Health Outcomes: East Midlands Sir Edward Leigh (Gainsborough)
(Con) 1. What steps his Department plans to take to improve health
outcomes in the east midlands.(900621) The Minister for Secondary
Care (Karin Smyth) Lord Darzi's report concluded that the health
service is in a critical condition across the country, including in
the east midlands, where healthy life expectancy has declined in
the past decade. Waiting lists in the region stand at slightly
below the...Request free trial
Health Outcomes: East Midlands
Sir (Gainsborough) (Con)
1. What steps his Department plans to take to improve health
outcomes in the east midlands.(900621)
The Minister for Secondary Care ()
Lord Darzi's report concluded that the health service is in a
critical condition across the country, including in the east
midlands, where healthy life expectancy has declined in the past
decade. Waiting lists in the region stand at slightly below the
national average for 18-week waits, at 57% compared to the
national average of 58%.
Sir
With two thirds of people having to wait more than four hours at
Lincoln County hospital's A&E department and with horror
stories from my constituents of people waiting up to 24 hours,
does the Minister understand that if we are to save the NHS and
give people the timely appointments they need, we must unleash
the full power of the private sector?
I thank the right hon. Gentleman for helping to underline the
shocking inheritance from the previous Government. He is
absolutely right. We are committed to cutting waiting times and
serving constituents, like mine, by delivering the long-term
reform the NHS desperately needs. The Government are committed to
the funding model. We are not going to change it. He tries this
every time, but we are committed to the funding model as it
exists.
(Warwick and Leamington)
(Lab)
A really important part of improving health outcomes in the east
midlands, and across the country, is the use of diagnostics. The
Rosalind Franklin laboratory, which was set up in my
constituency, was closed down just a few months ago at a cost of
£0.6 billion. Does my hon. Friend agree that one of the most
important things we could do is to restore good quality
diagnostics to our NHS?
My hon. Friend is absolutely right. We are committed to improving
diagnostics as part of our reform of the health sector. Analysis
of waiting lists shows that 20% of people will end up with a
hospital admission, most as a day case. To improve waiting times,
the focus must be on early prevention, diagnostics and consultant
review at an early stage.
NHS Urgent and Emergency Care
(Dover and Deal) (Lab)
2. What assessment his Department has made of the effectiveness
of NHS urgent and emergency care services.(900622)
The Minister for Secondary Care ()
The recent independent report by Lord Darzi makes it absolutely
clear that urgent and emergency care services are also
struggling, with the latest data published last week showing that
one in 10 patients spend over 12 hours in A&E. We are
committed to returning to service standards that patients rightly
expect through our ambitious 10-year plan to reform the health
service.
In September 2021, Victoria hospital in Deal lost provision for
blood testing. After a long campaign by residents, it was agreed
that it would return. However, that has stalled in the tendering
process. Will the Minister meet me to discuss how we can move
this forward?
I commend my hon. Friend for championing this issue on behalf of
his constituents. I understand that he has raised it with the
chief executive officer of his local trust. He will appreciate
that commissioning decisions are a matter for the local
integrated care board, in this case Kent and Medway ICB, but I
am, of course, very happy to meet him to discuss it further.
(St Ives) (LD)
I wish the Minister well in her efforts to address this issue,
because it is extremely serious. There are very often more than
20 ambulances queueing outside Treliske hospital, which has a
serious impact on expectations for patients. Will the Minister
please look at the potential for urgent treatment centres to take
pressure away from emergency departments, such as the urgent
treatment centre at West Cornwall hospital in Penzance, which
really needs to be re-established on a 24/7 basis? That would
make a real impact.
I thank the hon. Gentleman for his good wishes. It is, indeed, a
huge task we have before us. We will maintain ambulance capacity
throughout this winter. He makes a valuable point about
alternative models to hospital admissions and treatment in the
community. That is a matter for the local ICB, as I know he
knows. It needs to look at which model is the best fit,
particularly in rural areas, to reduce the pressure on frontline
A&E services.
(Liverpool Wavertree)
(Lab)
Intermediate care for people facing homelessness, which is
recommended by the National Institute for Health and Care
Excellence, can reduce rough sleeping by around 70%. That is
life-changing for people who have been sleeping rough and it
plays a significant role in relieving pressure on hospitals. A
recent evaluation of intermediate care for people facing
homelessness in one county in England found a 56% reduction in
A&E visits and a 67% reduction in emergency admissions. What
exists currently is a postcode lottery. How can we embed the NICE
approach in every integrated care system across England?
My hon. Friend has highlighted an issue that is often overlooked.
Homelessness has risen to shocking levels in the last 14 years.
When it was addressed under the last Labour Government, people
were moved off the streets, and there was decent care at the
front end of the hospital system and support in the community. My
hon. Friend is right: there are good examples across the country,
and we would like to see them embedded as part of our overall
goal, across Government, of reducing the scourge of homelessness
in society and once again supporting the front end of the health
service.
(Mid Sussex) (LD)
I recently met representatives of the Royal College of Emergency
Medicine, who told me that the inadequate state of social care
was resulting in the deterioration of people's physical health,
leading to more presentations at emergency departments. Does the
Minister agree that if social care were properly funded, pressure
on our hospitals would be reduced?
What we see at the front end of the system is a result of the
deterioration throughout the system, and the flow of patients
from the community, through discharge and, indeed, through social
care. Our ambitious 10-year plan will involve examining the
entire patient pathway to ensure that care is provided in the
community, closer to home. Prevention is a key part of that, as
is the look that we are taking at social care.
Adult Social Care
Greg (Mid Buckinghamshire) (Con)
3. What steps he plans to take to reform adult social
care.(900623)
The Minister for Care ()
After 14 years of Tory neglect and incompetence, adult social
care is on its knees. The number of people receiving long-term
care decreased between 2015 and 2023, and there were a staggering
130,000 staff vacancies in the system. Last Thursday, recognising
the central role of our amazing care workforce, we took a
critical first step by introducing the groundbreaking legislation
that will establish the first ever fair pay agreement for care
professionals. I think it fair to say that this Government have
done more for our adult social care workers in 14 weeks than the
last lot did in 14 years.
Greg
Given unfunded schemes such as the proposed national care
service, given the new negotiating body's aim of establishing a
minimum pay floor, and given what clearly amounts to an expensive
top-down reorganisation of the care system, can the Minister
explain how he will maintain and enhance the role of local
authorities, including Buckinghamshire Council, in targeting and
delivering care, and how he plans to maintain day-to-day spending
alongside this grand plan for reform, without raising taxes?
