Health Questions House of Commons

of Parliament at 11 o'clock tonight, but first questions to the Health

Secretary, Jeremy Hunt, and his team of ministers. We are finding 1500

additional school places each year to ensure the NHS delivers safe and

effective care well into the future and 500 places will be made

available and the remaining thing -- thousand places by 2018. In Taunton

Deane we are short of trained health professionals from dermatologist and

nurses. One of the worse shortages is GPs with some practices not able

to get locums. Could my right honourable friend update me on what

the department is doing to encourage more medical students to become GPs?

It is hard to believe they don't want to come at a Somerset but what

are we doing to encourage them? There is no greater champion in

Somerset by honourable friend. What I would say is what I would say to

all medical students which is general practices going to be the

biggest area of expansion in the NHS over the coming years and we are

planning to have the biggest increase in GPs in the history of

the NHS. It will take many years for those doctors to come on stream and

we have a workforce crisis in the NHS now. Partly because of the cuts

the Government made but also because of their irrational pursuit of the

hardest of Brexit will stop can he do something simple in terms of

addressing the crisis and announce all EU nationals who do vital work

in our NHS will be able to stay when we leave the European Union? The one

thing we will not do is refuse to listen to what the British people

said when they voted on June 23. We will do what they said. He is right

to highlight the vital role that EU doctors in the NHS do in this

country. I can reassure him that the number of doctors joining the NHS

from the EU was higher in the four months following the referendum

results than the same for months the previous year. Does my right

honourable friend agree that Kent, with its excellent academic

institutions and strong life sciences sector would be an ideal

location for a new medical school? Will he support a merging plan to

establish them? I can confirm the Garden of England would be an ideal

place for a new medical school alongside many other parts of the

country which actively competing for the potential to start Mozilla --

medical schools and it is an independent process run by the GMC

and we will await what they say with great interest. Will the Secretary

of State think about the training of GPs? We want them highly trained and

we want them knowing when someone suffers, that they shouldn't be

neglected and port on aspirin or warfarin and given the new

anticoagulants. He speaks very wisely about this and he is one of a

number of people that says we need to look at the training we give GPs

on matters of patient safety, in areas like mental health which are

growing new areas and the identification of cancers and this

is something we are having an ongoing discussion with the cheese

about -- with the GPs about. One given importance of training of new

doctors and nurses for the future of the health service, would you

welcome the building that will commence later this summer in

Chelmsford at the Anglia Ruskin University of any medicine or that

is there to train up doctors and meet the needs of Essex and beyond

its borders? I absolutely welcome mat and it is something he has

championed as a local MP. The historic mistake they're both sides

of the House have made is not to do long-term workforce planning for the

NHS and that is something we want to put right. Plans to train more UK

doctors are absolutely welcome. The Secretary of State knows it will

take ten years to train a doctor. What is his response to the surveys

by the BMA and GMC? My responses the response I get many times which is

too stressed to all of them how valued they are as critical parts of

the NHS and to tell her that we don't see any evidence of the number

of doctors joining from the EU going down. The NHS is one of the best

health services in the world and it is a great place for people from

other countries to work and train. Workforce is one of the biggest

challenges and particularly in rural areas as we heard earlier. With 92%

drop in EU nurses come to the UK and 60% increase in the number that left

last year, how does the Secretary of State to avoid an NHS staffing

crisis immediately post-Brexit before there is time to train

anybody else? She needs to be very careful in her use of statistics

because she will know that one of the reasons why there has been a

drop in the number of nurses coming from the EU is because prior to the

Brexit vote, we introduced stricter language tests which is because that

is better for the safety of patients and the important thing we need to

get right, but we are confident nurses will continue to want to work

in the NHS because it is a great place to work. I will take questions

to six together. Between February 2016 and January 2017, there were

3500 weights of two hours -- of 12 hours and this is unacceptable and

why the Government took urgent steps to free up NHS bed capacity in this

month's budget. Earlier this month the chair of the Royal College of

General practitioners said the best place the GPs is working within

their communities to provide the highest possible general practice

quality. What forecast as the Secretary of State made on the

reduction of A waiting times next winter with the new triage unit

being in A This is a small sticking plaster. In her own

hospital, St George's Park we have got 36... Order, the lady had a

question and the least courtesy she can do the House is to listen

quietly and with good manners to the reply. Thank you, Mr Speaker. In

this drastically underfunded NHS in her own hospital at Saint Georges,

there are 36 more doctors working in A compared with 2010 but we also

