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Topical Questions

Volume 704: debated on Tuesday 23 November 2021

It is a critical time for our country, and we are taking vital steps across health and care. First, on covid, we have now given over 112 million doses of the vaccine in total across the UK. Yesterday, our booster programme was opened up to all people over the age of 40 and we extended our offer of a second dose to all people aged between 16 and 17.

Secondly, on recovery, we are delivering the biggest catch-up plan in the history of the NHS, including the £5.9 billion capital investment we announced last month. Lastly, on reform, yesterday we announced our intention to put a policy of education and training for the health workforce and digital transformation at the very heart of the NHS, so we can plan more effectively as one for the long term, with clear accountability for delivery.

A young constituent of mine, Chris, has had to have part of his skull removed following a stroke. Although he is prone to falling, his brain has been largely unprotected for nearly two years. This is because his surgeon feels that the necessary surgery is primarily cosmetic. Several other of my constituents have been refused surgery on those grounds, despite procedures being available elsewhere. What steps is my right hon. Friend taking to level up such health disparities and make health inequality a thing of the past?

First, I am sorry to hear about my hon. Friend’s constituent Chris and wish him all the very best. She will know that clinical commissioning groups are responsible for commissioning local healthcare services. If the aim of a cosmetic procedure is health rated, such as the need to repair or reconstruct missing or damaged tissue or skin that might come through illness, birth defect or accident, it will be commissioned and seen to by commissioners. She refers to a particular case. If she would like to provide me with more details, I would be happy to take a look.

At the weekend, the Secretary of State effectively ditched his promise to deliver 6,000 extra GPs. Last week, the Infrastructure and Projects Authority said his promise to deliver 40 new hospitals is “unachievable”. Last night, he whipped a vote that sees poorer pensioners lose their homes to pay for care, while the homes of the richer are protected. Can he tell us which promise is he going to break next?

I have to say that the right hon. Gentleman is wrong on all three counts. The Government are absolutely committed to hiring more GPs, with over 1,800 full-time equivalent GPs entering primary care in the two years to September 2021. We are seeing success after success in the hospital building programme, with the biggest capital investment programme in hospitals that this country has ever seen. As for our social care programme, this Government are the first in decades to have the guts to deliver, and that is exactly what we are getting on with.

The Secretary of State’s social care programme is not levelling up when the promise in his manifesto that no one should have to lose their home to pay for care is broken and in tatters after last night.

The Secretary of State’s next promise was to give the NHS “everything” to get through the backlog. With waiting lists growing at pace, ambulances backed up outside hospitals, and cancer operations getting cancelled, what will he do to recruit the staff we need? He is apparently not going to support the cross-party amendment in the name of the former Health Secretary, the right hon. Member for South West Surrey (Jeremy Hunt), tonight, and he failed to win the funding needed for recruitment and training in the Budget, so how will he deliver on his promise to give the NHS “everything” when it does not have the staff to deliver the care to bring waiting lists down?

Once again, the right hon. Gentleman proves he still does not understand the social care programme that this Government have set out. I think that is deliberate; he chooses not to understand it. For the first time, catastrophic costs are being capped for everyone in the country, regardless of where they live, and the generous means-testing system will ensure that the vast majority of people will benefit and that no one will lose out.

The right hon. Gentleman asks me what I am doing about the workforce. We are making the biggest investment in the workforce that this country has ever seen. Yesterday I announced the merger of Health Education England into the NHS, so that we can have a better joined-up strategy, and we have already set out a 15-year framework to consider the long-term needs of the workforce.

T2. Hundreds of local people have responded to my High Peak GP surgery survey, and I look forward to presenting Ministers with the results shortly. One of the top concerns is about how we can improve access to primary care. One way would be finally to build a major new health centre for Buxton. The local NHS already owns a suitable town centre location with outline planning permission; all it requires is the capital funding. Derbyshire Community Health Service NHS Trust has submitted a strong bid, which I support, so will the Secretary of State meet me to discuss how we can deliver the proposal and improve healthcare for Buxton and the whole High Peak? (904321)

Yes, I will. I looked at the previous bid and have been trying to understand why it was not taken forward. However, I would like to look carefully at the revised bid. I reassure my hon. Friend that more funding is available for such capital projects, and I would be happy to discuss that with him.

