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Topical Questions

Volume 662: debated on Tuesday 18 June 2019

This week is Children’s Hospice Week, Loneliness Awareness Week, National Breastfeeding Week and Learning Disability Week, and today is International Fathers Mental Health Day. The Government have made plans to more than double funding for children’s palliative care and end-of-life care services, developed a loneliness strategy and launched a consultation on folic acid in flour to support expectant mothers, and yesterday the Prime Minister announced a package of further work to support people from all backgrounds in the UK with their mental health. I and my brilliant ministerial team will continue to drive forward the health of the nation.

I want to bring to the Secretary of State’s attention some mental health waiting times that my constituents have recently come to me with. Someone with an urgent referral for trauma counselling is looking at a minimum six-month wait. A teenager who has attempted to take her own life is waiting over a year to see a psychiatrist. Several adults have been told there is a three-year wait just to get a diagnosis of attention deficit hyperactivity disorder. These waits are appalling. The Secretary of State billed himself as the leadership candidate for the future, but he is the Secretary of State for Health now. What is he going to do to address this appalling waiting system?

The hon. Gentleman is right that we need to ensure that access to mental health services improves. As part of the increase in funding we are putting into the NHS, the biggest increase is in mental health services, and it is a critical part of what we need to do to address the sorts of problems he rightly raises.

T3. Will my hon. Friend take up as a matter of urgency the recommendations of the Public Administration and Constitutional Affairs Committee report on eating disorders treatment, which we have released today to follow up on the Parliamentary and Health Service Ombudsman’s report from 2017, named “Ignoring the alarms”? Does she agree with us that too many people are dying from eating disorders, which still have the highest mortality rate of any mental health condition, and that much more must be done to train health professionals, support sufferers and their families, and enhance and accelerate treatment and care in the community? (911428)

I thank the Committee for its report, which follows the health ombudsman’s report on the tragic death of Averil Hart. It is clear that we have made significant improvements in eating disorder provision since then, but there is still more to do. We have made considerable progress with regard to treating children, and that progress now needs to be translated to the care of adults with eating disorders. My hon. Friend is right that it is the mental health disorder that has the highest mortality rate. At any one time, 1% of the population will be suffering from an eating disorder, and we need to make this more of a priority to make sure that services are available.

I know the shadow Secretary of State will be brief, because he will not want to crowd out his colleagues. That would be an uncomradely thing to do—inegalitarian no less—and he would not do that.


I dare say that this is the Secretary of State’s final outing at Health questions, because we believe he has secured transfer to pastures new. In his time here, he has failed to deliver a social care Green Paper and failed to deliver a prevention Green Paper, while he is privatising Oxford cancer scanning services and we have hospitals charging £7,000 for knee replacements. Does he really think that is a record deserving of Cabinet promotion?

I am agog—and aghast. Over the last year, we have not only delivered £33.9 billion of increased funding, but we have produced the long-term plan for the future of the NHS. Starting this year, with the money already flowing, we are seeing the biggest increase in funding for community, primary care and mental health services. We have developed our work on the prevention agenda, and we have instituted a new verve and energy into the adoption of new technology in the NHS. I look forward to driving forward all these things in the future.

Will the Secretary of State tell us about the verve and energy in his own constituency in Suffolk, where 32 health visitors are being cut because of his cuts? He is apparently now supporting a candidate who wants £10 billion-worth of tax cuts for the richest in society. Will that not mean further cuts to public health, further cuts to social care and, ultimately, cuts to the NHS as well?

For the majority of its 71-year history, the NHS has been run under the stewardship of a Conservative Secretary of State. At this moment, it is getting the biggest funding increase and the longest funding settlement in its history, along with the reforms to make sure that everybody can get the health care that they need.

T4. What steps is my right hon. Friend taking to improve the diagnosis and treatment of prostate cancer, in particular increasing the use of new technologies such as gel spacers, laser ablation and MRI in diagnosis? (911429)

More than 94% of men survive prostate cancer for one year, and 86% for five years, but there is more to do. That is why last April the Prime Minister announced £75 million over five years so that 40,000 men can take part in innovative research into early diagnosis and treatment. The long-term plan sets out our commitment to speed up the path from innovation to business as usual, spreading proven new techniques and technologies faster. Safer and more precise treatments in diagnostic techniques will continue to improve prostate cancer survival.

T2.   Kensington has an ageing population, many of whom will need residential care at some point, yet our council seems determined to move needy elders out of the borough, far from family and friends. Our last ever council-owned care home was sold off to a provider of caviar care, which lets luxury flats at £300,000 a year, with care, plus caviar, on top, for those who can afford it. Will the Minister explain what, if any, statutory obligations councils are under to provide affordable residential care for their residents? We are not all billionaires in Kensington. (911427)

The Care Act 2014 gives councils a responsibility to provide residents with a choice of quality care options in a local area. More broadly, we are backing up councils with increased funding. Over the last three years, we have increased funding in real terms by 8%. That has given councils access to about £10 billion to help ensure that there is provision in local areas.

