Training of NHS Staff Theo Clarke (Stafford) (Con) 1. What steps
his Department is taking to train more NHS staff.(906544) The
Secretary of State for Health and Social Care (Steve Barclay) The
NHS long-term workforce plan sets out a path to double the number
of medical school training places, increase GP training by 50% and
double the number of adult nursing training places. Theo Clarke
What steps are the Government taking to increase the recruitment
of...Request free trial
Training of NHS Staff
(Stafford) (Con)
1. What steps his Department is taking to train more NHS
staff.(906544)
The Secretary of State for Health and Social Care ()
The NHS long-term workforce plan sets out a path to double the
number of medical school training places, increase GP training by
50% and double the number of adult nursing training places.
What steps are the Government taking to increase the recruitment
of midwives, given the closure of Stafford County Hospital’s
freestanding midwifery birthing unit due to shortages, and how is
the Secretary of State going to ensure that all midwives are
trained to deal with birth injuries to reduce risk?
My hon. Friend raises an important point, and I know she has
secured a debate in the House this week to further explore these
issues. She will be aware that there has been a 13% increase in
the number of midwifery programme place starters since two years
ago. That is alongside the £165 million added to the maternity
budget since 2021 and the key increase in midwifery places in the
long-term workforce plan.
(Halton) (Lab)
It is obviously welcome to train and recruit as many staff as
possible, but part of the problem is actually retaining the
staff. We are increasingly seeing among the reasons given for
leaving, particularly by nurses, their work-life balance. What is
the Secretary of State doing to address that?
Just yesterday, I met leaders of the NHS Staff Council, who
represent trade unions under Agenda for Change, as part of our
ongoing discussions on the agreement we will reach with them,
which includes working together on retention and how we address
some of the challenges the workforce face.
(West Suffolk) (Ind)
May I congratulate the Secretary of State on being ahead of track
to hire 50,000 more nurses this Parliament, as we committed to in
the 2019 manifesto? However, can I push him by asking him where
he is up to on ensuring that enough staff are trained to do
clinical trials, as set out in the excellent O’Shaughnessy
review, and can he give us an update of where implementation of
that review is up to?
I very much welcome my right hon. Friend signalling that we are
ahead of the manifesto commitment not just in nurses being
recruited, but in key additional roles in primary care, where the
target was 26,000 and actually 31,000 have now been recruited. He
is right about the importance of clinical research. The
O’Shaughnessy review speeds that up and reduces the cost. It
better leverages the taxpayer pound in investment from the
private sector, and standardises contracts across NHS trusts to
bring the time down. We are also looking at innovation in areas
such as the NHS app to better empower patients to take part in
clinical research trials. That ensures they are at the front of
the queue in getting the latest medicine, which is exactly where
we want the NHS to be.
(Worsley and Eccles South)
(Lab)
The Secretary of State did not mention the increase planned in
the number of physician associates. The Norfolk and Waveney
integrated care system has posted:
“Got abdominal pain that isn’t going away? A Physician Associate
based in your GP practice can help…They are highly skilled at
diagnosing conditions”.
After the tragic case of Emily Chesterton, who was misdiagnosed
after seeing a physician associate twice at a GP practice and no
GP at any point, when will the lesson be learned that the NHS
workforce cannot be safely expanded by this route of associates
with only two years’ medical training?
All clinical roles need to have the right regulation around them,
and we need to ensure that patient safety is to the fore. The
hon. Lady gives a very good illustration of how the Labour party
talks about reform, but not when it comes to the reform of new
roles, having new roles in the NHS and having a ladder of
opportunity for people to come into the NHS. Physician associates
are people with masters’ degrees: these people are highly
skilled. Of course, we need to get the regulation right. However,
the Labour party talks about reform, but when it comes to
standing up to the trade unions, it is not willing to do so,
which is why, when there is an innovation such as physician
associates, it wants to block it.
Suicide Prevention
(Sedgefield) (Con)
3. What steps he is taking to help prevent suicide.(906546)
(Blackpool South) (Ind)
18. What steps he is taking to help prevent suicide.(906562)
The Parliamentary Under-Secretary of State for Health and Social
Care ()
Last month, we published a cross-Government five-year suicide
prevention strategy. It sets out our pledge to reduce England’s
suicide rates within two and a half years, with over 100 measures
aimed at saving lives and providing early intervention for those
at highest risk of suicide, including new mums and middle-aged
men.
Like many others, I dropped into the campaign event for “One
Million Lives”, developed by Jacobs and supported by R;pple, and
I was impressed by its efforts to interfere with the online risk
of suicide-centric websites. The Minister may be aware that my
wife is a long-term volunteer with Darlington and district
Samaritans, which has raised with me the “Saving Lives Can’t
Wait” campaign. It asks the Government to review local funding
for suicide-safer communities, which is due to end. Could I ask
the Minister to support the “One Million Lives” campaign, and to
push for the renewal of local funding to support suicide-safer
communities?
I thank my hon. Friend for his hard work in this area and for his
mental health campaigning overall, and also his wife and all who
selflessly give their time to volunteer with the invaluable
mental health charities. We fully recognise that, and that is why
when we launched the suicide prevention strategy we also launched
our £10 million suicide prevention grant fund.
On my hon. Friend’s point about wider funding beyond 2024-25,
that is subject to a future spending review, but our commitment
and record in delivering record investment of £15.9 billion in
mental health services just in this financial year, which is 28%
more funding than in 2018, should give him confidence that this
Conservative Government deliver on mental health services.
Is the Minister able to provide an update on the suicide
prevention grant, and particularly on when the money is expected
to reach the successful organisations?
We have had a huge response to the opening of the grant, with
over 1,800 applications from voluntary groups and organisations.
We are assessing those bids and hope to make an announcement
before the end of the year.
(Washington and Sunderland
West) (Lab)
Campaigns such as 3 Dads Walking and Just 3 Mums Walking have
worked incredibly hard to raise awareness of suicide prevention.
Has the Minister had time to meet with either of those campaigns
yet?
I have met with 3 Dads Walking; I have not met the mums group but
am very happy to do so. Because of their intervention and
campaigning, we were able to successfully put their campaign
about improving mental health awareness in the school curriculum
into our suicide prevention strategy. It is a cross-Government
strategy, and the Department for Education has very much taken
their points on board.
