House of Commons
Tuesday 19 June 2018
The House met at half-past Eleven o’clock
[Mr Speaker in the Chair]
Oral Answers to Questions
Health and Social Care
The Secretary of State was asked—
NHS England, NHS Improvement and Health Education England are working with trusts on a range of recruitment, retention and return-to-practice programmes to ensure that the required workforce are in place to deliver safe and effective services.
The nursing vacancy rate in England is more than double that in Scotland, with one in 10 positions unfilled. The Royal College of Nursing has welcomed the Scottish Government’s Health And Care (Staffing) (Scotland) Bill, which will enshrine safe staffing levels in law. Will the Minister now follow the Scottish Government’s example and bring such a provision into law for NHS England?
I fear that the hon. Gentleman wrote his question before yesterday’s announcement. I thought that he might have started by welcoming the additional £2 billion of investment that Scotland’s NHS will be receiving. We are making historic investment in recruitment, which is why we are opening five new medical schools in England, training 1,500 new medical doctors, taking initiatives such as on apprenticeships and opening new pathways into clinical roles.
While I welcome yesterday’s announcement and the workforce strategy that is coming out in the autumn, will the Minister comment on the Home Office’s new proposals to allow greater flexibility for professional clinicians coming to work in the UK, and on what impact that might have on filling vacancies?
My hon. Friend is right to draw attention both to the Home Office’s welcome announcement on tier 2 visas and to the work on the workforce strategy, in which he played a key role. It will ensure that we have the right workforce for the NHS for the next 10 years.
But the Royal College of Nursing and the Nursing and Midwifery Council are both now so worried about Brexit’s impact on the staffing crisis that they have called for a people’s vote on a deal. Given their on-the-ground experience and the demolition of the myth of a Brexit dividend for the NHS, is it not becoming ever more clear that the dogmatic hard Brexit being pursued by the Government is already doing untold damage to our NHS?
The right hon. Gentleman, as a former Minister of State, will not want to choose selectively from the data on European economic area recruitment into the NHS. He will know full well that there are 3,200 more NHS staff from the EU since the referendum, which shows that people are still coming. If he has an issue with the Brexit dividend, perhaps, as my right hon. Friend the Secretary of State pointed out yesterday, he will raise that with his party leader, who sees that there is a Brexit dividend.
Kettering General is a wonderful hospital with amazing staff, but one of its big financial problems is caused by its over-reliance on agency staff. What can be done to reduce the reliance of so many hospitals, including Kettering, on agency staff to populate their wards?
My hon. Friend rightly points to the key issue of how we bring down the £2.5 billion of agency spend. That goes to the heart of the Prime Minister’s announcement yesterday. Up-front investment in our workforce will allow us to reduce that agency cost.
The two do go together because the mental health workforce is a key component of the NHS workforce. I am sure that the hon. Gentleman will welcome the extra £1 billion by 2020 that the Prime Minister announced yesterday, as well as the Government’s prioritisation of mental health, which for too long has been seen as a Cinderella service within the NHS.
In 2015, the Secretary of State suggested that junior doctor rotas contributed to avoidable hospital deaths, but research shows that the most important factor is the number of patients under the care of each registered nurse. A 7% increase in mortality for every patient means that 36,000 nursing vacancies in England pose a real threat to patient safety. So with no announcement, and a 33% drop in applications since the removal of the nursing bursary, will the Government follow the Scottish Government’s policy and reintroduce the bursary?
The hon. Lady will be well aware that there are 14,000 more nurses in the NHS than five years ago, but she is right to point to the wider issue of long-term workforce planning. That is why she will be aware that Audit Scotland criticised NHS Scotland for its lack of long-term workforce planning.
As the Minister heard, the Scottish Government have just passed a law on staffing. With an ageing population, social care is critical to the function of the NHS, but the charity Independent Age says that we will be short of 700,000 care workers by 2037. With no extra funding for social care announced yesterday, how will the Secretary of State make caring a real profession? Would not it be good to start with a decent wage?
The hon. Lady’s supplementary question really reinforces the answer that I gave a moment ago: the essence of why we need a long-term plan is so that we anticipate these issues. We are addressing that through the Green Paper on social care, and that is part of the investment that the Prime Minister announced yesterday.
Yesterday the Prime Minister said that
“current workloads are not sustainable”—
is that any wonder after eight years of Tory cuts and austerity? The Minister knows that the number of health visitors in the workforce is falling, and that health visitors are vital to improving child health and wellbeing outcomes. No new public health money was announced yesterday; new money will come in 2020. Can the Minister guarantee that health visitor numbers will not continue to fall and that the public health budget will be ring-fenced?
I am grateful that the shadow Secretary of State has drawn attention to public health because the Government have been making significant progress in that area. We have the lowest ever number of teenagers smoking and the lowest ever teenage pregnancy rate. Binge drinking is down and we are addressing child obesity with the sugar tax, which is among a number of measures that the Government have been bringing forward. We are making progress on public health and the hon. Gentleman is right to draw that to the attention of the House.
This Government are breaking the Tory manifesto promise and raising taxes, yet they cannot even answer basic questions about health visitor numbers. The NHS workforce deliver the constitutional performance targets, including the 18-week referral-to-treatment target, and targets for accident and emergency and cancer treatment. Will the Minister reassure patients and the taxpayers whose taxes are going up that he will rule out dropping those essential targets?
Once again—as we heard yesterday—there is no welcome for the announcement of additional funding for the NHS. Opposition Front Benchers are playing politics and talking down our NHS. The Prime Minister has set out a long-term vision to improve standards and raise mental health, which Labour Back Benchers highlighted. The hon. Gentleman should come to the House and welcome that investment in our NHS.
Regional Health Inequalities
We take a comprehensive approach to reducing health inequalities, underpinned by legal duties. This includes addressing the wider causes of ill health, promoting healthier lifestyles, and tackling differences in health access and outcomes. A formula is used to allocate funding to clinical commissioning groups, and health inequalities form part of this.
