Smoke-free 2030 Target Sir Charles Walker (Broxbourne) (Con) 1.
What steps his Department is taking to meet its target of England
being smoke-free by 2030. (906509) The Secretary of State for
Health and Social Care (Sajid Javid) I know that my hon. Friend has
long been a passionate advocate for a smoke-free England, and I
read his recent Westminster Hall debate with interest. Some 64,000
deaths a year are attributed to smoking and it is one of the
greatest drivers...Request free trial
Smoke-free 2030 Target
(Broxbourne) (Con)
1. What steps his Department is taking to meet its target of
England being smoke-free by 2030. (906509)
The Secretary of State for Health and Social Care ()
I know that my hon. Friend has long been a passionate advocate
for a smoke-free England, and I read his recent Westminster Hall
debate with interest. Some 64,000 deaths a year are attributed to
smoking and it is one of the greatest drivers of health
disparities in our country. I am personally determined that we
should do everything we can to reach the Government’s ambition of
a smoke-free 2030. That is why, in January, I asked Javed Khan to
lead an independent review into tobacco control. Once that review
is complete, the Government will set out their next steps.
To get to a smoke-free 2030, for every 100 people smoking today
we need to reduce that figure by eight, because “smoke-free”
actually means 5% or less of the adult population smoking. Can I
ask the Secretary of State to ruthlessly target the barriers that
stop people stubbing out their last cigarette? We need to get the
numbers of smokers down; otherwise, 2030 will be an ambition that
is not achieved.
My hon. Friend is absolutely right. The smoking rate is currently
13.5%, which is the lowest on record. However, smoking remains
the largest driver of health disparities in our country. The new
tobacco control plan, which will be informed by the new
independent review, will be looking to do exactly what my hon.
Friend says.
(Huddersfield)
(Lab/Co-op)
As one of the original campaigners for a ban on smoking in public
places, I fully support what has just been suggested, but can I
go further and beg the Secretary of State to come up very soon
with a plan so that every child, every person and every family in
this country can breathe clean, fresh air away from the pollution
coming from diesel vehicles and other sources?
The hon. Gentleman has long been a campaigner on this issue and I
commend him for that. He is right to continue pushing. I do not
want to pre-empt the outcome of the independent review because it
is just that, a review fully independent of Government. However,
once it is complete—I hope to publish it in May—we can set out
our plans.
Health and Care Integration
(Mansfield) (Con)
2. What steps he is taking to help ensure that health and care
services are well integrated. (906510)
(Northampton South) (Con)
19. What steps he is taking to help ensure that health and care
services are well integrated. (906529)
The Secretary of State for Health and Social Care ()
The past few years have shown that we are strongest when we work
together. Earlier this year we published the integration White
Paper, drawing on our experience of the pandemic to develop a
plan that will bring together the NHS and local government to
deliver jointly for local communities. We have also created
integrated care partnerships, such as the programmes in
mid-Nottinghamshire and Northamptonshire, through which we are
already showing how we can bring together health and local social
care services.
As covid regulations come to an end, I understand that the
discharge fund is also set to end. This could leave local
government vulnerable where there are no formal procedures
locally to pass funding from the NHS to local government services
and local authorities. Particularly as we seek to reduce hospital
backlogs, it is vital that we get people out of hospital and into
appropriate care settings. Will my right hon. Friend assure me
that, where local authorities seek to tackle such backlogs, they
will have access to appropriate funding?
I can give my hon. Friend that assurance. Of course, we are
already putting in record funding for local authorities and the
NHS to deal with backlogs. I believe the plan we set out earlier
this month for the integration of NHS and local authority care
services will make a real difference.
I thank the Secretary of State for referring to the work in
Northamptonshire to integrate health and social care. Can he
assure me that the central role of local government in ensuring
that health and social care services work together to make the
most efficient use of local resources will continue? And will he
give me a clear guarantee that adult social care will not be
taken over by the NHS?
I am pleased to give my hon. Friend the assurance he seeks. The
integration White Paper signals our intention to go further and
faster on health and care integration, building on the work
already being done by the NHS, adult social care and local
government to deliver services jointly. The plan will lead to
better collaboration, and we want to make sure that overall
responsibility is still shared between local authorities and the
NHS.
(Walsall South) (Lab)
The Secretary of State will know that Walsall Manor has been
merged with the Royal Wolverhampton—they share a chief executive
and chairman—without consultation with local people. How on earth
can integration take place when Walsall Manor does not have a
full-time chief executive to ensure that it happens? Will the
Secretary of State please ensure that Walsall Manor gets its own
chief executive?
