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Health and Social Care

Volume 709: debated on Tuesday 1 March 2022

The Secretary of State was asked—

Mental Health Services: Young People

We are committed to ensuring that everyone with mental health needs has timely access to support and treatment. We remain committed to the expansion in mental health services in the NHS long-term plan, which should see 345,000 more children accessing services by 2023-24. To accelerate that expansion, we have provided an additional £79 million this year in recognition of the impacts of the pandemic.

The NHS long-term plan promises a

“new approach to…mental health services for people aged 18-25”.

Could the Secretary of State set out in detail how university mental health and wellbeing services will work seamlessly with NHS mental health services so that students in need of support do not fall through the cracks?

The hon. Lady raises a very important point, especially as this week is Eating Disorders Awareness Week. Sadly, as she and many other hon. Members will know, eating disorders have increased significantly over the past couple of years.

Last year, during the pandemic, we published a mental health recovery action plan with an additional £500 million of funding, a minimum of £13 million of which was dedicated to young people between the ages of 18 and 25, particularly to help with the transition from children’s to adult mental health services. My hon. Friend the Minister for Care and Mental Health has been in talks with the Department for Education and has a meeting soon to discuss what more action we can take collectively.

Has my right hon. Friend made any specific assessment of the effect of the covid-19 lockdown restrictions on children’s mental health and general wellbeing?

I can tell my hon. Friend that we have and that that assessment continues. Sadly, as he will know, we have seen a significant increase in mental health referrals, especially for young people, over the past two years. The extra support that we have provided through the action plan and the £500 million of funding is helping, but I am afraid that there will be some long-term challenges created by the pandemic. We are very much looking at what more we can do.

I echo the words of solidarity with Ukraine that many colleagues have shared in recent days.

There are stark inequalities in children’s mental health services, from the postcode lottery of whether a child is ever seen after a referral to the luck-of-the-draw results of eating disorder treatment. Children from black and mixed-race backgrounds make up 11% of the population, but account for a staggering 36% of those detained in the highest-level mental health units. However, just 5% of those who access routine children’s mental health services are black. That is unacceptable—something clearly is not working.

Labour will put a mental health support hub in every community and a specialist mental health staff member in every school. What are the Government going to do?

I think we all agree, across the House, about the importance of mental health services, especially for younger people. As for what the Government are doing, before the pandemic there was already a commitment to increase funding for mental health services in the NHS’s long-term plan by an additional £2.3 billion a year. On top of that, there has been the response during the pandemic, with the mental health recovery action plan and the additional £500 million that I referred to a moment ago. When it comes to children’s mental health services, there is £79 million included, which will pay for an extra 22,500 referrals.

NHS Capacity

We have worked with the NHS to expand virtual wards and establish a new national discharge taskforce to safely maximise patient discharge and free up beds. We have also announced a delivery plan for tackling the covid-19 backlog of elective care, which sets out our clear vision for how an additional £8 billion will be spent over the next three years to help the NHS to recover and expand elective services.

I thank my right hon. Friend for that information. As we look beyond the pandemic, our priority must be tackling the NHS waiting list. Does my right hon. Friend agree that the record number of doctors and nurses working in our NHS shows that the Government are putting the NHS on the best possible footing to meet the challenges ahead?

I absolutely agree with my right hon. Friend. Let me take this opportunity once again to thank everyone who has been working in the NHS, especially for all that they have done during the pandemic. We are continuing to invest in the workforce through our 50,000-person expansion in the nurse programme, and we already have 44,000 more full-time employees in healthcare settings than we had this time last year, including 4,600 more doctors and 11,100 more nurses.

The lack of capacity in accident and emergency departments and other healthcare services is a major contributor to the ongoing ambulance waiting time crisis in my constituency. Will the Secretary of State meet me and representatives of the West Midlands ambulance service—as I have repeatedly asked him to do—to help to resolve the crisis?

The hon. Lady is right to raise this matter. As she will know, owing to the pressures of the pandemic we have seen significant challenges for ambulance services throughout the country. Just a few days ago I met the head of the West Midlands ambulance service to discuss some of the issues, and also how the extra funding that we provided over the winter—some £55 million of support for ambulance services—is helping.

May I press the Secretary of State on how the increases in NHS capacity will be maintained over the medium term? His own Department has forecast that waiting lists may hit 9 million or 10 million in the next couple of years. The Government also have a plan to take the extra funding coming from the increase in national insurance and the health and social care levy out of the NHS to fund our long-term social care plans. How are the two to be reconciled?

As my right hon. Friend will know, when I presented the NHS’s elective recovery plan for the covid-19 backlog in the House a couple of weeks ago, I made it clear that we expect waiting lists to rise before they fall. That is because some 10 million people stayed away during the pandemic, and we want as many as possible of those who want and are able to come forward to do so. At the same time, the NHS will be massively increasing its activity, in new ways and with new funding. It is essential for there to be much greater integration between the NHS and social care, and we set our plans in detail in the White Paper published last week.

The Government seem to think that there is some kind of magic staffing tree, but there is no increase in capacity, no elective recovery and no fixing of social care without an immediate and ambitious workforce plan. We have legislation in this place, and we have seen a tsunami of White Papers, but none of that includes a credible workforce plan. Given the estimated 93,000 NHS vacancies and more than 110,000 vacancies in social care, when will we have that plan?