T7. Will the Secretary of State assure my constituents in Kettering that taking advantage of the local government reorganisation in the county to establish a combined health and social care pilot is one of his Department’s very top priorities? (911432)

The House will not be surprised to know that the hon. Gentleman has raised this with me and my right hon. Friend the Secretary of State on a number of occasions. I am happy to reconfirm to him that we do consider it a top priority to make sure that all of his constituents get the care they need.

T5. With abortion rates for women over 30 rising, I am sure the Secretary of State will agree with Professor Lesley Regan, the president of the Royal College of Obstetricians and Gynaecologists, who said:“Women must have access to effective contraception and sexual health services to enable them to take control of their health and fertility by preventing unwanted pregnancies and sexually transmitted infections.”Does the Secretary of State also agree with Professor Regan’s comments on the need to end the fragmentation of commissioning, and the underfunding of services that disproportionately affect women? (911430)

The hon. Lady is quite right. As part of the long-term plan, we have considered the best way to commission sexual health services, which were moved over to local authorities five years ago. We think that the responsibilities are sitting in the right place, but we need to see far more co-commissioning, where local authorities and the NHS together ensure that there is more joined-up provision, rather than the siloed provision that she mentions.

T10. I welcome the successful trial of the new NHS app. How does the Department plan to use APIs to allow third-party developers to improve the app for patients? (911435)

My hon. Friend is quite right to celebrate the development of the NHS app. More than 80% of people are now able to use the NHS app to link to their GP practice. Our plans for the year ahead include API-based connections to a number of third-party products, including the NHS app. More importantly, I want the opening of this system to allow other innovators to be able to develop products for patients to use in a way that we have not imagined before. I want a load of innovations so that people can get the best possible access to their NHS.

T6. In York, it has taken 46 weeks for children and young people to commence the diagnosis process for autism—and demand and the number of referrals is going up. It takes a further 12 months, once there is a positive diagnosis, for parents even to access the SEND—special educational needs and disability—course. Precisely what service improvements can families expect to see in the next 12 months, and how will they be achieved? (911431)

The hon. Lady is absolutely right to draw attention to this issue. We are very concerned about the diagnosis times, which is why we are reviewing our autism strategy this year and are extending it to include children, whereas before it catered only for adults. We want to ensure it remains fit for purpose. We have launched a national call for evidence and have already received in excess of 1,000 responses.

Patient safety in the NHS depends on compassionate care training and staffing levels, but it also depends on patient safety systems. What progress is the national health service making towards implementing those systems in every place where patients are cared for?

Patient safety, as my hon. Friend suggests, remains an absolutely key priority for the NHS. NHS Improvement and NHS England are developing a national patient safety strategy, which will sit alongside the NHS long-term plan. It will be published this summer and will build on existing work to provide a coherent framework that the whole NHS can recognise and support.

T8. There are fears that NHS medical data could be on the table as part of a desperate post-Brexit trade deal with the US on digital services, where patient data would be mined by companies to develop medical technology that would then be sold back to the NHS. What guarantees can the Secretary of State give that private companies will not be profiteering from NHS assets in that way? (911433)

I wish my hon. Friend, with whom I have worked closely and whom I admire very much, great success in her leadership bid. I wish her more success than I had. With the hon. Member for Streatham (Chuka Umunna) sitting next to her, I am sure they will run a great race. I want to reassure her that, as I said the week before last, the NHS is not on the table in trade talks. We now have that assurance from the Americans. NHS data must always be held securely, with the appropriate and proper strong privacy and cyber-security protections.

I am sure the Secretary of State means well, but I am not entirely sure that the hon. Lady’s joy at the endorsement from the right hon. Gentleman was undiluted.

Will the Secretary of State support one of the key recommendations of the joint report from the Health and Social Care Committee and the Housing, Communities and Local Government Committee into the future funding of social care, which is for a German-style system of social insurance?

Absolutely. We are very keen to look at the Select Committees’ recommendations and the contributions of all key stakeholders. We are committed to ensuring that everyone has access to the care and support we need. The Green Paper will include ideas to protect people from high and unpredictable care costs.

