Interim NHS People Plan

Steve Double Excerpts

Wednesday 5th June 2019 Commons Chamber

[Stephen Hammond]

The good news is that I think the hon. Lady was agreeing with my right hon. Friend the Secretary of State, who set that out yesterday. I welcome the fact that she supports him.

[Steve Double (St Austell and Newquay) (Con)]

The fishing village of Mevagissey risks losing its GP surgery because the last remaining doctor there has handed the contract back to the NHS. The people of Mevagissey have launched an incredible campaign to find a new GP for their village. Does the Minister support their campaign, and will he spread the message far and wide that there is an amazing community waiting for a new GP and that all expressions of interest are welcome? Can he reassure me that the new people plan contains measures not only to recruit more doctors but to ensure that rural and coastal communities can find the GPs they desperately need?

[Stephen Hammond]

My hon. Friend is right, and I am happy to support the campaign by the people of Mevagissey, which is a wonderful part of the country to live in. I am happy, too, to assist him in that campaign if he wishes to come and speak to me about it. He is right that the plan sets out ways to recruit and retain more doctors, including GPs in rural and coastal locations, as well as those in urban locations.

Oral Answers to Questions

Steve Double Excerpts

Tuesday 7th May 2019 Commons Chamber

[Jackie Doyle-Price]

The hon. Lady is right to highlight this. Good care depends not only on money but on performance, and we expect the Care Quality Commission to be very challenging in inspections so that we can guarantee consistency in the quality of services, rather than experiencing the postcode lottery she mentions. I am disappointed that the CQC rated Sheffield Health and Social Care NHS Foundation Trust as requiring improvement following the inspection in May and June last year, but we expect that challenge to continue so that there are obvious improvements.

[Steve Double (St Austell and Newquay) (Con)]

The additional money for mental health in the NHS long-term plan is very welcome, but does the Minister share my concern that it is essential that that money reaches the frontline and results in improved services and improved access to services? What steps is she taking to ensure this money does result in improved services?

[Jackie Doyle-Price]

My hon. Friend will know that, in addition to the additional £2.3 billion, we are clear that this money will lead to more rapid treatment. NHS England will also be giving a really direct challenge to clinical commissioning groups and trusts to make sure improved services are delivered on the frontline.

Oral Answers to Questions

Steve Double Excerpts

Tuesday 23rd October 2018 Commons Chamber

[Stephen Barclay]

Again, the hon. Lady draws attention to my work on driving productivity improvements within the system, which looks at a range of efficiencies such as sending texts and emails, dealing with missed appointments and the use of green energy. We can implement a whole range of initiatives as a part of that agenda.

[Steve Double (St Austell and Newquay) (Con)]

As the first port of call for patients with often minor ailments, community pharmacists can really help to improve the efficiency of the NHS by taking pressure off GPs. What plans do the Government have to support and enhance the role of community pharmacists?

[Stephen Barclay]

My hon. Friend is right to draw attention to the valuable role played by pharmacies. This is part of a wider education campaign within the NHS and increased access to clinicians, such as through 111, is another component of that. We want to ensure that rather than people’s first port of call being a GP, they access the NHS and pharmacies at the appropriate time.

Oral Answers to Questions

Steve Double Excerpts

Tuesday 20th March 2018 Commons Chamber

[Royston Smith (Southampton, Itchen) (Con)]

14. What steps he is taking to increase the capacity and availability of GP services.

[Steve Double (St Austell and Newquay) (Con)]

16. What steps he is taking to increase the capacity and availability of GP services.

[Craig Tracey (North Warwickshire) (Con)]

21. What steps he is taking to increase the capacity and availability of GP services.

--- Later in debate ---

[Steve Brine]

The Secretary of State has already outlined the plans for the new medical schools and the record 3,157 GP training places that were filled. I am aware of the practice that my hon. Friend mentions, and that is why we are working with the profession on a range of measures to boost recruitment into general practice. The existing professionals also have a role to pay, and the superb chair of the Royal College of General Practitioners, Helen Stokes-Lampard, is really leading from the front in that respect.

