PARLIAMENTARY DEBATE
Topical Questions - 6 February 2018 (Commons/Commons Chamber)

I do not know whether the right hon. Lady is referring to my age, a proposition on which I think the House would have to divide, or the rosette. [Interruption.] Yes, I thought she meant the rosette.

On the day that we mark the 100th anniversary of giving a voice to women, I want to update the House on concerns in the medical profession that we may not be giving a voice to doctors and other clinicians who want the freedom to be able to learn from mistakes. The House will know that, as a Government Minister, I cannot comment on a court ruling, but it is fair to say that the recent Dr Bawa-Garba case has caused huge concern, so today I can announce that I have asked Professor Sir Norman Williams, former president of the Royal College of Surgeons and my senior clinical adviser, to conduct a rapid review into the application of gross negligence manslaughter in healthcare.

Working with senior lawyers, Sir Norman will review how we ensure the vital role of reflective learning, openness and transparency is protected so that mistakes are learned from and not covered up, how we ensure that there is clarity about where the line is drawn between gross negligence manslaughter and ordinary human error in medical practice so that doctors and other health professionals know where they stand in respect of criminal liability or professional misconduct, and any lessons that need to be learned by the General Medical Council and other professional regulators. I will engage the devolved Administrations, the Justice Secretary and the Professional Standards Authority for Health and Social Care in this vital review, which will report to me before the end of April 2018.

I thank the Secretary of State for that answer—or rather, for that statement—and also for the robust tweets that he makes on that and many other issues. Would he be amenable to the idea of following on Twitter the Oliver King Foundation? On the foundation’s advice, I have written to all the schools in Broxtowe urging them to install defibrillators. This is an important project. What assistance is the Department of Health giving to such an admirable charity and such an excellent project?

It is a fantastic charity. The boy concerned would have been 19 very shortly. It is a very sad story. I thank my right hon. Friend for her campaigning on this issue. We do indeed need to ensure that we have atrial fibrillators everywhere necessary to prevent these tragedies.

I welcome the review that the Health and Social Care Secretary has just announced. I also welcome the addition of social care to his role and the Government’s belated realisation that social care should be a Cabinet-level role, as Labour recognised with its shadow Cabinet in 2010. Yesterday, the Alzheimer’s Society reported that care homes were turning away people with advanced dementia—or even evicting them, sadly—because care providers do not get enough money from local authorities to cover the cost of their care. Will the Health and Social Care Secretary now be arguing with Treasury colleagues for the funding that is so badly needed to ensure that people with dementia are not evicted from care homes due to a lack of funding?

The hon. Lady always speaks powerfully about the social care system. One of the key parts of the social care Green Paper that we are currently working through is on market stabilisation. We have seen a number of care homes go under, although the number of beds overall has remained broadly stable, but our particular concern is, as she rightly points out, people in the advanced stages of dementia who might not be able to get the care that they want. This is a key focus of our work.

I have listened carefully to cancer charities, clinicians and patients on the importance of the cancer patient experience survey. I have been clear that, whatever form the CPES takes as a result of the changes to how confidential data is shared, we want the survey to continue with a methodology as close to that of the current survey as possible.

It is interesting, looking at the comparisons, to see that the NHS in Wales appears to have changed a number of them, to make it more difficult to compare performance between England and Wales. The more scrutiny there is of the performance in Wales—where clinicians say that the best performance often equates to the worst performance in England—the more we will see the need for serious changes in the way in which the NHS delivers its services in Wales.

In Sutton, we have hugely exciting plans for a London cancer hub, working with the Royal Marsden Hospital and the Institute of Cancer Research, on a single campus to provide a global centre for cancer innovation that will in turn provide a huge boost for our local economy, including 13,000 new jobs. Will the Minister join me in Sutton to see the opportunity at first hand? Will he also tell us how such a project can help to deliver on our Government’s life sciences strategy?

I am keen to visit my hon. Friend in Sutton, so let us fix a date as soon as we can. Cancer survival rates are at an all-time high, but I like the idea of a one-stop shop, and the hub that he talks about could be very exciting.

The King’s Fund has said that STPs offer the best hope for the NHS and its partners to sustain and transform the delivery of healthcare, so the King’s Fund endorses this recommendation. As the right hon. Lady will know, we announced an additional £325 million of capital funding in the spring Budget to invest in local areas, and in the autumn Budget we committed an additional £10 billion package of capital investment over this Parliament.

Last week, our former colleague Tessa, now Baroness, Jowell gave an inspiring speech about her battle with brain cancer. At this first Health questions after that speech, I am sure that colleagues will join me in paying tribute to her work and will agree that she spoke with courage, grace and the desire to make her suffering prevent others from having to go through the same. Will the Secretary of State assure me that last week’s report from the brain cancer research taskforce, which I set up as a Minister, will be taken seriously in the Department and that everything will be done to ensure that brain cancer, which has been something of a Cinderella for years, receives the support and funding that it deserves so that Tessa’s words were not in vain?

