Government Offer to NHS Specialist, Associate Specialist and Specialty Doctors

Victoria Atkins Excerpts

Tuesday 19th December 2023 Written Statements

[The Secretary of State for Health and Social Care (Victoria Atkins)]

After seven weeks of constructive negotiations with the British Medical Association specialist, associate specialist and specialty doctors committee, I am pleased to inform the House that on 16 December, I made a formal reform-based offer that the BMA SAS committee has agreed to put to its members for a vote.

No strikes will be called by these doctors while the deal is being put to members.

SAS doctors are a vital part of the NHS. They focus predominantly on providing direct patient care by providing clinical expertise in their specialist area and taking responsibility for a full range of patients within their area of practice, making them essential to our efforts to cut waiting lists and deliver the highest quality service to patients.

In 2021, the Government agreed a multi-year deal with the BMA SAS committee. If accepted, this offer will: address the unintended imbalances in the pay scales for these doctors on the 2021 contract and pre-2021 contracts to ensure consistency and fairness across the workforce; speed up the delivery of some of the key objectives of the 2021 deal, such as the roll-out of the new specialist grade; and encourage more existing doctors to take up the new contracts, which offer modernised terms and conditions.

The offer includes plans to set up a £5 million funding pot to encourage and support NHS employers to create more permanent specialist roles where there is a need. This will fund a significant increase in the number of specialist doctors, improving patient care and access, and will create further opportunities for doctors to progress in their careers.

A joint piece of work will also be undertaken to consider how locally employed doctors—doctors who are employed on local terms and conditions as opposed to national—can be better supported to progress in their careers, including the development of a potential process whereby such doctors operating at specialty level for 24 months could be transferred to a specialty contract.

The Government have made further commitments on career development, including the promotion of job planning for all such doctors; the development of guidance to support the career development of SAS doctors; the development of guidance for employers to encourage, establish and embed specialist roles in their organisation; and a research project to understand why specialist roles are not being created.

Both the Government and the BMA SAS committee engaged constructively and in good faith to identify fixes and reforms that address important concerns for SAS doctors. This offer is independent of the headline pay uplift that SAS doctors have already been awarded in 2023-24 through the Government’s acceptance of the independent pay review body’s recommendations.

The BMA SAS committee will now make arrangements to put this offer to a vote of its members in the coming weeks. I encourage them to accept this offer, and I will update the House in due course.

[HCWS162]

Oral Answers to Questions

Victoria Atkins Excerpts

Tuesday 5th December 2023 Commons Chamber

[Layla Moran (Oxford West and Abingdon) (LD)]

16. What recent assessment she has made of the potential impact of levels of availability of dentistry appointments on other NHS services.

[The Secretary of State for Health and Social Care (Victoria Atkins)]

May I, through you, Madam Deputy Speaker, wish Mr Speaker a very speedy recovery?

As Secretary of State for Health and Social Care, I want to reform our NHS and social care system to make it faster, simpler and fairer. Dentistry is a critical part of that. Integrated care boards are responsible for identifying areas of local need and determining the priorities for investment. NHS England published guidance in October this year to help ICBs use their commissioning flexibilities within the national dental contractual framework, and I will be looking carefully at how the boards are identifying need and investment across England, including for vulnerable people.

[Kim Johnson]

I am glad that the Minister mentioned ICBs. Liverpool has a very high percentage of children with dental decay, and tooth extraction is the most common hospital procedure for five to nine-year-olds at Alder Hey Children’s Hospital, yet there was a £10 million underspend for primary care dentistry, and instead of investing it in preventive care, NHS England gave permission to all ICBs, including NHS Cheshire and Merseyside, to use the balance to balance their budgets. Will the Minister agree, here and now, to reinstate the ringfenced funding to commission extra capacity for the most vulnerable patients?

[Victoria Atkins]

I am delighted to be able to inform the hon. Member that NHS England has provided guidance for ICBs that requires dental funding to be ringfenced, with any unused resources redirected to improve NHS dental access in the first instance. Interestingly, ICBs will report their expenditure against the dental ringfence to NHS England as part of their in-year financial planning, which will happen at the end of this financial year.

[Kim Johnson]

But the underspend is not being used on dentistry—

[Steve Brine (Winchester) (Con)]

The Government previously committed to publishing a dental recovery plan, which the former dental Minister, my hon. Friend the Member for Harborough (Neil O’Brien), said that the Government would publish shortly. He also told my Committee:

“We do want everyone who needs one to be able to access an NHS dentist”.

We were surprised, but he said it. We were told that the plan would be published during the summer or before the summer recess. When will the plan be published, if that is still the intention? Presumably it will come alongside the response to our “Dental Services” report, which was due on 14 September.

[Victoria Atkins]

I thank my hon. Friend and I look forward to being grilled by him and his Committee in due course—at least, I think I do. Perhaps I can assist him, first, on the very important dental report that his Committee published. I am looking through it myself this afternoon and I will be publishing the response and sending it to the Committee imminently. In relation to the dental plan, both the Under-Secretary of State for Health and Social Care, my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom), and I are looking carefully into the needs of communities in rural and coastal areas, as well as in more urban areas, to understand not just the need but the answers that we can provide to help with urgent care and, importantly, preventive care, particularly for our children and vulnerable people in our society.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

Last week another dentist in my constituency told my constituents that they were no longer able to provide NHS services. These people have literally nowhere else to go nearby. I want to come back to what my hon. Friend the Member for Liverpool, Riverside (Kim Johnson) asked about the underspend, because we had a meeting with the ICB and it was specifically told that the ringfence was being disapplied. Does the Secretary of State agree that that money should be spent on dental services and that that instruction should be given by her today?

[Victoria Atkins]

I agree, and that is why NHS England has provided guidance, as I set out earlier.

