Adult Social Care Funding

Tom Pursglove Excerpts

Thursday 6th July 2017 Commons Chamber

[Paula Sherriff (Dewsbury) (Lab)]

rose—

[Tom Pursglove (Corby) (Con)]

rose—

[Mr Speaker]

I call Paula Sherriff.

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[Mr Speaker]

There is somebody after the hon. Lady and so she need not develop a complex about the matter. Somebody has to be last, and on this occasion, nevertheless with a cheery disposition, it is Mr Tom Pursglove.

[Tom Pursglove]

Thank you, Mr Speaker. Some local authority areas are undoubtedly better than others at joining up social care departments with the NHS. Does my hon. Friend therefore agree that we need to see a greater focus on sharing best practice where it exists?

[Steve Brine]

Yes, I agree with my cheery hon. Friend, and this is a good place to finish. There is so much good practice in the sector, and the report highlights that today. We should celebrate that, as we do, and learn from it, as we will, while ruthlessly picking out those areas that need support in order to improve the care they are giving.

Kettering General Hospital

Tom Pursglove Excerpts

Thursday 29th June 2017 Commons Chamber

[Tom Pursglove (Corby) (Con)]

Will my hon. Friend give way?

[Mr Peter Bone (Wellingborough) (Con)]

Will my hon. Friend give way?

[Mr Hollobone]

Well, it is very difficult for me to choose, but since our younger and fitter colleague was faster on his feet I am going to give way first to my hon. Friend the Member for Corby (Tom Pursglove).

[Tom Pursglove]

I am very grateful to my hon. Friend for giving way. I entirely share his sentiment about the importance of developing a new urgent care hub at Kettering. Would he be keen to visit the Corby urgent care centre with me and, I hope, my hon. Friend the Member for Wellingborough (Mr Bone)? Given that this is a first-class facility, clear lessons could be learned and taken forward when we move towards trying to develop the new urgent care hub. It is a class-leading facility that is hugely popular with local people. I would love him to come and visit it with me.

[Mr Hollobone]

I am very grateful for that most kind invitation. I have visited the urgent care centre and I would be happy to do so again. I offer my hon. Friend my 100% support as he advances the importance of the urgent care centre with local funding bodies. He knows that he can always rely on me to support him in his endeavours. I am happy to give way to my hon. Friend the Member for Wellingborough (Mr Bone).

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[The Minister of State, Department of Health (Mr Philip Dunne)]

Let me start by congratulating you, Madam Deputy Speaker, on the resumption of your rightful place in the Chamber. It is a delight to serve under you in what I think is the first Adjournment debate that you have chaired in the new Parliament. I am delighted that you are looking after our proceedings this evening.

Let me also join in the congratulations of all who have spoken in the debate—apart from his usual modest self—to my hon. Friend the Member for Kettering (Mr Hollobone), who has been so gracious in encouraging me to take a personal interest in the hospital in his constituency. He was forthright in inviting me to join him last year when we previously debated the hospital, and I was pleased to be able to take up his invitation. Invitations have been flowing around the Chamber once more this evening from his neighbours, who show a consistent and collegiate approach to managing health issues in their constituencies and Northamptonshire in general.

When I visited Kettering in April, I was delighted to see my hon. Friends the Members for Corby (Tom Pursglove) and for Wellingborough (Mr Bone) taking such a close interest in the primary acute facility serving their constituents. I feel that the area is well represented by its Members of Parliament, who take such an active interest in health.

One thing that disappointed me about the speech made by my hon. Friend the Member for Kettering was the fact that his detailed grasp of the issues confronting the hospital was almost as good as that of the officials who helped me to prepare my speech. I therefore may not tell him too much that he does not know already, but it is a tribute to his perspicacity that he has such a good grip.

My hon. Friend raised a number of detailed issues relating to Kettering general hospital, and I shall try to address as many of them as possible in the time that is available to me. He concluded his remarks by making it clear that his No. 1 priority was to see progress on securing funds for the development of an urgent care hub at the hospital. I am pleased to join him in welcoming the progress that has been made since our debate last October. In particular, the foundation trust has secured funds from the Department of Health, with agreement from NHS Improvement, to enable the production of an outline business case, which, in the NHS approval system, is a necessary precursor of any significant capital investment.

