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Topical Questions

Volume 712: debated on Tuesday 19 April 2022

Our healthcare system is standing at a crossroads, and sooner or later we will have to make a choice between endlessly going back to the taxpayer to ask for more money and reforming the way in which we do healthcare in our country. Last month, I unveiled an ambitious new programme of reform, setting out how we are going to prioritise prevention, offer more personalised care, deliver improvements in performance and back the people making the difference in the NHS. The objective of this agenda is simple: to bring about the biggest transfer of power and funding in decades from our ever-expanding state to individuals, their families and their communities.

In Gloucestershire Hospitals NHS Foundation Trust, 30% of patients do not medically need to be in hospital; they are waiting for discharge. That figure is twice the national average. Will one of the Ministers contact the relevant people in the health service in Gloucestershire to ask them for ways in which the Government could help them to reduce that figure, because as it stands lives are being put at risk?

My hon. Friend is right to raise this. We are already in contact with the acute trust in Gloucestershire and some of the other trusts that are finding delayed discharge a particular challenge. My hon. Friend will know that, because of the pandemic, what has been a long-term challenge has become much more acute, not least because of the lost beds due to infection protection control and staff absences both in healthcare and in social care. Our delayed discharge taskforce is making a difference—the numbers are coming down overall—but we will be working with Gloucestershire.

Why does the Health Secretary think he has any licence to lecture the British people on their moral duty to pay taxes when he spent so many years avoiding his own?

I am very happy to answer if you will allow me, Mr Speaker. The hon. Gentleman could have asked me a question on anything to do with health and care—anything he wanted—but instead he chooses to talk about my personal affairs before public life. That was his choice. He could have asked me about the covid backlogs that he pretends he cares so much about. He could perhaps have given me suggestions—

Order. Secretary of State, I have got it. These are questions about your responsibilities. Now we can have another try—Wes Streeting.

Thank you, Mr Speaker. I would just say to the Secretary of State that he should be careful what he wishes for. I hope he will at least reply to the letter I sent him last Thursday—I will place a copy in the Library of the House. He has been stonewalling journalists’ questions, but since he says he wants to talk about the Government’s record, let me ask him about that instead. We went into the pandemic with NHS waiting lists already at 4.5 million. We went into the pandemic with NHS staff shortages of 100,000. We went into the pandemic with social care staffing vacancies of 112,000. So it is not just the case that the Tories did not fix the roof while the sun was shining; they dismantled the roof, removed the floorboards and now they have no plan to fix it. Where is the Secretary of State’s plan to fix the NHS crisis?

Order. Once again, I remind Members that topicals are short and punchy questions, not lengthy statements. A lot of Back Benchers on both sides deserve to get in to raise constituency matters, so please let us give them time. I do not want a lengthy fall-out, and these are Health questions.

Mr Speaker, you have been very generous to the hon. Gentleman: you gave him another try, but that was another failure to ask a question. Again, the hon. Gentleman is not asking about the serious issues, which again shows that he will play petty party politics and that Labour has no plan for the challenges this country faces.

May I just reassure the Secretary of State for Health that I was not being generous? The shadow Secretary of State had two questions, so I have not been generous in any shape, way or form.

T2. We have all seen the disturbing scenes in Shanghai recently. Does my right hon. Friend agree that this shows how dangerous a zero covid strategy is and that we were right to open up this country and to rely on our vaccines as the safest way out of the covid situation? (906500)

Like many across the House I have been deeply disturbed by the reports we have all seen from Shanghai and my thoughts are with the people affected. It shows what a dangerous fallacy this whole idea of zero covid was, and it also shows that we are the most open country in Europe and that we have got the big decisions right. We did not listen to the Opposition when they said we should not open up in the summer, and we did not listen to them when they again called for restrictions in the winter. We are showing the world how to live with covid.

T3. My constituents have been forced on to private and unaffordable dental plans or they have to wait up to five years to see an NHS dentist. The situation is getting worse and worse, so I met with the groundbreaking Hull York Medical School to see if it can assist in training a future generation of dentists and it is keen to help; what is the Minister doing to work with medical schools? (906501)

I thank the hon. Lady for her question, and we have met to discuss this previously. I am happy to discuss with Health Education England whether one of its centres for dentist development could be suitable for her constituency.

