PARLIAMENTARY DEBATE
Topical Questions - 10 October 2017 (Commons/Commons Chamber)

This week is Baby Loss Awareness Week, and the whole House will want to mark the tragedy faced by too many parents every year by redoubling our efforts to reduce avoidable baby death and harm. I am pleased to tell the House that to mark World Mental Health Day today the entire Cabinet was this morning briefed by two of the country’s leading mental health experts, Poppy Jaman and Professor Sir Simon Wessely, on our plans announced today to roll out mental health first aid to 1 million people in England.

Can the Secretary of State tell us what progress has been made regarding an inquiry into the contaminated blood scandal?

I can absolutely tell the hon. Gentleman the answer to that: we have been making very important progress with families over the summer; and we have decided the shape of the inquiry and the leadership of the inquiry and all the factors around the terms of reference need to be decided in close consultation with the affected families. So we are keen to get on as quickly as possible, but we have made some progress in understanding their wishes.

I thank one of my constituency neighbours for that question. Improving outcomes for all cancers is one of my main priorities in this job. I visited the Christie hospital in Manchester last week to see the progress being made on the proton beam therapy facility there. I know Barratt’s Wessex in my hon. Friend’s constituency, as it also does work with some of my constituents. We must do better on these rarer cancers with poor outcomes. I will look at what BW does exactly.

Order. I gently remind Ministers that answers from the Front Bench must be very brief during topical questions, because many other colleagues are waiting to contribute and I do not want to disappoint them, as that would be unfair.

Can the Secretary of State tell us how many elective operations he expects to be cancelled by 31 December?

What I can tell the hon. Gentleman is that every year over Christmas time, when we know that hospitals will be busy, we suspend elective care in particularly busy places. That is how we keep patients safe.

I am grateful to the Secretary of State for his answer, but already more than 80,000 elective operations have been cancelled. That is an increase on the past year. A&E attendance is up on the past year, bed occupancy is higher than last year and the Care Quality Commission has today warned that the NHS is straining at the seams. Winter is coming. Last week, the Tory party made spending commitments worth £15 billion, but not 1p extra for the NHS, so will the NHS fare worse or better than last year this winter, or are we set for another winter crisis made in Downing Street?

What the CQC actually said this morning is that the majority of health and care systems across the NHS are providing good or outstanding quality; that the safety of care is going up; and that performance is improving. None the less, the hon. Gentleman is right that we are always concerned about winter. Let me tell him the new things that are happening this year to help prepare the NHS: £1 billion more going into the social care system in the most recent Budget; a £100 million capital programme for A&E departments; 2,400 beds being freed up; and an increasing number of clinicians at 111 call centres. A lot is happening, but, overall, let me remind him that our NHS is seeing 1,800 more people every single day within four hours—that is something to celebrate.

I can confirm that because the legal accountability, whatever co-operation arrangements are made, will stay exactly the same.

That is a very attractive offer, and I am always happy to have a chinwag with the hon. Gentleman. Last week, we announced something that I hope will resolve that, which is that we are looking at holding nurse training courses on-site in hospital and community sites so that experienced healthcare assistants do not have to go to a higher education institution to do their training.

My hon. Friend is a doughty campaigner for Frenchay hospital and keeps it uppermost in our minds. The way in which we are looking at the pattern of health provision for the next period is through the STP process, and I encourage him to engage with the STP leadership in his area and make the case for Frenchay hospital.

As I previously advised the House, I am in conversation with Together for Short Lives to look at how we improve palliative care for children. This clearly raises a different set of circumstances and sensitivities, and it is essential that we do our best for these children.

Do Ministers have any plans to review the “do not resuscitate” guidance for hospitals? I have a constituent who has such an order placed on him, despite the fact that he has left hospital and is in a care home, it cannot be rescinded and his family have not consented.

My hon. Friend is right to raise this issue. Certainly, in CQC inspections in the past, the whole issue of “do not resuscitate” orders has been an area of concern. This is something we will very much look at as part of the end of life policy, but I would like to hear more about the case my hon. Friend mentioned, if he would like to write to me.

Accountable care systems are supported by such rabid right wingers as Polly Toynbee, writing in The Guardian, because they are about health systems coming together to co-operate to give the best care for patients. That is what is happening across the NHS, and it is already delivering great results.