I understand the right hon. Lady’s point, but it is about what
works on the ground. My understanding is that what is happening
in her area is about a shared management team that shares best
practice and tries to address challenges together, rather than
any kind of formal merger.
(Nottingham North)
(Lab/Co-op)
Across the country, tens of thousands of people sitting in
hospital are medically fit to go home but cannot do so due to a
lack of social care. The Health and Care Bill should have
addressed that, but it does not. Rather than making us wait for
more legislation, will the Secretary of State at least concede
that local health leaders, be they in clinical commissioning
groups or in integrated care systems in shadow form, should be
driving this locally as a matter of urgency?
That is exactly what the new integrated care systems are all
about. My understanding is that the hon. Gentleman sat on the
Health and Care Public Bill Committee, which made it a
reality.
Mr Speaker
I call the shadow Secretary of State, . [Laughter.] Sorry, .
(Ilford North) (Lab)
Thank you, Mr Speaker. You have clearly had a happy Easter.
The fact is that the Government’s failure to fix the social care
crisis is causing huge pressures on the NHS. As of last week,
more than 20,000 patients were fit to leave hospital but could
not be discharged because the care was not available, which means
that 22,000 patients each month are waiting more than 12 hours in
A&E and that heart attack and stroke victims have to wait
more than an hour for an ambulance. We are used to hearing about
winter crises, but is it not the case that, after more than a
decade of underinvestment in the NHS, a failure to fix social
care and the absence of a plan even to address the staffing
challenge in the NHS and social care, we have not just a winter
crisis but a permanent crisis in the NHS?<
That is not the case at all. The hon. Gentleman knows, although
he pretends not to, that the NHS and social care are facing
unprecedented pressure because of the pandemic. He will know that
as a result of the pandemic, both in NHS settings and in adult
social care there has been a necessity for infection and
protection controls. He will know that, sadly, staff absences are
higher than they have been in normal times. But the NHS is
stepping forward, with its colleagues in adult social care, to
provide whatever support it can bring, especially with the record
funding the Government are providing, both to the NHS and to
adult social care.
(Rossendale and Darwen)
(Con)
My hon. Friend the Member for Hyndburn () and I have been working
with east Lancashire local authorities and our GP services to see
whether we can increase the number of face-to-face GP
appointments. Will the Secretary of State say what action he and
the Government are taking to ensure that people in east
Lancashire can see their general practitioner face to face?
My right hon. Friend is absolutely right to raise this issue. We
have heard time and time again in this Chamber about the
pressures our constituents are facing in order to get that kind
of face-to-face access to their GPs. We all know why the
situation was particularly bad at the height of the pandemic, but
we expect it to improve rapidly. The percentage of people being
seen face to face is increasing substantially, in large part
because of the measures the Government have taken, including the
£250 million access fund that was announced a few months ago.
Mr Speaker
I call the SNP spokesperson, .
(Linlithgow and East Falkirk)
(SNP)
Thank you, Mr Speaker.
Integration and service improvement cannot be delivered without
sufficient staff, and the only way to attract people to a career
in social care is by valuing them. In Scotland, they are already
paid better than those in England and Wales, and through the
national care service the Scottish Government will improve terms
and conditions for care workers, through the introduction of
national pay bargaining. Have the UK Government considered
following the Scottish Government’s approach and commitments?
Integration between the NHS and social care requires the right
level and quality of workforce, both in the NHS and in adult
social care. In the NHS in England, we have more doctors and
nurses—more people working than ever before. In adult social
care, we are recruiting at high levels, not least because of the
huge recruitment campaign we ran with the sector, and some of the
other changes we made, including the £400 million- plus of
retention funding over the winter period. In addition, the
support for the workforce more generally is making a real
difference.
(Wellingborough) (Con)
In north Northamptonshire, integration is getting on very well,
with Councillor heading the adult social
services. However, going back to what my hon. Friend the Member
for Northampton South () said, there is the worry
that because the NHS is so big it will overwhelm local
government. I have told the Secretary of State that they do not
want to mess with , but can he ensure that
there is a mechanism for reviewing that?
I know that my hon. Friend knows extremely well, but he is
right to talk about the importance of the NHS and the adult
social care sector and local authorities working together. We
must make sure that it is a true partnership, where one does not
overwhelm the other and they work together towards their shared
interests.