The hon. Lady has just stood up and said that there is no increase in capacity. I am afraid she was probably not listening a few minutes ago when I said that in the last year the number of people working in the health service had increased by 44,000, and that we had 11,000 more nurses and nearly 5,000 more doctors. As for a plan, the hon. Lady may know that I have already asked the NHS to work on a long-term plan—a 15-year workforce plan. If she really wanted a new workforce plan, she should have thought about how we could fund it, and should not have voted against the increase in spending that the Government proposed.

On the subject of NHS capacity, data released by NHS Digital shows that NHS Bury clinical commissioning group had the lowest number and also the lowest percentage of face-to-face GP appointments in England in January 2022. Only 37% of Bury appointments are face-to-face, which is clearly unacceptable and unfair to my constituents. Will my right hon. Friend agree to meet me to find solutions to this serious problem?

It is a serious issue, and I will of course meet my hon. Friend to discuss it further. He may be interested to know that over the winter the Government provided an additional £250 million in a winter access fund for primary care services throughout the country. That has certainly helped to increase the number of face-to-face appointments, although the omicron wave made the process more challenging. As my hon. Friend suggests, it should ultimately be for patients to choose how they want to be seen.

Ethnic Inequalities in Healthcare

3. What assessment he has made of the implications for his policies of the NHS Race and Health Observatory’s February 2022 report on “Ethnic Inequalities in Healthcare”. (905775)

Addressing the disparities discussed in that report is one of my key priorities. We are already making progress in crucial areas such as increasing covid-19 vaccine take-up among ethnic minority groups. To go further, we also plan to publish a health disparities White Paper later this year that will set out impactful measures designed to address disparities and their causes, including those linked to ethnicity.

I thank the Secretary of State for his response. I hope he will ensure that he implements all the conclusions of that report. He is aware of the McLean review into the senior leadership of the Royal Wolverhampton NHS Trust, who have now annexed the Walsall Manor Hospital. Can he say what he will do to ensure that all those working in the NHS and using the NHS are treated with equality and transparency, starting with the Manor?

The right hon. Lady is absolutely right to raise this issue. This is one of the most important issues and one of the biggest longer-term challenges to face the NHS. I welcome the report and I will be taking it very seriously. She will know that I have commenced action on ethnic disparities in healthcare. For example, I have asked for an investigation, headed by Dame Margaret Whitehead, into potential bias in medical devices. The right hon. Lady is also right to raise the importance of inequality of treatment, and I will shortly have more to say on that.

This report is damning. The evidence shows that, over a decade of Conservative Government, we have not seen any significant change. Ethnic minority patients continue to receive poorer care because of their race at every stage of their life. The Tories have had 12 years to act. Why have they failed to do so?

The reason this report exists is that the Government want to see this kind of work being done by an independent organisation so that we can address these types of disparities and issues. There have been ethnic disparities in our health service for decades, sadly, under successive Governments, and it is this Government who are doing something about it. I have already referred to the medical devices review. Earlier this week, the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield), set out the maternity disparities taskforce, and we will have a lot more to say on this when we publish our forthcoming White Paper.

Covid-19 Lateral Flow Tests

4. What recent discussions he has had with the devolved Administrations on ending free-of-charge covid-19 lateral flow tests. (905776)

8. What recent discussions he has had with the devolved Administrations on ending free-of-charge covid-19 lateral flow tests. (905780)

In advance of the living with covid announcement on 21 February, ministerial colleagues discussed our living with covid strategy with the devolved Administrations. Officials were also in regular touch to understand the approach being taken by each Administration and any implementation issues.

Happy St David’s day to the people of Wales. The views of the Welsh Government—and of three of the four Governments of these islands—on this question are very clear. The Government in here appear to be in a minority of one, yet again. When someone takes a lateral flow test and reports a result, it does not do them any good at all, but it can have significant benefits for their friends, family and close contacts. When the results are reported in sufficiently large numbers, that can have significant wider public health benefits. With that in mind, what assessment has the Minister made of the likely reduction in the number of daily tests being taken if people have to pay for them, and how does that compare with the advice from all the UK’s chief medical officers on the level of background asymptomatic testing that is advisable to give us the quickest possible warning of the next wave of a new variant of covid?

As the Prime Minister announced last week, free tests will continue until April. He also stated that if the SNP in Scotland wished to continue to offer free tests after that date, it is certainly at liberty to do so. I am proud that, because of the amazing success of the vaccination programme, covid rates are coming down, hospitalisations are coming down and deaths are coming down. It is because of that that we can now live with covid and reduce the ongoing expense of testing and bring it to a proportionate and manageable scenario.

Scottish taxpayers paid their contribution towards the provision of free lateral flow tests. Scotland is allocated its share of UK debt, yet we are supposed to believe that covid support is somehow at the benevolence of the UK Government. Now we see the UK Government, again, making a decision that directly affects Scotland because we have a fixed budget. The Minister says the SNP Government can continue to provide free lateral flow tests, but is it not the case that Scotland needs its own borrowing powers so that it has much more fiscal responsibility and the proper levers of power?

As far as I am aware, and I am pretty sure I am right, the Scottish Government already have tax-raising powers, so perhaps they could use them in this instance.

The Department of Health and Social Care asked the Treasury for £5 billion to continue testing, which was refused, yet it has been revealed that the UK Treasury has effectively written off £4.3 billion given to fraudsters during the pandemic. Does the Minister think it is wrong to write off losses that have enriched fraudsters while refusing to support the continuation of free testing?

Covid-19: Pharmaceutical Interventions

Vaccines remain our best line of defence against covid-19. NHS staff and volunteers in our world-leading vaccination programme continue to work tirelessly, and I am sure the House thanks all of them. The offer of first, second and booster doses is always open. It is never too late to get jabbed.

