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Topical Questions

Volume 721: debated on Tuesday 1 November 2022

It is an honour to return to the Department of Health and Social Care to continue its important work, especially ahead of the challenges this winter. I pay tribute to my predecessor, my right hon. Friend the Member for Suffolk Coastal (Dr Coffey), for everything that she has done to get the system ready for the challenges ahead. I welcome my experienced ministerial team to their posts and thank Ministers from the summer. I am also looking forward to robust, I am sure, but—based on our previous experience—very constructive engagement with Opposition Front Benchers.

I am pleased that all GP practices will soon be able to automatically provide patients aged 16 and over with access to the latest information and their health records through the NHS app. We are switching on that ability from today in a process that we expect to be completed by the end of the month. That is an important milestone for patient empowerment and is part of a process that sees patients play an even more active role in managing their health and care. I hope that Members across the House will welcome that on behalf of patients.

I congratulate the Secretary of State on his reappointment. Will he reiterate the importance of getting ambulance waiting times down? Would he endorse the use of minor injuries units in community hospitals, such as those in Malvern and Tenbury, as a very effective way to open up access through other routes for our constituents?

My hon. Friend raises an important point, particularly for category 3 and 4 ambulance journeys. As she highlights, there are numerous aspects to the challenge of ambulance delays: the blockage in the flow from social care and delayed discharge, which we have debated many times in the House; issues in accident and emergency with pre-cohorting, post-cohorting and triaging nurses; conveyance rates, which often vary significantly between ambulance trusts; call handling, which we have put additional money into; and the work of the auxiliary service. My hon. Friend is quite right that within the portfolio of options, minor injuries units are an area that can help to relieve pressure on busy A&Es.

I welcome the Secretary of State back and welcome his team, but I have had boxes of cereal with a longer shelf-life than Conservative Secretaries of State. As a consequence of the turnover and chaos, the truth is that the NHS is not prepared for this winter—it cannot even get allocated funds out of the door.

Let us turn to the future. Over the summer, the Prime Minister promised to establish a “vaccines-style taskforce” to tackle the Conservatives’ NHS backlog on “day one” and to have overall waiting list numbers falling by next year. May I ask the Secretary of State who is on that taskforce, how many times it has met and what its programme of work is?

I am grateful that the hon. Gentleman raises the issue of vaccines; in fact, I raised it in Cabinet today. The UK is the first country in the world to have introduced bivalent vaccines targeted both at omicron and at the original strain of covid-19. We have now made the covid vaccine and the flu vaccine available to all over-50s; I hope that Members across the House will promote that. I think the UK can be very proud of its work to roll out vaccines against both covid and flu, which are a key part of preventing some of the pressure on our A&Es.

I can forgive the Secretary of State for mishearing the question, but what I find unbelievable is that it seems as if this is the first time he has heard about the Prime Minister’s own proposed taskforce to deal with the Conservatives’ NHS backlog. That is what the Prime Minister promised, and that is what I asked the Secretary of State about. This is obviously another case of the Conservatives over-promising and under-delivering.

If the Secretary of State cannot stand by the Prime Minister’s pledges, what about the views of the man next door? When we announced our policy to train a new generation of doctors and nurses, paid for by abolishing non-doms, it was welcomed by the Chancellor as—and I quote—“something I very much hope the government also adopts on the basis that smart governments always nick the best ideas of their opponents.” In the spirit of constructive opposition that the Secretary of State asks for, Labour has a plan to tackle the staffing crisis. The Conservatives do not. It is fully costed and paid for, so will he nick it?

The hon. Gentleman skirts over the fact that it is this Government who have opened five new medical schools, who have significantly boosted medical undergraduate training, who are investing more in our NHS as per the long-term plan, who have invested a further £36 billion as part of our covid response, and who are investing in technology and the skills of the workforce as a whole. We are boosting the number of medical trainees and—I touched on this question earlier—we are also boosting the number of doctors in training to be GPs.