It beggars belief that Opposition Members should lecture us on
fiscal discipline when there is a £22 billion in-year black hole.
We are committed to consulting widely on the design of a fair pay
agreement, and we will engage with all who may be affected. We
are keen to ensure that all voices are heard so that the
financial impacts on the adult social care market, local
government and self-funders can be considered, but in a week in
which this Government have attracted £63 billion of investment
and just days after the publication of the Employment Rights
Bill, we are seeing a Government who are pro-business, pro-worker
and pro-growth.
(Suffolk Coastal)
(Lab)
Adult social care is under extreme pressure. One in four hospital
beds are occupied by patients with dementia. Will the Minister
commit himself to the delivery of a dementia strategy in the
current Parliament?
That is an extremely important question. I recognise that
dementia is a huge issue that impacts on the entire country and,
indeed, many Members on both sides of the House. We are
absolutely committed to the research that is fundamental to
addressing the problem, and our fair pay agreement is about not
just pay but training and terms and conditions. We will be
ramping up dementia training for our adult social care
workforce.
Mr Speaker
I call the shadow Minister.
Sir (Maldon) (Con)
The Labour manifesto spoke of the need for a consensus on social
care, and the Secretary of State has said that he wants to reach
out across the political divide—although the message does not
seem quite to have reached the Minister yet. During Health and
Social Care questions in July, the Minister said that there would
be announcements in the near future, but since then we have heard
nothing. We are ready to talk; when will the Government be
ready?
I am not sure if the right hon. Gentleman was listening to my
previous answer. We have just set out a groundbreaking piece of
legislation to settle the issue of adult social care pay, which
is more than the last lot did in 14 years. We are absolutely
committed to building cross-party consensus. We know that we need
a process that will be sustainable and fix adult social care for
the long term. That absolutely includes engagement and dialogue
across this House, because we want to build a consensus that
works. We recognise that successive Governments have failed to
get a grip on this issue, but we recognise the vital role that
adult social care will play. It is going to be a hugely important
part of our 10-year plan for the future of the NHS, and I look
forward to engaging with all hon. Members on this issue.
Post-sepsis Syndrome
(Ashfield) (Reform)
4. What assessment he has made of the adequacy of treatment for
post-sepsis syndrome.(900624)
The Parliamentary Under-Secretary of State for Health and Social
Care ()
I thank the hon. Member for raising awareness of this important
issue. He has spoken powerfully about the experiences of patients
in his constituency and his wife's personal battle with sepsis.
The long-term complications of sepsis can have a devastating
impact long after discharge from hospital. Through the National
Institute for Health and Care Research, the Department is funding
research to improve outcomes for sepsis survivors.
Last year, Abbi Hickson from Ashfield lost both her hands and her
lower legs to sepsis. The local hospital was very slow to
diagnosis her condition, and since then she has been suffering
from shortness of breath, fatigue and a lack of sleep. This could
be post-sepsis syndrome, yet nobody at the hospital has spoken to
her about it. Does the Minister agree that every single sepsis
patient and survivor should be advised about this condition?
I absolutely do, and I pay tribute to Abbi, a beautiful woman
whom I was privileged to meet after the Westminster Hall debate
last week. Although care after sepsis will vary hugely on a
case-by-case basis, we need to make sure that the needs of each
individual are met. In this case, it sounds like they have not
been met. If the hon. Gentleman wants to meet me to discuss this
issue further, I am more than happy to do so.
(Dartford) (Lab)
Given that last month was Sepsis Awareness Month, will the
Minister join me in paying tribute to the courage of John Snow
and his family in my Dartford constituency? Tragically, he has
just experienced a quadruple amputation due to sepsis. He has
received amazing support from the Dartford community, who have
rallied around to help fund support for his family. Will the
Minister use that as a spur to improve treatment for sepsis more
generally across the country?
I pay tribute to John Snow and, indeed, my hon. Friend's
constituents, who have rallied around him at his time of need.
This matter highlights the need to have better joined-up care to
ensure that people who have sepsis receive the best care
possible, that those who tragically lose limbs as a consequence
of sepsis are able to have good-quality aftercare, and that we
continue to raise awareness of sepsis and the risks it poses.
(Kingswinford and South
Staffordshire) (Con)
We think that about 48,000 people a year lose their lives to
sepsis, but the truth is that we do not know, because the data is
inconsistent. Will the Minister look at establishing a national
registry to track sepsis cases, so that performance can be
measured, published and improved?
Given the national standards and framework that have been put in
place in this regard, I hope very much that the NHS will be able
to do precisely what the hon. Gentleman wants it to do.
(Dudley) (Lab)
Yesterday was Allied Health Professions Day, which raises
awareness of 14 professions, including physios, speech and
language therapists, and radiographers. Does the Minister agree
that all the hard work of those professionals is really important
for patient care?
My hon. Friend makes a really important point. The wonderful
staff we have working across health and care ensure that our
constituents receive, within a very tightly constrained health
service, the best possible care that we can give them. The NHS is
broken. We have to fix our broken health service, and having
good-quality staff at the heart of it is how we are going to
achieve that aim.
Patient Waiting Times
(Kingston upon Hull East)
(Lab)
5. What assessment his Department has made of the adequacy of
patient waiting times.(900625)
The Secretary of State for Health and Social Care ()
Waiting times are wholly inadequate in our country. That is
because the previous Conservative Government took a golden
inheritance of the shortest waiting times and the highest patient
satisfaction in history and left behind the worst crisis in the
NHS's history. What is more, they accept no responsibility and
cannot even bring themselves to say sorry.
I pay tribute to my own family GP, Dr Islam at the East Hull
family practice, who goes above and beyond for his patients.
However, I know that GPs are troubled by the amount of time
patients have to wait to see them. The disparity between GP
numbers in different areas is utterly shocking. In Kingston upon
Thames, for example, a GP looks after 1,800 patients, but in
Kingston upon Hull it is more than double that number. What is my
right hon. Friend doing to sort out the Tory mess of the last 14
years?
May I first, through my hon. Friend, say thank you to Dr Islam
and to GPs right across the country who, against the backdrop of
the extraordinary challenges they are working through, have none
the less managed to deliver more appointments now than when there
were thousands more GPs? My hon. Friend is right to point out
that we do not have enough GPs in this country. That is why,
within weeks of taking office, this Government found just shy of
£100 million to put into the frontline to employ 1,000 more GPs
who will be seeing patients before the end of this financial
year. That will make a real difference, and the shadow Secretary
of State should have the humility and to grace accept that.
