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Topical Questions

Volume 605: debated on Tuesday 9 February 2016

Significant progress has been made in our negotiations with the British Medical Association on a new contract for junior doctors, but agreement has not been reached on the issue of Saturday pay, despite previous assurances from the BMA that it would negotiate on that point. So, regrettably, 2,884 operations have been cancelled ahead of tomorrow’s industrial action, which will affect all non-emergency services. I urge the BMA to put the interests of patients first and to reconsider its refusal to negotiate.

At Prime Minister’s questions in February 2014, I raised with the Prime Minister my very serious concerns about the dangerous bullying culture at Liverpool Community Health NHS Trust. I understand that the Capsticks inquiry into parts of that is now complete, so will the Secretary of State, in the spirit of honouring his stated commitment to openness and transparency, ensure that that report is made available, perhaps via the NHS Trust Development Authority, if necessary, to the public trust board on 23 February?

I will happily look into that matter. The Under-Secretary of State for Health, my hon. Friend the Member for Ipswich (Ben Gummer), has held a round table on bullying and harassment. I thank the hon. Lady for raising the issue, because over the past decade—none of us should be proud of this—the number of NHS staff who say they are suffering from bullying and harassment has gone up from 14% to 22%. If we are going to deliver safer care, we have to make it easier for doctors and nurses on the frontline to speak out without worrying about being bullied or harassed.

Order. As in the health service, so at Health questions: demand always exceeds supply, so we need short questions and short answers.

T4. I am sure Ministers will join me in congratulating Number 18 surgery in Bath on being ranked in the top 10 GP practices in the country. Do they agree that patients having a choice of where they are treated will increase patient satisfaction in the NHS? (903563)

Yes, it certainly will. That is another reason why we hope to have 5,000 more doctors and 5,000 more allied health professionals working in general practice, to expand the primary care service by 2020.

Today’s The Independent reports that a potential deal on the junior doctor contract was put to the Government that would have resolved junior doctors’ concerns without costing any more money and potentially avoided tomorrow’s industrial action. A source close to the negotiations told the newspaper:

“The one person who would not agree was Jeremy Hunt. Even though the NHS Employers and DH teams thought this was a solution he said no”.

So let me ask the Health Secretary a very direct question: have the Government at any point rejected a cost-neutral proposal from the BMA on the junior doctor contract—yes or no?

The only reason we do not have a solution on the junior doctors is the BMA saying in December that it would negotiate on the one outstanding issue—pay on Saturdays—but last month refusing to negotiate. If the BMA is prepared to negotiate and be flexible on that, so are we. It is noticeable that despite 3,000 cancelled operations, no one in the Labour party is condemning the strikes.

I am aware of my hon. Friend’s keen interest in the rebalancing programme of work, and particularly the work on dispensing errors. We are fully committed to making that change. There are a number of stages to amending primary legislation through a section 60 order. Given the timetable, it is likely that the order will be laid before the Westminster and Scottish Parliaments in the autumn.

T2. The Secretary of State will be aware that Maximus is recruiting junior doctors to perform work capability assessments in the Department for Work and Pensions. The company is offering £72,000 a year, which is up to twice the salary that junior doctors would get in the health service. Is he concerned that that will result in inexperienced medical staff making judgments that relate to people’s livelihoods? Is he not also concerned that it will result in a drain of staff resources out of the NHS and out of providing general healthcare for the public? (903560)

As a result of the changes the Government have made on welfare reform, we have 2 million more people in work and nearly 500,000 fewer children growing up in households where nobody works. Part of that is making important reforms, including having independent medical assessments of people who are in the benefit system. I think everyone should welcome that.

T8. Comparative research has shown that proton therapy is as effective as radiotherapy for certain cancers, but has fewer side effects. Do Her Majesty’s Government accept the use of comparative evidence in deciding the availability on the NHS of emerging treatments such as proton therapy? (903567)

I will reflect on the wider point my hon. Friend makes, but the House will be keen to know that we are investing in building two proton beam therapy facilities at the Christie in Manchester and University College London hospitals. Work has already started on that £250 million project, and the first facility is due to become operational in 2018.

T3. Will the Secretary of State provide an update on efforts and contingencies to combat the Zika virus, and on how that is being co-ordinated with the devolved Administrations, including Scotland? (903561)

The Government are taking the matter extremely seriously, and they have it under active review. Up-to-date medical guidance has been cascaded to the NHS in England. As the hon. Gentleman will know, the UK is at the forefront of some of the world’s response. We are a major funder of the World Health Organisation. We have got people on the ground helping in Brazil, in particular. I assure him that we are maintaining close links with the devolved Administrations at official level, and I am always happy to speak to colleagues. We take very seriously keeping those links live.

T9. Has the Secretary of State seen the comments of Professor Angus Dalgleish, who is widely reported in the papers today as suggesting that EU rules are forcing us to spend billions of pounds treating health tourists and preventing us from undertaking important clinical trials? Has the Secretary of State made any assessment of Professor Dalgleish’s comments? (903568)

The Government have made a huge and significant assessment of the cost of overseas people using the NHS, and we think that there are £500 million of recoverable costs that we do not currently recover. When it comes to the EU, the biggest problem that we have is that we are able to reclaim the costs of people temporarily visiting the UK, but we do not do so as much as we should because the systems in hospitals are not as efficient as they need to be. We are sorting that out.