(Tooting) (Lab)
Over 1.8 million people languishing on mental health waiting
lists, black people five times more likely to be detained under
the Mental Health Act 1983, and over 2,000 people with learning
disabilities detained in hospital, all while the Government are
dragging their feet on mental health and suicide prevention. You
will be interested to know, Mr Speaker, that we had cross-party
support to tackle these burning injustices through the draft
Mental Health Bill, yet since the Joint Committee on the Draft
Mental Health Bill published our report in January we have heard
nothing from the Government, so will the Minister today commit to
including reform of the Mental Health Act in the King’s
Speech?
I was going to pay tribute to the hon. Lady for her work on
mental health campaigning, and she will know we have done a huge
amount. The suicide prevention strategy is a cross-Government
piece of work, which makes sure suicide is everyone’s business,
not just that of health and social care. Whether by supporting
families bereaved by suicide or rolling out mental health support
schemes in schools, it is this Government who are delivering on
mental health services.
Mr Speaker
I call the shadow Minister.
(Erith and Thamesmead)
(Lab)
The House of Commons Library says there has been no statistically
significant change in the rate of suicides in England since 2015.
Suicide remains the biggest killer of men under 50 in the UK. Why
has it taken so long for the Government to bring forward a
strategy, and why do they continue to drag their feet over reform
to the Mental Health Act? Can the Minister give the House a firm
timetable today?
The hon. Lady is not quite right in her statistics. Just before
covid we had seen a 20% reduction compared with two decades ago
in suicide levels in England. She might be interested to know
that in Labour-run Wales suicide rates are higher than in
England, and its suicide prevention strategy expired last year.
Mental health has been demoted on the shadow Front Bench, too, as
we saw from the resignation of the hon. Member for Tooting (Dr
Allin-Khan) when the role of shadow mental health Minister was
removed from the Opposition Front Bench.
RAAC in Hospitals
(Wansbeck) (Lab)
4. What steps his Department is taking to remediate hospital
buildings with reinforced autoclaved aerated concrete.
(906547)
The Secretary of State for Health and Social Care ()
We are determined to address the safety issues caused by RAAC. We
are prioritising the seven worst-affected hospitals and have a
fund of just under £700 million covering the four-year programme
of replacement.
Can the Secretary of State tell the House how many of the
hospitals where RAAC is an issue also have issues with asbestos
being present? What assessment has his Department made of the
impact should asbestos spores be released in a RAAC collapse?
The hon. Member raises an interesting point about asbestos,
because much of the NHS estate dates from a time when asbestos
was widely used. Of course, asbestos is considered safe if it is
undisturbed. It is a similar issue with RAAC.
On RAAC, we are following the guidance from the Institution of
Structural Engineers and monitoring it. The advice is not that
all RAAC needs to be replaced; the point is that it needs to be
monitored. Where there is deterioration, we have a fund of just
under £700 million to tackle that. The asbestos is being
monitored, as is the RAAC. We have been monitoring this since
2019 and have a four-year national programme backed up with £700
million to address issues as and when they arise.
(Stoke-on-Trent North)
(Con)
The residents of Stoke-on-Trent North, Kidsgrove and Talke would
like me to place their thanks on the record to the Secretary of
State for having ensured that the Haywood walk-in centre, which
has RAAC present, has just received £26.5 million for a new build
out-patient building, which will do a lot to improve the care of
residents locally. As spades are already in the ground, will the
Secretary of State commit to coming to visit so that we can show
off this fantastic progress?
It is always a pleasure to visit my hon. Friend’s constituency.
He highlights a good illustration of how the national programme
is working, backed with that £700 million of funding. We are
closely monitoring the estate and, where RAAC mitigation is
required, that work is taking place. He brings a good example of
that to the House’s attention.
Mr Speaker
I call the shadow Minister.
(Bristol South) (Lab)
Not only are the hospital buildings crumbling after 13 years of
neglect, creating huge capacity challenges; it seems that those
still standing do not have enough beds. As we heard from The
Times this morning, the number of
“hospital beds…has fallen by almost 3,000 since ministers
promised 5,000 before winter”.
It feels pretty much like winter to me. Is that just another
broken promise?
First, we have got more than £1 billion of investment in an
additional 5,000 permanent beds going into the NHS estate as part
of our urgent and emergency care recovery programme. More widely,
the Government are committed to the biggest ever investment in
the NHS estate, backed with more than £20 billion—the biggest of
any Government. Of course, we will not take lectures from Labour,
which bequeathed the NHS the consequence of expensive private
finance initiative deals that many trusts are still paying for to
this day.
Health and Social Care Recruitment: EU Exit
(Glasgow North) (SNP)
5. What recent assessment he has made of the impact of the UK’s
departure from the EU on trends in the level of recruitment in
the health and social care sector. (906548)
(Paisley and Renfrewshire
North) (SNP)
6. What recent assessment he has made of the impact of the UK’s
departure from the EU on trends in the level of recruitment in
the health and social care sector. (906549)
The Minister for Social Care ()
rose—
Mr Speaker
You can respond sitting down if you wish.
It is fine; thank you, Mr Speaker.
Since Brexit, we have more than 13,000 more doctors and 48,000
more nurses working in the NHS in England, and 40,000 more
full-time equivalent staff in adult social care. Our points-based
immigration system means that we can recruit the talent we need
from all over the world for our health and social care system,
including from the European Union.
If everything is as rosy as the Minister says, why did a
spokesperson for the Nuffield Trust say last year that
“greater costs, more paperwork and uncertainty over visas because
of Brexit have been among the biggest barriers to recruiting and
keeping EU and EFTA doctors”?
Cannot she admit that Brexit is exacerbating difficulties with
recruiting appropriate staff for the NHS across the whole of the
UK? Scotland did not vote for Brexit. Why are we having to pay
the price?
I suggest it is really time that the hon. Gentleman stops blaming
Brexit. He should in fact look to his SNP colleagues in Holyrood
and ensure that they make Scotland’s NHS a better place to work.
If he had listened to my answer, he would have heard me say that
since Brexit we have recruited more than 13,000 more doctors to
the NHS in England. In fact, we are doing so well that we
recently recruited a doctor from the SNP Benches. [Laughter.]
Very droll. I congratulate the Minister on that one.