(Witham) (Con)
Patient waiting times are reduced dramatically through the
recruitment and retention of more GPs, so will the Secretary of
State welcome the work of the Anglia Ruskin medical school in
Essex, and perhaps have a conversation with myself and
neighbouring MPs about how that medical school could be expanded
to do much more to support the recruitment and training of more
MPs—more GPs in Essex?
I am sure that the right hon. Lady does want more Conservative
MPs in Essex. She has raised an entirely constructive point,
which I strongly welcome. This Government are committed, as we
were in opposition, to doubling the number of medical school
places, and that means real opportunities for local medical
schools such as hers. As ever, I would of course be delighted to
meet her to talk about what more can do with her local
university.
(Sheffield Central)
(Lab)
The news that we are recruiting more GPs is very welcome. I spent
an afternoon shadowing a local GP and saw just how stretched the
services were. Will the Secretary of State give a commitment that
we are moving towards investment in primary care services and
moving from a national health service to a focus on neighbourhood
health services?
I am grateful to my hon. Friend for raising that question. When
in opposition, I was delighted to spend time with a whole group
of GPs from across Sheffield who showed us what primary care
reform could look like. We are committed to increasing primary
care as a proportion of the NHS's budget, which will be
important, and also to building exactly the kind of neighbourhood
health service she describes, with more care closer to people's
homes. General practice has a key role to play in that.
Mr Speaker
I call the Chair of the Select Committee.
(Oxford West and Abingdon)
(LD)
What we measure is often what we end up improving, and one of the
great assets of Lord Darzi's report is the technical annex with
its 330 analyses. It is incredibly useful; it is a baseline. Will
the Secretary of State make sure that it is updated yearly?
That is a great constructive challenge. I am absolutely committed
to transparency and to keeping that dataset updated in the way
that the hon. Lady requests. We are not going to get everything
right and sometimes we are not going to make progress as fast as
we would like, but where that is the case we are never going to
duck it or pretend that things are better than they are. The
reason that we will succeed where the previous Government failed
is that we are willing to face up to the challenges in the NHS
rather than pretend that they do not exist.
Mr Speaker
I call the shadow Minister.
Dr (Runnymede and Weybridge)
(Con)
The Prime Minister has repeatedly stressed the importance of
preventing people from taking up smoking, as one of his
priorities to improve the nation's health, reduce waiting lists
and lessen demand on the NHS, and we agree. The Government like
to talk about the record of their first 100 days in office but,
according to data from Action on Smoking and Health, 280 children
under the age of 16 take up smoking in England each day. That is
28,000 children in England during the Secretary of State's first
100 days. Why has he not yet reintroduced our Tobacco and Vapes
Bill? How many children need to take up smoking before he makes
this a priority?
Perhaps the shadow Minister would like to give us the figures for
the entire 14 years that his party was in government. By the way,
just to set the record straight, not only did I propose the
measures in that Bill during an interview with The Times earlier
last year, but if it was such a priority for the Opposition, why
did they leave the Bill unfinished? Why had it only had its
Second Reading? And why did we go into the general election with
that Bill unpassed? I will tell him why: because his party was
divided on the issue, and the then Prime Minister was too weak to
stand up to his own right-wingers who are now calling the shots
in his party. The smoking Bill will be back, it will be stronger
and, unlike the previous Government, we will deliver it.
Mr Speaker
I call the Liberal Democrat spokesperson.
(North Shropshire) (LD)
My constituent Mel Lycett has terminal cancer. After repeated
visits to her GP, she was referred to a two-week urgent pathway
in May. She was not diagnosed until the end of July, and she
still has not started treatment. Every single target for her
diagnosis and treatment was missed. That is not uncommon in
Shropshire, and it is not uncommon in the rest of the country.
Can the Secretary of State reassure me of what he is doing to
deal with this terrible legacy left behind by the Conservative
Government? How will he ensure that cancer patients are treated
in a timely manner?
I welcome the hon. Lady to her role. I am afraid that this case
is just one of countless stories of people whose lives might have
been saved had the NHS been there for them when they needed it.
It is bad enough when people receive a late diagnosis that
equates to a death sentence; it is worse still when people in
that position are not given the fighting chance of urgent,
life-extending treatment.
The inheritance we have received is truly shameful. I assure the
hon. Lady, as a cancer survivor myself—because the NHS was there
for me when I needed it—that we will work tirelessly through a
national cancer plan to make sure that we deliver the cancer
waiting time standards that the last Labour Government met, and
that are sorely needed today.
Primary Care Services for Men: England and Scotland
(Paisley and Renfrewshire
South) (Lab)
6. If he will make a comparative assessment of the adequacy of
access to primary care services for men in (a) England and (b)
Scotland.(900626)
The Parliamentary Under-Secretary of State for Health and Social
Care ()
As Lord Darzi identified in his NHS review, primary care is
broken, with 1,600 fewer fully qualified GPs than in 2017. We
recognise that men can face particular challenges in accessing
services, which is why we are committed to fixing the front door
to the NHS, bringing back the family doctor and shifting the
focus of care away from hospitals and into the community. Health
is devolved in Scotland, but I welcome opportunities to share
learning across our two nations.
In my Paisley and Renfrewshire South constituency, the rate of
premature death in men is 47.9% higher than the UK average.
According to National Records of Scotland, the number of people
who have died by suicide in Renfrewshire as a whole has increased
to the highest level in 10 years. Does my hon. Friend agree that
this is a damning indictment of the SNP Government's record on
health? Will he commit today to holding a summit in November,
with Movember, to raise men's health up the agenda?
Those statistics are both damning and shocking. Health
inequalities in any part of our United Kingdom need to be
tackled, and the SNP Government have real questions to answer on
these shocking statistics for men in my hon. Friend's
constituency and across Scotland. I will take up her challenge. A
summit with Movember, and with her and other interested Members,
to talk about men's health issues is a cracking idea, and I will
get straight on to it when I get back to the Department.