(North Shropshire) (LD)
One key cause of the urgent care crisis in Shropshire, in the
Shrewsbury and Telford Hospital NHS Trust, is the inability to
discharge patients who are medically fit to go home into social
care in the community. Shropshire Council’s resource challenges
in that area are well known. Will the Secretary of State commit
to putting extra resource into social care in Shropshire so that
the medically fit can be discharged into the community when they
are ready?
The hon. Lady is absolutely right to raise this issue, and the
whole House heard just before the recess the results of the
independent work done by Donna Ockenden. The hon. Lady is right
to talk about that and the pressure that has been faced locally.
I understand that she has already reached out to my hon. Friend
the Minister for Health and that he will be meeting her to
discuss just that.
NHS Dentistry Backlog
(Ipswich) (Con)
3. What steps his Department is taking to tackle the backlog in
NHS dentistry appointments.(906511)
The Parliamentary Under-Secretary of State for Health and Social
Care ()
The dental activity threshold has recently been raised to 95% of
usual activity. That is another quarter-on-quarter increase to
get us towards 100% of pre-pandemic activity. I fully recognise,
though, that access to NHS dentistry before the pandemic was
patchy and that the crux of the problem is the current NHS dental
contract, so work is under way to reform that contract. As
negotiations have started, I am limited in what further I can
say, but I will update the House as soon as possible.
A number of my constituents are finding it impossible to access
NHS dental care. They include Alison, one of my constituents who
worked as a midwife in Ipswich Hospital for 40 years. Some of
them have contacted 40 different practices and have not got
anywhere. My understanding is that there has been a 30% drop in
the number of dentists taking on NHS work in Suffolk. Will the
Minister explain what local work is going on between the
Department and the local NHS bodies to try to ensure that this
issue is addressed?
My hon. Friend is quite right in his question and is campaigning
hard to increase dental activity in his constituency. One of the
key pieces of work is being done through Health Education
England, which set out a range of recommendations in its
“Advancing Dental Care” review. That will do a number of things,
such as increase the skill mix and scope of practitioners across
dental teams, and we may well require legislation to bring some
of that work forward. Health Education England is also
introducing more flexible routes into dental training and doing
some workforce modelling to identify the parts of the country
with the biggest gaps in provision, so that we can establish
centres of dental development in those areas. I will look at
Ipswich in particular.
(Kingston upon Hull West and
Hessle) (Lab)
My constituent contacted me to tell me that when she broke her
canine and went to contact her NHS dentist, she found she had
been kicked off the list and was facing a bill of £4,000, which
she simply does not have, to have the work done privately. Will
the Minister speak to some of the dental practices about the
possibility of relaxing their rules on kicking people off their
dental lists, especially as covid has meant that patients might
have had legitimate reasons for missing appointments?
I am sorry to hear about the hon. Lady’s constituent’s
experience. There is not actually a list system for dentists as
there is for GPs, so patients can see any dentist when they have
a dental issue. With that said, we have asked dental practices to
update their availability for NHS patients on the website. This
morning, I looked at the website to see what availability there
was throughout the country and saw that many dentists still have
not updated their availability, so I will ask
officials—particularly in her constituency—to update the lists so
that patients can access NHS dentistry more easily.
(Worthing West) (Con)
I join the Minister in thanking dentists and their associates for
getting so much of the service back. Does she agree that in
places such as the Arun parts of my constituency, where people
cannot find a dentist and have not been able to for two or three
years, there must be a way for people to get on a dentist’s list
and get treated, and for dentists to be properly rewarded?
Dentists and patients would be grateful for a change in the
contract.
The Father of the House is quite right that the crux of the
problem is that there is a shortage throughout the country not of
dentists but of dentists taking on NHS work. The contract is the
nub of the problem, which is why work is under way to reform it.
We will shortly announce some short-term changes and some
longer-term reforms, which will hopefully help my hon. Friend’s
constituents.
(Strangford) (DUP)
Bearing in mind that dentists are now determined to turn their
practices wholly private as they cannot make ends meet with NHS
prices, will the Minister pledge to review NHS payments to stop
the haemorrhaging of NHS dentistry provision?
The hon. Gentleman is correct that the units of dental activity
payments are a perverse disincentive. Sometimes, when someone
needs more extensive work, their dentist is paid the same as they
would be for, say, one or two simple fillings. That is the nub of
the problem and we are currently in negotiations on the
matter.
(Basingstoke) (Con)
My hon. Friend the Minister is right to talk about the contracts
with dentists, but should she not also look at how dentistry is
structured and the regional nature of the contracting? It sits
outside our clinical commissioning groups, which reduces
co-ordination and accountability in respect of something that is
central to our health. Should this not change?