[Steve Double]

Does the Minister agree that part of the way to address some of the pressures that GPs face is to enhance the role of community pharmacies? Will he update the House on what steps he has taken to support pharmacies and further integrate them with general practice?

[Steve Brine]

We know that there are benefits to be had from the better integration of community pharmacies with sustainability and transformation partnerships. Through the pharmacy integration fund, we are integrating pharmacists into primary care. I hear good reports about how that is going and we will have 2,000 of them in general practice by 2020. Community pharmacies themselves should also be integrated, through STPs, because it is one NHS.

Mental Health Services: Children and Young People

Steve Double Excerpts

Thursday 8th March 2018 Commons Chamber

[Steve Brine]

As a former student union president, I think that is a very good point. One key proposal in the Green Paper is about the new mental health support teams, which will be very important in that. The hon. Lady is right to say that they should work across higher education as well as the earlier forms of education.

[Steve Double (St Austell and Newquay) (Con)]

In the next few weeks, work will begin on the construction of a new mental health residential unit for young people in Cornwall, which is long overdue and much anticipated. It is a clear sign that this Government are investing in young people’s mental health. However, we continue to have a problem with our clinical commissioning group in delivering frontline services, even though the Government are providing more money, so what steps will the Minister take to ensure that CCGs allocate the money provided to those services?

[Steve Brine]

I do not know the specific example that my hon. Friend raises, but he may wish to take it up with the Under-Secretary of State for Health, my hon. Friend the Member for Thurrock. I did say that there was a 20% increase in clinical commissioning spend for children and young people’s mental health between 2015-16 and 2016-17. We have all been frustrated about spend reaching the frontline, and we have made it very clear that we expect it to do so. I am pleased to see progress in the right trajectory.

Cancer Treatment: Patient Travel Times

Steve Double Excerpts

Wednesday 10th January 2018 Westminster Hall

[Tim Farron]

I am very happy to acknowledge the work of local charities in my area. The Rosemere Cancer Foundation and South Lakes CancerCare do immensely good work, just like the charities in the hon. Gentleman’s constituency.

For some people living in the remotest areas of my part of the world—in south Cumbria—who are eligible for hospital-provided pick-ups, a round trip to access treatment in Preston, including waiting times, could easily surpass six hours. That is on a good day, when all standards are being met.

[Steve Double (St Austell and Newquay) (Con)]

I congratulate the hon. Gentleman on securing a debate on this very important matter. The area of Cornwall that I represent has similar issues to those in Cumbria, and NHS England is consulting on closing our only treatment centre for radiography in Truro. That would mean people from the far west of Cornwall having to travel all the way to Plymouth for treatment. At the height of summer, when the roads are busy, that could easily be a five or six-hour round trip. Does he agree that that is far too long to expect patients to have to travel to receive this essential treatment?

[Tim Farron]

Yes, I fully agree. That is why the NHS England consultation is the right time to set criteria. If we all say, “We’d rather like it if these issues are addressed,” nothing will happen, but if they are set as firm criteria and priorities as a consequence of the consultation, something should happen. The hon. Gentleman was right to raise that point.

Requiring NHS trusts to make it a priority for investment to ensure that radiotherapy is available more locally—such as by bringing a satellite unit to our local hospital in Kendal—would significantly improve outcomes for patients. That has been the focus of our long-running community campaign. I want to say a massive thank you to the many thousands of people who have been involved in that campaign so far. Just before Christmas, on behalf of our community, I presented a private Member’s Bill that would specify 45 minutes as the maximum time that patients have to travel to access radiotherapy treatment. I urge the Minister to support that Bill and ensure that the Government accept it.

I was asked on the radio this morning why, after nine years of fighting this campaign, I had not just accepted defeat and walked away. The answer is that every week in Westmorland, more families learn that they must fight cancer, and we have no right to turn our backs on them. Sadly, the challenge of cancer renews itself week after week, and so our zeal in fighting for those families must also be renewed week after week.