We were the first country in the world to begin rolling out oral antivirals in the community, as part of a range of NHS antiviral and therapeutic treatment options to give us another line of defence. We are working hard to identify further safe and effective treatments through Government-funded national trials.

It was announced last month that covid vaccinations will be offered to healthy five to 11-year-olds, and the Joint Committee on Vaccination and Immunisation calculates that 2 million children in this age group will need to be vaccinated to prevent one intensive care unit admission, so any serious side effects occurring at a rate of more than one in 2 million would constitute a net harm. Given that reports of serious side effects, such as myocarditis, from other countries significantly exceed that rate, and given the lack of long-term safety data for the new vaccine, how confident are the Government that the vaccination of healthy five to 11-year-olds will do more good than harm?

We carefully considered and accepted the advice of the JCVI that the health benefits to five to 11-year-olds of a single dose of the covid-19 vaccine are greater than the potential health risks. I reassure the House that this is a non-urgent offer, and our priority is to continue vaccinating the most vulnerable.

NHS Managers: Performance and Efficiency

6. What steps he is taking to help ensure high standards of performance and efficiency for managers in the NHS. (905778)

The NHS is recognised as one of the most efficient health services in the world. Between 2010 and 2018, productivity in the NHS grew faster than in the wider economy. However, there is always room to do more. My right hon. Friend the Secretary of State has commissioned a review led by Dame Linda Pollard and General Sir Gordon Messenger to explore health and social care leadership and management, including the drivers of performance and efficiency, and they will report back later this year.

We have learned today that innocent children are being killed in Ukraine. I could not get the Ukrainian colours, but I am wearing my UNICEF tie.

We have brilliant nurses, doctors and support staff, but too often the management of hospitals is not as good as it should be to support them. The Topol review should be kept alive, but we should also make sure that the training of managers is of the utmost importance. A recent survey of the world’s best hospitals had only one British hospital in the top 100: Guy’s and St Thomas’s. Does the Minister agree that this is not good enough?

Possibly at some risk to my political prospects, I find myself in agreement with the hon. Gentleman on the importance of good and effective leadership. Of course I join him in his remarks about Ukraine.

I highlight that 84% of our NHS workforce are either clinically trained or are directly providing clinical support to clinicians, but it is also important that we recognise the importance and value of the administrators and managers who support the team. That is why we need the best people in those roles, and it is why my right hon. Friend the Secretary of State has commissioned the review led by two extremely eminent people. We are determined to continue driving up the quality and standards of management in the NHS.

Locum Doctors and Nurses

7. If he will make an estimate of the percentage of (a) doctors and (b) nurses being paid locum rates in the latest week for which figures are available. (905779)

In NHS hospital trusts to date in 2021-22, there have been on average 14,826 full-time-equivalent agency nurses and 4,621 medical and dental FTE agency staff. It is hard to draw direct percentage comparisons given different methodologies for measuring such percentages, but my understanding is that overall about 3% of nursing shifts and about 1.5% of doctors’ shifts in hospitals are filled by locums or agency staff.

Can we get greater clarity on that information and have it held centrally, given that wages are such a large proportion of the NHS budget? It is essential to know how many hours are paid at the higher locum rate to ensure value for money for the extra billions of pounds that the Government are putting into the NHS to get waiting lists down and for social care.

I am grateful to my right hon. Friend, who is tireless in her determination to ensure value for money for her and all of our taxpayers’ pounds, particularly in this space. We continue to work hard to drive down agency and locum spend, focusing instead on both bank staff and our full-time recruitment, on which the Secretary of State has set out the success that we have been having. Since 2015, we have controlled agency spend through price caps and procurement frameworks. However, she is absolutely right, and we want to see more full-time NHS employed staff working at NHS rates in our trusts.

Health Outcomes: Public-Private Partnerships

9. Whether his Department is taking steps to help improve health outcomes through the implementation of public-private partnerships. (905781)

Throughout the pandemic, partnerships between the public and private sectors have been vital in securing the resources to protect public health. As one element of that partnership, independent sector providers, for example, delivered almost 7 million episodes of care for NHS patients between April 2020 and December 2021 according to hospital episode statistics data. We continue to support the partnership approach more broadly as part of our plans both to tackle the backlog of elective care and to improve broader health outcomes.

I thank the Minister for that response. As he is aware, the national diet and nutrition survey has shown that average intakes of dietary fibre in the United Kingdom are well below recommended levels and less than a quarter of those of countries such as Denmark, where the Government work across industry on a public-private partnership basis to boost wholegrain intakes. What consideration has the Minister given to implementing such an initiative in the United Kingdom to provide a much-needed boost in fibre intakes among the public?

The hon. Gentleman makes a typically sensible and reasonable point. Government advice on a healthy balanced diet is encapsulated in the UK’s national food model, the “Eatwell Guide”. It includes advice on incorporating fibre into the diet through fruit and vegetables, bread, rice and pasta. We set nutritional standards for catering in all Government Departments and related organisations to improve the nutritional content of food served, including increasing fibre. I agree that it would be helpful to increase intakes of fibre in our diet, guided appropriately by clinical and medical advice, and a key element of achieving that is working with industry.

Motor Neurone Disease Research

10. What his timescale is for awarding the £50 million funding for targeted motor neurone disease research through specific scientific programmes proposed by MND charities. (905782)

Researchers can apply right now to the National Institute for Health Research and UK Research and Innovation to access the £50 million of funding. The timescale for spending the money depends on the research applications received. The £50 million over five years is a minimum commitment, and we hope to spend much more than that on research in this vital area. We are working with the motor neurone community to help it effectively access the committed funding and to boost MND research even further.