My right hon. Friend is right. Health Education England is
addressing the overall system of where dentists are training and
where the gaps in provision are filled in its “Advancing Dental
Care” review. It is also working with commissioners at a local
level to develop more opportunities in those places that we term
dental deserts, where there is currently a lack of provision.
(Enfield North) (Lab)
NHS dentistry is in crisis. Patients are stuck with either a
never-ending wait for an NHS appointment or footing the bill for
going private, which is simply not an option for most families
suffering rising bills and taxes. With a third of the population
experiencing untreated tooth decay, when will this Government,
who have had 12 years to do so, finally come up with some
practical solutions that put patients’ needs first, rather than
the half-baked, unworkable ideas we have heard to date?
I am sorry to the hear that tone from the hon. Lady. We are
working under Labour’s 2006 dental contract, and she may have
missed that dentists were unable to offer any routine care during
the pandemic over the last two years, which we have slowly worked
up to 95% of usual activity. She may want to play politics with
this issue, but perhaps she should speak to her Labour colleagues
who run the NHS in Wales, where 6% of dental posts were lost last
year. She should get her own side in order before lecturing this
side of the House.
(Winchester) (Con)
With the exception of the previous question, I do not think that
anybody on either side of the House who has raised this issue is
playing politics, because a pattern is emerging of a backlog and
problems in accessing NHS dentistry. An increasing number of
constituents are contacting me having gone to their NHS dentist
with an acute dental problem only to be told either that NHS
patients are no longer being seen or that they have fallen off
the list, as the hon. Member for Kingston upon Hull West and
Hessle () mentioned. How can Ministers
help in the short term? I know the long-term answer is around the
contract—I used to give that answer when I was in her seat—but
will the Minister please meet me over a cup of tea so that we can
try, as a starter for 10, get to the bottom of this?
I thank my hon. Friend for his question. We have had many
cross-party meetings with colleagues about dentistry, with many
raising constituency issues that we have followed up. He could
speak to his local commissioners, because there can sometimes be
local problems with the commissioning of dental services.
However, now that we are moving towards 95% of usual activity—a
significant change compared with last year— I hope that his
constituents will be able to access services more easily.
NHS Ear Irrigation and Microsuction
(Birmingham, Selly Oak)
(Lab)
4. What recent assessment he has made of the adequacy of access
to NHS ear irrigation and microsuction treatments. (906512)
The Parliamentary Under-Secretary of State for Health and Social
Care ()
Ear wax services are the responsibility of local commissioners,
who are responsible for meeting local healthcare needs. Depending
on a local area’s arrangements, services should be undertaken
either at local primary care practices or through referrals to
appropriate local NHS services.
Well, I obviously want to thank the Minister for that answer, but
I was recently contacted by a constituent who complained that she
was told by her GP surgery that such services were no longer
available on the NHS and that she should consider obtaining them
privately. This is happening despite recent studies that link the
effect of impacted cerumen with cognitive decline and dementia.
Will the Minister consider writing to clinical commissioning
groups to remind them of their obligations and patient
entitlements?
I thank the hon. Gentleman for his question. There has been no
national removal of ear wax services, which can still be
commissioned locally. NICE guidance is clear on the types of
services that should be commissioned. Traditional methods of
manual ear syringing are no longer offered for safety reasons,
but electronic irrigation and microsuction should be being
offered. If his local CCG is not commissioning such services, I
am happy to meet him and them to discuss why not.
(South West Bedfordshire)
(Con)
GPs provided the service for decades. We all understand why the
NICE guidance means that they no longer offer syringing, but
there is a gap in that many clinical commissioning groups are not
offering alternative services. We are talking about people with
dementia or receiving end-of-life care who literally cannot hear
and are going deaf. The Minister must be direct with CCGs on this
issue.
My hon. Friend is right that there must be consistency across the
country in how those procedures are commissioned. After today’s
questions I will take this up with officials to see why that is
not happening consistently across the country.
Regional Health Inequalities
(Bethnal Green and Bow)
(Lab)
5. What steps his Department is taking to tackle regional health
inequalities. (906513)
The Secretary of State for Health and Social Care ()
I am determined to tackle unfair disparities in health outcomes.
That is why I launched the Office for Health Improvement and
Disparities. OHID’s regional directors of public health will work
with local government and the wider health system to empower
local partners with the tools they need to respond to disparities
in their regional and local areas. We will also publish a health
disparities White Paper later this year, with a strong focus on
prevention, to improve health for the whole population.
