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Topical Questions

Volume 631: debated on Tuesday 14 November 2017

As well as congratulating the Minister for Public Health on being an excellent ambassador for the United Kingdom at the G7 health summit in Milan, I congratulate Colchester Hospital University NHS Foundation Trust on exiting special measures. It is the 21st trust to do so and was in special measures for longer than any other trust. The fact that it got a good rating for compassion, for the effectiveness of its care and for its leadership is a huge tribute to the hard work of staff.

Back in July, Ministers said that the goal was to ensure that patient access to innovative medicine is well protected

“through the strongest regulatory framework and sharing of data.”

Therefore, will the Secretary of State confirm that the UK will definitely be signing up to the new clinical trials regulation system, so that pharmaceutical companies do not have to move trials overseas?

That is absolutely our intention. We have signalled to the EU and to European countries that we want the closest possible relationship post-Brexit. We have made that big and generous offer, and we hope that they accept it.

T3. Thank you, Mr Officer Dibble Speaker. In my constituency we have the outstanding-rated Worthing Hospital and some outstanding GP practices, but we also have the Sussex and East Surrey sustainability and transformation plan, which has been rated in category 4 —“needs most improvement”. Part of the problem is that it is too big and does not follow a natural footprint. Will the Minister support local calls for it to be withdrawn, and help to make it fit for purpose and sustainable? (901684)

Sustainability and transformation plan footprints were determined as a result of discussions between local areas, NHS England and NHS Improvement. They reflect a number of factors including patient flow, the location of different organisations in the local health economy and natural geographies. We stated in the next steps of the “Five Year Forward View” that adjusting STP boundaries is open to discussions between us and NHS England when that is collectively requested by local organisations, and we mean that.

Last month, Lloyds announced the closure of 190 community pharmacies. The company’s managing director was very clear that this action was a result of recent cuts to pharmacy budgets. Does the Minister have any idea how many community pharmacies are at risk of closure as a result of Government cuts, and what assessment has he made of the likely impact of these closures directly on patients and the wider NHS? Will he join me in asking the Chancellor adequately to fund this vital service?

The hon. Lady will have to wait for the Budget like everybody else. We continue to monitor the market carefully in the community pharmacies sector. Access to pharmaceutical services is very good in England, with 88% of people falling within a 20-minute walk of a community pharmacy. For areas with fewer pharmacies, our access scheme continues to provide additional protection, and a growing number of internet pharmacies also support access, offering patients greater choice. Pharmacies are a critical part of the primary care infrastructure in this country.

T2. A few months ago, Medway hospital came out of special measures, with the improvement to patient safety being one of the most notable highlights in the report. Given the success in my local area, will my right hon. Friend inform the House what progress he is making to boost patient safety across the rest of the country? (901683)

I am happy to do that. I had a very good visit to Medway recently, and Lesley Dwyer and her team are doing a fantastic job there. They had real challenges to turn the trust around, but they succeeded, and the staff did amazingly well. However, the truth is that we still have far too high levels of avoidable harm across the NHS. I want us to be the safest in the world. That is why, in the next few months, we will see campaigns to improve maternity safety, to deal with medication error and to improve transparency when there are avoidable deaths.

T5. Could I raise the issue of mesh implants, which has been raised with me by constituents? A report in the United States indicates the associated pain—the headaches and the aches and pains in joints. Are Her Majesty’s Government looking at this issue? Rather than Ministers saying that this is merely a matter for the devolved Administrations, it would be instructive if they could give me an answer, because that would help inform the Scottish Government. (901686)

The hon. Gentleman raises an issue that is of concern to many women up and down the country, and no one can fail to be moved by some of the horrendous injuries they experience. We now have 18 centres of specialist care that can treat those women. However, the advice we still receive is that, in some very narrow cases of stress incontinence, mesh remains the best possible treatment. The issue will be kept under review, and my noble Friend Lord O'Shaughnessy is due to meet the all-party group on surgical mesh implants to consider it in greater detail.

T4. The James Paget Hospital at Gorleston, which is doing great work under great pressure, has highlighted the fact that it and the clinical commissioning group have two different regulators. Does my right hon. Friend agree that it would be sensible for one body to oversee both organisations, so as to avoid duplication and redirect funds to the front line? (901685)

My hon. Friend makes an important point. We have no plans for legislative changes, but we do want to see closer working between NHS Improvement and NHS England on the ground, so that people working in constituencies and areas such as his get only one set of instructions. We are making good progress.

T7. I have repeatedly asked the Secretary of State, and I ask him yet again, whether he will visit my area to see for himself the damaging impacts that the downgrades and closures of local hospital services in Dewsbury and Huddersfield will have on my constituents. (901688)

I am very happy to accept the hon. Lady’s invitation to visit her area, which I will do, but what I know I will see when I go there is that 8,300 more people are being treated within four hours at her local hospital, where there are 42 more doctors and 56 more nurses than in 2010.