Birmingham has some of the worst health outcomes in the country. It is not a surprise, as A&E waits of over four hours are up by more than 127% in recent years, and waits of more than 18 weeks for treatment are up by 65%. Yet, according to freedom of information request responses I have received, our trusts in Birmingham have to make savings of £155 million this year. What are the Government going to do to save the health system in Birmingham, which is currently in a state of collapse?
It is disappointing to hear the right hon. Gentleman making such negative points about his local NHS when 86% of GPs in his area are rated good or outstanding. Everything about yesterday’s announcement will tell Members that we are not complacent about the health challenges facing us, and we will make the necessary resources available. It ill behoves Opposition Members to keep continually talking down our NHS.
I could not have put that better myself—[Laughter.] Opposition Members can laugh, but the Government firmly believe that work is good for people’s health. We are committed to getting 1 million more people with disabilities into work so that we actually treat them as assets, and we are encouraging them to be more independent and to take control of their own lives. The only way to achieve that is by having a strong economy.
When the coalition Government came into office in 2010, life expectancy began to stall for the first time in over a century. This, coupled with eight years of funding cuts, means that there are grossly disproportionate health inequalities across the country. For example, according to Northern Health Science Alliance, people in the north are 20% more likely to die early than people in the south. Is not it a failure of the Government’s funding deal for the NHS that it comes with no public health money to tackle these astonishing regional health inequalities?
No, it is not. Labour Members like to draw attention to north-south divides and so on, but the issues about health inequalities are much more complex than how money is spent and where. Within my constituency, for example, there are differences of 10 years in life expectancy depending on the particular locality. We need a much more multi-layered approach to tackling inequality, and that is what this Government will have.
Tier 2 Visa Cap
Last week the Home Secretary removed doctors and nurses from the tier 2 visa cap.
Perhaps I can help the hon. Lady by pointing out that tier 2 visa cap is specifically for higher-paid workers. We do need to think about social care workers, but a lot of them are lower paid. That is why we are putting together a 10-year workforce plan for the health and social care sectors, both of which are very important. We will make sure that that goes hand in glove with the NHS plan that we announced yesterday.
The real effect of the cap is that there are not enough staff in the health service, as is shown by “NHS SOS”, a campaign run a few weeks ago in Stoke by The Sentinel that highlighted the lack of doctors and nurses. Realistically, what will the Secretary of State do to remedy that situation in Stoke-on-Trent? Will he meet people from The Sentinel so that they can present the evidence?
Let me tell the hon. Gentleman what we have been doing in the past five years: we have 14,300 more nurses, 10,100 more doctors, and over 40,000 more clinicians across different specialties. He will be very relieved to know that, on top of that, we are promising 50% more than his party did at the last election.
People with Learning Disabilities
Commissioning high-quality health and social care services is a local responsibility. The Care Quality Commission monitors, inspects and regulates services that people with a learning disability may use. Where quality and safety standards are not met, it will take action.
The Association of Directors of Adult Social Services warned this week that social care services are on the verge of collapse. Despite the announcement of £20 billon yesterday, there was no mention of social care. Cuts of more than £7 billion have left hundreds of thousands of elderly and disabled people without adequate support. What specific measures are the Government taking to ensure that the elderly and disabled are receiving proper care?
Adult social care was mentioned yesterday, specifically in the news that we plan to bring together the way in which health and social care interoperate. We need more collaborative work between health and social care to reduce the amount of pressure that one puts upon the other. We have set out very clearly that we will produce a Green Paper later this year to address how we will tackle the challenges that we face in adult social care, and we will look at how we fund that.
Providers of day care services for people with learning disabilities are not currently subject to an inspection regime. Will the Minister consider bringing such services within the scope of the Care Quality Commission to reassure families about quality and safeguarding issues?
My hon. Friend is absolutely right to draw attention to the fundamental importance of being reassured that all services that are provided are safe and reliable. Since the CQC has been looking at services up and down the country, it has brought to them a level of transparency and, indeed, quality. We keep under review the services that it regulates, and this is certainly something that we can discuss with it.
We are aware of concerns in the sector with regard to sleep-ins and we are looking very carefully at the options. We have been developing the evidence base very carefully. We have been engaging with the European Commission, the sector and other Government Departments.
My hon. Friend makes an excellent point. It is vital that when we look at how to move forward with both our health and social care services, we are able to capture all the latest technology to ensure that we improve the experience for all our service users.
Much of the health and social care for people with learning disabilities in Plymouth is provided by Livewell Southwest, a social enterprise. The new pay increases for NHS staff will not be mapped over to social enterprise staff, so when they merge back into the NHS, we risk a two-tier workforce. Will the Minister consider extending the pay increases to support those who work with people with learning difficulties in the social enterprise sector so that we ensure that everyone doing the same job is paid the same amount?
Life Sciences and Medical Research
The life sciences sector is critical to the UK economy, which is why we support it with a £1 billion annual grant through the National Institute for Health Research.
I am happy to do that. The life sciences industry is critical to Scotland, and Scotland’s role is critical to the UK. We all remember Dolly the sheep being pioneered in Edinburgh University, and last week’s announcement of a new centre in Renfrewshire is another good example of the great things happening in Scotland.
Getting new drugs approved more quickly would not just be a big boost for the life sciences and medical research sectors, but would help my constituents and others across the country with cystic fibrosis who desperately need access to Orkambi. They have been waiting for years; it is not good enough. Why can the Secretary of State not sort this out, get a grip, get his officials and Vertex in a room, and force them to come to an agreement? People have waited too long for this.
That is exactly what we have been doing, but we need Vertex to be reasonable regarding the price that it offers the NHS. We need to pay fair prices. We have heard that it will be coming back with a new offer next week—we hope it is a reasonable one—but we urge Vertex to waive commercial confidentiality so that we can all see, in the interests of transparency, the kind of prices it is trying to charge the NHS.