T5. Despite the prevalence of pancakes in Parliament today, I am pleased to be asking a food-related question. A recent opinion poll performed by Diabetes UK showed that three quarters of British adults think food and drink manufacturers should reduce the amount of saturated fat, salt and sugar in their products. Does the Minister support introducing mandatory targets for industry to reformulate food and drink products to help people to eat more healthily, and will that form part of the Government’s childhood obesity strategy? (903564)

We made considerable progress in this area in the last Parliament, under the responsibility deal, but we have always said that there is more to do and the challenge to industry remains. We will say more about that when we publish the childhood obesity strategy in due course.

Midwife-led units, such as the brilliant Crowborough birthing centre in my constituency of Wealden, are key to the provision of high-quality, safe and compassionate maternity care. Last year, it scored 100% satisfaction on a friends and family survey. Will my hon. Friend outline the Government’s plans for midwife-led care, particularly given this weekend’s launch by The Sunday Times of the safer births campaign?

Midwife-led units have increased in number in the past few years, to the great advantage of women wanting a full range of choice when they give birth. That is why we are all looking forward to the publication of the Cumberlege review, which I hope will map out the future of maternity services and show what midwife-led units will do within maternity services in the NHS. I am very excited about that, and I know that my hon. Friend will be, too.

T7. Ministers will be aware of The Lancet series on breastfeeding and the open letter signed today by a range of organisations in the field calling for concerted action to promote, protect and support breastfeeding. Will the Minister meet me and these organisations to discuss the proposals further? (903566)

I am aware of The Lancet review, which makes some important points. We are not doing well enough yet in England, and it is of note that progress has been made in Scotland, Wales and Northern Ireland that we should be able to copy in England. I know that the Under-Secretary of State for Health, my hon. Friend the Member for Battersea (Jane Ellison), who has responsibility for public health, will want to hold such a meeting to discuss that. We have made considerable progress, but there is still a differential between rich and poor that we need to fix.

I am pleased to support the National Society for the Prevention of Cruelty to Children’s “It’s Time” campaign, which is an initiative to ensure that children who have been the victims of abuse receive ongoing support. May I seek assurances from the Government that they will actively help with this initiative?

Yes, indeed. We strongly support the initiative. Our work to look after children who need extra care, particularly in relation to their health and emotional needs, has been helped by the transforming care package, which is going through local authorities at the moment. Their vulnerabilities are certainly a matter of great concern, and that will be followed up by the Government.

Over 1 million elderly people are able to maintain independence and remain in their own homes due to the attendance allowance. What discussions has the Minister had with his colleagues about ensuring, when the fund is transferred from the Department for Work and Pensions to the Department for Communities and Local Government, that the allowance will remain at the same level?

The consultation is ongoing between Departments. A unit has been set up by the Department of Health and the DWP to look at a range of issues that concern us both. The actual detail of the future attendance allowance has not been finalised yet, but it is a matter of concern and discussion between Departments.

In asking a question about mental health, may I remind the House that I am married to an NHS forensic psychiatrist, who is also registrar of the Royal College of Psychiatrists? Have the Government looked carefully at today’s report from the independent commission on improving mental health services, particularly its finding that provision nationally for the most severely ill acute patients is inadequate? Will the Government set out what measures they will take to make sure we really see progress on parity of esteem and on improving access to such severely ill patients?

I thank my hon. Friend for her question, and the Royal College of Psychiatrists for its work on Lord Nigel Crisp’s commission, which we have supported. The report and recommendations have only just come to us, but they certainly travel in the direction in which the Government are already going. We want to reduce out-of-area placements. The NHS is already committed to that, and is working on moving to a definitive target to reduce the number of them and, I hope, eventually to scrap them. I was up in Hull last week to look at problems in that particular area. The recommendations on waiting times are very important. As we all know, this area has been undervalued in the past. It is under greater scrutiny, and more investment and support are going in through the Government. Today’s report will help us in relation to that.

Leeds has a shortage of integrated care beds and pressure on acute services. Will the Secretary of State—[Interruption.] That was a comma, Mr Speaker. Will the Secretary of State please intervene, so that Leeds Teaching Hospitals NHS Trust can open wards at Wharfedale hospital, which it wants to do, while the clinical commissioning group provides the money?

By refusing to condemn the junior doctors strike, the hon. Member for Lewisham East (Heidi Alexander) has shown that she has little regard for patient safety. [Interruption.] Will my right hon. Friend repeat his condemnation of this strike, which will seriously endanger patient safety, and assure me that he will continue to press for the new contracts, which will guarantee safer patient care and a better contract for doctors?

I think my hon. Friend got a bit of a reaction with those comments. The Labour party is saying that if a negotiated settlement cannot be reached, we should not impose a new contract—in other words, we should give up on seven-day care for the most vulnerable patients. There was a time when the Labour party spoke up for vulnerable patients. Now it is clear that unions matter more than patients.

The 6% cut in the pharmacy budget will come in in October—halfway through the next financial year. Will the Minister tell us what the percentage cut will be in a full financial year?

Negotiations are ongoing with the Pharmaceutical Services Negotiating Committee. The amounts that have been set out cover this financial year and the settlements are moved on from year to year, so the discussion is ongoing. The future for pharmacy is very good, although it will be different, as the profession has wanted for some time. Not only is there a great future for high-street shops in areas where we need them, but there will be an improvement in and enlargement of pharmacy services in healthcare settings, primary care settings and care homes around the country.