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Topical Questions

Volume 663: debated on Tuesday 23 July 2019

This week, the Department has released a consultation on the future of clinicians’ pensions, a new five-year deal to support our approach to community pharmacy, the Government’s prevention Green Paper and a £20 million collaboration with the Prince’s Trust on the NHS widening participation initiative, which will allow and support more apprentices into the NHS. There has been a lot done just this week, and there is a lot more still to do.

Another item for the Secretary of State’s list might be to engage with his counterpart in Scotland on the issue of the NHS taper on the pensions programme. When I raised the issue with a Treasury Minister, she seemed unaware that there was more than one NHS in the UK. If there is some co-ordination and joint representation to the Treasury, that might assist matters. Would the Secretary of State agree?

Of course, in solving this problem, many of the changes can take place within the NHS, and we are working on that with the Treasury. I am happy to ensure that discussions take place with devolved colleagues, but of course, the NHS is devolved in Scotland.

T2. Provision of in vitro fertilisation in Redditch has been reduced from two cycles to one. I warmly welcome the work that the Minister has done to increase equity across the country, but what more can she do to address the postcode lottery in this and other areas, such as hip and knee surgery? (912136)

My hon. Friend is right: the postcode lottery is not acceptable, and patients manage to get around it; my local clinical commissioning group, having funded three courses of IVF, has had to reduce that to two, because demand has doubled owing to the lack of provision in neighbouring CCGs. I have made it very clear that it is unacceptable for any CCG to offer no IVF cycles at all; I have given them that guidance.

My I pursue the question asked by the Chair of the Select Committee, the hon. Member for Totnes (Dr Wollaston)? We know that obesity is a major cause of cancer and other diseases, and we know that we have severe rates of childhood obesity, so why does the prevention Green Paper say only that the sugar tax “may” be extended to milkshakes? The evidence is clear. Is the Secretary of State not kicking this into the long grass?

I have asked the chief medical officer to review the evidence to ensure that our policy for tackling obesity is evidence-driven. Follow the evidence: that is what we do on this side of the House.

A year ago the Secretary of State said, to great fanfare, that prevention was one of his priorities. Now the prevention Green Paper has been sneaked out in the night on the Cabinet Office website. Health inequalities are getting wider and wider, and life expectancy is stalling, but the Secretary of State still cannot give us any clarification on the future of the public health ring-fenced grant. Is it not the truth that he has buckled under pressure from the sugar industry, is not taking on the alcohol industry, and is not taking on the tobacco industry? That is more about trying to get in with the new Prime Minister than putting the health needs of the nation first.

I thought that the hon. Gentleman would welcome the prevention Green Paper, which was published yesterday. We have been working very hard to publish a huge amount of policy, including the Green Paper, which contains about 80 different policies to ensure that we prevent people from becoming ill in the first place. However, it is also part of a broader drive, which Conservative Members support, to ensure that we are the healthiest of nations, and that people can take personal responsibility for their health, as well as relying on the NHS, so that it is always there when people need it.

T7. Has the Secretary of State given further consideration to providing extra funds to meet the challenges of running unavoidably small hospitals, such as Scarborough and the Friarage in Northallerton? (912143)

My hon. Friend has campaigned on this matter for a while, and I was pleased to meet him to discuss it earlier in the year. We absolutely recognise the challenge that small acute providers face, and over the past two years the Advisory Committee on Resource Allocation has been considering how we might meet that challenge. The committee has endorsed a new community services formula to reflect the pressure in remote areas, which may help the two hospitals mentioned by my hon. Friend.

T3. My constituent Catherine is undergoing post-operative breast cancer treatment. A new drug, Pertuzumab, which has been approved by the National Institute for Health and Care Excellence, has been shown to improve a woman’s life chances. The drug was prescribed for Catherine by her oncologist at the Mid Yorkshire Hospitals NHS Trust, but that was overruled by NHS England, although in the neighbouring trust patients are allowed it. Can the Minister guarantee that women who could extend their lives by taking this drug have access to it, no matter where they live? (912138)

When drugs have been approved by NICE, there is an obligation to prescribe them. If the hon. Lady will write to me, I shall be able to look into this matter more closely.

I welcome the consultation on NHS pensions that was announced this week, and while I do not think that 50:50 is the ultimate solution, I welcome the invitation to present other proposals. However, given that this is causing an issue now, how quickly does the Department think that it will be able to turn the outcome of the consultation into action?

We are working very hard to turn it into action as soon as possible, and I can give my hon. Friend an absolute commitment that the new rules will be in place in time for the new financial year.

T4. I am not going to shout at the Secretary of State this morning, but I will say to him that Huddersfield is a typical town, and a lovely place in which to live and work. Given that it is so attractive, why is it so difficult for us to find doctors and dentists who can give a good service to my constituents under this modern NHS? (912140)

The hon. Gentleman will know that the Government have produced an interim people plan setting out the course and the trajectory that will mean more doctors and nurses being trained. He will also know that we have opened new medical schools this year, and that more doctors are now being trained.

I should declare that I am chair of the all-party group on eating disorders. Despite eating disorders affecting 1.25 million people across the UK and being the most deadly of mental health issues, the average time dedicated to training about eating disorders in a five-year medical degree was found to be only three or four hours; in some cases, there was none at all. Will the Minister agree to look into this and perhaps report back to the all-party group?

I certainly will. This recommendation was also made by the Public Administration and Constitutional Affairs Committee following its report into the death of Averil Hart, and we are in discussions with the royal colleges to see what more can be done, in terms of training medical staff and doctors in mental health, because we want to make sure that intervention happens at the earliest possible stage, which means that all our medical professionals need to understand it better.