I thank the Secretary of State for his answer, but a decade of
under-investment and mismanagement have left 4.5 million people
on waiting lists and staff shortages of more than 100,000 people
even before we entered the pandemic, which exacerbated health
inequalities. I welcome the work his Department is doing, but the
reality is that people who live in a constituency such as mine
are twice as likely to end up on a waiting list for treatment for
more than a year as those in better-off areas. While I welcome
what he has announced today, may I ask that he puts in
appropriate investment to go along with tackling those appalling
health inequalities?
The hon. Lady is right to talk about the importance of tackling
health inequalities; on that we absolutely agree, and I hope she
will contribute to the health disparities White Paper that I
mentioned a moment ago. However, it is wrong of her to suggest
that some of the current challenges we face are because of
under-investment or because of a smaller workforce than
otherwise. We have the largest investment ever going into the
NHS. Its budget this year is bigger than the GDP of Greece. It is
the highest amount ever, rising by billions each year. We also
have more going to social care than ever before, and the highest
level of workforce that the NHS has ever seen in its history.
Dame (Gosport) (Con)
Surely one of the cruellest health inequalities is in fertility
treatment. Of the 106 CCGs in the country, only six limit the age
at which women can have in vitro fertilisation treatment to 35,
and two of those are in Hampshire. Will the Secretary of State
meet me to discuss how we can end that most devastating of
postcode lotteries?
My hon. Friend is right, and of course I will be happy to meet
her and discuss this further, but I can also tell her that that
is one of the key things we will be covering in our upcoming
women’s health strategy.
Mr Speaker
I call the shadow Minister, .
(Denton and Reddish)
(Lab)
Warm words from the Secretary of State, but people in the most
deprived parts of England are almost three times as likely to
lose their lives from an avoidable cause as those in the least
deprived areas. With the cost of living soaring and the
Resolution Foundation estimating that 1.3 million people will be
pushed into poverty as a result of the Chancellor’s spring
statement, those inequalities will worsen. Why will the Secretary
of State not just admit that his Government have failed the
poorest communities, and start doing something about it?
The hon. Gentleman acts as though health inequalities are
something that has just emerged under this Government. There have
been long-running health inequalities in this country over
decades under successive Governments, and this Government are
putting in record investment and coming up with the ideas to deal
with them. As ever, the Labour party has no idea how to deal with
the challenges this country faces.
(Stoke-on-Trent North)
(Con)
Mental health is a serious challenge of our time. It is totally
unacceptable that waiting times, average number of sessions and
minimum number of sessions differ according to which part of the
country someone lives in. Sadly, recent statistics show that in
Stoke-on-Trent people are taking their own lives at double the
national average. That is why I am proud to support the
cross-party “No Time to Wait” campaign, led by with the backing of The
Daily Telegraph and the Royal College of Nursing, for the
provision of mental health nurses in GP surgeries, which could
make a real difference to those who bravely come forward asking
for help. Will my right hon. Friend meet me, hon. Members of this
House who are supportive, and James to discuss how we can make
that possible?
Yes, of course; I would be delighted to meet my hon. Friend and
others to discuss the campaign. He speaks with passion and I know
this is something he has long campaigned on. I have had time to
look at some of the content of the campaign, but I would
certainly be happy to discuss it further.
NHS Waiting Lists: Southampton
(Southampton, Test)
(Lab)
6. What steps he is taking to reduce NHS waiting lists in
Southampton. (906514)
The Minister for Health ()
Reducing waiting lists and waiting times, exacerbated of course
by the impact of the pandemic, is a key priority for this
Government. Southampton, like the rest of the country, will
benefit from the detailed actions set out in the elective
recovery plan published by my right hon. Friend the Secretary of
State a few months ago. In addition, as part of Solent Acute
Alliance hospital upgrade programme, University Hospital
Southampton NHS Foundation Trust has received £12.1 million to
increase capacity at Southampton General Hospital.
Dr Whitehead
The hospital trust in Southampton, which is an excellent
provider, is desperate to get back to elective surgery and
non-life-threatening procedures, but finds that it cannot because
it cannot integrate covid treatment into general ward activities,
and has a continuing high level of staff sickness, which means
that procedures are often undertaken very inefficiently in terms
of resources. What assistance can the Minister provide for the
trust to enable it to get on the front foot as regards elective
procedures and non-life-threatening treatments in the near
future?