Pharmacies and Integrated Healthcare: England

Steve Double Excerpts

Wednesday 11th January 2017 Westminster Hall

[Steve Double (St Austell and Newquay) (Con)]

It is a pleasure to serve under your chairmanship, Mr Bailey. I congratulate my hon. Friend the Member for St Albans (Mrs Main) on securing this debate on what I believe is a very important issue.

There is no doubt that our health service is currently under great pressure, as we have heard already. People are living longer and we are able to treat far more conditions than we could in the past, which adds to the demand on our health services. Although more money is always welcome, I am sure that many of us would agree that simply throwing more money at the health service is not the solution. We need to find better, smarter, more efficient and more effective ways of working to provide the healthcare that our growing population so desperately needs.

I have no doubt that pharmacies, particularly community pharmacies, can play an important role in finding better and smarter ways of providing healthcare to the people of this country. Community pharmacies continue to be an undervalued and underutilised section of our health service. As a country, we really need to embrace the role that community pharmacies can play in delivering health services. They have much more to offer than they are currently seen be to offering.

The Government have started to recognise that, with the current pilot scheme, started in 2015, to increase the presence of clinical pharmacists in general practice. That is clearly a step in the right direction, but I propose that we should also look the other way. We should not only look at integrating pharmacies into GPs’ surgeries; we should be looking to integrate GP services into our community pharmacies. It is quite clear that many of the routine services that people typically go to their local GP for could be provided by their local pharmacists in a much more cost-effective way.

[Oliver Colvile]

rose—

[Jake Berry (Rossendale and Darwen) (Con)]

rose—

[Steve Double]

I will give way to my hon. Friend the Member for Plymouth, Sutton and Devonport (Oliver Colvile) first.

[Oliver Colvile]

I thank my hon. Friend for giving way. He makes a very powerful point. I have thought for some while that we should be trying to put GP surgeries into pharmacies, so that when someone goes to their GP and says, “I have got this ailment and I need some help,” he can say, “Don’t come and talk to me; go and talk to the pharmacist, because he or she can manage the thing properly.” To my mind, that seems a very clever way in which we could take some of the pressure off the finances of GPs, as they would not necessarily have their own lease, but could get the likes of Boots or others to provide facilities.

[Steve Double]

I thank my hon. Friend for that intervention and I agree with him. Clearly, part of the answer is getting GPs and pharmacies working much more closely together, and co-locating can often be one way to help with that.

[Jake Berry]

My hon. Friend is making an excellent speech. Does he accept that the demand for prescribing pharmacies can be demonstrated by the recent proliferation of adverts we have seen on television for “pay to see your GP” services, which I was very surprised to see so many of on TV over Christmas? For £20, someone can pay to have a Skype consultation with a GP, who will then email or contact the local pharmacy to issue them with a prescription. An NHS that is free at the point of use should be absolutely fundamental to us in this country, but the fact that people are now paying to see GPs rather than waiting to see them shows that there is huge demand for people to have minor ailments prescribed for by a pharmacist.

[Steve Double]

I thank my hon. Friend for that intervention; he clearly watches far more TV than I do, because I was not aware of that. However, he makes the point well that there has been a huge increase in the demand being placed on our GP services, and people are therefore looking for other ways to meet that demand when it cannot be met in the usual ways.

I applaud and support the Government in their desire to create a truly seven-day-a-week health service. Part of the way to achieve that is by making far better use of our community pharmacies. Many are already open for longer hours than GP surgeries, typically on a Saturday, and my hon. Friend the Member for St Albans made the point that maybe some need to consider opening for longer still. That is something the Government could certainly help with. If we are to achieve a truly seven-day-a-week health service, we need to make more effective use of our pharmacy services.

[Margaret Greenwood]

The hon. Gentleman is making a strong case for the importance of community pharmacies. Pharmacies in my constituency of Wirral West that will be unable to receive money under the planning access scheme have written to me to say they are very concerned that they face closure. Does the hon. Gentleman agree that it would make sense for the Government to pull back from those cuts while they consider the whole issue of integrating services?