[Derek Thomas (St Ives) (Con)]

I welcome the guidance that ICBs have received. Cornwall ICB has committed to ringfencing money for dentistry next year, but the truth is that, before it took on that commitment, £4.5 million for unmet units of dental activity was returned to NHS England. What can the Secretary of State do to ensure that Cornwall gets the money that was intended for Cornwall to deliver NHS dentistry?

[Victoria Atkins]

A theme is emerging of underspend in dental work, which is one of the things that the ministerial team and I are looking at. NHS England emphasised in its guidance to ICBs that the funding should be ringfenced. I very much understand the pressures that my hon. Friend and other south-west Members have been raising over many months on the care that their constituents are getting. To ease pressures in the south-west, NHS England has commissioned additional urgent dental care appointments that people can access through NHS 111.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I call the shadow Minister.

[Abena Oppong-Asare (Erith and Thamesmead) (Lab)]

I begin by welcoming the Secretary of State and her Ministers to their posts.

Last year, the Prime Minister pledged to restore NHS dentistry, including a specific promise to protect its budget, yet last month we learned that he will break that promise and allow ICBs to raid dentistry budgets to fill the gaps. Labour has a plan for 700,000 extra appointments, supervised toothbrushing in schools and a targeted dentistry recruitment scheme in left-behind areas. It is all fully funded by abolishing non-dom tax status. We have a plan, but the Government’s plan is four months overdue. Where is it?

[Victoria Atkins]

I thank the hon. Lady for her warm welcome. I look forward to discussing these matters with her over the Dispatch Box.

Over the weekend, I was rather pleased to see the Leader of the Opposition’s damascene conversion to the Conservative cause. As the shadow Secretary of State is on his world tour investigating what other health systems are doing, the Labour party may wish to bear in mind the words of wisdom from the great lady herself: “The problem with socialism is that at some point you run out of other people’s money.”

[Michael Fabricant (Lichfield) (Con)]

2. What recent steps she has taken to help prepare for a future pandemic.

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[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

9. What steps she is taking to help reduce health inequalities.

[The Secretary of State for Health and Social Care (Victoria Atkins)]

I am pleased to reiterate to my right hon. Friend the Member for Witham (Priti Patel) that Essex is receiving funding from the National Institute for Health and Care Research, which is funded by the Department of Health and Social Care, to promote research into health inequalities and support better health outcomes for her constituents and all residents in Essex.

[Priti Patel]

I thank the Secretary of State for her response and welcome her to her new role; it is a real pleasure to see her in her position today. My Witham constituents have one of the highest patient-GP ratios in the country. That brings many challenges in accessing the NHS, from primary care to dentistry, social care and hospital appointments, some of which have been exacerbated by industrial action. Will she give an update on the work she is leading to address some of those issues and will she support my work and campaign locally to get a new primary health centre in Witham town?

[Victoria Atkins]

I thank my right hon. Friend very much for her kind words. She will remember how much I enjoyed sitting on the Front Bench alongside her when we were in the Home Office. In terms of her work in Essex, she is a formidable campaigner and she will know that the decision on such a healthcare centre lies with her integrated care board, to which the Government have given some £183 million of capital funding between 2022 and 2025. I am sure she will make a compelling case to the ICB for such a centre in her constituency. Interestingly, the Mid and South Essex integrated care board is one of seven sites receiving additional support and funding from NHS England to address health inequalities, and I know she will pay close attention to how that is spent.

[Debbie Abrahams]

There were multiple warnings from experts such as Professor Sir Michael Marmot of the widening health inequalities that started in 2015. Covid just exposed and amplified those inequalities, so that in the north there were 17% more deaths, or more than 2,500 avoidable deaths. While I welcome the new Health Secretary to her post and I welcome her announcement this morning, what else is she going to do to address in particular the socioeconomic inequalities that drive those health inequalities?

[Victoria Atkins]

I thank the hon. Lady for her welcome. Having grown up in Lancashire myself, I very much understand why she is speaking up on behalf of her constituents. There are many different ways that we deal with this, but let me use a couple of headline points. First, we are increasing the public health grant to local authorities, providing more than £3.5 billion this year, so per capita public health grant allocations for the most deprived local authorities are nearly two and a half times greater than for the least deprived.

There is also interesting work going on with family hubs. Indeed, the Under-Secretary of State for Health and Social Care, my right hon. Friend for South Northamptonshire (Dame Andrea Leadsom), who has responsibility for start for life, is leading on that. The family hubs and start for life programme will deliver a step change in outcomes for babies, children and parents in 75 local authorities in England with high deprivation. We believe strongly that if we can give the best start in life to our babies and children, it will bode extremely well for their future years.

[Maggie Throup (Erewash) (Con)]

A report that is to be published shortly by the all-party parliamentary group for diagnostics, which I chair, has highlighted that community diagnostic centres are essential for tackling health inequalities. I welcome my right hon. Friend to her new role. Will she honour her predecessor’s commitment to meet the all-party group to discuss the benefits of diagnostics in general and the preventive role that they can play in reducing health inequalities across the country?

[Victoria Atkins]

Not only am I delighted to accept my hon. Friend’s kind invitation, but I am also extremely grateful for her work in that area. Of course, we think that community diagnostic centres are an important and exciting part of healthcare in this country. We have 136 centres operational at the moment, and we know that they have provided 5 million additional tests since July 2021. That is the future and we very much support it.

[Kirsten Oswald (East Renfrewshire) (SNP)]

We know that socioeconomic inequalities drive health inequalities and that poverty increases adverse health effects. Research by the Trussell Trust shows that one in seven people faces hunger across the UK because they simply do not have enough money. Will the Secretary of State raise with her Cabinet colleagues the Trussell Trust joint campaign with the Joseph Rowntree Foundation calling for an essentials guarantee in universal credit to ensure that the basic rate at least covers life’s essentials so as to ensure that people can afford essentials such as food and heating and to mitigate against health inequalities?

