(4 years, 10 months ago)
Commons ChamberI suggest to the hon. Lady, whom I greatly respect, that the overall figure is actually what counts. I agree that public health spending matters, but it is absolutely the case that we are heading to being one of the higher spenders in our commitment to health. That is very significant and should not be dismissed.
Often, the debate about funding can distort some of the real debates that we need to have about the NHS. One of those is the debate on social care. If we do not have an equivalent five-year funding plan for social care, there will not be enough money for the NHS. That is because of the total interdependence of the health and social care systems. It is not about finding money to stop people having to sell their homes if they get dementia, important though that is; it is about the core money available to local authorities to spend on their responsibilities in adult social care. I tried to negotiate a five-year deal for social care at the same time as the NHS funding deal we are debating today. I failed, but I am delighted to have a successor who has enormously strong skills of persuasion and great contacts in the Treasury. I have no doubt that he will secure a fantastic deal for adult social care to sit alongside the deal on funding, and I wish him every success in that vital area.
The second distortion that often happens in a debate about funding is that while everyone on the NHS front line welcomes additional funding, their real concern is about capacity. The capacity of staff to deliver really matters. I remember year after year trying to avert a winter crisis by giving the NHS extra money, and most of the time I gave the money and we still had a winter crisis, because ultimately we can give the NHS £2 billion or £3 billion more, but if there are not doctors and nurses available to hire for that £2 billion or £3 billion, the result is simply to inflate the salaries of locum doctors and agency nurses and the money is wasted. Central to understanding capacity is the recognition that it takes three years to train a nurse, seven years to train a doctor and 13 years to train a consultant, so a long-term plan is needed. It is essential that alongside the funding plan, we have in the people plan that I know the NHS is to publish soon an independently verified 10-year workforce plan that specifies how many doctors, nurses, midwives, allied healthcare professionals and so on we will need.
Will my right hon. Friend give us his views on the maternity safety training fund, which I understand is up for renewal soon, and its importance to the midwives of the future?
When we talk about the workforce, training is vital. We know from the 2018 “Mind the Gap” report on the issues at the Shrewsbury and Telford and the East Kent trusts, among others, that only 8% of trusts supply all the care needs in the saving babies’ lives bundle, so the maternity safety training fund is essential. I hope the Health Secretary will renew it, because it makes a big difference.
It is vital that we have an independent figure for the number of doctors and nurses the NHS needs, not a figure negotiated between the Department of Health and Social Care and the Treasury because the Treasury will always try to negotiate the number down and we will end up not training enough people. I know the Health Secretary is on the case.
The final distortion when we talk about funding for the NHS is the link between funding and the quality of care. It is totally understandable that many people think that the way to improve the quality of care is to increase funding, but in reality the relationship is much more complex. As the Health Secretary knows well, we pay the same tariff to all hospitals in the NHS, and with the same amount of money some of them deliver absolutely outstanding, world-class care and others do not. Almost without exception, hospitals rated good or outstanding by the Care Quality Commission have better finances than those rated as requiring improvement or inadequate, which are often losing huge sums. The reason for that, as every doctor or nurse in the NHS knows, is that poor care is usually the most expensive type of care to deliver. A patient who acquires a bedsore or an MRSA or C. diff infection, or has a fall that could have been avoided, will stay in hospital longer, which will cost more. It will cost the hospital more, it will cost the NHS more, and finances will deteriorate. Invariably, the path the safer care is the same as the path to lower cost. That is why it is so important that we recognise that the safety and quality agenda is consistent with the plan to get NHS finances under control.
It is also why it is important to remember that the Mid Staffs scandal happened in a period of record funding increases for the NHS. So when it comes to NHS funding, transparency, openness, a culture that learns from mistakes, innovation and prevention are every bit as important as pounds and pence.
(5 years, 1 month ago)
Commons ChamberAs ever, I am grateful to be called to speak, Madam Deputy Speaker, although I was not anticipating it because I was not here at the beginning of the debate. I can only apologise for that, but I was elsewhere on unavoidable duties.
