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Topical Questions

Volume 586: debated on Tuesday 21 October 2014

Last week, the Care Quality Commission published its “State of Care” report. This affirmed that the pace and scale of change to improve care in the NHS last year has been unprecedented, but it also contained some hard truths. It found that the variation in the quality of health in adult social care was too wide, and that too many hospitals have not got to grips with the basics of safety. This Government want every NHS patient to have confidence that their care will be both safe and compassionate. We have turned around six hospitals put into special measures, and people saying that their care is safe and compassionate are at record highs. We are determined to change the culture of the NHS away from secrecy towards transparency, and away from targets towards personal care where patients’ needs always come first.

In August 2014, 10,616 patients had to wait longer than six weeks for a key cancer test. That is five times the number of people who had to wait that long in May 2010. If the Government do not support Labour’s commitment to a one-week cancer test guarantee, what action will they be taking to reduce waiting times?

As I said earlier, we welcome the fact that Labour is now interested in cancer policy. If we look at the reason for those delays, which we are working hard to address, it is because the number of cancer referrals—[Interruption.] Labour left this country with the worst cancer survival rate in western Europe; we are doing something about it. The reason for the delays is that the number of people being referred for cancer tests has gone up by 50% since 2010. We are treating record numbers of people with cancer because we want to do something about that survival rate.

T2. The Public Health Minister is pursuing a long list of nanny state proposals that we might have better expected from the Labour party, including plain packaging of tobacco, outlawing parents smoking in cars and having higher taxes on alcohol. Will she give us a list of which policies, if any, she is pursuing that have a Conservative flavour to them? (905564)

Following on from the Secretary of State’s previous answer, tobacco control is an integral part of tackling cancer. I am delighted to let the House know that smoking prevalence among adults in England fell to 18.4% in 2013. This is a record low, which means that the Government have hit their tobacco control plan target for 2015 two years early. I am sure that even my hon. Friend would welcome that news.

At their conference, the Tory party promised flat funding for the NHS in the next Parliament, but experts say that the service is at breaking point now and that the funding promised is not enough. Now, the Secretary of State’s own side are saying the same thing. The Chair of the Health Committee said last night:

“The Chancellor is going to have to write a bigger cheque”

or we will

“see reductions in services or waiting times increase”


“go down the route of top-ups and charges”.

Does the Secretary of State agree with her, and will he concede that a flat budget for the NHS in the next Parliament will not stop it tipping into a full-blown crisis?

I am afraid that the shadow Health Secretary is misrepresenting what was said at the Conservative party conference. We promised not just to protect the NHS budget but to protect and continue to increase the NHS budget in real terms. I gently say to him that we have increased the NHS budget spend this Parliament by double the amount that Labour promised at its conference. We did that because on this side of the House we understand a simple truth: a strong NHS needs a strong economy.

The House will have noticed that the Secretary of State did not answer my question. There is a very simple reason why the Secretary of State cannot answer my question: his party has prioritised unfunded tax cuts for higher earners, leaving a large black hole in the public finances. There will be nothing left for the NHS if the Tories are re-elected. We on the Labour Benches, in contrast, have promised £2.5 billion over and above what they are committed to. Does that not make the choice on the NHS now clear: under Labour, more money for the NHS; under the Tories, tax cuts for some but an NHS crisis for all?

The right hon. Gentleman cannot have it both ways. The tax cuts the Government have prioritised are for lower-paid people, many of whom work in the NHS. When we had a strike last week, he was criticising the Government for not being more generous, but we have been generous—with the tax cuts he is now criticising. The NHS is facing the biggest financial squeeze in its history partly because of an ageing population but partly because the last Labour Government forgot about the deficit.

T3. In my constituency, waiting times for GP appointments remain long and practices are struggling to recruit enough doctors. Will my right hon. Friend reassure me as to when the improvements he is making elsewhere in the country will take effect in Gosport, and will he meet me to discuss the matter? (905566)

I would be delighted to discuss it with my hon. Friend, who is right to focus on the role of GPs. If we are to transform the NHS by the end of the next Parliament, we need fundamentally to improve out-of-hospital care, and GPs are at the heart of that. We have recruited 1,000 more GPs during this Parliament, but we need many more, and that will definitely include her constituency.

We have a shortage of GPs in Halton. Constituents tell me it is more difficult to get an appointment, and in recent months, two GPs have told me that there are major problems with GP services in Halton and the country as a whole. Despite what the Secretary of State says about increased numbers of GPs, that is not happening in Halton. What is he doing to address the problem, particularly in areas of great deprivation, such as Halton?

