Integrated Health and Care Services
(Henley) (Con)
1. What steps his Department is taking to integrate health and
care services.
The Secretary of State for Health and Social Care ()
We are committed to the delivery of world-leading health and
social care across the UK. The Health and Care Bill will ensure
that every part of England is covered by our integrated care
boards and integrated care partnerships. This will remove the
silos within the NHS while supporting the NHS, local authorities
and the wider system of partners to join up healthcare, social
care and public health services to achieve the long-held ambition
of more integrated care.
Will the Secretary of State come with me to visit Townlands
Community Hospital in my constituency, where we have built into
the process of keeping the hospital going a real potential for
the integration of NHS and social care services? It would be very
good if I were able to share that with him.
I would be pleased to visit the hospital with my hon. Friend. I
know that the site to which he refers is multi-disciplinary and
provides rehabilitation and palliative care together and is doing
well at it. I know also that it is an excellent example of good
integration at work.
Mr Speaker
I call the shadow Minister.
(Ellesmere Port and Neston)
(Lab)
I apologise for once again returning to the subject of integrated
care boards. One important question remains unanswered following
yesterday’s debate. If we are to have truly integrated health and
social care, all voices need a seat at the table: public health;
social care; mental health; the workforce; and, of course,
patients and carers. As matters currently stands, there is
nothing guaranteeing each of those groups a seat at the table. I
am sure that the Secretary of State will agree that none of them
should be missed out, so what will he do, for example, if an ICB
decides to exclude the patient’s voice?
That is an important point, which is why the Government have
listened to it. The hon. Gentleman will know that a lot of
consultation was done before the Bill that he refers to was
presented. In terms of voices around the table in the ICB, we
have deliberately set up a permissive system that allows those
local voices to be catered for, and for local decisions to be
made. While there are minimum requirements, there are no maximum
requirements.
(Loughborough) (Con)
Humphrey Perkins School in my constituency had carried out all
the necessary preparations ahead of its anticipated roll-out of
the vaccine prior to the autumn half-term. However, the day
before, the school was informed that the roll-out would be
postponed until 30 November. Please can my right hon. Friend set
out the reasons for this delay, and will he confirm that this
date will not be pushed back again, as that could have an impact
on transmission between local adults, among which cases have
increased recently?
Mr Speaker
Unfortunately, that question is not relevant to Question 1. We
will come back to it as a substantive question later.
(Strangford) (DUP)
When it comes to the integration of health and care services, it
is very important that we have early diagnosis. The covid-19
pandemic has shown that there are some 200,000 potential type 2
and type 1 diabetics. What can be done to address the issue of
diabetes, speaking as one who is a diabetic?
The hon. Gentleman is absolutely right to raise that as one of
the unintended impacts of the pandemic. The reassurance that I
can offer him is that there is close co-operation across the
devolved Administrations when it comes to working on those
impacts. NHS England is working with the health service in
Northern Ireland to see what more can be done.
(Redcar) (Con)
Can the Secretary of State outline the ways in which yesterday’s
votes on integrated care systems and the increased social care
cap will benefit my constituents in Redcar and Cleveland?
I am very happy to do so. My hon. Friend will know that the
system that we set out back in September for social care will
mean that no one loses out. In fact, when it comes to receiving
social care in the future, the vast, vast majority of people
across the country will be better off, including his
constituents.
(Linlithgow and East Falkirk)
(SNP)
While the Scottish Government are taking action to establish a
national care service in Scotland, the UK Government’s plans
allocate the bulk of the money raised over the first three years
of the national insurance rise to the NHS backlog. Does the
Secretary of State agree that A&E functioning is greatly
impacted by the lack of beds due to delayed discharges to social
care? Will his Department provide urgent funding for the critical
support for social care?
The Government have provided urgent funding, especially because
of the impact of the pandemic. We have put more than £34 billion
extra into health and social care, with the relevant Barnett
consequentials, from which Scotland will of course have
benefited. The issue of delayed discharges is an important one to
continue working on and addressing, which is exactly why NHS
England has a delayed discharge fund of almost £500 million for
this winter.
Covid-19 Booster Doses: Shipley
(Shipley) (Con)
2. What assessment he has made of the adequacy of the number of
locations providing booster doses of the covid-19 vaccination in
Shipley constituency.
The Secretary of State for Health and Social Care ()
There are more clinics in England delivering covid-19 vaccines
than there were at any point during the covid-19 vaccination
programme. A lot of planning has gone into ensuring that sites
are distributed according to demand. I can tell my hon. Friend
that there are three vaccination sites in Shipley itself—at
Lynfield Mount Hospital, Shipley health centre and Windhill
Green’s emerald suite—and eight walk-in centres within 10 miles
of Shipley. These sites are available to all those who are
eligible and need to book.
Lynfield Mount is not in my constituency. Many of my constituents
want to have the booster vaccine, but are unable to access it
locally and are instead being told to go to Bradford, which many
are unable or unwilling to do. If the Government want a bigger
take-up of the booster vaccine, may I urge my right hon. Friend
to ensure that there are more places available in the Shipley
constituency where my constituents can have their booster?
My hon. Friend, as always, make an important point. I thank his
constituents for their excellent response to the national
roll-out of the vaccination programme, and for playing their part
in that. I have heard what he has said very clearly. We want to
make access to vaccination as easy and convenient as possible. I
will speak to the NHS to see what more can be done.
(Nottingham North)
(Lab/Co-op)
The vaccination programme has lost momentum over the summer and
autumn. To ensure that everyone who is eligible gets their
booster jab by Christmas, we need to be vaccinating half a
million people a day, but we are currently not near that figure.
We need to reboot the national effort in Shipley and
beyond—[Interruption.] Always just for you, Mr Speaker. We need
to be mobilising retired medics, and using pop-up clinics and of
course our nation’s pharmacies, which are crying out to help.
Will the Secretary of State commit to that, and confirm by which
day the 500,000 person target will be met?
