Rural Healthcare

Debate between Will Quince and Bob Seely

Wednesday 12th October 2022 Westminster Hall

[Will Quince]

I thank the hon. Member for his question. I am not going to make policy on the hoof, so I will not say yes now, but we are fast approaching the next GP contract, which will run from April 2024, so we have an opportunity to look at all these things in the round. I am passionate about securing access to GPs in rural and remote areas. Perhaps we can double-tag our meeting, make it twice as long and discuss that issue too. I will respond to some of the issues raised about GPs in a moment.

I reassure my hon. Friend the Member for Newton Abbot that we are in full agreement that the NHS needs to be flexible enough to respond to the particular needs of rural areas. That is vital, and that is why we passed the Health and Care Act 2022. The Act embeds the principle of joint working right at the heart of the system, promoting integration and allowing local areas the flexibility to design services that are right for them. Integrated care boards and integrated care partnerships give local areas forums through which to design innovative care models, bring together health and social care, and, importantly, prioritise resources to ensure that they best align with the needs of individual areas.

We are also enabling the NHS to establish place-based structures covering smaller areas than an integrated care system. That could match the local authority footprint, for example, or in some cases it could be even smaller—a sub-division based on local need. That is fully in line with the view expressed in the APPG report that the NHS should foster and empower local place-based flexibility. I think that is at the heart of the report.

As my hon. Friend knows, in establishing those models for the NHS to follow, we have set the framework but have left it to individual areas to tailor them to local needs. I think that is the right approach, because local areas know better than Ministers. We do not always hear Ministers say that, but I think local areas often know better than I do, sitting here in Whitehall, how best to organise themselves, and how to design and, importantly, deliver the best possible care for patients. While we in Westminster can support, guide, hold accountable and occasionally chest prod, it is right that we also protect local flexibility.

[Bob Seely]

When the Minister talks about local flexibility, I interpret that through the guise of funding. Does he accept that there is a funding issue for the 12 unavoidably small hospitals in England and Wales, and will he look at the funding mechanism that was established in 2019? It gives more money to unavoidably small hospitals, but arguably only about 50% to 60% of what is needed.

[Will Quince]

I have made a note of my hon. Friend’s question and I am going to come to it in a moment. The answer is no, but only because it is not my responsibility. It is the Minister of State, Department of Health and Social Care, my right hon. Friend the Member for Newark (Robert Jenrick), who has responsibility for hospital funding, and in the next seven minutes I intend to commit him to lots of meetings with every single Member present.

Let me turn briefly to the question of resources, about which I know a number of Members are concerned, and which has just been raised by my hon. Friend the Member for Isle of Wight (Bob Seely). It is vital that we allocate resources fairly, as my hon. Friend the Member for Newton Abbot mentioned. That is why NHS England asked the Advisory Committee on Resource Allocation to consider the issue and provide a formula for allocations to integrated care boards. That formula took into account various factors, including population, age and deprivation —but we changed it.

In 2019-20, we produced a new element of the formula, recognising the points that my hon. Friend the Member for Newton Abbot makes, to better reflect the needs of some rural, coastal and remote areas, which on average tend to have a much older population. With an older population very often comes complex health needs. NHS England is using that formula to make allocations accordingly, but we recognise that some systems are significantly above or below target, and NHS England has a programme in place to manage convergence over several years. We also recognise the important challenge in ensuring that rural areas have the workforce—another point rightly raised at length—to provide the integrated patient-centred services that we all want to see.

We know that doctors are more likely to stay in the places where they trained, as my hon. Friend said. That is why, as part of a 25% expansion of medical school places between 2018 and 2020, we opened five new medical schools in rural and coastal locations that historically have been hard to recruit in: Sunderland, Lancashire, Chelmsford, Lincoln and Canterbury. I am conscious that my hon. Friend would want far more; that is perhaps a conversation to have at a later date. We hope—in fact, we expect—that graduates from those schools will stay in the area and will have a far greater understanding of the lives, needs and challenges of the people they serve in the locality.

My hon. Friend mentioned ambulances. As part of our plan for patients, which we launched in July, there is an extra £150 million for 2022-23 to address issues relating to ambulances. I hear what she says about differential pay rates, particularly in rural areas, between different blue light services, and I will take that away. Ambulances fall under the remit of my right hon. Friend the Member for Newark, and I know that he would be delighted to meet my hon. Friend the Member for Newton Abbot to discuss that issue.

On backlogs, I completely understand the points that my hon. Friend makes about recruitment challenges. I will take away her point about incentives not working, and I will look at other measures to attract people to rural and coastal areas, because we know that is a particular challenge.

The hon. Member for Westmorland and Lonsdale (Tim Farron) raised cancer wait time variance. As the Minister with responsibility for cancer, that absolutely concerns me. We are opening new diagnostic centres, but we have to look at more.

Oral Answers to Questions

Debate between Will Quince and Bob Seely

Thursday 11th July 2019 Commons Chamber

[Mr Bob Seely (Isle of Wight) (Con)]

1. What steps the Government are taking to support women facing pension inequality.

[The Parliamentary Under-Secretary of State for Work and Pensions (Will Quince)]

Before I respond, may I say, on behalf of our Front-Bench team and, I hope, of the whole House, how proud we are of the Lionesses for their exceptionally inspirational performance in the women’s World cup?

Recent state pension reforms have meant that by 2030 more than 3 million women will be £550 a year better off on average. Automatic enrolment has helped to equalise workplace pension participation, and the Government’s gender inequality road map sets out our proposals to tackle financial instability in later life.

[Mr Seely]

Equalising the pension age has been very painful. We understand the reasons for it, but it is very painful for many of my constituents—females born in the 1950s. What has the Minister’s Department done to militate against that? What more can be done to avoid hardship for that age group?

[Will Quince]

My hon. Friend is a strong advocate for his constituents. This Government have already introduced transitional arrangements costing £1.1 billion; this concession reduced the proposed increase in state pension age for more than 450,000 men and women, and means that no woman will see her pension age change by more than 18 months, relative to the original Pensions Act 1995 timetable. For those experiencing hardship, the welfare system continues to provide a safety net, with a range of benefits tailored to individual circumstances.

Oral Answers to Questions

Debate between Will Quince and Bob Seely

Monday 1st July 2019 Commons Chamber

[Will Quince]

I respect the hon. Lady’s knowledge in this area on the Select Committee, but I would say that advances are not loans from a separate fund; they are the claimant’s benefit paid early, which is then recovered over an agreed period. So they are in place to ensure that those in genuine need are able to receive financial support and are not reliant on illegal or high-cost lenders. But if a claimant considers they are facing financial hardship because of the amount that is being deducted from their universal credit award, they can ask the Department to consider reducing their deductions. As of October this year, the maximum deduction goes down from 40% to 30%.

[Mr Bob Seely (Isle of Wight) (Con)]

6. What steps her Department is taking to increase working people’s incomes through universal credit.