A mobilisation meeting was held only last week to discuss the preparation of the outline business case, which is a welcome development. The initial draft of the outline business case is expected to be shared with NHS Improvement in August. The current intention is for the trust board to approval a final outline business case by the end of the year, provided it is satisfied with the progress that has been made, before a formal submission is made to NHS Improvement. I hope that that gives my hon. Friend some idea of the pace of the process. I am talking about a period of months, but I am afraid that that is the nature of the world we are in. It must be ensured that all appropriate internal procedures are followed correctly in order to give the proposition the best prospect of success.

The business case is intended to create a long-term solution for the hospital: a 10 to 15-year proposition that will take into account the significant increase in house building envisaged in the local plans, and the accompanying population growth to which my hon. Friend referred. In the meantime, the trust has put in place as a temporary facility a modular unit—a Portakabin —which we visited a couple of months ago. The outline business case will include plans to replace it with a permanent structure in due course.

More immediately, I am delighted to join my hon. Friend in welcoming the solution to the current challenge, which was very evident to me when I visited, that faces staff and patients trying to gain access to the hospital. The challenge of finding somewhere to park for anyone arriving by car was such that I had to be plucked out of the queue waiting to get into the car park by the chief executive herself, who had come to find me. Otherwise I might have spent my entire allotted time for the visit trying to get into the car park. The good news, as my hon. Friend has identified, is that work begins next week on the construction of the second level of the car park. The additional tier will provide an extra 240 spaces. I am told that the work will be completed by mid-November, which sounds like pretty pacey progress. This will cost some £1.3 million over five years, and the funding has been found by the trust from its own resources, which is very welcome.

My hon. Friend made reference to various pressures affecting the hospital. NHS England is working closely with the two local clinical commissioning groups to ensure that local care homes, general practices and the ambulance service are supported to care for patients outside the hospital, when that is appropriate. That is designed to help to reduce pressure on the hospital, and it was referred to in the interventions from my hon. Friends the Members for Corby and for Wellingborough.

In the longer term, the draft Northamptonshire sustainability and transformation plan, which was published last December, proposes an early focus on improving the urgent care system to reduce the pressures on A&E. Part of that will include introducing more front-door clinical streaming at Kettering general, with plans to put in place a seven-day discharge capability to help patient flow through the hospital. However, I have heard the comments in this debate about the quality of the STP, particularly from my hon. Friend the Member for Wellingborough. The STPs are being assessed by the Department of Health, and we will be making some comments before the summer recess on their relative attributes. We will see where Northamptonshire comes out in the context of the others.

[Tom Pursglove]

As part of that work in the Department, will the Minister take away from this debate the significance of the Corby urgent care centre to our local health economy, particularly in the context of how it relieves the pressure on Kettering A&E? Will he also acknowledge that there are significant healthcare needs in the Corby community that that facility helps to address?

[Mr Dunne]

I was not going to allow my hon. Friend the Member for Corby to leave without passing comment on the Corby urgent care centre, so I shall do that now, as he raised the matter so specifically. As we have heard, the STP does not perhaps place as much emphasis on what is to happen outside the acute hospital setting as hon. Members would like, and I shall take that away.

One of the issues that we need to address is the urgent care centre in Corby. As I understand it, the current service expires at the end of September. A new contract will be let as a caretaker arrangement for the ensuing 12 months to ensure that the existing facility continues, thereby allowing time for the CCG to engage with the public about the future shape of urgent care services in Corby, which will help to inform the development of the STP plan for the long term. The intent is that public engagement will lead to a proposal for an enduring longer-term contract to be procured in the next calendar year—during 2018—which will take into account the additional population around Corby. As we have already heard, the population is extensive around Kettering, but that is not unique to that part of north Northamptonshire. I am reassured by the CCG that the temporary arrangement will continue to provide the highest standards of patient care and safety for Corby’s population. My hon. Friend should not be concerned; this is a short-term contract extension that is facilitating a much longer-term solution.

My hon. Friend the Member for Kettering referred to the better care fund and how services are being provided in the community beyond the acute setting. As he knows, the fund supports programmes not only at Kettering general, but at Northamptonshire general. The better care fund and what we are describing as the improved better care fund—a similar pot of funding for the current financial year—are being used to fund both non-elective admissions and discharge to support at Kettering general, which is aimed at relieving pressure on the hospital.

