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Topical Questions

Volume 615: debated on Tuesday 11 October 2016

Last week, I announced plans to make the NHS self-sufficient in the supply of newly qualified doctors by the end of the next Parliament. We recognise the brilliant work that is done by the many outstanding overseas doctors who work in the NHS and have made it clear that, whether or not they are from the EU, we wish that work to continue post-Brexit. However, as the fifth largest economy in the world, Britain should be training all the doctors it needs. While there will always be beneficial exchanges of doctors and researchers between countries, we have a global obligation to train enough doctors for our own needs, otherwise the inevitable consequence will be to denude poorer countries of doctors whose skills are desperately needed.

Thornbury health centre is crying out for redevelopment to cater for the growing local population. Will my right hon. Friend meet me, representatives of the health centre and NHS Property Services to see how we can take a co-ordinated approach that will move the health centre forward?

I can do better than that, because I have said that I am prepared to go to the health centre. I remember a very good visit to Thornbury community hospital during the general election campaign. I understand what those at the health centre are trying to do and they are absolutely right to be thinking about how they can improve out-of-hospital services.

Will the Secretary of State look into the creation of a sideways move for a chief executive of a trust that was criticised for failing to investigate patient deaths? Six weeks after the special recruitment exercise by Southern Health, Katrina Percy has resigned from her advisory role, with a substantial 12-month salary payoff that has been signed off by the Department of Health and the Treasury. The campaign group, Justice for LB, has called that “utterly disgraceful” and I agree. Will the Secretary of State investigate?

I agree with the hon. Lady that the way this case was handled was by no means satisfactory. The truth is that it took some time to establish precisely what had gone wrong at Southern Health. As this House knows, because we made a statement at the time—I think it was an urgent question, actually—there was a failure to investigate unexplained deaths. I do not think the NHS handled the matter as well as it should, but we now have much more transparency and we do not have a situation where people go on and get other jobs in the NHS, which happened so often in the past.

T4. What will the Government do to scrutinise and assist the London ambulance service, which has had an appalling and consistently poor record on call-out times for category A emergencies? (906472)

My hon. Friend is right to highlight the fact that the London ambulance service is in special measures and has been for some time. I visited it this summer and am pleased to confirm that some £63 million of additional funding has been provided to the ambulance service since April 2015. The service is starting to make significant inroads in increasing the number of paramedics who are available on call, with some 250 more being added over the last couple of years.

T2. Last October, the then Health Minister, the right hon. Member for North East Bedfordshire (Alistair Burt), confirmed that my constituency fell far below the national average in terms of NHS dental provision. In fact, it is one of the worst in the country. Unfortunately, nothing has changed since then. Does the Secretary of State believe it is acceptable that my constituents, including many children, are unable to get an NHS dentist? (906470)

It is clearly unacceptable if the situation that the hon. Lady sets out is the case. I am happy to meet her and work with her to take the action that is needed to make things better.

T6. The Government have provided a welcome increase in funding for mental health support, yet it does not appear to be reaching my constituency effectively, particularly for children. Now there are concerns that the Millbrook unit at nearby Macclesfield hospital might close. Will the Secretary of State look into those concerns? (906474)

I am very happy to do that. My hon. Friend is right to highlight the fact that the provision of mental health services to children is one of the biggest weak spots in NHS provision today. It is an area that we are putting a big focus on. I would be happy to talk to her about the situation in her constituency.

T3. I know that this is a devolved matter, but I look forward to the Union working together on it. In Northern Ireland, the health service is in crisis. To give cancer as an example, 6.7% of those with breast cancer are called in to be checked within 14 days—not 100%—and yet we have 392,000 people on the waiting list. Will the Secretary of State or his officials meet us to find a better way forward, so that we can all work together? (906471)

I have made it clear that we should all be working together to defeat cancer. We know that the best way of doing so is early diagnosis. We have made a lot of progress on that in England over the past few years but have a lot further to go. We are of course willing to talk to the devolved Administration about what they can learn from us—and perhaps vice versa.

T7. Will the Secretary of State look again at the decision not to fund second stem cell transplants for adults and children with blood cancers, given the significant clinical evidence of their benefit for those who relapse? He should not just take my word for it but should take it from the Anthony Nolan Trust and the 36 specialists who have written to him asking him to review the decision. (906475)

This is a very difficult area, but decisions on priority are clinically driven and must continue to be based on peer-reviewed data. The most recent review determined that less than one third of second transplants would result in survival after five years; that is why they were not funded. There will, however, be a further review next April, and to the extent that the data have changed there will be a new evaluation at that time.