think, because a lot of people go to A departments with minor injuries

and things that can be dealt with by GPs, that we need to have GPs on

site and this Parliament, we're planning to have 5000 more doctors

working in general practice. In January, over 1000 patients had to

wait more than four hours. 81% of patients had to wait under four

hours. Now they have abandoned the 95% target until midway of next

year, what can he guarantee to my constituents that we won't get a

repeat next winter? We haven't abandoned the 95% target. We have

reiterated its importance. There is one part of the UK that has said

they want to move away from the 95% target and that is Wales. The Welsh

Health Minister said last week that you can go to A and be there five

hours and have a good experience. That is not looking after patients,

is giving up on them. On this important question of A

putts-macro, does he agree it makes no sense for my local CCG to be

bringing forward a business case to spend an extra ?300 million on

bulldozing Huddersfield Royal Infirmary and downgrading our A? I

do recognise the very strong arguments my honourable friend makes

and the campaigning he does on behalf of his own constituents and

we are waiting for the final recommendations to come from his

local CCG. I agree that too often we have closed beds in the NHS when we

don't have alternative capacity in the community and we need to be

careful not to repeat that mistake. It costs 10% of A element

presentation for the cost within the pharmacy sector. What more can be

done to help persuade those that present themselves to A, that the

pharmacy sector could be a better use of their time? I agree with him

and I think the pharmacy sector, despite the current debate, has a

very bright future and we have set up a ?40 million integration fund

precisely to help pharmacists play more of a role in the NHS and to

reduce pressure on A's. This year the winter crisis has been the worst

ever. Things have got so bad that rather than broke waiting A,

record numbers are giving up. There are many who wish the secretary of

state would do likewise. In January there were 1000 people stuck on

trolleys waiting more than 12 hours to be admitted to A We fully

accept this is far more than a small number of isolated incidents after

five years in the job come he has two except responsible deeper the

crisis he has created? I accept responsibility for

everything that happens in the NHS, including the fact that in 2010,

within four powers, we are seeing 2500 more patients every day. What

we are also seeing is a big increase in demand, that is why there were

particular measures in the Budget to make sure we return to the 95%

target, including ?2 billion for social care, ?2 billion more than

his party was promising at the election. The urgent care centre at

Corby has done much to relieve pressure on Kettering A and is a

class leader. With the ?100 million for new triage projects, would he

like to visit the care centre to see this beacon of best practice first

hand? That is a generous offer. I would love to take him up if I can.

Mr Speaker, these machines are one of a variety of respiratory

assistance machines, which is... there are good practices that can be

followed by health boards and CCG 's. Given the work being done to

extend the lives of those suffering from muscular dystrophy, what

assistance can be Department revived to ensure this policy is more likely

to be adopted than at present? It is not for the Government to direct

clinicians regarding the efficacy of addictive treatments. It is for

clinicians to decide based on decisions while others. And a recent

guidance, the evidence for routine use for cough assist machines was

weak. That may change. Number four, Mr Speaker. Many NHS bodies work

with international peers and each make their own determination at the

local level rather than at the national level. It does not impair

their ability to deliver services. 18 of clinicians from Southmead

hospital, led by Riverside Tim Draycott have exported a system of

paternity health care which is transforming maternity safety and

childbirth. What is his Department doing to support and ensure that the

evidence base that this team have developed is embedded in and

incorporated...? My audible friend will be aware that the professor she

refers to has been to present his findings to the Secretary of State

and partly in response to that, we set up an ?8 million innovation fund

to take such initiatives forward and spread best practice across the

country. Can I endorse what the woman before Bristol said. In the

area of diabetes, we have the best clinicians in the wild in our

country. -- in the world. Can we show what can be done to the rest of

the world? He is an expert in South and diabetes. I have visited

facilities around the world. The UK is unacknowledged expat. We are

launching -- expert -- and hacked knowledge to expert.

I will encourage the Prime Minister to consider his proposal that we

should expand this on other trade visits, certainly for health, around

the world. Question above five, Mr Speaker. This government was the

first to promise that no children will be

sent away from the area to be treated for mental health issues.

One of my constituency sent to Colchester, the nearest bed

available. She was able to come home on some weekends, but it meant an

800 mile trip for her mum. The Secretary of State tells us he's

working on this and I believe that he does want to improve things. Can

he tell us what progress is actually being made? This really is not good

enough. I agree with her. She makes the case very powerfully. What I

would say is we need to make progress, we need to make it fast.

We particularly need to make it for young people. Their recovery can be

closely linked to the potential for parents to come and visit them.

