Alcohol-dependent Parents: Support for Children
(Hyndburn) (Con)
1. What steps she is taking with Cabinet colleagues to support
the children of alcohol-dependent parents. (901098)
The Secretary of State for Health and Social Care ()
May I start by wishing the hon. Member for Ilford North () a speedy recovery?
We are taking a wide-ranging approach to alcohol harms. Some £27
million has been invested in specialist alcohol care teams in a
quarter of hospitals with the highest need, and we have published
the first ever UK-wide clinical guidelines on harmful drinking
and alcohol dependence, as well as providing around £300 million
in funding to 75 local authorities through the family hubs and
Start for Life programme. Family hubs funded through that
programme are encouraged to provide full wrap-around support for
families, which may include alcohol support services.
To the Government’s credit, they are currently putting money into
addiction services. However, at the same time, there is no
national strategy for children of alcohol-dependent parents. That
has not always been the case. Between 2017 and 2021, there were
local and national helpline services funded through a national
strategy. Will the Secretary of State meet me to discuss this
matter, as the children in these awful situations are some of the
most vulnerable in society?
May I thank my hon. Friend for her care and also for sharing her
experiences on this subject? Through the drugs strategy, we have
committed an extra £532 million of funding over three years to
improve alcohol and drug treatment services, with £15.7 million
invested in Lancashire. Last year, we saw a further £2.8 million
invested nationally in line with guidance for the extra drugs
strategy funding, which allows local authorities to fund targeted
services for parents in need of treatment and support for their
children and families. I will, of course, be happy to meet my
hon. Friend to discuss this further.
(Huddersfield)
(Lab/Co-op)
rose—
Mr Speaker
, briefly—[Laughter.]
Mr Sheerman
I have turned over a new leaf, Mr Speaker.
May I urge the Secretary of State to take this issue very
seriously, to direct much more social media at young people and
to get into schools the message about the real damage that can be
done to the entire life of a child if the mother is drinking
alcohol during pregnancy?
I thank the hon. Gentleman for bringing some insight into how we
can best reach families. Of course, it is not just mums, but
fathers or carers who can have a huge impact on our children.
That is why the Under-Secretary of State for Health and Social
Care, my right hon. Friend the Member for South Northamptonshire
(Dame ), is investing so much
energy and commitment in our family hubs. We believe that they
can be the centre for families to make the very best start to a
child’s life.
Hospital Discharge: Social Care
(Chesham and Amersham) (LD)
2. What recent progress her Department has made on supporting the
timely discharge of patients from hospital into social care.
(901099)
The Minister for Social Care ()
Discharging people on time is better for them and frees up
hospital beds. We are changing how our health system works to do
that: joining up health and social care and care transfer hubs;
helping people to recover at home, with more than 10,000 new
virtual ward beds; and investing in social care. And it is
working. Last month, delayed discharges were down 9% compared
with the end of December 2022 despite almost 1,000 extra urgent
admissions to hospitals every day in December.
Nearly one in six beds in my local healthcare trust in
Buckinghamshire continues to be occupied by patients fit for
discharge. A recent King’s Fund report found that the
Government’s current practice of providing one-off funding to
reduce delay, while welcome, comes with insufficient advance
notice to allow for effective planning. What steps is the
Minister’s Department taking to ensure the best use of this
funding?
One reason we distributed discharge funding back in April last
year was to give more advance notice to organisations, so that
they could put in place what is needed to speed up discharges. I
say to the hon. Lady that our plan is working. That is why, in
her own trust, discharges at the end of December were down by a
third compared with the previous year.
(Colchester) (Con)
I note the progress that my hon. Friend referenced, but delayed
discharges are still a major issue. Patient flow through a
hospital is a critical factor, especially at the front door
through emergency departments. We know the role that electronic
bed management systems can play in helping that flow. What steps
is my hon. Friend taking to ensure that more hospitals roll out
that technology?
My hon. Friend is right. I know how much work he did when he had
oversight of urgent and emergency care services, which included
his contribution to our urgent and emergency care recovery plan
that was published almost a year ago. That plan included a host
of steps to improve the flow through hospitals, including
investment in bed management systems, as he described. The plan
is working, which is why we are improving the flow through
hospitals and seeing reductions in delayed discharges.
Nurses from Overseas
Mr (Delyn) (Ind)
3. What steps she is taking to increase the recruitment of
qualified nurses from overseas. (901100)
The Minister for Health and Secondary Care ()
NHS data shows that we have delivered early on our manifesto
commitment to have an extra 50,000 NHS nurses, with the number of
nurses working in our NHS increasing from around 301,000 in 2019
to 357,000 today. That has been achieved through boosting
training and education routes, ethically recruiting
internationally and taking actions to improve retention. Measures
such as the health and care visa introduced in 2020 support
international recruitment.
Mr Roberts
I thank the Minister for his answer. As he knows, the national
health service would completely collapse without the input and
expertise of clinical staff from around the world. One barrier to
those people coming to help us are the high fees for applying for
permanent residency. Some nurses from countries such as India and
the Philippines are having to take out expensive loans just to
feel like they are welcome and able to stay in our country. I
have presented a private Member’s Bill to exempt NHS clinical
staff from paying those high fees to become residents. Will the
Minister support the Bill and work with his Home Office
colleagues to find a way to make that a reality for those people
who work so hard in our health service?
I join my hon. Friend in paying tribute to the enormous
contribution made by internationally recruited staff to our NHS.
As he will know, immigration policy and fees are a matter for my
right hon. Friend the Home Secretary. However, our long-term
workforce plan supports international recruitment. In addition to
the new visa route, we are exempting health and care staff from
the immigration health surcharge.
(Vauxhall)
(Lab/Co-op)
The Minister will know that without our fantastic workforce, the
NHS would not work. I pay tribute to all those hard-working
nurses in all our hospitals and care centres, including at St
Thomas’ Hospital in my constituency. Does the Minister recognise
that in addition to recruiting staff we have to look at retaining
staff, who talk about the workload, their mental wellbeing and
the fact that the cost of living is having a big impact on them?