[Victoria Atkins]

Of course, conversations continue between Ministers across Government in terms of helping not just with health inequalities but with inequality of opportunity. That is why I very much hope that the hon. Lady and her colleagues will welcome the thoughtful focus that both the Chancellor and the Secretary of State for Work and Pensions have put into the back to work plan. We know that getting people into work can have enormous benefits, not just financially but, importantly, for their wellbeing. The idea behind the back to work plan is that we do it by working with people to draw out their full potential and help them to lead healthy lives.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

8. If she will review the provision of health services for people living with (a) Ehlers-Danlos syndromes and (b) hypermobility spectrum disorder.

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[Marion Fellows (Motherwell and Wishaw) (SNP)]

T1. If she will make a statement on her departmental responsibilities.

[The Secretary of State for Health and Social Care (Victoria Atkins)]

My priority as Secretary of State is to reform our NHS and social care system to make it faster, simpler and fairer. Since my appointment, we are making progress. To make our system faster, we have hit our manifesto target to recruit and retain 50,000 more nurses for our NHS, and to deliver 50 million more GP appointments, achieving both commitments months ahead of time. We have made an offer to health unions that I hope will end the consultants’ strike, which has disrupted care for the public and put a strain on staff. To make our system simpler, we have announced Pharmacy First, which will make it quicker and easier for millions of people to access healthcare on the high street. To make our system fairer, we have agreed a deal with pharmaceutical companies that will save the NHS £14 billion in medicine costs and give patients access to more life-saving treatment. The NHS is one of the reasons I came into politics—[Interruption.] I know Labour Members do not like to hear that, but I look forward to working with patients and staff across the country—[Interruption.]

[Madam Deputy Speaker]

Order. I do not need any help, thank you. The Secretary of State has answered the first question at length. I am sure that means she will answer the other questions much more briefly.

[Marion Fellows]

People with disabilities and serious health conditions already have higher living costs, and the proposals in the work capability assessment activities and descriptors consultation will mean that if they are reassessed they will lose £390 a month. I appreciate that the Secretary of State is new to her role, but will she commit as a priority to taking this up and consulting Cabinet colleagues, to ensure that people who are disabled and have serious health conditions are not pushed even further into dire poverty?

[Victoria Atkins]

As I said earlier, careful thought has gone into the announcements that were made in the autumn statement, and of course I will work with the Secretary of State and the Chancellor to ensure that the commitments we already have to people living with disabilities are maintained, and that we have their wellbeing at the heart of all our policy making.

[Priti Patel (Witham) (Con)]

T4. The Secretary of State’s predecessor took a strong interest in the deaths that took place in the Essex mental health trusts, and a statutory inquiry is now taking place. Will she meet me and our Essex colleagues, and the families, to discuss that important inquiry, so that they can have justice for the loved ones they have lost?

[Victoria Atkins]

I would be very pleased to meet my right hon. Friend, the families and other Essex MPs to discuss that important inquiry.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I call the shadow spokesman.

[Ashley Dalton (West Lancashire) (Lab)]

With your indulgence, Madam Deputy Speaker, I welcome the Secretary of State and the new members of her Front-Bench team to their roles. I am honoured myself to stand at the Dispatch Box today for the first time on behalf of the shadow Secretary of State for Health, my hon. Friend the Member for Ilford North (Wes Streeting), who is currently in Australia exploring international best practice in healthcare.

Talking of best practice, on this Government’s watch, people with suspected breast cancer are not getting it. The two-week target from GP referral to a first consultant appointment for breast cancer has not been met since March 2020. I know from my own experience of breast cancer that the waiting is terrifying, wondering whether it has been left too late and the cancer has become incurable. How much longer will patients have to wait before the Government can meet their own targets and deliver the timely care that patients need and deserve?

[Victoria Atkins]

I genuinely thank the hon. Lady for her warm welcome, and indeed I welcome her to her first outing at the Dispatch Box. As she was describing where the hon. Member for Ilford North (Wes Streeting) is, I had images of “I’m a Celebrity… Get Me Out of Here!” Sadly for citizens in Wales, they are experiencing what it is like to live under a healthcare system run by Labour, and they might fully agree with that sentiment.

The hon. Lady raises the important issue of breast cancer, and the NHS has an ambition to diagnose 75% of cancers as stages 1 or 2 by 2028. In January last year we provided £10 million of funding for 28 new breast screening units and nearly 60 life-saving upgrades to services in the areas where they are most needed, because we understand our constituents’ concerns and also their determination that we continue to improve cancer survival rates.

[Ashley Dalton]

Unfortunately, the reality is that cancer referrals have only got worse with the Conservatives in government. In September 2023, only 74% of urgent cancer referrals to a consultant met that two-week target. That is the second-lowest rate for two-week referrals since 2009. When can the public expect this performance to improve?

[Victoria Atkins]

We have in fact made progress by delivering record numbers of urgent cancer checks, and levels of first treatments following an urgent cancer referral have been consistently above pre-pandemic levels, with activity in September standing at 108% of pre-pandemic levels on a per working day basis.

[Peter Gibson (Darlington) (Con)]

T6. Some six months ago, the dentist based at Firthmoor community centre, serving 8,000 of my constituents, handed back its contract to the integrated care board. I was shocked last week to learn that the ICB has still not commenced the tender process to replace that provision. What advice can the Minister give me to ensure that our ICB is doing what it needs to do?

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[Dr Luke Evans (Bosworth) (Con)]

T9. My local practice, on Heath Lane in Earl Shilton, released its “did not attend” figures. Between 20 November and 24 November, 69 appointments—including 36 GP appointments and 28 nursing appointments—were missed. That was 12 hours lost in five days. If that is happening up and down Hinckley and Bosworth and across the country, that is thousands of hours being missed. I know that the Government are keen to see more on data, so will they consider statementing patients on how much missed appointments cost, because clinically that would make a big difference to the awareness of what people are cashing out on?