The hon. Gentleman rightly pays tribute to the staff at his
hospital trust, and I join him in doing so. The number of those
in his area waiting for an elective procedure or routine
operation has reduced slightly. There is more to do, but the
trust is making inroads, as he says, and I know that it wants to
do more. As we set out in the elective recovery plan, some
innovations, such as surgical hubs, allow a greater separation
between covid areas, or areas where covid may be present, and
elective activity is a key part of that. If it is helpful, I am
always happy to meet him to discuss the specifics of his local
hospital.
Poor Housing Conditions: Health Outcomes
(Wansbeck) (Lab)
7. What steps he is taking with Cabinet colleagues to tackle the
effect of poor housing conditions on health outcomes.
(906515)
The Parliamentary Under-Secretary of State for Health and Social
Care ()
The Government are committed to tackling poor-quality housing. In
the social housing White Paper, we committed to a review of the
decent homes standard to test whether it is up to date and
reflects current needs and expectations. The levelling-up White
Paper sets out a commitment to halve levels of non-decency in all
rented homes by 2030, with the biggest improvements in the
poorest-performing areas. These reforms will have a positive
impact on health, and we will work closely with the Department
for Levelling Up, Housing and Communities to support their
implementation.
The NHS spends a staggering £2.5 billion-plus annually on
treating people with illnesses directly linked to living in cold,
damp and dangerous conditions. As a consequence, severe
respiratory diseases such as asthma, mesothelioma and other
asbestos-related diseases are on the increase, mainly in the most
deprived areas. Sadly, more and more people are dying. How does
the Government’s levelling-up policy plan to tackle this
increasingly urgent health issue?
The hon. Gentleman raises a really important issue that we are
determined to tackle. Housing is one of the key determinants of
health. A decent home can promote good health and protect from
illness and harm. As he said, poor housing conditions have severe
consequences for mental and physical health. That is why we are
determined, not just through the levelling-up White Paper but
through the health disparities White Paper that will be published
later this year, to set out a bold ambition to reduce the gap in
health outcomes and the actions that the Government will be
taking to address the wider determinants of health, including the
impact of poor housing on health.
(North Devon) (Con)
In North Devon it is not just the quality of housing that is
causing health issues but the lack of availability of affordable
housing and a complete collapse of the private rental sector,
which is creating mental health issues among my constituents and
also means that my much-loved North Devon District Hospital is
struggling to recruit adequate local medical services. What steps
is the Department taking to try to address these concerns?
My hon. Friend raises an important issue specific to her area,
and other areas that attract people who go there for their
holidays and are perhaps not there on a permanent basis. We are
determined through our White Papers to address every health
inequality, whether caused by a moving population or a static
population, in the sorts of areas that the hon. Member for
Wansbeck () talked about.
Cancer Treatment Backlogs: Derbyshire and England
(Chesterfield) (Lab)
8. What recent assessment he has made of the scale of the backlog
in cancer treatments in (a) Derbyshire and (b) England.
(906516)
The Parliamentary Under-Secretary of State for Health and Social
Care ()
Cancer treatment and diagnosis remained a top priority throughout
the pandemic, with 4.4 million urgent referrals during the period
and over 1 million people receiving cancer treatment. Thanks to
the brilliant work of our NHS staff, first treatments for cancer
have been maintained at above 94% of usual levels over the course
of the pandemic. However, we know that fewer people came forward,
so we are now seeing record numbers of people coming through the
system, with November last year having the highest number of
11,000 cancer referrals per working day.
Mr Perkins
I asked specifically about Derbyshire, but I did not get an
answer. Derbyshire clinical commissioning group has failed to
reach any of the cancer referral targets for the most recent 12
months. Although this is a national failure, the shortages are
particularly acute in Derbyshire. These failures have tragic
consequences. My constituent Paul Bryan is just 58. He has been
attending his surgery for two years; he kept getting dismissed
and was not tested, and now the prostate cancer that was
undiagnosed for all that time has spread to his ribs, spine and
bones, and his diagnosis is terminal. His family are urging the
Government to show more urgency to improve outcomes, so that
other families do not have to experience such needless
heartbreak. Will the Minister explain to the Bryans why the
Government rejected the workforce planning amendment to the
Health and Care Bill that could have helped our NHS get the
cancer specialists it needs and prevented heartbreak like the
Bryans in other families?
I am sorry to hear about the case of the Bryan family, but I
reassure the hon. Gentleman that, in Derby and Derbyshire, 92% of
treatments start within 30 days, despite record numbers of
patients coming forward. To tackle the issue of getting people
diagnosed earlier, which is key to getting more successful
treatment, we are rolling out rapid diagnostic centres across the
country so that people can access screening and testing much more
quickly and easily. We have 159 of those live right now, with
more to follow.