(Aberdeenshire North and
Moray East) (SNP)
I appreciate that the Secretary of State is unlikely to comment
on the Chancellor's forthcoming statement, but he and his
Front-Bench colleagues have already mentioned funding issues a
number of times this morning, so will he confirm that it is the
policy of his Government to take steps to increase the UK's
health spending to the average of other countries in north-west
Europe? That would lead to an increase of around £17 billion for
the national health service and would help address some of the
issues referred to by the hon. Member for Paisley and
Renfrewshire South ().
Mr Speaker
Order. Questions ought to be linked to the subject being dealt
with, which is access to primary care. I am sure that the hon.
Gentleman meant to ask, “Will there also be funding to improve
access to primary care?”, which I am sure the Minister can
answer.
This Labour Government were elected to tackle health
inequalities, fix our NHS and ensure that more people live
longer, healthier lives. That will require a concerted Government
effort, which is why we have the health mission board in place.
My right hon. Friend the Secretary of State is making the case
for investment and reform at every opportunity, but let us be
clear: every single Labour Government have left the country with
a better NHS than they inherited, and this Labour Government will
fix our NHS once more.
Whipps Cross Hospital: Redevelopment
Sir Iain Duncan (Chingford and Woodford Green)
(Con)
7. What his Department's timetable is for announcing the outcome
of its review of the new hospital programme in relation to the
proposed redevelopment of Whipps Cross hospital.(900627)
The Secretary of State for Health and Social Care ()
I must declare an interest, because Whipps Cross hospital serves
my constituents, as well as those of the right hon. Gentleman. On
that basis, I am well aware that we desperately need the proposed
redevelopment of the hospital. That is why, in common with so
many Members across the House, I am furious that the previous
Government's new hospitals programme had a timetable that was a
work of fiction and money that will run out in March. The
assurance I can give to the right hon. Gentleman, his
constituents, my constituents, and the constituents of every
right hon. and hon. Member across the House whose constituents
are waiting for news on the new hospitals programme, is that we
will deliver on a timetable that is credible and a programme that
is funded, giving our constituents the clarity and consistency
they deserve, and rebuilding by placing the Government among our
construction industry supply chain.
Sir Iain Duncan
The Secretary of State knows that we have campaigned together for
the redevelopment of Whipps Cross hospital, and whether that is
delivered by a Labour or Conservative Government makes no
difference to me. I want to drag him to the reality of a specific
point about the hospital: it was granted £1.2 million towards
undertaking a business case, which it received in August, but
that money has run out. A total of £5 million is required to be
ready when the decision is made; if it is not available, the
hospital will lose the architects and builders. Will he go back
to the Department and ensure that the hospital receives that
money, so that managers can be ready with the full, detailed
business case the moment the decision is made? Otherwise, it will
cost £50 million extra over the next year to get the architects
and builders back. I beg the Secretary of State—I literally beg
him—to look at that carefully.
I am grateful to the right hon. Gentleman for his question. Those
practical considerations are very much part of the review. I say
to the poor project managers across the country who have had to
deal with the previous Government's stop-start approach that we
are not going to make that mistake. We are going to come forward
with a credible plan that is also funded, not the work of fiction
or the £22 billion black hole that the shadow Secretary of State
left in her wake.
Mr (Leyton and Wanstead)
(Lab)
Whipps Cross hospital is in my constituency and it is my
constituents who have had to endure five years of the previous
Government organising photo opportunity after photo opportunity,
not putting the contracts in place for the project to be up and
running and ready to go. Does my right hon. Friend agree that
only a fully costed, long-term approach from this Labour
Government can deliver the modern healthcare that my constituents
need?
My hon. Friend, my constituency neighbour, is absolutely right.
He has been doing an outstanding job of representing the people
of Leyton and Wanstead since his arrival. What our constituents,
and indeed constituents right across the country, deserve is
honesty, clarity and consistency. That is how we will turn the
new hospitals programme from a press release into reality and
how, in doing so, we will restore trust in politics and, for
businesses, the construction industry and the supply chain,
restore confidence in public sector procurement.
Mr (Mid Leicestershire)
(Con)
Many Leicestershire residents are concerned about the
Government's review of the new hospitals programme, which would
have seen two new hospitals, a midwifery-led unit and a
multi-storey car park in the city. What representations has the
Minister made to the Chancellor to retain this vital investment
for the NHS in Leicestershire?
The hon. Gentleman asks what representations I am making to
retain the funding. If only that were the case. The funding was
not there. The Conservative party went into the general election
with a programme timetable that was a work of fiction and a claim
to have a funded programme that was simply not true. What we
arrived to find was a timetable that was a load of rubbish and a
£22 billion hole in the public finances that the party hid from
the country because it did not want to confront the hard truths.
This Government are facing the facts and answering the
challenges.
Ms (Walthamstow) (Lab/Co-op)
I am probably the only MP in this current Chamber who has
recently used Whipps Cross hospital, which also serves my
community in Walthamstow, because I had both my children there,
so I know at first hand how desperately it needs redevelopment
and how poor the facilities are that the amazing staff are having
to use. Does my right hon. Friend agree that finally getting this
project moving under a Labour Government will also deliver
thousands of much-needed homes in our local community? It is a
win-win situation, which is why it is such a travesty that, for
years, Conservative Ministers came and took photos, but we never
saw any diggers or spades in the ground. Does he agree that
Labour can change that?
My hon. Friend is absolutely right. This is about not just the
necessary hospital projects, but the growth that will come
through construction, getting these projects up and running and,
of course, the role that the NHS plays as an economic anchor
institution in communities, as some of these projects will
necessarily unlock new housing sites and a local transport
infrastructure. We are mindful of all of that. The most important
thing is that we come forward with a timetable that is credible
and a programme that is funded, and that is exactly what we will
do.
Mr Speaker
We look forward to getting the land in Chorley on that basis.
District Hospitals
(Barrow and Furness)
(Lab)
8. What assessment he has made of the effectiveness of district
hospitals in providing services that meet the needs of local
communities.(900628)
The Parliamentary Under-Secretary of State for Health and Social
Care ()
Lord Darzi's report concluded that the health service is in a
critical condition across the country. District hospitals have a
vital role to play in meeting the needs of their communities, and
this Government will support them to reduce waiting times, to
improve urgent care and to play their part in building a
neighbourhood health service.
Critical care at Furness general hospital in Barrow has been
temporarily downgraded, meaning that those in most need of the
highest level of care are now exposed to potentially
life-threatening delays during a 50-mile transfer on difficult
roads. Will the Minister please look at this worrying decision by
the University Hospitals of Morecambe Bay NHS foundation trust
and do everything to enable the reopening of this service as soon
as possible?
