery Plan

Debate between Steve Barclay and Baroness Keeley

Monday 30th January 2023 Commons Chamber

[Steve Barclay]

I am happy to give my right hon. Friend that assurance. I assure the House that our commitment to the cancer mission and the dementia mission through the Office for Life Sciences is absolutely there. He is right that we are bringing that together in one paper—I think we should take a holistic approach—but I share his ambition on prevention. In early January, I set out a three-phased approach: first, the £250 million immediate response to the pressures we saw from the flu spike over Christmas; secondly, as I announced today, building greater resilience into the system looking ahead to next winter; and thirdly, the major conditions paper on prevention, which is about bringing forward the innovative work that colleagues are doing through the Office for Life Sciences to impact the NHS frontline much sooner than might otherwise have been the case.

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

I want to raise the case of a constituent who described to me the state of Salford Royal’s A&E earlier in January, saying:

“My partner was taken by ambulance yesterday at about 11am. He has a severe chest infection and breathing problems. He was left sitting in a chair on oxygen until 10pm when a trolley was found for him to sleep on. There are no beds available.”

My constituent said that patients and staff

“feel that no one cares”.

After such a long wait, my constituent’s partner was found to have pneumonia and he has been very poorly. Now the Secretary of State is talking about a target of 76% of A&E patients being seen within four hours by next March. Will he tell me and my constituent why he thinks it is acceptable for patients to wait longer than is safe?

[Steve Barclay]

We are bringing times down; I think the current mean response for C2s is much more in the region of 25 or 26 minutes than it was in late December-early January, because across the UK there was a massive spike in flu. The hon. Lady will have seen exactly the same in the Labour-run NHS in Wales. Over December there was a 20% increase in 999 calls, for example. That is why we need to put in place greater resilience, as the plan I have set out to the House does.

NHS Winter Pressures

Debate between Steve Barclay and Baroness Keeley

Monday 9th January 2023 Commons Chamber

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

It is one thing to talk about blocked beds but, as many Opposition Members have said, care is also about staff. How does the Secretary of State expect care homes to cope with this increased pressure when one in 10 social care posts remains empty and when staff feel overworked, underpaid and exhausted?

Last year, a report commissioned by the Department of Health and Social Care found that the rapid discharge of people from hospital to care homes during the first wave of the pandemic, without adequate covid testing, was “highly likely” to have caused some outbreaks. How will the Health Secretary avoid the fatal mistakes of the past by militating against the seeding of more infections in care homes and, as my hon. Friend the Member for Ilford North (Wes Streeting) said, the danger of unsuitable care leading to hospital readmissions?

[Steve Barclay]

The hon. Lady makes a good point about the risk of introducing infections into care homes, as happened in the past. It is worth the House reflecting on the fact that we are in a very different position from the start of the pandemic. First, we now have vaccines in place for care home residents and staff. Secondly, we now have antivirals. Thirdly, we now have huge knowledge about covid. From an infection point of view, the risk of releasing people into care homes is now in a very different place.

On the wider workforce, part of the reason for the £500 million announced in the autumn statement is to support measures for the workforce, but we are also looking to boost numbers through international recruitment.