There are places not serving her constituents, but nearby, the

Sheffield health and social care foundation trust has actually

eliminated out of area placements. They saved ?2 million in the

process. It is about spreading that best practice. Schools are often the

first contact for young people who have mental health problems. Does he

share my view that we must ensure that school age children have access

to mental health services where they are? I think he speaks very wisely

about this. In the end, schools are Bible place where we can spot mental

health conditions. We know around half of mental health conditions

become established before the age of 14. This will be a big part of the

green paper we publish later this year. Does the Secretary of State

recognise the way in which poverty and financial strain and deprivation

intersect with mental health, and the need for him to work with the

Secretary of State for Work and Pensions to ensure that mental

health is properly recognised in PIP assessments and could be more

effective if people out of their area residents? I have a number of

discussions with him and we're doing a joint green paper on health and

work, precisely to make sure we do address those issues. On health

trust is working alongside voluntary organisations and charitable

organisations, which are delivering improved support for mental health

patients. With the Secretary of State congratulate the work they are

doing in Bradford on this, and would he like to visit so we can share the

best practice to other parts of the UK? I'm happy to congratulate the

trust at more than happy to come and visit if I can find the time to do

so. I do think he is right to say that voluntary organisations have a

vital role. Often, they can see the whole picture and they treat the

whole person, not just the specific housing issue or whatever. He is

right to commend their work. Thank you, Mr Speaker. Recent figures show

that 18 mental health patients were placed more than 185 miles away from

home for treatment, including five from the Northern region. As we have

heard. Their families will have to travel the Government of Manchester

to London or further to visit. Money was being taken out of CCG budgets

to help NHS England balance the books was the Temasek to your state

tell both armies and patients why they should be treated so far from

home when the local CCG should be able to fund the inpatient beds?

With great respect, we are the first government to count out of area

placements and to commit to eradicating them. What she doesn't

tell the House is the context of this, which is the biggest expansion

in mental health provision anywhere in Europe, with 1400 more people

being treated every day. This year, an extra 342 million being spent on

mental health impact of last year. Number seven, Mrs big. -- Mr

Speaker. As part of our plan to improve access to general practice,

we are taking steps to ensure there will be an extra 5000 doctors

working in general practice by 2020. We are increasing the number of

training places for GPs, recruiting up to 500 from overseas and

encouraging doctors who have retired to return to practice. I'm aware of

a number of issues with the recruitment of GPs in my

constituency. Can my other friend meet with me to discuss the issues?

I'm happy to meet with him. He will know that the surgery got an ?80,000

grant this year through the NHS practice resilience scheme, but I'm

aware of a lot of pressures in surgeries. I'm happy to talk

further. I'm delighted to hear the Secretary of State issue some

information about the additional GPs that will be coming on stream. How

many of those will be coming to North East and, and when will they

be there? We have got a critical shortage of GPs and people are

struggling to get appointments. She is absolutely right that areas like

Lincolnshire find it difficult to attract GPs, that is why we have set

up a fund which gives a financial incentive to new GP trainees to move

to some Laura Bunt parts of the country. -- more remote parts of the

country. I welcome its efforts to recruit more GPs. I know he wants

all GPs and doctors have high levels job satisfaction. Is he aware of the

fact that reasonable mothers of doctors are leaving the UK to go and

work overseas, and is this an issue he will look at in terms of the cost

of medical training, requiring a certain commitment to the NHS as a

result of the money that taxpayers have put into their education? I

think you raise is an important point. At the moment, there is no

evidence of an increase in doctors going to work abroad. There is an

issue of fairness, because it costs about ?230,000 to train a doctor

over five years. In return for that, we should have some commitment to

spend time working in the NHS. That is what we are consulting on at the

moment. GPs around the country are facing unprecedented pressures as

they work to deliver the highest standards of care, despite

underinvestment and increasing patient demand. In 2016, we saw a

record number of GP practices close. Is the Government serious about

addressing this problem for the sake of GPs and their patient? If so, why

has the resilience fund not been delivered in full when this has

promised by October 2016? To date, there is little evidence of the

Government delivering on any of the promises in the board view, nor a

sign of the extra 2.4 billion, nor a sign of... We got the general dress.

Can I gently say, the longer the front bench takes, the less time is

available for the backbenches. It really must stop. It is not fair to

quench members will stop during my time as Health Secretary, the Bill

to investment has gone up by ?700 million, or 8%. We are planning to

increase it by 14%, ?2.4 billion. There is a lot of extra money going

in, but I recognise there are issues will stop the x-ray best bit is

welcoming Lincolnshire, but should he not be making greater use of

existing practitioners? His ingenuity in bringing these issues

up in question after question never ceases to amaze me. I think, as he

knows, recognise that the pressure in primary care cannot just be borne

by general practice, but we must always follow the science as to

where we get our help from. I will say to the Secretary of State,

recently, a surgery has been closed down in my constituency. How will

merging clinical commissioning groups help? Can he ruled out any

merger between Warrington and Bolton? This is where we take

guidance from what local CCG 's say. There are times when the CCG 's feel

their scale is not big enough to have the impact they want. If they

make a good case... He says from a sedentary position that we set up

the commission or clinic -- clinical commissioning groups. They came

together that central perception as to what their size should be. We

will always listen to advice. The premise herself and out -- announced

our commitment to helping support mental health.