T6. May I thank the Secretary of State for all the help he gave with Minehead hospital in my constituency? I am very grateful. However, one problem is that Somerset pays the lowest amount in the peninsula to keep people in homes, and that is putting more people into hospitals. Will the Secretary of State offer some advice on how we can get round this situation? (901687)

I am very happy to do that, and it is very straightforward. We listened hard when local authorities said they needed more support for the social care budget. We put an extra £2 billion into it in this year’s Budget. Spending is going up this year by 8.6%, so all local authorities are expected to play their part in reducing pressure on hospitals.

T8. If the Health Secretary does visit Huddersfield and Dewsbury, can I join the party? [Interruption.] I will not spoil his visit. I would like him to meet our local vice-chancellor, who would be very interested in having a teaching hospital in Huddersfield if the money were available to start one up. Will the Secretary of State meet my vice-chancellor when he comes to Dewsbury and Huddersfield? (901689)

In principle, I would be delighted to meet the hon. Gentleman’s local vice-chancellor, but I have to tell him that the decision about where the new medical schools will be based will be taken independently of me, because I have a constituency interest in the issue as well.

T9. Rural communities, and towns such as Newark without an A&E, desperately need a high-performing ambulance service, yet East Midlands ambulance service, and services across the country, are generally missing their targets. This is not a new problem—it began with Labour’s disastrous regionalisation of ambulance services—but it needs to end, and improvement is required. What strategy do the Government have to improve response times for ambulance services in the east midlands and across the country? (901690)

I am aware that the performance of the East Midlands ambulance service is not what local residents or we would like at present. The strategy that is being adopted is to introduce a new ambulance response programme, and EMAS has an ongoing consultation with staff on introducing new working models to bring that into effect.

The Minister has just said that pharmacies are a critical part of our primary care infrastructure. Does he therefore share my concern that Lloyds Pharmacy has announced 190 branch closures across England due to funding cuts exacerbated by rising drug costs and cash-flow problems? At least two of those are in Hull. Why can 30% of pharmacies in the Health Secretary’s constituency get remedial help under the pharmacy access scheme but only 1.3% of pharmacies in Hull get that help?

The simple answer is that it is because it is a rural constituency. On the Lloyds Pharmacy announcement, when I first heard that news my thought was not to play any politics with it but for the staff who will be affected by it. As I said at the all-party parliamentary group on pharmacy, chaired by the right hon. Member for Rother Valley (Sir Kevin Barron), Lloyds has made a commercial decision. We do not yet know which pharmacies within its portfolio will close, but we do know that 40% of pharmacies are within a 10-minute walk of two or more others.

T10. In December 2014, the Secretary of State said to the Health Select Committee: “There are GPs who prescribe homeopathy and GPs who prescribe acupuncture, but the system we have is that we allow GPs to decide whatever they think is in the clinical interests of their own patients.”Is that still the position? Is the Minister aware of the parliamentary petition in favour of homeopathy that has 22,000 signatures? (901691)

Consistency personified, Mr Speaker. It is the responsibility of local NHS organisations to make decisions on the commissioning and funding of any healthcare treatments for NHS patients, such as and including homoeopathy. Complementary and alternative medicine treatments can, in principle, feature in a range of services offered by local NHS organisations, including general practitioners.

What safeguards will the Secretary of State put in place to ensure that NHS trusts do not finance the lifting of the pay cap by making staff cuts, downgrading roles or reducing terms and conditions under the guise of reforms?

NHS trusts are under pressure to make very ambitious efficiency savings anyway. We have listened carefully to their case that they would not be able to make further efficiency savings to finance an increase in pay beyond the 1% cap.

Congratulations, Mr Speaker, on noticing that it is actually me behind this extremely impressive facial growth for Movember, which is a serious cause promoting men’s health, particularly this year with the addition of mental health. In 2015, three out of four suicides were young people, and suicide is still the biggest killer in men under 45. Will the Minister commit to renew this Government’s relentless pursuit of parity of esteem between mental health and physical health?

The Mercer moustache is impressive indeed. I am a big supporter of Movember, because it has a positive mindset—it is very honest. As Movember says on its website, one in eight men in the UK have experienced a mental health problem and, tragically, three out of four suicides are men. So we welcome this campaign this month, focusing as it does on raising awareness of prostate cancer and of testicular cancer—“Check your Nuts”, to stay on message. Movember has also built partnerships with mental health services in the NHS and across the charity sector. I wish my hon. Friend well with his growth.

