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Topical Questions

Volume 648: debated on Tuesday 23 October 2018

The Department is working with the NHS to ensure that the £20 billion of extra taxpayers’ money is well spent: supporting social care, backing the workforce, using the best modern technology and strengthening prevention. On that note, I can tell the House that we now have a record number of GPs in training: 3,473—10% up on last year.

I thank the Secretary of State for so promptly accepting our invitation to visit us in East Sussex in January. He will be warmly welcomed. With that season in mind, what assessment has he made of the NHS’s resilience with winter approaching?

Of course winter always challenges the NHS, and this year will be no different. We have put in extra funding, including more capital funding, to ensure that we get the best possible flow through A&E and to ensure there is further funding for social care so that people who do not need to be in hospital can leave hospital.

Last week, The Times reported that a young autistic woman with severe learning disabilities and an IQ of 52 was sexually exploited for months after her care provider had a court accept a plan for her to have sexual relations with men at her home. It is unacceptable that the agency charged with the care of this young woman decided that unsupervised contact with men for sex was in her best interest, yet the Government would give all such care providers a role in assessing the mental capacity of the people for whom they care. Will the Secretary of State urgently investigate this case? Given that the case illustrates the conflict of interest that arises from involving care providers in mental capacity assessments, will he pause the Mental Capacity (Amendment) Bill to allow time to make it fit for purpose?

The hon. Lady is absolutely right to raise this incredibly concerning case. Unfortunately, because the case is ongoing and due to be heard before the High Court very shortly, we are unable to discuss the specifics of the case, but we are incredibly concerned by what it suggests. We have made it clear in statutory guidance to support the implementation of the Care Act 2014 that we expect local authorities to ensure that the services they commission are safe, effective and high quality. Once this case has gone through the High Court, we will look to take further action.

T2. A constituent has just written to me saying that his diabetic care has been moved from John Coupland Hospital to Lincoln Hospital under the mistaken bureaucratic belief that bigger is better. United Lincolnshire Hospitals NHS Trust, which covers Lincoln Hospital, is struggling. It is treating only 69% of people in A&E within four hours, when the figure should be 95%. What is the Minister going to do to ensure that large rural areas get the best and the same healthcare as large cities? (907234)

My hon. Friend is right to highlight this. The Secretary of State was at the trust last week, and I visited earlier in the year. There is a specific range of actions, including partnership with Sherwood Forest Hospitals NHS Foundation Trust; advanced clinical practitioner courses, which started in June; £1.8 million of capital to support improvements to patient flow; and a frailty pilot at Lincoln. There is an intensive programme of work with this trust, because we recognise my hon. Friend’s concerns.

T8. North West Ambulance Service NHS Trust spent £30 million in the past three years on private ambulances. Does the Minister agree that that money would have been far better spent on the recruitment and retention of NHS ambulance staff? (907240)

As the hon. Lady will know, since 2010, the number of paramedics has increased by more than 30% and the pay band has been increased from band 5 to band 6. She will also know from the excellent work of Lord Carter that there was significant variation between ambulance services and a significant opportunity to make savings that can be reinvested in ambulances by addressing differences in sickness rates, “hear and treat” and “see and treat” rates and other variables. We have also committed additional funding for new ambulances, including in the north-west, which will be in place by this winter.

T3. I can personally testify to the passion, the care and the professionalism of staff at Hillingdon Hospital. They do a fantastic job, but, sadly, too much of the physical environment in which they work is no longer fit for purpose. I invite my right hon. Friend to visit and see it for himself and to commit to providing the medical facilities that my constituents will need for the long term. (907235)

My right hon. Friend is an assiduous supporter of his constituents. I look forward very much to taking up his invitation to visit. I have looked into some of the details of the proposal on the table and, indeed, at some of the other proposals that may benefit the Hillingdon area. I look forward to discussing them with him.

T9. I welcome Baroness Cumberlege’s ongoing review of the impact of the use of Primodos pregnancy tests, but for the families affected to have confidence in this review they must be given sufficient time to give evidence. Will the Health Secretary ensure that that happens? (907241)

Yes, of course I will make sure the appropriate action is taken in this case. It is a sensitive matter, and I look forward to discussing it with the hon. Lady.

T4. The NHS diabetes prevention programme, which was one of the first of its kind, has helped many people since 2016. As someone who has been diagnosed as a type 2 diabetic since that point, it is of particular interest to me. Will the Minister assure me that when the long-term NHS plan is published, we will be even more ambitious? (907236)

We certainly will. I do not wish to pre-empt what the long-term plan will say, but it is an excellent opportunity for us to look at how the NHS can best support people who have or are at risk of developing diabetes, and that includes transformation funding beyond next spring and how technology can be used to help people better manage that long-term condition.

T10. Will the Minister provide an update on the revised capital bid by Warrington and Halton Hospitals NHS Foundation Trust to provide Halton General Hospital with a secure future? (907242)

I am not aware of the specific details of that, but I am happy to meet the hon. Gentleman to discuss it if he has particular concerns he wishes to raise.

