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Topical Questions

Volume 593: debated on Tuesday 24 February 2015

At the end of this Parliament, and before returning, I trust, to the same side of this Chamber in late May, I am pleased to update the House on NHS work force numbers. On the back of a strong economy, our NHS now has more doctors, nurses and midwives than ever before in its history, including 7,500 more nurses and 9,500 more doctors. The result is 9 million more operations during this Parliament than the previous Parliament, fewer people waiting a long time for their operations, and a start in putting right the scandal of short-staffed wards that we inherited and were highlighted by the Francis report. Indeed, last year the Commonwealth Fund said that under this Government the NHS has become the safest, most patient-centred and overall best health care system in any major country.

Let me point out that topical questions and answers should be brief. It is a rank discourtesy—[Interruption.] Order. It is a rank discourtesy to the House to expatiate at length and thereby to deny other Members the chance to put their questions. It will not happen. Simple, short, factual answers are what is required.

In the past couple of days, a number of Devon and Cornwall hospitals have declared black alert status, meaning, essentially, that they are full and cannot cope with any more demand. Do Ministers therefore understand the public concern that the clinical commissioning group is considering closing beds in community hospitals, including Ilfracombe and South Molton in my constituency? Can anything more be done to help rural health economies that are trying to restructure but already struggling to cope with existing demand?

We do understand those concerns. It is absolutely essential that CCGs make sure that they have the right bed capacity to deal with the pressures of winters.

Let me take the Secretary of State back to a subject he likes to avoid—NHS privatisation. He tries to deny that it is happening on his watch, but we heard earlier about the ideological privatisation of cancer scanning in Cheshire and Staffordshire, despite its being more expensive than the NHS bid—and now it could get much worse. On the Friday before the recess, the Government sneaked out the public contracts regulations, which require NHS contracts worth over €750,000 to be opened up to full EU competition. Will the Secretary of State confirm that that is indeed the case in these regulations, and can he explain what mandate he has from the public to open up the NHS to private bidders across Europe?

Since the last time the right hon. Gentleman and I met, the King’s Fund has published its assessment of the NHS reforms over the past few years, and its words were:

“Claims of mass NHS privatisation were and are exaggerated”.

He knows perfectly well that outsourcing grew at double the rate under the previous Labour Government than it has grown under this Government.

The King’s Fund report said that as a result of the Secretary of State’s reforms there is

“greater marketisation of the NHS”.

People will notice that he failed to answer my question. That is because he wants to sneak these plans through under the radar. I serve notice on him today that we will fight him all the way, right to the very last day of this Parliament. If passed, these regulations will mean that almost every NHS contract will be forced to be advertised across Europe, shattering the promise he made to protect the NHS from EU competition law. Is it not now abundantly clear that he has forfeited the public’s trust on the NHS, and that five more years of this Government will lead to huge acceleration in NHS privatisation?

I repeat:

“Claims of mass NHS privatisation were and are exaggerated”.

If the right hon. Gentleman does not like the reforms, let us look at a country that did not have them—Wales. The number of people waiting too long for A and E is nearly double that in England, the number of people waiting too long for urgent ambulances is nearly double that in England, and the number of people waiting for operations is 10 times that in England. That is our record—it is a record of success.

T3. Not enough GPs want to practise in rural Wales. I am told that one of the reasons is that GPs registered in England have to go through a bureaucratic process to be able to work in Wales. Will my hon. Friend the Minister work with the Welsh Government to ensure that we have a common registration process so that GPs can move between England and Wales without having lengthy, time-wasting new bureaucracy? (907720)

I am very happy to look into that issue and to do what we can to support our NHS work force to move as freely as possible between England, Scotland, Wales and Northern Ireland. GP numbers in England have increased because we have protected the NHS budget, unlike in Wales, where it has been cut by the Labour Administration.

T2. A recent Ashcroft poll shows that only 15% of the public think that this Government have the best approach to running the NHS. Will the Secretary of State stand up at the Dispatch Box and apologise for his top-down reorganisation of the NHS and his Tory privatising Health and Social Care Act, and accept that the public will never trust the Tories with the NHS? (907719)

I will tell the hon. Gentleman what the public think about the NHS: last year, under this Government, dissatisfaction was at its lowest ever level and satisfaction jumped the highest among Labour voters. And where did satisfaction go down? In Wales.

T5. I have previously made Ministers aware that there are no beds for females in Dorset who need intensive psychiatric care. Our local newspaper, the Daily Echo, reports that such places will not be provided in Dorset for another three years. Meanwhile, patients are being sent as far away as Bradford. Do Ministers regard that as satisfactory? Are there enough resources coming to Dorset, or is it a local organisational issue? (907723)

No, I do not regard that as satisfactory and I am happy to talk to the local commissioners. We have ensured that there will be real-terms increases in mental health funding for 2015-16, and that should be regarded locally as a matter of urgency.

T6. Bolton’s accident and emergency department has been in crisis recently, partly because the clinical commissioning group closed the town’s walk-in centre. Will the Secretary of State support my petition calling for its reinstatement, or will he say, more predictably, “It’s not me, guv; I’m just the Secretary of State for Health”? (907724)

I am accountable for what happens in the NHS, so let me tell the hon. Gentleman what is actually happening in Bolton: compared with four years ago, 2,756 more people are being seen at A and E within four hours. That is a record of investment and success.

What alternatives do clinical commissioning groups have to a full-scale commercial procurement when their existing contracts for community health services approach the time when they have run their course?

That is a matter for local commissioners. There is no requirement on them to tender competitively if their judgment is that it is right for the local community that services remain with the existing provider. We have been very clear that that is a matter for local commissioners.