If not the Nuffield Trust, perhaps BMA Scotland’s Chair Dr Iain
Kennedy will be good enough. He recently said that the
recruitment and retention of senior medical staff across the NHS
in Scotland remains a huge challenge, with the health immigration
surcharge cost increases announced by this Government potentially
further deterring foreign workers from joining the NHS. Given the
recently announced NHS long-term workforce plan, what steps is
the Minister taking to ensure that Scotland has the immigration
we need for future recruitment and retention for our health
service?
We have the health and social care visa, which supports our
health and social care services to recruit doctors, nurses and
other professionals, as well as social care staff, helping to
boost those numbers. The hon. Gentleman referred to the important
NHS workforce long-term plan, which will increase the home-grown
staff in our health service. That will give us 60,000 more
doctors, 170,000 more nurses and 70,000 more allied health
professionals in our NHS over the next 15 years.
Mr Speaker
I call the SNP spokesperson.
(East Dunbartonshire)
(SNP)
It has been reported that the Home Secretary plans to tighten the
rules for those arriving on a health and care worker visa, to
block most from bringing dependents with them—yet another in a
long list of her vendettas against children coming to these
isles. What recent assessments has the Secretary of State made of
how that will impact international recruitment and capacity in
our already struggling health and care services?
I work closely with colleagues in the Home Office to ensure that
the health and care visa achieves the objectives set out. We are
seeing real success in social care—the recent Skills for Care
workforce report showed that we have 20,000 more care workers in
England. We are doing well on recruitment to social care.
HIV: Emergency Department Opt-out Testing
(Darlington) (Con)
7. What recent assessment he has made of the effectiveness of
emergency department opt-out testing for HIV. (906550)
The Parliamentary Under-Secretary of State for Health and Social
Care (Neil O’Brien)
Provisional NHS data shows that opt-out testing has found around
700 cases of HIV during its first year. In total, it has found
more than 2,000 cases of blood-borne diseases, including
hepatitis B and C.
I welcome the Minister’s news on those figures. He will have seen
the impact of opt-out testing—detecting more people, treating
them earlier and saving the NHS money. However, if we are to meet
our 2030 target on no new infections, we cannot delay a further
roll-out of opt-out testing. Will he commit the resources needed
to expand it in time for World AIDS Day on 1 December?
Neil O’Brien
I pay tribute to my hon. Friend for all his work on this
important issue. We will assess all the evidence and reply before
the end of the year. Opt-out testing is not the only thing we are
doing to drive down HIV transmission. We have had a 40% rise in
the number of people getting pre-exposure prophylaxis, and we
have increased the number of people testing, with 20,000 free
testing kits handed out this year. We are doing everything we can
to meet that visionary goal to stop HIV transmission in this
country.
(Strangford) (DUP)
I thank the Minister for his answer to the question from the hon.
Member for Darlington (). It is clear that today, HIV
is not the death sentence that it once was, because of the
progress of medication and healthcare in prolonging life and
improving quality of life. In Northern Ireland we are proactive,
as the Minister will know, on PrEP and young people. We are doing
progressive things through the Department of Health, Social
Services and Public Safety in the Northern Ireland Assembly. Has
the Minister had the opportunity to discuss with the Northern
Ireland Assembly and the Health Department how we can work better
together? I always say we are better together in every case.
Neil O’Brien
The hon. Gentleman is completely correct. He has been a fantastic
champion on this issue. The UK is leading the world on this
issue, hitting the UN’s 95-95-95 goals, driving down transmission
and reducing stigma. People increasingly realise that as well as
suppressing the virus, the treatment makes it impossible to
transmit, transforming the lives of people with HIV.
Access to GPs: Rural Communities
(Buckingham) (Con)
8. What recent assessment he has made of the adequacy of the
level of access to GPs in rural communities. (906551)
The Parliamentary Under-Secretary of State for Health and Social
Care (Neil O'Brien)
We have increased funding for general practice by about a fifth
in real terms since 2018. We have increased the workforce by
about 30% since 2019 alone, with 2,000 extra doctors and 31,000
extra clinicians going into general practice. With the hard work
of GPs, that has enabled about 15% more appointments than before
the pandemic. In rural areas we are going further with things
such as the targeted in-house recruitment scheme and the elements
of the funding formula that favour rural areas.
I am grateful to my hon. Friend for that answer, but I have
repeatedly raised with Ministers the specific case of an
innovative model from Long Crendon Parish Council to use land
secured through planning gain to replace Long Crendon Surgery,
which closed during the pandemic. There is an agreement for Unity
Health to provide primary care services there, but no money to
physically build. My right hon. Friend the Secretary of State has
advised consistently that the money be sought from the integrated
care board, but after prolonged talks it has said that there is
no money. Will the Minister look at this innovative model again?
It is a great way of building rural GP provision in the future,
with a mind to his Department making it happen.
Neil O’Brien
I will absolutely look closely at that specific case. My hon.
Friend has put a huge amount of work into Long Crendon. As he
knows, we are already changing the national planning policy
framework to enable more developer contributions to flow into
such innovative projects. We have more GP practices than we did
in 2010, but we continue to look at ways to go further.
Cardiovascular Disease Prevention
(Stourbridge) (Con)
9. What steps he is taking to help prevent cardiovascular
diseases. (906552)
The Secretary of State for Health and Social Care ()
We are making the most significant public health intervention in
a generation by creating a smoke-free generation. To put that in
context, every five cigarettes a day increases the risk of stroke
by 12%. We are also rolling out free blood pressure checks to
people over 40 in community pharmacies, which will help to detect
much earlier thousands more people living with high blood
pressure.
I thank the Secretary of State for that answer. Many commercial
infant and toddler foods are ultra-processed, which sets alarm
bells ringing as ultra-processed food is strongly associated with
cardiovascular diseases and 40% of 10 to 11-year-olds are obese.
I strongly believe that parents are being misled by companies
that put health claims on ultra-processed infant food, when in
fact the food is anything but healthy—it is high in fat, salt and
sugar. What steps are the Government taking to address the
disingenuous and grossly misleading marketing and labelling of
commercial infant and toddler food and drink?
As my hon. Friend knows, there is no agreed definition for
ultra-high processed food. As a general principle, I do not think
we should be taxing and banning things—smoking is an outlier. We
have to empower the patient and recognise the pressures from the
cost of living. We are also rolling out anti-obesity drugs to
give patients access to the most innovative drugs as part of our
wider response to the challenge of obesity.