The Minister has made a positive announcement in the course of the last few months, and this is an important repetition, but there seems to be a slight miscommunication going on because organisations are telling me that they are not sure where the co-ordination is coming from. May I invite her to meet me and the coalition of patients and researchers to try to nail down exactly what is happening, in a spirit of good faith?

I would be happy to meet my hon. Friend. I have also met some of the campaigners and researchers in this area, and the head of our research arm, so that we are clear. The support we are providing to the community includes a new £4 million MND partnership. That will bring the research community together so that they can pool resources and expertise to leverage that funding further, and ensure that they put forward strategic applications.

Children with Epilepsy: Treatments

11. If his Department will make an assessment of the long-term impacts of use of (a) benzodiazepines and (b) other opioids on children being treated for acute forms of epilepsy. (905783)

Benzodiazepines are an important medicine in the treatment of severe cases of certain types of epileptic conditions in children. The Medicines and Healthcare products Regulatory Agency continues to monitor the safety of treatment with benzodiazepines. Opioids are not authorised to treat children for acute forms of epilepsy.

Benzodiazepines are not appropriate for all children, and the Secretary of State has been instrumental in approving medicinal cannabis for use by children with epilepsy. I recently visited a medicinal cannabis farm in the borders of Scotland, which is poised to make an important contribution to the pharmaceutical industry in this country. Given the economic benefits, and the moral imperative of helping those children who can only benefit from medicinal cannabis, will the Minister say what steps the Government will take to make it available on NHS prescriptions?

The National Institute for Health Research welcomes funding applications for research into any aspect of human health, including epilepsy, and we would welcome those pharmaceutical companies coming forward to partake in trials. The NIHR and the NHS will support a programme of two randomised control trials into epilepsy, which will compare medicines containing cannabidiol, and CBD plus tetrahydrocannabinol and a placebo. This is a pioneering area of research, and I am aware that NHS England and NIHR are working closely to get those trials started as soon as possible.

Regional Health Inequalities

12. What steps his Department is taking to tackle regional health inequalities including waiting times for NHS treatment. (905784)

We are determined to address the many health disparities that exist across England, particularly in areas such as maternity. Last week I was pleased to announce the maternity disparities taskforce. It aims to tackle the difference in outcomes for pregnant women based on their race and background, which we want to end.

The problem is that the Government talk a good scrap, but their record on health inequalities is utterly deplorable. Before the pandemic, 4.5 million people were waiting for treatment on NHS lists, and 5,000 people in Hull were waiting for treatment at Hull Royal Infirmary and Castle Hill. Why is someone who lives in east Hull more than twice as likely to be waiting for more than 12 months on an NHS waiting list?

While I recognise that the waiting times in Hull are some of the highest in the country, I am sure the hon. Gentleman will welcome the investment that the Government are putting into his constituency to change that. The Royal Infirmary and Castle Hill Hospitals have £60 million of funding, and his own hospital recognises that it will provide some of the most modern facilities in the country. That includes £2.8 million for new respiratory wards, £1.6 million for new specialist theatre facilities, and £1.1 million for oxygen resilience wards, ensuring that his local hospital is able to tackle some of those health disparities.

In addition to regional disparities, will the Minister look into disparities between men and women’s health? Men die four years earlier than women on average, 75% of suicides are by men, and during the time taken for oral questions, one man will die from prostate cancer. Through my work as chair of the all-party group on issues affecting men and boys, we have taken evidence that points to the need for a men’s health strategy. The Government have done much over the years to reduce the gender pay gap. Will the Minister help me to reduce the gender age gap?

I absolutely take the point that my hon. Friend makes around the disparity in life expectancy between those in the most and the least deprived areas, which is greater for men. We will be publishing the health disparities White Paper, and we will focus on any disparities, including those that affect men.

The Minister’s answer to my hon. Friend the Member for Kingston upon Hull East (Karl Turner) was quite frankly unbelievable. The fact is that waiting lists are projected to continue increasing year on year. NHS data shows huge regional inequalities in waiting times. Across the river, at Guy’s and St Thomas’ NHS Foundation Trust, over 70% of patients are being seen within 18 weeks, but in University Hospitals Birmingham NHS Foundation Trust just 38% of patients are being seen in that time. That is not levelling up, so exactly when do the Government plan on getting a grip on those health inequalities?

I am disappointed that the hon. Gentleman is not happy with the investment going into Hull that will try to tackle some of those disparities, because we recognise that there are waiting lists.

I do not know whether the hon. Gentleman realises that there has been a pandemic for two years. The Government have committed funding for elective recovery. We are investing in those areas that are in greatest need in the country, including Hull. I am sure that the residents of Hull welcome the investment that the Government are making in their hospital.

New Health Centre: Maghull

13. What plans he has for capital investment in a new health centre at Maghull in Sefton Central constituency. (905785)

Following the recent spending review, the next round of projects, including those from Mersey Care NHS Foundation Trust, are being considered, and local health systems should receive confirmation of their funding envelope for 2022-23 shortly.

In November 2018, the then Health Minister, the hon. Member for Winchester (Steve Brine), told me that building a new health centre in Maghull was a priority for NHS England, but the estates and technology transformation fund has closed and the funding for Maghull has not been approved by the Government. Can the Minister confirm that the Government still agree that a new health centre, as opposed to what she mentioned before, which is a mental health facility, is needed in Maghull? Can she also tell me what the funding arrangements are in the absence of the estates and technology transformation fund?