The Minister will know that for people with mental health, attending

A or seeing the GP is not the best point of intervention. I welcome

measures to improve access ability. One service provides a range of

services and self help courses. What support is her Department giving to

provide projects like healthy minds, with the support and accessibility

they need? In addition to the funding we are

providing, we are also providing ?500,000 in development of six

digital tools with a focus on children and young people's mental

health. I want to pay tribute to the work in her constituency and the

champion -- championing of the honourable lady herself. Sun-macro

it is an idea to Bob consistency -- to Bob consistently. I am not

psychic. I am very grateful for you asking me to ask a question. Mental

health is a serious problem. It is a growing problem and I have been out

with my local police force and appreciate the emphasis on the

digital technology. What we are doing on the front line, we can just

have digital operations. Because of the Government's cuts, we are

removing the mental health work from the front line force. Whilst we are

doing something around digital, we are removing mental health services

in that post goes on the 31st of March. Hasn't the Government not got

a coherent policy towards mental health? I was tough on the

honourable lady. The honourable gentleman took his time. The

honourable gentleman misrepresents this it duration and not only will

we be investing an extra 1 billion a year into mental health services and

expanding mental health services at a faster rate than anywhere else in

Europe, we have also invested 15 million extra places of safety for

those in crisis and are expanding triage services to address the

problem which he has raised of those in mental health crisis that come

into contact with the criminal justice service. While digital

platforms can be useful in guiding patients to the right service, does

the Minister accept that there are still huge shortages of people who

can carry out talking therapies and long waits for other services? When

will he stop about improving mental health services and ensure the money

is going to recruit staff? We are working extremely hard on increasing

staff. We are introducing our new mental health workforce strategy

which we will be publishing shortly but we are also increasing the

number of people who are actually seeing its services. We have seen 4

million extra people seeing psychiatry services and we are

seeing 90% of those patients meeting the waiting time target of six weeks

which is exceeding our waiting time targets. We have engaged fully with

the health and research community to ensure there would be a positive

application of the GDP are in the UK. Data is vital to the delivery of

safe and high-quality care but we do need to ensure there is a trusted

system in place and people understand their information is

secure and they have confidence in its use. I have to share with her

that the EU's general data protection regulation becomes

enforceable next year and will make it more difficult to share data.

Cancer charities are concerned including Cancer Research UK because

the life-saving research, especially into rare and children's cancers,

would not have been possible were it not for data sharing. Will the

Minister do what she can to shield the UK from this harmful regulation

given it disproportionately affects us given the wealth of our data? We

will introduce the data regulation and we will work in a balanced way

that encourages data sharing. We have set up a subgroup to examine

the impact of the GDP are on research and it is hosted by the

trust and includes members of the Cogdell Ishii -- confidentiality

advisory group and BH jeep foundation. We will ensure this

works in an effective way to address the concerns. My right honourable

friend will be aware that Public Health England published a paper in

June 2015 on this subject. It concluded that within the accepted

guidelines, there are no clinical indicators protesting women using

enriched methods. This is not recommended for routine use at

present. He will be aware from my reading of the British Paediatric

surveillance unit report that the incidence of group B Streptococcus

has increased. When he agreed that this matter has now gone on far too

long and the Government must come to the conclusion to prevent further

tragedies? There is a public consultation and

their recommendation will be published very soon and I can assure

my right honourable friend that I would consider this recommendation

very carefully and write him with my view. The GP for Woodview announced

investment in general practice will increase from 9.6 billion

6,000,000,020 15/16 to over 12,000,000,020 21. This represents

14% in real terms, almost double the increase in the rest of the NHS. Two

years into the forward view, we have remained on track to deliver this.