Personalised Healthcare
(Ruislip, Northwood and
Pinner) (Con)
9. What steps he is taking to increase the delivery of
personalised healthcare. (906518)
The Secretary of State for Health and Social Care ()
Personalised healthcare is a key priority in my reform agenda. I
recently set out a new ambition: that as many as 4 million people
benefit from personalised care by 2024, covering everything from
social prescribing to personalised support plans. We are also on
track to deliver 200,000 personal health budgets and integrated
personal budgets by 2023-24.
I welcome the Secretary of State’s answer. My constituents are
still telling me that they are experiencing some delays beyond
the NHS guidelines on diagnosis for special treatment. What plans
does my right hon. Friend have to address the lack of capacity
and need for capacity in specialty-trained doctors and specialist
diagnostic equipment, to make personalised care a reality?
My hon. Friend is absolutely right to mention the importance of
the workforce and medical equipment. He will be reassured to know
that the NHS has more doctors and nurses working for it than ever
before, with more in training than ever before. We are investing
record amounts of capital for new medical equipment, including
investment in some 160 new community diagnostic centres, which
will all include the latest, state- of-the-art diagnostic
equipment.
Mental Health Support for Veterans and Military Charities
Ms Anum Qaisar (Airdrie and Shotts) (SNP)
10. What recent discussions he has had with Cabinet colleagues on
the adequacy of mental health support for veterans and military
charities. (906519)
The Minister for Care and Mental Health ()
NHS England has several bespoke services for veterans, including
Op Courage, the veterans’ mental health and wellbeing service,
which provides a complete mental health care pathway for
veterans. Veterans can benefit from personalised care plans,
ensuring that they can access support and treatment both in and
out of hours. As part of the care and support available to
veterans, Op Courage works with military charities and local
organisations to provide healthcare and address wider health and
wellbeing needs, including for drug and alcohol addiction.
Ms Qaisar
My constituency of Airdrie and Shotts has a long military
history, with many people having previously served in the armed
forces. When I meet veterans from my constituency, we often
discuss the mental health of veterans. The war in Ukraine will
undoubtedly have an immediate and lasting impact on the mental
health of veterans, as they may be reminded of their experiences
of war. To help support our veterans, will the Department come
forward with a package of emergency funding for armed forces
mental health charities?
The hon. Lady raises a very good question. Last year, we
committed an additional £2.7 million to further expand Op Courage
following the recent events in Afghanistan, and NHS England has
put in place several bespoke services and initiatives to meet the
needs of our armed forces community. In addition to Op Courage,
there is the veterans trauma network, the veterans prosthetic
panel and the veteran-friendly GP accreditation scheme, but given
ongoing events in Ukraine, we will of course keep everything
under review. I am very happy to meet the hon. Lady to discuss
further what may be required.
Mr Speaker
We now come to the shadow Minister, .
(Tooting) (Lab)
Our veterans have risked their lives for our country and deserve
excellent mental health support. We must go even further: from
the military frontline to frontline workers who have kept us
safe, everyone deserves proper mental health provision. People
have stepped up to protect our country and save lives during the
pandemic, so is it any wonder that teachers and NHS staff are so
furious with the comments made by the hon. Member for Lichfield
(), about how they would go
back to the staffroom and have a “quiet drink”, in an attempt to
justify the indefensible actions of the Prime Minister? What does
this say about the effect of mental health on our frontline
staff? Will the Minister please condemn those comments and
apologise for the hurt caused by those remarks?
I am very happy to say that we of course thank very much all the
staff who have been on the frontline, whether veterans or
teachers, and involved in everything that kept us going
throughout the pandemic. We are of course very much aware of the
impact of those stresses and strains on mental health. There is
additional support for mental health, and there will continue to
be additional support for young people’s mental health and for
adult mental health. That is one reason why I launched a call for
evidence last week to inform a new 10-year cross-departmental
mental health vision, and I urge everybody to input into that
process before it closes on 5 July.
NHS Workforce Planning
(Aberdeen North) (SNP)
11. What recent progress his Department has made on NHS (a)
short-term and (b) long-term workforce planning. (906520)
The Minister for Health ()
The workforce are the heart of our NHS, and I join the Minister
for Care and Mental Health, my hon. Friend the Member for
Chichester (), and Opposition Members in
paying tribute and putting on record our thanks to those who work
in the NHS. In the short term, the NHS has well-established
processes to ensure that the health service has the right number
of staff with the right skills, and that is alongside our
investment in workforce expansion, including delivering 50,000
more nurses over the course of this Parliament. For the longer
term, we have commissioned Health Education England to set out
the key drivers of workforce supply and demand. It is due to
report this spring. Building on that, my right hon. Friend the
Secretary of State has commissioned NHS England to develop a
long-term workforce framework. We will share the conclusions in
due course.
