Countess of Chester Hospital Inquiry

Debate between Steve Brine and Steve Barclay

Monday 4th September 2023 Commons Chamber

[Steve Brine (Winchester) (Con)]

I place on record my sympathy to the families, who have conducted themselves with the utmost dignity throughout this process and who remain in my thoughts and prayers as well. I welcome the judge-led statutory inquiry that my right hon. Friend has announced. It is the right thing to do, as are the phases of the inquiry, which prevent stuff from taking too long to move fast. As that work moves forward, and the debate rightly continues to touch on how we regulate managers working in the NHS, and remove them, I ask that Ministers remain alert to any “us and them” thinking between managers and clinicians. Surely any successful hospital trust is one team working together, so that defensive medicine is all but impossible.

[Steve Barclay]

I very much agree with the Chair of the Select Committee on the need for a one-team approach, and on looking at how we encourage more clinicians into management roles. We need to be clear-eyed that often some of those in management positions were already regulated, because they were in medical or nursing regulatory positions, but it is important that we consider the right approach to ensure accountability for the families. That is why NHS England will look at this further.

Health and Social Care

Debate between Steve Brine and Steve Barclay

Wednesday 12th July 2023 Ministerial Corrections

[Steve Barclay]

I am pleased to see those services going into Scunthorpe. That underscores the investment we are making now while preparing for the long term, through the largest ever expansion in workforce training in the NHS’s history. My hon. Friend is right about the importance of tie-ins. Let me explain why that matters in particular for dentists: around one third of dentists do not do NHS work. That is why the plan has looked at tie-ins for dentistry, which we will explore in the weeks and months ahead.

Topical Questions

The following is an extract from Health and Social Care topical questions on 11 July 2023.

[Steve Brine (Winchester) (Con)]

Back to NHS dentistry, I am afraid. Later this week, the Select Committee will publish its report on NHS dentistry services. Spoiler alert: it will be uncomfortable reading for some. Will the Secretary of State tell us when and how he plans to bring forward plans for the tie-in of newly qualified dentists? Could that go hand in hand with a “return to the NHS” campaign for dentists who have already left that part of the service?

[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.

[Official Report, 11 July 2023, Vol. 736, c. 174.]

Letter of correction from the Secretary of State for Health and Social Care, the right hon. Member for North East Cambridgeshire (Steve Barclay):

An error has been identified in my response to my hon. Friend the Member for Winchester (Steve Brine).

The correct response should have been:

Oral Answers to Questions

Debate between Steve Brine and Steve Barclay

Tuesday 11th July 2023 Commons Chamber

[Steve Brine (Winchester) (Con)]

Back to NHS dentistry, I am afraid. Later this week, the Select Committee will publish its report on NHS dentistry services. Spoiler alert: it will be uncomfortable reading for some. Will the Secretary of State tell us when and how he plans to bring forward plans for the tie-in of newly qualified dentists? Could that go hand in hand with a “return to the NHS” campaign for dentists who have already left that part of the service?

[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.

NHS Long-term Workforce Plan

Debate between Steve Brine and Steve Barclay

Monday 3rd July 2023 Commons Chamber

[Steve Brine (Winchester) (Con)]

This is a serious piece of work, and it is very welcome. Despite calls from people like me to get on with it, it was right for the Government to take their time and get it right. The Select Committee will scrutinise it—as we do—on 12 July.

The training piece is very strong. Doubling the number of medical school places has to be right, and I am glad that the Secretary of State thought of it. On retention, if we are saying—rightly, I would contest—that it is not all about pay, what role does he envisage the integrated care systems and, therefore, the trusts having in supporting staff as he makes the “one workforce” that is mentioned in section 5, with which I agree, come to pass?

[Steve Barclay]

Characteristically, my hon. Friend the Chair of the Health and Social Care Committee makes an extremely pertinent point about the role of the ICSs. As we move to place-based commissioning and look to integrate more, the interplay between the workforces in the NHS and in social care will be a key area where the ICSs will be extremely important.