(North West Leicestershire)
(Reclaim)
What is the Secretary of State’s view of the worrying trend of
increased cardiac-related deaths in the UK and around the world
since 2021, which correlates closely with the roll-out of the
experimental mRNA vaccines?
It is always important to follow the science. That is why, at the
G20, Health Ministers agreed to look at the various research
being done in multiple countries, particularly on long covid but
also on the lessons from that period, to ensure that research
from that period is shared internationally so we can learn best
practice from other countries as well as within the NHS.
Radiotherapy Linear Accelerator Machines
(Westmorland and Lonsdale) (LD)
10. How many and what proportion of NHS radiotherapy linear
accelerator (LINAC) machines will reach the end of their
recommended lifespan in 2024. (906553)
The Minister for Health and Secondary Care ()
The Government and NHS England are committed to ensuring cancer
patients can receive high quality radiotherapy treatment. Between
2016 and 2021, £162 million was invested which enabled the
replacement or upgrade of around 100 radiotherapy machines.
Responsibility for investment in radiotherapy machines has sat
with local systems since April 2022. I look forward to meeting
the hon. Gentleman and the all-party group for radiotherapy on
this matter soon.
I am very grateful to the Minister for his reply and in
particular for the offer of the meeting coming soon. Radiotherapy
UK says that for us to even meet average international standards
we must commission 125 additional new linear accelerators. Will
he make the commitment to do that and, in doing so, ensure that
rural and remote communities do not lose out by placing some of
those machines in new satellite centres, such as the Westmorland
General Hospital?
The hon. Gentleman is hugely passionate on this subject. As I
said, integrated care boards are responsible for meeting the
health needs of their individual populations, and that includes
capital allocation. The 2021 spending review set aside £12
billion in capital funding, and since 2016 over £160 million has
been invested in radiotherapy equipment, but of course I want to
see more investment in this important technology and the
necessary upgrades across England. I very much look forward to
our meeting, where we can discuss that further.
Paediatric Cancer Strategy for London
(Wimbledon) (Con)
11. What recent progress NHS England has made on implementing its
paediatric cancer strategy for London. (906554)
The Minister for Health and Secondary Care ()
Following Professor Sir Mike Richards’s review, it is now a
national requirement for all paediatric cancer services to be
co-located with a children’s intensive care unit. The current
principal treatment centre for south London and the south-east
does not meet those requirements. NHS England has launched a
reconfiguration process to identify a new location, which
includes a public consultation. The future centre will achieve
world class outcomes for children with cancer. I would be very
happy to meet Members whose constituents may be affected to
discuss that further.
I am grateful to the Minister for that offer, because that would
have been part of my question.
Mr Speaker
Then you don’t need to ask it.
But in true style, Mr Speaker, I was hoping for two bites at the
cherry. [Laughter.]
In my recent discussions with the management of St George’s
Hospital, one concern about the consultation is that the
specialist paediatric cancer surgical unit based at St George’s
may be lost if the current proposal goes through. That would
potentially affect real outcomes for a number of children. Will
the Minister have a look at that and explain to me whether he is
concerned about the current scoring by the NHS?
I thank my hon. Friend for his supplementary question. While I
cannot pre-empt the outcome of the consultation, which closes on
18 December, I can assure him that there will be no sudden
changes in the way patients receive their care. Any move will of
course be carefully planned with the full involvement of current
teams, and clear information will be provided for parents and
families. NHS England will help as many experienced staff as
possible to move to the future centre, and I can reassure my hon.
Friend that that centre will build on all the strengths of the
existing service and provide the best quality of care for
patients.
Integrated Care Systems
(Ellesmere Port and Neston)
(Lab)
12. What recent assessment he has made of the effectiveness of
integrated care systems. (906555)
The Minister for Social Care ()
Integrated care systems and the organisations within them are
making real progress in understanding the health needs of their
populations, setting out their plans, developing the
infrastructure needed for collaboration, and bringing health and
social care organisations together to serve the needs of their
communities.
NHS Cheshire and Merseyside integrated care board has instructed
all NHS providers to make cuts of 5% in their services. Its
instruction is not being discussed with members of the public,
Members of Parliament or indeed anyone, and it is clear there is
no mandate for this action. Given that the Government have made
great play of the NHS having more funds than ever before, I am at
a loss to understand why the cuts are necessary, so will the
Minister intervene to ensure that they do not happen on her
watch?
NHS England determines the funding received by integrated care
systems. That follows a formula which takes into account the
needs of local populations, demographic deprivation and so on,
and ICSs are then able to direct resources as they are best
needed across those populations. Part of their value, and part of
the intention in setting them up along with the organisations
within them, lies in that ability to understand the health needs
of local populations and direct resources accordingly.
(Ynys Môn) (Con)
Integrated care systems bring partner organisations together to
improve health, tackle inequalities, and enhance value for money.
Detailed data such as that produced by NHS Digital is critical to
their work, but we learnt this week that A&E waiting times in
Wales had been under-reported for the last 10 years. Does the
Minister agree that without accurate data, the Labour Government
in Cardiff are scuppering the attempts of NHS Wales to deliver
better health outcomes throughout Wales?
My hon. Friend has made a good point about the importance of
transparency and accurate data. As she said, just this week we
learnt that Labour-run NHS Wales had been under-reporting its
A&E waiting times. According to the Royal College of
Emergency Medicine, about 45,000 patients are missing from the
data. While we are working hard to improve services in the NHS in
England, the Labour-run NHS in Wales is merely fudging the
figures.
Mr Speaker
I call the shadow Minister.
(Denton and Reddish)
(Lab)
The whole purpose of integrated care systems is to join up social
care and NHS services in a better way. We know, for example, that
fracture liaison services keep 100,000 people out of hospital,
but only 50% of English NHS trusts have them, and despite the
commitment given by the Under-Secretary of State for Health and
Social Care—the hon. Member for Lewes (Maria Caulfield—to
providing more, nothing has happened, and Lord Evans has walked
back from her commitment. I realise that I am pushing at an open
door in directing this question to a Minister whose leg is
strapped up, but when will the Government finally deliver for the
“back better bones” campaign to help older people to survive and
thrive?