T5. Deer Park medical centre in Witney faces closure, and patients will be dispersed a long way into other practices in an area where one in four already waits more than a week to see their GP. Duncan Enright, who is Labour’s candidate in the Witney by-election, is campaigning to save the centre. Will the Secretary of State reward his campaign by saving it today? (906473)

The Conservative candidate in the Witney by-election will be saying very clearly that because of the extra funding from this Government we are aiming to have 5,000 more doctors working in general practice by the end of this Parliament, something that would not have been possible with the increase of less than half that amount promised by the Labour party.

T8. As Ministers will be aware, this week is baby loss awareness week. Access to neonatal cots and neonatal transport services are vital parts of the care of premature and sick babies. What assurances will my right hon. Friend give that his Department is continuing to review the findings of the Bliss report, and when can we expect to hear more? (906477)

I am grateful to my hon. Friend for raising baby loss awareness week. I am sure that, along with other hon. Members, she will be participating in the Backbench Business debate on that later this week. In February the independent maternity review, Better Births, made a number of recommendations, including on neonatal critical care. We are studying those recommendations and are due to report initial findings from our work in December.

I listened very closely to the Secretary of State’s comments earlier on mental health. On 9 December he stood at that Dispatch Box and said that

“CCGs are committed to increasing the proportion of their funding that goes into mental health.”—[Official Report, 9 December 2015; Vol. 603, c. 1012.]

However, my research shows that 57% of clinical commissioning groups are reducing the proportion they spend on mental health—yet another broken promise. When will we have real equality from this Government for mental health?

I will tell the hon. Lady what this Government have done. We have legislated for parity of esteem for mental health. We are treating 1,400 more people every single day for mental health conditions compared with six years ago. We have a new plan that will see 1 million more people treated every year by 2020, including a transformation of child and adolescent mental health services. That is possible because we are putting into the NHS extra money that her party refused to commit to.

T9. Does my right hon. Friend agree that the Government have a moral obligation to end the raid on poorer countries for their skilled doctors and nurses and to make our NHS recruitment more self-sufficient? (906478)

My hon. Friend is absolutely right. I find it extraordinary that the Labour party said that our plan to train more doctors was “nonsense”. We currently have 800 doctors in the NHS from Sri Lanka, 600 from Nigeria, 400 from Sudan and 200 from Myanmar. They are doing a brilliant job and I want them to continue doing that job, but we have to ask ourselves whether it is ethical for us to continue to recruit doctors from much poorer countries that really need their skills.

I was alarmed to read at the weekend that NHS chiefs are warning that hospitals in England are on the brink of collapse. Is it the Government’s intention to cut the public supply of healthcare in order to create demand for a private healthcare system, or will they give the NHS the additional funds it needs?

Let me remind the hon. Lady that the party that introduced the most outsourcing to the private sector was her Labour Government under the previous Health Secretary, Alan Milburn. Our view is that we should be completely neutral as to whether local doctors decide to commission their care from the public sector or private sector. We want the best care for patients.

I welcomed last week’s NHS Improvement report which states that there are now sufficient staff for Chorley and South Ribble hospital’s A&E department to reopen, but I am dismayed that the trust is delaying the reopening until January next year. Will the Minister reassure me that he will work with me and other stakeholders to oblige the trust to open as soon as possible?

My hon. Friend has been a doughty champion of Chorley, in combination with another Member of the House and local campaigners, who visited the Houses of Parliament yesterday to meet local MPs. While welcoming the reopening of the A&E from January, I am happy to continue to work with my hon. Friend to see whether it can be brought forward.

The other doughty champion of the hospital is of course the right hon. Member for Chorley (Mr Hoyle), who regularly deputises for me in this Chair. I am sure the House will want to acknowledge that important fact.

I heard the Minister’s response earlier. He was of course right that sustainability and transformation plans are led locally, but he failed to acknowledge that the Government have given a mandate to make cuts attached to STPs. Without consultation, my local hospital has been downgraded. What on earth will the Secretary of State say to my constituents who may lose loved ones because they have had to travel miles further to another hospital?