Does the Minister agree that the Government need to come forward
with a wide-ranging plan on addressing workforce planning, pay,
training, staff wellbeing and retention?
I completely agree with the hon. Lady, which is why this
Government became the first Government ever to introduce a
long-term workforce plan. Retention is one of the key pillars of
the long-term workforce plan, and we are already seeing that
deliver the result of keeping more staff in our NHS.
Accessibility to Dental Services
(Oxford West and Abingdon)
(LD)
4. If she will make an assessment of the potential impact of the
level of accessibility to dental appointments on urgent dental
and oral surgery services. (901101)
(Clacton) (Con)
7. What recent steps she has taken to increase capacity in NHS
dental care. (901106)
(York Central)
(Lab/Co-op)
18. What progress she has made on introducing a dentistry
recovery plan. (901117)
The Parliamentary Under-Secretary of State for Health and Social
Care (Dame )
I am determined to ensure that everybody who needs NHS dental
care can receive it. We have already implemented a package of
reforms to improve access and provide fairer remuneration for
dentists. That has had an effect, with 1.7 million more adults
being seen, 800,000 more children being seen and a 23% increase
in NHS activity in the past year. We know we need to do much
more, and our dentistry recovery plan will be published shortly,
setting out a big package of change.
I listened carefully to what the Minister said. That change has
not come to Oxfordshire, for sure—it is in a dire state. An
Oxford resident wrote to me saying that when his NHS practice
closed, he rang a dozen others across the county. Each one said
they were offering NHS services but, in fact, they were not; they
were only offering private care. In this cost of living crisis,
people simply cannot afford that. As a result, they are waiting
in A&E rather than getting treatment, and that ends up in
their having oral surgery. What is the Minister doing now to
improve the situation in Oxfordshire and across the country?
Dame
I am incredibly sympathetic to what the hon. Lady says. In fact,
in Buckinghamshire, Oxfordshire and Berkshire West integrated
care board, the number of adults seen by an NHS dentist rose in
the 24 months to June 2023 from 448,000 to 485,000, with a
similar increase in the percentage of children seen. The
situation is improving, but I completely agree with her that we
need to do more, and we will be coming forward shortly with a big
package of dental recovery plan reforms.
I thank my right hon. Friend for her answer. Following my very
productive meeting with her only a few days ago, will she confirm
that NHS England locally has finally been unblocked and that my
constituents in Clacton will soon benefit from more dentists
practising on NHS patients?
Dame
As my hon. Friend will know, this is a local matter, and it is
for his ICB to determine whether it wishes to support the
excellent pilot proposal for overseas dental students in Clacton.
At the same time, it needs to ensure that its actions are
compliant with current legislation and within the delegation
agreement with NHS England. I have just written to my hon. Friend
about that, and my letter should address his concerns, but of
course I would be happy to see him again if he has any further
questions.
We were promised “before the summer”, we were promised “after the
summer”, we were promised “before Christmas”, we were promised
“soon” and now we have been promised “shortly”. The reality is
that Labour has a plan and the Government have not. In York, we
cannot get an NHS dentist either. Blossom Family Dental Care is
just handing back its contract. My constituents have nowhere to
go. What is the Minister going to do to ensure that my
constituents can access NHS dentistry?
Dame
As I said to the hon. Member for Oxford West and Abingdon (), I absolutely understand the
challenge for some people. The situation has improved over the
last year. Since the covid pandemic, where almost every dentist
had to stop working altogether, we have not seen the recovery we
want. We are putting in plans—not a paper ambition like the one
Labour has put forward, but significant reforms that will enable
many more people to be seen by NHS dentists. I say gently to the
hon. Member for York Central () that a recent Health
Service Journal article states that Humber and North Yorkshire
ICB
“have indicated in board papers that dentistry funding will be
squeezed to help them balance their books.”
I encourage her to talk to her ICB about that too.
(Peterborough) (Con)
For new patients, accessing an NHS dentist in Peterborough is
almost impossible. Should a new medical centre wish to establish
a new NHS dental practice, doing so would require flexibility in
units of dental activity rates and the ability to recruit
dentists from overseas. Would the Minister give that effort her
enthusiastic support and encourage NHS bosses to do the same?
Dame
My hon. Friend is pushing against an open door. He may be aware
that in 2023 we made some legislative changes to give the General
Dental Council more flexibility to expand the registration
options open to international dentists, tripling the capacity of
three sittings of the overseas registration exam from August 2023
and increasing the number of sittings for the part 2 exam in 2024
from three to four. That will create an additional 1,300 places
overall for overseas dentists aiming to work in the UK. We will
also be bringing forward measures to enable dental therapists to
work at the top of their training, which will expand the
capacity. He is right that reform of the UDA is also required and
we will be bringing forward our plans shortly.
Mr Speaker
I call the shadow Minister.
(Birmingham, Edgbaston)
(Lab/Co-op)
I want to share with Ministers the experience of Emma from
Grimsby, who said:
“NHS dentistry is a joke in the town at the moment. Thankfully I
managed to get an emergency appointment in Scunthorpe (after
being offered one in Doncaster originally) and I’ve now been
referred to hospital to have 3 wisdom teeth removed. My dentist
closed at the onset of the pandemic and I’ve not been able to
register with an NHS dentist since.”
What does the Minister have to say to Emma and the millions like
her who cannot get an appointment when they need one?
Dame
The hon. Lady is absolutely right to point that out. Emma has my
absolute sympathy and apology for the fact that since the covid
pandemic we have not seen the recovery of dentistry that we would
have liked. I can tell her that in July 2022 we brought in
significant reforms to encourage dentists to take on more NHS
patients, but we recognise the need to do more. The long-term
workforce plan will increase training places and the overseas
registration will improve capacity, as will the changes to dental
therapists’ programmes. All those things will improve the
situation, but in the meantime we will be bringing forward our
recovery plan very soon, which will immediately expand the
incentives to NHS dentists.
