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Topical Questions

Volume 633: debated on Tuesday 19 December 2017

Next week, many NHS and social care staff will give up their family Christmas to keep NHS patients safe. I know that the whole House would like to thank them for their dedication and commitment over the festive period.

Is my right hon. Friend aware that, due to the difficulties in recruiting general practitioners, neither of the two GP surgeries in Maldon are taking on any new patients, despite the significant development taking place in the town? May I therefore welcome the 1,500 extra medical training places that the Government have funded, and ask for his support for some of those to go to the excellent Anglia Ruskin medical school in Chelmsford?

I have a great deal of sympathy with what my right hon. Friend says, and he is right that the recruitment and retention of GPs is a big issue. I have a constituency interest, in that I have a university that is also very keen to host more medical school places, so I am recusing myself from the decision. However, I wish all universities good luck, because this is a historic expansion of medical school places for the NHS.

Order. I am sure that the shadow Secretary of State will be brief, in recognition of the enormous demand from Members wishing to contribute in this session.

May I join the Secretary of State in wishing all our NHS and social care staff a very merry Christmas, and in thanking them for their commitment this winter?

Virgin Care recently won a £100 million contract for children’s health services in Lancashire, but in the Secretary of State’s own backyard of Surrey, Virgin Care recently took legal action against the NHS, forcing it to settle out of court. This money should be going to patient care, not the coffers of Virgin Care, so why will he not step in and fix this scandal so that his Surrey constituents and the NHS do not lose out?

I, too, am very disappointed about the action taken by Virgin Care, but I gently point out to the hon. Gentleman that, contrary to the narrative that he and his colleagues put out, the reason why it took action was that the NHS stripped it of its contract and gave that back to the traditional NHS sector—hardly the mass privatisation that he is always talking about.

The Secretary of State’s Surrey constituents will have heard that he will not be taking action against Virgin Care.

Our research has revealed that there are vacancies for 100,000 staff across the NHS, and there is a “national crisis in workforce”—not my words, but those of the Royal Surrey County Hospital NHS Foundation Trust in the Secretary of State’s constituency. With bed occupancy at the Royal Surrey hitting a peak of 98.7% this winter already, and 94.5% across the NHS on average, can he tell us how he expects the NHS to cope this winter when it is understaffed, overstretched and underfunded?

If we decide that we want more nurses following Mid Staffs, that creates vacancies. If we want to transform mental health provision, that creates vacancies. That is why we announced a workforce plan, which I notice the Welsh Government have not had time to do yet. But I will finish by wishing the hon. Gentleman a merry Christmas. If he wants to take a bit longer off and stay away for January, we are happy to hold the fort.

T2. Research shows that breast density is a strong predictor of developing breast cancer, yet many women remain unaware of the risk. Will the Minister confirm what steps are being taken to educate women with this potentially life-saving information? (903039)

My hon. Friend asks an important question. We have just commissioned Warwick University to investigate the links between breast density and breast cancer. If the findings suggest that there should be any changes to the national breast screening programme, the UK national screening committee will of course consider that, as it does with any new evidence that helps it to target screening appropriately and make women aware of any increased risk of breast cancer. I will be watching this like a hawk.

T3. What assessment has the Secretary of State made of NHS funding for the 2018-19 financial year? Will it be sufficient to deliver the standards set out in the NHS constitution? (903040)

The NHS mandate is very clear that we expect the NHS to move towards hitting those constitution standards which we consider to be vital for patients.

T5. The Secretary of State will be aware of the decision by my Northumberland CCG to close in-patient beds at Rothbury Community Hospital last year. It was done on the premise of underuse, but local sources continue to indicate that it was due to a shortage of nurses at our excellent Northumbria A&E hospital. Following a passionate campaign led by Katie Scott and the Save Rothbury Community Hospital supporters, Northumberland County Council has referred the decision to the Secretary of State for review. I would be grateful if he could update the House on the timescale for a decision. (903042)

I can confirm that the health and wellbeing overview and scrutiny committee has submitted a request for a review by the Independent Reconfiguration Panel. I understand that officials have reverted to the committee to clarify the terms of the referral. Once that has come through to the Department, I am sure that the review will take place.