[Victoria Atkins]

May I thank my hon. Friend for bringing his professional expertise to the Chamber? Of course, minimising “did not attends” is a critical part of ensuring that clinical time is optimised, and I will take his suggestion away and mull it over.

[Kate Hollern (Blackburn) (Lab)]

T2. I understand that pathology staffing levels at Royal Blackburn Hospital have not been reviewed for 15 years and the workload is up 300%. The national deficit in pathology is a ticking time bomb, as hospitals are unable to offer surgical and emergency services. What steps is the Minister taking to address recruitment and ensure that staff and patients are safe?

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[Imran Hussain (Bradford East) (Lab)]

T5. The Health Secretary declared at the weekend that the Government will miss their target to cut NHS waiting times if doctors strike to defend their pay and conditions, but she seems to forget that since the Tories took power in 2010, waiting lists for hospital treatments are up, A&E waiting times are up, cancer referral times are up and ambulance response times are up. The only thing that has fallen is not waiting times; it is public confidence in the Government. Will the Minister finally admit that the threat to waiting time targets is not striking doctors, but her party being in government?

[Victoria Atkins]

I assume from the hon. Gentleman’s question that he fully supports our efforts to get consultants back into hospitals as well as junior doctors and doctors in training. It is all very well to sit there commenting, but we on the Government side of the House are working with doctors to try to help them look after the NHS for us all.

[Selaine Saxby (North Devon) (Con)]

While I recognise that money does not grow on trees, neither do teeth. Can my right hon. Friend advise me of how quickly my North Devon constituents will be able to see the NHS dentists they so desperately need?

[Patricia Gibson (North Ayrshire and Arran) (SNP)]

T7. Last week, the former Health Secretary admitted at the covid inquiry that sick pay across the UK is “far too low”. It is far lower than the European average and encourages people to go to work when they should be getting better. Does the Secretary of State agree with her predecessor? What discussions will she have with her Cabinet colleagues to improve the inadequate sick pay system?

[Victoria Atkins]

I will not comment on evidence from the covid inquiry, given that it is an independent inquiry. However, on the general principle of encouraging people back into work, we have the plans set out by the Secretary of State for Work and Pensions and the Chancellor at the autumn statement. We want to encourage people back into work and to support them when they fall ill and need help from the state.

[Anna Firth (Southend West) (Con)]

Last year, I asked the Government to show me the money with respect to £118 million of long-awaited capital funding for south Essex hospitals. With £8 million now delivered and the other £110 million now confirmed to be on its way, will the Secretary of State please come with me to Southend Hospital and see how that vital money will transform care in Southend and Leigh-on-Sea?

[Victoria Atkins]

I will be delighted to visit that hospital with my hon. Friend—I suspect that I will be visiting a lot of hospitals.

[Paul Blomfield (Sheffield Central) (Lab)]

T8. Was the Secretary of State consulted about yesterday’s announcement by the Home Secretary? If she was, did she agree with him that it will have no impact on overseas recruitment, or does she hear the fear of care providers about its consequences?

[Victoria Atkins]

Yes, I was. What is more, we looked carefully at the figures in relation to overseas care workers. We are grateful to all international people who work in our NHS and our care system, but we need to tackle the migration rate, which is too high. The package presented yesterday by the Government is a thoughtful and careful one to tackle legal migration.

[Siobhan Baillie (Stroud) (Con)]

Stroud Maternity Hospital is doing a great job, but the post-natal beds are still not open. We have been chasing a ministerial meeting about that for some time. Will my hon. Friend meet me and the Gloucestershire NHS scrutiny chair, Andrew Gravells, to discuss the issue? We think that we need some help with the Care Quality Commission.

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[James Sunderland (Bracknell) (Con)]

Would the Health Secretary please agree to meet me to discuss improved access to GPs and dentists in Bracknell Forest and Wokingham boroughs?

[Victoria Atkins]

I will; it would be a pleasure.

[Pete Wishart (Perth and North Perthshire) (SNP)]

My constituent Air Marshal Dr David Walker, an inspirational leader and academic, sadly died of glioblastoma in June. When diagnosed, he and his wife Catherine were shocked to learn of the woefully low funding for brain and other less survivable cancers and established the charity the Right to Hope with Cancer. Will the Minister show the courage and leadership so epitomised by the life of Air Marshal Walker, and properly resource and fund less survivable cancers, so that everyone living with cancer has some sort of hope?

Public Health: Opt-out HIV Testing

Victoria Atkins Excerpts

Wednesday 29th November 2023 Written Statements

[The Secretary of State for Health and Social Care (Victoria Atkins)]

The Government remain committed to ending new HIV transmissions within England by 2030. In order to do this successfully, we must identify and treat more of those who are unknowingly living with HIV.

As part of our HIV action plan, NHS England is currently operating a bloodborne virus emergency department opt-out testing programme for HIV and for hepatitis B and C for 34 emergency departments across London, Manchester, Salford, Brighton and Blackpool, focusing on areas with extremely high HIV prevalence (five or more HIV cases per 1,000 residents aged 15 to 59), in line with National Institute for Health and Care Excellence HIV testing guidance.

This means that anyone aged 16 years and over attending an emergency department in these areas and having a routine blood test will automatically be tested for HIV and for hepatitis B and C, unless they opt-out. Accessible public-facing information about testing, its benefits and how they can opt out allows individuals to make informed choices.

Through their recently published evaluation report, the data from NHS England and the UK Health Security Agency (UKHSA) indicate that the existing opt-out testing programme has been highly successful in areas of extremely high HIV prevalence, helping identify over 2,000 cases of bloodborne viruses, including 550 cases of people living with undiagnosed or untreated HIV.