This Friday marks Secondary Breast Cancer Awareness Day. In 2015, the Government recognised that data collection for this type of cancer was not good enough. However, research by Breast Cancer Care shows that less than a third of trusts collect the number of people diagnosed with secondary breast cancer. Will the Minister confirm what actions the Government are taking to ensure that all trusts are collecting this information, given its importance to improving outcomes?

I thank the co-chair of the all-party group on breast cancer in what is BCAM—Breast Cancer Awareness Month. We must never forget the treatment and support we give to those living with and beyond the cancer diagnosis. We must always remember those living with secondary breast cancer and the work of the third sector—brilliant charities such as Breast Cancer Haven and Breast Cancer Care—so that we can focus on access to a specialist nurse. As my hon. Friend says, the collection of data is critical, and I will be discussing that at my roundtable with some of the main players in the cancer community later this week.

Will the Minister abolish the patient penalty and scrap hospital car parking charges, which punish both the sick and hard-working NHS staff, as well as causing problems for residents living adjacent to NHS hospitals, such as Peterlee Community Hospital in my constituency?

I do understand the concerns raised, and all hospitals are under a responsibility to make sure that they have proper arrangements in place for people on low incomes and people who have to visit hospitals regularly.

Antibiotic resistance is a major threat to humanity. Will the Minister outline the progress we have made in opening up the £50 million global antimicrobial resistance innovation fund to applications?

I thank my hon. Friend for that. We expect the first launch to be the bilateral UK-China partnership £10 million fund, which we expect to go live early in 2018. Further information on the calls for the remaining £40 million will be announced in due course.

I am very happy to meet the group, and the hon. Lady should contact my office. The Home Office is the lead Department for cross-governmental drugs policy, and we obviously released the new cross-Government drugs strategy earlier this year. However, this cannot all be about drugs services and picking up the pieces after things have gone wrong; it can also be about prevention. We should, as somebody once said at this Dispatch Box, understand a little more and condemn a little less.

This month is Stoptober, and someone who manages to stop smoking for 28 days is five times more likely to quit for good. Legislation is obviously part of this, but perhaps the Minister could update us on what more could be done.

At the last health oral questions, I committed to publishing the new tobacco control plan. I did that on 18 July. We have had a lot of legislation, from this and the previous Government. It is Stoptober, and there has never been a better time to quit. We now need to take that legislation, work with the control plan the Government have published and work it through local authorities and smoking cessation services, because my hon. Friend is absolutely right that where buddying services are used, we have better outcomes.

There is a crisis in mental health staffing levels. Does the Secretary of State accept that today, throughout the country, there are 2,000 fewer mental health nurses than there were when he took charge five years ago?

What I accept is that we have 30,000 more professionals working in mental health than when my Government came into office. There has been a decline in the number of mental health nurses, but we have in place plans to train 8,000 more mental health nurses, and that will make a big difference.[Official Report, 17 October 2017, Vol. 629, c. 6MC.]

The Gloucestershire Hospitals NHS Foundation Trust capital expenditure bid would fund a 24-hour urgent care service, and it would also increase bed capacity and improve hospital performance in Gloucester and Cheltenham, to the benefit of patients throughout the county. When do Ministers expect to announce the results of the bid? Will they take this particular bid into careful consideration?

I am aware that, under the Gloucestershire STP, a proposal has been submitted for capital funding to support plans to improve the clinical environment for patients and staff at the Gloucestershire Royal Hospital. I am afraid that my hon. Friend will have to join me in awaiting the Chancellor’s announcement in the Budget as to whether there will be a second phase of capital funding for STPs. If there is any funding, it will be allocated thereafter.

GPs in my constituency tell me that because of changes to personal data rules they will no longer be able to charge for providing reports for private insurance and legal claims. Will Ministers update the House on the situation? What assessment has been made of how GPs will cope with the additional costs they will face?

I am happy to look into that matter and write to the hon. Lady.

If nurses or other NHS staff are awarded a pay rise above the current pay cap, will the Government fund that pay rise fully, or will they require it to be met by cuts in patient services?

That is something I cannot answer right now, because the latitude that the Chancellor has given me with respect to the negotiation of future pay rises is partly linked to productivity improvements that we will negotiate at the same time. The fact is, though, that we do have that flexibility, and I hope we can get a win-win as a result.

May I take the Secretary of State back to the issue of nursing associates? Given that evidence shows that for every 25 patients for whom a professionally qualified nurse is replaced by a non-nurse, mortality on an average ward rises by 21%, how comfortable is he with reports that hospitals in Lincolnshire and Leicester are using nursing associates to plug gaps in the nursing workforce?