The reality on the ground in areas like Redcar and Teessiders were

facing a deficit of ?291 million by 2020. How can he reassure my

constituents who are finding it hard that scarce services are not going

to be even more so? We do recognise parts of the country had shortages

of GPs. We are planning to have 5000 more doctors working in general

practice by 2020 and a proportion will be in Teesside. It is important

that we meet that. GPs in Whickham site long hours, bureaucracy and the

decline of the partnership models as reasons why people don't want to be

in general practice. It should be directed to deal with those key

problems. The contract discussions we have competed with the BMA

addressed a number of the types of issues he is talking about in terms

of the pressures on doctors working in general practice. We acknowledge

the workload pressures of enormous and we need to work through the

contract to do what we can to mitigate that. Over 80% of clinical

appointments are carried out by GPs but they receive lower levels of

funding is. What steps is the Department of Health going to ensure

to make sure... One of the criteria by which STP's been dredged --

judged is the tilt from secondary into primary care in the way she

suggests. It is why the extra funding for primary care is so

important and is happening. The GP for Woodview talks of supporting

general practices in improving digital technology that patients.

Given the recent data challenges, would he agree that putting a

national data Guardian on a statutory footing to protect

patients and professionals is now becoming an imperative? I know the

honourable member has to build this area and is intent to support it.

Support provided to GP practices in relation to IT is crucial to their

effective operations but problems continue when my constituency with

the service provided by Capita. They can't get certificates for local

GPs. When will the Government get a grip on this failing contract and

get someone else to deal with it? There has been issues with the

Capita contract and we are working hard to get that sorted. The

undersecretary meets weekly with Capita to get this fixed and we are

making process. We believe the issues will be fixed in the

foreseeable future. A shortage of GPs and in Kettering and the age

profile of local GPs means a large number are about to come to

retirement making the problem worse. What can we done to encourage

experienced GPs to stay longer and to encourage those who have retired

to come back? He is right that one of the things we need to achieve is

to encourage older GPs either to work part-time or to make it easier

for them to step down into more of a mentoring role. We have brought

forward working with the Royal College of GPs, a scheme called

career plus which enables AGP's in pilot areas, to work as mentors

across practice areas. Congenital heart disease services

are not met by many hospitals. NHS England is consulting on proposals

to seize commissioning level one surgical services from the Royal

Brompton and Leicester. No final decisions had been made and public

consultation continues until the 5th of June and I encourage my

honourable friend to participate in that consultation. I doubt the

honourable lady will require any encroachment. You are correct in

that last comment. Does the Minister agree the standards review found not

all clinicians of an agreement as to how essential co-location up

services are stop at Cheadle -- a child being treated when I would

have 24 accessed and medical specialties. Can a minister tell us

what improvements co-location at the world-class Royal Brompton Hospital

would achieve? The honourable lady has considerable expertise and I am

advised that having all relevant children's specialties on the same

site is the ultimate model of care the most critical ill children. It

has integrated ways of working between specialist teams and ensures

rapid access to key services such as paediatric surgery at the most

critical times when they are needed. Mortality rates fell from 14% in

1991 to 2% last year. Royal Brompton does better than this. What evidence

is there that the programme will produce any further improvement and

if there is none, why is it being pursued? He is right to point out we

have some of the world's leading patient outcomes for congenital

heart disease and he read the statistics out which I recognise.

This is being driven by patient outcomes across the country. In some

areas to ensure greater resilience of service where they are being

provided with relatively low volumes and over reliance on locums. That is

not the case in Royal Brompton but it is in some of the others. Leads

heart unit is performing very well. Three from the threat of closer that

it was facing a few years ago. Can lessons be learned from the

disastrous safe and sustainable review process which pitted his --

pitted hospital against hospital and clinician against clinician? Can we

find a better day -- wait to respect -- can we find a better way to

reconfigure services? It led to a process that we felt was wrong and

we therefore stopped it. This process is being conducted in a more

rigorous way and a fairer way and will lead outcomes driven by

improving patient experience. Labour's legacy cost from 103

Hospital PFI schemes entered into between 1997 and 2010, was a public

sector liability of ?77 billion. The estimated total NHS PFI payments for

the financial year ending the end of this month 1.9 seven billion and for

the next three subsequent financial years, two point 04 billion, 2.11

billion and 2.16 billion. Those are alarming figures and I want what the

Government is doing to support trusts affected by those in flexible

PFI and other deals and what assessment he has made of what the

funds could be buying in the NHS now, if not saddled by this Labour

debt legacy. He is right to point out the party opposite complaint

about the cost of the PFI programmes which they themselves initiated. The

Government is making large efforts to support trusts in dealing with

the PFI legacy. We are providing the seven worst affected trusts with PFI

schemes, access to ?1.5 billion support fund over a 25 year period

and in 2014 alone, trusts negotiated savings worth over ?250 million on

their contracts. What assessment has he made and the

changes...? We' undertaking work to work out what the airbag will be the

NHS. The Government will adjust the NHS Budget to meet the cost

associated with the change in the discount rate. He should --

shoehorned in question 21 into a question we did get to. He did it so

quickly that it took this a while to notice. A very naughty boy! There is

a huge financial hangover. Can the Minister have a word with his

colleagues in Treasury, because Treasury figures on hospital

liabilities are different from the figures that some of the hospitals

themselves produce. There is a discrepancy there, so we don't do

what the liabilities are. He has been assiduous in trying to get to

the bottom of the costs of the costs of PFI in this area. It would be

helpful if he could point that out me and I will get back to him.