I thank my hon. Friend for his work in this job on this subject. The Secretary of State was in the other place to listen to Baroness Jowell’s speech, and I read it and watched it back. It was a moving and brave piece of work. We take this matter seriously. My colleague Lord O’Shaughnessy has the report, which we are going through line by line, and he and I will jointly chair a roundtable on the subject in the next few weeks.

Will the Secretary of State give an assurance that any accountable care organisations that he establishes will not be able to use commercial confidentiality excuses to evade scrutiny under freedom of information legislation?

Public money is public money, and Members have a right to know how it is being spent, so we will absolutely ensure that those contracts are signed in a fair way.

As the Secretary of State carries out his social care funding review, I urge him to look carefully at whether we should look again at implementing the Dilnot commission’s proposals. Given that we legislated for them, they are the only way that we are going to tackle the issue with the sufficient urgency.

At the heart of the Dilnot proposals was the idea of risk pooling—that there is a randomness in the illnesses that affect us in the later years of our life that we would want, as a society, to do something about. I will confirm what the Prime Minister said in the election campaign: we will consult on a cap on social care costs.

The hon. Lady highlights an important point about the variance in performance between trusts and how we look at some of the lessons from, for example, Lords Carter’s work on efficiency, rotas and how to maximise the value of funding. I am happy to consider her specific point, but she is right that how we manage the patient pathway, in particular the 43% of hospital beds occupied by 5% of patients, is a key challenge.

For the first time ever in Devon and Plymouth, GP practices are struggling to recruit new doctors and new partners in particular and are spending a fortune on locums as a result. The Government have a plan to fix the situation by 2020, but what more can be done in the meantime to ensure that my constituents can access primary care services?

There are two things. First, we have succeeded in increasing the number of medical school graduates who go into general practice—a record 3,157 this year. Secondly—I know this from my conversations with GPs in my hon. Friend’s constituency—we are doing what we can to reinvigorate the partnership model. Since meeting those GPs, I have agreed with the Royal College of General Practitioners and the BMA that we will carry out a formal review of how the partnership model needs to evolve in the modern NHS.

I point the hon. Gentleman to what the King’s Fund says, which is that accountable care organisations and integrated care systems make a “massive difference” in care to patients. The King’s Fund is not a pro-Government organisation; it regularly holds the Government to account at election time and throughout the year. Not just the King’s Fund but Polly Toynbee and many other people are saying that.

It is very positive that Corby clinical commissioning group has announced that core urgent care services will be protected in Corby, along with the announced new GP access and new primary care facilities, but will the Minister join me in keeping a close eye on the CCG as it designs the new access arrangements? People need to be able to access those urgent care services at the right place, at the right time and without delay.

My hon. Friend is right to draw attention to the funding going into Corby, and it is a tribute to his campaigning as a constituency MP that there is such progress on that measure. I am happy to look at the specific issue. It is important that the CCG continues to consult both Members of Parliament and the public as it takes that work forward.

We have been listening to the Royal College of General Practitioners and the BMA, which is why last year funding for GPs went up by £314 million and why it will be going up by £2.4 billion over the five-year period, which is a 14% real-terms increase.

There really is a magnificent array of rosettes on both sides of the Chamber, which today—today only—I will allow to influence me.

This is a very proud day to be a woman in this House. In mid and south Essex there are plans for a hyper-acute stroke unit at Basildon Hospital. Will the Secretary of State or one of the Ministers confirm that that will be an improvement of services for my constituents in Chelmsford, and not a downgrade?

I am very happy to confirm my hon. Friend’s observation. It is absolutely about improving services. This proposal for a new hyper-acute stroke unit in Basildon will ensure there are specialist nurses and doctors available to manage patients at all times, which very much draws on the lessons from London, where we consolidated stroke services and where health outcomes were improved and lives were saved.

The hon. Lady will know that we are currently implementing the findings of the expert working group, and we are continuing our discussions with the all-party group to see how much further we can go in answering people’s questions and in responding to these moving cases, one of which she has just explained to the House. Obviously I would be happy to have further discussions with any hon. Member who wants to discuss it with me further.

In Shropshire, we have had four years of confusion on the future of our two hospitals. Will the Secretary of State tell the people of Shropshire whether there is Government funding for the proposed reconfiguration of the county’s hospitals?

As my hon. Friend will be aware, we announced further funding in the Budget and the autumn statement. On the specifics of Telford, which she has raised on a number of occasions, I am very happy to have further discussions with her.

I am not aware of the specific case the hon. Lady highlights, but I am happy to look at it and to understand why she feels the rents are disproportionately high. This relates to the point I made earlier in response to the hon. Member for West Lancashire (Rosie Cooper), which was about the variance in the system and how we ensure that we obtain best value for money. The reality of the debate on health is that the Labour party simply sees it in terms of how much is put in, whereas Conservative Members recognise that we need to both invest more in the NHS and make sure we get the best outcomes. That is the key dividing line between the parties.