My hon. Friend is a doughty fighter for her constituents. I am
aware that the decision she mentions is an interim measure made
by the critical care network, the Lancashire and South Cumbria
integrated care board and the NHS trust. The decision will be
kept under review and patients impacted will receive the
appropriate support. The Government recognise that more must be
done to improve the sustainability of the NHS both nationally and
in rural and coastal areas.
(Farnham and Bordon)
(Con)
Services at Chase community hospital in my constituency, in
Whitehill and Bordon, are being run down by the ICB. This is
based on a promise that a brand-new health hub will be built in
place, which is much welcomed. It has the support of the Defence
Infrastructure Organisation, which owns the land, East Hampshire
district council and the community, but the ICB is suffering from
inertia. Can the Minister speak to the ICB and suggest that it
either builds this new health hub or refurbishes and renovates
the Chase community hospital?
I have every sympathy with the case that the hon. Gentleman has
put forward. This Government want to see a shift of health
services from hospital to community, from analogue to digital,
and from sickness to prevention, but these decisions are not
taken through inertia; they are taken because of the Government's
inheritance from the Conservative party. We have had 14 years of
running down our health services, with needless reorganisations
that have destroyed and set back the progress that the last
Labour Government made on the NHS. This Government will fix the
NHS, including in the hon. Gentleman's local area, but he has to
recognise that the root cause of many of the problems faced by
Members across the Chamber lies at the feet of the former
Secretary of State and the last Government.
Dr (Sleaford and North
Hykeham) (Con)
We have heard about the challenges facing Whipps Cross hospital.
The Secretary of State's decisions to pause capital projects
across the country and put them under review has caused worry and
uncertainty for staff in hospitals nationwide. Can he say when
the review will be completed, so that we have certainty about
when things will go ahead?
The review will be completed when all the information has been
analysed. The hon. Lady should not just be a little more patient;
she should be a little more apologetic for the fact that the
Government found a hospital rebuilding programme that was not
worth the paper it was written on, because the ultimate paper we
needed—the cash—was not there.
NHS Dental Contracting Framework
(Doncaster East and the Isle
of Axholme) (Lab)
9. What assessment his Department has made of the effectiveness
of the NHS dental contracting framework.(900629)
The Minister for Care ()
I pay tribute to my hon. Friend for the excellent work he does
for the people of Doncaster East and the Isle of Axholme. The
scale of the problem that he points out is massive. One of the
most shocking statistics I have discovered since taking up this
position is that the most common reason for children aged five to
nine being admitted to hospital is tooth decay. That is
completely and utterly shocking—truly Dickensian. We cannot fix
the matter overnight, but we are committed to reforming the
dental contract and working with the British Dental Association
to focus on prevention and on the retention of NHS dentists. We
are also working at pace to ensure that patients can access an
additional 700,000 urgent dental appointments.
The horror stories I hear in my constituency are just awful: from
the mum on the Isle of Axholme who could not find an NHS dentist
after five years and who carries out her own treatment on her
son, to a gentleman in Doncaster East whose teeth are crumbling
due to illness, causing him horrendous pain, and who cannot get
an appointment. The Government's pledge to provide more emergency
appointments is great, but I know that it will take time to
rebuild dentistry. Can the Minister reassure me that people in my
constituency will be given the priority they deserve?
My hon. Friend is right. South Yorkshire has the highest level of
hospital tooth extractions in England, and I want to assure him
that we will target interventions at the areas of greatest need.
For example, integrated care boards have started to advertise
roles through our “golden hello” scheme, which will drive
recruitment of graduate dentists to areas of greatest need for
three years. We have inherited a mess and we are working at pace
to clear it up.
(Strangford) (DUP)
The Minister is right to underline the issues for children, but
can I remind him of the issues for those above the state pension
age—which is increasing to 67, including for ladies—in particular
when it comes to certain benefits, such as attendance allowance?
Will he look at the contract for those who are elderly and in
receipt of such benefits?
We are in a situation where a staggering 28% of the country—13
million people—have a need that is unmet by NHS dentistry. There
are so many issues that we need to resolve. We are looking at the
contract with the BDA and I am more than happy to look into the
issue raised by the hon. Gentleman.
(Meriden and Solihull East)
(Con)
Last month, the Secretary of State for Wales told the Labour
party conference that this Labour Government will “take
inspiration” from Labour-run Wales on dentistry. That is the same
health system in which less than 60% of dentistry courses are
being completed in comparison with pre-pandemic figures—a rate
that is far lower than in England. Does the Minister agree that
the Secretary of State for Wales is right and that Wales is a
blueprint for what a Labour Government will do in England, or
will they drop the bluster, get serious and commit to the dental
reforms set out in the dental recovery plan, including a tie-in
to NHS dentistry for graduate dentists?
I find it extraordinary that yet again we see a total lack of
humility and contrition from the Opposition. The key difference
that we will see in how our United Kingdom works is that we now
have some grown-ups in charge in Westminster, who will work with
colleagues in Cardiff Bay to ensure that a rising tide lifts all
boats and we improve the state of NHS dentistry across the United
Kingdom.
Access to NHS Mental Health Services
(North Durham) (Lab)
10. What assessment he has made of the adequacy of access to NHS
mental health services. (900630)
(Blackpool South) (Lab)
15. What assessment he has made of the adequacy of access to NHS
mental health services. (900636)
The Minister for Care ()
Our mental health service is on its knees, thanks to 14 years of
Tory neglect and mismanagement. A staggering 1 million people are
waiting to access mental health services, and vacancy rates are
around 10%, the highest across the NHS. This Government are
committed to fixing our broken NHS so that people can be
confident of accessing high-quality mental health support when
needed. That includes recruiting 8,500 more mental health
workers, introducing specialist mental health professionals in
every school, rolling out Young Futures hubs in every community
and modernising the Mental Health Act.
Patients tell me they cannot get access to community mental
health nurses, putting huge pressure on GP practices and leading
to people going to A&E in desperation. Can the Minister
confirm whether the 8,500 extra mental health staff pledged in
Labour's manifesto will include much-needed nurses in the
community?
I pay tribute to my hon. Friend, who is doing excellent work for
the people of North Durham. I would also like to take the
opportunity to thank our mental health nurses, who do such vital
and valuable work. The Government are committed to shifting from
hospital to community, and that of course includes the mental
health sector. I can assure my hon. Friend that we are working
with NHS England on how best to deploy those additional 8,500
mental health workers.