NHS: Winter Pressures
(Wakefield)
(Lab/Co-op)
5. What steps her Department is taking to help reduce pressure on
NHS services in winter 2023-24. (901103)
The Secretary of State for Health and Social Care ()
Our plan includes opening 5,000 more beds, increasing ambulance
capacity, expanding innovative services such as virtual wards and
bringing forward covid and flu vaccinations for the most
vulnerable. Thanks to the hard work of staff, NHS performance
this winter has improved on last year, despite the impact of
industrial action.
I am sure the caveat to that was the word “shortly”. I have had
constituents contact me in desperation regarding delays at
Pinderfields Hospital in my constituency. They tell me they have
waited hours in emergency care this winter for routine blood
tests—literally all day in some cases—even while in extremely
poor health. The Tories’ patchwork reforms and sticking-plaster
politics are not fooling anyone. Does the Secretary of State not
think that those dangerously long waiting times are a damning
indictment of 14 years of Conservative mismanagement? What does
she say to my constituents who are suffering right now?
I am sure that the hon. Gentleman is a fair man, and that, being
so, he will point out to his constituents, when they call him
with their issues, that ambulance response times for category 2
emergency incidents in his local area have in fact been over 30
minutes faster than last year. However, we accept of course that
this is a two-year plan and will take time to meet our full
ambitions. Interestingly, the latest figures show that we have
provided £6.9 million from the community diagnostic centres fund
for the development of a community diagnostic centre at
Wakefield. Presumably he welcomes that Conservative
innovation.
Mr Speaker
I call the Chair of the Health and Social Care Committee.
(Winchester) (Con)
The pressure on services is acute this winter, as it is every
year. So far, we have heard very little mention in these 20
minutes of the biggest headache facing trusts, integrated care
boards, patients and, of course, the Prime Minister’s pledge to
cut the waiting lists further. Given that the British Medical
Association ballot on consultants’ action closes today, and that
the dispute among doctors in training continues, can the
Secretary of State update the House on her message to those
voting today, and on where we are in wider industrial disputes,
which are a drag anchor on the NHS right now?
My hon. Friend is right to point out that we are in the final few
hours of the consultants’ ballot on the pay reform programme that
we have offered the British Medical Association. I very much hope
that consultants will feel able to support that programme,
because it is about bringing together the frankly quite
bureaucratic system that they have to deal with at the moment, so
that they are assessed in a shorter time with less bother and
paperwork, while respecting their need to train and keep up their
education and supporting professional activities commitments. I
hope that they will agree with us on that. As I have said to the
junior doctors committee from this Dispatch Box, should they
return with reasonable expectations, we will, of course, reopen
negotiations.
Mr Speaker
I call the shadow Minister.
(Bristol South) (Lab)
The Secretary of State has said that preparation for winter
started last January, but 54% of A&E departments were still
rated inadequate or needing improvement in December, exacerbating
the winter crisis. What will she do differently this year to
ensure that we do not have another winter crisis in 2024-25?
Again, the plan that we laid out last year is having a real
impact at local level on the services being deployed through our
accident and emergency services. We have seen discharge rates
improving, for example. We appreciate that there can be local
differences, but the importance that we put on maintaining that
flow through hospitals is critical to ensuring that the waiting
lists and waiting times that the hon. Lady describes are reduced.
However, I gently remind the Labour party that it has been
running the NHS in Wales for some time now, and it is a great
shame that the good people of Wales—[Interruption.] The good
people of Wales are waiting longer for their
treatment—[Interruption.] They are almost twice as likely—
Mr Speaker
Order. I am a little bothered, because we have a long way to go
on the Order Paper. I call the SNP spokesperson.
(East Dunbartonshire)
(SNP)
We cannot discuss winter pressures in the NHS without
acknowledging workforce shortages. The Secretary of State is
having to contend with new immigration policies from her Cabinet
colleagues that prevent dependants from coming to the UK, meaning
that we are asking people to come and care for our loved ones
while they leave behind theirs. I imagine that she is frustrated
that that is now another barrier to recruiting staff to our
health and care sectors. Has she expressed those frustrations to
her Cabinet colleagues?
I genuinely want to work with the Scottish Government, because I
am troubled, to put it bluntly, that Scotland has some of the
worst health outcomes in western Europe. It has the worst level
of drug death rates in Europe, the highest alcohol death rates in
14 years, and there was a fall in life expectancy for three years
in a row. We offered to allow Scottish patients to receive
lifesaving operations in England, but sadly, that offer has been
declined. I remain genuinely willing to work with the Scottish
Government to help them with their health service.
Child and Adolescent Mental Health Services
(Tamworth) (Lab)
6. What steps she is taking to increase access to child and
adolescent mental health services. (901104)
The Parliamentary Under-Secretary of State for Health and Social
Care ()
We are investing an extra £2.3 billion a year to expand mental
health services in England, with the aim of enabling 2 million
more people to access mental health support, including 345,000
more children and young people.
Many constituents in Tamworth are coming to me in desperate need
of support for their children. Those constituents include Kate,
whose daughter is at crisis point and has been without a
psychiatrist since November; Roger, who has been waiting 18
months for an autism referral for his daughter; and Jess, who has
been waiting for an attention deficit hyperactivity disorder
assessment for her son. Will the Minister explain what action she
is taking so that children, parents and families in my
constituency can get the support they need?
Through the investment we are putting in, particularly in the
hon. Lady’s local area, there are a number of initiatives to help
support children and young people with their mental health. The
Sandbox scheme, which is a funded NHS service, supports those in
the south Staffordshire area; Malachi provides family support
across Tamworth and east Staffordshire; and Combined Wellbeing,
which is an online resource, covers north Staffordshire. There is
also the Family Wellbeing Service, Action for Children for those
aged five to 18 with mild to moderate mental health needs, and
the Staffordshire Emotional Health and Wellbeing Service for
those aged five to 18. I would recommend that the hon. Lady’s
constituents look up those services, because we are funding them
to improve mental health care for children in her local area.