T5. Constituents of mine recovering from mental health problems have told me that when they have shared their desire to return to work with jobcentre staff, jobcentre staff have used that as a trigger to move them from employment support allowance to jobseeker’s allowance, with, obviously, the financial loss involved in that. Do Ministers agree that whoever is still in their job by the end of the week could usefully talk to the Department for Work and Pensions team about how people with mental health problems can be supported back into work without being penalised? (912141)

Yes is the short answer, and the hon. Gentleman will be pleased to know that I have regular discussions with colleagues in the DWP to see what we can do to humanise all our processes for benefits claimants, because it is important that when people suffering from mental ill health interact with organisations of the state, we are not causing them harm. I can assure the hon. Gentleman that that is very high on the list of things in my in-tray.

I greatly welcome the publication of the prevention Green Paper. How will that strategy enable people to keep well by living in warm homes?

Clearly, the need for join-up across Departments of Government is a vital part of this agenda, as my hon. Friend knows from her work across different Departments; the specific point she raises is one example of that, and we must drive it forward.

T6. In the north-east, we die on average two years younger than those in the south. The Northern Health Science Alliance estimates that that costs our economy £13 billion a year, on top of the emotional and personal costs. The Secretary of State talks a lot about technology in health, but what is he doing about equality in health—or should I ask Alexa? (912142)

Technology and the data that show these inequalities are an important part of the answer, but of course it is much broader than that, and tackling health inequalities is an underpinning part of the long-term plan for the NHS; it is absolutely critical in order to address the sorts of inequalities that the hon. Lady rightly raises.

Life skills courses can be key to helping people out of depression, loneliness and isolation, and into work and training, yet the course in Glossop in my local area has been cut by the county council, in spite of it having a £2.8 million underspend this year. Do Ministers agree that local authorities should be looking to spend the public health money that they have, and to use it effectively?

Yes, emphatically we do, and there is a drive across the country for more of the sort of social prescribing that the hon. Lady talks about. The clinical solution to many people’s health issues, and in particular mental health challenges, is often about changes in behaviour and activity, and the support people are given, rather than just drugs. On the face of it, the project the hon. Lady mentions sounds very good; of course I do not know the details, but I would be very happy to look into it. However, we wholeheartedly and emphatically support the broad direction of travel of helping people to tackle mental illness both through drugs where they are needed and through activity and social prescribing.

I recently met three care workers who work for Sanctuary Care. Between them, they have 60 years of experience of, and dedication to, caring for vulnerable people, but Sanctuary Care has decided to cut their pay and conditions because they were TUPE-ed over from the Borough of Greenwich. Is this the way to treat dedicated care staff? Will the Minister meet me and those care staff to discuss what is going on at Sanctuary Care, whose chief executive gets a handout of almost a quarter of a million pounds a year, while it cuts low-paid staff’s wages?

I thank the hon. Gentleman for raising that, because one of the things that I have learned in this role is that working in care should never be described as unskilled. It is probably one of the most skilled professions, and it requires people with exactly the right principles and values to deliver it. We are clear that people should be paid a fair and decent wage, and I am more than happy to meet the hon. Gentleman to discuss it further.

The Minister with responsibility for mental health is a very sympathetic person. Unfortunately, that does not seem to translate into action. Our clinical commissioning group has stopped funding the voluntary sector to provide counselling, and now it is taking counselling services out of GP surgeries as well. Will she look into that?

Yes. What the hon. Lady has just outlined to me flies in the face of the advice that I and the clinical directors of NHS England are giving CCGs. We are clear that voluntary sector provision of additional services is crucial in the support of people with mental ill health. Unfortunately, some commissioners seem to want to medicalise everything, but that is not the key to good treatments, and I will look into it.

The prevention Green Paper talks about the risk of an opioid epidemic. In Scotland, we feel that that is already here, with 1,187 deaths in Scotland last year, 394 of them in Glasgow. Will the Secretary of State work with the Scottish Government and Glasgow health and social care partnership and support the opening of a medically supervised drug consumption room in Glasgow?

Yes, the risk of an opioid epidemic across the UK is a serious one. We have seen that risk materialise in the United States. I was as shocked as anyone to see the recent figures for the growth in opioid addiction in Scotland. While public health and the NHS are devolved to the Scottish Government, and they must lead on tackling this issue, for the UK elements of my responsibilities, we in England will do absolutely everything we can and put aside all party politics to tackle this serious problem.

In January the Health Secretary declared air pollution a health emergency, yet today, tomorrow and Thursday we will see ozone layers in the south and south-east of England that will be a health hazard to the old, the young and the sick. Unlike in equivalent situations in other countries, the Government have released no warnings to people or advised how they should take appropriate action. How bad does air pollution have to get before the Government use their not inconsiderable communications budget to warn people to take appropriate action?

We have. Through Public Health England, which is the responsible agency, we have absolutely put out communications, which I heard this morning. The communications that the hon. Lady asks for are out there. Of course air pollution is a significant risk to public health. I am delighted that it is falling to its lowest levels since the industrial revolution, but there is clearly much more that we need to do.

Can the Secretary of State confirm that the Care Quality Commission has recently inspected Calderdale and Huddersfield NHS Foundation Trust, and that patient safety was raised as an issue during that inspection? If that is the case, what action is he taking?

Clearly, patient safety is a massive priority for the Government. I do not know the exact details of the site that the hon. Lady is talking about, but if she would like to drop me a line, I will definitely find out and get back to her.