I know that the hon. Gentleman sees it as his job always to be
negative about the Government, although on the vaccination
programme he and his colleagues have so far been very
co-operative across the House. We should not talk down our
world-successful vaccination programme, because we have delivered
more than 15 million booster vaccines across the UK to 26% of the
population over the age of 12—the most successful booster
vaccination programme in the whole of Europe.
Unpaid Carers
(Sheffield Central)
(Lab)
4. What steps his Department is taking to help ensure that unpaid
carers can access support when caring for family members.
The Minister for Care and Mental Health ()
We recognise that carers perform a difficult role and often find
it challenging to access support. The Care Act 2014 secured
important rights for carers, including a responsibility for local
authorities to assess and support their specific needs where
eligible. We will work with unpaid carers and stakeholders to
co-develop further detail in a White Paper for reform later this
year.
The Minister will know that among those unpaid carers are 800,000
young carers, who play an extraordinary role—some from as young
as seven or eight years old—in looking after parents with
long-term conditions. Too many are unidentified, and as a
consequence struggle without the support that they deserve. Does
the Minister agree that integrated care boards could require GPs,
who are uniquely placed to do this, to identify young carers and
signpost them to support services? Will she also work with
ministerial colleagues to require schools to create a young
carers lead, as with special educational needs co-ordinators, to
co-ordinate the identification of and support for young
carers?
We will certainly be looking at all those points within guidance.
Local authorities have a duty to assess the needs of young carers
under the Children and Families Act 2014, and that duty has
remained in place throughout the pandemic. Authorities must
ensure that young carers are identified and referred to
appropriate support if needed, and that the young carer is not
taking on excessive or inappropriate care and support
responsibilities. We have also announced an additional £1 billion
of new recovery premium funding, which schools can use to support
young carers’ mental health and wellbeing, alongside their
academic recovery.
(Gosport) (Con)
The carers action plan published in 2018 was a two-year
cross-Government attempt to try to change the way we identify and
support the millions of unpaid carers across our country. They
save our health and care system a fortune, but for their loved
ones they are literally the world. What plans are there to
publish a progress report and set out the next steps for how the
Government intend to keep focused on this really important
issue?
I pay tribute to my hon. Friend for her work in this role and
also to all unpaid carers. There are 5.4 million unpaid carers in
England and they do a fantastic job. In the forthcoming Bill that
we are co-producing with unpaid carers, we will make sure that we
continue to make progress in this area. I look forward to sharing
that with her before the end of this year.
John Mc Nally (Falkirk) (SNP)
Carers UK recently called for an additional payment across the UK
for unpaid carers after its survey found that more than one in
five unpaid carers are worried that they may not cope financially
over the next 12 months. In Scotland we already have a carer’s
allowance supplement, and the Scottish Government will once again
make a double payment this December, recognising the impact that
the pandemic has had on our carers. Will the Minister now urge
her colleagues in the Department for Work and Pensions to make a
commitment to match the Scottish Government’s offer?
There is a carer’s allowance in the UK as well, but in most cases
financial incentives are not the main driver for those providing
unpaid care. However, we may see a shift towards less intensive
caring activities or a reduction in the hours spent caring as
people become more eligible for state support and we push through
some of the reforms. Charging reforms bring an end to the
unpredictability of care costs for care users and will do the
same for those who provide unpaid care for them, allowing them to
make informed choices. We need to do more to support them in
providing respite and day services.
(Chipping Barnet)
(Con)
What action have the Government taken to support the charities
and community groups that provide help to unpaid carers, because
many of these charities found it very hard to operate and raise
funding during the covid shutdown?
My right hon. Friend is absolutely right: charities are also a
vital part of the network of support for our unpaid carers, and
some of them did have to close during the pandemic, so we have
been encouraging them to open up now that we can all open up.
Additional financial support was provided for the charitable
sector to make sure that it could continue its vital services
during the pandemic when fundraising activities were very
difficult.
(Leicester West) (Lab)
Many families are pushed to breaking point because they cannot
get the help they need to look after the person they love. Will
the Minister now confirm that somebody who is trying to hold down
a job and care for their elderly mum whose house is worth
£100,000 will face a tax rise that will not improve their mum’s
care or give them a break from caring, and will not even stop
them from having to sell their mum’s home, because under the
plans Tory MPs voted through last night, she will never hit the
cap on care costs? Will the Minister further confirm that this
tax rise on working people will be used to protect 90% of a home
worth £1 million? If she disputes these figures, why does she not
publish the impact assessment before MPs are asked to vote on the
Health and Social Care Bill tonight?
From October 2023, the Government will introduce, for the first
time in our history, a new £86,000 cap on the amount any adult in
England will need to spend on their social care. That will
protect them from unpredictable and unlimited costs. But as well
as that there is a more—[Interruption.] The hon. Lady may like to
listen to the answer. As well as that, there is a more
generous—[Interruption.] Please listen. On top of that, a more
generous means test for adult social care will come into effect,
allowing more people to benefit from the means-tested support.
Under the current system, about half of all older adults in care
receive some state support. This rises to roughly two thirds
under the recently announced charging reforms, which will help
many adults, including unpaid carers. Everybody will benefit from
this system.
Young People’s Mental Health Services
(Newbury) (Con)
5. What steps he is taking to reduce waiting lists for (a)
children and adolescent mental health services and (b) other
mental health services for young people.
The Minister for Care and Mental Health ()
We are committed to ensuring that children and young people get
the mental health support that they need. That is why we are
expanding mental health services through the NHS long-term plan
so that 345,000 more children and young people a year have access
to services by 2023-24. This year the Government and the NHS,
under NHS England, have provided an additional £109 million on
top of long-term planned funding. This additional funding will
allow 22,500 more children and young people to access community
health services this year, earlier than planned, and that will
accelerate the roll-out of mental health support teams in schools
and colleges.