There is pressure throughout the NHS because there are nearly 1 million more over-65s than there were four years ago, which puts pressure on GPs, as it does on any department or hospital providing elective care. However, this is not just about getting an appointment; it is also about ensuring that GPs have personal responsibility for the patients on their list and are accountable for the care of some of the most vulnerable people. We have brought back named GPs with personal responsibility for over-75s, and I hope the hon. Gentleman welcomes our going further and bringing it back for everyone.

T4. Meningitis Now, based in my constituency, is a keen supporter of the Men B vaccination for infants. Given the Joint Committee on Vaccination and Immunisation’s recommendation that it start, will the Minister update us on how the roll-out is progressing? (905567)

My hon. Friend is right to highlight this important issue. As he knows, the Department is negotiating with the manufacturer to purchase the vaccine at a cost-effective price, and he will understand that we need to ensure that NHS funds are used as effectively as possible. We are keen to see a positive conclusion to the negotiations as soon as possible so that plans for the Men B immunisation programme can be finalised.

Will the Secretary of State explain why NHS England has entered into a contract with a company based in Kent to provide GP services, when my constituents have just seen a string of locum GPs at a higher cost to the NHS?

Wherever we can avoid it, we do not want to use locum GPs or nurses or agency doctors, because they are much more expensive—our spend on that is far too high—but sometimes when there are issues of patient safety we need a quick solution. That is what has happened in response to the Francis report: as well as recruiting 5,000 additional nurses on a permanent basis, we are using extra agency nurses. However, we hope to bring those numbers down.

T5. I congratulate the Minister of State, Department of Health, my right hon. Friend the Member for North Norfolk (Norman Lamb), who has responsibility for care and support, on securing the introduction of NHS waiting times for mental health for the first time next year. How will he ensure that the resulting treatment is not only timely but evidence-based and effective? (905568)

Last week, Mike Richards told me how waiting-time standards had transformed cancer care, and I think the same can happen for mental health. It is outrageous that somebody with a suspected cancer gets seen by a specialist within two weeks, but that if someone has a first episode of psychosis, who knows what will happen to them. That discrimination has to end, and we are delivering that.

The good people who work in the NHS have faced six years of pay restraint. How much longer must they carry the can for the failures of the people who got us into this mess—the moneylenders, the LIBOR fixers, the people who mis-sold mortgages? How much longer must front-line staff pay for the mistakes of capitalism?

Even in very difficult times this year, all NHS staff, either through their increments or through the 1% increase, will be getting a pay rise. Of course, we would like to do more, but the NHS finances are under pressure, and our priority is to ensure that we employ as many front-line staff as we can. We now have more than 13,000 more front-line staff working in the NHS than we did when we came into government.

T6. Can the Secretary of State confirm to the House whether there are any plans to sell off the NHS and will the NHS remain free at the point of delivery? (905569)

I can confirm that there are no such plans and it will remain free at the point of delivery. Nor do we have any plans to pay private providers 11% more than NHS providers, as happened under the previous Labour Government.

In response to my amendment to the Care Bill earlier this year about the portability of care packages to the countries of the UK, the Minister of State, Department of Health, the right hon. Member for North Norfolk (Norman Lamb), promised that a voluntary framework would be in place by November. It is 10 days until November, so how is progress going?

I thank the hon. Lady for that question. We have drawn up a statement of principles, we have been discussing them with the devolved Administrations and we hope very much that we will be able to achieve an agreed statement of principles in November. I cannot guarantee it, but that is absolutely our objective.

T7. Healthwatch England recently released a report, “Suffering in silence”, that found that almost two thirds of people felt that their complaint about the NHS was not taken seriously and half ended up not receiving an apology or even hearing the word “sorry”. What action is my hon. Friend taking to ensure that complaints are taken seriously in the NHS? (905570)

My hon. Friend makes an excellent point. Following the appalling systemic abuse and neglect described in the Francis report, our response, set out in “Hard Truths”, focused relentlessly on hearing the patient voice, learning tough lessons on patient safety and care, and, in particular, the creation of the new independent chief inspector of hospitals, who is looking closely at all complaints. The health ombudsman has increased its caseload and we are also taking measures to display information on how to complain in every hospital and ward across the country.