After careful consideration of the available evidence, I am pleased to announce that the Government are committing to new research, commissioned through the National Institute for Health and Care Research, to evaluate the expansion of HIV opt-out testing to a further 46 emergency departments, in areas across England where there is high HIV prevalence (two or more HIV cases per 1,000 residents). Funding will support 12 months of testing for each emergency department, to begin during the next financial year.

We anticipate that this will be an effective way to reach a substantial proportion of the estimated 4,500 people England who are living with HIV but unaware of their status.

We will continue to keep Parliament updated on our progress to meet our 2030 ambitions as set out in our HIV action plan. We also want to thank our partners across the NHS, in NHS England, UKHSA, local government, and the community and voluntary sector, for their work towards ending HIV transmission in England.

[HCWS79]

NHS Consultants: Pay Offer

Victoria Atkins Excerpts

Tuesday 28th November 2023 Written Statements

[The Secretary of State for Health and Social Care (Victoria Atkins)]

After several weeks of constructive negotiation with the British Medical Association and Hospital Consultants and Specialists Association committees, I am pleased to inform the House that, on 27 November, I made a formal offer to both unions, which includes a package of reforms to be applied from January 2024. If accepted by their members, this would end damaging strike action, benefit patients and deliver for consultants by reforming outdated aspects of their contracts.

The Government’s position is that the headline pay uplift for 2023-24 was settled through the pay review body process. This offer builds on that and focuses on reform. All parties strived to find a fair deal for NHS consultants that acknowledges the wider economic pressures facing the UK and the need to continue to bring down inflation. We have heard the concerns consultants have raised about outdated pay scales that have poor equalities outcomes. This offer would invest in modernising the consultant pay scale to reduce the number of pay points and the time it takes to reach the top.

As part of this reform, we would also be introducing more consistent performance gateways so that there is a clearer link between pay progression and evidence of skills, competencies and experience. This would make it faster for consultants to progress and help mitigate the gender pay gap, which was expressly highlighted in the independent review into gender pay gaps in medicine in England. To enable these reforms, unions have agreed to end local clinical excellence awards—an employer-level bonus scheme that has been seen to contribute to pay inequalities.

In addition, the Government will work with the unions to review the operation of the Review Body on Doctors’ and Dentists’ Remuneration. This work will extend to looking at the process for the appointment of members to the DDRB, the timing of the round, the data provided to the DDRB, and changes to remit letters and the panel’s terms of reference.

The Government have listened carefully to the concerns of consultants, their representatives and employers, particularly around retention, motivation and morale. This offer has been carefully balanced to meet those concerns while also ensuring value for the taxpayer. Together, this represents the biggest transformation in the consultant contract in 20 years. This offer, should it be accepted, will improve the working lives of consultants while ending damaging strike action that has had a detrimental impact on patients and the NHS.

The BMA and HCSA will put this offer to their members for a vote in the coming weeks. No further industrial action will be called while this happens.

[HCWS75]

NHS Federated Data Platform: Contract Award

Victoria Atkins Excerpts

Tuesday 21st November 2023 Written Statements

[The Secretary of State for Health and Social Care (Victoria Atkins)]

Today, NHS England announced that, following an open and competitive procurement, it has awarded a group led by Palantir Technologies UK, with support from Accenture, PwC, NECS and Carnall Farrar, the contract to provide the new NHS Federated Data Platform (FDP).

The NHS manages data in different systems that do not connect effectively or efficiently. Every day, clinicians and other hospital staff spend time on the phone and in meetings, trying to join this information up themselves—to manage their theatre lists, waiting lists and information on patients ready to be discharged. This time could be better spent caring for patients.

The FDP is software that will sit across NHS trusts and integrated care systems (ICSs), allowing them to connect data they already hold, such as health records, waiting lists, and theatre and staff rosters, in a safe and secure environment, to better manage patient care. The FDP will support key priorities of the NHS, including recovery of elective care and the improvement of discharge processes to get medically fit patients treated and home quicker.

The safety and security of patient data is front and centre of this new system. As happens currently, there will be clear rules and auditability covering who can access this data, what they can see, and what they can do. Only authorised users will be granted access to data for approved purposes—for example, NHS staff and those supporting them, such as administrators, bed managers or care co-ordinators, and staff in social care supporting the move from hospital care. The provider of the software will not hold or have access to NHS data for any purpose, other than as directed by the NHS; they will not control the data in the platform, nor will they be permitted to access, use or share it for their own purposes. The contract makes strict stipulations about confidentiality. No new data will be collected, and GP data will not be part of the national platform.

In addition, NHS England has awarded a contract to a separate provider, IQVIA, for privacy enhancing technology, as an additional safeguard to enhance the security of data used in the FDP. The FDP will not go live at trusts or ICSs until this privacy enhancing technology is in place.

Across England, 26 trusts have been piloting what the FDP will provide. Clinicians have described the results as “game-changing”. It has helped them to better organise their clinics and waiting lists by integrating and consolidating data from different hospital systems or by creating a single list of information used by everyone working in health and care on discharge of patients from hospital. Patients in these vanguard trusts have seen falls in waiting times, discharge delays reduce, and diagnoses speed up. Theatre utilisation has increased by more than 6%, meaning an average of 120 additional patients per month are being treated at each trust. A new discharge tool has allowed one trust to reduce unnecessary days in hospital for long-stayers by 36% and halve the number of patients occupying a hospital bed for 21 days or more, compared with the England average.

It is these real benefits that an FDP will bring for patients and clinicians that have seen the chief executives of all 42 integrated care boards sign up to an open statement of support for the procurement.

Every hospital and integrated care board will have its own version of the platform which can connect and collaborate with other data platforms as a “federation”. In the first contract year, investment is expected to be at least £25.6 million and over the total contractual period of seven years, there will be up to £330 million investment in the Federated Data Platform and associated services. Learning about how to make the roll-out to trusts as efficient as possible will be built in overtime to reduce costs.