(Mid Norfolk) (Con)
The agony and damage of undiagnosed and untreated mental health
conditions is nowhere more acute than in rural areas, where we
see an epidemic of silent suffering. The Norfolk and Suffolk NHS
Foundation Trust has long struggled with a series of management
problems. I am sure the Minister has seen the recent report
highlighting that between 2019 and 2022, we saw over 8,500
avoidable deaths—that is nearly 45 a week. Will she agree to meet
me, other Norfolk and Suffolk MPs, and those affected to look at
what is really going on here and make sure that we turn that
trust into a beacon of the best mental health services, rather
than the worst?
I thank my hon. Friend for raising this issue. We were holding
regular meetings with Norfolk and Suffolk MPs, the trust, the
Care Quality Commission and NHS England, and with the new
management team, that trust did appear to finally be turning
things around. However, I am concerned to hear the points that my
hon. Friend has raised. I am very happy to restart those meetings
and will ask my office to arrange them as quickly as
possible.
Adult Social Care
(Eltham) (Lab)
8. What steps she is taking to increase staff recruitment and
retention in the adult social care sector. (901107)
The Minister for Social Care ()
Care is a skilled profession, and I want care workers to get the
support and recognition they deserve. This month, we took the
next step in our ambitious care workforce reforms, publishing the
first ever national career structure for the care workforce
alongside our new nationally recognised care qualification.
Ambitious care workforce reforms—it is all blah, isn’t it? We
have had 14 years of Conservative Government, and we have a
crisis in every area of the NHS. Job insecurity, poor working
conditions and low pay—one in five care workers is living in
poverty—are all reasons why we have a recruitment and retention
crisis in social care. Is not the truth that that is a damning
indictment of 14 years of Conservative Government, and the only
thing that is going to sort out social care and the crisis in
recruitment and retention is a general election?
I am actually really shocked by the way the hon. Member referred
to the care workforce, with terms like “It is all blah”—very
shocking. I am determined that care workers should get the
recognition they deserve. We have a 10-year plan for social care,
and it is working: the care workforce grew by over 20,000 last
year, vacancies in social care are down, and retention is up. We
are reforming social care so that it works as a career. That is
why, as I said a moment ago—I wish the hon. Member had been
listening—we have introduced the first ever career pathway for
social care workers and a new national care qualification.
Mr Speaker
I call the shadow Minister.
(Denton and Reddish)
(Lab)
But according to Care England and Hft, 54% of social care
providers have increased their reliance on agency staff; 44% have
turned down new admissions; and 18% have had to close services
altogether. Labour’s fair pay agreements will ensure that staff
in the sector are treated with the dignity and respect that will
make them want to stay, but after 14 years, why do Ministers not
have a proper plan to address the workforce crisis facing adult
social care? Is it because it is a crisis of their making?
We have a plan for the social care workforce, and it is working.
The social care workforce increased by over 20,000 last year, and
it is still going up. But I will take no lectures from the hon.
Member. In fact, his hon. Friend the Member for Bristol South
(), early this morning on
television, made it clear that Labour does not have a plan for
social care—or if it does, it is clear that it will cost a lot of
money and is yet another unfunded Labour plan.
Men’s Health
(Bexleyheath and Crayford)
(Con)
9. What steps she is taking to help improve men’s
health.(901108)
The Parliamentary Under-Secretary of State for Health and Social
Care ()
I assure my right hon. Friend that this Government are committed
to improving men’s health. That is why, in November, we announced
a suite of measures, including a £16 million fund for a new
prostate cancer screening trial, and the recruitment of a men’s
health ambassador. We have also launched our men’s health
taskforce to tackle the biggest health issues facing men.
I thank the Minister for that answer, and I would urge her to
continue to make men’s health a top priority. In particular, can
she look at how we can detect prostate cancer better and sooner?
It is the most common cause of male cancer in the United Kingdom,
and anything that can be done to reduce that number will be most
welcome.
I thank my right hon. Friend and male colleagues on the
Government Benches, including my hon. Friend the Member for Don
Valley (), who are fighting so hard
to improve men’s health. He is absolutely right: 12,000 men a
year die from prostate cancer. That is why we are investing in
the £16 million prostate cancer trial called Transform, using
methods such as MRI to detect prostate cancer rather than PSA,
which can be inaccurate. Thousands of men will be recruited. We
are hoping that the trial will start in the spring, with
recruitment in the autumn, including the recruitment of black
men, who are disproportionately affected by prostate cancer.
(Westmorland and Lonsdale) (LD)
Does the Minister agree, however, that the information she has
just given about why screening for prostate cancer does not
happen for men is based on a study that is 20 years old? There
are 12,000 deaths a year—it is the biggest killer among men, and
the second biggest killer among all people—yet here is this evil
cancer for which there is no screening programme whatsoever. Will
she take steps to update current NHS guidance to ensure that all
those at high risk of prostate cancer receive a targeted early
detection service? I think she has hinted that she may be doing
that, but will she finally introduce mass screening for prostate
cancer? It is the only cancer without specifically commissioned
early diagnosis work, and men are dying unnecessarily because of
the failure to bring this in.
We have more than hinted: we have just announced a £16 million
pilot study of prostate cancer screening. We have a plan to
tackle those 12,000 deaths a year, and it will work, because
until now we have not had a diagnostic test. PSA is not a
sensitive test in all prostate cancers: there are many men with
prostate cancer who do not express PSA. That is why the Transform
study, using detection tools such as MRI, will be trialled, and
if they are effective, such tools will be rolled out across the
country.
Midwifery and Maternity Services
(Bristol East) (Lab)
10. What steps she is taking to increase the recruitment and
retention of NHS midwifery and maternity staff.(901109)
The Secretary of State for Health and Social Care ()
We are investing an additional £165 million a year to improve
maternity and neonatal care, rising to £186 million a year from
April. This will increase the number of midwifery posts and
improve the quality of care that mothers and babies receive. As
of October last year, there were 23,100 full-time equivalent
midwives working in NHS trusts and other core organisations in
England, which is more than 1,000 more than a year ago and 3,500
more than in 2010.
