(8 years ago)
Commons ChamberIn a previous answer, I made the point that every local authority should be engaging with its STP, and the NHS must ensure that that happens. That is not the same as saying that every local authority has a veto on the STP, which was the implication of the hon. Gentleman’s point.
The Government are giving councils access to a further £3.5 billion for social care by 2019, which will mean a real-terms increase over the lifetime of this Parliament. The causes of delayed transfers of care are complex and, frankly, vary considerably by local council.
The Care Quality Commission has commented that social care is on the verge of collapse. The Government have had six years of warnings in relation to this matter, yet they have cut £4 billion from the social care budget. Will the Secretary of State for Health be talking to his colleague the Chancellor of the Exchequer to ensure that the £4 billion is replaced in the autumn statement?
The system is under pressure but we also know that the best way to achieve the best results is faster integration, and not just money. I will give the hon. Gentleman an example. There is a massive disparity between councils. The best 10% of councils have 20 times fewer delayed transfers of care than the worst 10%. It is not just about money, as the budgets are not 20 times different. Indeed, many councils have been able to increase their budgets, including Middlesbrough.
(8 years ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
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That is absolutely the point. In Wales, people wait twice as long to have a hip replaced and the figure on A&E is about 10% lower than in England. The consequences for patients in Wales are horrific. That is why everyone watching today’s exchanges will take them with a big pinch of salt.
The Health Committee has been quite clear that of the actual £4.5 billion being spent by the Government on increased funds—not the £8 billion or the £10 billion mentioned by the Secretary of State— £3.5 billion comes from cuts to public health and to education and training. The Secretary of State can come to the Dispatch Box and twist it all he likes, but he has been found out. Every health sector worker in this country has his number and knows him to a tee—we know exactly what he is doing.
I just do not agree with the hon. Gentleman. I stand by the numbers. I am afraid that, on this occasion, the Health Committee got its numbers wrong. The figure of £10 billion did not come from the Government; it was a figure that the NHS said that it needed. In fact, it needed less than £10 billion and we are delivering more than was asked for—something that the Labour party was not prepared to do.
(8 years, 1 month ago)
Commons ChamberYes—modern, efficient and oriented towards excellent patient care.
My constituency lies within the South Tees clinical commissioning group’s area, which is one of the pilots for the roll-out of the minor ailments service. The scheme was brought in due to the closure of minor injuries units at Guisborough and East Cleveland and medical centres at Park End, Skelton and Hemlington —all in my constituency. We are now seeing a shortfall in national vanguard funding for the minor ailments service and lack of GP provision in the region. What on earth is going on with primary care?
I do not wholly understand the thrust of that question. I assume that the hon. Gentleman, like others in this House, is welcoming the fact that we are rolling out a national system on ailments, delivered by pharmacists. As the hon. Member for Central Ayrshire (Dr Whitford) said, that is the future.
(8 years, 9 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
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The hon. Gentleman should address that question to the Minister. The timing represents an unfortunate mismatch, for which pharmacists in England might pay the price. The timetable is of the Government’s making, not mine, so the Minister needs to reflect on that.
I want to talk about two facets of this debate that have been touched on by the hon. Members for St Ives and for Bexhill and Battle (Huw Merriman): the issue of rurality and the impact of the cuts. The consultation document stated:
“40% of pharmacies are in clusters of 3 or more meaning that two-fifths of pharmacies are within 10 minutes walk of 2 or more other pharmacies”.
I am sure that the hon. Gentleman is going to make an excellent point about rural pharmacies, but there is another element in my constituency, where I met my local pharmacist, Mike Maguire of Marton Pharmacy. Two of our minor injury units have closed and there is a proposal to close another walk-in centre, after the last one was closed. The collateral impact of the withdrawal of those services reduces the ability of the average patient and customer to access services. There is not only the rural aspect but the specific need at the time.
The hon. Gentleman is right. That has been the message of many contributions. The work of our community pharmacies complements the work of the national health service. When the hon. Gentleman’s constituency is hit in the way that it has been, that represents the proverbial nail in the coffin of decent community-based services for his constituents.
On the urban point, to reiterate the point made by the right hon. Member for Rother Valley (Kevin Barron), we are talking about well-established community businesses that impact on many people in the locality. Two or three businesses clustered in the same area doing a generally good job will have an impact on the local economy, but the rural point is fundamental. We have heard about the pressures on GPs and the difficulties in getting appointments. In my vast rural constituency of Ceredigion, we have a district general hospital in Aberystwyth: Bronglais hospital. We have a good many GPs throughout the county. We also have a network of very effective pharmacists, and it is a jigsaw that works in providing good services. There are 716 community pharmacies in Wales—in high streets, villages and towns—with 50,000 people visiting those facilities every single day, proving the efficiency of the much-maligned Welsh national health service and bridging the real difficulty that people have in visiting the closest hospital or a GP for something as routine as blood pressure or cholesterol checks. It is really important that the outcome of the debate is that we support community pharmacies. That is fundamental.