I take the hon. Gentleman’s point, and of course he will lobby for more investment in his constituency. As I said, the funding envelope will be announced shortly, and it will be for his local area to decide how it spends that.

Waiting List Times: Non-consultant Led Services

15. If he will make an assessment of the potential merits of requiring mandatory reporting of waiting list times for non-consultant led services in NHS mental health trusts. (905788)

NHS England and NHS Improvement have been field testing waiting time standards across 35 different local pilot initiatives. Through that clinically led review, we hope to understand the merits of introducing them. NHS England and NHS Improvement published the outcome of a consultation on those standards on 22 February, just over a week ago. We will work with them now on the next steps for the proposed measures.

I am very interested in what the Minister says, and I would be really interested to see the review, but in Rotherham the waiting time for children’s neurodevelopmental assessments is 200 weeks. That is almost four years of a young life. Consultant led NHS services are required to report waiting times against the 18 and 52 week standard, but neurodevelopmental assessments having no such requirements means that the political will is not there to challenge. Will the Minister please look into putting the resources necessary into children’s mental health so that no child, wherever they are, goes without that support?

I thank the hon. Lady for her question. She raises an incredibly important point. As a Government, we are determined to tackle long autism diagnosis waiting times. We are investing £2.5 million as part of the NHS long-term plan to test and implement the most effective ways to reduce autism diagnosis waiting times for children and young people across England. That is vital, because we know that the earlier children get the support, the better the outcomes are for them. We are absolutely determined to work on this, but the diagnosis pathways are sometimes quite complex.

Early Medical Abortion: Telemedicine Service

16. What plans his Department has to take steps to permanently implement the telemedicine service for early medical abortion. (905790)

The Government will end the temporary approval put in place at the beginning of the pandemic. We have extended the temporary approval for six months until midnight on 29 August 2022. From that point, abortion services for early medical abortion will return in line with pre-covid regulatory requirements. As with any healthcare service, this measure will be kept under review.

Can my hon. Friend explain how the decision to end telemedicine for early medical abortion supports women who responded to the Department’s own consultation, how it works in line with the Royal College of General Practice, the Royal College of Obstetricians and Gynaecologists, and the Royal College of Midwives, and what the dangers are in ignoring their advice when pulling together a women’s health strategy?

The temporary approval was put in place during the pandemic to address a specific and acute medical need to reduce the risk of transmission of covid-19. It was recognised that without it, significant numbers of women would not have been able to safely access abortion services. Thanks to the success and impact of the national vaccination programme, the situation is now very different. In making this decision, the Secretary of State has considered all the risks and benefits regarding the temporary approval.

Child Mental Health In-patient Provision: Derbyshire

17. What assessment he has made of the adequacy of child mental health in-patient provision in Derbyshire. (905791)

We want to ensure that more children and young people can access appropriate support in their community, and that those who require in-patient cases are treated as close to home as possible. The East Midlands Provider Collaborative is responsible for commissioning tasks for tier 4 in-patient children and adolescent mental health services, including for Derbyshire. It has implemented strategies to ensure the most efficient use of in-patient beds, including a review of the types of beds required by east midlands patients.

My constituent Stephen Jones wants what the Minister wants, but when his daughter required in-patient child mental health facilities she was forced to go to Stoke to receive them. He had a 70-mile journey every time he wanted to see her, which was obviously very expensive and also just impossible to do. It meant that his daughter’s mental health got worse, because she felt that she had been abandoned by her own family, putting the whole family under pressure. In addition, if people do not receive universal credit, they get no support with the financial impact. Will the Minister tell us more about how we can ensure that children’s mental health is not exacerbated by the inability to access services locally?

The hon. Gentleman raises a very important point. Clearly, these are distressing enough times without having that commute and those travel arrangements on top of that, but sometimes the services are highly specialised. We are trying to get the right blend between access to highly specialised in-patient services and making sure that we increase community efforts. We have been working very hard to ensure that there are more community efforts, but we have also invested £10 million more in capital for more beds to make sure people can get treatment closer to home.

Support for Young Carers

We have introduced significant changes to support for young carers, with statutory entitlements to young carers’ assessments from April 2015. Local authorities are held to account for such assessments and support through the social care inspection framework. Further, as we set out in our adult social care White Paper, we will amend the school census at the earliest opportunity to include young carers, allowing us to establish a wealth of evidence on this cohort.

I welcome more information being found out about young carers, because this is a hidden health crisis. A constituent came to see me. She is a young person now and has been a young carer for many years. The impact on her educational attainment, physical health and mental health has been devastating. There are 800,000 young carers in the UK, with 800 of them in Wandsworth where support services have been slashed. Does the Minister recognise the impact of that unpaid child labour and does she have a plan to tackle it?

Very much so. Young people should be protected from inappropriate and excessive caring responsibility, and adult and children’s services need to work together better. We recognise, though, the lack of hard data and evidence on outcomes for young carers. That is where we are and that is why we have made the commitment, with the Department for Education, to amend the school census. We intend to introduce that as early as 2022-23 and each year thereafter. The data will be collected at primary school and secondary school, so we will be able to look at all kinds of outcomes for this particular cohort and take actions.