T4. Last week the Brexit Secretary stated that UK membership of EU agencies is unlikely to continue beyond March 2019, so what provision has the Secretary of State for Health made to replace the European Chemicals Agency, which regulates the raw chemicals required by the pharmaceutical industry to produce drugs in the UK? (903041)

That area will obviously be very important in the negotiations, but we have made our preference clear: a deep and special partnership with the EU in which the benefits of co-operation that we currently have can continue.

T6. Public Health England has stated that e-cigarettes are at least 95% safer than tobacco products and are now the most popular way to stop smoking. What is being done to encourage smokers to quit using this method, and what steps are being taken to ensure that e-cigarette users are not forced to share their space with people who continue to smoke? (903043)

The truth is that we do not yet know enough about e-cigarettes. I welcome the Science and Technology Committee’s investigation into them. We have asked Public Health England to include messages about the relative safety of e-cigarettes in its Quit Smoking campaign next month, but it is for local organisations and businesses to implement their own policies on e-cigarette use in the workplace.

T8. Seriously unwell individuals continue to be placed in immigration detention, despite the “adults at risk” policy, which states that that should not happen. Will the Secretary of State update the House on what discussions are taking place with Home Office colleagues to ensure that assessment, treatment and screening processes, and the application of rule 35, are properly followed so that vulnerable individuals are not held in detention in that way? (903045)

I always listen to what the hon. Lady says on these issues. I have had discussions with the Immigration Minister, but if she would like to write to me in detail I am happy to take the matter up further.

T7. Progress on cancer survival overall is hugely welcome, but what more can be done to improve outcomes for oral cancers? The main causes of oral cancer are smoking, drinking and the human papilloma virus, and men are twice as likely as women to suffer from it. Will the Minister inform the House what steps the Government are taking to address this issue? (903044)

As the House knows, cancer is a huge priority for me and for the Government. Survival rates are at a record high, but we know there is much more work to do. Early diagnosis is key, and that is never more true than with oral cancers. We are supporting dentists to play a vital role in spotting mouth cancers early. I was discussing this very point just last week with the British Dental Association, which shares our passion on this issue.

T9. One of my local hospitals, Sandwell, has a problem with the high number of nurses leaving the profession. But this problem is not confined to Sandwell; it goes across the NHS. What analysis has the Minister done of the reasons for nurses leaving and what will he do to address them? (903046)

We have not been very good at making it easy for people to work flexibility in the NHS. Contracts are too rigid and we are looking to change them. We recognise that for many nurses their commitment to the NHS runs very deep, but that they have to juggle that commitment with family responsibilities. We want to do better.

There are many very committed individuals working in health and social care services in Somerset, but one challenge is getting enough registered nurses into the system to allow them to integrate. What can the Minister do to help to get more registered nurses?

My hon. Friend will be aware that last week we published the workforce strategy. One major focus was on meeting the Secretary of State’s commitment to increase the number of registered nurses by 25% and to broaden the routes into nursing. There is a commitment to expand the nursing associate role, which is helping to provide opportunities, through an alternative route, for healthcare support workers to become registered nurses.

T10. Possibly as many as 20,000 babies have been born with birth defects as a consequence of their mothers having used sodium valproate during pregnancy. When will mandatory warnings be given to pregnant women about the risks associated with valproate, and when will we see independent analysis of how we got to this dreadful situation? (903047)

There is huge interest in this subject in the House. Over the past three years, there has been extensive work to communicate advice on the risks of valproate in pregnancy, through a huge number of channels, to help professionals and patients. It is evident from monitoring activities that providing health professionals with information, even when repeated constantly through multiple sources, is not changing prescribing behaviour sufficiently to minimise harm to children exposed to valproate in pregnancy. The expert working group of the Commission on Human Medicines is informing the UK position in European negotiations and advising on the national action required within the UK health system. [Interruption.] Sorry, Mr Speaker.

Forgive me. I did not mean to be unkind to the Minister who was attending closely to his answer. It is just that we want the whole House to get the benefit of it.