I thank the Secretary of State for that response. The Royal
College of Midwives estimates that there is a shortage of around
2,500 full-time midwives working in the NHS. I know that at first
hand from Cossham Hospital in my constituency, which has a
wonderful birth centre, but it has been closed for most of the
last few years, because it simply cannot get the midwives to
staff it—they have to go elsewhere where more serious cases need
to be dealt with. What is she doing specifically about the
retention of midwives? I know that student numbers are,
thankfully, coming up, but a lot of midwives are choosing to
leave the profession because there is not enough flexibility in
their work.
I think we all agree that a career as a midwife is just one of
the most rewarding and fulfilling careers that one can hope for.
That is why we have placed such priority on retention in the
long-term workforce plan that we launched last year. The national
retention programme for midwifery and nursing has prioritised
five actions to support staff retention, including menopause
guidance, because we know that that can be an issue for midwives,
and valuing them and their contribution is also a key objective
of NHS England’s three-year plan for maternity services.
(Chelmsford) (Con)
As well as recruitment and retention, training matters. Anglia
Ruskin University has a campus in Chelmsford and is the provider
of the largest number of health and social care degrees in the
country, training midwives, nurses and, since the medical school
opened, doctors. Will the Secretary of State back the campaign to
expand the medical school in Chelmsford so that we can train even
more local people to work in our local NHS?
I thank my right hon. Friend for raising her local college, which
does amazing work for the whole of the NHS as well as in her
local area. I may have to retain a discreet silence over that
particular application but I know that if any Member is sure to
advocate effectively for their local area, it is my right hon.
Friend.
Mr Speaker
I call the shadow Minister.
(Erith and Thamesmead)
(Lab)
Recruiting and retraining more NHS staff is crucial if women are
to get gynaecology, obstetric and maternity care. I would like to
share the story of Sandy Simmons. She was told 11 months ago that
she needed surgery for a uterine prolapse; today, after nearly a
year of pain, she is still waiting. Labour candidates such as
in Great Yarmouth are speaking
up for women like Sandy and the 905 women waiting more than a
year for treatment in Norfolk and Norwich University Hospital.
Will the Secretary of State apologise to these women—or, like the
Prime Minister, will she just walk away?
I was genuinely delighted to welcome the hon. Lady to the
Government’s women’s health summit last week to announce the
consolidation, and indeed the improvement, of the women’s health
strategy that this Government have launched. We saw significant
success last year with hormone replacement therapy improvements
and she knows, because she attended the summit, that I have just
announced a £50 million research fund looking at maternity
disparities and also research into female-specific conditions.
Any concern she has about operation times she should take up with
the local trust and it will perhaps tell her what impact
industrial action has had, sadly, on elective surgery.
Cancer: Early Diagnosis
(Chipping Barnet)
(Con)
11. What steps she is taking to support the early diagnosis of
cancer. (901110)
The Minister for Health and Secondary Care ()
I know this is an issue close to my right hon. Friend’s heart and
pay tribute to her for her work as vice-chairman of the all-party
group on radiotherapy. The pandemic has of course presented a
real challenge to delivering the Government target to diagnose
75% of stageable cancers at stage 1 or stage 2 by 2028, but I am
pleased to be able to tell the House that we are coming through
that and last year diagnosed more cancers at stage 1 and stage 2
than ever before.
Cancer Research UK has published an ambitious plan, “Longer,
better lives”, which reminds us that for some cancer patients
just a few weeks of delay can make the difference between whether
they can be offered curative treatment or just palliative care.
Will the new diagnostic centres being opened by the Government,
including at Finchley Memorial Hospital, bring waiting times down
and secure that early diagnosis that is so important to surviving
cancer?
My right hon. Friend makes an important point. Diagnostic checks
are a key part of the cancer pathway and the 150 community
diagnostic centres opened by this Government, including the one
at the Finchley Memorial Hospital, will provide earlier
diagnostic tests, support earlier diagnosis and bring down
waiting times, benefiting millions of patients. These centres
have delivered more than 6 million additional tests for all
elective activity since July 2021 and we expect the Finchley
Memorial Hospital CDC to provide over 126,000 tests for elective
care in the next financial year.
(Strangford) (DUP)
I thank the Minister for that response. Research and development
is very important; it means we can find more cures for cancer. My
father, who is dead and gone, survived cancer on three occasions;
that happened because of advances in finding cures. What is being
done to work alongside those in research and development to
ensure that even more cancers can be cured and we can go from a
50% rate to perhaps a 60% or even 70% rate for those who live
longer?
I was delighted that one of my first visits in the new year was
to Northern Ireland to see some of the life sciences companies,
particularly those based around Queen’s University Belfast. That
sector in Northern Ireland is flourishing. We are keen to support
companies working in research and bring together world-leading
universities such as Queen’s with the private sector and the NHS
to deliver improved outcomes for all patients across every part
of the United Kingdom.
Sickle Cell Disease
(Lewisham East) (Lab)
12. What steps she is taking to improve healthcare outcomes for
patients with sickle cell disease. (901111)
The Minister for Health and Secondary Care ()
I know this is an important issue for the hon. Lady in her role
as chair of the sickle cell and thalassaemia all-party
parliamentary group. We are working hard to provide the best
possible care to those living with sickle cell disease. That
includes boosting Ro subtype blood donation numbers, identifying
improvements in clinical pathways and delivering world-leading
treatments, such as the new blood-matching genetic test announced
by NHS England yesterday, which will reduce the risk of side
effects and offer more personalised care.
I congratulate NHS England on the launch of the new
blood-matching genetic test for sickle cell patients, but it has
been more than two years since the “No One’s Listening” report,
which made the key recommendation that sickle cell patients
receive pain relief within 30 minutes of attending accident and
emergency. Why is that still not happening for sickle cell
patients, and would the Minister like to meet me and the Sickle
Cell Society to discuss how to achieve that?
I of course would be happy to meet the hon. Lady and the Sickle
Cell Society to look at how we can improve patient experiences
and ensure that all patients benefit from timely access to the
medications they need. I am delighted that she welcomes
yesterday’s announcement. It is an example of how the NHS can
bring forward world-firsts and is leading the way to transform
patient care and improve patient outcomes.