T6. In 2019 Kettering General Hospital, which serves my constituency, was promised £46 million for a major upgrade. Three years later the hospital still has not got the money. Secretary of State, will you go out and buy a very big pair of scissors, cut through the red tape and get it sorted? (906504)

No one, with the possible exception of my hon. Friend the Member for Kettering (Mr Hollobone), is more passionate than my hon. Friend the Member for Wellingborough (Mr Bone) about seeing improvements delivered in their local hospital, and I had the pleasure of visiting. As my hon. Friend will know, the £46 million was allocated originally for an urgent treatment centre; the hospital asked that that be changed and it folded in with the overall programme. It has yet to submit a business case for the enabling works; when it does, I will make sure that it is expedited.

T4. The gap in life expectancy between people living in the richest and poorest areas is once again growing. That affects my constituents directly. I have heard nothing to date that tells me what the Secretary of State is going to do to narrow the gap; Secretary of State, what will you do to protect my constituents? (906502)

As the hon. Gentleman is aware, I know his constituency well; it is my birthplace. He might also know that just a couple of months ago I visited his constituency and met members of the local community at the Deeplish community centre to talk about exactly what he has rightly raised today: the importance of tackling inequalities in Rochdale and beyond. We will set out our plans in our upcoming health disparities White Paper.

T9. The Cass review interim report found that to date there is a profound lack of evidence on the best approach to treat gender dysphoria in children. Does my right hon. Friend share my concern that in spite of this the NHS insists on making a child’s expressed gender identity the start-point for treatment, and my surprise that the NHS has chosen so far not to track patient outcomes, particularly for under-18s? (906507)

I share my hon. Friend’s concerns, which is why the NHS commissioned this review from one of our top paediatricians. It is already clear to me from her interim findings and the other evidence I have seen that NHS services in this area are too narrow; they are overly affirmative and in fact are bordering on ideological. That is why in this emerging area, of course we need to be absolutely sensitive, but we also need to make sure that holistic care is provided, that there is not a one-way street and that all medical interventions are based on the best clinical evidence.

T5. Since February 2020 my local borough of Lambeth has seen a 14% drop in dementia diagnosis. That means people are not getting the support that comes from diagnosis. We also know that so far none of the announced £8 billion backlog funding has been dedicated to addressing the stagnation of diagnosis rates. Can the Secretary of State explain what exactly he is going to do to make sure that people get diagnosed on time? (906503)

The hon. Lady raises a very important question. We want a society in which every person with dementia and their families and carers receive high-quality, compassionate care from diagnosis through to end of life. We have provided £17 million this financial year to NHS England and NHS Improvement to increase the number of diagnoses. That funding was spent in a range of ways, including investing in the workforce to increase capacity in memory assessment services.

The Secretary of State will have read the scandal exposed in The Sunday Times this weekend that six babies are born every month after being exposed to sodium valproate, which has been known for many years to cause disabilities. Last year the Government consulted on putting warning labels on valproate. Is it not time to go much further and ban the prescription of sodium valproate to epileptic pregnant mothers?

My right hon. Friend is right to raise this, and many of us will have seen the recent reports, especially from the families affected. It is right that we reconsider this and make sure that sodium valproate, and any other medicine, is given only in the clinically appropriate setting.

T7. The Secretary of State is right that we all want to get to the bottom of many important health matters, and we do not want what he described as personal affairs to get in the way of that. In order to ensure that the House concentrates entirely on those matters, will he welcome HMRC investigating whether he was claiming non-dom status on a solely— (906505)

Thank you, Mr Speaker. I will try not to make this one a waste. I was grateful to the Minister for meeting me to discuss my ongoing campaign to restore the A&E to Bishop Auckland Hospital. Many of my constituents face a long drive to get to Darlington or Durham, and given that swift treatment can be a significant factor in outcomes for conditions such as strokes and heart attacks, does he agree that having A&E services spread geographically rather than just in strong population centres is an essential part of keeping our community safe?

I did indeed have a positive and constructive meeting with my hon. Friend. It is right that we have access geographically spread to A&E services, but the decisions are rightly taken by clinical commissioners on the basis of clinical evidence. I know that she will continue fighting the corner for the reopening of her local A&E with tenacity and passion.

T8. The 10-year cancer plan that the Secretary of State has announced is a key opportunity to ensure that future services are designed with the patient at their core, especially for those living with cancer. What steps is his Department taking to engage with under-represented groups in the development of the 10-year cancer plan, and will he agree to meet with Macmillan Cancer Support to discuss how it can provide support in this key area? (906506)

I would be pleased to have the meeting that the hon. Lady has suggested. She should know that we just closed the consultation on the 10-year cancer plan. There has been a fantastic response. She may also have seen the announcement that we made today about lung cancer health checks. With improvements like that, we intend to do a lot more.