T5. Spina bifida is one of the most prevalent causes of infant mortality and disability, and a campaign has been running for quite a long time to try to fortify flour to prevent it. Successive Governments have ducked the issue, so will we now please seize it? (907237)

We are continuing to review the advice from our expert advisory groups on safe levels of folate intake, but, continuing our tradition of announcing things to the House first, I want to inform the House today that we are going to issue a public consultation, as of now, on adding folic acid to flour.

The service from the East Midlands Ambulance Service NHS Trust has been a considerable disappointment for many of my constituents in recent months. When I met them about the service, they told me that on a huge number of occasions they have ambulances sat waiting outside accident and emergency departments, rather than getting to the next call. What more can the Government do to make sure we get these A&Es cleared?

The hon. Gentleman is right to say that we need to improve those handovers. We have improvement programmes in place at 11 hospital sites in the east midlands, alongside which we are making a £4.9 million investment in 37 new ambulances. Part of this is also about the length of stay and addressing the pathway.

T6. The recent report from the Royal College of Physicians, “Hiding in plain sight: Treating tobacco dependency in the NHS”, made clear the cost savings and health benefits there would be if doctors identified smokers and referred them to smoking cessation services, so will next month’s plan include that, particularly for pregnant women and mental health patients? (907238)

As my hon. Friend, the chair of the all-party group on smoking and health, knows, those groups are key to delivering our tobacco control plan. We are not complacent at all; the delivery plan that was published in June sets out the actions that different agencies will take to deliver the five-year plan, and that absolutely includes mentor cessation services.

I very much welcome news of the consultation on the mandatory fortification of flour with folic acid, but are the Government consulting on whether it should happen or on how it should happen?

We will be taking evidence, including from the Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment, which is meeting as we speak, to look at the safe upper limit of folate levels. I am particularly keen to get that right, but I am convinced that the evidence shows overwhelmingly that this is something we should be doing.

T7. What is it, precisely, about the NHS’s management and leadership that means it seems to be unable to achieve consistent excellence in its hospitals, such as happens at the Salford Royal NHS Foundation Trust? Why is it so hard for lessons learned to be better disseminated? (907239)

My right hon. Friend identifies a critical factor in improving the future of the NHS, which is to have stronger leadership at all levels, to be able to support innovation and to find out the best that is happening elsewhere and bring it to trusts. I know he has a particular interest in that, and I look forward to working with him on it.

Foetal alcohol spectrum disorders mean permanent brain damage. In the United States, studies show that one in 20 children are affected. So when will this Government carry out their own prevalence study, so that we can confirm the extent of this entirely preventable disability in the UK?

Public Health England collects some data on foetal alcohol syndrome, but we recognise that the data do not reflect the range of FASD. These disorders are difficult to diagnose, which is why we are engaging experts and those affected to explore what more could be done to improve our understanding.

I thank the Secretary of State for the extra £5 million for East Midlands ambulance service and for the £4.5 million extra for Nottingham University Hospitals Trust, which will mean at least 150 more beds this winter, all of which will help with winter planning, but does he agree that it behoves us all to play our own part in keeping fit and healthy and to use the NHS services responsibly?

My right hon. Friend makes a very important point, which is that, while we drive to ensure that the NHS is prepared as possible for this winter, it is incumbent on everybody to exercise their judgment, yes, to access the NHS where it is needed and important, but also to make sure that they bear a personal responsibility, too.

The Mid Yorkshire Hospitals Trust is proposing to close our midwife-led maternity unit, telling me that, while it is safe, unless it has 500 births a year, it is not value for money. Is that a new national standard for midwife maternity units, because if so it would close 90% of free-standing units? Will a Minister meet me on this matter, because it is unfair on local parents, and, frankly, we are sick and tired of losing services from our towns?

I am extremely concerned about the case of Logan, a young boy in my constituency who requires round-the-clock care and the handling of his case by Corby clinical commissioning group. I have written to the Minister raising concerns about this case, but is he willing to meet me and Logan’s parents, Darren and Wendy, to talk about how this could perhaps be resolved and to apply any pressure that he can, because, as a family, they should be making memories at the moment, not battling local NHS bureaucracy?

Is it true that the Secretary of State is now so worried about the supply of vital medicines in the event of a no deal or a hard Brexit that he has asked the pharmaceutical industry to extend the period of stockpiling from six weeks to 20 weeks?

No, that is not true. We are working very closely with the pharmaceutical industry to make sure that, in the event of a no-deal Brexit, which I regard as unlikely, we mitigate as much as possible the impact on the supply of medicines and that the supply of medicines can be unhindered.

Will my hon. Friend, the Minister with responsibility for antimicrobial resistance, consider a 10% levy on antibiotics? If such a levy were applied globally, it would raise £3 billion a year, which is the amount specified in the O’Neill review to fund research into this area properly.

I thank my hon. Friend for his consistent work in this area. Stimulating the pipeline for new antimicrobials and alternative treatments is a complex matter. I can assure him that we continue to work with our international partners—I mentioned the G20 earlier —and that absolutely involves market entry awards, which, as he knows, is a global problem that requires a similar solution.