Question 14. Mr Speaker, social care can do to be a key point for

government. There will be an uplifting the amount of money

available for social care and the level of 17%. That is just half what

is needed to recognise the shortfall in social care. Will he tell the

House what he's doing to make sure the sector gets the additional money

and stocks councils being bankrupted by their social care requirements?

Mr Speaker, the figure of 17%, in terms of a cache of blood over the

next three years, is in excess of what we have been asked for by a

number of stakeholders in this sector. I have conceded many times

that the sector is under pressure. The additional money that we have

come forward with will alleviate that and will make a big difference.

In Lancashire, the figure is not 17%, it is 18% over three years.

Central garment are providing extra money for social care and ensuring

local councils to raise a preset and the tax for social care. How will

the governor to make sure this is spent by councils and social care?

Much of the money will go figure -- will go through the better care

fund. We will expect councils to spend that money and social care,

and we believe that will be the case. We understand the pressures

and we have acted. 1.2 million older people are living with and that care

needs. ?1 billion announced in the Budget this year is not enough to

prop up the failing care sector, where many councils are suffering

contracts being handed back. 1 million people over the age six to

do not have adult children, so can the minister explain how all those

people living with unmet care needs are meant to manage? The figure on

unmet care needs comes from a Age UK analysis. We do not accept that

analysis because the care act, which came with cross-party support in

2014 set statutory consistent definitions of what care councils

have to provide. It is illegal for that not be met. Our follow-up work

is indicated with the LGA that it is being met. Furthermore, we have put

in 17% increases over the next three years. Number 15. Our childhood

obesity plans includes school based interventions which will help all

children, including those from inner-city communities. We will be

monitoring levels carefully and we will routinely publish developments

on all the key measurements for the programme. It stands to reason that

those who are most in need will benefit most. I thank her for her

answer. It remains the case that childhood obesity is twice as high

in deprived areas about or how broad areas. In Tower Hamlets, 20% of

children are obese, and a third are overweight. What will the Government

do to equalise so that no child is obese and when will the plan be

published? The childhood obesity plan has been published. She may be

talking about the reformulation targets, add the baseline data,

which is coming out imminently. The experts are working feverishly to

make sure that data is as it should be. Some measures she will be

particularly keen to see the investment in schools, which was

committed to by the Chancellor in the Budget, including the voluntary

healthy rating scheme, which will be published in June. What measure is

being used to ascertain the success or otherwise of this strategy? When

will we know whether it has worked or not? As I mentioned, we will be

publishing Debbie formulation baselines against which all future

success will be measured, and this will include measurements across all

industry targets. In addition to that, we will at the voluntary

healthy rating scheme for primary schools to recognise and encourage

their contribution to preventing obesity. Topical questions. Number

one, Mr Speaker. It is part of our ambition to make the NHS the safest

health care system in the world. I'll be speaking at the largest ever

conference on learning from avoidable deaths and what we can do

to improve care in the future. As part of that, I can inform the House

that there will be a change in focus from defending NHS litigation claims

to the early settlement of cases, learning from what goes wrong and

the prevention of errors. As part of those changes, it will change its

name to NHS Resolution. My constituents, Pauline E, was cleared

of misconduct last September following a public case surrounding

her return from Sierra Leone and contraction of Ebola. Will she be

receiving an apology, and will it be reimbursing her legal costs? With

respect to Pauline Cafferty, who is a brave lady who gave a good service

to the study and the people are serially on with their work during

the Ebola crisis, she will understand that disciplinary

procedures are not dealt with by government, it has to be done at

arms length, and we have to respect what is said. I was police to see

emergency funding in the Budget. I'm concerned to see the rest but three

admissions to A twice the rate of general admissions in the last five

years. What steps is the Department making to address this issue? We are

firmly committed to improving the quality and cutting harmful

admissions. We have increased the uptake of low emissions cars and the

production of clean air zones. We also announced a further 290 billion

to support a vehicles, low emission buses, taxis and green fuels.