Further to the point made by the hon. Member for Dudley North (Ian Austin), we know that the UK is a world leader in research into rare conditions, but that does not always translate into timely access to those treatments. The Secretary of State will know that there are many CFTR—cystic fibrosis transmembrane conductance regulator—treatments in the pipeline that could benefit people who are living with cystic fibrosis. Will he meet me to see how we can ensure that those are available in a timely manner for the people who desperately need them?
Of course I am happy to meet my hon. Friend. I recognise that this is one of the things that we are not good at at the moment. We have fantastic research, with amazing new drugs developed in this country, but our uptake can be painfully slow, and that is of course something that we want to put right.
ME affects approximately a quarter of a million people across the UK, and while there has been substantial psychological research into the condition, there has been very little biomedical research. What funding will the Secretary of State make available specifically for biomedical research into the treatment and diagnosis of ME?
I am grateful to the hon. Lady for raising that issue. She is introducing a debate on it in Westminster Hall on Thursday. I have met a number of families who have suffered very badly as a result of ME, and we would all like better research, so I hope that her campaign is successful.
Sport: Public Health
There is a strong body of evidence on the health benefits of participating in sport— possibly not watching it, if last night is anything to go by. Last year, a review by Sport England brought together evidence to show the association between sport and physical and mental wellbeing.
As the Minister may be aware, I co-chair the all-party parliamentary group for golf—a sport sometimes labelled, rather unfairly, a good walk spoiled. Does he agree that there are many positive health benefits associated with participation in golf, especially for people with long-term conditions?
I certainly would, as someone who used to work in the golf industry before coming to the House. I was at Wentworth last month for the PGA, and a good example of what my hon. Friend refers to is a social enterprise that I met called Golf in Society led by an inspirational chap called Anthony Blackburn. He founded a project at Lincoln Golf Centre that works with people with dementia and Parkinson’s disease to show that golf is one of the best leisure activities out there, and gives people with those long-term conditions a sense that their life is not over and that they can still play golf, and play it rather well—probably better than me.
In 2016, Stoke-on-Trent was the European city of sport, but it faces some of the highest health inequalities in the country. The Stoke newspaper The Sentinel highlighted the power of exercise in its recent NHS SOS campaign. Will the Minister meet the editor Martin Tideswell and my hon. Friend the Member for Stoke-on-Trent Central (Gareth Snell) to receive details of that incredibly important local campaign?
I am aware of that campaign. Something that we want to see in schools across the country, including in Stoke, is the Golden Mile. I see good examples in schools in my constituency and across the country when I travel. We are interested to learn more about what Stoke has done on this subject.
NHS England has a legal duty to commission services to meet local need, which includes people who are homeless, and we are very clear that a patient should not be turned away from a GP if they cannot produce any supporting documentation. If they state that they reside within the boundaries for the practice, the GP is expected to accept the registration. The same applies for dentistry, and training is in place to remind people of their obligations.
Mags Drummond is a Walthamstow woman on a mission, to try to help our many rough sleepers get decent quality healthcare, but she, like me, has hit a brick wall with our local dentists and doctors. It is little wonder that one study shows that 15% of homeless people have pulled out their own teeth because they cannot get access to services. Will the Minister meet Mags and me to look at what we can do to change that and make sure that her promises are not toothless?
Very good—I commend the hon. Lady for her wit, and I agree with her. Notwithstanding our expectations of GPs and dentists in this regard, it is quite clear that homeless people do not always have access to the treatment they should have. The hon. Lady will be aware of the work that we are doing to support rough sleepers, and I would be delighted to meet her and Mags Drummond to see what insight they can provide on how we can improve services in this area.
Does anyone else want to come in on this? Apparently not. I do not wish to proceed to the next question because of the unpredictability of the time that it will take. Colleagues will want to prepare themselves for the one-minute silence that we are about to observe. I think I can say with some confidence that everyone who is in the House today will wish to observe that one-minute silence. Perhaps they will think it appropriate to stand. That one-minute silence is going to start very soon. The next question is grouped, so it would be highly inconvenient to take it. Any moment now we shall observe the silence. [Interruption.] There is much merit in repetition in certain circumstances.
Order. We shall now observe silence for one minute to remember those who died or were affected by the attack outside Finsbury Park mosque, I remind colleagues, a year ago today.
The House observed a minute’s silence.
Personal Health and Care Budgets
I know that the thoughts of the whole House are with the families affected by the terrible atrocity a year ago.
Personal health budgets have a transformative effect on people with very complex health needs, and we plan for 50,000 to 100,000 more people to benefit from them by 2021.
I thank the Secretary of State for that reply. Does he agree that a key part of integrating health and social care is giving individuals more say and flexibility in how they use their entitlements? Will he consider extending his pilots to my constituency of North West Norfolk?
Absolutely, and not just to North West Norfolk, but to the whole country. We are currently consulting on giving a right to personal health budgets to people with the most complex health needs. That would be about 350,000 people and would include anyone with a continuing NHS need combined with a mental health need, a learning disability, autism or PTSD. Obviously, it would be hugely significant if we were able to proceed with that.
Will the Minister ensure that the long-term NHS plan puts a major emphasis on empowering patients through the wider availability of personal budgets? May I also join my hon. Friend the Member for North West Norfolk (Sir Henry Bellingham) and make a pitch for my local area of Northampton for one of the next wave of pilots?
Absolutely, and technology will have a big role, because this year we intend all NHS patients to be able to access their health records through an app. That will be extremely empowering, but my hon. Friend is right that giving people with long-term conditions control over their health and care destiny is a potentially huge leap forward.