One of the best ways to maximise NHS capacity is to increase people’s access to GP appointments and treatments such as mental health services and physiotherapy in their own communities. Will the Minister join me in backing our bid for a new health centre in East Leake and in calling on Nottinghamshire’s clinical commissioning group to prioritise funds for this vital service?

I thank my hon. Friend for her question. I had an excellent visit to the surgery in East Leake, and I look forward to the submission of the business case so that we can look at it further. She is right that investing in primary care does a huge amount to support the health of the local community.

T10. A survey by the charity stem4 has found that 95% of GPs believe that children and adolescent mental health services are in crisis, with children and young people waiting up to two years for treatment after referral. Will the Secretary of State stop treating children as an afterthought and act to provide open access mental health hubs for young people in every community, to put an end to these agonising waits? (906508)

The hon. Lady raises a very important point. I know that children’s mental health services are treating more young people than ever. However, the demand has quadrupled since the pandemic and that is why we have invested £79 million in these services. By 2023-24, an extra 345,000 more young people will be accessing support. I mentioned the call for evidence. It is important that we work through our vision for our 10-year plan. We are also introducing mental health support teams in schools, which will help, plus access to community and mental health hubs, and more young people will have access to eating disorder services, but there is a lot of work ongoing.

I know from discussions with constituents that needle phobias are a real thing. Will my right hon. Friend therefore tell the House what support the Government are giving to intranasal vaccine delivery systems to ensure that the maximum number of people take up the vaccine?

The Department of Health and Social Care commissioned research through the National Institute for Health and Care Research, co-funded with UK Research and Innovation, for an Imperial College London study, worth £580,000, looking specifically at the safety and effectiveness of two covid-19 vaccines administered by respiratory tract. The study is ongoing, but it is in the later stages of the phase one clinical trial, and the results will be made public in due course, following peer review.

Those providing social care often work long hours and are a real lifeline for the most vulnerable. Will the Minister act to ensure that those in social care are paid properly with a real living wage, as Citizens UK is campaigning for?

Actually, according to Skills for Care data from 2020-21, the majority of care workers were paid above the national living wage in that year. Most care workers are employed by private sector providers who set their terms and conditions. However, we have committed £1.36 billion to the market sustainability and fair cost fund, which will support local authorities to move towards paying providers a fair cost of care. We hope that will lead to better sustainability and better staff.

At Prime Minister’s questions, I raised a local campaign for a specialist menopause clinic in Devon. I am pleased the Minister agreed to meet me. Will my hon. Friend encourage local NHS leaders to fund specialist menopause centres?

The Government recognise that menopause services need to improve, which is why menopause is a priority area in our women’s health strategy. We recognise such services are often best provided in primary care, but that some women need specialist services. We are looking at that in our women’s health strategy and the menopause taskforce.

In December last year, the Department of Health and Social Care promised three urgent actions to tackle the gender health gap: the appointment of a women’s health ambassador; legislation to ban hymenoplasty; and the publication of the women’s health strategy for England in spring 2022. Can I ask the Minister when those vital actions are actually going to happen?

I can let the hon. Lady know that interviews have taken place for a women’s health ambassador. We are expecting an announcement on the appointment any day now. We will be publishing the women’s health strategy in the coming weeks.

I welcome all that my right hon. Friend is doing to address health inequalities. However, could I ask him to look carefully at public health funding for my borough of Bexley, as we are seriously underfunded compared with similar boroughs in London?

I would be very pleased to meet my right hon. Friend to discuss that further. I am sure he will welcome the publication of the upcoming health disparities White Paper.

In a recent survey by Carers UK, almost half of unpaid carers said that they are currently unable to manage their monthly energy bills and expenses, and that any further increases would negatively affect their own physical and mental health, or that of the person they care for. What steps are being taken, along with the Secretary of State for Work and Pensions, to support those hard-working exhausted unpaid carers with the cost of living?

I thank the hon. Lady for her question and of course we have a great deal of gratitude for every unpaid carer. Around 360,000 carer households on universal credit can receive an additional £2,000 a year through the carer element. The weekly rate of carer’s allowance increased to £69.70 in April 2022. Also, real-terms expenditure on carer’s allowance is forecast to increase by around £1.3 billion. In addition, there is a big focus, in our reforms and in the White Paper, on what more we need to do to support unpaid carers.