In West Berkshire, a family seeking a child and adolescent mental
health services diagnosis of autism spectrum disorder or
attention deficit hyperactivity disorder can face a waiting time
of up to two years. The Berkshire West clinical commissioning
group has recently made £1.6 million available to recruit extra
staff, but when I spoke to it, I was struck by the absence of any
hard targets to reduce waiting lists and any consequences if it
fails to deliver. These waiting times are causing misery to my
affected constituents, so can my hon. Friend say what steps can
be taken to ensure accountability in the provision of this
service, and will she meet me to discuss waiting times in West
Berkshire?
I share my hon. Friend’s concern that waits for autism
assessments and diagnosis are often way too long, and that is why
we are investing an additional £13 million of funding this year.
That funding will allow local systems to test different
diagnostic pathways—including working on a multi-disciplinary
basis, which will shorten the diagnosis time—and to find new
solutions for addressing long waits. The precise allocation of
funding for diagnostic pathways are decisions made at the local
level, and those should be compliant with National Institute for
Health and Care Excellence guidance. NHS England is working with
local systems to evaluate what works well. Since November 2019,
we have been reporting on waiting times between referral and
first assessment, and that is important, because we use that to
drive up local performance. I would be very happy to meet my hon.
Friend to discuss this further.
(Tooting) (Lab)
When the Government talk about waiting times, they refer to how
long it takes simply to get an assessment, and not to when
treatment may start. Most children face an incredibly long wait
after that first step, or even have their referral closed. The
real truth is revealed when we look at how long it takes for
children to complete treatment. In Yorkshire and the Humber, it
took one child more than 13 years to complete treatment for their
anxiety. In the north-west, some children took three years to
complete treatment for eating disorders. In the midlands, it is
not uncommon for treatment completion to take five years. Will
the Minister commit, as we have, to the provision of a counsellor
in every school, a mental health access hub in every single
community and regular mental health assessments for children in
all key stages?
We know that the prevalence of children and young people with a
mental health condition has increased—in some cases, it has
increased massively. That is why we remain committed to
increasing investment through the long-term plan. Also, we have
consulted on the potential to introduce five new waiting times
standards, including for children and young people and their
families and carers presenting to community-based mental health
services. In addition, NHS England and NHS Improvement have
announced an additional £40 million to address the impact of
covid on children and young people’s mental health, including for
eating disorders. Since 2014, extra funding has been going into
children and young people’s community eating disorder services
every year, but we know that we have more to do. This extra
funding will enhance the development of more than 70 new and
improved community eating disorder teams, but there is no doubt
that there is much to catch up on. We are also introducing
services into schools for young people.
(Mitcham and Morden)
(Lab)
When the chief inspector of hospitals placed St George’s in
Tooting into special measures, he warned that the
“emergency department was not large enough for the number of
patients that passed through it and privacy and dignity were
compromised.”
Given the report by the British Red Cross in this morning’s
edition of The Times highlighting the causal link between A&E
attendance and deprivation, does the Minister understand the
further huge impact that moving acute services from St Helier to
wealthy, healthy Belmont will have on A&E attendances at St
George’s?
The Minister for Health ()
Forgive me, but I fear the hon. Lady may not have moved her
tabled question.
I was just so keen to ask my question!
I can answer the hon. Lady’s supplementary question, but would it
be in order for me to answer her tabled question and then the
supplementary?
Mr Speaker
Yes.
St Helier and St George’s Hospitals
6. What recent assessment he has made of the impact of the
proposed downgrade of services at St Helier hospital on the
delivery of acute services at St George's hospital.
I am grateful to the hon. Lady. To answer the tabled question, no
recent assessment has been made of the changes associated with
the Epsom and St Helier reconfiguration, including proposed
changes to some services outside the new Sutton site. The hon.
Lady will know that these proposals have been through
consultation, judicial review and the independent reconfiguration
panel, which all supported the plans as being in the local
population’s interest. The Secretary of State agreed with their
advice.
Turning to the hon. Lady’s supplementary question, I am grateful
to her and I know how strongly she feels about the issue, but I
take her back to the point I have just made, which is that these
proposals have all been through extensive consultation and
extensive legal process and been looked at by the independent
reconfiguration panel. Those processes all concluded that what is
proposed is in the best health interest of the population.
Community Pharmacies
(Warley) (Lab)
7. What assessment he has made of the viability of the community
pharmacy sector.
The Parliamentary Under-Secretary of State for Health and Social
Care ()
The community pharmacy contractual framework outlines a
transformational programme of work to integrate community
pharmacies into the NHS, delivering more clinical services and
making them the first port of call for many minor illnesses. The
framework commits £2.5 billion annually to the sector to support
that ambition.
That is a welcome response from the Minister, and shows that she
and the Department now seem to recognise our pharmacies for their
magnificent efforts during the pandemic, providing frontline
primary care and delivering and encouraging vaccination. Will she
further recognise their expertise and dedication, and push
rapidly forward with integrating pharmacies into the delivery of
primary care—thus also, of course, easing pressure on GPs and
hospitals?
The right hon. Gentleman will find no greater supporters of
community pharmacists than this Government. That is why we
launched the community pharmacist consultation service, where GPs
and NHS 111 can refer patients directly to pharmacy services. We
now see pharmacies dealing with minor ailments such as sore
throats, coughs and colds, providing the new medicines service
and providing public health services such as weight management
and stop smoking services. We place on record our thanks to all
in community pharmacies.
(Aylesbury) (Con)
Community pharmacies in my constituency have played a crucial
role during the pandemic, not least in providing vaccines, as at
Hughenden Valley. Will my hon. Friend join me in thanking them,
as well as the pharmacists working in GP surgeries such as
Meadowcroft surgery in Aylesbury, which I visited last week?
Their growing role in primary care is an important part of our
efforts to improve the health service and ensure that patients
get the best possible care.
My hon. Friend makes some excellent points, and I put on record
again our thanks to community pharmacists and all community
pharmacy teams. During the pandemic, more than 1,500 community
pharmacy-led covid vaccination sites have been set up, delivering
15 million covid vaccinations so far, and this winter more than
3.8 million flu vaccines have been delivered through community
pharmacies, which shows that they are leading the way in primary
care.