T7. My constituent Wilma Ord was prescribed Primodos in the 1970s, an oral hormone pregnancy testing pill that she blames for her daughter’s birth defects. As the Secretary of State is aware, it was announced back in October that an inquiry would be established to look into the whole issue. What progress has been made in setting up the inquiry and what assurances can he give my constituent, and the many other women and families affected throughout the country, that the inquiry will be fully comprehensive, transparent and independent? (907725)

I am delighted to report that I have met colleagues from across the House and patient representatives of that campaign on a number of occasions. We have appointed the chair and made sure that the terms of reference for the inquiry are clear and comprehensive. It is not, I stress, a judicial inquiry; it is a medical inquiry looking at the evidence.[Official Report, 19 March 2015, Vol. 594, c. 1MC.]

A constituent of mine has pointed out that, despite it being a long-term condition, drugs for cystic fibrosis are not subject to an exemption from prescription charges, apparently because, when it was first diagnosed, it was considered to be only a children’s disease. Will Ministers look into this anomaly?

This issue came up in a debate on cystic fibrosis last year and I am very happy to look at it again. I looked at it subsequent to that debate, in response to an inquiry from, I think, the hon. Member for Colchester (Sir Bob Russell), but I am happy to look at it again and get back to my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton).

T8. When I asked the Minister last June what guarantees he would give to GP practices at risk because of the withdrawal of the minimum practice income guarantee, I was told that NHS England would ensure threatened practices “get to the right place.”—[Official Report, 10 June 2014; Vol. 582, c. 400.]Over the past seven months, those discussions have not alleviated the threat to two highly regarded practices in my constituency that face closure. Will the Minister agree to meet me and representatives of the practices to discuss what is really happening, and to consider what can be done to save them? (907726)

I am very happy to meet the hon. Gentleman, but he will be aware that the move away from the historical funding formula towards a per head or capitation formula is a move in the right direction. If there are certain local concerns, I am very happy to meet him to discuss them.

May I commend the Government on raising the priority for dementia in their announcement last week? Will the Secretary of State and the Department of Health put all their resources behind towns such as Newark, which are trying to establish themselves as dementia-friendly towns and are working with shopkeepers, banks and the business community to make it easier for older people with dementia to lead fulfilling lives?

I commend my hon. Friend on his work in that area. People with dementia want to lead as normal a life as possible, and being able to go out to the shops is one very important thing they want to continue to do. We now have 1 million dementia friends in this country. That is a great step forward, and with his help we will do even more.

When does the Secretary of State expect NHS England to confirm a date for the national tariff for the supply of prosthetic services and equipment? The lengthy and, quite frankly, unacceptable delay on his watch is now causing really serious issues for those who need prosthetics, as well as for those who want to deliver the services.

In addition to the work that Monitor does on tariffs for individual pathways, what work has it done to assess the base funding that acute hospitals need to maintain core services, which are so interdependent?

Monitor has done extensive work on this issue, but my hon. Friend is absolutely right to talk about it. If we are to meet the financial challenge that the NHS faces over the next five years, we need to have a very sensible discussion about what realistic efficiency gains need to be made, and I am sure that he will engage in those discussions.

Medway clinical commissioning group is looking at putting GPs at the front of our accident and emergency department to help relieve pressures on emergency doctors. Do Ministers believe that that is a promising way forward?

There is certainly a lot of benefit from having general practice co-located alongside A and E so that people with more minor ailments or concerns can be seen by GPs. That can often take the pressure off A and E services, but more senior expertise is also on hand when required.

I am absolutely happy to do that. Overall, we have 1,000 avoidable deaths every month by some estimates, and a number of those are from sepsis. We have launched a big campaign to prevent those deaths. Indeed, we will shortly have the results of the Morecambe Bay inquiry, from which I think we will hear more about the issue. I want to thank my hon. Friend for her campaigning and her work with the all-party group on sepsis to raise awareness of this very important issue.

GPs across the north-east say that they are facing a work force crisis, with falling numbers of family doctors. Does the Secretary of State not recognise the connection between people being unable to get an appointment to see their GP and the rising and major pressure on our A and E department?

I am sure that the hon. Lady would like to support the plans we have put in place to ensure that we increase the number of GPs by 2020, and to ensure that 50% of doctors leaving foundation training go into careers in general practice.

In order to combat fraud, the previous Government quite rightly introduced five-year prescription charge exemption certificates. Now that the certificates are coming up for renewal, people are finding that they have to pay for their medicines once their certificate has expired, and they have even been fined. Unlike for a TV licence, there is no renewal reminder. Will the Government look at how to ensure that people are told they need to renew their prescription exemption certificates?

As my hon. Friend will be aware, 90% of patients receive free prescriptions either because they are older—over the age of 60—or because of long-standing or other factors. If his constituents are running into difficulties and have problems with renewing their certificate, I am very happy to look into that and to meet him to discuss it further.

Despite assurance from the Prime Minister, it is now clear that the drug Translarna will not be available until after NHS England has concluded its internal consultations. The Secretary of State and others have told me repeatedly that they have no control over the issue, but can the Minister give the House any idea when the drug will be available for young boys suffering from Duchenne muscular dystrophy in this country, in the same way as it is across Europe? The drug is saving young boys from going into wheelchairs earlier. Does the Minister have any idea when it will be available?

I have had a number of meetings with patient groups, campaigners and charities over recent months, and the hon. Gentleman will appreciate that due process is important. NHS England is looking at whether to make an interim ruling on the drug in advance of a decision by the National Institute for Health and Care Excellence, and I have worked with NICE to ensure that its process is accelerated. We should get a decision from NICE this summer, and I hope that NHS England will make a rapid decision based on that judgment.

Order. I am sorry to disappoint remaining colleagues, but as usual demand has exceeded supply.