While I agree with the philosophy and approach behind health and personal care budgets, will the Secretary of State acknowledge that the 21% fall in social care funding between 2010 and 2015-16 has caused a catastrophe in this area? Will he acknowledge that if this approach is to work in future, the funding has to be there?
I congratulate the last Labour Government on introducing direct payments, which were the first step in this process. The hon. Lady talks about cuts in social care, which I acknowledge, but, with respect to her, she never talks about the reason, which was that in 2008 we had the worst financial crisis in our peacetime history, and we had to take measures. It is as a result of creating 3.2 million jobs since then that funding for social care is now going up.
Bearing in mind that the number of bed days lost increased in the second quarter of 2017-18, with most of the patients subject to delays being elderly people, will the Minister outline a dedicated strategy for getting people out of hospital and back home with appropriate care as a matter of urgency, for the good of the patient as well as the public purse?
This is a huge challenge in all parts of the United Kingdom. In England, about 22% of bed days are occupied by people who have been in hospital for more than three weeks, and probably less than 20% of those people should be in hospital. We are taking urgent steps to rectify that, because it is very, very bad for the patients involved.
Mental Health Workforce
The mental health workforce plan published last summer underpins our expansion of mental health services, as set out in the “Five Year Forward View for Mental Health”. We aim to create 21,000 new posts in mental health by 2021.
I thank the Minister for her response. Mental health is one of the many complex drivers of rough sleeping, and can add to the complexity of getting rough sleepers off the street and into accommodation. Will my hon. Friend say how the new mental health employees in the NHS can help us to get rough sleepers off the streets and into accommodation?
I hope the expansion of mental health services will stop people becoming rough sleepers in the first place by bringing forward support earlier in the process. In January, we announced a £1 billion investment in mental health, part of which will be focused on crisis care and helping people who are experiencing crisis to stay out of hospital. The workforce plan backs that commitment by planning 5,200 posts to support those in crisis. We will be working with the Ministry of Housing, Communities and Local Government on a forthcoming strategy to make sure we honour our commitments.
It is not just the size of the mental health workforce that is critical, but the pressures faced within those workforces. We have just learned that there was the highest number of out-of-area placements in January since records were first kept. Mental health doctors and nurses often spend hours hunting for out-of-area beds, taking them away from other patients. When is the Government’s pledge to reduce and eventually ban out-of-area placements actually going to start to become a reality?
The hon. Lady is right to raise this issue. We are determined to end out-of-area placements, but clearly that will require behavioural change on the part of commissioners, as well as making sure that the investment takes place. I know she will continue to hold me to account on this issue, because it is clear that out-of-area placements can cause harm and we must tackle them.
According to data from 48 of 56 NHS mental health trusts, 3,652 patients suffered an injury in 2016-17 through being restrained—the highest number ever. There are concerns that increased use of insufficiently trained agency and bank staff since 2013 is contributing to this increase. Employing 21,000 new staff by 2021 just is not good enough. What is the Minister doing now to ensure that wards are safely staffed and patients are not injured?
I am grateful to the hon. Lady for her question. She will be aware that I have been working with her colleague the hon. Member for Croydon North (Mr Reed) on his Bill to limit the use of restraint, because we on the Government Benches also very firmly believe in that. An essential part of his measure will be to improve training for staff in mental health units. That will be a tool in making sure that restraint is minimised.
Capital Investment Projects
In the Budget we announced £3.9 billion of additional capital funding, and 77 projects have conditional approval.
Earlier this year, Torbay and South Devon NHS Foundation Trust was allocated £13.3 million of capital funding for improved urgent care and a new emergency department at Torbay Hospital. Will my right hon. Friend confirm what progress is being made to get those major construction projects under way?
Warrington desperately needs a new hospital to replace its old, out-of-date buildings, so in allocating future capital funding will the Secretary of State bear in mind the levels of health deprivation that exist in the area, and will he ensure that any new hospital is accessible to those in my constituency, which has areas that are among the most health deprived in the borough?
The Secretary of State knows that he has presided over a crisis in capital funding, with a £5.5 billion estimated maintenance backlog, £1 billion of which is classified as urgent. Yesterday’s statement hopefully goes some way to addressing that, although it was far from clear whether capital funding was included in that announcement. Can the Secretary of State confirm today whether any cash generated by the sale of NHS property under the Naylor review is in addition to the money announced yesterday?
Highly Specialised Technologies Evaluations
My officials have regular discussions with the National Institute for Health and Care Excellence, of course, but we are clear that there is no fixed capacity in NICE’s HST programme. The number of drugs that it evaluates each year is driven by the pipeline of drugs expected to come to market, and we will refer any suitable drugs to it for evaluation.
There is a risk that new treatments for life-limiting conditions, such as Duchenne muscular dystrophy and spinal muscular atrophy, might not be approved by NICE, so will the Minister meet me and Muscular Dystrophy UK to discuss ways to facilitate access to treatments, as highlighted by the charity’s FastTrack campaign?
NICE has recommended the drug Translarna for use in the treatment of Duchenne muscular dystrophy; it is now routinely available on the NHS. It is a disease that I grew up with—the friends that I grew up with did not, and I did, and this is a timely reminder of how terrible this disease can be. I would be really pleased, therefore, to meet the hon. Lady and the charity that she mentioned.
Is the Minister aware of the recent NICE draft review regarding treatment of abdominal aortic aneurysms? Some 1,500 to 2,000 lives are saved yearly by NHS AAA screening. If the draft recommendations are adopted, a patient is likely to have an aneurysm erupt before treatment and 80% of patients are then likely to die. Will the Minister look carefully at this issue to avoid this unintended consequence?
Community First Responders
In just five years, the Neilston and Uplawmoor first responders have responded to over 1,300 calls, saving many lives, and earlier this month they received the Queen’s award for voluntary service. Will the Minister join me in congratulating all the volunteers and paying tribute to community first responder units right across the United Kingdom?