(Angus) (SNP)
The role of community pharmacies across Angus and Scotland during
the pandemic cannot be underestimated. The way they were able to
alleviate pressure on clinical services and the wider NHS must be
noted. That is why the Scottish Government have introduced their
NHS Pharmacy First Scotland service, backed by £7.5 million last
year and going up to £10 million. Can the Minister assure me that
the lessons we have learned in Scotland are accepted by
Whitehall, and would she like to come to see the lessons we have
learned in Scotland? I would be happy to accompany her.
As I have said, this Government are leading the way in England in
the way community pharmacies are transforming services in primary
care. That is why we have the new medicines service, where
patients with conditions such as asthma and high blood pressure
or who are on blood-thinning medication are able to go and see
their pharmacist as a first port of call in managing their
medication. We will be expanding those services and are in
discussion with community pharmacists about how we take that
forward.
Covid-19 Vaccination: 12 to 15-year-olds
(Loughborough) (Con)
8. What steps his Department is taking to roll out the covid-19
vaccination to 12 to 15-year-olds.
The Parliamentary Under-Secretary of State for Health and Social
Care ()
We have vaccinated more than 1.1 million 12 to 15-year-olds since
roll-out began. Vaccine clinics have been held at around 3,500
schools, with 800 more to be visited next week, and there are
more than 240 out-of-school vaccine sites in operation. To
bolster the roll-out, since 22 October vaccination bookings for
any 12 to 15-year-old in England can be made through the national
booking service to attend a vaccination site outside school
hours. I take this opportunity to thank everybody involved in
making this programme so successful.
Humphrey Perkins School in my constituency had carried out all
the necessary preparations ahead of its anticipated roll-out of
the vaccine prior to the autumn half-term, but on the day before,
it was informed that the roll-out would be postponed until 30
November. Please could my hon. Friend set out the reasons for
this delay, and can she confirm that this date will not be pushed
back again as this could have an impact on transmission between
local adults, among whom cases have increased recently?
In late September, the Leicestershire Partnership NHS Trust
school age immunisation service devised an updated schedule for
covid-19 and flu vaccinations comprising the remaining schools to
be visited. This was to address some operational challenges,
reduce the need to postpone sessions at short notice and offer
the best experience to the young people receiving vaccinations.
All affected schools were notified as soon as possible. As my
hon. Friend said, the service will be attending Humphrey Perkins
on 30 November, when eligible students with consent will be
offered both the flu and the covid-19 vaccines. West
Leicestershire clinical commissioning group has confirmed to me
that this date will not be moved.
(Linlithgow and East Falkirk)
(SNP)
Wales has now joined Scotland in having vaccinated more than half
of all 12 to 15-year-olds, Scotland’s figure being 57.7% in
comparison with England’s 36.3% of eligible pupils. Given that 10
to 19-year-olds have maintained the highest rate of infections in
recent months, what steps are the UK Government going to take to
follow Scotland’s lead and improve vaccination further in this
age group?
As I said earlier, we have already vaccinated over 1.1 million 12
to 15-year-olds since the roll-out began, which to me is a huge
success. We have opened up the national booking service, and
provided more opportunities for youngsters to come forward
whether within the school environment or outside the school
environment. We always look at every opportunity to ensure
complete accessibility for people to get their vaccine.
Social Care: Staff Numbers and Vacancy Rates
(Bolton West) (Con)
9. What steps his Department is taking to increase the number of
carers in the adult social care sector.
(Sefton Central) (Lab)
10. What steps he is taking to tackle the high job vacancy rates
in social care.
(Dulwich and West Norwood)
(Lab)
16. What steps he is taking to tackle the high job vacancy rates
in social care.
(Epsom and Ewell) (Con)
20. What steps he is taking to tackle staff shortages in the
social care sector.
The Minister for Care and Mental Health ()
We recognise the considerable challenges the adult social care
sector faces in recruiting and retaining staff. We have put in
place a range of measures to support local authorities and care
providers to address workforce capacity pressures. These include
a new £162.5 million workforce recruitment and retention fund,
and the latest phase of our national recruitment campaign,
launched on 3 November, which highlights adult social care as a
rewarding and stimulating place to work.
I thank my hon. Friend for her reply. The latest figure I have
for the vacancy rate for carers in August was significantly worse
than those from before the pandemic, and it is likely to worsen
still further due to the requirement for compulsory vaccination.
When does my hon. Friend believe the vacancy rate will return to
pre-pandemic levels?
The first thing to say is that obviously the vaccine saves lives,
and it is our responsibility to do everything we can to reduce
the risk for vulnerable people. As of 14 November, 92.5% of care
home staff have had their second dose. We have put in place
measures, as I said earlier, to support workforce capacity, which
have only just gone to local authorities. The Department
continues to closely monitor workforce capacity, bringing
together the available data, including the vacancy rate, with
local intelligence. Longer term, we have committed at least £500
million to support and develop the workforce, and that will go
some way to addressing the barriers to people taking up work in
adult social care, which has been an issue for a number of
years.
There are 105,000 vacancies across all social care workforce
grades, but employers are unable to recruit across those grades.
The Government have accepted the need to add senior care workers
to the shortage occupation list—they did that in April—but the
Migration Advisory Committee is not due to report until next
April on the need to recruit social care workers. It is no good
the Minister saying employers need to pay more money to recruit
UK workers, because this Government are the ones underfunding the
employers, who cannot then compete with the likes of Amazon. When
will the Government admit that they need to add all grades of
social care workers to the shortage occupation list if they are
to have any hope of addressing this shortfall and providing the
care that is needed to address the care crisis?
As I mentioned earlier, we have sent out £162.5 million, which
has not yet been put into effect. For example, Sefton received
£1,032,474. That money has only just gone into the bank account,
and has not yet been utilised to retain staff, or to recruit
agency or other staff. As the hon. Gentleman says, adult social
care providers can recruit key adult social carers from overseas
from the shortage occupation list. That provides lower fees and a
reduced salary threshold of £20,480 for someone to be eligible
for the skilled worker visa.