In Wales we have developed our services. I visited the pioneering pharmacy of Mr Richard Evans in the town of Llandysul 11 years ago. He was clearly of the view that we could develop services much more, to relieve pressure on the national health service, and he achieved that. In Wales pharmacies have offered NHS flu jabs for at-risk groups for the fourth winter running. Almost 20,000 people in Wales benefited from that last winter. After four years of that provision in Wales, the NHS in England introduced the same service for the first time. Community pharmacies in Wales can treat about 30% of the common ailments that people would normally go to a GP for. That is a huge saving for the national health service. Pharmacies also promote meaningful public health campaigns. I visited the pharmacy in Borth, where there is a campaign on Parkinson’s disease. The staff are doing a good job talking with victims of Parkinson’s disease about their medication, and promoting awareness in the community.
Finally, having praised what is being done in Wales, in a rural area, I want to seek an assurance from the Minister that if his consultation has an effect on the three levels of services in the framework, there will be meaningful consultation with Assembly Ministers in Cardiff, and that any negotiations on changes to the contract will involve Welsh Government officials at the negotiating table. This is one of the small areas where health is not devolved, and that is particularly relevant on the Welsh border; it requires the respect agenda, on anything that the Minister concludes.
(8 years, 10 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
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I have said before at this Dispatch Box that successive Governments of both parties have under-invested in general practice, and that is part of the reason why it takes too long for many people to get a GP appointment. It is why we have said that we want to have about 5,000 more doctors working in general practice by the end of this Parliament. That is an important part of what we want to do.
The other side is improving our offer to the public. When you have a child with a fever, and you are not sure, and it is the weekend, very often you have a choice between an out-of-hours GP appointment, a weekend appointment at your GP surgery, calling 111 or showing up at an A&E department. It is just confusing to know the right thing to do. If we are to improve standards of care, we need to standardise safety standards across the NHS, including for spotting potential sepsis cases, and that means a much simpler system.
My hon. Friend the Member for Lewisham East (Heidi Alexander), the shadow Secretary of State for Health, commented on the concerns expressed in the report about the quality and effectiveness of the tools at the disposal of call-handlers at the 111 service. How many other cases have been misdiagnosed by the 111 service?
We believe from the independent case note analysis that has been done across the NHS, not just for sepsis but for hospital deaths, that there are around 200 avoidable deaths every week. That is something we share with other health systems; it is not just an NHS phenomenon. It is why we are asking hospitals to publish their estimated avoidable death rates, and we are having an international summit on that next month.
We think there are about 12,000 avoidable deaths from sepsis every year, and that is as a result of a combination of different parts of the NHS—GP, hospital or the 111 system—not spotting the signs earlier. That is what we are determined to put right.
(9 years, 10 months ago)
Commons ChamberI asked the Prime Minister some weeks ago about the number of nurses in the NHS. In December, the number of NHS nurses in the system had been reduced by over 900 since May 2010, but we were told in November that it was up by about 2,500. The Government were using the figures, and the Prime Minister was answering questions, in terms of hours worked. As we know, nurses are working massive amounts of overtime on single-rate time. Nominal headcount nurses, at this moment in time, are minus over 900 compared with May 2010.
My hon. Friend makes his point very well. This is what we must challenge as we move forward. Before the general election, people need the facts about what is happening to the NHS. There has been a big drop in the number of nurses working in the community, as my hon. Friend mentioned, and these are the facts that we need to bring home to people.
It is not just the fact that the GP headcount has gone down. One of the present Government’s first acts was to scrap the guarantee of an appointment within 48 hours and incentives to open GP surgeries in the evenings and at weekends. That, combined with cuts to the GP budget, means that it has got harder and harder to get a GP appointment in recent years. The constituents of all the Members present say, “I am ringing the surgery at 8 or 9 every morning and being told that nothing is available for days.” In 2010, the vast majority—80%–of people said they could get an appointment within 48 hours; now, according to the GP survey, one in four people say they must wait a week or more to see a GP.
(9 years, 10 months ago)
Commons ChamberI congratulate my hon. Friend on his campaigning for Crawley hospital and pay tribute to staff at the hospital, which was rated “good” by the Care Quality Commission last year as part of the new inspection regime. He will welcome the fact that since 2010 the number of doctors at the hospital has increased by 97 and the number of nurses by 107. Of course, we will always consider ways to improve services for his constituents.