Urgent and Emergency Care
(Rugby) (Con)
13. What steps her Department is taking to increase access to
urgent and emergency care. (901112)
The Minister for Social Care ()
Almost a year ago, we published our urgent and emergency care
recovery plan. The NHS has already halved the waiting times for
category 2 ambulances and brought down waits in A&E. We are
determined to cut NHS waits, and our plan is working.
Rugby is one of the fastest growing places in the UK. While we
have had additional services introduced at our local Hospital of
St Cross, my constituents have insufficient accident and
emergency provision. Thousands of local residents have signed my
petition for doctor-led accident and emergency care at the
Hospital of St Cross. I know it is a matter for the integrated
care board, but will the Minister give her support? As a previous
Minister, my hon. Friend the Member for Colchester () and the previous Secretary of
State have visited in the past few months, and I invite this
Minister to do likewise.
I thank my hon. Friend for his invitation. He has been a tireless
campaigner on this issue on behalf of his constituents. The
future of healthcare is about getting people the care that they
need, where they need it and when they need it, and Rugby is no
different. New local NHS services are bringing care closer to
home in his area, such as the new imaging unit at the Hospital of
St Cross that opened in September.
Mr (East Londonderry)
(DUP)
Access to urgent and emergency care can be greater facilitated
when greater protection is offered to staff, particularly the
many who suffer attacks in emergency departments at hospitals
across the United Kingdom—often by people who are
intoxicated.
The hon. Member makes an important point. The safety of our staff
in the national health service is important, including those in
urgent and emergency care departments, as well as the ambulance
services. He is absolutely right to point that out, and it is
never acceptable for anyone, including patients, to be violent
towards staff.
Mental Health Services
(Manchester, Withington)
(Lab)
14. What steps she is taking to increase access to mental health
services. (901113)
The Parliamentary Under-Secretary of State for Health and Social
Care ()
We are investing a record amount in NHS mental health services,
committing £2.3 billion extra a year for the expansion and
transformation of services in England, which will enable 2
million more people to access mental health support.
If only the reality was that rosy. The entire sector is calling
out for reform of the Mental Health Act 1983. With our mental
health services in crisis, why did the Government scrap the
long-awaited and overdue mental health Bill, which could have
started to alleviate pressures on trusts by reducing the numbers
of people detained inappropriately and making services more fit
for purpose? Is it not true that we need a Labour Government to
take action on this issue?
Mr Speaker
It is going to be a long year.
I have news for the hon. Gentleman, because we have a plan and it
is working. Our investment of £143 million into crisis support is
showing early evidence of reducing admissions—admissions are 8%
lower. With the crisis telephone services, which are available
24/7, we have admissions down 12%. More importantly, detentions
under the Mental Health Act are 15% lower. We have a plan, and it
is working.
In-patient Units: People with Learning Disabilities
(East Kilbride, Strathaven
and Lesmahagow) (Con)
15. What recent progress her Department has made on reducing the
number of people with a learning disability in in-patient units.
(901114)
The Secretary of State for Health and Social Care ()
We have made progress against our target to reduce learning
disability and autism in-patient numbers in England by 50% since
2015. For people with a learning disability without an autism
diagnosis, there has been a 58% net reduction; for people with a
learning disability who are autistic, the net reduction is
35%.
Dr Cameron
I thank the Secretary of State for that comprehensive answer. As
chair of the all-party parliamentary group for disability, I have
been hearing from organisations such as Mencap that remain
concerned that people with learning difficulties are
disproportionately detained for five to 10 years and for over 10
years. Will she reassure those organisations that the “Building
the right support” action plan will continue to progress the
great work that is being done?
I thank my hon. Friend for her interest and, of course, her many
years working as a clinical psychologist. She brings that
experience to the Chamber. National commissioning guidance to
integrated care boards was published in November. It sets out
that a mental health in-patient stay for a person with a learning
disability
“should be for the minimum time possible, for assessment and/or
treatment which can only be provided in hospital”.
In overseeing implementation of the action plan going forwards,
the “Building the right support” delivery board will maintain
focus on quality of care and on reducing long stays.
(Worsley and Eccles South)
(Lab)
It is vital for the Government to do more to move autistic people
and people with learning disabilities out of in-patient units and
back to their communities. Recently, in the trial of staff at
Whorlton Hall, we saw staff who were cruel and uncaring.
Delivering sentences, the judge said that Whorlton Hall was
an
“unpredictable and…frightening place to live”.
Is it not time for the Government to close down those units and
move the majority of people into the community?
I thank the hon. Lady for raising that point. We were all
dismayed and upset to see the experiences of residents in those
units, and we saw the correct criminal outcomes—if I am allowed
to say that—for those involved in those assaults. A review is
going on as to how those issues are affecting the estate as a
whole, but we are clear that in-patient stays should happen only
when they are strictly necessary. We must be mindful that
clinicians will be taking many situations into account, including
not just the safety of the patient but the safety of the wider
community.
Topical Questions
(Brentford and Isleworth)
(Lab)
T1. If she will make a statement on her departmental
responsibilities.(901123)
The Secretary of State for Health and Social Care ()
Women’s health needs are often overlooked and under-researched.
Through our women’s health strategy, the Government are changing
that. Last year, we made menopause a priority, helping almost
half a million women get hormone replacement therapy for less
than £20 a year. This year, we are building on that work and will
have a women’s health hub in every integrated care board area in
England. We will promote research into conditions that only
affect women, such as endometriosis and lobular breast cancer,
and those that affect women differently from men, such as heart
attack symptoms.
We have also launched the first research challenge—worth £50
million—to tackle maternity disparities that have no place in
modern Britain. Following the brave campaigns of my hon. Friends
the Members for Hyndburn () and for Stafford (), by March we will make
dedicated maternal mental and physical healthcare available to
every woman in England.