The adult social care sector faces the worst staff shortages in
living memory. A recent survey by the National Care Forum found
that one third of managers of registered care homes are limiting
or stopping admissions from hospital, due to staff shortages,
with direct consequences for both the NHS and for vulnerable
people who cannot access the care they need. The care sector
needs action now, not warm words and job adverts. Will the
Minister commit to paying a retention bonus to frontline care
staff, to help stem the tide of those exiting the care sector
this winter? Will she commit to a fully funded, permanent pay
increase, to bring the minimum level of pay for care workers up
to £10 an hour—the minimum rate at which Amazon is recruiting in
many areas where the care shortage is at its most acute?
We have committed to bring forth new measures in the White Paper,
and to spend at least £500 million on recruiting that workforce.
To address the emergency now, as I mentioned, there is £162
million. In addition, we have put around £500 million
particularly to address discharge processes, and to ensure a
discharge to assess process, which means it can be much quicker.
We must ensure that those teams work together to shorten the
discharge process. There is no doubt that our NHS and our whole
system is under extreme pressure this winter, and we thank it for
all the work it is doing.
There is a particular challenge in a county such as Surrey that
has a rapidly ageing demographic, high housing costs, and where
the cost of living is high generally. Could I urge the Minister
and the Secretary of State to ensure that they consider all
possible avenues to assist with what is becoming an acute
shortage of key staff? We cannot end up in a position where the
elderly do not receive the care they need, and we need maximum
flexibility to ensure they get that care.
There is no doubt that the sector is facing extreme pressure. It
always faces pressure as the demographic need grows by 1% to 2%
every year, but we have set out money to help with the short-term
impact of that. Surrey will receive £2,704,702, so just over £2.7
million. We recently started the biggest national recruitment
campaign we have ever done, Made with Care, to thank our care
workers and to show what a fantastic and rewarding career it
would be. We will continue to work with local authorities to help
as much as we can.
(Rochdale) (Lab)
In the context of what the Minister has announced about increased
money for staff terms and conditions, what does she make of the
Alternative Futures Group, which operates in the north-west? It
refuses to take up the real living wage, even when councils offer
to fund it, and is in a process that is seeing the terms and
conditions of its workforce deteriorate? Is there a need to look
at that group, and to have a collective agreement for the whole
sector?
Yes, and I would be grateful if the hon. Gentleman would write
with the details. We have a skills shortage in many areas across
our economy. Because of the success of the Plan for Jobs, and our
bounce back from the pandemic, anybody who does not treat their
staff well will find that their skills shortages become very
acute indeed.
Covid-19 Booster Doses: West Dorset
(West Dorset) (Con)
11. What steps he is taking to ensure booster doses of the
covid-19 vaccine are available to all eligible people in West
Dorset.
The Parliamentary Under-Secretary of State for Health and Social
Care ()
We have delivered more than 15.3 million booster doses in the UK,
and we know there is a strong demand for boosters in Dorset. The
NHS has worked hard to deliver boosters and third doses at all 18
primary care networks in Dorset, providing them across a number
of sites. Additional provisions are also in place for those who
are housebound, elderly, or in care, to ensure that they get
their booster.
I thank my hon. Friend for her answer. Almost a third of
constituents in West Dorset are over the age of 65. While I
welcome very much the Secretary of State’s announcement this week
that he is rolling out the booster to those over the age of 40, I
am afraid that, in the county town of Dorchester and the second
town of Bridport particularly, it is still very difficult for the
elderly to receive their vaccine boosters. Will my hon. Friend
help urgently with sorting this issue by arranging walk-in
centres so that we might address it rapidly?
The Department of Health and Social Care and the NHS keep the
covid-19 vaccine programme under constant review in order to
ensure that there is sufficient capacity across the country.
There are more vaccination sites than ever before in England,
including hundreds of walk-in centres. A lot of planning goes
into ensuring that those sites are distributed to meet the level
of demand, and there are measures in place to ensure that
boosters are accessible for all in West Dorset, but I will look
into this matter further on behalf of my hon. Friend.
Covid-19: Booster Vaccinations
(Milton Keynes North)
(Con)
12. What assessment he has made of the effectiveness of the
roll-out of booster doses of the covid-19 vaccine.
(Runnymede and Weybridge)
(Con)
19. What assessment he has made of the effectiveness of the
roll-out of booster doses of the covid-19 vaccine.
The Secretary of State for Health and Social Care ()
The UK’s covid-19 vaccination programme has been a recognised
success story. It is the largest vaccination programme ever
undertaken by the NHS. We are working at speed to get people
their covid-19 booster vaccines. Our vaccination programme is
making great progress, with over 15.3 million people across the
UK already having taken their covid-19 booster or third jab.
It is great to hear about the uptake of the booster vaccine
nationally. I have seen some data to suggest that in Milton
Keynes, uptake is slightly below the national average. We have
some great advertising campaigns—MKFM, for example, has been
really good on this—but what more can we do to encourage people
who need to take the booster to protect themselves and protect
the NHS over the winter?
I think my hon. Friend might be wearing a booster badge, because
I understand that he has taken his own boost this morning. What
more encouragement would the people of Milton Keynes want than
their very own Member of Parliament getting boosted? I can tell
him that the Bedfordshire, Luton and Milton Keynes clinical
commissioning group is in regular dialogue with Healthwatch and
the local authority to see what more it can do to encourage local
people to take up their booster jabs, and the national “Boost
your immunity” campaign is helping to encourage more and more
people to come forward, not just for their booster jab but for
their vital flu jab.
I thank my right hon. Friend for his answer and for the speed of
the booster roll-out. In fact, it is so speedy that the criteria
for getting a booster are changing all the time, and many
constituents have contacted me confused about exactly what the
criteria are. I have spoken to my CCGs to try to get them to
improve the public engagement that they are doing, but will my
right hon. Friend lay out what the criteria are for getting a
booster at the moment, and what support he is giving to CCGs so
that they can get the message out to people and get them into
walk-in centres or booking their appointment for a booster?