Kettering General Hospital

19. If he will ensure that the NHS new hospital programme team complete approval processes by summer 2022 to allow the preparation of the full business case for the redevelopment of Kettering General Hospital by the local NHS trust. (905794)

The joint DHSC and NHSE/I—NHS England and NHS Improvement —programme team is working closely with all schemes in the programme, including Kettering, on how and when new hospitals will be built across the decade. That is to maximise the potential benefits that the programme’s approach can bring for all the new hospitals. We will continue to support all trusts in the programme, including Kettering, to ensure that there is the swift approval of all business cases—including, in this case, for early enabling works—but that will always be in line with due process to ensure that there is value for money, as my hon. Friend would expect.

I thank the hospitals Minister very much for his visit to Kettering General Hospital on 17 February. Specifically, can we have feedback from the new hospital team on the strategic outline case for the hospital by the end of April, so that the hospital can submit its outline business case for the next stage in July?

It was a pleasure to visit my hon. Friend’s constituency. He is a forceful advocate for that constituency and for his hospital, as indeed—if I may slightly crave your indulgence, Mr Speaker—was the late Sir David Amess. Today is the day that Southend-on-Sea officially becomes a city, so I just wanted to shoehorn that into the record. On my hon. Friend’s point, we will do everything we can to expedite the approval of business cases while ensuring that due process is followed to make sure that there is value for money.

NHS Dentistry

There are three ways in which we are increasing dental provision. First, we are increasing dental activity levels to 85%, as infection controls now allow us to. The second way is through the £50 million access fund, which will increase appointments by 350,000, and we encourage local commissioners to apply for that funding. Finally, we are reforming the contract, which, for too long, has resulted in a perverse disincentive for dentists.

I thank my hon. Friend for that answer, but my constituents are telling me that there are no places available with NHS dentists in my constituency. Will the Government now make that a priority following the covid pandemic?

I thank my hon. Friend for all her hard work on campaigning for more dental appointments for her constituents. I believe that she met the Secretary of State last night to push him further on this. Her local area has an allocation of £4.7 million from the £50 million fund, and I encourage her to speak to her local commissioners to make use of that allocation. We are also looking at improving dental training so that we can get more dentists into her area.

Since dentistry was debated just a few weeks ago, another 10,000 of my constituents have received letters to tell them that they will have to go private. They are already waiting for five years to get an appointment. When will they actually get to see a dentist, or are they expected to have poor teeth?

I am not sure where those constituents’ letters have come from, but if a contract has been handed back and that is the reason for the letter, the local commissioners should be looking for new providers, so I am very happy to meet the hon. Lady and her commissioners to see what is going on to make that happen.

Topical Questions

I share the horror and disgust of almost everyone in this House, this country and the whole world at the unprovoked, unjust and unjustifiable invasion of Ukraine by President Putin last week. That appalling act has created a humanitarian emergency and we are looking at every opportunity to give the people of Ukraine the support that they so urgently need.

On Sunday night we sent almost 50,000 items of medical supplies to Poland via air for onward transport to Ukraine. I can inform the House that another plane departed at 7 o’clock this morning with more supplies, including medical equipment and personal protective equipment. We have all been in awe of the bravery and heroism shown by the Ukrainian people. Rest assured, we all stand with them shoulder to shoulder in their hour of need.

On behalf of my constituents with blood cancer, will the Secretary of State please consider providing free asymptomatic testing for the close contacts of immunocompromised people?

We will keep under review the testing offer that we will provide over the coming weeks and months. We continue to consider whether any changes are necessary, but as we learn to live with covid we will target our free asymptomatic testing offer on vulnerable people. That includes, of course, those who are immunocompromised. Such individuals will also be eligible for antiviral treatments through a free priority PCR test service.

I associate myself and everyone on the Opposition Benches with the Secretary of State’s remarks and warmly welcome the support that the Government are providing to the people of Ukraine and the Ukrainian army. We all stand with the people of Ukraine in their fight for freedom and democracy.

Turning to matters closer to home, the Secretary of State asked the Chancellor for £5 billion to cover essential covid costs—ongoing covid costs—and he came away with nothing, so where will the cuts now fall in the NHS budget?

We must all learn to live with covid. The Government have been very clear about that, and we set out a very detailed plan. As infections fall, cases fall and rates of hospitalisation for covid fall, which means we can now have this type of plan. It is a properly funded plan that focuses on vaccines, treatments and targeted testing, and that builds in resilience should there be future variants of concern. It is right that this plan is funded by the Department because it is our No. 1 health priority.

Hang on a minute. So one minute the Secretary of State is asking for £5 billion from the Treasury, and the next minute he has found the money within the Department. Either he was trying to pull a fast one on the Treasury, because he had the money he needed, or he has not got the money he wanted and therefore the cuts are going to fall within existing budgets. Members do not need to take my word for it; it was reported in The Times that the Health Secretary threatened that, if he did not get the funding, it would mean delaying investment in social care, fewer elective surgeries and cuts to the hospital building programme. Having, I think, not tried to pull a fast one on the Chancellor, is he now pulling a fast one on patients, and is it not really the patients who are going to pay the price for his failed negotiations?

First, the hon. Gentleman should not believe everything he reads in the press. We would think he knew that by now. As I said, when it comes to funding our plan for living with covid, it is right that it continues to be the No. 1 priority of my Department to keep this virus at bay and that it is funded by the Department. When it comes to funding, this is the hon. Gentleman who, with all his colleagues, voted against extra funding when he was given the opportunity.

T5. I welcome the record funding that is going into our NHS and also the plans to catch up with appointments and treatments that were delayed because of the covid-19 pandemic. Can my right hon. Friend say a little bit more about how he will increase the number of face-to-face GP appointments available to my Crawley constituents and, indeed, people across the country? (905767)

My hon. Friend is absolutely right to raise this. NHS England has already given clear guidance to all GP practices that they must provide face-to-face appointments alongside remote consultations. Patients’ input into the type of consultation they want should be sought by all practices and their preferences should be respected.