My hon. Friend mentioned the special measures regime, which was the immediate trigger for my visit in April, the time of the publication of the CQC report that rated the trust as inadequate. I was pleased that he welcomed the introduction of special measures, because they provide an opportunity for focus across the NHS on areas that have been rated as not performing as we would all like. The evidence thus far is that trusts that go into special measures get considerably more attention not only from NHS Improvement, but from right across the NHS and up to a ministerial level. Special measures have a significant impact on improving performance within a hospital. I see that as a positive step, and I was pleased that he welcomed it. NHS Improvement has agreed an initial package of support. It has allocated an improvement director who will be working with the trust from next month. NHSI is also setting up “buddy trust” arrangements with highly rated trusts.

Oral Answers to Questions

Tom Pursglove Excerpts

Tuesday 21st March 2017 Commons Chamber

[Mr Hunt]

I accept responsibility for everything that happens in the NHS, including the fact that, compared with 2010, we are seeing 2,500 more patients within four hours every single day. We are also seeing a big increase in demand, which is why there were particular measures in the Budget to make sure that we return to the 95% target, including £2 billion for social care, which is £2 billion more than the Labour party promised for social care at the election.

[Tom Pursglove (Corby) (Con)]

The urgent care centre at Corby has done much to relieve the pressures on Kettering A&E, and it is a class leader. Given the announcement of £100 million for new triaging projects, would the Secretary of State like to visit the Corby urgent care centre to see this beacon of best practice at first hand?

[Mr Hunt]

That is a very generous offer, and if I possibly can, I would love to take my hon. Friend up on it.

NHS Shared Business Services

Tom Pursglove Excerpts

Monday 27th February 2017 Commons Chamber

[Mr Hunt]

For the second time, it was £2.2 million.

[Tom Pursglove (Corby) (Con)]

Will the Secretary of State reassure the House that appropriate staffing resources have been made available throughout to deal with the backlogs, not just nationally but in the east midlands?

[Mr Hunt]

We have always been concerned to make sure that, because of the extra administrative work involved in going through more than 700,000 records, other patients using the NHS do not find that their care is delayed. We made extra resources available for GP practices so that they could do that without interrupting the ordinary work that they have to do for their patients.

Oral Answers to Questions

Tom Pursglove Excerpts

Tuesday 7th February 2017 Commons Chamber

[Mr Speaker]

Demand dramatically exceeds supply, as usual, but we will have one last question. I call Tom Pursglove.

[Tom Pursglove (Corby) (Con)]

Thank you, Mr Speaker. Corby and east Northamptonshire is taking thousands and thousands of new homes. What reassurance can Ministers give to my constituents that GP services will keep up with housing growth?

[Mr Hunt]

I can absolutely reassure my hon. Friend that we take that into account in all the funding we give for NHS primary care, but it depends on having a strong economy. That is something this Government will always do for the NHS.

NHS and Social Care Funding

Tom Pursglove Excerpts

Wednesday 11th January 2017 Commons Chamber

[Jonathan Ashworth]

If I may, I would like to make a bit of progress. I promise my hon. Friends, and indeed Conservative Members, that I will try to give way as much as possible, but I am very aware that many Members have put in to speak.

We are all becoming familiar—far too familiar perhaps—with the grim statistics: in December, 50 of the 152 English hospital trusts called for urgent action to cope with demand; the number of patients being turned away from A&E and sent to other hospitals is at a record high; A&E departments have turned patients away more than 140 times; and 15 hospitals ran out of beds in one day in December. Last night, the BBC revealed that leaked documents from NHS Improvement showed that there were more than 18,000 trolley waits of four hours or more; that almost a quarter of patients waited longer than four hours in A&E last week, with just one hospital—just one—hitting its target; and that since the start of December, hospitals have seen only 82.3% of patients who attended A&E within the four-hour target. We will return to the four-hour target in a few moments.