This is a debate in which we love to hate participating. It is not a pleasurable experience for anyone who has lost a child, and I know that some Members across the House feel exactly as I do when speaking in this debate. Nevertheless, I am grateful for the opportunity to lay my annual asks on the table.
First, I must give an enormous amount of thanks to the previous Secretary of State for Health and Social Care, my right hon. Friend the Member for South West Surrey (Mr Hunt), whose speech I am really looking forward to watching on catch-up tonight. I am immensely grateful, as are all of us who have been involved in this area for many years, for all that he did. It must be counted as one of his major achievements as Secretary of State that there has been a 19% reduction in stillbirths and an 8% reduction in maternal mortality since 2010. Those are really good figures, and I hope that he will look back on his career in many years when he retires—
I hope that my right hon. Friend will count that among his most important achievements. I expect that he said, as did the hon. Member for Ellesmere Port and Neston (Justin Madders), that blame is probably not the way to go, and that we need a cultural shift in the NHS, so my ask this year is that we should make maternal death a never event. Luckily, maternal deaths are rare—I was almost one of them myself—but making them a never event, with the definition and the muscle that that provides, would be very helpful.
With my prison service background, I should add that a child or, indeed, a mother dying in custody should also probably be a never event, with all the chain of investigations that should flow from that. I know that the recent death in custody is being very well investigated, and there is no need to comment further on that case now. The never event definition is helpful, because it sets in train a course of investigations that need not be blamed-filled but which are helpful for learning.
Sadly, the situation elsewhere is not as helpful as in this country. A baby dies every 11 seconds worldwide, and many maternal deaths are completely preventable. I am pleased that the Secretary of State for International Development has chosen to make maternity a priority for the Department for International Trade. He wrote an excellent article about it in The Times last week, and I encourage hon. Members to read that article.
The Secretary of State for International Development is helping members of the Royal College of Midwives to provide training in rural Bangladesh, and he is resourcing organisations that work with women who have had female genital mutilation performed on them and who have dreadful maternal complications as a result. He is working to provide vaccinations, which are so helpful in preventing the death of newborn babies. Across the board, the fact that maternity is now a priority for DFID is really helpful.
I close by thanking you, Madam Deputy Speaker, for your support in this area and for allowing me to say a few brief words this afternoon, and by advertising the baby loss service at St Mary’s, Banbury at 6 o’clock this Sunday. It is an extraordinary event, and we have been doing it for only a few years. People came to that church in the first year who had never talked about their loss, and it is overwhelming.
Such services are taking place all over the country, as the hon. Member for Ellesmere Port and Neston said. Unfortunately we have not organised one in Parliament this year, as we normally do, because we are not sitting, but I am sure we will organise one in future years. I thank everybody who has taken part in this debate, which I think is now annual. I am thrilled that we have Government time, and I hope we have it again in future.
(5 years, 8 months ago)
Commons ChamberI thank my hon. Friend for mentioning the Open Doors report, which contains some stark statistics. It states, for example, that 80% of the people who suffer persecution for their religious belief are Christians. The most striking statement is that the vast majority are in the very poorest countries: this is not, on the whole, a problem affecting people who live in affluent countries.
My hon. Friend is right to mention that countries such as North Korea have been singled out. The purpose of the review is to ensure that we use all the UK’s diplomatic leverage to highlight these issues and put pressure on those regimes to change.
The Open Doors report says that about 245 million Christians are suffering high levels of persecution in 73 countries. Where is the UK focusing our help?
I want to ensure that we exercise maximum influence where we have that influence. The striking thing about that report is that, notwithstanding the comments that my hon. Friend the Member for Cleethorpes (Martin Vickers) made about North Korea, some of the worst offenders are in the middle east, notably Afghanistan, Libya, Sudan and Somalia, where the population of Christians has fallen from 20% to around 5%. In many of those countries, we have big aid budgets and a lot of influence.
(6 years, 1 month ago)
Commons ChamberI think that the hon. Gentleman is creating a totally false dichotomy. We have a proper, established, robust and thorough regime that is designed to make sure that we do not sell arms to countries where there is a clear risk of breaches of international humanitarian law. That applies to countries such as Saudi Arabia as well as lots of countries to which we could sell arms but to which we do not, because that clear risk exists. At the same time, when we look at the representations made by British ambassadors and British Ministers all over the world and at the fact we have the third largest development budget in the world, I think that it is hard to find a country that does more on human rights, but the point is that we have to do both.