The Scottish Government have now confirmed their initial aid for humanitarian support to Ukraine of £4 million, as well as medical supplies. They are keen to work with aid agencies and other UK nations to get support to where it is most needed as soon as possible. What discussions has the Secretary of State had with his Cabinet colleagues on boosting urgent medical equipment provision to Ukraine from the UK and on guaranteeing access for doctors to the country?

The hon. Gentleman raises a very important point, and he will be pleased to know that the UK was one of the first countries in the world to provide medical aid. As I mentioned a moment ago, one flight left on Sunday night and one left this morning, and there will be many more, I hope. I welcome the work of the Scottish Government and their offer, and we will certainly work together in making sure that aid reaches the people who need it.

T6. Devon’s community hospitals and minor injury units, such as the Tyrrell in Ilfracombe, have been unable to open fully for some time. Would my hon. Friend consider extra help where it is needed to enable them to reopen, because although adding extra capacity is welcome, using what we have effectively is surely essential? (905768)

I am grateful to my hon. Friend for her question. The minor injuries units at Ilfracombe and Bideford have been temporarily closed since March 2020 due to the pandemic, to allow skilled staff to be redeployed to the emergency department at North Devon District Hospital to meet clinical needs. The Northern Devon Healthcare NHS Trust continues to work with the local CCG to ensure planning for safe staffing levels for the temporary reconfiguration and for permanent solutions. Were anything to be made permanent, it would of course have to go through the local authority health overview and scrutiny committee. No such referral has been made, and this remains temporary.

T2. Happy St David’s day, Mr Speaker. Physician associates in my constituency, who play a vital role in the NHS, want to hear from the Government when long-awaited regulations that will allow them to take on more responsibility and play an even greater role in our NHS will come forward. Can the Secretary of State update the House and will he meet me and constituents to discuss this? (905763)

First, I wish a happy St David’s day to the hon. Member and all those celebrating. I would be happy to meet her on this issue. The Government greatly value the role of physician associates. She knows that they bring new talent to the NHS and act in an enabling role, where they can help healthcare teams with their workload. Physician associates will be regulated by the General Medical Council, and the Department has consulted on draft legislation on just how to do that.[Official Report, 3 March 2022, Vol. 709, c. 8MC.]

T7. I recently met Specsavers to discuss how patient choice should be promoted by making all routine community services patient self-referrals, especially when that can free up GPs’ time by not using them as administrative gatekeepers. Will the Secretary of State commit to meeting me to discuss how we can increase GP capacity using such measures? (905769)

I am very interested in hearing proposals on patient self-referral. I am happy to meet my hon. Friend. From a cancer perspective, we are also potentially looking at self-referrals for skin diagnosis for possible skin cancer and for breast lumps, because we want to reduce waiting times and increase GP capacity.

T3.   Dydd Gŵyl Dewi hapus to you, Mr Speaker, and the whole House. The Minister should be aware of my long-fought campaign to improve how IVF add-ons are marketed to people who are longing for a baby. These add-ons, such as embryo glue or assisted hatching, often have limited success rates and cost thousands of pounds on top of an already expensive procedure. The system simply needs more regulation, so will she commit to meeting me to discuss this important issue further? (905764)

I am happy to meet the hon. Lady. She raises a very important point that affects people who are desperate to try for children.

T8. I thank the Secretary of State for the extremely welcome news that he will introduce a licensing regime for non-surgical cosmetic interventions. This is a huge step forward for women’s health, and one that I have campaigned for over many years, along with many across the House. I am absolutely delighted. Can he inform us how the proposed licensing regime will keep pace with the rapidly changing landscape of these treatments? (905770)

First, I pay tribute to my hon. Friend and to my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes) for all the work they have done on this most important of issues. Over the past few months, we have all heard in this House some horrific examples of botched, non-cosmetic procedures scarring people for life. No longer will that be allowed. We will be introducing a licensing regime for such procedures. The details of the regime will be set out in regulations, meaning that it will be flexible, agile and change in response to changes in the cosmetics industry.

T4. The response from the hon. Member for Lewes (Maria Caulfield) to the question from my right hon. Friend the Member for Kingston upon Hull North (Dame Diana Johnson) on health inequalities gives me no confidence that the Government have a plan to address these inequalities at all. She says that we have had a pandemic—of course we have, but the point is that it has happened everywhere. What does it say about this Government’s priorities that waiting times are escalating to a far greater extent in more deprived communities than they are in the more affluent communities that the Tories are so happy to represent? (905766)

I can only reiterate that we have a laser focus on this issue, and that is why we will be bringing forward the health disparities White Paper. I also point the hon. Gentleman to the NHS’s approach of the Core20PLUS5, where it is targeting the most deprived 20% of the population in five clinical priority areas: maternity, severe mental illness, chronic respiratory disease, early cancer diagnosis and hypertension. We will deliver on resolving disparities issues.

Today is the first day of Brain Tumour Awareness Month. The Secretary of State kindly wrote to me in January when my mother died from a brain tumour, and Baroness Tessa Jowell, who was much loved on all sides of the House, also died from a brain tumour. Given that it is the biggest cause of cancer death for the under-40s, and we still do not really know what causes them, does he agree that this should be a priority for research, so that we understand as much about brain tumours as about other cancers?