My hon. Friend will understand that there is often good reason to
change the criteria. They might be changed, for example, on the
latest advice from the Joint Committee on Vaccination and
Immunisation; the Government must of course consider that advice
and take it seriously. As was mentioned earlier, we are extending
the booster jab to 40 to 49-year-olds. NHS England has issued
guidance to CCGs on the covid-19 vaccination programme, which
includes guidance on eligibility for booster vaccines and how to
manage those appointments. We encourage everyone to visit the NHS
website on gov.uk for the very latest information on the
programme.
(Kingston upon Hull West and
Hessle) (Lab)
A disabled member of my community needs the booster and is very
keen to have it. However, he is housebound and unable to go the
1.2 miles to where the booster is being offered. What can the
Secretary of State do to ensure that people who are housebound
and unable to leave their homes can get the booster that they
desperately need?
The hon. Lady makes a very important point. Hundreds of thousands
of people have received their booster jabs directly from primary
care—from their GPs—in most of the type of cases that she
describes. If anyone is housebound or, for example, in a care
home, they will receive a visit from their GP. That has happened
up and down the country. If the hon. Lady is aware of any
individual that has not received such contact, I ask her please
to contact me, and I will do everything I can to assist.
Mr (East Londonderry)
(DUP)
Take-up of the booster jab in Northern Ireland has been somewhat
behind, although it is now beginning to catch up. Does the
Secretary of State agree that the roll-out is best done as a
voluntary roll-out, so that we can persuade people that it is a
good thing, and that it protects both them and their family and
friends, to take up the booster jab?
I very much agree with the hon. Gentleman. The general
vaccination programme for covid-19, or any other vaccine for that
matter, should be voluntary. It should be a positive decision
that people take to protect themselves and those around them. The
only exception to that in England, as the hon. Gentleman will
know, is those who work with vulnerable people in the NHS or in
social care. Otherwise, it absolutely should be a positive
decision that people are encouraged to take.
GPs: Sittingbourne and Sheppey
(Sittingbourne and
Sheppey) (Con)
13. What recent steps he has taken to help ensure that everyone
in Sittingbourne and Sheppey constituency has access to a GP.
The Parliamentary Under-Secretary of State for Health and Social
Care ()
The Kent and Medway clinical commissioning group has informed us
that all practices in the area have open lists and are accepting
new patients. It has also informed us that practices in
Sittingbourne and Sheppey are being prioritised for support to
help them manage the high levels of demand they are currently
facing.
I think the Minister has been misled by my local CCG. I can tell
her that all the GPs in my area are oversubscribed and people are
finding it very difficult to get an appointment with their GP,
even including a virtual appointment. Indeed, some patients
struggle even to speak to a receptionist, because the phones are
engaged for hours on end. I understand that the NHS is planning
to give GPs an upgrade of their telephone systems, but such
upgrades will be of no use whatever unless doctors have the
resources needed to recruit and train additional receptionists to
answer the phones. What assurances can my hon. Friend give me
that GPs will get those resources?
We recognise the difficulty that patients have had in particular
with telephone access and GPs have fed in that phone lines have
been busier than ever. That is why the Secretary of State,
through the winter access fund, has addressed the issue in two
ways: the availability of the cloud-based telephone system that
GPs and primary care networks can be a part of, which will help
to build their telephone capacity; and the £250 million winter
access fund, which GPs can use to either recruit more telephone
receptionists and train up existing telephone receptionists or
build up more resources. I am very happy to discuss that further
with my hon. Friend.
Topical Questions
(Hartlepool) (Con)
T1. If he will make a statement on his departmental
responsibilities.
The Secretary of State for Health and Social Care ()
It is a critical time for our country, and we are taking vital
steps across health and care. First, on covid, we have now given
over 112 million doses of the vaccine in total across the UK.
Yesterday, our booster programme was opened up to all people over
the age of 40 and we extended our offer of a second dose to all
people aged between 16 and 17.
Secondly, on recovery, we are delivering the biggest catch-up
plan in the history of the NHS, including the £5.9 billion
capital investment we announced last month. Lastly, on reform,
yesterday we announced our intention to put a policy of education
and training for the health workforce and digital transformation
at the very heart of the NHS, so we can plan more effectively as
one for the long term, with clear accountability for
delivery.
A young constituent of mine, Chris, has had to have part of his
skull removed following a stroke. Although he is prone to
falling, his brain has been largely unprotected for nearly two
years. This is because his surgeon feels that the necessary
surgery is primarily cosmetic. Several other of my constituents
have been refused surgery on those grounds, despite procedures
being available elsewhere. What steps is my right hon. Friend
taking to level up such health disparities and make health
inequality a thing of the past?
First, I am sorry to hear about my hon. Friend’s constituent
Chris and wish him all the very best. She will know that clinical
commissioning groups are responsible for commissioning local
healthcare services. If the aim of a cosmetic procedure is health
rated, such as the need to repair or reconstruct missing or
damaged tissue or skin that might come through illness, birth
defect or accident, it will be commissioned and seen to by
commissioners. She refers to a particular case. If she would like
to provide me with more details, I would be happy to take a
look.
(Leicester South)
(Lab/Co-op)
At the weekend, the Secretary of State effectively ditched his
promise to deliver 6,000 extra GPs. Last week, the Infrastructure
and Projects Authority said his promise to deliver 40 new
hospitals is “unachievable”. Last night, he whipped a vote that
sees poorer pensioners lose their homes to pay for care, while
the homes of the richer are protected. Can he tell us which
promise is he going to break next?
I have to say that the right hon. Gentleman is wrong on all three
counts. The Government are absolutely committed to hiring more
GPs, with over 1,800 full-time equivalent GPs entering primary
care in the two years to September 2021. We are seeing success
after success in the hospital building programme, with the
biggest capital investment programme in hospitals that this
country has ever seen. As for our social care programme, this
Government are the first in decades to have the guts to deliver,
and that is exactly what we are getting on with.
The Secretary of State’s social care programme is not levelling
up when the promise in his manifesto that no one should have to
lose their home to pay for care is broken and in tatters after
last night.