The Government has met the target for A The mandate finally

published yesterday, the Secretary of State is telling hospitals that

they don't need immediate in 2017, but in aggregate within the course

of 2018. Is that not the clearest admission that these targets will

not be met next year because in the next two months, the NHS is being

denied the funding it needs and, as a consequence, patients will suffer?

Let me just, apart from observing the fact that if the honourable

gentleman cares so much about the 95% target, he might want to ask his

colleagues in Wales while the are looking at scrapping it will. Let me

be clear, in the next year, the NHS will be getting around ?1.5 billion

than his party were promising at the last election. The social care

system will be getting 1.5 billion more than they were promising at the

last election. We doing our job. He says he is doing his job. Because of

the underfunding, it will be it possible to deliver those standards

of care. Did you notice that in the mandate, there is no mention

whatsoever of Brexit. Even though the NHS relies on 140,000 NHS and

care workers, and no mention... I know the Secretary of State is not a

member of the Cabinet Brexit committee. Can he uses influence

with the Prime Minister to ensure that when she triggers Article 50

next week, she finally gives an absolute guarantee to guarantee the

rights of all those EU workers in the NHS? First of all, Mr Speaker, I

will reassure you that I will be attending the Brexit committee when

it is relevant to the NHS. In fact, I will be attending this week

because there are issues relating to the NHS that will be coming up. What

we will not do in that committee is take steps that would risk the

welfare of British citizens living in countries like Spain and Ireland

and France, and that is why, whilst it is a top priority to negotiate

the rights of EU citizens living in Britain, including those working in

the NHS, it has to be part of an agreement which protects the rights

of British citizens abroad. Last Friday, a surgery in my constituency

attended a careers fair at a high school. Does the Secretary of State

agree that that kind of outreach work by GPs amongst young people

encourages them to study medicine and work in our great NHS? I agree

with that. I think what she should be telling her constituents, and I'm

sure she will, is that general practice will be the most exciting,

fastest-growing part of the NHS, where care will be absolutely

transformed. So it is the right thing to do. Is the Secretary of

State aware that my constituents are deeply disappointed with what he got

out of the Budget. What that means is they will face the closure of an

A in Huddersfield, the hospital there, and we will know love you

have any dentists that will take an NHS person in the whole of the

constituency. With great respect, what was secured in the Budget was

?2 billion for social care. That is ?2 billion more than his party was

promising at the last election. Following the publishing of the

report and read diseases, what strategy is therefore NHS England?

Firstly, may I pay tribute to my honourable friend on his leadership

on that report. The UK is recognised as being at the forefront of the

genomics industry. This is a personal commitment of mine. With

in-built health inequalities and poorer health outcomes in my area,

Kathy Secretary of State explain to me why my area in Hull is getting

just ?30 million out of the additional money for social care set

out in the Budget, while the local authority area that the Secretary of

State represented in Surrey is getting ?21 million of additional

support. The formula that is being used is based on the better care

fund formula, which is based on the spending power of local authorities.

I will tell her that over the next year, that improved better care fund

is going up by 35%. Surrey's allocation is only going up by 5%.

As my right or more threads knows, I have the vice-chairman the all-party

group on pharmacy. Goody update the House and the progress for the

decriminalisation of dispensing errors of pharmacists, and what is

the hitch? There is no hitch. The Government remains committed at

putting this into place. The legislation will be brought forward

shortly. Last week, a leading trauma surgeon said his surgical team have

seen more young patients with serious stab injuries than people

with appendicitis. This is a societal problem, so can the

Minister inform us of his Department's public health approach

to tackling this issue? She is right to point out this is a

serious issue. I would like to commend the brilliant work done by

NHS trauma centres which are world beating. We have set up closer

cooperation with local police forces so we can work out where the crime

hotspots are and help them prevent things happening. We have a crisis

in GP recruitment in rural North Lincolnshire. Does the Secretary of

State agree that the best way to get doctors to come and now our Boreas

County is to have a medical school establish attic Lincoln University?

Will she join our campaign to make that a real possibility come true?