I am very happy to join my hon. Friend in congratulating Stuart McLellan, Ross Nelson and the volunteers that play such a key role. I know that my hon. Friend the Member for Brigg and Goole (Andrew Percy) also performs this service in his constituency. I have spoken to him about it and I know that it plays a very valuable role.
Epilepsy Guidance (Autism)
The UK’s autism research charity Autistica advises that up to 40% of people with epilepsies are, in fact, autistic, and that epileptic seizures are the leading cause of early death for autistic people with a learning disability. NICE guidance has never mentioned autism when referring to epilepsy, and autistic people have distinctive types of epilepsies that require different clinical approaches. Will the Minister please ensure that NICE includes autism in the guidelines on epilepsy?
At this stage, it is too early in the update process for NICE to say exactly what its guidance will cover. However, my right hon. Friend is chair of the all-party group on autism and vice-chair of the all-party group on epilepsy, and she was the driving force behind the Autism Act 2009. I think that NICE would do very well to heed her advice.
Clinical Staff Shortages
I had wanted to ask the Secretary of State to get behind exempting nurses and doctors from the tier 2 visa process, but I do not need to do that; I just have to thank him for his support in doing that. Instead, for his next challenge, will he commit to looking again at the pensions cap, which I fear might be one reason some senior NHS professionals and doctors are retiring sooner than they might otherwise do?
I am grateful for my hon. Friend’s support on tier 2 visas. She will be aware that clinicians who reach the £1 million lifetime allowance limit can expect a pension of about £44,000, payable at age 60, increasing with inflation, plus a tax-free lump sum of about £132,000. Although these are ultimately issues for the Treasury, it is important that we ensure that tax allowances, two thirds of which go to higher-rate taxpayers, are fair to other taxpayers.
Innovative Drugs and Devices
The Government are committed to ensuring that innovative healthcare products reach patients faster than ever before. We have established the Accelerated Access Collaborative to identify transformative innovations and help their route to market, and today we have appointed Lord Darzi as the new chair of the AAC to lead this work.
I welcome the fact that the Prime Minister in her speech yesterday announced much more funding for personalised medicines and new technologies that will transform care. On that basis, will the Minister update the House on when the groundbreaking CAR-T— chimeric antigen receptor T-cell—therapy might be made available to NHS patients suffering from cancer?
Yes, indeed. As the cancer Minister, I consider CAR-T to be one of the most innovative and exciting treatments ever offered on the NHS. NICE is considering the first of the therapies this year and preparations are well under way. We are working closely with NHS England to make these transformative medicines available to cancer patients.
Patients with PKU—phenylketonuria—are awaiting progress on the approval of a drug called Kuvan. In the meantime, their illness is controlled by diet. Will the Secretary of State and other Members join me in Committee Room 21 after this meeting to hear about the “Diet for a day” challenge, which many Members across the House are taking up next Thursday?
Thank you, Mr Speaker. Probably the most important recommendation in the new O’Neill review into antimicrobial resistance was the requirement for diagnostics prior to the prescription of antibiotics by 2020. Will the Minister update the House on progress towards that goal, and will he agree to meet me and colleagues, including Lord O’Neill, to discuss the establishment of an antibiotic diagnostics fund?
Yes, the Government’s response to Lord O’Neill’s review in 2016 set out new ambitions building on existing progress, including ensuring that tests on epidemiological data are used to support clinical decision making and delivering high-quality diagnostics in the NHS in support of our other ambitions. My hon. Friend is right to raise this issue, and I am happy to meet him.
We are delivering the most ambitious childhood obesity plan in the world, and we are already seeing results. We always said that our 2016 plan was the start of the conversation, not the final word. [Interruption.] Yes, it does say that here, but I have also said it everywhere else many, many times.
With one in three primary school children leaving either obese or overweight and more than 77% of children not doing the minimum requirement for physical activity, surely the Government’s priority should be getting children active by opening up school facilities after hours and in the holidays, not faffing around with political gestures on television advertising that children have long since stopped watching.
I do not think that it is a binary choice. We recognise that child obesity is caused by many different factors, and that no one policy will work on its own. Yes, this is about tackling advertising, and yes, it is about tackling children’s activity and working with schools; and, as I said recently, we will present new proposals very shortly.
As the Minister will know, perhaps the two biggest challenges that we currently face in relation to young people’s health are mental health and child obesity. Will he update the House on the progress of chapter 1 of his childhood obesity plan in reducing the amount of sugar in both food and drink?
Since we published the plan, progress has been made on sugar reduction. The amount of sugar in soft drinks has been reduced by 11% in response to the industry levy, and Public Health England has published a detailed assessment of progress against delivery of the 5% reduction for the first year. Progress is good, but it is not good enough, which is why we have said that we will produce chapter 2 shortly.
Because we believe that there should be a mixture of carrot and stick. We believe that the soft drinks industry levy has been successful, but we are also working with the industry on reformulation across the board. I recently visited Suntory, which makes Lucozade and Ribena. If we work with industry, we see transformative results for companies and for the people who buy their products.
A few years ago, I initiated a debate on this issue in Westminster Hall. Since then, no progress has been made on childhood obesity. Would the Minister care to outline what he thinks will happen in the lifetime of this Parliament in terms of achieving the objectives that he has set out?
We assess the plan all the time, and we make progress reports on it, as we did last month with the sugar report. However, when I addressed the Health Committee recently, I could not have made it clearer that we think there has been progress.
This is a world-leading plan. When we talk to other people around the world, they are very keen to hear about what we are doing and very interested, and we are interested in learning from them. If we do not take action, one of our biggest public health challenges will get worse and worse, and that will have implications for the health service and for all our constituents.
When something goes tragically wrong in healthcare, the best apology to grieving families is to guarantee that no one will experience the same heartache again. Last week I accepted the recommendations of the Williams review of gross negligence manslaughter, and we announced a new national clinical improvement programme to provide NHS consultants with confidential data on their clinical outcomes. From next April independent medical examiners will examine every hospital death, and the learning from deaths programme will be extended to primary care.