Additional funding has been set aside for other organisations to bid in separate, future procurements to build new products on to the platform that are interoperable and provide the opportunity for the NHS to benefit from new innovations from a range of suppliers. This makes it easier for health and care organisations to work together, compare data, analyse it at different geographic, demographic and organisational levels, and share and spread new effective digital solutions.

The contract will not only benefit users of the NHS; it will see investment in the UK-based data industry: the contract includes the creation by the supplier of a hub in the north-west. Data will not leave the UK.

Contract award for the FDP is the first stage of the process. An advisory group made up of expert health and care stakeholders, as well as patients and regional system representatives, will help to shape how the FDP is implemented. NHS England has already carried out engagement on the FDP requirements, including with patient and professional representative bodies. Ongoing public engagement is planned throughout the period of the contract, including as part of a recently announced circa £2 million national programme of engagement on the use of health data.

Further information on the FDP can be found on NHS England’s webpages at:

https://www.england.nhs.uk/digitaltechnology/digitising-connecting-and-transforming-health-and-care/fdp-faqs.

[HCWS57]

Voluntary Scheme for Branded Medicines Pricing, Access and Growth

Victoria Atkins Excerpts

Monday 20th November 2023 Written Statements

[The Secretary of State for Health and Social Care (Victoria Atkins)]

I am pleased to inform Parliament that agreement has been reached on a Heads of Agreement for the 2024 Voluntary Scheme for Branded Medicines Pricing, Access, and Growth (VPAG). This is an agreement between the Department of Health and Social Care—representing the UK Government, the Governments of Scotland and Wales and the Northern Ireland Department of Health—NHS England and the pharmaceutical industry, represented by the Association of the British Pharmaceutical Industry (ABPI).

This is an important milestone in the agreement of a new scheme. Once the Heads of Agreement has been formalised in a full scheme document, the 2024 VPAG will operate for five years starting from 1 January 2024, when the current scheme ends.

The 2024 VPAG stands to deliver savings to the NHS across the next five years, rapid patient access to new clinically and cost-effective medicines, and a sustainable approach to medicines provision.

The proposals also demonstrate the Government’s commitment to supporting a strong UK life sciences industry to drive economic growth, including through the establishment of a £400 million fund to support investment in the UK life sciences ecosystem, including improved clinical trial capacity.

[HCWS52]

Mental Health Units (Use of Force) Bill

Victoria Atkins Excerpts

2nd reading: House of Commons
Friday 3rd November 2017 Commons Chamber

[Victoria Prentis]

Rather than get too party political, I think it is appropriate to talk about other difficulties that have led to reductions in staffing in real terms in the Prison Service, because we on this side of the House can give lots of facts and figures about how much more is being spent. The difficulty that I know about personally now in my Banbury constituency is in recruiting and retraining staff—not with the money to pay for them, but with finding the right people. I pay tribute to all who choose to work in the very difficult mental health sphere, with patients who suffer from dreadful illnesses; the House should pay tribute to the work they do day in, day out with people who are often very difficult to deal with while they are ill.

One matter on which I am sure we can agree is the importance of reducing further the number of black, Asian and minority ethnic people detained for mental health reasons in police cells. The figures are disproportionately high. It simply cannot be right that black people are four times more likely to be detained under the 1983 Act than white people. The hon. Member for Croydon North mentioned the Angiolini review and the importance of standardised data recording. I apologise for again referring to my Prison Service experience, as the mental health system is completely different from the criminal justice system, but there are themes that run through the way BAME people are treated in both systems which we increasingly find utterly unacceptable.

[Victoria Atkins (Louth and Horncastle) (Con)]

I pay tribute to the hon. Member for Croydon North (Mr Reed) for bringing the Bill to the House. Does my hon. Friend join me in welcoming clauses 8 and 9 requiring mental health units to record the relevant characteristics of the patient on every occasion in which force is used, and to submit an annual report to the Secretary of State, so that health units and also the Secretary of State can review and understand where there are patterns of behaviour?

[Victoria Prentis]

I could not agree more. The provision of statistics and retention of figures and then the crunching of them is vital. It might not sound exciting, but it is the only way to deal with the big problem of racial imbalance in both the mental health and the criminal justice system. It sounds absurd to say that figures are what will push through action on racial imbalances, but I truly believe that facts and figures—such as those provided recently in the report on the Prison Service, where we learned that 277 black women are in prison for every 100 white women—will help achieve that. Such figures are unacceptable on any level. The more we can talk about such figures, backed up by good evidence, the better. A civilised society cannot put up with such things.

I have strayed far from my brief. I am proud that the Government have committed to addressing the disproportionately high rates of BAME people detained for mental health reasons, and I am proud of the work the Government have done generally on mental health.

We all know that the 1983 Act is outdated, and it will be reformed to make it fit for the modern era. In October 2017, the Prime Minister announced a comprehensive review of the Act, with a planned end date for the report of autumn 2018. I am pleased that the review is being led by Professor Simon Wessely, former president of the Royal College of Psychiatrists. I worked closely with him in my previous role. We were working on a case concerning the pardoning of first world war prisoners who had been shot for cowardice, and he was able to recreate their mental health states from the limited records we had available and give invaluable evidence to the court. He is a great man and I am sure he is the right person to lead this review. He has said that he expects some of the solutions to the difficulties in the mental health system to lie in practice, leadership and culture, as well as in potential legislative change.

I have been encouraged by the work on mental health in my constituency, including in the veterans support group. It meets at Behind the Wire in Heyford Park, next to my constituency office, about once a month. It is a former military establishment and the veterans who access it feel very comfortable in that environment. It is well known that veterans as a group are more prone to experience mental health issues. This particular group offers drop-ins for veterans living in the local area so they can meet organisations including the Support, Empower, Advocate, Promote service, Help for Heroes, the Royal British Legion, Veterans UK and Rethink Mental Illness, which the hon. Member for Croydon North mentioned, and which does a great deal of good work across the country.