The anti-immigration, “hostile environment” rhetoric and actions
of this Government are having a significant impact on our NHS
workforce, both by not encouraging people to come here to work in
our NHS and by discouraging current staff from staying here. The
Health and Social Care Committee recommended the introduction of
a national policy framework on migration to support national and
local workforce planning. When will the Government implement that
recommendation?
I am very grateful to the hon. Lady for her question. We are
clear, and always have been clear, about how much we value the
huge contribution that overseas workers in our NHS make towards
keeping our health service up and running, and delivering
first-class care every day. There are three strands to our
approach to building and increasing our workforce. The first is
increasing the numbers of people training in this country and the
second is increasing retention. The third focuses on the
workforce who come from overseas and who are incredibly welcome
here. Indeed, the number of people coming from countries outside
the EU into our NHS workforce has increased.
(Newton Abbot) (Ind)
The Minister will be aware that I have highlighted the challenge
for rural areas in developing a workforce plan on a number of
occasions. Indeed, the last report from the all-party
parliamentary group on rural health and social care made 10
recommendations, including for how we might address workforce
planning in rural areas. Will the Minister advise me of what
steps he has taken to put in place any of those recommendations
to improve the plight of those living in rural areas?
I am grateful to my hon. Friend, who takes a close interest in
this issue, which she and I have discussed on a number of
occasions. She is right to highlight the challenges that some
more remote or rural communities can face in securing the
workforce they need to meet their communities’ needs. The HEE
work and the subsequent workforce framework will be looking at
that across the whole range of different geographies and the
challenges they face.
Mr Speaker
I call the SNP spokesperson.
(Linlithgow and East Falkirk)
(SNP)
The Scottish Government have recently bought Carrick Glen, a
private healthcare hospital, in order for it to become part of
the national network of treatment centres, which once fully
operational will have capacity for over 40,000 additional
surgeries and procedures each year. In contrast, the UK
Government have taken the path of further privatisation of the
NHS, so what recent assessment has the Minister made of the
impact on the workforce of further privatisation of NHS
England?
I am grateful to the hon. Gentleman, and had we been going
further down the route of privatisation, his question might have
had a little more resonance. What we are doing in the NHS in
England is investing in our workforce and investing in our
national health service, while of course working closely with the
independent sector to maximise the use of its capacity in
parallel to make sure we bring down waiting lists and waiting
times.
Topical Questions
(Tewkesbury) (Con)
T1. If he will make a statement on his departmental
responsibilities.(906499)
The Secretary of State for Health and Social Care ()
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.
Mr Robertson
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.
Mr Speaker
I call the shadow Secretary of State.
(Ilford North) (Lab)
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?
rose—
Mr Speaker
Order. I am not quite sure that is relevant in topical
questions.
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—
Mr Speaker
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?
Mr Speaker
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.
Mr Speaker
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.
(Bolsover) (Con)
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.
(York Central)
(Lab/Co-op)
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)
Several hon. Members rose—
Mr Speaker
Come on; we have got to get others in.
The Parliamentary Under-Secretary of State for Health and Social
Care ()
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.
(Wellingborough) (Con)
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)
The Minister for Health ()
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.
(Rochdale) (Lab)
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.
(Bracknell) (Con)
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.
(Streatham) (Lab)
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 Minister for Care and Mental Health ()
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.
Mr Speaker
I call the Chair of the Select Committee, .
(South West Surrey) (Con)
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.
(Chesterfield) (Lab)
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)
Mr Speaker
Order. Let us move on. What a waste of a question. .
(Bishop Auckland)
(Con)
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.
(Washington and Sunderland
West) (Lab)
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.
(Rushcliffe) (Con)
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.
(Dulwich and West Norwood)
(Lab)
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.
(South Basildon and East
Thurrock) (Con)
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 Parliamentary Under-Secretary of State for Health and Social
Care ()
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.
(Ealing, Southall)
(Lab)
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.
(East Devon) (Con)
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.
(Jarrow) (Lab)
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.
(Bexleyheath and Crayford)
(Con)
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.
(Batley and Spen) (Lab)
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.
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