Will the Secretary of State encourage NHS England to respond to my freedom of information request of 13 March this year regarding Greater Manchester Shared Services and the likely failure of the NHS to correctly enforce guidance on recruiting agency staff in the reappointment of Deborah Hancox after her criminal conviction and two-year prison sentence for defrauding the NHS? How can we employ these people?
The hon. Lady has highlighted what is potentially an extremely serious issue. Obviously the FOI is a matter for NHS England, but let me reassure her that the Minister for Health, my hon. Friend the Member for North East Cambridgeshire (Stephen Barclay)—the hospitals Minister—met the chief executive of the NHS Counter Fraud Authority this morning.
I thought that the report made powerful reading, and I know that my hon. Friend was associated with it. Yesterday the Prime Minister was straightforward about the fact that, if we are to preserve our NHS and make it one of the best systems in the world, the burden of taxation will need to increase, and she was willing to listen to the views of colleagues about the most appropriate way in which that should be done.
The Association of Directors of Adult Social Services has reported a £7 billion reduction in adult social care funding since 2010, and Age UK has reported there are now “care deserts” in some parts of the country. There are 1.2 million older people living with unmet care needs, and one in five care services has the poorest quality ratings from the Care Quality Commission.
As well as a long-term funding solution for social care, we need the extra £1 billion this year and £8 billion in the current Parliament that Labour pledged before last year’s general election. However, all that the Government offer is a delayed Green Paper. When will the Secretary of State deal with the current crisis in social care?
No, that is not correct. Yesterday we made very clear our support for the social care system and our recognition that reform of the NHS must go hand in glove with the social care system, and we said there would be a new financial settlement for the social care system. It is also time that the Labour party took some responsibility for the financial crisis that made all these cuts necessary.
Survival rates are high, but I am ambitious for more. That is why the Prime Minister recently announced £75 million to support new research into the early diagnosis and treatment of prostate cancer. We will recruit 40,000 patients into more than 60 studies over the next five years, and further to this even more exciting is the rapid pathway that I was discussing yesterday with Cally Palmer, our national cancer director, which we are trialling across three hospital sites in west London as part of its local cancer alliance.
May I gently remind the hon. Lady that it was this Conservative Government who introduced the national living wage, and we did that on the basis of transforming the economy, championing policies that were by and large opposed every step of the way by the Scottish National party?
I very much enjoyed visiting the trust with my hon. Friend. As he will be aware from our discussion during that visit a process for capital bids is under way. As my right hon. Friend the Secretary of State set out, the date for that is mid-July and I look forward to seeing the bid from my hon. Friend’s trust.
I recently met the hon. Gentleman’s party colleague, the hon. Member for Birmingham, Selly Oak (Steve McCabe), to discuss this matter with the facility. We are very clear: we expect all clinical commissioning groups to honour the NICE guidelines. I am very cross that CCGs tend to view IVF services as low-hanging fruit with which to make cuts. That is totally unacceptable and I will be taking steps to remind them of that.
My right hon. Friend is right to champion this, as he did through the recent Adjournment debate, when he set out the case in more detail. We recognise, as we did at the last Health questions and in the Adjournment debate, that there are significant issues with the local hospital, and that is why it is working very actively on its bid for capital funding.
I reject that accusation; we are far from burying it. The Prime Minister is looking at responding to the interim report. I will repeat what I said to the hon. Lady when she last asked this question. We are quite clear that the child migrant policy was wrong. We have apologised for that policy, and we have established a £7 million family restoration fund. The response from the Government to that report will be laid in due course.
Can the Minister provide an update on the work being undertaken by the policy research unit on obesity to consider the relationship between the many streams of marketing and obesity, and can he tell us whether the unit is looking specifically at childhood obesity?
The National Institute for Health Research—the policy research unit—is specifically looking at the impact of the marketing of products with a high sugar, fat or salt content on children’s food and drink preferences and consumption. The unit has already published a report on children’s exposure to television advertising, and it will be publishing further findings from other projects later this year.
I am delighted that our NHS will be getting an extra £20 billion. This has long been at the top of my agenda, and the agenda of my constituents. Does my right hon. Friend agree that, to ensure that that money is always spent on the NHS, we need to consider a hypothecated tax as part of the funding plan?
As I say, there are compelling arguments in favour of hypothecated taxes, but there are also strong reasons why we have to be cautious—namely, the fact that tax revenues go up and down, year on year, while the NHS needs stable funding. Important arguments and discussions need to happen between now and the Budget, when the Chancellor will make that decision.
Two for the price of one. Up to 70% of strokes are preventable if hypertension, atrial fibrillation, diabetes, cholesterol and other lifestyle factors are detected and managed earlier. The current national stroke strategy came to an end last year, so we are working closely with NHS England and the Stroke Association on a new national plan, which I hope to publish this summer.
The fundamental issue here is that we need a social care system that works hand in hand with our health services—the two are umbilically linked. The key plank of the new NHS 10-year plan must be the full integration of health and care services. It does not make sense to publish the Green Paper before the NHS plan has even been drafted. We will bring forward a Green Paper, but in the meantime, spending on adult social care has gone up by 8% this year.
Like many others, I welcome the announcement yesterday of the £20 billion investment in the NHS. Will my right hon. Friend join me in seeking assurances that the £2 billion extra for the Scottish Government shall be allocated to spending on the NHS in Scotland?
What comparison has the Minister made of the cost of preventing children and young people’s mental health issues by tackling adverse childhood experience in the first few years of life, rather than letting them develop into much costlier issues for school-age children?
The hon. Lady will be aware that there is much work going on in this area. We are clear that we need to tackle these issues in schools, which is in the Green Paper, but more support also needs to be given in the early years. We are looking at how we can do that.