I have other local organisations who are doing great things in supporting my constituents, including Restore in Banbury, which I was also lucky enough to meet recently. I visited the local branch of Mind in September, which has contacted me in recent days urging me to support the Bill. Its letter said that

“the proposals in this Bill are crucial to protecting people experiencing a mental health crisis...With your support this Bill would lead to better training for staff, better data, improving transparency and highlighting problem areas”.

It therefore gives me great pleasure not only to support the hon. Member for Croydon North, but to stand up for those of my constituents who have asked me to attend this debate and to speak in it.

As a former civil servant, I cannot emphasise enough how important it is that we have a joined-up approach across Departments. It is very much not just a matter for the Department of Health; the Ministry of Justice is also involved. I speak to it frequently about mental health and prisoners and the use of restraint in the criminal justice system, and I hope that the Minister will reaffirm the importance of cross-governmental co-operation, including work with NHS England, on the delivery of reforms to detention.

--- Later in debate ---

[Oliver Dowden]

I quite agree that we need to have the right levels of staff, and that is why I am so pleased that the Government have protected police funding. I was going to come on to this point, but I will raise it now. In the health service, we are moving towards achieving parity between mental and physical health. Some of the stats on this are very welcome. We are now spending £11.6 billion a year on mental health, for example. I believe that that is more than we have ever spent before. Also, the Health and Social Care Act 2012 is giving parity of esteem.

[Victoria Atkins]

Does my hon. Friend agree that this is not just about the numbers of staff but about how well they are trained to work in the particularly difficult circumstances of a mental health unit? The pressure on members of staff is particularly acute in such an environment. Clause 5 requires training in the appropriate use of force, which will provide positive benefits for members of staff.

[Oliver Dowden]

My hon. Friend is absolutely right. I do not think anyone is suggesting that police officers are actively seeking to treat mental health patients in an incorrect fashion, but there is a need for training so that they understand the correct way to behave.

--- Later in debate ---

[Mrs Trevelyan]

My hon. Friend is exactly right. It is incumbent on us as we go forward with this Bill to set these new markers to ensure that we get a cultural change; we need that understanding that mental ill health is part of our life experience and most of us may well suffer from it in one form or another. For those who are the most vulnerable we absolutely need to ensure that the practices are the best they can be, so that dignity and respect is afforded to every person who needs that support.

Transparency and accountability will also allow health professionals and emergency staff to manage the risks, protecting not only the patient, but our public servants. This can protect them from false allegations and allow us to have that evidence should things go wrong. Body-worn cameras are so important in this regard. The prison in my constituency, HMP Northumberland, was one of the prisons where body-worn cameras were trialled. This has been running for nearly two years now and there has been a dramatic drop not only in the reported cases of argy-bargy between prison officers and inmates, but in poor behaviour, because inmates who might have decided to have a go cannot be bothered anymore because they know it is going to be filmed; the relationship has improved so much as a result. This has created the same thing as we see where a teacher has good discipline in the classroom, understanding that if we provide a framework everyone within it works in a more conciliatory and more constructive fashion.

[Victoria Atkins]

I am a huge supporter of body-worn cameras on police officers and on prison officers, because I believe it protects not only them, but members of the public. Does my hon. Friend agree that just as—I hope—body-worn cameras will help victims of domestic violence who perhaps do not have the confidence to give evidence against their assailants, or cannot face the consequences of doing so, the same thing may apply in respect of prisons?

[Mrs Trevelyan]

My hon. Friend is absolutely right. Interestingly, even in the social media world we all live in, a storm of anonymity allows a level of poor behaviour. If the body-worn camera empowers people to remember that anything from good manners and good behaviour to constructive dialogue rather than more violent interventions is the way forward, this must be a tool we should be encouraging across the board. One hopes that behaviour can improve once people remember how these things can be done more constructively and with less violent interventions.

Surgical Mesh Implants

Victoria Atkins Excerpts

Wednesday 18th October 2017 Westminster Hall

[Emma Hardy]

I absolutely agree and thank the hon. Gentleman for raising that.

Currently in the UK, there are about 100 types of vaginal mesh implants. Carl Heneghan, professor of evidence-based medicine at the University of Oxford, has raised concerns about the evidence that mesh manufacturers need to provide before their products are approved and made available on the NHS. It is extremely worrying that the Pelvic Floor Society, which is associated with the surgeon Mr Dixon and was set up as a world expert group, is partly sponsored by mesh manufacturers. The BBC spoke to the Pelvic Floor Society on camera during the “Inside Out West” documentary and was told that it had discovered complications only in 2014. However, minutes of a joint meeting of the southern, midland and northern groups of the Pelvic Floor Society in October 2012 say:

“We need to ensure that all individuals are appropriately consented for the risks of mesh placement; Long term Shrinkage, Mesh erosion, Mesh failure. We need to have a prospective registry for”

laparoscopic ventral mesh. Why, if the industry knew about these problems in 2012, are they only coming to light now? That is further proof that the Government must do something about this.

One thing that could be done is to follow the recommendations of the all-party parliamentary group and bring forward publication of the NICE guidelines on mesh for stress-related urinary incontinence. Currently, NICE says that it plans to publish revised guidelines in 2019, but we think that is too long to wait. We want NICE to urgently prioritise them. Mesh as a first-line treatment for incontinence and prolapse should be suspended until the NICE guidelines are revisited.

In May this year, the Scottish Cabinet Secretary for Health and Sport, Shona Robison, confirmed that the Scottish Government had suspended the treatment for people with pelvic organ prolapse. Until we have a proper understanding of just how many women are suffering from mesh injury, we think the surgery should be suspended, but in all cases, not just for pelvic organ prolapse.

