Countess of Chester Hospital Inquiry

Debate between Steve Barclay and Caroline Johnson

Monday 4th September 2023 Commons Chamber

[Steve Barclay]

Again, I agree. It is extremely important that we have the right levels of escalation and the right routes available to those raising concerns. I have already signalled to the House a number of safeguards that have already been put in place following various reviews, including the Francis review. Indeed, I spoke to Sir Robert about the lessons from his report, as I have with a number of other chairs in recent weeks. It is important and a number of safeguards are already in place, but of course the inquiry will look at how those fit together and whether any further steps are required.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

I welcome the dashboard the Secretary of State has announced, which will identify outliers so that trusts that have abnormal events can be looked at, but in this particular case the fact that events were happening unexpectedly was identified, staffing analysis was done and seven consultants raised that this was a problem. They identified Lucy Letby as potentially causing this harm and they were repeatedly, repeatedly and repeatedly ignored. We also need to bear it in mind that, if they had not been ignored, some of these babies might not have died, and that is not good enough. As the Secretary of State seeks answers to how this can be prevented, I urge him to focus on three things: how he can develop clear lines of medical, nursing and managerial accountability; how he can prevent poor managers from moving from trust to trust to evade such accountability; and how, if seven consultants find themselves in a similar position in future, they can escalate beyond their trust—outside their trust—to get some attention.

[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.

Recovering Access to Primary Care

Debate between Steve Barclay and Caroline Johnson

Tuesday 9th May 2023 Commons Chamber

[Steve Barclay]

I have touched on the numbers a few times, but let me give the hon. Gentleman the precise figures. There are 335 more pharmacists than there were in 2010, so it is simply not the case that there are fewer. There are 2,000 more doctors in general practice, and there are also the extra 25,000 in additional roles. As I have said, someone who wants a prescription review should see a pharmacist, and someone with back pain should see a physiotherapist; not everything has to go through a GP, and it is better for GPs’ time to be used more effectively. There are also more doctors in training: 4,000 are receiving training in primary care, as opposed to 2,600 in 2014. So we are seeing more staff, more effort on recruitment, more effort on retention through the pension changes, and better use of the additional roles.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

I am pleased that the Government are looking at how they can best support GPs and improve access to primary care, but how will these plans protect and enhance the role of GPs who dispense in their own practices? How will my right hon. Friend deal with concerns about antibiotic resistance, and how will he solve the root cause of the problem, which is the fact that there are not enough GPs?

[Steve Barclay]

In respect of my hon. Friend’s first point, these plans will not make any changes. As for the second, about prescribing, that will be part of the consultation, and we will be learning lessons from what is being done elsewhere: for instance, Pharmacy First is already up and running in Scotland. We are looking into what tests can be performed alongside those prescribing rights so that antimicrobial resistance is targeted effectively.

NHS Strikes

Debate between Steve Barclay and Caroline Johnson

Monday 17th April 2023 Commons Chamber

[Steve Barclay]

I share my hon. Friend’s concern. We have worked constructively with the Royal College of Nursing and, as I say, I was happy to put on the record my acknowledgment of the exemptions it had previously granted. I hope that between now and the end of the month, it will further reflect on the fact that the 48 hours of continuous strike action will happen without consultation with other staff council members and without waiting for the decision of other trade unions that are currently balloting. He will know that “Agenda for Change” is a deal that covers all the trade unions, not just the RCN in isolation, and I think it is right to wait for all the trade unions to vote and for the staff council to meet.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

I draw the attention of Members of the House to my entry in the Register of Members’ Financial Interests.

On Friday, I was working at the hospital and my usual clinic had cancelled all but one patient. I spoke to the secretaries about the various cancellations they had had to make as result of the strikes, and I was really sad to hear not only that they had often been verbally abused by people who were upset, but that they have had to cancel some patients on two occasions because of the earlier strikes and the more recent ones. I was also sad to hear that we are looking at further strikes in the next few weeks.

Will the Secretary of State join me in thanking the members of staff who came into work, who did not strike and who continue to deliver a very important and valuable service? What is he doing to expedite the legislation on minimum service guarantees, so that we do not have any implications from strikes on emergency and intensive care in particular?

[Steve Barclay]

First, I thank my hon. Friend for her service and for the work she was doing on Friday. I join her in putting on the record my thanks to all those staff who did provide cover, as I said in my opening remarks. She is right to highlight the minimum service legislation, and we will obviously need to reflect on recent events in that context. She also points to the fact that the decision by the BMA junior doctors committee to advise members not to notify hospital management about whether they were striking obviously made it more likely that clinics would be cancelled, even when it then transpired that doctors could have provided cover. That is clearly regrettable and indicates the need for resolution, and we want to work constructively with the junior doctors on this.