Northern Devon Healthcare Trust recently announced that it is to share the chairman and chief executive of the Royal Devon and Exeter NHS Foundation Trust. Will the Minister meet me to ensure that the new arrangements will help to secure services in North Devon?
Last November, the Health Secretary committed to ending out-of-area mental health placements by 2020, but the number of people placed more than 100 km from their home rose by 65% over the past year. The earlier response from the Under-Secretary of State for Health and Social Care, the hon. Member for Thurrock (Jackie Doyle-Price), was no answer, so what are the Government actually going to do to turn the situation around?
I remember that debate. The matter was on the Joint Committee on Vaccination and Immunisation’s June agenda, and I am awaiting its advice with bated breath. As I said in the debate, I will turn that advice around as soon as I get it and get a decision. I know a lot of people are waiting on that.
Thank you, Mr Speaker. NHS Property Services intends to sell the Bootham Park Hospital site, but reinvesting in that site would make such a difference to the health needs of our city. Will the Minister ensure that that happens?
Very brief, Mr Speaker. Yesterday, the Secretary of State for Health and Social Care said that he would place the details of the funding settlement in the Library, but the paper has not yet been deposited. Mr Speaker, given the implications for higher tax and spending, will you use your good offices to ensure that that paper is deposited as soon as possible?
Forthwith. Splendid. The hon. Gentleman looks satisfied—at least for now.
We have an urgent question in a moment from Alison Thewliss. I advise the House that it is on an extremely important matter that warrants urgent treatment on the Floor of the House, but it does not warrant treatment at length. I do not intend to run it for any longer than 20 minutes, because there is other business to protect.
Glasgow School of Art
As the House will be aware, a fire broke out at Glasgow School of Art’s renowned Mackintosh building on the night of 15 June. The building is one of Glasgow’s iconic landmarks and is regarded as Mackintosh’s greatest work. It is rightly of global architectural significance and a unique and irreplaceable building in the eyes of many people worldwide. The art school itself is a work of art—a jewel in a city that sparkles with architectural splendour. It is worth noting that the building next door, the O2 ABC music venue, has also been affected, and it is even older and has a colourful and varied history. The art school was never a museum piece, but a living, breathing, working art school—a powerhouse of creativity and a much-loved part of the fabric of Glasgow. We can be grateful, however, that the tragedy was not worsened by loss of life, and my heartfelt thanks go out to the emergency services, particularly the fire service, who attended the scene under such adverse conditions and in the heart of the vibrant city’s nightlife.
Many people, such as myself, are still in disbelief that this could happen again after the devastating fire of 2014, particularly given the painstaking and careful efforts that have taken place to restore the building over the past years. I visited the building on 1 June as the guest at the opening of the 2018 degree show and saw the restored library and the famous “hen run”. I was struck by the love and passion of those involved in restoring the building. I am personally devastated by the fire, a fact which I communicated directly when speaking to the school’s director, Professor Tom Inns, over the weekend. My heart goes out to the school, its students and supporters, who did so much to raise funds for the restoration after 2014.
At this point, we do not know the cause of the fire, but I note that the fire service has assured us that a comprehensive and professional probe will be carried out in due course. The UK Government previously gave £10 million to rebuild the school after the last fire, and we stand ready to help again. There was never a question about the need to rebuild and restore the building when tragedy struck four years ago. The situation is far worse after the weekend’s fire, but I hope we can start with that aim in mind.
Obviously, there are real questions about what will happen next. We stand ready to work with the school, the city council and the Scottish Government. I am visiting the site and meeting the head of the school on Friday, and I will update Members when I am in a position to do so.
I thank the Secretary of State for his comprehensive response and for the support he has given.
The loss of the Glasgow School of Art, particularly in the 150th anniversary year of Mackintosh’s birth, is a very sore loss indeed for the city. As the Secretary of State mentioned, the building is internationally significant and is held very preciously in our hearts in Glasgow. All who have visited and studied there, and even those who have not been inside, feel that the building belongs to the city of Glasgow and to each individual.
It is a catastrophe to lose the building, and my heart goes out to the staff at the GSA, to Professor Tom Inns and his staff, to those who worked on the restoration and particularly to the craftspeople who put so much love, care and attention into bringing back skills that have gone out of fashion to bring the school back to its former glory.
The Secretary of State is right to mention the vibrant O2 ABC venue, which was very much part of the cultural scene in the city of Glasgow. That will also be a very sore loss to Glasgow.
Like the Secretary of State, I pay tribute to the Scottish fire and rescue service, which pumped water uphill from the Clyde to try to douse the huge flames of the inferno on Friday night; the police, who kept everybody safe; and the Salvation Army, which was on hand to provide rolls, sausages and Irn-Bru to the Weegie fire crews. They did a tremendous job in reacting to the fire, too.
Does the Secretary of State agree that speculation at this time about the future of the building and the cause of the fire is unhelpful and that we should allow the experts in the fire and rescue service to do their investigations and to carry out their very detailed work, which may take some time to reach a conclusion? It is important that we get the answers and that we learn the lessons of this fire.
Will the Secretary of State support looking at all options to ensure that traders and residents of the Sauchiehall Street and Garnethill area are supported through this and are given the financial support they need? Will he look at the further detail of whether sprinklers can be made mandatory in historic buildings?
Finally, I am glad to hear that the Secretary of State is offering support for the renovations, and I look forward to hearing more on that in the coming weeks. Can he confirm that he will give more support for donations coming from other sources and that he will use the Government’s efforts to bring in more money?
The House can hear the hon. Lady’s passion for the Glasgow School of Art, which is reflected across the city of Glasgow, across Scotland and across the world. She is right that speculation is unhelpful at this time, which is why I do not support calls at this stage for a public inquiry. The investigations that would normally follow a fire and the detailed investigations that are under way should be allowed to follow their course. Of course, some of those investigations will be into the structure of the building and will determine what can happen next.