As the hon. Member has mentioned, I have a broken ankle, and I am
taking my responsibility as Minister with oversight of urgent and
emergency care very seriously in making use of several of those
services. As for my oversight of integrated care systems, what I
am seeing is that they are making a very good job of enabling the
integration of services. For instance, we are seeing real success
in the growth of virtual wards—or “hospital at home”—which bring
together acute and community services to look after people in
their homes and help them to be discharged earlier. The NHS has
achieved its target of having 10,000 “hospital at home” places
ready for this winter.
Access to Primary Care
(Slough) (Lab)
13. What steps he is taking to improve access to primary care
services. (906556)
(Aylesbury) (Con)
21. What steps he is taking to improve access to primary care
services. (906565)
The Secretary of State for Health and Social Care ()
Our primary care recovery plan supports GP practices in
addressing the 8 am rush for appointments, cutting bureaucracy
for GPs and expanding community pharmacy services. We have
recruited over 31,000 additional primary care staff and have over
2,000 more doctors working in general practice, compared with
before the pandemic.
Mr Dhesi
People are finding it nigh-on impossible to see their GP when
they need to. Labour has pledged to guarantee face-to-face
appointments when people want them by training more NHS GPs but,
as my constituents point out to me, under the Tories, a two-tier
healthcare system is emerging where some are forced to pay to be
seen quicker while those that cannot afford it are left behind in
agony. Why have the Conservatives broken their promise, made in
2019, to deliver 6,000 more GPs, and when will this GP crisis
finally be resolved?
There is a two-tier approach within the UK, between what is going
on with the NHS in Wales and what is going on in England. We have
more appointments, more staff—over 2,000 more doctors and over
31,000 additional roles—and more tech, with £240 million invested
in delivering the digital telephony and the online booking system
so that we can get patients to the right level of care with an
appointment as part of our commitment to 50 million more
appointments in primary care.
In my constituency of Aylesbury we have some absolutely fantastic
GPs and some brilliant services being delivered, thanks in part
to many of the policies that have been introduced under this
Government. I thank my right hon. Friend for continuing with
that. However, there are still challenges for constituents to get
through to their GP surgery to make an appointment in the first
place. He has just mentioned digital telephony. Could he update
the House on the progress that is being made on rolling out this
technology to health centres to end the incredibly frustrating
waits that people have, sometimes being on hold on the phone for
hours at a time?
Through that £240 million, we have 100% adoption from GP
practices that want to take part in receiving those funds and
putting digital telephony in place if they have not already done
so. This includes call-back, which allows people to know where
they are in the queue, and links to online booking, which allows
us to maximise the 31,000 additional roles that we have put into
primary care so that people can see the specialist that they
need. In my hon. Friend’s own integrated care board, appointments
for July increased from 768,000 last July to 816,000 this July,
so more patients are being seen, more appointments are taking
place and more tech investment is going into the practices in his
area.
Mr Speaker
I call the shadow Secretary of State.
(Ilford North) (Lab)
To listen to the Secretary of State, you would think it was all
going so well, so let me give him a reality check. In Tamworth
last year, only a third of patients said it was easy to get
through to their doctor on the phone, one in three GP
appointments were not conducted face to face and fewer than half
of patients were offered a choice of appointment. The Government
are not listening to the people of Tamworth. Perhaps the
Secretary of State would like to explain to the people of
Tamworth why, after 13 years of Conservative Government, this is
the case, and better still, adopt Labour’s plan to cut red tape,
incentivise continuity of care and bring back the family
doctor.
I am glad that the hon. Gentleman raised GPs in Tamworth. The GP
lead for the Doctors Association said that his plans for general
practice filled them with despair, and his proposal for GP
nationalisation was mocked by the Nuffield Trust, one of the
respected think-tanks. The reality is that this Government are
investing in more tech in primary care, have recruited 31,000
additional roles into primary care and have over 2,000 more
doctors working in primary care than before the pandemic. Those
are the facts. His plans have been mocked by respected
think-tanks because he talks a good game on reform but we know
that he will never stand up to the trade unions.
New Health Centre: Thornbury
(Thornbury and Yate) (Con)
14. What steps his Department is taking to provide a new health
centre in Thornbury. (906557)
The Minister for Health and Secondary Care ()
I am aware of the project to provide a new health centre in
Thornbury and, of course, my hon. Friend’s tireless work to
champion it. My officials are working closely with colleagues in
NHS England and the integrated care board to help progress the
scheme. I understand that he met earlier today to discuss
imminent funding for the development of the business case, and we
will be in touch in the coming days.
I am grateful to Ministers for taking the time to meet me this
morning to discuss the £40 million bid for a new health centre in
Thornbury, which is a growing town that desperately needs this
new facility. The health centre will provide more GP
appointments, more mental health support and, crucially, more
out-patient services. Can the Minister update me on the
timescales for the announcement on funding for Thornbury health
centre so we can get this crucial facility open as quickly as
possible?
My hon. Friend makes a powerful case, and I know how passionate
and determined he is to deliver the new Thornbury health centre.
I can assure him that my officials will continue to work closely
with him, with the integrated care board and with the NHS to
progress the scheme. We will be in contact in the coming days,
following the meeting he had earlier today with .
NHS Dentistry
(Fylde) (Con)
15. What recent steps his Department has taken to increase the
availability of NHS dentistry services. (906558)
The Parliamentary Under-Secretary of State for Health and Social
Care (Neil O’Brien)
We are making NHS work more attractive to dentists. We have
started to reform the contracts and create more UDA bands. We
have introduced the minimum UDA value to help sustain practices
where values are lower, and we are allowing dentists to deliver
110% of their UDAs. We are also reforming the rules to empower
both clinicians and commissioners, for example by enabling
therapists to start delivering medicines such as anaesthetics. We
are rebasing contract values where they are underperforming, and
we are growing the workforce with a record commitment to grow the
number of dentists in training by 40%—a commitment never made by
the Opposition.
UDA rates, the sum paid to NHS dentists for each unit of dental
work undertaken, have long been deemed insufficient. Being based
on figures from 2005, there are huge differences in rates between
practices, with some receiving less than the NHS charges patients
for the service. A recent 5% uplift was based on the Government
estimate of a 3% rise in costs, a figure that local dentists tell
me is more like 10% to 15%, compounding the losses that NHS
dentists are already making. What steps is my hon. Friend taking
to reform the UDA system and to stop the flow of dentists leaving
the NHS?