Oral Answers to Questions

Debate between Steve Barclay and Caroline Johnson

Tuesday 6th December 2022 Commons Chamber

[Steve Barclay]

I refer the hon. Lady to the autumn statement, in which my right hon. Friend the Chancellor set out a wide range of support packages to help with the cost of living across the United Kingdom, including the cost of energy. That is part of wider discussions that we have on a regular basis with the Treasury.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

The pandemic has had a devastating effect on the number of people waiting for treatment. In 2019, there were 54 women waiting more than a year to see a gynaecologist. That number is now more than 40,000. What is my right hon. Friend doing to reduce this wait?

[Steve Barclay]

This is a good illustration of the challenge the country faces with backlogs that are very much driven by the pandemic. We are working with senior figures such as Jim Mackey and Professor Tim Briggs and the Getting It Right First Time programme to look at patient pathways, how we use our diagnostics and our surgical hubs and streamlining the way we get services to patients where backlogs have built up.

Lockdown: Economic Support

Debate between Steve Barclay and Caroline Johnson

Tuesday 3rd November 2020 Commons Chamber

[Steve Barclay]

The hon. Lady is right to point to the pivotal nature of leisure centres in our constituencies. I think all Members would agree with that. I draw her attention to the £4.7 billion of additional funding we have given to local authorities as part of our response to covid, and to the discretion we have given local authorities so that they can apply that funding with the local knowledge they have and target it in the most effective way.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

First, I would like to welcome the unprecedented innovative package of support the Chancellor has put in place, which has undoubtedly helped to support businesses and families in my constituency. What more can my right hon. Friend do to support the coach tourism sector specifically? Small family companies such as A & P Travel and Sleafordian Coaches have done so much to make their transport covid-secure. However, while the venues they support have received funding from the culture recovery fund and enhanced local authority grants, they have not. We need to ensure that when the theatres, museums and the like are able to reopen there is still a viable coach tourism industry to get their customers there.

[Steve Barclay]

The coach firms sector has been particularly impacted as a consequence of covid. That is why, in response, we worked with the Department for Education to provide over £70 million of funding for local transport. That has been to the benefit of many, including coach firms. Of course, the wider package of support—for example, the furlough scheme, the cash grants of up to £3,000 for businesses that are closed, the extended loans and so on—applies to the sector as it does to others. The wider package applies, but I also draw my hon. Friend’s attention to the specific education funding that has been provided, which I know has been a help to a number of coach firms.

Dangerous Waste and Body Parts Disposal: NHS

Debate between Steve Barclay and Caroline Johnson

Tuesday 9th October 2018 Commons Chamber

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

I welcome the fact that there has been no gap in service provision and no public health risk and that the Minister has confirmed that nobody’s operation has been delayed because of this build-up of clinical waste, but it is still concerning that the contract was not properly delivered. How long has he given the site to return to compliance and what action is he taking to supervise the remaining contracts?

[Stephen Barclay]

The key issue for performance under the contracts is what, contractually, the legal requirements on HES are and whether those contractual terms have been breached. Part of the lessons learned is to look at whether contractual enforcement powers are sufficient. In terms of moving forward in respect of the other HES sites, that will depend on the contracts that the supplier has and whether it is in breach of those contracts or of enforcement action from the Environment Agency. To date, the Environment Agency has served one partial suspension, on the Normanton site. As I referred to, the Environment Agency was at the other site over the weekend. This is an area of significant scrutiny, but it will be for the Environment Agency to determine whether the company is not in compliance with its permits.

NHS Trusts: Accountability

Debate between Steve Barclay and Caroline Johnson

Tuesday 10th July 2018 Commons Chamber

[Stephen Barclay]

I beg to differ from my right hon. Friend on that, because this gets to the crux of the issue. The NHS must evolve. It has to move with technology and with the skills mix. Alongside the significant funding injection that the Prime Minister announced at the Royal Free Hospital, the NHS must also deliver productivity. At the specialist level, such as oncology or neuroscience, we often have populations of 3 million that need to be treated. Look at the footprint of the Christie NHS Foundation Trust, for example.

If we look at the other end, we need to deliver more care in the home and not have acute trusts soaking up so much investment. We need dynamic reconfigurations without acute trusts being the sole focus of our attention. We need service changes but—this goes to the core of my right hon. Friend’s remarks—they must be taken forward with clinical leadership and in a way that delivers trust.

I am happy to continue to engage with my right hon. Friend’s specific allegations on a case-by-case basis.

[Dr Caroline Johnson]

The Minister talks about dealing with things on a case-by-case basis, so I wonder whether he will consider Grantham’s A&E, which has had to close overnight for nearly two years, to see what can be done to facilitate its reopening as soon as possible.

[Stephen Barclay]

Again, I am happy to consider that issue. I have been up to visit the United Lincolnshire Hospitals NHS Trust and have met the chief executive and the leadership team, so I am aware of the issues, which are partly due to geography. However, we are straying slightly away from Hemel Hempstead.

As I said, I am happy to engage with my right hon. Friend the Member for Hemel Hempstead on his specific allegations. It is important that service changes are done at the local level with clinical leadership in a way that builds trust, and I will continue to engage with him in the weeks and months ahead.

Question put and agreed to.