[Steve Double]

I thank the hon. Lady for that intervention, and in many ways I share her concerns. While I respect the desire of Department of Health’s to ensure that money is well spent and delivers value for money, there are cases of over-duplication, as we have already heard. Some changes need to be made to the funding models. I agree that we need to do all we can to protect our community pharmacies, particularly in more rural areas such as my constituency in Cornwall, where they play such a vital role for rural communities. I was pleased that the Department was able to do something to help—certainly many pharmacies in my area benefited from the changes to the funding—but I respect the fact that that may not have been the case in her constituency, and I will be urging the Minister to do all we can to ensure that these vital services in our rural areas are protected as much as possible.

With the right support, and indeed the right funding streams, our pharmacies could play a role that would take pressure off the parts of our health service that are clearly under severe pressure, in particular primary care and acute and urgent care. We are all aware of the pressure that our A&E departments are under at the moment. I believe that many times, when people go to A&E—perhaps because they cannot get to see their GP as quickly as they would like or feel they need to—they could actually get what they need from their local pharmacy.

Part of this is about increasing people’s awareness of what our pharmacies can offer. Part of the learning curve that I have been on since becoming an MP has involved going to see our local community pharmacies and getting a better understanding of exactly what services they provide, which I was not aware of before. More could be done to promote the role that pharmacies can play and the services that they can offer by making the public more aware of those services. That in itself would take pressure off our GPs.

[Mrs Main]

I did not make this point in my speech, but my hon. Friend is almost making it for me—it is that our pharmacists are hugely qualified, but too often they are the most under-utilised highly qualified local health professional. It is nonsense that their expertise is not being used routinely, challenged or made available, because people do not seek to use it and are not even necessarily aware that it is there for them to utilise.

[Steve Double]

I thank my hon. Friend for making that point, which I completely agree with. There is much more we could do to increase the general public’s awareness of exactly how highly qualified our pharmacies’ staff are and of the excellent services that pharmacies can provide.

My hon. Friend the Member for Plymouth, Sutton and Devonport talked about the need to integrate IT systems better, which I believe is part of the solution we seek. My understanding is that community pharmacies can access summary care records, but on a read-only basis. Many pharmacists I talk to say that if they had read-write access to that information, so that they could input data about treatments they have given to patients, that would be better. For example, if they could take a patient’s blood pressure and input that reading into the patient’s care record, that would save the patient time as they would not then have to go their GP to have the same reading taken and put into their record. I urge the Government to consider carefully whether read-write access could be granted to pharmacies, because I believe it would save a huge amount of time and reduce what I believe is often duplication of work within our health system.

An interesting fact that I discovered in my discussions on this subject is that the average time that someone waits when they go to see their pharmacist—that is, the time between entering the pharmacy and actually getting to see the pharmacist—is eight minutes. Many people in this country would be absolutely delighted if they could see a health professional within eight minutes of asking to see one. I am sure that many hon. Members here today have in-boxes full of people’s complaints about how long it takes them to see their GP. If people were aware that if they went to see their local pharmacist they would only have to wait eight minutes on average to see a very well qualified health professional who has a good chance of providing them with what they are looking for, I believe they would be delighted. That is another example of how we can promote the work of pharmacists, which would provide a far better service to the people of this country and take pressure off the other parts of our health system.

[Bill Esterson (Sefton Central) (Lab)]

I am grateful to the hon. Gentleman for giving way and I apologise, Mr Bailey, for missing the start of the debate.

The excellent pharmacies in my constituency do much of the fine work that the hon. Gentleman and other speakers have described, but it struck me as I was sitting here listening to him that he is making a very powerful case for investment in our pharmacies, rather than the cuts that the Government have proposed. Does he accept that point? Will he and his hon. Friends take this opportunity to call on the Health Secretary to think again about pharmacies and the important role they play and to see them as an investment, so that they can play their part, particularly in taking pressure off A&E?

[Steve Double]

Although I agree with some of what the hon. Gentleman says, I believe the funding model for pharmacies needs to be looked at because there is a great deal of duplication. The money spent could be better utilised, so the funding model needs to be reviewed. Some of the recent changes are a step in the right direction, but I will always make the case that, particularly in our rural communities, we need to be careful how those changes are applied so that our local pharmacies continue to be viable and able to provide the services that are needed.