Neil O’Brien
That is exactly why we have started to reform the UDA system. As
well as the introduction of the first ever minimum UDA rate,
which will help constituencies such as my hon. Friend’s, we have
changed the rules nationally so that commissioners can take UDAs
away from dentists who are underperforming and give them to those
who want to do more NHS work. As a result, nearly a quarter more
NHS dentistry is being done than a year ago.
NHS Dentistry: South-west England
(West Dorset) (Con)
16. What steps he is taking to increase access to NHS dentistry
services in the south-west. (906560)
The Parliamentary Under-Secretary of State for Health and Social
Care (Neil O’Brien)
In addition to the steps we are taking to drive up NHS dentistry
everywhere, we are going further in the south-west, with NHSE
commissioning additional urgent appointments. There are several
hundred extra appointments every week.
I thank my hon. Friend for his answer. It is not sustainable for
the people of West Dorset who have needed dental care for some
time when there is a £400 million national underspend in the
dental care budget. The NHS and local dentists tell me that the
incompatibility often relates to the national dental care
contract, which is up for review. When does the Minister expect a
solution to be found to this contract difficulty? Will he meet me
and the NHS Dorset ICB to discuss the matter in detail to find a
solution?
Neil O’Brien
Absolutely. I am keen to continue the conversation with my hon.
Friend. These issues are exactly why, this summer, we legislated
to allow rebasing and to end the inflexibility he describes. We
are also in the process of ringfencing local dental budgets,
because we do not want to see underspends. We want to see that
money going to NHS dentistry.
Cancer Treatment Waiting Times
Mrs (Birmingham, Erdington)
(Lab)
17. What steps he is taking to improve waiting times for cancer
treatment. (906561)
(Manchester, Withington)
(Lab)
20. What steps he is taking to improve waiting times for cancer
treatment. (906564)
The Minister for Health and Secondary Care ()
Improving cancer treatment waiting times is a top priority for
this Government, and it is a key focus of our elective recovery
plan, backed by an additional £8 billion in revenue funding
across the spending review period. In August 2023, cancer
treatment activity for first treatments stood at 105% of
pre-pandemic levels on a per working day basis, and the 62-day
backlog has fallen 30% since its peak in the pandemic.
Mrs Hamilton
Pancreatic cancer is the deadliest type of common cancer, killing
more than half of those diagnosed in England within three months.
I know the pain of losing close friends and family to pancreatic
cancer and how important it is that people are diagnosed and
treated quickly. Under this Government we have seen NHS waiting
lists go up, not down. What is the Minister doing to ensure that
people with pancreatic cancer are seen, diagnosed and treated
quickly?
I thank the hon. Lady for her question, and, of course, I
recognise the importance of early diagnosis and treatment. Cancer
checks are up by a quarter on pre-pandemic levels, and in August
more than 91% of patients started their first cancer treatment
within a month of a decision to treat. We have opened 123
additional community diagnostic centres and an additional 94
surgical hubs, but I accept, of course, that there is much more
that we need to do.
The Minister has again been referring to “pre-pandemic levels”.
Ministers have a tendency to blame covid for increased waiting
times, including in respect of cancer. I presume they are aware
that the number of cancer patients not getting care on time rose
in every year since the Conservatives came to power before the
pandemic. How can the Government defend that dreadful record?
We are continuing to support NHS England in increasing cancer
treatment capacity. As I say, I recognise the importance of early
diagnosis and treatment of cancer. NHS England has instructed
integrated care boards to increase and prioritise the diagnostic
and treatment capacity for cancer. As of the middle of this year,
we have 93 additional surgical hubs that are currently
operational and 123 additional community diagnostic centres,
which have delivered more than 5 million additional tests since
July 2021, but we know and recognise that we need to do more.
(Sleaford and North
Hykeham) (Con)
Members will know from my entry in the Register of Members’
Financial Interests that I am an NHS consultant and a member of
the British Medical Association. I congratulate the Minister on
the work he is doing to reduce waiting lists, but BMA strikes
have led to the loss of more than 1 million appointments, have
delayed the reporting of scans, including scans for cancer, and
have disrupted people’s chronic long-term condition treatment.
What is he doing to ensure that there are no further strikes?
What talks is he having on minimum service levels to expand the
provision if further strikes do take place?
I thank my hon. Friend for her question, which is better directed
at the BMA. However, she is right to suggest that we are taking
action on minimum service level legislation. We recognise that
industrial action means that services are under increased
pressure, with appointments and treatments being cancelled
because of the strikes. The NHS is taking action, prioritising
urgent and cancer care, and will of course continue to do so. It
will do its best to maintain appointments and elective
procedures, wherever possible, but she is right to say that these
strikes and the actions of the BMA are having a devastating
impact on patients.
(Meriden) (Con)
My constituent Elaine Lynch was diagnosed with stage 4 lung
cancer in September 2021. The drug she needs, Enhertu, is
available free on the NHS to treat breast cancer, but not lung
cancer, so it is costing my constituent £10,000 a month to get
the treatment, without which she will die. The public petition on
this matter has received more than 200,000 signatures, so it is
very much in the public interest. As the company Daiichi Sankyo
does not offer the drug on compassionate grounds, will the
Minister meet me to see how we can make this drug available for
Elaine as soon as possible, because this is literally a matter of
life or death?
I have huge sympathy and empathy with the case that my hon.
Friend raises. The National Institute for Health and Care
Excellence is rightly independent, and strict and robust
processes are in place on drug repurposing and clinical trials.
Nevertheless, I would of course be happy to meet him to see what
can be done.
Topical Questions
(Newcastle-under-Lyme)
(Con)
T1. If he will make a statement on his departmental
responsibilities.(906584)
The Secretary of State for Health and Social Care ()
First, may I welcome Opposition Front-Bench Members to their new
roles, as there have been changes since we last met? Since then,
we have launched a new £30 million fund to speed up the adoption
of tech across the NHS. Even when local pilots prove their
effectiveness, it often takes too long for those innovations to
be rolled out nationally. This fund can change that, giving
integrated care systems across England the chance to invest in
tech that is proven to improve care, for instance in detecting
cancer sooner. These investments will be made this financial
year, getting patients care faster. We are also making more than
200 more medical school places available for universities from
next September, accelerating a commitment that we made in the NHS
long-term workforce plan and delivering more doctors to areas
that need them most.