22. The Home Secretary talked about the £2 billion he has put aside for the NHS, some £1.5 billion of which is for clinical commissioning groups and specialised commissioning. Why are more than 50 CCGs in the south of England to receive a 3.6% increase in funding to the detriment of the north, where my own CCG is to receive only 0.24%, which is below inflation and a pittance compared with the south?
These things are decided independently by NHS England, which made the decision on the basis of which CCGs were most off their target allocation and on social deprivation and the number of older people. I remind the hon. Gentleman that there are many older and vulnerable people in the south, too, and they need a fair settlement from the NHS. That is why the decision was made.
(9 years, 10 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
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If the hon. Lady is making a criticism, I would ask her what she is going to do, because the shadow Chancellor confirmed this week that he will not find extra money for social care. I will tell her what we are doing. We are merging the social care and local NHS systems to try to stop people being pushed from pillar to post, and to give them the joined-up, compassionate, safe care that we think is an absolute priority. That is happening in Bolton—I have visited facilities in Bolton that are displaying excellent care—and we should support such efforts, not criticise them.
In January 2013, I raised with the Health Secretary the incident in which an 84-year-old lady had to wait 11 hours for an ambulance. This Christmas, a 101-year-old lady had to wait six hours for an ambulance, and an 89-year-old pensioner also had to wait 11 hours for an ambulance. When do individual incidents of failure become a pattern, and is the Health Secretary himself an individual incident of failure?
I take huge interest in individual examples of where things have gone wrong, and that has informed a lot of my approach to the job. Just like A and E departments, when ambulance services get calls, they have to triage them and deal with the highest-priority calls quickest. The calls they get can sometimes be dealt with after a period of hours, but other calls are much more urgent. The important thing for ambulance services is to know that we are backing them with more paramedics, more investment and more ambulances, and that is what we are doing.
(9 years, 11 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
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My hon. Friend is absolutely right to draw attention to that issue. One issue that has been debated often in this House is the money we waste in the NHS on locum staff, who are much more expensive than full-time staff. One of the ways we can deal with that is through something I announced in my response to the extra money in the autumn statement on our long-term plan for the NHS, which is to give multi-year commissioning contracts and multi-year tariffs to trusts, so that they can have a longer-term horizon. Too often the planning horizon is just for the next year. Indeed, I think there is a discussion to be had about whether this winter pressures money we put in every year to help could be better integrated in NHS core budgets, as a way of making sure we get the best use of that money.
North-East ambulance service is now the eighth out of 10 ambulance services to be moved to operational level 4 as a result of winter pressures—while temperatures are 12° C and above. In my area, the local hospital trust is £91 million in deficit and the Government have gone into a process of closing minor injuries units in Guisborough hospital and Brotton hospital and walk-in centres in Skelton and Park End. Does the Health Secretary believe any of those factors might be adding to winter pressures, or am I just scaremongering and being political?
If the hon. Gentleman looks at the facts, rather than being political, he will see that in his constituency there are more doctors and nurses and more front-line clinical staff than there were, and he will find that more people are getting operations and more people are being seen at A and E departments than when his party was in power. That is why, I am afraid, it is very political. I notice that on the day when the Labour party is saying that there is a big issue with winter pressures in the NHS, fewer than 10 Labour Back Benchers are present—fewer than 10; that is how seriously Labour is interested in this issue. Is it not really about the politics?
(9 years, 11 months ago)
Commons ChamberI think what the public find very perplexing about this is that the Labour party opposed reforms that mean we have 10,000 more doctors and nurses on the front line. Labour is now not welcoming additional financial investment in the NHS that means we will have even more doctors and nurses, and it does not recognise the fundamental point that affects the whole NHS, which is that, in employing those extra doctors and nurses, we have to back them with a culture of safety and compassionate care that we never saw under Labour.
Our NHS is indeed reliant on a strong economy, but we should note that the UK’s state deficit is the worst in the European Union at the moment and our state debt has more than doubled since May 2010. Can I take it from the Secretary of State that I can go back to the constituents of Middlesbrough South and East Cleveland and tell them that their acute hospital trust will have its £91 million deficit removed; that its PFI, which was opened up in the Major years, will be dealt with properly; that Hemlington, Park End and Skelton medical centres will stay open: and that minor injuries units in Guisborough and Brotton will remain open?
I warmly congratulate the hon. Gentleman on being the first Labour Member to say in this House that a strong NHS needs a strong economy. May I encourage him to transmit that message to those on his Front Bench, and perhaps to the shadow Chancellor, who might then understand why people in the NHS are backing this Government because they know that we will deliver a strong economy? I do not know whether we can do all the things the hon. Gentleman talked about, but we will have a better chance with the fastest-growing economy in the G7.