If I may, I will give a quote:

“To reshape services over the next 10 years, the NHS will need the freedom to collaborate, integrate and merge across organisational divides.”

That comes from the 2015 Labour manifesto. The STP process is designed to bring about better care and health, and better productivity. We should be critical friends of the process because we all want a better national health service.

Local health commissioners have concluded that Telford’s brand new women and children’s centre, which serves some of the most deprived populations in the country, should be closed and moved to a more affluent area where health is better than the national average. The commissioning process has lost the confidence of local people. Will the Secretary of State intervene and ensure that local health commissioners fulfil their legal duty to reduce health inequalities?

I thank my hon. Friend for standing up for her constituents—it is absolutely right that she should do so. She would agree that that has to be a local matter led by commissioners locally, but she can be reassured that we are always watching what is happening to ensure that people follow due process, and that the results of any changes proposed benefit patients as intended. I will therefore watch very carefully what is happening in Telford and in Shropshire more broadly.

About half a dozen times in the last hour, the Secretary of State has bragged about the extra money he is putting in to the national health service, so why is Bolsover hospital, like many others that have been referred to in the past half hour, due to close? Why are neighbouring hospitals in countless constituencies in Derbyshire closing? Why does he not use some of that money to save the Derbyshire hospitals?

The extra money we are putting in to the NHS is going to better cancer care, better mental health care and better GP provision—it is going to all the things that Members on both sides of the House know matter. It will also mean that we can support our hospitals better. With our ageing population, we will continue to have great demand for hospital care, but the best way to relieve pressure on those hospitals is to invest in better out-of-hospital care, which has not been done for many years.

Kettering general hospital is treating a record number of patients with increasingly world-class treatments, yet despite being located in an area of rapid population growth, due to an historic anomaly, the funding for the local clinical commissioning groups is among the worst in the country in relative terms. What can Her Majesty’s Government do to correct that?

I am happy to look at that particular funding issue for my hon. Friend. I know that Kettering hospital is under a great deal of pressure. The one thing that it could do to relieve its financial pressures is to look at the number of agency and locum staff that it employs. As with many hospitals, there are big savings to be made in that respect in ways that improve rather than decrease the quality of clinical care.

The Secretary of State will be aware that the Public Accounts Committee has questioned both the Department of Health and NHS England on the parlous state of NHS accounts this year, following the comments by the Comptroller and Auditor General. It is clear that STPs are the only plan on the table. Will the Secretary of State make clear his support to the NHS to deliver the STPs in the teeth of opposition from his own Back Benchers? If he will not, what is plan B?

I do not recognise the picture the hon. Lady paints about opposition to STPs. We need to ensure we have good plans that will deliver better care for NHS patients by bringing together and integrating the health and social care system, and improving the quality of out-of-hospital plans. While we are in a period where those plans have not been published there will obviously be a degree of uncertainty, which we will do everything we can to alleviate, but she is right to say that these plans are very important for the future of the NHS. The process has our full support.

The Secretary of State will be aware of the concern in my constituency about the future of Paignton hospital, which prompted hundreds to turn up to a recent meeting. Does he agree with me that it is vital the clinical commissioning group, in publishing its plans, does not just publish what it will remove but the details of what it will replace them with?

Considerable efforts are going into sorting out some of the historical challenges in the provision of both acute and community care in Devon. I hosted a meeting for a number of colleagues who are concerned about this and I am happy to continue to engage with colleagues across the county.

Two years ago, Nottingham University Hospitals NHS trust privatised support services, including cleaning, handing them over to Carillion in an effort to save money. Since then there have been shortages of equipment, shortages of staff and an appalling decline in standards of cleanliness. Will the Secretary of State condemn Carillion for putting patients at risk? When will he ensure that hospital services in Nottingham are properly funded?

The decision on whether to outsource services must be a matter for local hospitals. I know that that hospital has been struggling with its deficit. I have been to visit the hospital myself and I know it has been trying very hard to improve clinical care. If the contract is not working and the quality is not right, I would expect the hospital to change it, but it must be its decision.

I am sorry, but, rather as in the health service under any Government, demand has exceeded supply and we must move on.

I was keeping the hon. Lady waiting for only a moment, so that there was a due sense of anticipation in the House. That sense now definitely exists.