The Secretary of State’s next promise was to give the NHS
“everything” to get through the backlog. With waiting lists
growing at pace, ambulances backed up outside hospitals, and
cancer operations getting cancelled, what will he do to recruit
the staff we need? He is apparently not going to support the
cross-party amendment in the name of the former Health Secretary,
the right hon. Member for South West Surrey (), tonight, and he failed to win
the funding needed for recruitment and training in the Budget, so
how will he deliver on his promise to give the NHS “everything”
when it does not have the staff to deliver the care to bring
waiting lists down?
Once again, the right hon. Gentleman proves he still does not
understand the social care programme that this Government have
set out. I think that is deliberate; he chooses not to understand
it. For the first time, catastrophic costs are being capped for
everyone in the country, regardless of where they live, and the
generous means-testing system will ensure that the vast majority
of people will benefit and that no one will lose out.
The right hon. Gentleman asks me what I am doing about the
workforce. We are making the biggest investment in the workforce
that this country has ever seen. Yesterday I announced the merger
of Health Education England into the NHS, so that we can have a
better joined-up strategy, and we have already set out a 15-year
framework to consider the long-term needs of the workforce.
(High Peak) (Con)
T2. Hundreds of local people have responded to my High Peak
GP surgery survey, and I look forward to presenting Ministers
with the results shortly. One of the top concerns is about how we
can improve access to primary care. One way would be finally to
build a major new health centre for Buxton. The local NHS already
owns a suitable town centre location with outline planning
permission; all it requires is the capital funding. Derbyshire
Community Health Service NHS Trust has submitted a strong bid,
which I support, so will the Secretary of State meet me to
discuss how we can deliver the proposal and improve healthcare
for Buxton and the whole High Peak?
Yes, I will. I looked at the previous bid and have been trying to
understand why it was not taken forward. However, I would like to
look carefully at the revised bid. I reassure my hon. Friend that
more funding is available for such capital projects, and I would
be happy to discuss that with him.
(Middlesbrough) (Lab)
T4. Now that the cap on care costs has unravelled, many of
my constituents feel misled and betrayed, especially those with
modest capital in the value of their home. How can it be that
those with the most will contribute the least and that those with
the least will contribute the most? Where is the equity, where is
the fairness, and where is the justice in any of that?
The Minister for Care and Mental Health ()
I thank the hon. Gentleman for his question. We are trying to
solve something that has not been solved for decades, and the
Labour party does exactly what it always does when it comes to
this point: it picks one specific part without looking at the
package as a whole and misleads the whole country. I want a
better system not only for our grans and grandads, but for our
mums and dads and all of us. If this system had been in place for
my grandmother when she had dementia before dying in 2018, she
would have been a lot better off. While we sit here doing
nothing, the reality is that everybody loses—
Mr Speaker
Order. Questions and answers are meant to be short and punchy. We
cannot get into a full-blown debate.
(Ruislip, Northwood and
Pinner) (Con)
T5. My constituents benefit from the excellent healthcare
provided at Hillingdon Hospital, but it is long overdue a
rebuild. Can my right hon. Friend give me an update on when we
might expect to see progress on those plans?
It is a vital project, and the trust project team are working
well with NHS England and with my Department. The scheme, as I
understand it, remains on track; like my hon. Friend, I look
forward to its completion.
(Lewisham, Deptford)
(Lab)
T7. New research from the Disabled Children’s Partnership
shows that nearly three quarters of disabled children and young
people have seen their conditions regress in the pandemic because
of a lack of adequate support. Therapies, short breaks and health
services have all been massively reduced, and there are huge
backlogs. Will the Secretary of State outline how the Government
plan to rapidly sort that out?
I thank the hon. Lady for her very important question. There is
nothing more important than our children. Sadly, some of the
actions that were taken at the height of the pandemic, for
understandable reasons, have had unintended consequences. That is
exactly why we are putting in a record amount of funding, with
the biggest catch-up programme for elective procedures in the
history of the NHS. I know that that will help.
(Ludlow) (Con)
T6. The capital transformation of acute hospitals in
Shrewsbury and Telford has been eight years in the making. Will
the Secretary of State confirm what is now needed to start
delivering the £312 million of capital committed by the
Conservative Government to improve Shropshire’s healthcare
facilities? Will he also confirm that it does not make sense to
head down the rabbit hole of a new hospital and start this whole
process all over again?
The Minister for Health ()
I am grateful to my right hon. Friend, who has taken a long-term
and consistent interest in the matter. The strategic outline case
for transforming the Royal Shrewsbury Hospital and Princess Royal
Hospital Telford was received at the end of October 2021. It has
been reviewed by the NHS and detailed feedback has been given; I
look forward to it coming forward to me early next year. We
remain committed to delivering the investment and improvement
that Shropshire’s hospitals need and that he and his colleagues
have helped to secure.
(Chesham and Amersham) (LD)
Women across the country have lost jobs and life savings as a
result of chronic pain and disability caused by complications
after the use of medical mesh. Many, including one of my
constituents, have had to pay for corrective surgery overseas.
The Government have so far refused to set up agencies to provide
financial redress, as was recommended in the Cumberlege report.
Will the Secretary of State revisit the Cumberlege report, and in
particular the need for financial redress?
The Parliamentary Under-Secretary of State for Health and Social
Care ()
Women who have suffered are being helped and supported through
the difficult choices that they are having to make. The
Government have set up eight specialist mesh centres across the
country to provide them with the specialist treatment that they
need. Our priority is patient safety, preventing anything like
this from happening again, and supporting women who have been
affected. There is no evidence that a redress system would
improve patient safety or improve the outcome for those
women.
(South West Bedfordshire)
(Con)
T8. As ear syringing is no longer being undertaken in local
surgeries, and as self-care does not work for many people, will
the Government make sure that microsuction is at least available
in every primary care network area? Otherwise, we are leaving
people to go deaf.