T4. Now that the cap on care costs has unravelled, many of my constituents feel misled and betrayed, especially those with modest capital in the value of their home. How can it be that those with the most will contribute the least and that those with the least will contribute the most? Where is the equity, where is the fairness, and where is the justice in any of that? (904323)

I thank the hon. Gentleman for his question. We are trying to solve something that has not been solved for decades, and the Labour party does exactly what it always does when it comes to this point: it picks one specific part without looking at the package as a whole and misleads the whole country. I want a better system not only for our grans and grandads, but for our mums and dads and all of us. If this system had been in place for my grandmother when she had dementia before dying in 2018, she would have been a lot better off. While we sit here doing nothing, the reality is that everybody loses—

Order. Questions and answers are meant to be short and punchy. We cannot get into a full-blown debate.

T5. My constituents benefit from the excellent healthcare provided at Hillingdon Hospital, but it is long overdue a rebuild. Can my right hon. Friend give me an update on when we might expect to see progress on those plans? (904324)

It is a vital project, and the trust project team are working well with NHS England and with my Department. The scheme, as I understand it, remains on track; like my hon. Friend, I look forward to its completion.

T7. New research from the Disabled Children’s Partnership shows that nearly three quarters of disabled children and young people have seen their conditions regress in the pandemic because of a lack of adequate support. Therapies, short breaks and health services have all been massively reduced, and there are huge backlogs. Will the Secretary of State outline how the Government plan to rapidly sort that out? (904326)

I thank the hon. Lady for her very important question. There is nothing more important than our children. Sadly, some of the actions that were taken at the height of the pandemic, for understandable reasons, have had unintended consequences. That is exactly why we are putting in a record amount of funding, with the biggest catch-up programme for elective procedures in the history of the NHS. I know that that will help.

T6. The capital transformation of acute hospitals in Shrewsbury and Telford has been eight years in the making. Will the Secretary of State confirm what is now needed to start delivering the £312 million of capital committed by the Conservative Government to improve Shropshire’s healthcare facilities? Will he also confirm that it does not make sense to head down the rabbit hole of a new hospital and start this whole process all over again? (904325)

I am grateful to my right hon. Friend, who has taken a long-term and consistent interest in the matter. The strategic outline case for transforming the Royal Shrewsbury Hospital and Princess Royal Hospital Telford was received at the end of October 2021. It has been reviewed by the NHS and detailed feedback has been given; I look forward to it coming forward to me early next year. We remain committed to delivering the investment and improvement that Shropshire’s hospitals need and that he and his colleagues have helped to secure.

Women across the country have lost jobs and life savings as a result of chronic pain and disability caused by complications after the use of medical mesh. Many, including one of my constituents, have had to pay for corrective surgery overseas. The Government have so far refused to set up agencies to provide financial redress, as was recommended in the Cumberlege report. Will the Secretary of State revisit the Cumberlege report, and in particular the need for financial redress?

Women who have suffered are being helped and supported through the difficult choices that they are having to make. The Government have set up eight specialist mesh centres across the country to provide them with the specialist treatment that they need. Our priority is patient safety, preventing anything like this from happening again, and supporting women who have been affected. There is no evidence that a redress system would improve patient safety or improve the outcome for those women.

T8. As ear syringing is no longer being undertaken in local surgeries, and as self-care does not work for many people, will the Government make sure that microsuction is at least available in every primary care network area? Otherwise, we are leaving people to go deaf. (904327)

Local commissioners are responsible for meeting the health needs of their local population and should continue to ensure appropriate access to ear wax services. However, should a CCG not routinely commission ear wax removal or the suction method that my hon. Friend refers to, a patient can request an individual funding request. I am happy to help my hon. Friend if that is not happening locally.

Cancer targets are not being met. This September had the worst figures on record for both the 31-day and the 62-day targets; the 62-day target has not been met since 2015. Extra funding is welcome, but where is the detailed implementation plan that was promised to follow?

I reassure the hon. Gentleman that cancer has remained an absolute priority for the NHS during the pandemic, as it will continue to be. The funding that has been awarded to deal with long-term electives includes funding for cancer referrals. Some amazing work is being done by our cancer alliances, which are looking to deal with the urgent backlog that has developed during the pandemic.