Will the Minister provide an update on efforts to move Worcestershire Acute Hospitals NHS Trust out of special measures, and on the status of the promised £29 million for much needed capital improvement programmes?

As my hon. Friend is aware, I visited all three hospitals in the trust. I am pleased to be able to announce to him today that the Department of Health has concluded its analysis of the outline business case for the £29 million allocated in July and that it has been approved.

On admissions to hospital for malnutrition, will the Minister tell me what has been happening at Wirral University Teaching Hospital? Admissions for malnutrition went up from 21 in 2009-10 to 707 in 2014-15. They went up again to 728 and this year currently stand at 586. That seems very, very high. Can anyone tell me what is going on? If not, will Ministers write to me to explain these huge figures?

There is £2.8 million in extra winter funding, but I will write to the hon. Lady with the details she asks for.

I would like to thank the Minister for listening very sensitively to the victims of Paterson, the rogue surgeon, many of whom are constituents of mine. Does he agree that the evidence from the Hillsborough inquiry is that a bishop-led inquiry can indeed get justice and closure for victims? Will he join me in wishing the Bishop of Norwich great success in getting a good outcome from this inquiry?

I pay tribute to my right hon. Friend for her role in helping to support the victims, many of whom, as she said, are constituents of hers. We are pleased that Bishop James has agreed to take on this inquiry. Bishops provide the ability to empathise with victims and their families, which might not always be the case with judge-led inquiries. As she rightly points out, the Hillsborough inquiry was led by a bishop, but so too is the current Gosport inquiry, while the Morecombe Bay inquiry was led by Bill Kirkup, rather than a judge.

Those with erythropoietic protoporphyria cannot be exposed to sunlight or even some artificial light without extremely painful and violent skin reactions. Trials of the drug Scenesse have proved life-changing for constituents such as James Rawnsley, who, for the first time, can now take his kids to school and go on holiday. The decision to make it available on the NHS will be taken soon. Please will the Minister look at it?

EPP has a devastating impact on a person’s health and quality of life, and is something that the hon. Lady has discussed with me before. We will of course take the matter seriously, and I am very happy to talk to her more about it.

Given that my own brother’s funeral will be held later today, may I ask the Secretary of State what help and support he is giving to the families of drug and alcohol abusers?

The whole House will want to express its condolences to my hon. Friend on what is happening this afternoon. He, alongside many people on both sides of the House, including the shadow Health Secretary, has raised this issue, and we are looking closely at what more support we can give to children in one of the most vulnerable situations imaginable. I thank him for raising the issue.

The NHS patient declaration form for free dental care and prescriptions requires patients to determine the difference between contribution and income-related employment and support allowance. Getting it wrong attracts really hefty fines. Will the Minister ensure that patients first get the opportunity to make the right choice before fines are applied?

Yes, of course. The NHS Business Services Authority issues the penalty charge notices for incorrect claims for exemption from NHS dental care and prescription charges. We have recently increased the number of checks, however, because ultimately this is taxpayers’ money, and we need to ensure that it is spent properly and legally.

I warmly welcome the extra £1.1 million to help with winter pressures at Luton and Dunstable Hospital, and I can tell the ministerial team that the merger with Bedford Hospital is proceeding well, but it needs £150 million of capital. May I ask that favourable consideration be given to that in the allocation of the £3.5 billion announced in the Budget?

My hon. Friend will be aware that the Chancellor provided a package of £10 billion in the Budget last month to be invested in the NHS, of which £3.9 billion will come from the Treasury. All bids for capital are being assessed through the STP prism. The proposal that his area will be making will be assessed against others. As far as I am aware, no such proposal has yet been made to NHS England, but it will obviously be looked at in due course.

You may recall, Mr Speaker, that I raised earlier in the year the issue of a private mental health hospital in my constituency where a young woman had MRSA and was infecting staff and patients. Since then, there have been numerous inspections in relation to children having access to ligatures and medicines in order to overdose. Will the Secretary of State commit to a policy to ensure that no child or young person is placed in a mental health facility that is deemed unsafe?