T2. At a face-to-face surgery this weekend, a constituent mentioned the difficulties that a relative of hers, who has subsequently died, had had in getting a face-to-face GP appointment at a surgery run by an American company called Centene, which now covers 600,000 patients. Will the Government insist that we are fully committed to the traditional approach of a committed and caring family doctor seeing patients face to face, and that we will not allow GP surgeries to be fully commercialised? (901971)

My right hon. Friend raises an important point about face-to-face care, which matters to many constituents, but I gently remind him that in the Lincolnshire integrated care system, 71.9% of appointments were face to face in September 2022. It is not the case that every patient wants a face-to-face appointment; there can be instances in which an online service is better. For patients facing domestic violence, for example, it can often provide a much more convenient service.

Order. I know we are bedding back in, but Front Benchers have to think about Back Benchers. These are their questions as well, so please let us make sure that I can call as many of them as possible.

The Scottish Government introduced new national guidelines to make it easier for retiring NHS staff to return to support the NHS, while drawing their pensions. However, there is a substantive issue of pension tax rules pushing senior clinicians to reduce their commitments or retire early. As we know, pension taxation is a wholly reserved matter, so will the Minister address this issue with Cabinet colleagues in order to find a permanent solution that will allow us to help the NHS retain senior staff?

T4. More than 13,000 people who are in hospital today would be out of hospital if the care system had the necessary capacity, and most of them could go back to their own homes if we had enough domiciliary care workers. Can the Secretary of State assure me, and the House, that he will produce a proper workforce plan for the care sector as a matter of urgency? (901973)

Very much so. The hon. Member for Ilford North (Wes Streeting) asked about a taskforce. With our colleagues in NHS England, we launched a “delayed discharge” taskforce with a “100-day challenge” over the summer; we have also set up an international recruitment taskforce within the Department to prioritise the establishment of a “clearing house for care”. I will not add further to my answer, other than to say that this is a key area of focus.

T3.   I recently visited a local GP surgery which is short of a third of the staff that it needs. Surgeries are finding it increasingly difficult to retain staff owing to stress and burnout. Do the Government recognise that it is stress and burnout that make it so difficult for us to retain GPs in their profession, and for them to retain their staff? If so, what on earth are they going to do about it? (901972)

The wellbeing of staff—especially in the NHS, and especially after the pressure of the pandemic—is a crucial issue, and one on which I have focused in particular since returning to the Department. I look forward to having discussions about it with the hon. Lady.

T6.   Last year I raised with the Department worrying data from the Alzheimer's Society about the number of care home residents with dementia who were being prescribed anti-psychotic drugs when they did not have a psychosis diagnosis. Can my hon. Friend provide an update on the current levels of prescribing? (901975)

I have shared my hon. Friend’s concern about this issue in the past, and I know he has taken a long-term interest in it. We must ensure that people living with dementia are prescribed anti-psychotic medication only when it is clinically appropriate., and NHS England is actively monitoring the position. I have already asked for the latest data, and I will be keeping a close eye on it.

T5. The Secretary of State says that he is boosting GP trainee numbers, but according to the Royal College of General Practitioners, 49% of the more than 40% of GP trainees who are international graduates have reported visa processing problems and 17% are considering leaving the UK altogether, taking their desperately needed skills elsewhere. Why are the UK Government hamstringing the NHS with red tape, and what is the Secretary of State doing to sort this out with ministerial colleagues? (901974)

Across the clinical workforce—whether we are talking about dentistry, nursing, social care or doctors—we are seeking to boost recruitment, including international recruitment, and to remove red tape. Within the GP population, however, we are looking at retention, recruitment and boosting the number of trainees.

T7. The Government have given Epsom and St Helier University Hospitals NHS Trust the green light to get on with improving St Helier and building a new hospital in Sutton. We know that the pandemic has had an effect on timetables, so will my hon. Friend facilitate a meeting between his Department, the Treasury and the trust to ensure that we can get a planning application in by the end of the year? (901977)

We are fully committed to delivering a new hospital in Sutton, one of the 40 new hospitals to be built by 2030. Officials from the Department and the NHS are working closely with the trust at every step in the process, and I look forward to working with my hon. Friend to deliver this much-needed hospital improvement.