T9. Over the weekend, I was contacted by a number of parents of severely disabled children with very distressing news. Up until now they have been receiving five pads a day, because their children, grown up or otherwise, are very severely disabled. However, they have been told by the clinical commissioning group that that has been cut to three. This is incredibly distressing. Some of the parents are on universal credit and the additional cost they will have to pay themselves will be £80 a month. That is unacceptable. Will the Secretary of State agree to meet me and representatives of my constituents, the parents of these very disabled children from Eastbourne, so that we can try to sort this out before it really gets out of hand? (911434)

I am very grateful to the hon. Gentleman for raising this case. The ministerial team has not seen the details in advance, but if he would like to write, the appropriate Minister will of course meet him.

The inquiry into the contaminated blood scandal, the biggest treatment disaster in the history of the NHS, is currently taking place in Leeds. What is the Department doing to compensate the victims of this scandal and to make sure their voices are heard?

My hon. Friend will wish to know that we are collaborating fully with the inquiry, and it has raised with us several issues about payments. We have made available an additional £30 million to give to those affected and will consider any conclusions the inquiry ultimately draws.

As the Minister will know, two weeks ago I went to the Netherlands with Teagan Appleby’s mother, Emma, to collect one month’s supply of medical cannabis. The Department laid down the requirements for Emma to meet with Border Force, and she met them by providing a UK prescription. Will the Secretary of State and Ministers meet me to ensure that there is no more ambiguity in a policy that currently criminalises parents in possession of a UK prescription bringing their much-needed medicine into the country?

As the hon. Lady and other colleagues know from having worked on this important issue, we acted swiftly to change the law to make sure that medicinal cannabis was available. Those patients for whom it is clinically appropriate can now be prescribed medicinal cannabis. As she knows, whether to prescribe is a clinical decision, but those prescriptions are available and flowing and are being issued where it is judged clinically appropriate for the patient. We will continue to work on this to make sure we get it right.

My constituent Max is aged eight and has Batten disease. He is one of only two sufferers of this disease who are not receiving the medicine that can improve their quality of life and keep them alive. Eleven other children in this country with Batten disease are receiving the drug, which is very effective but very expensive. The drug manufacturer has offered six months’ free supply to Max and the other person not getting it and has made other proposals to NHS England, which is currently refusing even to have meetings with the drug company to discuss how my constituent, this dying child, may receive the drugs he needs. Will my right hon. Friend intervene and use whatever reserve powers he has to ensure that my constituent gets this life-saving drug?

My hon. Friend speaks for the whole House about the need for these rare diseases to be given the attention they need so that sufferers such as Max can get the medicines if at all possible. As he knows following our meeting, the formal legal responsibilities lie with NHS England and NICE. I have raised this case, and that of others mentioned earlier, with the chief executive of NHS England and will raise it once again following this Question Time. We will do all we can to resolve this.

Thousands of my constituents will be left without access to dental care because a Swiss-owned investment firm has decided to shut three practices in my city. What is the Department doing to ensure that the people of Portsmouth have access to vital oral health services?

I understand the hon. Gentleman’s concern. As I understand it, the Colosseum dental group practices will remain open until 31 July. NHS England has put in place plans to ensure that where possible patients currently undergoing dental treatment will complete their course of treatment before the practice closures and is working with other local dental practices to provide additional capacity to treat patients as well as considering the longer-term options for procuring dental services in the Portsmouth area.

I declare an interest as a doctor’s wife. If the sub-dean at Chelmsford’s brilliant new medical school continues to teach the students and work in the hospital, she faces a 90% tax rate. If she continues to do the weekend hours the hospital needs, she faces having to pay more in tax than she is earning. Will the Minister look again at the taper, which is driving our consultants out of our hospitals?

As I said in response to an earlier question, we are putting out a consultation on pensions that will allow for looking at a number of issues, including the taper.

Order. I am very sorry, but, as in the national health service—under Governments of both colours, I emphasise—demand invariably exceeds supply. I will take the remaining questioners whose names are on the Order Paper and who wished to ask substantive questions but did not manage to get in. That seems only fair, as they have been bobbing up and down for the duration. Let us hear them.

Regardless of which type of Brexit we face this autumn, bureaucracy, customs charges and stockpiling costs will inevitably drive up the price of imported drugs and medical devices. Will the Secretary of State undertake to provide additional funds for NHS England and the devolved nations to cover those Brexit-induced costs and to avoid cuts in clinical services?

Additional funds have already been provided to ensure that medicines are available throughout the country, whatever the Brexit scenario.

Given the increased likelihood that the next Prime Minister will be determined to leave the European Union at the end of October, deal or no deal, will the Secretary of State update the House on what preparations are currently being made to protect the import of critical supplies such as insulin and radioisotopes?

Meeting the need for unhindered medicine supplies was an incredibly important piece of our Brexit planning, which was successfully completed ahead of 29 March. Of course we are updating those plans as we speak, but the ability to reassure people that there will be no impact on the supply of medicines is an important part of that work.