I wish to pay my respects to the family of Jamie Pearson, the
27-year-old Blackpool man who sadly took his own life in a local
hospital in August after waiting nearly 24 hours to see a mental
health worker in A&E. Jamie was in a mental health crisis,
but got himself to what should have been a place of safety. What
steps is the Minister's Department taking to ensure that no one
is left to suffer in A&E because they cannot access mental
health treatment in their community, and will he meet me to
discuss that tragic issue, so that we can make sure that it never
happens again?
I thank my hon. Friend for raising that deeply tragic case. Words
cannot express the heartbreak caused to Jamie Pearson's friends
and family. I hope it might be some small comfort to them to know
that all acute hospitals should now have a 24/7 mental health
liaison service in A&E, and we are looking at how best to
take forward the Government's suicide prevention strategy for
England. We will do everything in our power to ensure that the
tragic circumstances of Jamie's untimely death are addressed, and
that lessons are learned. I am happy to meet my hon. Friend to
discuss that further.
(Westmorland and Lonsdale) (LD)
Those providing child and adolescent mental health services in
south Cumbria do an outstanding job, but they are without a
dedicated crisis team, unlike the rest of Lancashire and South
Cumbria NHS Foundation Trust. That is devastating and dangerous
for my constituents. Will the Minister use his power to intervene
with the integrated care board and Lancashire and South Cumbria
to make sure that young people in our communities have access to
a crisis team?
I thank the hon. Gentleman for that question and the passion with
which he put it. We are committed to rolling out Young Futures
hubs across the country and, of course, we need to prioritise
areas of particular need. I would be happy to meet him to discuss
that further.
(Twickenham) (LD)
A recent review of children's mental health services in my local
authority, the London borough of Richmond, found that,
staggeringly, children with mild to moderate needs in tier 2
waited on average 15 months before receiving treatment, and those
with more severe needs waited on average nine months. The
Minister does not need me to tell him that during that time,
children's conditions get worse; they need greater treatment and,
sadly, too many present at A&E self-harming and attempting to
take their own life. As well as committing to mental health
professionals in every school, will he put some money into acute
provision, so that children do not end up in A&E?
We are absolutely committed to the three shifts: from hospital to
community, from sickness to prevention and from analogue to
digital. The sickness to prevention aspect is important in the
question that the hon. Member raises. Treatable mental health
conditions such as anxiety and depression should be identified
early to prevent them from developing into something more serious
and into a crisis, so I absolutely share the sentiment behind her
question. They will be at the heart of our 10-year strategy for
the future of our health.
Access to Primary Care
(Wokingham) (LD)
11. What steps his Department is taking to improve access to GP
appointments. (900631)
(Cumbernauld and
Kirkintilloch) (Lab)
14. What assessment his Department has made of the adequacy of
patient access to primary care services. (900635)
(Derby North) (Lab)
17. What assessment his Department has made of the adequacy of
patient access to primary care services. (900639)
(Wolverhampton West)
(Lab)
20. What assessment his Department has made of the adequacy of
patient access to primary care services. (900642)
The Minister for Care ()
As identified in Lord Darzi's review, primary care is broken.
Satisfaction with GP services has fallen from a peak of 80% in
2009 to just 35% last year—a truly damning indictment of 14 years
of Tory failure. We will rebuild general practice. We have
invested £82 million to recruit 1,000 new GPs, we have launched
our red tape challenge, and we are committed to improving
continuity of care and ending the 8 am scramble. On primary care
more broadly, we are committed to boosting the role of community
pharmacies, enabling patients to be treated for certain
conditions by their local pharmacists, without the need to see a
GP.
The Arborfield Green community in my Wokingham constituency has
around 10,000 residents in new homes, with many more to come, but
there is no local primary care provision. To see a GP, residents
must travel to neighbouring villages, which are often
inaccessible because of a lack of public transport. What steps
will the Minister take to guarantee that there will be enough GPs
in any major new developments that come down the line?
The hon. Member is absolutely right: there are seriously
under-doctored areas of the country. Given the finite resources
that we have, we must focus on areas with the greatest need. I
would be more than happy to meet him to discuss how that might
best be reflected in his constituency.
Access to GP appointments is consistently raised with me in
Cumbernauld. A number of constituents have informed me that,
having made complaints, they have been removed from the list of
the general practice at which they have been patients for many
years. Will the Minister raise the matter with the Scottish
Government's Cabinet Secretary for Health and Social Care, so
that we can get some resolution for my constituents?
Patients have an absolute right to complain about NHS services,
and they should not be removed from a practice's list because of
a complaint they have made. Health is of course devolved, but I
have asked officials in the Department to engage with their
Scottish Government counterparts on that matter to ensure that
patients in my hon. Friend's constituency are treated with the
respect and compassion that they deserve.
Residents in Mickleover have been queuing from 7 am to get an
appointment with their GP, and Healthwatch says that seven in 10
people in Derby find it very difficult to book appointments. That
is the legacy of the previous Government. With new homes being
built in and around Mickleover, we need even more additional
capacity. Does the Minister agree that GP capacity must be a
priority?
We are absolutely committed to the challenge of cutting red tape
and reducing the administrative burden for staff to help patients
get the care that they need. An important element of our plan
will be streamlining access to registration in order to move it
online, and we are working at pace to make online registration
available in all practices. I am very happy to come back to my
hon. Friend on the constituency issue that she raises.
Lord Darzi's report on the NHS states that people are struggling
to see their GPs. Prevention is better than cure, and
interventions to protect health tend to be far less costly than
dealing with the consequences of illness, both financially and in
terms of outcomes. Early and quick access to primary care is
therefore crucial. I accept that it is not always necessary to
see a GP—an appointment with a nurse may suffice—but what steps
are being taken to ensure that patients in my Wolverhampton West
constituency have quick, easy and direct access to GP
surgeries?
I note that Wolverhampton West has seen a decrease of 28
full-time equivalent GPs since 2018, which of course massively
exacerbates the issues to which my hon. Friend refers. We will
introduce a modern booking system to end the 8 am scramble and
make it easier for patients to contact their GP. In particular,
we are committed to increasing the use of the NHS app to view
patient records and order repeat prescriptions. All of that will
take pressure off the booking system.