The ICSs will have a particular role in the apprenticeship and vocational training, which are key retention tools in those parts of the country where it is hard to recruit, as well as in offering more flexibility to staff. When I talk to NHS staff, they often talk about having different needs at different stages of their career—whether for childcare commitments, which relate to the measures the Chancellor set out in the Budget, caring for an elderly relative, or wanting to retire and work in more flexible ways—and the ICSs have a key role to play in that. I welcome my hon. Friend’s comment that this is a serious and complex piece of work, and that it was right that we took our time to get it correct.

Lung Cancer Screening

Debate between Steve Brine and Steve Barclay

Monday 26th June 2023 Commons Chamber

[Steve Brine (Winchester) (Con)]

I remember dear James Brokenshire saying the words that the Secretary of State repeated today in the House. James made this happen—this is a fantastic prevention announcement. Although this nationally expanded programme cannot prevent lung cancer, will the Secretary of State confirm that we will stick by the principle of making every contact count? When people come forward for a lung risk assessment, we can offer emotional support where a problem has been detected, provide smoking cessation services to those who are still smoking, or just put our arms around people where there are comorbidities. When people come into contact with the health service, will we make every contact count for them?

[Steve Barclay]

I know that my hon. Friend was a Health Minister at the time that James was raising these points, and that he takes a close personal interest in the issue. He is right about the importance of the point at which people come forward. I was having a discussion this morning about the fact that when most patients come forward for screening, they will not be diagnosed with cancer, but it is still an opportunity for smoking cessation services, for example, to work with them on reducing the risk that continued smoking poses. My hon. Friend is right about using the opportunity of screening to pick up other conditions and to work constructively to better empower patients on the prevention agenda.

New Hospitals

Debate between Steve Brine and Steve Barclay

Thursday 25th May 2023 Commons Chamber

[Steve Brine (Winchester) (Con)]

I am grateful for the statement; the Select Committee will want to have a good look at it, and we will start when the Secretary of State comes to see us next month. At the last election, I promised my constituents significant investment in Winchester Hospital. That is already happening, and now with early work in cohort 4 we have the promise of the elective hub to scale the orthopaedic list. Can the Secretary of State be clear with my constituents that, as the new Hampshire hospital comes together as part of the wider cohort 4, it will be for clinicians to make the clinical case on what safe and sustainable services look like in the long term for those people?

[Steve Barclay]

There are different issues around construction and service design. In terms of service design, there will need to be discussions with local clinicians and others. As my hon. Friend knows, with his scheme in North and Mid Hampshire, there are issues around the new site for junction 7 of the M3, where there is significant work on potential land acquisition and what upgrading of the motorway would be required. There is a question about the size of the hospital versus other services offered locally. Those are the issues we are keen to get in discussion with the North and Mid Hampshire trusts on, and that will be part of the rolling programme we take forward.

Patient Choice

Debate between Steve Brine and Steve Barclay

Thursday 25th May 2023 Commons Chamber

[Steve Brine (Winchester) (Con)]

This form of patient choice has of course been available for at least 15 years; it just has not been made available to patients. Can the Secretary of State confirm that the referral management centres sitting at integrated care board level will be compelled, not asked, either to change that or to get out of the way altogether? Given that the vast majority of people on the waiting lists are already there with a specific trust, how exactly will they be given the option either to stick where they are, or to twist and exercise that choice to receive treatment sooner?

[Steve Barclay]

My hon. Friend, as ever, makes a shrewd point. Yes, the referral centres are part of this system. The key focus is on the initial GP referral and how we facilitate that with better data, transparency and tech, but the referral centres are a part of this. We want to roll it out to the 40-week waits from October, and to bring waits down to 18 weeks. There is a clear plan to achieve that wider scope, and that is what I have set out to the House today.

Recovering Access to Primary Care

Debate between Steve Brine and Steve Barclay

Tuesday 9th May 2023 Commons Chamber

[Steve Brine (Winchester) (Con)]

I welcome the plan, which I note the Government have released at the first possible moment after the local election purdah period. Members of the Health and Social Care Committee and I will study it carefully, and I know the primary care Minister has already agreed to come before us so that we can give it a good going over. My question is about timing. How quickly can investment in the 8 am scramble part of the policy make a difference to those practices that do not have it? The Secretary of State said that they were already negotiating with the Pharmaceutical Services Negotiating Committee, so how quickly can that very welcome new investment get to the frontline of community pharmacy?