[James Cartlidge]

My hon. Friend is making an excellent speech. I understand why Labour Members want to focus on the potential savings that once again the Government are having to make, but I point out that the two pharmacies that I visited in Clare and Hadleigh in my constituency accept the changes, provided they are balanced by their having a more positive role in the healthcare system and doing more for our communities. That is what they want.

[Steve Double]

I agree absolutely. This is not only about money; it is about reviewing the way we provide our healthcare services, embracing a greater role for our pharmacies, and understanding and promoting the role that they can play.

I want to pick up on the point about tourist areas made by my hon. Friend the Member for St Albans. I represent the constituency of St Austell and Newquay in mid-Cornwall, and tourism is the biggest part of our economy. Hundreds of thousands of tourists come every year, which puts a great deal of pressure on our A&E and local GPs, because if people fall ill on holiday, they try to get to see a GP.

I commend the work of one of my local pharmacists, Nick Kaye, in Newquay. The Secretary of State visited a couple of years ago and saw the excellent work that he does working closely with the local GP surgery to provide a frontline service particularly for tourists. By doing so, he takes pressure off the other parts of the health service. We could see more of that if we supported pharmacists and promoted the excellent work that they can do.

We have already touched on my final point. We cannot have a one-size-fits-all approach. The services provided in urban metropolitan areas are very different from those provided in more rural parts of the country. As we have heard, there might be multiple pharmacies in a town, all falling over one another to compete for business—so different from the many rural villages that have one local pharmacy, which is struggling to make ends meet and to provide an ongoing service to the community. Another fact I have learnt is that there is an oversupply of qualified pharmacists in many areas, whereas in Cornwall we have a shortage. We cannot get enough into Cornwall to meet demand, so we cannot have a one-size-fits-all solution. I encourage the Minister to look carefully at the specific needs of different parts of the country, particularly with regard to pharmacies, to make sure that funding streams meet need and that we can sustain the vital role that community pharmacies play in our rural towns and villages.

I am pleased to have been able to contribute to this important debate. As we continue down the path of integrating pharmacies into the health service, we must value and promote the role they play and make sure they are able to provide a service. They are part of the solution that we need to make sure our health service is fit for purpose.

[Mr Adrian Bailey (in the Chair)]

I intend to bring the Front-Bench spokesperson in at 10.30.

Social Care Funding

Steve Double Excerpts

Monday 12th December 2016 Commons Chamber

[David Mowat]

The right hon. Lady would be right that I had missed the point, had I not said that that issue is addressed by how we distribute the additional better care funding, which uses a formula that takes into account relative need.

[Steve Double (St Austell and Newquay) (Con)]

The Minister will know that following recent events I have taken a particular interest in this issue. Does he agree that saying that it is just about money is too simplistic, and we see a wide variety of the quality of care from homes with the same funding packages? Does he also agree that we need to improve the inspection regime to ensure that concerns are taken seriously?

Community Pharmacies

Steve Double Excerpts

Wednesday 2nd November 2016 Commons Chamber

[Oliver Dowden (Hertsmere) (Con)]

As we have already heard in the debate, many of us have seen the considerable value that local community pharmacies provide in our constituencies. I have seen that myself with the Manor pharmacy in Elstree, which is run by Graham Philips, to whom my right hon. Friend the Member for North East Bedfordshire (Alistair Burt) paid tribute. I would urge the Minister to meet him; he really is a pool of expertise on this issue. The same is true of those at the Crown pharmacy at Borehamwood and Shenley.

What we see time and time again in these places is that the commitment to the customers goes way beyond what we would see from a normal retailer. There is a genuine understanding of the needs, health and wellbeing of the people who use such pharmacies. The services range from dementia-friendly services, picking up the early stages of the disease; healthy living advice, including assistance with drugs and weight management; and smoking cessation services.