Ministers can try to deny what is going on, but they cannot deny these facts about what is happening this winter in the NHS on their watch. We know that what happens in the NHS in the winter is a signifier of a wider crisis, because across the piece bed occupancy levels now routinely exceed the recommended maximum level of 85%—often to levels higher than 95%. As I have said, the NHS is going through the largest financial squeeze in its history. Indeed, the former Secretary of State, Lord Lansley, said that five years of NHS austerity had been planned for, but having 10 years of it was never expected. We have seen £4.6 billion cut from social care budgets—

[Tom Pursglove (Corby) (Con)]

rose—

[Jonathan Ashworth]

I will give way in a moment. As the King’s Fund said, the reason there is a problem is quite simply because there is a

“mismatch between funding and activity”

affecting our hospitals. The response of Ministers, from the Prime Minister downwards, has been one of utter complacency. The Secretary of State told “Sky News” on Monday that things had only been

“falling over in a couple of places”.

When he came to the House on Monday to make his statement, he did not commit to extra emergency funding for social care and he did not promise that the financial settlements would be reassessed in the March Budget. It is worse than that, because while he was making his statement, his spin doctors were telling the Health Service Journal—this on the day when the winter crisis is leading the news and he is making a statement in the House—and letting it be known that there is “no prospect” of

“additional funding to support emergency care any time before the next election.”

So there is nothing for social care, nothing for emergency care, nothing to tackle understaffing and nothing to tackle underfunding—well thank you very much. What did we get as a response? We got a downgrade of the four-hour A&E target.

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[Jonathan Ashworth]

The hon. Lady refers to history; under this Government the NHS is going through the largest financial squeeze in its history. When we had a Labour Government, we more than doubled investment into the NHS.

[Tom Pursglove]

Will the hon. Gentleman give way?

[Jonathan Ashworth]

Because he is a Member from the east midlands, I shall give way to the hon. Gentleman from Corby.

[Tom Pursglove]

I agree with the shadow Secretary of State that we need to have an honest debate, so does he accept that he stood on a general election manifesto that would have seen Labour spend billions less on our national health service? Will he set out for the House exactly what NHS services he would be spending less on now?

[Jonathan Ashworth]

We stood on a manifesto that would have delivered more doctors and nurses for our NHS; the hon. Gentleman stood on a manifesto that said the Conservatives would cut the deficit and not the NHS. They are cutting the NHS and failing on the deficit.

I have a few direct questions for the Secretary of State about Royal Worcestershire hospital. I was grateful for his remarks on Monday, but I want to press him a little further. It has been reported that NHS England was warned of a bed crisis as early as 22 December. Will he update the House on what urgent meetings he is having on Royal Worcestershire? When will we be closer to knowing the outcome of an inquiry? In that context, there is a proposal in the sustainability and transformation plan for the Worcestershire area for a significant reduction in the number of acute beds. The Secretary of State will say that these are local plans and so on, but in the context of the issues in Worcestershire, will he comment on whether he thinks that is the right proposal to follow?

On STPs more generally, the NHS is going through a winter crisis, and it is about to go through another top-down reorganisation—[Interruption.] Someone says it is bottom-up, but it is not; we know it is coming from the top. Those making the STPs are being told that they have to fill a financial gap of £21.764 billion—that is the reality that STPs throughout the country now have to face. We have seen the plans, so we know that that is going to mean a number of community hospitals being closed, a number of A&Es being downgraded, and acute beds being lost.

In places such as Devon, where the STP talks of an over-reliance on hospital beds, the implication is that beds will be lost. Closures and downgrades are being considered throughout Somerset, with their priority list of vulnerable services including maternity and paediatrics. In London, a city with the very worst health inequalities, the STPs are expected to deliver better health outcomes for the city’s growing 10 million residents with £4.3 billion less to spend. Will the Secretary of State explain to the House how he expects the NHS to perform in future winters, when we have a growing elderly population and STPs are pursuing multibillion-pound cuts to beds, A&Es and wider services?

Oral Answers to Questions

Tom Pursglove Excerpts

Tuesday 20th December 2016 Commons Chamber

[Nicola Blackwood]

As I have already answered, we are a world leader on AMR. We have not only the bilateral fund with China but the £265 million Fleming fund, through which we will deliver bilateral national action plans with a number of developing nations. We are committed to going further than that through the global action plan with the UN.

