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Topical Questions

Volume 609: debated on Tuesday 10 May 2016

Last week I agreed to pause the introduction of the new junior doctors contract for five days and return to talks with the junior doctors committee. I commend the junior doctors for their decision to return to talks. They have agreed to suspend the threat of further industrial action and those talks are now in their second day. We have always been clear that we want to see a negotiated solution to this dispute, and the resumption of these talks shows that the Government’s door is and always has been open to meaningful talks.

Last Friday I met my constituent Lisa Cass whose son Ben was recently diagnosed with type 1 diabetes. Ben had been showing signs of the four T’s of type 1 diabetes—toilet, thirst, tired and thinner—and Lisa took him to her local GP for an appointment. No test was done on the day at the surgery and a blood test was booked for the following week. The following day Ben was back at his GP’s surgery after a rapid decline which could have been fatal, and the air ambulance was called. Thankfully—credit is due to the excellent medical professionals who treated Ben—he is now doing well and is managing his condition. However, this case shows the need for awareness of type 1 diabetes to be improved right across the country. Will my right hon. Friend meet me and my constituent to see what more we can do to raise awareness of type 1 diabetes and its symptoms among health professionals and the wider public?

Of course I am happy meet my hon. Friend and his constituents. A close friend of mine who wanted to take a place in this House ended up dying tragically early because he had type 1 diabetes and was not able to get the care that he needed, so I am very aware of those issues. What we are doing in England, which is different from Wales, is publishing transparent indicators of the quality of diabetes care CCG by CCG. Those data will be published before the summer recess and will enable us to look at the disparities in care. I am sure there is more we can do.

Research published yesterday by NHS Providers and the Healthcare Financial Management Association showed that half of mental health trusts had not had an increase in their budget in 2015-16 and just a quarter of providers are confident that they will receive a funding increase for this financial year, 2016-17. Will the Secretary of State finally admit that the supposed additional investment in mental health that he talks about so often has not materialised for the patients and services that need it most? What is he going to do about it?

I thank the hon. Lady for her question and for her support for me in the recent London marathon. With reference to her question, it is precisely for the reasons she gives that it is so important for us to make sure that CCGs do transfer the extra money that is available for mental health into mental health services. That is why there will be more transparency and a scorecard for CCGs. She is absolutely correct—it is essential that that money flows through and we are determined to ensure that. Yesterday’s report only shows how right our current actions are to make sure that that happens.

T3. The Havant Men’s Shed movement has created community workspaces across my constituency, helping to boost mental health and wellbeing, especially for older residents. Will the Minister join me in congratulating the movement on its work and come to Havant to open its new building? (904930)

Yes. My family know I am a keen supporter of the shed movement, just as I am a keen supporter of the 5 Live Saturday afternoon movement and the beer in the shed movement. I can assure my hon. Friend that an opportunity to visit the Havant Men’s Shed movement will be an important part of the ministerial diary in the very near future.

T2. During March, at one of my local trusts the A&E ambulance target was missed for 937 patients, and more than 4,000 patients waited for more than four hours in A&E. Staff and management agree that this is a trust in crisis, with many wards staffed to less than half the minimum safe staffing levels. Patient safety is being compromised every day. Will the Secretary of State please stop passing the buck and act to stop the downgrade of Dewsbury and Huddersfield hospitals, because it is clear that our local healthcare is in absolute crisis? (904928)

The hon. Lady mentioned to me yesterday that she would raise this issue today. We are absolutely not passing the buck; the Under-Secretary of State for Health, my hon. Friend the Member for Ipswich (Ben Gummer), had a very productive meeting with her and local representatives to address these issues. She is right to have concerns about some of the safety indicators, but it is also true that summary hospital-level mortality for the trust has improved, and there are encouraging improvements in morale, as recorded through the NHS staff survey. However, there are worrying things, and we will continue to monitor them closely.

T4. Last month, Coperforma took on the patient transport contract for Sussex. Unfortunately, since then there have been unacceptable and serious delays for some very sick and elderly patients. May I have assurances that the Department of Health will follow up this issue? (904931)

Sussex CCGs are responsible for monitoring Coperforma’s performance, and High Weald Lewes Havens CCG acknowledges that, as my hon. Friend said, the early performance of the new non-emergency patient transport service has not been acceptable. For that reason, the CCG, on behalf of all Sussex CCGs, has begun an inquiry, with the aim of making a report available by June, and with interim progress reports. We will of course monitor the issue carefully.

T5. In my corner of Essex, there is a primary care crisis: demand for GP services is rising, the supply of GPs is falling and many surgeries are simply no longer accepting new patients. What assurance can the Minister give me that we will definitely get more GPs, and when will we get them? (904933)

The concerns the hon. Gentleman raises are very real, and they are shared by GPs around the country, which is why we put so much work into analysing them. The recently published “GP Five Year Forward View” addresses a number of concerns brought to us by GPs, but the determination to have 5,000 more doctors working in general practice by 2020 is a reflection of the fact that making sure there are enough doctors physically to work in general practice is an important aim of the Government’s.