Local commissioners are responsible for meeting the health needs
of their local population and should continue to ensure
appropriate access to ear wax services. However, should a CCG not
routinely commission ear wax removal or the suction method that
my hon. Friend refers to, a patient can request an individual
funding request. I am happy to help my hon. Friend if that is not
happening locally.
(Denton and Reddish)
(Lab)
Cancer targets are not being met. This September had the worst
figures on record for both the 31-day and the 62-day targets; the
62-day target has not been met since 2015. Extra funding is
welcome, but where is the detailed implementation plan that was
promised to follow?
I reassure the hon. Gentleman that cancer has remained an
absolute priority for the NHS during the pandemic, as it will
continue to be. The funding that has been awarded to deal with
long-term electives includes funding for cancer referrals. Some
amazing work is being done by our cancer alliances, which are
looking to deal with the urgent backlog that has developed during
the pandemic.
(Haltemprice and Howden)
(Con)
T9. In the next week or so, the Secretary of State will
receive the Goldacre report on maximising the use of data in the
national health service for both research and operational
reasons. The Department has failed dramatically, a couple of
times in the past decade, to maximise the use of this enormously
important resource. Will he undertake to read the report,
consider carefully the policies in it with a view to implementing
them quickly, and publish it before the end of January?
My right hon. Friend has raised this issue with me before, but he
is right to raise it again, because proper use of data is
important to the future of the NHS. He may have noted our
announcement yesterday that we are merging NHS Digital and NHSX
with NHS England, which will enable us to do a much better job
with data. I will of course look carefully at that report, and I
should be happy to meet him to discuss it further.
(York Central)
(Lab/Co-op)
Poppy is just eight. She has severe epilepsy, with ever more
frequent and enduring episodes. Her specialist consultant has
said that surgery is her only hope, but Sheffield and Leeds have
refused to assess her for capacity and administration reasons,
not clinical reasons. Will the Minister work with me to ensure
that Poppy receives the treatment that she needs?
I am sorry to hear about the hon. Lady’s constituent, and of
course a Minister will meet her.
(Bromley and Chislehurst)
(Con)
T10. I refer to my interest as chair of the all-party
parliamentary group on stroke and as the husband of a stroke
survivor.Mechanical thrombectomy can be a game-changer for
sufferers of strokes, greatly reducing the levels of disability
they are left with. NHS England committed itself to a full
roll-out of mechanical thrombectomy availability by 2022, but we
are lagging seriously behind. Where are the plan and the
investment to bring the programme back up to date and on
track?
I know that my hon. Friend has a personal interest in improving
stroke services. I can reassure him that the national stroke
service model was published by NHS England and NHS Improvement in
May this year, and that as of 1 April there are 20 operational
integrated stroke delivery networks, bringing together key
stakeholders to improve the diagnosis, treatment and
rehabilitation of those who have suffered a stroke.
(St Albans) (LD)
Ambulance response times are at their highest since records
began. A month ago, on 22 October, I tabled a parliamentary
question asking the Secretary of State how many ambulance trusts
had moved into level 4—the level at which potential failures
creep into the service. I am still awaiting an answer. Will the
Minister answer that question today, please?
If the hon. Lady supplies the number of the question, I will
ensure that it is dealt with today. As for her broader point,
yes, ambulance services across the country are under significant
pressure this winter, which is one of the reasons why we have
already invested an additional £55 million in helping them to
cope with that pressure.
Mr Speaker
I call the Chairman of the Health and Social Care Committee,
.
(South West Surrey) (Con)
Thank you, Mr Speaker.
The Secretary of State knows that some in Government are worried
about the extra cost of training additional doctors, but does he
agree that every additional doctor we train means one fewer
locums that the NHS has to hire, which is cheaper for the NHS and
better for patients?
I agree that we want more and more full-time doctors, which will
mean that there is less demand for locums and is, of course, very
good for the NHS. I also agree that there should be more focus on
the workforce, and I hope that my right hon. Friend welcomes the
measure that I took yesterday of merging Health Education England
with the NHS, so that we can have a much more joined-up workforce
plan.
(Oldham East and
Saddleworth) (Lab)
Andrew Dilnot, whose commission undertook the inquiry into social
care nearly 10 years ago, says that the impact of the
Government’s social care plans on working-age disabled people
will be “catastrophic”. What is the Government’s assessment of
the impact?
The hon. Lady is right to raise the importance of doing
everything we can to look after working-age people who need
social care. As she will know, the total funding of social care
from the state now constitutes most of the funding, and it is
right that all needs are met through those funds. As for the new
plan, everyone will benefit—no one will lose out from this versus
the current system—so the vast majority of people will be better
off, including working-age adults.
(Shrewsbury and Atcham)
(Con)
The Minister has heard from my right hon. Friend and neighbour
the Member for Ludlow () how essential it is that the
£320 million we have secured for the Future Fit programme be
released, so that construction can start. We are beginning to see
a definite negative impact on A&E services because of the
seven or eight years of delays. Please will the Minister do
everything possible to ensure that the money is finally released
and construction can start?
I am grateful to my hon. Friend, and likewise to my right hon.
Friend the Member for Ludlow (), who has campaigned
vigorously this issue. We now have the outline business case from
the trust, and we are reviewing it at pace to ensure that we can
deliver the investment in both of Shropshire’s hospitals that
they need to continue to serve my hon. Friend’s and colleagues’
constituents.
(Manchester, Withington)
(Lab)
My 90-year-old constituent, Jimmy, fell in his garden recently
and broke his hip. When his family rang 999, they were told that
it would be up to 14 hours before an ambulance could attend. The
family got the fire brigade out after two and a half hours to
sort him out. When the Government going to get a grip on the
crisis in our ambulance services?
The hon. Gentleman might have done this already, but if he wishes
to, I would be grateful if he wrote to me about that case, not
only to see whether there is anything I can do, but because it is
always interesting and useful to hear from individual Members
about specific incidents. To his broader point, as I set out to
the hon. Member for St Albans (), we have invested £55 million
this year ahead of the winter to support our ambulance services,
but it is entirely true to say that they are under considerable
pressure this winter across the country.