T8. In rural areas such as the west country, NHS dentistry is more of a distant memory than a vital service. Does the Minister agree that more must be done to boost NHS dental services in rural areas, and will he commit himself to reforming the NHS dental services contract to ensure that it meets patient need and properly incentivises dentists to take on NHS patients? (901978)

In the hon. Gentleman’s local NHS this year there were 758 active NHS dentists, up from 736 in the previous year. I have already mentioned some of the steps we are taking to tackle the problem of dental deserts and ensure that everyone in the country can see the dentists—and the GPs—whom they need to see.

Members of the Kent and Medway integrated care board are doing their best to recruit more GPs, but they are finding it difficult to attract them to our area. One reason is their close proximity to London, where newly qualified GPs can earn thousands of pounds more than they can if they practise in Kent. Will my right hon. Friend consider extending the NHS London weighting allowance to Kent and Medway?

Part of the reason for having the targeted funding is so that ICSs can look at those areas under particular pressure for recruitment and do that on a place-based basis. It would be interesting to look at the evidence, but I know that the fund has been used by my hon. Friend’s local ICS.

T9. Care workers were already struggling to get by on wages that hardly pay the bills, and now, with an escalating cost of living crisis, care workers in Nottingham and beyond are being pushed deeper into poverty. Does the Secretary of State back trade union calls for a £15 an hour minimum wage for care workers, and what steps is he taking to make this a reality? (901979)

Care workers should be properly paid for what they do, the skills they bring and the compassion they bring to their work. That includes being paid at least the national living wage, which was increased by 6.6% in April. I am also increasing the Care Quality Commission’s oversight of local authority commissioning, and we have created a £1.36 billion market sustainability and fair cost of care fund, which will ensure that local authorities always pay a fair cost of care.

Early access to scans and testing can prevent more serious illness, improve health outcomes, reduce health inequalities and reduce pressure on the acute sector. Will my right hon. Friend prioritise increasing the number of diagnostic centres across the United Kingdom and support my campaign for the establishment of one in Wimbledon town centre?

My hon. Friend is right to say that we are supporting the NHS to deliver up to 160 community diagnostic centres by March 2025, 89 of which are already operational, as part of £2.3 billion of capital funding, delivering around 2 million additional scans so far. Community diagnostic centres are closer to people’s homes in the hearts of communities, and they will help us not just to reduce and bust the covid backlogs but to tackle health inequalities.

As we get older, many of us—individually or our close family and their immediate family—will be touched by cancer. Can the Minister confirm when the 10-year cancer plan will be published in full, and will the Minister agree to meet me and a small delegation from the all-party parliamentary group on radiotherapy to hear more from the experts on the frontline about how we can use this technology to improve cancer outcomes?

Sadly, cancer takes far too many people before their time, and the Government are determined to improve cancer outcomes in the short term and the long term. I am very happy to meet the hon. Gentleman to discuss this further.

What steps is the Minister taking to improve health outcomes and early diagnosis for people with aortic dissections?

I know that my hon. Friend has a real understanding of this particular challenge. In March 2022, NHS England launched an aortic dissection toolkit to support the implementation of robust clinical pathways to identify and manage type A and type B aortic dissection, and English regions are working with the cardiac pathways improvement programme to improve diagnosis and treatment.

Tens of thousands of NHS workers are entirely dependent on the use of their car to do their vital job, but while petrol prices have rocketed, NHS mileage rates have remained frozen since 2011. Will the Secretary of State look at what can be done to increase NHS mileage rates?

That fits within the wider issue of how we work with and support our NHS workforce and what packages we can look at in discussion with Treasury colleagues. Of course, the approach to the NHS is also in line with other Government Departments, but the hon. Gentleman raises an important point and it is obviously one that Ministers discuss.

With flu cases on the rise, what action is my right hon. Friend taking to ensure that all parents are aware that they can access the free nasal vaccine at their GP surgery for all pre-school children?

My hon. Friend’s question gives me an opportunity to thank her for her fantastic work on vaccinations and our world-leading roll-out of vaccines across the country. She has also provided an opportunity to remind everyone of the opportunity to get those life-saving vaccines this winter and to get boosted.