This Government are listening to patient voices too, particularly
on the importance of biological sex in healthcare. That is why,
following a consultation later this year, we will amend the NHS
constitution to make sure that we respect the privacy, dignity
and safety of all patients. The Prime Minister has also unveiled
plans to introduce a new law to prevent children who turn 14 this
year from ever legally being sold cigarettes, creating the first
smokefree generation. Last week, my Department launched an
expedited consultation to crack down on youth vaping.
I thank the Secretary of State for his statement, particularly
what he said about tech. On dental provision, I recently met with
Dr Khan of Westbury Park dental practice in my constituency to
discuss access to NHS dentistry, which is becoming more difficult
for many of my constituents. I welcome the plans we have to
increase the number of dentists and I reiterate my support for a
dental school at Keele University, but those plans will take
time. In the short term, there is a huge backlog of overseas
clinicians waiting to take the registration exam so that they can
practise here. What steps is the Secretary of State taking to
expedite this?
He is right that we are taking both long-term and short-term
actions. A key part of the long-term workforce plan is to boost
the number of dentists being trained. In the more immediate term,
earlier this year we made legislative changes that give the
General Dental Council the flexibility to improve the way
professionals are registered, giving more flexibility in terms of
the skills mix and, for example, tripling the number of people
sitting part 1 this year, so that more overseas professionals can
be recognised and qualified to practise in the UK.
Mr Speaker
I call the shadow Secretary of State.
(Ilford North) (Lab)
In Mid Bedfordshire last year, 165 children—[Interruption.] I do
not know why Government Members are laughing; perhaps they should
listen, as it is not our party that has let down the people of
Mid Bedfordshire. Last year, 165 children in Mid Bedfordshire had
teeth removed due to tooth decay. Some 800 patients were forced
into A&E for the same reason and 100,000 people across the
region cannot get access to an NHS dentist. Instead of laughing,
the Government might like to adopt Labour’s plan to provide
700,000 extra dentistry appointments every year.
Since 2010, we have had 6.5% more dentists, a quarter more
appointments and, as we have just touched on, increasing
flexibility in regulation and boosting overseas recruitment. It
is striking that one area of the country that the shadow
Secretary of State does not want to talk about is Wales, which
has a record of what a Labour Government will deliver. Indeed,
the Leader of the Opposition says that he wants Wales to be the
“blueprint” for what the NHS would be in England. There, this
week, we have seen a fiddling of the figures on health. Even
without that fiddling, we know people are twice as likely to be
on a waiting list in Wales as in England—
Mr Speaker
Order. One of us has got to sit down and it is not going to be
me. I let you have a good crack at the beginning, Secretary of
State. Your opening statement took quite a long time, which I do
not mind. I do not mind your having a go about Wales, but I am
certainly not going to open up a debate between the Government
and Opposition Front Benches. Topical questions are for Back
Benchers and about short questions with short answers. I want it
to be kept that way, so please understand that. There must be too
many by-elections, because Members are getting carried away.
It is not just Mid Bedfordshire. Across the country, the No.1
reason children aged six to 10 are admitted to hospital is tooth
decay. Given that, will the Secretary of State at least adopt the
modest measure that Labour has proposed to introduce national
supervised tooth brushing for small children—low cost, high
impact—to keep their teeth clean and keep children out of
hospital?
We are reforming the NHS workforce more fundamentally, looking at
how we expand the roles that dental hygienists and dental
therapists can perform. We are looking at how we can boost
training, which is why we have made the commitment for more
dentists in the long-term workforce plan, backed by £2.4 billion.
How does that help? It increases the number of dentists being
trained and we have a quarter more activity compared with last
year.
Philip Dunne (Ludlow) (Con)
T2. Can the Minister confirm that the £312 million capital
investment to transform the Shrewsbury and Telford Hospital NHS
Trust acute hospitals is on track through the NHS approval
process, with its outline business case, to enable a full
business case to be concluded in the coming months so that
construction can commence during this financial year?(906585)
The Minister for Health and Secondary Care ()
My right hon. Friend has long championed this cause. I hope it is
good news that I am able to confirm that enabling works have
recently been approved for the Shrewsbury and Telford Hospital
NHS Trust hospital transformation programme and are expected to
commence this financial year. I can also confirm that funding has
been provided for the development of the full business case and
is expected to be submitted in the coming months.
Mr Speaker
I call the SNP spokesperson.
(East Dunbartonshire)
(SNP)
New research by UNICEF UK has made clear how badly the cost of
living crisis has hit the mental health of families with young
children. Rising prices and services gutted by austerity have
left 60% of parents feeling overwhelmed, anxious, unsupported and
lonely all or most of the time. What representations has the
Secretary of State made to his Cabinet colleagues ahead of the
upcoming autumn statement to support families and to improve
health outcomes?
That shows just how divorced the SNP line of questioning is from
the reality of funding. The funding for mental health is £2.3
billion more this year than it was four years ago. We are funding
160 mental health crisis cafés and we have a programme of mental
health support teams being rolled out in our schools, all of
which is subject to Barnett consequentials on which the Scottish
Government receive money. This Government are committed to
investing in mental health. That is what we are doing. The
question for the Scottish Government is why they are not getting
the same results that we are.
(Stourbridge) (Con)
T3. Most supermarkets practise
place-based and price promotions mainly on ultra processed
food—food that plays a key part in feeding the obesity crisis.
How can the Government best ensure that supermarkets promote
affordable, unprocessed and sustainable foods, not foods high in
fat, sugar and salt, and, importantly how can we ensure
that supermarkets comply
with the regulations?(906586)
The Parliamentary Under-Secretary of State for Health and Social
Care (Neil O'Brien)
We have already brought in restrictions on the places that
unhealthy food can be sold to stop pester power. That is on top
of other measures that we are taking on obesity such as the sugar
tax, calorie labelling, the extra money for school sport, and the
extra facilities for young people. It is a serious issue and one
on which we are taking urgent action.
(Norwich South) (Lab)
I was going to ask a question about the shocking statistic of
85,000 people on the waiting list at Norfolk and Norwich
University Hospital, but so poor was the Secretary of State’s
response to the question of my hon. Friend the Member for Ilford
North () about the dental desert that I will tell him a
quick story. Ukrainian refugees who come to my constituency are
travelling back to war-torn Ukraine to have their teeth seen to
because there is a better dental service there than in Norfolk
and Norwich. What does he have to say to that?