As I have said, I want to work with the school, the city council and the Scottish Government once views are formulated on how a restoration can be taken forward. We stand ready to help, as we did in 2014. I will discuss the traders, businesses and residents around the Glasgow School of Art with the Scottish Government and the council.
My daughter-in-law is a postgraduate of the Glasgow School of Art, which is a much loved institution. Will the Secretary of State undertake to come back to the Dispatch Box when things are much clearer, so that we can get a clear understanding of what the UK Government’s undertaking will be?
I pay tribute to the hon. Member for Glasgow Central (Alison Thewliss) for securing this urgent question. I fully support her efforts, and I am sure all Glasgow Members will stand in total solidarity to ensure we get the best outcome possible for our city.
Charles Rennie Mackintosh’s Glasgow School of Art, that magnificent edifice that dominates the skyline of Garnethill, is the epitome of what it means to be a Glaswegian. It embodies the very essence of the city’s character and soul, and is a true example of human genius. The grief I experienced after the first fire in 2014 was profound; it felt like part of our city had died that day. Now to witness an even more severe conflagration consume this precious art nouveau masterpiece has left me both angry and incredulous that it could have happened again. What on earth has gone wrong here?
More generally, this fire represents a wake-up call for Glasgow and the entire country. We need to have a much more robust approach to protecting our amazing Victorian architectural legacy in Britain in the future or we will continue to see these tragic losses mount up as buildings of these ages continue to suffer degradation. Government at all levels—city, Scottish and British—needs to step up to meet this challenge with radical and imaginative measures.
The good thing about the Glasgow School of Art is that the past four years have seen a meticulous process of understanding the building take place. The work of the architects and craftspeople has been extraordinary. We therefore have a critical mass of knowledge and understanding of this iconic building and its construction that makes it easier than ever before to restore Mackintosh’s original vision. They are geared up and more than ready to take on that challenge, and I will be making the strongest possible case that they should be allowed that chance.
In the face of reckless calls to tear the building down, what plans do the Government have to support the safeguarding and renewal of such an iconic and important cultural asset for the world? What conversations has the Secretary of State had with the Scottish Government on the need to safeguard the building and ensure it is appropriately restored? Given that Glasgow needs a more preventive, comprehensive strategy for preserving its ageing stock of Victorian architecture, much of which is vulnerable to fire, what plans do the Government have to support a review of the way that heritage buildings are managed and safeguarded, with fire prevention policy as a priority? What discussions has the Secretary of State had with the Scottish Government on the need to set up an investigation into the safety measures taken by the contractors for the restoration works? All I would say in conclusion is that the people of Glasgow deserve roses as well as bread, and the Mack will rise again.
The hon. Gentleman raises important points, and I know that he has a strong personal connection with the School of Art. Like those people who have been part of it, he feels this tragedy, but, as the hon. Member for Glasgow Central said, people who have never crossed the threshold of the School of Art feel it, too. I feel particularly for those craftsmen who restored the “hen run” and the library, bringing back these crafts, and how they must be feeling this week, when their work has been decimated. I take on board the points he makes about safety issues in buildings. The Under-Secretary of State for Digital, Culture, Media and Sport, my hon. Friend the Member for Northampton North (Michael Ellis), who is responsible for heritage in the UK and is in his place, will also have heard what he said and we will respond specifically to that.
As a representative of many of the students and staff of the school, and as a former frequent visitor to the ABC, this fire was a real blow to me. When the Secretary of State meets representatives of the school on Friday will he talk about ways in which the community and alumni can most appropriately help with any fundraising efforts for future restorations?
I most certainly will do that. The effort to raise funds after the 2014 fire was tremendous. One way in which the Government can help is through Government funding, which can be a catalyst for other funding coming in. That was very much the case in 2014, and it is very much in my mind at this time.
This was a cruel and gut-wrenching blow to the people of Glasgow, coming just as the refurbishment from last time was nearing completion. Last night in this House we demonstrated our ability to disagree with each other and have a vigorous debate, but I am pleased that this morning we are seeing all shades of political opinion in Scotland come together in solidarity with the people of Glasgow as they deal with this great tragedy. I want to ask a couple of specific questions. Yesterday, the Secretary of State for Housing, Communities and Local Government said that it was a matter for the owners of buildings to determine whether or not to install sprinklers. What action does the Secretary of State for Scotland think the Government should take to ensure that sprinklers are installed in such public buildings? He mentioned the need for a thorough investigation. Does he agree that erroneous press speculation on the cause of the fire before that investigation is complete is unhelpful and undesirable?
I certainly agree with the hon. Gentleman’s last point: press speculation on the cause of the fire is very unhelpful. We need to let those people who are carrying out the professional investigation get on with it. I also agree that it is important that all levels of government—the city council, the Scottish Government and the UK Government—work together, and whatever our other differences, I absolutely commit to do that. The issue of sprinklers has been debated extensively in the House in recent times. The hon. Gentleman will be aware that a sprinkler system was in the process of being installed in the building, but sadly that process had not been completed.
Glasgow School of Art has a base in Moray; I spoke to people at the Altyre campus this morning, and they asked me to express their sympathies and thoughts for everyone involved in Glasgow. What can our constituents throughout Scotland do to support the efforts to restore Glasgow School of Art?
When I visited the School of Art on 1 June, I met some of my hon. Friend’s constituents from Moray who had raised very considerable sums of money for the first restoration. Although those fundraisers will be as devastated as the rest of us, I am sure that, given the vigour and passion that I witnessed, they will stand ready in Moray and throughout Scotland to start the process again.
As we know, highland chieftains are very good at getting rich clan members and estates to help to pay for repairs to the roofs of their castles and mansion houses. There are some extremely well endowed art-supporting funds out there, in the US and the rest of the world; what efforts will be made to see whether they would help to pay for the restoration?