T8. My constituent Archie Hill and his parents, Louisa and Gary, were really excited when, on 15 April, the National Institute for Health and Care Excellence recommended that the drug Translarna—a breakthrough drug for children with Duchenne muscular dystrophy —should be funded by NHS England. Hon. Members can imagine what happened when, on 4 May, NICE unexpectedly announced that it required extra time to come to an agreement with NHS England. What is going on? We thought this drug had been cleared. Time is of the essence, because the boys affected are eligible for this drug only if they are still walking. Can we please look into this issue, and can we please go back to the original timetable? After all, these boys have had to wait several years to get to this stage. (904936)

I commend my right hon. Friend, and we have had numerous discussions over the last year on this subject. She can rest assured that I am actively doing everything I can to make sure we expedite this. She will understand that there are important negotiations with NHS England, NICE and the company at the moment, which are key to making sure we can get this drug accelerated quickly.

T6. Other EU countries charge us £650 million a year more for the health treatment of our citizens abroad than we do for the treatment of their citizens here. Is that because we cannot charge them, or because we have not got our act together? (904934)

The answer, regrettably, is that for many years we have not got our act together. That is why I have changed the system of incentives for trusts to make sure that they get a premium for identifying EU nationals they treat and that we can then recharge the treatment to their home countries. We are, as a result, now seeing significant increases in the amount we are reclaiming from other countries.

Community hospitals are immensely valued by the communities they serve. Will the Secretary of State meet me to discuss the proposals for south Devon, which will particularly affect my constituents living in Dartmouth and in Paignton?

Yes, I am happy to do that. I have a number of community hospitals in my own area. It is really important that even as the functions and jobs that community hospitals do inevitably change, we recognise that they have a very important long-term future in the NHS.

T7. Wigan A&E is expected to take a third of the patients turned away from Chorley A&E owing to Chorley’s unplanned closure, yet it has a similar ratio of staffing vacancies. What extra resources are being given to Wrightington, Wigan and Leigh NHS Foundation Trust to help it to cope with this crisis? (904935)

We are making sure that neighbouring hospitals have the resources to deal with the temporary closure of Chorley A&E. The more patients that any hospital sees, the more resources it gets. This is none the less a very worrying situation that we are monitoring very closely.

The success regime review in Devon is causing real concern about the future of acute services at North Devon District Hospital. Does the Minister recognise that the unique geographical circumstances of Barnstaple mean that the reduction of any of those services will, for some of my constituents, mean a round journey of more than 120 miles to access them?

I do recognise the unique geographical circumstances in my hon. Friend’s constituency. That is precisely why the success regime is being led by local clinicians. I hope and expect that in formulating plans they take account of all the views and all the clinical needs of his constituents and his own views.

There is growing concern that the additional investment in children’s mental health services committed last year is not getting through to where it is intended. What will the Secretary of State do to guarantee that that money gets through to help children with mental health needs? It would be scandalous if it did not get through. Transparency is not enough.

I thank the right hon. Gentleman for all the work he did in relation to this. I can assure him that the £1.25 billion committed in the 2015 Budget will be available during the course of this Parliament. As I said to the hon. Member for Liverpool, Wavertree (Luciana Berger), it is absolutely essential to me and to us that we make sure that that money does get through to CCGs. The regime will be more transparent, but there will be a determination to expose it to make sure that the money is spent on child and adolescent mental health services, as it needs to be.

My right hon. Friend will be well aware that the business case for the rebuilding of the Royal National Orthopaedic Hospital has been dragging on within the NHS for more than six years. We now seem to have a decision for the Trust Development Authority to make. Will he put pressure on the TDA to approve this business case so that work can begin this summer?

As my hon. Friend knows, I have done a shift as a porter in that hospital and seen for myself just how much it needs the extra investment to transform its facilities. I will happily look into the matter for him, and I am keen to see it progress as fast as possible.

The Minister will be aware that mortality rates in England and Wales have increased by 5.4% in 2015—the biggest increase in the death rate for decades. She will also be aware that mortality rates have been rising since 2011. Has she done any analysis of what has been behind those trends? Specifically, with the Cridland review starting, what will her Department do to negotiate with Cridland on the increase in the pensionable age to take account of the recent changes taking place?

We welcome the overall trend towards longer life expectancy. There are annual fluctuations, but overall the trend remains positive. The key thing is helping people to live longer, healthier lives. Therefore, tackling health inequalities among people of all ages and in all communities is embedded in policy right across the Department—for example, the investment in nearly doubling the health visitor workforce over the previous Parliament—so that we can really bear down on the things that drive those health inequalities, particularly among poorer communities and poorer children.

I thank the Secretary of State for working so tirelessly to get the BMA back to the negotiating table. Will he confirm that Saturday pay for junior doctors will be at a 30% premium, which is above that for any of the hard-working midwives, nurses, firefighters, paramedics and so on in my constituency?

I thank my hon. Friend for her question. She makes the important point that the proposals on the table in the new contract are incredibly generous compared with the terms of the other people working in hospitals. That is why it is very important that we have some flexibility from the BMA on Saturday pay so that we can deliver the seven-day service that we all want. It is a very good deal for junior doctors, and I think that if they look at it objectively, we should be able to come to an agreement this week, but it will take flexibility on both sides.

Order. I shall call the hon. Member for Nottingham North (Graham Allen) if he guarantees that his grey cells will produce a one-sentence, pithy question.

Will the Minister responsible for dental matters meet me and the hon. Member for Mole Valley (Sir Paul Beresford) to discuss dental ill health in children and how we can change the dentist contract to make it more prevention-friendly? I have got a lot more to say, but I will sit down.

Marvellous. I am sorry to disappoint remaining colleagues, but we must move on. I am most grateful to colleagues for their good humour.