Will the Department urgently review waiting times targets for children to access mental health services? Even if CAMHS—child and adolescent mental health services—in my constituency achieves its targets, on current referral rates more than 100 children will need to wait more than nine weeks for their first appointment.

The hon. Lady is absolutely right; that is totally unacceptable. Anyone who is a parent would say that it is far too long. That is why we decided to have a Green Paper on children’s and adolescents’ mental health, which we are hoping to publish very soon.

In its annual “State of Care” report, the Care Quality Commission has highlighted that there are 4,000 fewer nursing home beds in England than there were in April 2015. What plans does the Secretary of State have to address the workforce and funding issues that lie behind this? Will he meet me to discuss the situation in my constituency and nationally?

I congratulate my hon. Friend on becoming Chair of the Liaison Committee. Of course, I am always happy to meet her, and the issue that she has raised is very important. Our figures show that the number of nursing home beds, as distinct from the number of nursing homes, is broadly stable. There is real pressure in the market, however, and there are real issues about market failure in some parts of the country, so I am more than happy to talk to her about that.

The south Cumbria area is one of the few places in England where patients who need even the least complex radiotherapy treatment must travel for longer than the maximum 45 minutes recommended by the National Radiotherapy Advisory Group. In NHS England’s consultation, which will close on 18 December, will the Secretary of State make sure that access to radiotherapy within 45 minutes is a key criterion in allocating resources so that Westmorland general can be given its much-needed satellite radiotherapy unit?

I am grateful to the hon. Gentleman for raising that point. We are absolutely aware of the need to have more radiographers and sonographers available to support facilities around the country, and we have currently some 200 radiographers in training. I would like him to write to me so that we can follow up the specific point he makes about south Cumbria.

Local A&Es serving my constituents in Kent now have 24/7 mental health services, thanks to this Government’s determination to improve mental healthcare. Can my right hon. Friend assure me that the Government will fulfil their commitment to increase mental health spending by at least £1 billion by 2020?

We are absolutely committed to that. We are spending around £1.4 billion more than we were three years ago, and there is more that we need to invest. I am pleased that my hon. Friend mentioned crisis care, because for people who believe in parity of esteem, ensuring that people can get help in a mental health crisis as quickly as they could go to A&E for a physical health crisis is one of the big gaps that we have to fill.

I know that the Secretary of State will have been impressed by and enjoyed his visit to Whiston and St Helens hospitals. I am very proud of the collaboration between St Helens Council, the CCG and the hospitals, but additional resources are needed. The Secretary of State will see the good use that is made of those resources, but we cannot deliver everything that is required without that additional push of resources. Will he help us, please?

I recognise the picture that the hon. Lady paints. I did have an excellent visit to the hospitals, and they are doing some fantastic work on patient safety. Collaboration between the partners in the local health economy is much better than it has been, but there are financial pressures. We are going to have a million more over-75s in this country in 10 years’ time, and that is why we have committed to increasing the resources going into both the NHS and the social care system.

The NHS sustainability and transformation plan review in my region recently recommended that all acute services be maintained at North Devon District Hospital. That was a very welcome decision and a victory for the community. Will the Minister work with me and local NHS managers to ensure that the clinical need that has been identified can be fully met?

I share my hon. Friend’s ambition. I greatly enjoyed visiting his hospital in Barnstaple during the summer, and I have been impressed by the way in which the four trusts in Devon that provide acute services have decided to come together and provide a collaborative pool of, in particular, emergency department staff to ensure that each hospital is adequately covered and there is continuity of service. I think that is a model that we can adopt elsewhere.

The Health Committee heard that to obtain a diagnosis of autistic spectrum disorder, many struggling children and families face a postcode lottery. Will the Department seek to publish baseline data so that we know where trained clinicians are positioned across NHS England, to ensure that workforce planning is undertaken appropriately?

I give the hon. Lady an assurance that we will be publishing those data in the new year. It is important that we work hard to make sure that people with autism get a timely diagnosis. That means that we are working to get referrals seen more promptly, while recognising that to give a full diagnosis will take some time.

Recruitment and retention is just one reason why United Lincolnshire Hospitals Trust is currently going through the special measures process. Will the Secretary of State join me in paying tribute to the staff in Lincolnshire, and does he agree that part of the challenge that the trust faces on recruitment and retention will be solved by the establishment of a medical school in Lincolnshire?

If I may say so, that question was absolutely beautifully put. I do congratulate the staff. I have met the staff of Lincoln hospital, although I have not been to all the hospitals in the trust, and it is very nice to see the hon. Member for Lincoln (Ms Lee) in her place. Wherever the new medical schools eventually end up, one of the key priorities will be their ability to get more doctors from areas where we are struggling to recruit.