(Central Suffolk and North
Ipswich) (Con)
Last week, NHS Suffolk and North East Essex integrated care board
announced plans to scrap the super-surgery in north Essex. To say
that my constituents were incandescent would be an
understatement; many of them have waited since 2021 for a
replacement to closed surgeries in Bramford, Claydon and Great
Blakenham. Many have to use Needham Market surgery, which is also
awaiting plans to move to larger premises with increased
capacity. Will the Secretary of State meet me to discuss how we
can expedite plans to expand primary care in north Ipswich and
the surrounding villages?
I thank the hon. Gentleman for setting out a list of all the
failures of the past 14 years. He is dealing with that mess
thanks to Members on the Benches he sits on. I strongly encourage
his constituents to get actively involved in the 10-year plan
that we will launch. There will be an important national
engagement exercise on shifting from hospital to community, from
sickness to prevention and from analogue to digital, because
given the total and utter chaos that we inherited, we need
systemic reform.
Dr (Bexhill and Battle)
(Con)
I recently met representatives of Martins Oak and Oldwood
surgeries in my constituency. Both surgeries have ambitious plans
to move to bigger premises so that they can see more patients,
but they face numerous challenges, including the gap between the
lease lengths that the integrated care board will support and
those that GP practices can get developers to sign up to. There
are other challenges that I am sure the Minister can help unpick,
so will he meet me to see whether we can help bring those
ambitious plans for new surgeries to fruition?
The hon. Gentleman has considerable expertise in this area, given
his background. I would be happy to discuss that issue with him,
but I remind him that although there may well be specific issues,
there is a generic problem: the total and utter failure to ensure
investment, reform and strategic thinking about our system.
Topical Questions
(Stockton North) (Lab)
T1. If he will make a statement on his departmental
responsibilities.(900646)
The Secretary of State for Health and Social Care ()
Today, I am publishing the full findings of Dr Penny Dash's
review of the Care Quality Commission. Her interim report made it
clear that the CQC was not fit for purpose, with fewer
inspections being carried out, urgent follow-ups being neglected
and patient safety being put at risk. Today, she makes seven
recommendations for improvement, and I have made sure that the
CQC has begun urgently putting them into practice. We are also
publishing a review of the CQC's deeply flawed single assessment
framework today. Sir Hartley will shortly begin as its
new chief executive, with my full support.
My constituent Mark has been unable to find an NHS dentist for
his 19-month-old child, even at the seventh time of trying. My
right hon. Friend well understands the crisis he has inherited.
Will he meet me to discuss the shortage of dentistry in Stockton
North and across Teesside?
I am sorry for my hon. Friend's constituents, and so many others
who are dealing with the consequences of the Conservatives'
failure on dentistry. I would be delighted to meet him to discuss
the challenges in his area.
Mr Speaker
I call the shadow Secretary of State.
(Louth and Horncastle)
(Con)
I congratulate all nominees and winners in the NHS parliamentary
awards yesterday. Their success was richly deserved, and the
awards were a very good example of the House coming together to
celebrate those who work so hard in our health service and social
care services.
In the past five weeks, I have asked the Secretary of State 29
questions at this Dispatch Box, yet he has managed to answer only
one. For the rest, he has tried to bluster his way out of his
policy decisions, as we have seen this morning. Let us try again.
When will be the first week in which we see delivery of his
promised 40,000 more appointments?
After the performances I had to put up with when the right hon.
Lady was at the Government Dispatch Box, she has some brass neck
complaining at the Opposition Dispatch Box that I am not
answering her questions. She will know that we are working at
pace to stand up 40,000 more appointments every week as our first
step, as promised in our manifesto, and we will deliver. More
than that, we will go into the next election with a record of
which the right hon. Lady can only dream.
After 14 years of opposition—two and a half of which the
Secretary of State spent on the Front Bench and travelling around
the world, funded by other Governments, to look at their
healthcare systems—and more than 100 days in government, the
right hon. Gentleman does not even know the start date of his own
flagship policy. He is no Action Man; he is Anchorman.
Let us deal with Labour's cruel decision to slash winter fuel
payments, which will add pressure not only to patients, but to
the NHS. The NHS's deputy chief operating officer—
Mr Speaker
Order. I have got a lot of people to get in. Members on both
Front Benches must be quicker.
After Labour's cruel decision to slash winter fuel payments,
which will add pressure to the NHS, its deputy chief operating
officer warned that this winter our health service will not have
the extra capacity or funding that it needs, which the
Conservatives had previously provided. Why has the Secretary of
State—
Mr Speaker
Order. I gave the right hon. Lady a hint to come to an end and
not to carry on fully. It is unfair to Back Benchers, who I am
trying to represent. I want a short answer.
The shadow Secretary of State questions the budget for this
winter, but it was set by her Government. Is that finally an
admission of failure on her part? Something else that we will
have this winter, which we did not have last winter or the
previous winter is no—
Mr Speaker
I call .
(Darlington) (Lab)
T2. Will the Secretaryof State meet me to discuss a
cross-departmental pilot in my constituency, bringing together
the Department for Work and Pensions, the Department for
Education and the Department of Health and Social Care, to tackle
some of the immediate pressures that face child and adolescent
mental health services in my area, and the impact on schooling,
the local work force and family outcomes?(900647)
The Minister for Care ()
By cutting mental health waiting lists and intervening earlier,
we can get this country back to health and back to work. There
are 2.9 million people who are economically inactive, a large
proportion owing to mental health issues. Many people can be
helped back into work through talking therapies. We will put a
mental health professional in every school and roll out 8,500
specialists. I would be happy to meet my hon. Friend to discuss
the matter further.
Mr Speaker
I call the Liberal Democrat Health spokesperson.
(North Shropshire) (LD)
In England, 4.4 million children have not seen a dentist for at
least a year. Meanwhile, in Shropshire, Telford and Wrekin
integrated health board, £1 million of dental funding went
unspent in 2022-23. The system is clearly broken. When can we
expect the Secretary of State to fix it?
It is precisely because of the situation the hon. Member
describes—the poor services and, ironically, the underspends in
the dentistry budget—that we will work not only to stand up the
700,000 urgent and emergency dental appointments we promised, but
to do the prevention work for children in our schools.
Mr (Slough) (Lab)
T4. Many people in my constituency are grateful that Slough will
soon be home to a £25 million community diagnostic centre, which
will help to reduce waiting lists, but many are also concerned
that the local trust may be contracting out services for MRI
scans. Does the Minister agree that, instead of just outsourcing,
local trusts should, whenever possible, try to increase expertise
and capacity in-house?(900649)
The Parliamentary Under-Secretary of State for Health and Social
Care ()
We are committed to expanding community diagnostic capacity to
build an NHS that is fit for the future. However, we are clear
that independent sector providers have a role to play in
supporting the NHS as trusted partners to recover elective
services.