Will the Secretary of State join me in paying tribute to Eilish Hoole, who sadly passed away in July from ovarian cancer. She was only 47 and the mother of five children. Following her diagnosis of late-stage ovarian cancer she campaigned tirelessly in Parliament with Target Ovarian Cancer, which led to the recent successful pilot of the awareness campaign in the north-west. Will the Secretary of State commit to roll that out to the rest of the country so that other women in her position get to see their children grow up?

I am very happy to pay tribute to Eilish Hoole, to the many cancer campaigners and to the many people who have survived cancer and put their lives back together again. There is still a huge job to do in getting earlier diagnosis. I think there is agreement across the House about the need for much earlier cancer diagnosis, particularly for ovarian cancer, which makes a huge difference. I know that we would all like to pay tribute to her work.

NHS England has identified south Cumbria as one of just three places in England where travel times to receive radiotherapy are unacceptably and debilitatingly long. Will the Secretary of State meet me and NHS England to talk about how Kendal hospital can be the place for a new radiotherapy centre this autumn?

I would be happy to meet the hon. Gentleman and discuss this important issue for his constituents.

The NHS Litigation Authority is piloting a new approach to improve feedback and learning in response to allegations of negligence. Will the Secretary of State say how patients can find out what feedback the NHSLA has given to individual trusts and how the trusts have responded?

The hon. Lady raises an important issue, which is that the NHS Litigation Authority often picks up on things when they do not go well and when the communication between patients and trusts has broken down. That is one of the things that need to be put right. I will look into the matter and write to her, because it is important that when things go wrong patients are supported in the right way and the lessons are learned.

T9. Currently, there are no psychiatric intensive care unit beds for women in Dorset. One of my constituents was recently sent to a unit in Bradford. Will additional funding be available to address this appalling situation? (905572)

I am very happy to meet my right hon. Friend to discuss the concerns in her area. I heard similar concerns when I was in Devon last week and clearly the objective must be to have facilities close to where people live, rather than their having to travel long distances.

I assume that the Secretary of State has read the National Audit Office’s report on local funding for health care. In the 17 years for which I have been Member of Parliament for Slough, we have never reached our target for funding and now the gap between Slough’s target and our actual funding is greater than ever before. What is he going to do to ensure that areas get the funding they need to provide the health care their residents require?

First, we have made the decision an independent one, taken at arm’s length from Ministers, to try to take the party politics out of it. Secondly, we protected the NHS budget. Thirdly, one of the most important and significant things for the hon. Lady’s constituents has been the way in which the Heatherwood and Wexham Park NHS Trust has been turned round from failing and being in special measures to being taken over and run by Frimley Park NHS Trust—the most successful trust in the country.

Order. We have overrun, principally because of long questions and answers earlier, but I am keen to accommodate a couple more colleagues.

Mitochondrial technique was last tried on humans in 2003 by John Zhang, resulting, I understand, in two still births and an abortion. Last week, one of the members of an expert panel of the Human Fertilisation and Embryology Authority said he had only just become aware of Zhang’s study. What action will Ministers take to ensure that this worrying study is properly examined before any steps are taken to bring this issue before the House?

My hon. Friend takes a great interest in this matter and led the Back-Bench business debate on 1 September. I will certainly ask the HFEA and the expert panel to look at the study to which she refers, but I can provide the reassurance I have given before—that the wide body of expertise and information out there about mitochondrial disease is regularly reviewed over a long period of time.

The Secretary of State makes great play of protecting the NHS budget, but NHS England, the Nuffield Trust and his hon. Friend the Chair of the Health Committee all agree that it needs another £30 billion investment, so how can he tell people that the NHS is safe under his watch?

We have not just protected the NHS budget, but increased it in real terms, which I think is a huge achievement given the state of the economy we inherited. [Interruption.] I simply say to the hon. Lady that the way to protect and secure NHS funding for the future is by making sure that there is a strong economy to pay for it. That is the single most important thing of all.

Thank you, Mr Speaker.

Devon clinical commissioning group is embarking on a major programme of change next year, closing community hospital beds and replacing them with services at home. Do Ministers see that public and staff would have more confidence in the new services if they were being worked up first before getting rid of the existing services? Could the better care fund put money into the transition?

I thank my hon. Friend for that question. The better care fund is the biggest ever transfer of resources to preventive care and for integrated care. I saw last week in my hon. Friend’s own county fantastic integrated care in Torbay and Southern Devon NHS Trust, but I would be happy to discuss his particular concerns as soon as possible.