The hon. Lady should be very careful before talking down nurse associates. They do a fantastic job, they are trained, they are helping our NHS and they are welcomed by their nursing colleagues.

Under this Government, there has been an unprecedented fall in the number of nurses: the NHS is short of 40,000 nurses and more than 6,000 have gone since 2010, under this Conservative Government. When will the Secretary of State acknowledge that he is failing the NHS and failing patients, and when will he do something about it?

With respect, I really think the hon. Gentleman needs to get his facts right. The number of nurses has gone up, not down, since this Government have been in office. The number of nurses in our hospitals has gone up by more than 11,000, because this Government are supporting safer care in all our hospitals.

The number of unfilled nursing posts in London is now more than 10,000—whatever the Secretary of State’s figures say, it is more than 10,000. When will they be filled?

When we have put through the biggest increase in nurse training places in the history of the NHS—the 25% increase that I announced last week.

Suicide is the most common cause of death for men under the age of 45, and men are significantly less likely than women to seek support from loved ones or medical professionals when they have mental health problems. How can services be better targeted at men to encourage them to seek help more quickly and thereby reduce misery?

This is a very important issue and the hon. Lady is right to raise it. The Time to Change campaign has said that this year it will focus on men, specifically to try to address the issues she mentioned. We are rolling out crisis plans throughout the country to make sure we are better able to reach people who reach out to us.

What reassurance can the Secretary of State give to the Amplify youth project in Northwich in my constituency that timely and improved access to mental health services will be provided?

We have said that by 2020-21 we want to be treating an extra 70,000 young people every year, but the truth is that that is still not enough. We need to bring down waiting times much more dramatically, which is why we are doing a lot of work across Government and we have a Green Paper coming out shortly.

Newly released NHS guidance makes it clear that walk-in services can have a future as part of urgent treatment centres. Does the Secretary of State agree with me and thousands of patients in Bury North that Bury walk-in centre can, should and must stay open and that Bury CCG should ensure this when it concludes its review?

Current plans by NHS England to look at the urgent and emergency care pathways include creating 150 urgent treatment centres by the end of this year. I am happy for the hon. Gentleman to write to me about Bury and will respond in due course.

Is the Secretary of State aware that there is widespread support in the House for his Government’s commitment to enact the principle of deemed consent for organ donation? He knows from a previous meeting that my private Member’s Bill is due for its Second Reading early in the new year. Will he therefore agree to an early meeting now, so that we can co-ordinate the two and see how to advance his intentions? I know that my hon. Friend the Member for Barnsley Central (Dan Jarvis) will be with me again and, with the Secretary of State’s commitment to this, we look forward to an early meeting.

I very much enjoyed our previous meeting, which was not so very long ago. I hope the hon. Gentleman is happy that we have made good progress since that meeting, with the Prime Minister announcing that we will start a consultation, but I am always happy to see him and his colleague the hon. Member for Barnsley Central (Dan Jarvis).

The Secretary of State will be aware that he and he alone has responsibilities under the Health and Social Care Act 2012 to deal with referrals from local authorities of clinical commissioning group decisions. Almost a year ago, Stoke-on-Trent City Council and Staffordshire County Council referred a matter to the Minister regarding the closure of community care beds. To date we have had no response. Letters from me and my hon. Friend the Member for Stoke-on-Trent North (Ruth Smeeth) have gone unanswered. When will we get a response? Is this a case of wilful indifference towards his responsibilities or just ignorance of the Act?

May I apologise to the hon. Gentleman if he has not had a prompt reply to any letters to me or my Department? I will look into the issue that he raises and ensure that he gets a rapid response.

The hon. Gentleman will be aware that private and independent providers of patient transport services provide services all across the country and support the ambulance services in that work. I will look into the case that he raises in relation to Bedford and write to him.

All of the local dementia and rehabilitation beds in my rural constituency of High Peak are earmarked for closure. In some cases, patients and their families will have to travel 25 miles across the moors to Chesterfield. Given the importance of staff being able to work with families to support patients to return home, will the Minister agree to look again at such decisions, which make this work practically impossible?

The hon. Lady will be aware that the STP plans being considered for her area include providing more services in the community by community nurses and other nurses in our community hospitals being reassigned, which will allow them to undertake care for more patients than they can at present within community hospitals.

Order. I am sorry, but we must move on. Demand invariably tends to exceed supply.