[Steve Barclay]

The short answer is this year, but the Chair of the Health and Social Care Committee is right to focus, as with all recovery plans, on deliverability. I hope he will take comfort from the fact that around half of GP practices already have cloud telephony, which is why we are so confident that it is the right approach. It is one that is already working. We are seeing from patients’ positive feedback that they hugely value online booking and call-back systems, but they also allow primary care to better triage calls to specialists and therefore to use the additional roles we have recruited in an optimum way. That will be rolled out this year, but it is already up and running and we can see that it is working.

Oral Answers

Debate between Steve Brine and Steve Barclay

Tuesday 25th April 2023 Commons Chamber

[Steve Brine (Winchester) (Con)]

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?

[Steve Barclay]

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.

NHS Strikes

Debate between Steve Brine and Steve Barclay

Monday 17th April 2023 Commons Chamber

[Steve Brine (Winchester) (Con)]

Reports over the weekend suggest that the British Medical Association has asked its members not to engage with trusts if they intend to strike, as the Secretary of State has confirmed today. That is putting trust chief executives—and this is not their fault—in an impossible position. They are being asked to meet very challenging targets that we are rightly setting them, not least with respect to the covid backlog. What more can he do by his good offices to break that impasse? It is patients who are losing out.

[Steve Barclay]

I agree; it is extremely surprising that the BMA has asked its members not to liaise with NHS managers as they put in place those contingency plans. I urge the BMA junior doctors committee to think of those colleagues who have to provide the cover for those strikes. I reaffirm my thanks to all those staff in the NHS who provided cover following the Easter period, but it puts more pressure on other NHS staff if the BMA junior doctors committee is not willing for its members to liaise with management on sensible contingency measures, as I urge them to do.

NHS Winter Pressures

Debate between Steve Brine and Steve Barclay

Monday 9th January 2023 Commons Chamber

[Steve Brine (Winchester) (Con)]

There is no doubt that, in some places more than others, patient flow in acute hospitals is the issue gumming up the system, and the Secretary of State is right to say that demand far outstrips supply, in part because of the very high flu numbers. Today’s injection of funding is very welcome as is the additional surge capacity the Secretary of State spoke about in his statement. His mention of prevention is especially welcomed by me; let us do so much more on this. Another £250 million is a lot of the public’s money. What real-time oversight does he have to ensure that NHS England spends it wisely, and may I make a plea that domiciliary care is not overlooked, because the lack of care in people’s homes is every bit as much the enemy of patient flow as the lack of care home places that he has identified today?

[Steve Barclay]

My hon. Friend raises an important issue about getting flow into the system, not least because delays in ambulance handovers lead to the highest risk in what is a whole-of-system issue where the patient is not seen and treatment is delayed. That is why flow through discharge is so important, because, while that often concerns the back door of the hospital, it is actually the pressure at the front door that is most acute. The Government recognised that in the autumn statement and that is why there was additional funding with the £500 million for delayed discharge. That has taken some time to ramp up, but we recognise that because of the flu there is an immediacy in the pressure on A&E that we need to address.

My hon. Friend’s point speaks to one of the key lessons from the covid period. It is not simply about releasing patients from hospitals who are fit to discharge; it is also about the wraparound services provided for those patients so that they do not get stuck in residential care for longer, and they are still able to go home and get the domiciliary care packages. NHS England is focused on that so that they have the wraparound services alongside that discharge.

Oral Answers to Questions

Debate between Steve Brine and Steve Barclay

Tuesday 1st November 2022 Commons Chamber

[Steve Barclay]

As a rural MP and having worked in Kendal earlier in my career, I know the geography to which the hon. Gentleman refers. That is why we are investing in more GP training, increasing the number from 2,671 in 2014 to 4,000, but it is also why we introduced the payment of £20,000, to encourage GPs into those areas that are hard to recruit in.