I recently met two constituents with experience of invasive
lobular breast cancer. Invasive lobular carcinoma is the second
most common form of breast cancer, but it is not generally picked
up by mammograms, and it behaves differently from other breast
cancers. However, lobular breast cancer has been understudied and
underfunded, and it urgently needs research funding. Will the
Secretary of State tell the House what specific actions her
Government are taking to address those gaps? Will she also reply
to the Lobular Moon Shot Project, to which she—
Mr Speaker
Order. This is topical questions.
I gently remind the hon. Lady about the statement that I just
gave. Last week we held the women’s health summit, at which I
announced that we are encouraging research into conditions such
as lobular breast cancer. I made that announcement because of two
amazing women I met recently who were living with the condition.
They were introduced to me by my right hon. Friend the Member for
Horsham (Sir ) and my right hon. Friend—
Mr Speaker
Order.
I am waiting for the reply.
Mr Speaker
Order. Please can I just say that these are topicals? I have got
to get through a big list, and lots of Members are standing. We
need short, punchy questions, and the same with answers.
(Harrogate and Knaresborough)
(Con)
T6. I have been carrying out a health survey of thousands of
residents in Harrogate and Knaresborough, to ask them for their
experiences and views of the NHS. I will share the results with
local healthcare professionals, to support them and their work.
When the results are in, will the Secretary of State meet me to
discuss how they will help inform and shape our local healthcare
planning ?(901128)
I would be delighted to meet my hon. Friend to discuss that. As
always, he is an excellent advocate for his constituency, and I
will enjoy listening to the results of his survey.
Mr Speaker
I call the shadow Minister.
(Denton and Reddish)
(Lab)
, Labour’s candidate for
Northampton South, shared with me the horrific experience of
Stanley, who had severe abdominal pain and called an ambulance,
only to be told it would take hours and to go to A&E. There,
he was told to wait for assessment on a patio chair outside. It
was 3°. Who is to blame?
The Minister for Social Care ()
I am very sorry to hear of the experience of that specific
constituent. Because of challenges that the NHS faces,
particularly our urgent and emergency care services, almost a
year ago we set out our urgent and emergency care recovery plan,
to speed up care for people in A&E and reduce waits. That
plan is working. We are seeing ambulances get to people quicker,
and people treated quicker in A&E.
That is not a one-off. Why will the Minister not take a shred of
responsivity for the chaos that her party has caused our NHS? The
last Labour Government achieved the shortest waits and the
highest patient satisfaction in NHS history. The Conservatives
have delivered the longest waits and the lowest patient
satisfaction in history. Let us have that general election, so
that she can defend her abysmal record to the public.
The hon. Gentleman obviously was not listening to my answer; in
fact, he was reading aloud. Our urgent and emergency care plan is
working. It is reducing rates in A&E, and ambulances are
getting to people faster. Meanwhile, I am sorry to say that in
the Labour-run NHS in Wales, more than half of patients are
waiting more than four hours in A&E.
(Northampton South) (Con)
T7. What steps is the Minister taking to ascertain the cause of
ongoing problems affecting access to riluzole, the only licensed
drug for the treatment of motor neurone disease in the UK, to
provide clarity to the MND community and ensure that normal
supply is restored as soon as possible?(901129)
We understand how worrying the possibility of medication
shortages can be. There is a supply issue with riluzole 50 mg
tablets, caused by a supplier experiencing manufacturing issues.
We have a well-established procedure in place to deal with such
issues, and are working with the industry, the NHS and others to
resolve it as quickly as possible. We have contacted alternative
suppliers and have secured sufficient volumes of stock.
Mr Speaker
I call the Scottish National party spokesperson.
(East Dunbartonshire)
(SNP)
Cancer Research UK has found that too much UV radiation is the
third biggest cause of cancer across these isles. Does the
Secretary of State recognise that cost is a barrier for people
wishing to protect their skin from the sun, and will she commit
to having conversations with Cabinet colleagues to remove VAT on
sun protection products, which will help protect NHS budgets and
ultimately save lives?
We see that as part of a much wider campaign to ensure that we
treat the sun safely, by reducing the amount of time we spend in
the sun, particularly during peak hours of the day in summertime.
I keep all these discussions in play with my Treasury
colleagues.
(South East Cornwall)
(Con)
T10. Rural constituencies such as mine are seeing a growing
number of dentists withdraw from NHS provision. What steps is the
Department taking to ensure that vital dental care is provided
for everyone, particularly in rural communities?(901132)
The Parliamentary Under-Secretary of State for Health and Social
Care (Dame )
My hon. Friend is a great advocate for her community, and I pay
tribute to her for working with determination to see more access
to dentistry in Cornwall. She is right to do so. We have a plan,
which is almost ready. I urge her to wait just a little longer.
She, like all colleagues across the House, will see significant
and real measures to improve access to dentistry.
(Liverpool, West Derby)
(Lab)
T2. NHS staff have expressed concerns about the Anaesthesia
Associates and Physician Associates Order 2024. Can the Minister
tell me if resource will be needed for AAs and PAs to be properly
supervised by doctors on a one to one ratio? Will he meet trade
unions and professional bodies as a matter of urgency to clarify
the Government’s position on this hugely important public health
issue?(901124)
The Minister for Health and Secondary Care ()
PAs and AAs are an essential part of the reform piece to the
long-term workforce plan. I note that the order was passed by the
House last night without a Division, so I am grateful for that
cross-party support. We are working with the General Medical
Council, the British Medical Association and others to ensure
that the regulations are fit for the purpose. We look forward to
the GMC launching its consultation on the fine print of the
regulations very soon.
(South Derbyshire)
(Con)
As my constituents have to travel to Tamworth, Burton or Derby
for diagnostic tests, can I encourage the Secretary of State to
look favourably on a bid for a new much-needed community
diagnostic centre in South Derbyshire?
I thank my hon. Friend sincerely for her question. The good news
is that community diagnostic centres have now delivered over 6
million additional tests and scans since July 2021 thanks to the
hard work of NHS staff, but I will of course be delighted to meet
her to discuss her plans for her local constituency.