There are a number of areas that are competing to secure a new medical

facility. It is one of our criteria on how we encourage doctors to be

trained in areas where there are shortages of doctors. That, I'm

sure, will be a factor that Lincoln Hospital will put in. The BMA

recently highlighted funding announced in the budget is

inadequate for the task and we know that health trusts across the

country are being forced to look at rationing of treatment, and in

downgrading local services like A which will result in longer waits

and journey times to access care. Why doesn't the Government call

STP's what they are, secret Tory plans to decimate the National

Health Service? Really this is a year when funding for the NHS has

gone up by ?3.8 billion in real terms. I don't really know how he

can say that when he stood on the platform in 2015 to give the NHS 1.3

billion less this year than they are getting under the Conservatives. As

the House heard early in the session from my honourable friend the corgi,

there is an excellent care centre. There is a plan to have a reckless

-- in Wellingborough. Replica I understand he might be visiting the

centre in Corby. Could he drive half an hour down the road and visit the

site in Wellingborough where this proposed excellent urgent care

centre will be? I feel the onset of happy visit to Northamptonshire

coming on. What might clinch it is if I had the promise of potentially

meeting the famous Mrs Bowden on such a visit. -- -- Mrs Bone. To the

distress of its vulnerable residents, or doing house became the

latest care home to close last week. Does the Government accept that the

care home industry is at breaking point and what are they doing about

it? The number of care home beds across the country has remained

broadly constant out half a million over the last ten years. There is a

variation and churn between areas. I do believe the 17% increase in cash

terms we have injected into the social care market in the budget and

better care fund to come will make a difference. I welcome the new

nursing assistant role. Could the Minister confirm areas such as

Portsmouth can be offered the same opportunities in the future and will

they be open to older women -- order people wanting to return to the

workplace? We are launching a second wave of nursing associates from the

beginning of April and I'm pleased to confirm that Southern health,

which manages Portsmouth Hospital, will be one of the trusts will be

receiving nursing associates and is designed to provide opportunities

for those social care workers to upscale. The Secretary of State will

be aware of a recent High Court case regarding surrogacy leading to legal

limbo. The existing legislation has let children down and urgent reform

is needed. I can confirm that we are making a judgment and the current

provisions are discriminatory and the Government is acting with

reasonable timescales. We are intending to lay an order before the

summer recess to address some of these challenges. One of my

constituents has been diagnosed with a chewy map... Her consultants say a

drug will not only transform her life but save her life. Well my

right honourable friend the with me how we can get the best treatment

for Harriet and how it is possible for NHS England to review this

decision? My honourable friend has raised this case with the Department

and has been making a number of pleas on behalf of his constituent.

I would like to pass on my sympathies to his constituents.

Nice's is independent and this drug is not recommended. I don't know the

details of the case because it is confidential but I would be happy to

be with my honourable friend and his constituency -- constituent to see

if anything can be done. I don't know if he spotted the topical news

story about children's dentistry. 1464 hospital admissions for

children 14 extractions across one commended -- clinical commission

area of Birmingham, the highest figure since 2010/ 11. How does the

Minister account for this and what is he going to do about this? The

figures the child extractions are disappointing and there are two key

actions that need to take place. Less sugar and we expect the soft

drinks levy and also getting more fluoride onto teeth, particularly

through fluoride varnishing. That has increased across the NHS over

the last year and has increased by 12% in Birmingham. We hope that will

make a difference. The NHS mandate was published yesterday, days before

coming into force. I wanted the Secretary of State can set the

reason for the delay because it allows very full-time the scrutiny

of this important document that would out how he will prevent money

being leached from mental health services and primary care to prop up

deficits so we can meet objectives around community services? The

reason for the delay was because we had wind a month ago that we might

be successful in securing extra money for social care in the budget

and we needed to wait until the budget was completed before we

completed discussions on the mandate. Our confidence as a result

of that has enabled us to make the commitments we have made in the

mandate. Part of that is to make sure we continue to invest in the

class the motion out of hospital. The Secretary of State will be aware

that very many migrants in the UK are not registered with GPs and yet

now when they come to Britain, they have to pay an NHS fine. What is he

doing with the Home Office to ensure that migrants are registered with

the GP and are aware of community health facilities? I am not quite

sure I understand her question but there isn't a filing system for

migrants. People who come to the UK as a visitor should pay for their

health care or they should pay the Visa surcharge if they are coming

here for a while. When it comes to public health, there is an exemption

because it's important that everyone that we make sure we treat people

for things like TB will stop the Secretary of State is aware of the

concern that I have for the future of Deer Park medical Centre. I'm

grateful for him to meeting with me. Please could he confirm he will

press the IR P for a response at the earliest opportunity given the CCG

are determined to close this vital practice in three days' time and he

will consider the views of the patients of very carefully indeed? I

am very happy to relay that concern to the IRp. -- IRP. We must move on.

Urgent question. John McDonald. To ask the Chancellor of the Exchequer

if he will make a statement on allegations of money-laundering

against British banks. Mr Speaker, we want our financial institutions

to lead the way in the global fight against money-laundering. This is

not only a question of financial crime, as well as terrorist

organisations, this is about keeping our citizens safe. That is where the

Government is doing what it takes to prevent and pursuing anyone who

might seek to abuse our financial