Professor Carl Heneghan says that some of the devices used in mesh treatment have not been clinically tested or trialled and that the number of people affected by mesh injury means that this could be one of the biggest medical scandals of our time. Suzy Elneil, consultant urologist at University College London, has also warned about the number of women affected by mesh injury. She is one of the few qualified surgeons in the UK who can remove mesh once it has been fitted and she tells me that she sees about 15 women a week who are suffering following mesh surgery. Consultant gynaecologist Dr Wael Agur from the University of Glasgow was once an advocate of mesh surgery, but has changed his mind since seeing at first hand the evidence of mesh risks. He agrees that there is significant under-reporting of mesh complications and says that, as a result, the MHRA has only a fraction of the knowledge of adverse events associated with mesh.

[Victoria Atkins (Louth and Horncastle) (Con)]

I apologise for arriving late to the debate, Mr Owen. I congratulate the hon. Lady on holding this important debate. The point that she makes about long-term complications is just as important as that about the short-term complications. My constituent developed fibromyalgia as a result of the complications arising from her mesh surgery for stress urinary incontinence. Does the hon. Lady agree that long-term conditions such as that must be taken into account?

[Emma Hardy]

Absolutely. Studies need to go far beyond the two years.

I am delighted that Labour has called for a public inquiry into the use of mesh. As my hon. Friend the Member for Washington and Sunderland West (Mrs Hodgson) rightly said, it is extremely worrying that mesh surgery has been introduced so widely, with so little evidence and with limited trials to support it.

I call on the Government to do four things. First, they must commit to a full retrospective and mandatory audit of all interventions that involved mesh, followed by a full public inquiry. Secondly, they must suspend prolapse and incontinence mesh operations while the audit is being carried out. Thirdly, they must bring the NICE guidelines for mesh in stress-related urinary incontinence forward from 2019 to 2018. Fourthly, they must raise awareness among the general public and GPs.

Mesh implants have affected thousands of people all over the country. For some, the consequences of operations will be life-changing and devastating. A Government commitment to taking these actions will not undo the suffering and pain that these people have endured, but would go a long way to making sure that nothing like this happens again.

Contaminated Blood

Victoria Atkins Excerpts

Tuesday 11th July 2017 Commons Chamber

[Victoria Atkins (Louth and Horncastle) (Con)]

I welcome you to your place, Madam Deputy Speaker.

I join other Members in paying tribute to all those affected by this terrible tragedy, to the families of those affected and to hon. Friends and hon. Members, including the hon. Member for Kingston upon Hull North (Diana Johnson) and my hon. Friends the Members for Worthing West (Sir Peter Bottomley) and for Stratford-on-Avon (Nadhim Zahawi). I also pay tribute to the new hon. Member for Oxford East (Anneliese Dodds) for delivering her maiden speech in this important debate.

I speak today to give a voice to a constituent, who understandably wishes to remain anonymous. He was born with haemophilia and has had to endure that terrible chronic condition, the treatment for which has poisoned him—he has been infected with both HIV and hepatitis C. Those infusions have condemned him to a life of pain, of serious medication, which has its own side-effects, of major surgery and of worry. “Worry” seems an inadequate word to describe the constant weight that must be on his mind, and on the minds of those who love him, each and every day of his life.

This tragedy has affected every single day and every single aspect of his life, from his marriage to his ability to work and his family. He told me recently that he and his wife have told their grown-up child of his condition and his infections because, as he told me, “when is the right time to tell your child that you have HIV and hepatitis C?” So my constituent welcomes today’s announcement. He asks for a Hillsborough-style inquiry because, as others have said, people affected by this do not have time on their side.

I must declare an interest as a barrister. I hope the public inquiry will ensure that public money is directed towards those who need it most, namely the victims and their families, not towards massively expensive tribunal costs. I state that warning to any of my former colleagues in the legal profession.

I am conscious that some of my colleagues wish to speak in this debate, so I will finish by talking about a school photograph that my constituent brought into a surgery. It was like any other school photograph—children smiling, and with teachers on either end of the row—but this photograph was different. It showed my constituent’s class at the special school he had to attend because of his medical condition. Eight of his school friends had haemophilia. Four of those eight are now dead as a result of contaminated blood infections, and another is so ill that, in his early 50s, he is forced to live in a specialist care home because of how his body has been left.

My constituent and the thousands of others we have heard about today are the victims of a terrible episode in our national life. They have fought for justice for 30 years, and I thank this Prime Minister and this Government for listening and acting. I hope this inquiry delivers answers for those affected.

NHS Shared Business Services

Victoria Atkins Excerpts

Tuesday 27th June 2017 Commons Chamber

[Mr Hunt]

The costs are in excess of £6 million, and we are seeking to recover as much of that as we can from the company involved. I know that the regime in the Labour party has changed, but to try to turn this into an issue of privatisation when under the right hon. Gentleman’s own party’s Government—and indeed, during his own time as Health Secretary—we had problems at Mid Staffs that were squarely in the public sector is wholly inappropriate. This is about proper assurance of what is going on in the NHS, and both sides of the House need to learn the lessons.

[Victoria Atkins (Louth and Horncastle) (Con)]

In order to reassure my constituents, will my right hon. Friend confirm that NHS SBS no longer provides this mail redirection service, that all backlogged correspondence has now been delivered to the relevant GP surgeries for filing and that no patient harm has been found in this case?

[Mr Hunt]

My hon. Friend is exactly right. Of course we welcome the fact that no patient harm has been identified to date. We have to wait until the process of the third clinical review is completed on at-risk patients’ records, which will happen by the end of December. She is absolutely right to say that SBS is no longer performing this contract; it has been taken in-house. Other parts of the SBS contract not related to what we are discussing today were given to another supplier.