[Steve Brine (Winchester) (Con)]

The new Secretary of State—it is great to see him back—understands that there is a wealth of evidence that higher levels of continuity of care in general practice are good for patients and, indeed, for GPs themselves. I wonder if I could press him a little further. Is the new ministerial team open to limiting the list size of patients a GP has, as more GPs come online through the Government’s plans? Would he like to see personal lists reimplemented in the GP contract during his tenure?

[Steve Barclay]

Alongside the Government, no one wants to see better patient outcomes more than GPs themselves. By their training, they are evidence-led, so I look forward to discussing with the GP workforce how we can work together in a constructive spirit to deliver on whatever the evidence is showing. As I said, there is a body of evidence around continuity of care, but it is more weighted towards those with more complex needs, and not every patient prioritises that in terms of access to their GP.

Health and Social Care Levy Bill

Debate between Steve Brine and Steve Barclay

2nd reading
Tuesday 14th September 2021 Commons Chamber

[Steve Barclay]

It is not just that the first 40% will not pay anything, as my right hon. Friend the Chancellor mentioned. The next 40% will pay less than 1% of their wage bill, and indeed 70% of the employer contribution comes from just 1% of business. To some extent, the hon. Lady’s point was also picked up by the Monetary Policy Committee in its evidence to the Treasury Committee, when it said, “You should not ignore one half of the policy announcement.” Of course, one needs to look at the spending implications of the measures, not just—

[Steve Brine (Winchester) (Con)]

In my experience of being a Minister at the Department of Health—with my right hon. Friend, indeed—Treasury Ministers do not like to spend billions of pounds without knowing exactly what they are getting for their money, and rightly so: it is our constituents’ money. We know that there is a very carefully worked out plan that the Secretary of State for Health and Social Care has agreed with the NHS for the catch-up programme. Will the Minister help us to see that published, so that we as representatives can hold the NHS to account for the money that this levy is raising and our constituents are therefore spending?

[Steve Barclay]

I could probably go slightly further—Chief Secretaries do not like to spend, not necessarily just on any particular area of Government policy—but my hon. Friend is absolutely right about the importance of delivery and how the money is spent, particularly the £8 billion allocated to electives catch-up. Just yesterday I was at a meeting in No. 10 with the leadership of the NHS, discussing that issue with the chief executive of NHS England and other senior health leaders. I know that it is an issue of concern to a number of Members, but ultimately it is an issue of concern throughout the House, because through our constituency surgeries we see the consequence of the backlog in terms of electives. That is, I think, an area of common ground.

Self-employed Persons: Financial Support

Debate between Steve Brine and Steve Barclay

Tuesday 24th March 2020 Commons Chamber

[Steve Barclay]

I agree with the first part of that. The right hon. Gentleman is absolutely right about the vast majority of these people. I have made that point repeatedly. I referred earlier to the fact that the target population has different elements, but the vast majority of those who are self-employed face enormous challenges. We absolutely hear that, and I accept that. On his second point, we have taken a number of measures, but we recognise that more is needed. That is why my right hon. Friend the Chancellor is meeting leaders on this issue today to look at what further measures we can bring forward.

[Steve Brine (Winchester) (Con)]

May I say that I do understand that this is difficult? If it were easy, the Chancellor would have announced it last Friday with the rest of the package. The self-employed people I represent just want a sign; they just want some hope and an indication. I think they have had that today from the Chief Secretary and the Chancellor, but may I make a suggestion? For self-employed people and all other people right now, if they cannot get the same in, they have to send less out. The Government worked magic last week with the mortgage companies, which seem to be falling over themselves to offer mortgage holidays, but all the other fixed costs that our constituents face—utilities; insurance premiums; car finance; council tax bills, which landed on the doorstep last week; and even, for some, a business improvement district levy due next week—are still there. I wonder whether there is something the Minister can take back to the Treasury, perhaps with help from the shadow Chancellor, on those sorts of fixed costs, because they are dragging people down at a time when they have a lot less coming in.

[Steve Barclay]

My hon. Friend is right that there is a range of costs. As I say, we are looking as part of our support at what action can be taken. He can see, as an illustration of that, the action that has been taken on mortgages and in support of renters—both for mortgage holders directly and in terms of the buy-to-let market. Measures have been taken, but we stand ready to look at further measures.