I once again express my condolences to my right hon. Friend for his loss. He is absolutely right to raise this issue and the need for more research. That is one of the reasons why, back in 2018, we announced £40 million of extra research funding over the next five years. I can tell him that some £9 million of that has already been committed to 10 projects. In addition, the Tessa Jowell Brain Matrix is an exciting new trials platform that will give people with brain cancer access to trials of treatments that are best suited for their individual tumours.

T9. According to the Royal College of Obstetricians and Gynaecologists, less than 3% of medical research funding in the UK is focused on women-specific diseases such as endometriosis and polycystic ovary syndrome. They are serious conditions, but too little is known about them and we do not hear enough about them, especially polycystic ovary syndrome. The failure to increase research funding is holding back women’s outcomes and experiences. What are the UK Government doing to increase the priority given to research funding for both those conditions? (905771)

The hon. Lady raises an important point. She is right that women are under-represented in clinical research and are waiting far too long for diagnoses of conditions such as endometriosis. The women’s health strategy will be published very shortly and I think that she will be pleased with some of its recommendations to drive improvements forward.

I am grateful to the Minister for Health for giving his time over recent months to hear the case for an exciting and innovative new health centre for the village of Long Crendon in my constituency, as proposed by the parish council and action group. Will he update the House on where we are with finding funding to help the construction of the project?

My hon. Friend is, as ever, persistent and tenacious in his advocacy of Long Crendon’s surgery plans; not only at the Dispatch Box but whenever he runs into me around this place, it is often the first thing on his lips. I will continue to work with him on the surgery bid and I encourage him to continue to work with his local NHS systems.

Will the Secretary of State meet me as chair of the all-party parliamentary group on sexual and reproductive health in the UK? Can I bring along the Royal College of Obstetricians and Gynaecologists, the Royal College of Midwives, the Royal College of General Practitioners, the Royal Pharmaceutical Society and the Faculty of Sexual and Reproductive Healthcare to explain why the decision to remove telemedicine is wrong for women in this country?

A dental practice in Shepshed has informed me that its NHS contract has changed little since 2006. Can the contracts and value of units of dental activity for treatment be increased to focus on prevention, rather than treatment alone?

I absolutely agree; my hon. Friend hits the nail on the head of why we are seeing such problems in dentistry. We have started negotiations on the dental contract and are working with the British Dental Association. The UDA has to be reformed as part of that: it is a perverse disincentive that turns dentists away from providing NHS services. I will keep her updated on our progress.

I thank all the Ministers for their responses. What steps have been taken to work with the Education Secretary to provide a higher number of places for medical students containing a golden handshake that allows for no student loan repayment or fees on condition that they stay in the NHS for a set time?

It is an important question on the workforce. The hon. Gentleman will know that over the last two years we have removed the cap on medical places and we have the highest number of doctors and dentists in training ever. It is right to think about what more we can do, however, and we are having active discussions with the Secretary of State for Education to see what can be done.

On the issue of children’s mental health, does the Minister agree that children with ADHD and autism have found the last two years even more stressful than usual? A cross-departmental approach is long overdue to ensure that their needs are adequately met.

The hon. Lady is absolutely right, which is why we are working cross-departmentally to bring forward a mental health strategy. It is also why we have put in place mental health recovery funding specifically for the recovery from the pandemic, which has had a terrible effect on children’s mental health.

The Secretary of State is on record saying:

“Making medicinal cannabis available on prescription will benefit the lives of ill patients currently suffering in silence. There is nothing harder than seeing your loved ones in pain”.

Since he said that, there have been three prescriptions for medical cannabis on the NHS. They are important, because they set a legal and medical precedent that it can happen, and it can happen now. Currently, however, if I can afford it, I can buy it, but if I cannot, I cannot. When will he address that anomaly?

The hon. Gentleman will know that for medicines to be generally available on the NHS, they have to be deemed safe and effective by the independent medical regulator. That requires trials to take place and that is where the focus should be. Those who want those medicines to be more easily available should encourage the companies that produce them to have trials and the NHS will support them in doing so.

Chloe Rutherford and Liam Curry from South Shields were tragically murdered in the Manchester Arena terror attack. Their parents’ pain is unimaginable and constant. After sitting through hours of the inquiry, they have been told that, in just two days’ time, the registration of their precious children’s deaths will be done not by them, but by a stranger. Apparently that is standard practice for mass casualty events. These grieving parents are being denied this final act for their children. Please can the Secretary of State explain why, and urgently intervene?

Of course I would be very happy to meet the hon. Lady. It is a very important issue that she has raised. I also send my condolences to the parents of Chloe and Liam.

The right decision was taken by this Government last week in confirming that the temporary telemedicine at-home abortion pill should cease. I commend the Government for that decision. Given that more than 10,000 women have ended up in hospital in the year 2020 after taking a first abortion pill, can my hon. Friend confirm that the Government will follow through on that decision?

As we clearly stated, the decision has been made to end the temporary approval, which means that face-to-face consultations and taking the first pill in a healthcare setting returns to England from 30 August 2022. As I said earlier, all healthcare services are kept under review as evidence and information emerge.

Since the NHS was created, it has been governed by the principle that services are free at the point of use, and, of course, the Secretary of State has a duty to protect that. Many of my constituents want to know whether the Government’s decision to start charging for covid tests marks a departure from that founding principle.

Clearly, that is one of the most important principles of the NHS and it will not change. It is right, though, that when we look at living with covid, we target testing on those who are most vulnerable or who are in vulnerable settings. That is the right, proportionate and balanced approach.