For six years, the people of Redditch have endured a painful consultation on their hospital, the Alex, which has dragged on and on. As a result, they have lost maternity and children’s emergency services, even though nobody wanted that when they were consulted. People have taken the pain, but when will they get the gain? When will they see the urgent care centre? When will the £29 million be spent on the Alex?

There are good plans in place for getting Worcestershire Acute Hospitals NHS Trust and the Alex, specifically, out of special measures. A package of support is in place to enable the trust to improve its quality of care. Delivery of the acute service redesign plan is a key driver to sustaining services in the medium term and £29.6 million of STP funding has been agreed to support that.

At the weekend, NHS England, as my colleagues have pointed out, gave up on the key A&E waiting time target. Does the Minister agree that it is very important that when people go to A&E they do not have to wait longer than four hours, as more than 2.5 million did last year? Whose responsibility is this delivery failure?

I have great respect for the right hon. Gentleman, but he is saying something that is a big exaggeration. What the NHS has committed to is that by the end of the year coming up more than half of the trusts in the country will meet the A&E target and that we will go back to meeting it across the whole country in the following year. So we are absolutely committed to this target. We recognise there are real pressures, which is why it is going to take time to get back to it, but we will get there.

I congratulate the Secretary of State on securing the £10 billion capital commitment in the Budget at the end of the last year to spend on the NHS. May I take advantage of my position on these Benches to urge him for the next allocation of STP funding to adopt the advice of my hon. Friend the Member for Telford (Lucy Allan) and ensure that the Shrewsbury and Telford Hospital NHS Trust gets the Future Fit funding it needs?

May I first pay tribute to my hon. Friend for the work he did in the Department and the high esteem in which he was held by those working in the NHS? On Shrewsbury and Telford, I very much appreciate the importance of the reconfiguration of the trust. We expect a decision shortly on that, although I am not in a position to announce it today.

The Secretary of State will be aware of the huge disruption at the Manchester hospitals this week because of problems with water supplies and a big water leak. He might also be aware that Emmeline Pankhurst’s home is on the site of the Manchester hospitals. What conversations has he had with United Utilities and other water companies to ensure that we have safe, constant supplies of water to our hospitals, so that these disruptions do not happen?

I know that NHS Improvement is aware of that situation and that important conversations are going on to improve the resilience of all our hospitals, including those in Manchester. However, I am happy to write to the hon. Lady on the issue.

I will call the hon. Member for East Worthing and Shoreham (Tim Loughton) if his question is shorter than his tie.

Lipoedema affects 10% of women in this country, many without a diagnosis, so why are an increasing number of my constituents saying they cannot get any therapeutic interventions funded by the CCG? Will the Minister meet a delegation of those people and other hon. Members similarly affected?

Yes, of course I will meet my short-tied hon. Friend with the delegation he requests.

We are well over time, but I do not want the hon. Member for Strangford (Jim Shannon) to feel isolated or excluded. Let us hear it.

Child suicide calls to Childline are at a record high among girls—it is at 68%. Despite that, the NHS spends only 11% of its budget on mental health issues. Will the Minister indicate what he is going to do to prevent child suicides?

We are very focused on reducing all suicides. As the hon. Gentleman will know, we have a plan to reduce suicide rates by 10%, and last week we announced a plan to reduce in-patient suicides to zero, which is a big aspiration to which the NHS in England is certainly committed. We are very committed to this agenda.

Thank you, colleagues.

On a point of order, Mr Speaker.

Order. I think this appertains to the exchanges we have just had and relates to a ministerial answer. If the Secretary of State would be kind enough to wait a moment to hear it, we would be grateful.

I seek your advice, Mr Speaker, on something that is very important to my constituents. In my question earlier, I asked about pain infusions and highlighted a letter from consultants saying that the withdrawal of such treatment would increase the risk of mortality. The Under-Secretary of State for Health, the hon. Member for Winchester (Steve Brine), had previously agreed by email to meet me and said that he would answer my question today, if I was called to speak, yet a different Minister answered my question and there was no promise to meet. My office called the Department of Health and Social Care and was told that my case was labelled as “no further action”. What steps are available to me, Mr Speaker, to ensure that the Minister sticks to his word and agrees to meet me?

I think that the explanation of the situation is innocent and that I can probably reassure the hon. Lady. She came in on a question that was being answered by another Minister. On the whole, it is deprecated if Ministers play musical chairs in answer to the same question, even when supplementaries come. It tends to be expected that one Minister will deal with, to put it bluntly or in the vernacular, the whole caboodle. I think that was why the hon. Lady lost out. However, I just asked the Under-Secretary of State for Health, the hon. Member for Winchester (Steve Brine), who is a very agreeable fellow, whether he stood by his commitment to meet, and he gave a nod of assent. He is very happy to meet the hon. Lady to discuss the matter. They may or may not end up agreeing, but of one thing she can rest assured: there is no conspiracy to exclude her. I hope that the hon. Lady will now go about her business with an additional glint in her eye and spring in her step, confident in the knowledge that she shall shortly meet the hon. Member for Winchester.