[Tom Pursglove (Corby) (Con)]

A fortnight ago, I visited the pharmacy at the Corby urgent care centre to thank the dedicated staff for all that they do all year round, and to have a flu jab as part of the ongoing campaign. Does the Minister agree that exactly that sort of proactive working is crucial in trying to tackle winter pressures?

[David Mowat]

I do agree with my hon. Friend. I am particularly pleased that this year, the pharmacy network has done more flu jabs so far than in the entire period last year. I had my flu jab, and it is holding up well.

CQC: NHS Deaths Review

Tom Pursglove Excerpts

Tuesday 13th December 2016 Commons Chamber

[Mr Hunt]

In fairness to the hon. Gentleman, he makes two important points. I know that he worked very closely with James Titcombe, who is one of his constituents.

We are now learning the right way to deal with the tension between accountability and having a learning culture. Essentially, this boils down to an understanding that 98% of the time a mistake is made because of a systems problem—a structure or a framework that did not enable a doctor or a nurse to operate to the best of their ability—while 2%, 1% or perhaps even less of the time it is a case of genuine negligence by an individual that deserves full accountability. When we understand it in that way, we start to realise that the first thing to ask is what could be changed in the system, but if we uncover bad behaviour by individuals—there are 1.3 million people in the NHS, so it is obviously going to happen at some stage—then there of course needs to be full accountability.

On the tone of these exchanges, let me say something optimistic: I really do believe that the NHS can become the safest, highest-quality healthcare system in the world. That would be welcomed by the Labour party, as the party that was in power when the NHS was set up, and we would welcome it as part of our absolute commitment to higher standards in public services. There is no country in the world that is even considering what we have announced today, which is to ask hospitals to publish the number of their avoidable deaths on a quarterly basis. It is a very big step that can happen in a system built around public service.

[Tom Pursglove (Corby) (Con)]

Kevin, the son of my constituent Desmond Watts, suffered from very significant learning difficulties and was neglected in a care home in the county, which led to his tragic death. This was completely avoidable. Des has never seen justice for Kevin, but I know that he would want my right hon. Friend to consider whether it is possible to apply to social care some of the principles that he has set out today. I join the right hon. Member for Slough (Fiona Mactaggart) in encouraging him to do that.

[Mr Hunt]

My hon. Friend makes a really important point. I will have discussions with the Minister responsible for social care, the Under-Secretary of State for Health, my hon. Friend the Member for Warrington South (David Mowat), about what we can do in the social care field. I am optimistic that we can do something, because if we make this part of the framework of the new CQC inspection regime—obviously, that has to happen with the consent of the CQC—we can create a very strong incentive for adult social care providers to do what we want and to follow what is happening in the NHS.

Oral Answers to Questions

Tom Pursglove Excerpts

Tuesday 15th November 2016 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Nicola Blackwood)]

The hon. Lady is right that the current delivery of this contract by Capita is unacceptable. I have met NHS England and Capita regularly to make sure that rectification plans are in place. We are assured that these steps are now in place and that the programme will improve.

[Tom Pursglove (Corby) (Con)]

T4. Across north Northamptonshire there is an enormous appetite for the new urgent care hub to be built at the site of Kettering general hospital, relieving pressure on A&E and improving services for patients. Will the Minister update us on progress?

[The Minister of State, Department of Health (Mr Philip Dunne)]

As I said to my hon. Friend’s parliamentary neighbour, my hon. Friend the Member for Kettering (Mr Hollobone), we are aware that Kettering hospital has put forward a proposal. The outline business case is due to be discussed with NHS England in the coming weeks. In the meantime, we are looking at an interim solution for relieving pressure on A&E services in the area.

NHS Funding

Tom Pursglove Excerpts

Monday 31st October 2016 Commons Chamber

[Tom Pursglove (Corby) (Con)]

I am very proud of the Government’s funding record, but does my right hon. Friend agree that it is also crucial to make the right strategic decisions? For example, it was a Conservative-led Government with a Conservative Health Secretary who delivered the urgent care centre in Corby, which has transformed health opportunities in our area and taken pressure off our A&E.

[Mr Hunt]

My hon. Friend is absolutely right. Although I was not personally responsible for the decision in Corby, I am very happy to take credit for it.