Every week in this country, two children are born with spina bifida or anencephaly, and I am delighted that the Minister has just announced the consultation on the fortification of flour, which could stop 70% of those birth defects. Can he tell the House how quickly he hopes to bring about the conclusion of the consultation?

Let me just pay tribute to the hon. Gentleman for the work that he has done, bringing this matter to the fore and really pushing it forward. The answer is as soon as possible. I also want to make sure that I can involve the other agencies. Public Health England will be very important in this, because, of course, not every woman eats bread and therefore takes the flour supplement.

I am sure that the Minister is aware that October is breast cancer awareness month. I welcome the ambition that the Prime Minister set out at the party conference for 75% early-stage diagnosis. There is some concern that, as breast cancer is already above that, there is no ambition left for it to do even better. Can he assure me and the breast cancer community that that is not the case?

That is certainly not the case. We had a very good debate on breast cancer last week. It is BCAM still this month for another week. The 75% was a target, a new national ambition. It most certainly is not the limit of our ambition.

Will the Government write off the debts of Yorkshire hospitals so that extra money invested can go into patient care?

As the Secretary of State set out, we are making a significant funding commitment to the NHS—the extra £20 billion—but that is not conditional on writing off debt.

Will the Minister please provide an update to the House on work to ensure that we train more GPs for England, particularly for west Oxfordshire?

Yes. My hon. Friend will have heard that we have record numbers of GPs in training— 10% up on last year. I want to see more GPs—5,000 more across the country—and, no doubt, some of those in west Oxfordshire.

I have a constituent who has Turner syndrome, a female-only genetic disorder that affects one in every 2,000 baby girls. Owing to this, she has to take several medications every day of her life, and this is mounting up as she gets older. She works so she is not on any benefits and has to pay for her medications herself. Will the Minister consider exempting those who suffer from lifelong conditions such as Turner syndrome from paying for their prescriptions? Surely, it cannot be right that people in England should be treated differently from those in Scotland, Wales and Northern Ireland, where such prescription charges have been abolished.

I am hearing deeply concerning reports about ambulance waits outside Worcestershire Acute Hospitals NHS Trust, and the Minister is aware of these concerns. We welcome the capital funding that is going into this trust, but will he meet me to discuss what more can be done to improve patient handover, which is concerning for my constituents?

As my hon. Friend says, there is significant capital investment into Worcestershire, as well as a major programme of improvements addressing variation in ambulances, but of course I am also happy to meet her to discuss the matter.

Last week, the chief executive of the Association of the British Pharmaceutical Industry warned that even associate membership of the European Medicines Agency would not do for our life sciences sector, so can the Secretary of State tell us how much longer we will have to wait and how much more we will have to pay for new medicines if we are outside the European medicines market?

We will not have to wait longer; we will ensure that we get the best medicines to the people of Britain long after we are members of the European Union, as we did before we were members of the European Union.

As in the health service under successive Governments of both colours, demand exceeds supply and we cannot carry on indefinitely, but let us hear a few more questions.

Last week, the Royal College of Paediatrics and Child Health revealed that there has been an increase in infant mortality for the first time in 100 years. Four in every 1,000 babies will not reach their first birthday, compared with 2.8 in every 1,000 babies in Europe. This was warned against as an effect of austerity. What assessment has the Health Secretary done on the effects of next week’s Budget on child health and the longevity of our children?

I saw that report and we are analysing it. Last week was Baby Loss Awareness Week, and I am glad that there is more awareness of the issue now than there was previously. It is a very important issue that we are looking at right across the board.

About two hours ago, I rang to book a flu jab less than a mile away from here. Unfortunately, staff said that they had run out and will not be able to do it until 2 November. The Secretary of State is nodding. He seems to know the answer to everything. What is the issue? Will he give me the answer? This never happened under Labour.

If the hon. Gentleman is claiming that there were not enough flu jabs under Labour, I might agree with him, because there are now more flu jabs. More than 4 million flu jabs have already taken place. I am delighted that lots of people want flu jabs because everybody who needs one should get one. The arrival of the flu jab medicine is phased, because we have to ensure that we get the right flu jabs. If the hon. Gentleman could carry on promoting flu jabs for the elderly, I would be delighted.

Nevertheless, the hon. Gentleman has had his say, and I feel sure that he will say it again as often as is necessary.

Will the Minister tell me whether the withdrawal of funding for the Healthy Futures programme in the north-west and Public Health Action in the south-west is likely to help or hinder us meeting the smoking cessation targets in the tobacco control programme?

This comes back to the matter of public health budgets—£16 billion during the current spending review period, with local authorities best placed to make local decisions on what is needed in their local area. That is the same in the right hon. Gentleman’s area as it is in mine.

Last month, the Mayor of Greater Manchester adopted the five recommendations of my report, “Living Well and Dying Well”, which seeks to include hospice care provision more formally in our NHS and social care planning. Will the Minister meet me and representatives of our hospices to see how we might best make use of these brilliant community health assets?

Yes, I am happy to meet the hon. Gentleman to discuss the matter. Hospices provide an incredible level of care right across the UK, and we cannot do enough to support them.

Order. There were 30 topical questions. Although there was scope for many more, I am afraid that we have to stop now. Thank you, colleagues.