(Halton) (Lab)
T3. New British Heart Foundation analysis shows that the number
of people dying before the age of 75 in England from heart and
circulatory diseases has risen to its highest level in over a
decade. The rate of premature deaths from cardiovascular disease
has now increased in England for three years back to back. Why
are the Government taking such a long time to get to grips with
this crisis?(901125)
The NHS long-term plan commits to a number of key ambitions to
improve care and outcomes for individuals suffering from
cardiovascular disease, including enhanced diagnostic support in
the community, better personalised planning, and increasing
access to cardiac rehabilitation. Those ambitions will support
the delivery of the aim to prevent 150,000 heart attacks, strokes
and dementia cases by 2029.
(Bolton West) (Con)
The single biggest concern my constituents raise about healthcare
is access to GPs, especially in Blackrod and Westhoughton. What
more can my right hon. Friend do to ensure we have better GP
access?
Dame
I am pleased to tell my hon. Friend that our NHS long-term plan
sets out a real-terms increase of at least £4.5 billion a year
for primary and community care by 2023-24. We now have over 2,000
more full-time equivalent GPs working in our NHS, and we have had
the amazing achievement of more than 50 million more appointments
per year, beating our target several months early. Things are
improving significantly, and there are many more measures I would
be delighted to talk to him privately about.
(City of Chester) (Lab)
T4. In the NHS in Cheshire and Merseyside between April and June
last year, the 62-day cancer waiting time target was not met. If
the target had been achieved, around 150 extra patients would
have been treated on time. What would the Secretary of State like
to say to those 150 patients?(901126)
The 62-day backlog has fallen by 27% since its peak in May 2020.
We know there is more to be done, and that is why we are bringing
forward more measures as early as possible. In April 2023, more
than nine in 10 patients—90%—started their first cancer treatment
within one month of a decision to treat.
(Halesowen and Rowley Regis)
(Con)
Many of my constituents who use Regis Medical Centre have been
left angry and frustrated by the botched implementation of an
Anima booking system, leading to them being unable to get an
appointment or the treatment they need. Will the Secretary of
State meet me to discuss how we can learn the lessons from that
botched implementation and make sure trust in that GP surgery is
restored?
Yes, happy to.
(Somerton and Frome) (LD)
T5. I recently met the staff of a pharmacy in Bruton in my
constituency to hear about some of the challenges it is facing.
Community pharmacists are dispensing some of the country’s most
widely prescribed drugs at a loss, therefore subsidising the NHS.
What steps is the Secretary of State’s Department taking to
prevent the closure of community pharmacists?(901127)
We are ensuring that community pharmacists have an even greater
role in primary care than they have already. For example, we saw
the first stage of the roll-out of Pharmacy First in December,
with blood pressure checks and contraceptive care being rolled
out. I am very pleased that we are on track to deliver the full
roll-out of Pharmacy First by the end of the month.
Sir (Bromsgrove) (Con)
The colour of someone’s skin should not have an impact on the
reliability of medical devices, but we know that that is what
happened during the pandemic for many black and Asian patients.
When I was the Health Secretary, I commissioned an independent
review of the equity of medical devices from Professor Dame
Margaret Whitehead. Her report was handed to the Department in
June last year, but the Department has not yet published it or
responded to it. I know that my right hon. Friend cares about
health inequalities as much as I do, so may I ask her to publish
the report, along with a full Government response, as a matter of
urgency?
I thank my right hon. Friend for commissioning that vital piece
of work. I am giving the matter my closest attention, and I hope
very much to be in a position to respond to his points in due
course.
(Bristol East) (Lab)
T8. This week the Riverside unit in my constituency, which treats
young people with severe eating disorders, had to close
temporarily because of concerns about its ability to provide safe
care. What are the Government doing to ensure that young people
who, in many cases, go through mental health crises as a result
of their eating disorders receive the care that they need as
close to home as possible?(901130)
The Parliamentary Under-Secretary of State for Health and Social
Care ()
As the hon. Lady will know, we are investing more in mental
health services for young people in particular and, indeed, for
those with eating disorders. We are seeing more young people more
quickly than ever before, but if the hon. Lady wishes to raise a
local issue with me, I shall be happy to meet her and discuss
it.
(Torbay) (Con)
The opening of a new block of operating theatres next month marks
the latest investment in Torbay Hospital, but it is, of course, a
prelude to the major rebuilding work. When does the Secretary of
State plan to deliver the next update on the progress of that
project?
Hon. Members
Hear, hear!
I am delighted that the House is as happy about that expansion as
the hon. Gentleman and I are. I will meet him to go through his
plans, because I know how carefully he has campaigned for this
important asset in his constituency.
(Lancaster and Fleetwood) (Lab)
T9. In the early hours of Friday morning, I arrived at the Royal
Lancaster Infirmary with my sick son in an ambulance. As we
walked past trolleys in the corridor, the nurse who was treating
him said, “Our A&E unit is too small. We were promised a new
hospital four years ago, but I think they have forgotten about
us.” Can the Secretary of State tell that nurse, my constituent,
whether we have indeed forgotten about that new
hospital?(901131)
The hon. Lady is aware of my knowledge not only of that hospital,
but of her local area. I will look into this matter for her,
because I want to ensure that the good people of Lancashire, Mr
Speaker, are looked after as we would all hope and expect.
Mr Speaker
I look forward to seeing that in Chorley.
Sir (Horsham) (Con)
I warmly welcome what my right hon. Friend said last week about
encouraging research on lobular breast cancer, and I look forward
to meeting the Under-Secretary of State for Health and Social
Care, the hon. Member for Lewes (), shortly to work out how
we can operationalise what is her clear ambition.
I thank my right hon. Friend and my hon. Friend the Member for
Bishop Auckland () for bringing two amazing
women to talk to me about the impact of lobular cancer. For the
benefit of Members on both sides of the House, last week we sent
out a “Dear colleague” letter and graphics about the women’s
health strategy so that we can all help our constituents to
understand what this Conservative Government are doing to ensure
that the healthcare of women is faster, simpler and fairer.