(Mid Bedfordshire)
(Con)
T3. I welcome all efforts to increase the number of GPs
throughout England. Residents in new and growing towns such as
Wixams in Mid Bedfordshire need a GP surgery. My local councils
have been told that they need to put up the capital to deliver
one, causing concern about cash flow and borrowing costs. Will
the Minister meet me to discuss a new capital investment
programme to ensure that residents in new towns such as Wixams do
not have to wait for developer contributions to get the services
they need?(900648)
The Minister for Secondary Care ()
As Lord Darzi outlined, capital development in the NHS is
shocking, with a backlog of £11 billion in maintenance. I would
be happy to meet the hon. Member to discuss his problem.
(Newport West and Islwyn)
(Lab)
T5. Alan Petersen is a senior pharmacist in my constituency. He
tells me that pharmacies have experienced high volatility in
drugs pricing and big increases in bills in recent years. At the
same time, they are expected to do far more in direct
consultation with the public. Given the UK Government's
jurisdiction over funding dispensing services in England and
Wales, when do they plan to review pharmacy funding?(900650)
Obviously, health is a devolved matter and funding for pharmacies
in Wales is the responsibility of the Welsh Government.
Nevertheless, I pay tribute to the Welsh Government for securing
a deal with pharmacies in Wales in line with DDRB—the review body
on doctors' and dentists' remuneration—pay recommendations. I
know that arrangements in England affect matters in Wales and I
am working as a matter of urgency to conclude the consultation on
the community pharmacy contractual framework.
Bob Blackman (Harrow East) (Con)
T6. To correct the Secretary of State, the Tobacco and Vapes Bill
went through its Committee stage in the previous Parliament, with
several amendments proposed across the Chamber, which the then
Minister, , agreed to take away and
bring back. Will he incorporate those amendments so that we
strengthen the Bill?(900651)
Whatever stage the Bill got to, it was not completed, was it? We
will bring back a tobacco and vapes Bill that is stronger than
the Conservatives' and I look forward to seeing if they support
it.
(Salford) (Ind)
T7. Ingleside, the only birthing centre in the city of Salford,
was temporarily closed in 2022 amid an acute midwifery staffing
deficit across Greater Manchester. Will the Minister be kind
enough to meet me to discuss what he can do to ensure that that
unit reopens safely as soon as possible?(900652)
My hon. Friend is right to raise the crisis of midwifery
services. We have already had debates in Westminster Hall about
this, and the issue affects the entire country. It is a priority
for this Government, and I am of course happy to meet her to
discuss her constituency issue.
(Didcot and Wantage) (LD)
T8. Lord Darzi's report highlighted the importance of local focus
and alignment to co-ordinating local services and improving
health, contributing to reduced hospital admissions. In
Oxfordshire, the integrated care board is proposing to remove
Oxfordshire's dedicated place director. Will the Secretary of
State give his support to place- based roles to maintain local
authority alignment, as recommended in Lord Darzi's
report?(900653)
I absolutely take the point the hon. Gentleman is making about
the importance of place-based leadership. That is why one thing
we will be looking to do, as part of the 10-year plan process, is
to clarify roles and responsibilities in different parts of the
system to ensure that we have better strategic place-based
leadership.
Gareth Snell (Stoke-on-Trent Central) (Lab/Co-op)
T9. The Royal Stoke hospital is leading the way when it comes
to treatment for stroke patients, but as with so many illnesses,
prevention is better than cure. Can the Minister set out what
this Government are doing to minimise the number of people
affected by these life-altering events?(900654)
I agree with my hon. Friend, which is why we have set a goal for
fewer lives being lost to cardiovascular disease. We will make it
easier for people to have checks in the comfort of their own
homes through, for example, the digital NHS health check and the
new workplace trials.
(Broadland and Fakenham)
(Con)
Labour's cut to the winter fuel payment will cause 262,000 cold
pensioners to seek NHS treatment, according to the End Fuel
Poverty Coalition. Do the Government agree with those figures,
and if not, what are their own estimates?
The decision on the winter fuel allowance is not one that the
Government took lightly, but we inherited a £22 billion hole in
the nation's finances. We continue to stand behind vulnerable
households by increasing the state pension with the triple lock,
delivering the warm home discount and extending the household
support fund to support the most vulnerable pensioners.
(York Central)
(Lab/Co-op)
T10. Prevention is the most important intervention to improve
health outcomes, yet since 2015 the public health grant has
fallen in value by 25%, and by 30% in York. Will the Minister say
what he is doing to restore the value of the public health
grant?(900655)
My hon. Friend is incredibly knowledgeable about public health
matters both at national and local level. Lord Darzi's
investigation into the NHS set out the impact of past reductions
in local government public health funding. We will confirm public
health grant allocations for the next financial year as part of
the forthcoming spending review, but the points she made have
been made loudly and clearly.
(Tatton) (Con)
Can the Secretary of State update the House on the status of
? Does he still attend meetings
in the Department and have access to confidential information?
Does he now have an official role in the Department? Does he
still have private sector interests in the healthcare sector?
The right hon. is alive, he is safe and we
are treating him well.
(City of Durham) (Lab)
October is Breast Cancer Awareness Month, and I stand here today
as someone who was diagnosed, treated and cured of breast cancer
this year by the amazing staff in the north-east, but not enough
women are taking up their breast screening appointments. Will the
Minister do more to raise awareness of, and access to, breast
screening appointments, and may I urge all women to check
themselves regularly?
I pay tribute to my hon. Friend for her work in this area and for
setting out eloquently her own personal experiences. Of course
this Government will do more to raise awareness and enable more
women to access breast screening services.
(North Dorset) (Con)
A significant impediment to improving adult social care is the
split of budget and responsibility and policy between the
Secretary of State's Department and the Ministry of Housing,
Communities and Local Government. Will he and colleagues work to
remove that hurdle, to have better outcomes more cost-effectively
delivered to improve the lives of all our constituents?
The hon. Gentleman is right to raise that risk. I assure him and
the House that I and the Deputy Prime Minister, herself a former
care worker, are working in lockstep to align strategy, policy
and delivery.
|