As I have said, we have 6.5% more dentists now than when we came
to power. There is also a quarter more dental activity this year
compared with last year. I understand why the hon. Gentleman does
not want to talk about the investment that we are making on the
elective programme in Norfolk, because it includes funding for
two new hospitals in Norfolk through our new hospitals programme
and significant funding into diagnostic capacity, with a number
of diagnostic centres being opened in Norfolk, which he does not
want to mention.
(Stockton South) (Con)
T4. My local hospital, North Tees, is tired, dated and well
beyond its life expectancy, with operating theatres too small to
meet modern requirements, so I was hugely disappointed that my
NHS trust failed even to apply for Government funding that could
have built a new state-of-the-art surgical hub on the site. Will
my hon. Friend work with me to ensure that the people of Stockton
get the healthcare facilities that they need?(906587)
We will always work with my hon. Friend and the trust on capital
improvements where needed, but I am pleased to note that the
trust has been allocated significant investment from national
programmes in recent years, which my hon. Friend fought hard for,
including £32.2 million from our community diagnostic centres
programme, which will provide vital testing to local residents
close to home, and £3 million from our A&E upgrade programme.
We will of course continue to work closely with colleagues in the
NHS and the local trust to continue delivering for the people of
Stockton.
(York Central)
(Lab/Co-op)
Ten years on from the Francis report, the National Guardian’s
Office—for freedom to speak up—reports that last year there were
937 cases where whistleblowers were not listened to and
experienced detriment. If we add that to 170,000 complaints, with
30,000 reaching the Parliamentary and Health Service Ombudsman,
we can see that the complaints system across the NHS is defensive
and dangerous. Will the Secretary of State review the NHS
complaints system, and embed a listening and learning culture and
early intervention?
I discussed this with Henrietta Hughes, the patient safety
champion, just yesterday as part of the sprint that we have
commissioned in the Department in response to Martha’s rule. We
are doing considerable work with NHSE colleagues on how we better
respond to the concerns of patients, whether it is through the
work on Martha’s rule or the complaints process, and a
significant amount of work is ongoing as part of that.
(Kettering) (Con)
T5. The Secretary of State has seen for himself the dilapidated
steam generators at Kettering General Hospital. The new £34
million net zero energy plant designed to replace them faces
challenges from rising costs and new design requirements. Will he
ensure that the final business case approval process for this new
power plant is completed as soon as possible, so that spades can
hit the ground on time in spring 2024?(906588)
Yes I will. I pay tribute to my hon. Friend for the way he has
championed this issue. I have visited the hospital; I have seen
it for myself. As he will be aware, the full business case was
received by the Department this morning. While the cost has
increased, it is still within the wider funding envelope for the
scheme on that site and I will do everything I can to expedite
the process as he asks.
(Liverpool, Wavertree)
(Lab)
In recent months, there was a concerted campaign from the public
to prevent the closure of Park View Medical Centre in Liverpool,
which was subsequently closed by the Merseyside and Cheshire
integrated care board. Not long after the conclusion of the
campaign, during which members of the public were turning up to
board meetings, the ICB announced that 50% of its meetings would
now be held exclusively in private. I for one do not believe that
that is a coincidence. What would the Secretary of State’s advice
be to Merseyside and Cheshire ICB on transparency and
accountability, and is it not time we looked at strengthening the
guidance?
The hon. Lady raises an important point. I was not aware of that
decision by the local ICB. As a principle, I think we can agree
across the House that greater transparency on such meetings is
important, so I will follow up on that. The Government are making
significant investment into Merseyside; both Alder Hey Children’s
Hospital and the Royal Liverpool University Hospital have been
rebuilt at significant cost as part of this Government’s
commitment to investing in the NHS estate in that area.
(West Dorset) (Con)
T6. Will the Secretary of State join me in thanking the outgoing
chief executive of the South Western Ambulance Service, Will
Warrender? He came to join the service in the middle of covid,
during very difficult times, and did a lot of work to help, and
that comes after his 32 years of public service in the Royal
Navy.(906589)
I am happy to join my hon. Friend; indeed, I am sure the whole
House is happy to pay tribute to the exemplary public service Mr
Warrender has provided, both in the Royal Navy and with the
ambulance trust, and to wish him a very happy retirement.
(St Albans) (LD)
Immunocompromised patients are facing their fourth winter without
adequate protection from covid, despite a new study showing that
they now comprise approximately 25% of all covid
hospitalisations, intensive care unit admissions and deaths. In
the last few days, some hospitals have been giving guidance to
their staff that they should not even test for covid unless they
are working on specific wards. After three and a half years, what
are the Government going to do to put an end to this appalling
situation, where some of the most clinically vulnerable patients
are scared of accessing the healthcare they need for fear it
could literally be a death sentence?
During the pandemic, as the hon. Lady knows, the Government
prioritised the clinically extremely vulnerable and significant
investment went in there. We follow the guidance from the UK
Health Security Agency about the right level of infection
control. More widely, we need to look at what medicine is
effective. If it relates to immunosuppressants, there was a big
debate in summer 2022 about that issue and we keep the science
under active review.
(Weston-super-Mare) (Con)
T7. I thank Ministers for their earlier helpful replies about NHS
dentistry, but I am afraid the situation in Weston-super-Mare
remains extremely worrying. Local residents regularly say there
is not a single local dentist accepting new adult NHS patients,
and many practices have actively reduced NHS work since the
pandemic. I have pushed both NHS England and the local integrated
care board, but all we have so far are PowerPoint presentations
rather than bookable appointments. What hope can the Secretary of
State offer to Westonians who have paid their taxes, but are not
getting any NHS dentistry in exchange?(906590)
Neil O’Brien
My hon. Friend is right. The amount of NHS dentistry being
delivered in his ICB has gone up in the last year, but we want to
go further. The NHS has recently commissioned additional
children’s orthodontic capacity within his ICB, but through the
actions we are going to take, we will go further.
Mr Speaker
I call with the final
question.
(Bradford South) (Lab)
Having 100% fracture liaison services coverage in England would
prevent an estimated 74,000 fractures, including 31,000 hip
fractures, over five years. Will the Minister finally commit to
100% FLS coverage across England?
In the interests of brevity, I will actively look at that issue
and write to the hon. Lady about it.
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