[Steve Double (St Austell and Newquay) (Con)]

Would my hon. Friend add to his list Nick Kaye in my constituency? He is carrying out some excellent work to collaborate with local GPs and to find innovative ways to deal with patients. Does my hon. Friend agree that pharmacies are particularly important in tourist areas, as the frontline that can deal with tourists who have health problems, and take pressure off the other health services?

[Oliver Dowden]

My hon. Friend is absolutely right that pharmacies play a crucial role in relieving the frontline of NHS services. However, that does not mean that reforms are not necessary. Of course we need to incentivise the kind of advantageous behaviour we have talked about; but we also need to recognise some of the problems with the provision of pharmaceutical services.

We know the basic problem; it has been referred to by other Members. The pharmacy budget has increased by 40% over the last decade. Even taking into account all the changes that the Government are proposing, funding for community pharmacies will still be 30% higher than when this Government first came to office in 2010. Equally, we have the problem of excessive clustering—a situation where there are many pharmacies within a short distance of one another.

Those who argue that there is no need for reform really need to explain where the money will come from. If we are not recycling these services to the frontline, we need to look for other savings, or we need to look at lower levels of service in the frontline of the NHS, whether that is services for diabetes or for cancer. There is no magic money tree. We have to take these difficult decisions in order to provide for the frontline, so I completely agree with the overall thrust of Government policy.

We can take an intelligent approach towards this issue. As we have heard, there is a big difference between various types of pharmacies. At one end of the scale, there are the very large pharmacies that are often in large retail outlets such as supermarkets and sit at the very back of the store. They are there, in essence, to encourage customers to go through the rest of the store to purchase other goods. They could easily take a larger cut than is being proposed, because they are just operating as loss leaders for those stores to get customers in the door in the first place.

Brain Tumours

Steve Double Excerpts

Monday 18th April 2016 Westminster Hall

[Steve Double (St Austell and Newquay) (Con)]

It is a pleasure to serve under your chairmanship, Ms Buck. I am a member of the Petitions Committee, which hosted this debate, and I pay tribute to our Chairman, the hon. Member for Warrington North (Helen Jones), for her opening speech, in which she laid out clearly and comprehensively the argument that we need to make today. The subject of this debate is close to many people’s hearts. We have heard many tragic stories of people who have suffered from this terrible disease, but also the stories of hope of people who received treatment and survived. It is absolutely right that we are holding this vital debate.

As many hon. Members said, brain tumours are the biggest cancer killer of children and adults under 40. It is the most costly form of cancer in terms of years lost. It is therefore legitimate for us to ask why research into brain tumours has been so underfunded for so long. Patients and families up and down the country understandably feel let down by the lack of action of successive Governments. During the Committee’s research into this issue, I was particularly saddened to learn that the survival rates for brain tumours have improved little in the past 30 years. Surely we as a nation should not and cannot accept that. It is time to take action for change.

It was highlighted to us that the funding of brain tumour research is inadequate and has not been sufficiently prioritised. As many hon. Members have said, of the total amount of money spent on cancer research, about 1.5% is spent on research into brain tumours. I join those who call for the number of years lost to be a major factor in allocating funds for research.

Like many hon. Members, I have been contacted by constituents who told me their stories. I want to highlight the story of a family who do not want to be named. They battled to get to the bottom of why my constituent was feeling so poorly. His GPs maintained that he was suffering from depression. In desperation, they eventually paid for a private MRI scan, which revealed a brain tumour. Having already faced major battles to get the diagnosis, the family quickly learned that there was a lack of money for support and treatment for that devastating illness. Tragically, they do not doubt that if they had not had the money to pay for the scan privately, my constituent would not be here today. That is not acceptable. I wholeheartedly support their calls for better awareness among GPs and fairer funding for brain tumour research.

The Petitions Committee report sets out some clear recommendations to the Government, and I urge the Minister to consider them carefully. We can provide better leadership to raise awareness of brain tumours among GPs and other health professionals. We can strive for earlier diagnosis. I ask the Government a question that many hon. Members have asked: is the current level of funding adequate? If not, what can the Government do about it? It is too late to save those who have already tragically lost their lives to this disease, but it is not too late for us to take action to save lives in the future.