I was lucky enough to meet the Turkish Foreign Minister some 10 days ago as details were emerging of this horrific event, and he was visibly and viscerally upset by what he was being told, of which we of course do not yet know the full facts. I welcome the measured tones of the Foreign Secretary’s statement, but does he have any timescale in mind for the investigation that will take place in Turkey, and has he offered full assistance to the Turks?
I, too, had a long conversation with Foreign Minister Çavuşoğlu, and I echo what my hon. Friend has said; I think he was deeply personally shocked by the story. I do not think that the investigation will take a long time to conclude. All the suggestions are that it might even conclude in a matter of days. That is very important, because we need to start proper accountability through the judicial system for the people who were responsible for this terrible crime.
(6 years, 5 months ago)
Commons ChamberOn Friday, I was lucky enough to visit the award-winning neck of femur service at the great Horton General Hospital. The length of time that patients stay is very dependent on great links between the hospital and social care. Does my right hon. Friend agree that spending to save is possible, so that even more of this great funding can be spent on patient returns?
Absolutely. The most important way of spending to save is to invest in prevention, and a lot of that work comes from strong local hospitals. Before my hon. Friend finally leaves this place, I have no doubt at all that her local hospital will be called not the Horton General Hospital, but the Great Horton General Hospital.
(6 years, 7 months ago)
Commons ChamberChildhood obesity is one of the biggest public health challenges we face, which is why we are committed to reducing the sugar in products consumed by children by 20% over four years.
I recently met my constituent, Professor John Wass, at an Obesity Health Alliance tea, where—the Secretary of State will be pleased to know—no cake was served. Professor Wass shares my concerns about the availability of hospital services for those with established obesity. Will my right hon. Friend set out what plans his Department has to treat those who are already obese?
We recognise the value of bariatric surgery, which is of course subject to the normal waiting time standards for those for whom it is appropriate. However, prevention is better than cure. That is why we are hoping to bring forward shortly further measures to tackle childhood obesity, which is one of our biggest concerns.
(7 years ago)
Commons ChamberI will look into that very carefully. I am satisfied that there is strong new leadership at the Pennine trust and that it is being turned around, but it has told me about some of the cases to which the hon. Gentleman refers. They are of very great concern, and we absolutely must do everything we can to give answers to bereaved families.
As a bereaved parent, but also as a lawyer who has conducted many inquests, I ask the Secretary of State to consider two points. The first is the fact that not many families will need an inquest to determine what went wrong during the birth of their child. Secondly, will he commit to the training of special coroners, just as we have in military inquests, to ensure that those who deal with these very sad cases are the best equipped people to do so? Finally, on behalf of the all-party group on baby loss, may I thank him for today’s announcement and encourage him in his work to make maternity care kinder, safer and closer to home—and may I encourage him to save Horton General Hospital?
First, may I apologise to my hon. Friend, because I should have mentioned her in my statement as someone who has spoken very passionately and movingly on this topic in the House? I will take away her point about specialist coroners, because we are now going to have specialist investigators, which we have never had before. I would make one other point. I hope she does not think I am doing down her former profession, but really when people go to the law, we have failed. If we get this right—if we can be more open, honest and transparent with families earlier on—it will, I hope, mean many fewer legal cases, although I am sure that the lawyers will always find work elsewhere.
(7 years, 5 months ago)
Commons ChamberThe hon. Gentleman is right to say that it is time we had more medical schools, given that health and social care will be one of the fastest-expanding areas of the economy in the coming years. I think the Prime Minister was absolutely right to say that there should be no scaremongering about important local plans that will improve services for patients.
Will the Secretary of State reassure my constituents that the component parts of the NHS can communicate with each other sufficiently to ensure that decisions such as the one by a medical dean to remove accreditation for anaesthetic training will not lead to the closure of A&E departments in hospitals such as Houghton general, where my father was treated so well last Friday?