This month a care provider in my constituency is closing, citing the workforce crisis. I have listened carefully to the Ministers’ answers, and the current Chancellor spent the last year telling us about the critical need for a workforce strategy. The door is open. Has the Secretary of State had a conversation with the new Chancellor to ask for a workforce plan on which we can all rely?

Forty per cent. of GP appointments are now related to mental health. That is why James Starkie and I launched the cross-party “No Time to Wait” campaign, which had the support of the Prime Minister when he was Chancellor. We have a fully costed plan with the Royal College of Nursing to pilot such a scheme. Is the Secretary of State willing to meet James and me?

I thank my hon. Friend for his suggestion. We are committed to boosting the mental health workforce, and I am happy to meet him to discuss his suggestions.

My constituent Wilma Ord and her daughter Kirsteen are victims of the Primodos hormone pregnancy drug. Will the Minister update me on where the Government are in getting justice and compensation for the affected families? Many people have died. Will she meet me and other families and representatives from the campaign group to get justice for these families? They have waited far too long.

As the hon. Lady knows, there is an ongoing legal case about Primodos, but I am very happy to meet her and the campaigners because I am keen to hear their experience. Unfortunately, I cannot comment further while there is an ongoing legal case.

I refer to my entry in the Register of Members’ Financial Interests. Last Saturday was World Stroke Day. Will my right hon. Friend the Secretary of State commend the work of the Stroke Association and its “saving brains” campaign? And will he meet members of the all-party parliamentary group on stroke to discuss how we can increase the provision of life-saving thrombectomy services across England and Wales?

I am very happy to commend the work of the Stroke Association, and I would be delighted to meet my hon. Friend to discuss this further.

A respected woman pharmacist in my constituency, with a lifetime of NHS experience, went solo with her own practice in the hope and expectation of an NHS licence, which she has been denied. Will the Secretary of State look into the opaque decision-making process? Our increasing population otherwise means increasing demand, and my constituent cannot survive on private alone.

Suicide is the biggest killer of under-35s in the UK, with more than 200 school-aged children taking their own life every year, including two, very sadly, in my constituency in recent months. We have heard about the pressures on mental health services, so will the Secretary of State look at alternative ways of supporting mental health by meeting the 3 Dads team and his counterpart in the Department for Education to discuss how we can embed age-appropriate suicide awareness and prevention in schools?

Part of the reason why we are putting an extra £2.3 billion into mental health is to recognise the sensitivity and the importance of this issue. I am very happy to look at all practical suggestions. The tragedy for constituents is something that unites the House. In particular, I will look at what technology can do to support people.

The New Statesman has reported that the spend on Healthy Start has fallen by two thirds in the last decade, and this afternoon I will be presenting a Bill that would help to increase take-up. Will the Secretary of State or one of his team meet me to discuss the details of what campaigners and I are proposing so that we can make this helpful benefit reach more of the families it is intended to benefit?

I am very happy to ensure that the ministerial team engages with the hon. Lady. I take this opportunity to commend my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom), who has done a huge amount of work on early years, which dovetails with this important issue.

Following a recent unannounced inspection by the Care Quality Commission, some services at Tees, Esk and Wear Valleys mental health trust have improved, but the trust’s overall rating remains “requires improvement.” Can my right hon. Friend assure me and my constituents in Darlington that his Department will keep a laser-like focus on the trust and that he will do everything in his power to ensure the trust carries out the improvements that are so desperately needed?

I thank my hon. Friend for raising this important issue. I understand he recently wrote to the Secretary of State, and we will respond shortly. NHS England and the North East and North Cumbria integrated care board have commissioned an intensive support team review of the trust, and I will keep him updated. He is right to make sure that we keep this high on the agenda.

Children who are born premature or sick are often discharged from neonatal care with energy-intensive equipment, such as oxygen machines, which has an impact in terms of the cost of living crisis. Is the Secretary of State willing to meet Bliss and myself to look at the costs faced by families who come out of neonatal care and how we can support them better?

The Bliss charity is recognised across the House for the extremely important work it does, and I know that the ministerial team will be happy to engage with the hon. Gentleman on how we can work on the matter he raises.