I commend the hon. Lady for raising this issue, which she and I have met to discuss before. She is right to highlight the ongoing inspections and issues, and I have written to her to offer to discuss the matter with her again. It is absolutely unacceptable that anybody is placed in a facility that is deemed unsafe.

May I thank the ministerial team on behalf of my constituent Susan Bradley for finally laying the remedial order for single-parent surrogates, and can they assure me that they will do everything they can to get it through Parliament as quickly as possible?

An all-party parliamentary group has been established this week, I believe, to take this issue forward, and I look forward to speaking to that group, if invited, next month. The remedial order will follow due parliamentary process, which involves its being laid for 60 days and then, after an interval, for a further 60 days.

There have been 15,000 violent assaults on mental health workers in the west midlands over the last five years. What is the Government’s response to the Care Quality Commission’s opposition to routine searches of all mental health service users for weapons on admission or return to acute in-patient units?

I have a great deal of sympathy with what the hon. Gentleman has said. We are putting a lot of effort into patient safety and staff safety in mental health trusts, and we are discovering that there is a wide variation between practices. The hon. Gentleman has made an important point, and, if I may, I will write to him to inform him of our progress.

The patient transport service in northern Lincolnshire is contracted to Thames Ambulance Service Ltd, which is failing miserably to perform to an adequate standard. Will the Minister meet me, along with my hon. Friend the Member for Brigg and Goole (Andrew Percy) and other neighbouring Members, to discuss what influence the Department can bring to bear?

Order. I appreciate the commitment of colleagues. The session has overrun, but I feel that colleagues will go home for Christmas content only if they have asked their questions and they have been answered. I am extremely grateful to the Front-Bench teams on both sides of the House.

Is the Secretary of State aware that in the course of this hour there have been more questions about hospital closures than about almost anything else, covering East Yorkshire, Berwick on his own side, Warwickshire on our side, and High Peak in Derbyshire, including Bolsover and Bakewell Hospitals? There is a growing suspicion that what this Secretary of State is up to is leaving those hospitals and losing all the beds in them forever so that the private sector can move in and take the lot. That is what is going to happen.

I thank the hon. Gentleman for his Christmas cheer. Let me just say to him that if that were the Government’s intention, we would not have found an extra £2.8 billion for the NHS in the Budget, including £1.95 million for Chesterfield Hospital, which will benefit his own constituents.

Some 50% of young people do not use a condom with a new partner and one in 10 young adults never uses one, which means the chance of an unwanted pregnancy or, indeed, a sexually transmitted disease. Please will the Department do something to ensure that people are aware of the benefits of condoms?

Men may not be very good at wrapping at this time of year, but they need to get this one right. I welcome Public Health England’s “protect against STIs” campaign, which was launched last week and aims to reduce rates among 16 to 24-year-olds, and I encourage young people having fun this Christmas to do so sensibly.

There is an increasing trend for women to share breast milk over the internet with no recourse to the milk banking guidelines from the National Institute for Health and Care Excellence. Will the Minister meet me, and other members of the all-party parliamentary group on infant feeding and inequalities, to discuss the matter further and to ensure that breast milk can be used safely?

As the hon. Lady says, it is important for us to ensure that anything that happens in this space is safe, and I should be very pleased to meet her and other members of the all-party group.

What funds are being made available to our mental health services to meet the additional demands placed on them by changes in the Mental Health Act 1983, which came into force on 11 December this year?

I can reassure the hon. Lady that we are putting a lot of extra funding into mental health— £575 million last year alone—to meet those and other obligations.

NHS Property Services exists on a merry-go-round of taxpayers’ money. Will the Secretary of State give us all a Christmas present by closing it down and returning the control of property to local health communities?

I understand why the hon. Lady has asked that question. I think it fair to say that NHS Property Services has been on a journey and needs to do even better, but we also want to ensure that NHS land is made available for housing for NHS staff.

Will the Secretary of State consider the NHS as a funder of last resort for hospices such as Bury hospice, so that they can operate at full capacity and play their part in the delivery of social care?

We often are a funder of last resort for the hospice movement—and perhaps thanking hospices for the extraordinary work that they will be doing over the festive period and beyond is the right note on which to end today.