T9. In the next week or so, the Secretary of State will receive the Goldacre report on maximising the use of data in the national health service for both research and operational reasons. The Department has failed dramatically, a couple of times in the past decade, to maximise the use of this enormously important resource. Will he undertake to read the report, consider carefully the policies in it with a view to implementing them quickly, and publish it before the end of January? (904328)

My right hon. Friend has raised this issue with me before, but he is right to raise it again, because proper use of data is important to the future of the NHS. He may have noted our announcement yesterday that we are merging NHS Digital and NHSX with NHS England, which will enable us to do a much better job with data. I will of course look carefully at that report, and I should be happy to meet him to discuss it further.

Poppy is just eight. She has severe epilepsy, with ever more frequent and enduring episodes. Her specialist consultant has said that surgery is her only hope, but Sheffield and Leeds have refused to assess her for capacity and administration reasons, not clinical reasons. Will the Minister work with me to ensure that Poppy receives the treatment that she needs?

I am sorry to hear about the hon. Lady’s constituent, and of course a Minister will meet her.

T10. I refer to my interest as chair of the all-party parliamentary group on stroke and as the husband of a stroke survivor.Mechanical thrombectomy can be a game-changer for sufferers of strokes, greatly reducing the levels of disability they are left with. NHS England committed itself to a full roll-out of mechanical thrombectomy availability by 2022, but we are lagging seriously behind. Where are the plan and the investment to bring the programme back up to date and on track? (904329)

I know that my hon. Friend has a personal interest in improving stroke services. I can reassure him that the national stroke service model was published by NHS England and NHS Improvement in May this year, and that as of 1 April there are 20 operational integrated stroke delivery networks, bringing together key stakeholders to improve the diagnosis, treatment and rehabilitation of those who have suffered a stroke.

Ambulance response times are at their highest since records began. A month ago, on 22 October, I tabled a parliamentary question asking the Secretary of State how many ambulance trusts had moved into level 4—the level at which potential failures creep into the service. I am still awaiting an answer. Will the Minister answer that question today, please?

If the hon. Lady supplies the number of the question, I will ensure that it is dealt with today. As for her broader point, yes, ambulance services across the country are under significant pressure this winter, which is one of the reasons why we have already invested an additional £55 million in helping them to cope with that pressure.

Thank you, Mr Speaker.

The Secretary of State knows that some in Government are worried about the extra cost of training additional doctors, but does he agree that every additional doctor we train means one fewer locums that the NHS has to hire, which is cheaper for the NHS and better for patients?

I agree that we want more and more full-time doctors, which will mean that there is less demand for locums and is, of course, very good for the NHS. I also agree that there should be more focus on the workforce, and I hope that my right hon. Friend welcomes the measure that I took yesterday of merging Health Education England with the NHS, so that we can have a much more joined-up workforce plan.

Andrew Dilnot, whose commission undertook the inquiry into social care nearly 10 years ago, says that the impact of the Government’s social care plans on working-age disabled people will be “catastrophic”. What is the Government’s assessment of the impact?

The hon. Lady is right to raise the importance of doing everything we can to look after working-age people who need social care. As she will know, the total funding of social care from the state now constitutes most of the funding, and it is right that all needs are met through those funds. As for the new plan, everyone will benefit—no one will lose out from this versus the current system—so the vast majority of people will be better off, including working-age adults.

The Minister has heard from my right hon. Friend and neighbour the Member for Ludlow (Philip Dunne) how essential it is that the £320 million we have secured for the Future Fit programme be released, so that construction can start. We are beginning to see a definite negative impact on A&E services because of the seven or eight years of delays. Please will the Minister do everything possible to ensure that the money is finally released and construction can start?

I am grateful to my hon. Friend, and likewise to my right hon. Friend the Member for Ludlow (Philip Dunne), who has campaigned vigorously this issue. We now have the outline business case from the trust, and we are reviewing it at pace to ensure that we can deliver the investment in both of Shropshire’s hospitals that they need to continue to serve my hon. Friend’s and colleagues’ constituents.

My 90-year-old constituent, Jimmy, fell in his garden recently and broke his hip. When his family rang 999, they were told that it would be up to 14 hours before an ambulance could attend. The family got the fire brigade out after two and a half hours to sort him out. When the Government going to get a grip on the crisis in our ambulance services?

The hon. Gentleman might have done this already, but if he wishes to, I would be grateful if he wrote to me about that case, not only to see whether there is anything I can do, but because it is always interesting and useful to hear from individual Members about specific incidents. To his broader point, as I set out to the hon. Member for St Albans (Daisy Cooper), we have invested £55 million this year ahead of the winter to support our ambulance services, but it is entirely true to say that they are under considerable pressure this winter across the country.