:00:10. > :00:16.Good afternoon at welcome to the live coverage of the Commons. There
:00:17. > :00:21.are four ministerial statements on this first parliamentary day of 20
:00:22. > :00:26.first the Prime Minister will be briefing MPs about the outcome of
:00:27. > :00:30.the European Council summit in November. The Home Office will make
:00:31. > :00:33.a statement on reports that a British national is believed to be
:00:34. > :00:40.the main suspect in the latest Isis video and he fled written in 20
:00:41. > :00:44.while on bail for terror offences. Liz Truss will be addressing MPs
:00:45. > :00:49.about the recent severe flooding in the north of Britain and after all
:00:50. > :00:53.of that comes the fourth statement concerning Britain's relationship
:00:54. > :01:00.with Saudi Arabia following the execution last week of 40 people in
:01:01. > :01:04.the country. Then there is the Housing and planning Bill. Join me
:01:05. > :01:10.Keith Macdougall for a round-up of the day in -- when the Commons
:01:11. > :01:14.debate are finally concluded tonight. First it is questions to
:01:15. > :01:19.the Secretary for health Jeremy Hunt and his ministerial team. The first
:01:20. > :01:26.question concerns the revision of care outside hospitals. -- provision
:01:27. > :01:55.of care. Order! Order! Questions to the
:01:56. > :01:59.Secretary of State for Health. Happy New Year Mr Speaker and happy New
:02:00. > :02:06.Year to familiar faces in the Shadow Cabinet offices. Vista Speaker, the
:02:07. > :02:10.government is committed to transforming out of hospital care
:02:11. > :02:15.for everyone in every immunity by 20 we have seen excellent progress in
:02:16. > :02:20.areas led by pioneers such as Torbay and Greenwich and the government
:02:21. > :02:26.remains committed to programmes such as the Medicare fund and the
:02:27. > :02:32.Vanguard. 70% of people would prefer to die in their own home. Should we
:02:33. > :02:36.allow 60 to die in hospital it has to change. There should be better
:02:37. > :02:40.social care provided outside hospitals. What message would he
:02:41. > :02:43.give to Clinical Commissioning Group is like mine who are trying hard to
:02:44. > :02:49.bring this about and two integrate services. I am grateful to my
:02:50. > :02:53.honourable friend for raising this and we share his views that we
:02:54. > :02:56.should see greater choice in end of life care so that people are able to
:02:57. > :03:01.be cared for and die in the place that they choose and that is
:03:02. > :03:07.appropriate for their needs, whether it is a hospice or hospital or their
:03:08. > :03:12.own home. The review set out to enable greater choice at the end of
:03:13. > :03:15.life and I am working on the NHS to see how this best can be achieved
:03:16. > :03:21.and the government will comment on it soon. We recently received a
:03:22. > :03:23.letter from a range of social care organisations and charities which
:03:24. > :03:29.has really panned the spending review offer, saying it is not
:03:30. > :03:32.sufficient to defend the care crisis and they warned of an increasing
:03:33. > :03:38.number of older people without sufficient support increasing
:03:39. > :03:47.pressure on the NHS. Will the health set churchy admit that the offer in
:03:48. > :03:51.the statement is not good enough? Social care was an important part of
:03:52. > :03:56.the spending review and that has been noted by all. Up to two will be
:03:57. > :04:00.available through the social care preceptor that will be added to
:04:01. > :04:09.council tax and there is another one point of by 2020 so over all three
:04:10. > :04:15.point will be available by then. We all know social care is tight and we
:04:16. > :04:18.need best practice everywhere to make the best use of resources which
:04:19. > :04:25.many leading authorities are already doing. As my right honourable friend
:04:26. > :04:29.to integrating and improving care outside hospitals will he discuss
:04:30. > :04:34.with the secretary of state the medical system in China which brings
:04:35. > :04:38.together Western medicine herbal medicine and acupuncture which is
:04:39. > :04:44.bearing down on the demand for antibiotics and before he responds
:04:45. > :04:47.on the report will he look very carefully at dispensing arrangements
:04:48. > :04:51.for small-scale Assembly of herbal product, something that the People's
:04:52. > :04:59.race public of China government is very interested in? Mr Speaker
:05:00. > :05:04.herbal product 's are slightly beyond my normal portfolio re-met.
:05:05. > :05:11.Anything that assists in social care and makes people feel better and dad
:05:12. > :05:14.still a vitality and well-being is to be welcomed and I am sure that in
:05:15. > :05:23.many local areas they are taken extremely seriously. I thank the
:05:24. > :05:26.Minister for his response. Integration and improving care and
:05:27. > :05:31.hospitals is just one way to improve the health service. Will the
:05:32. > :05:37.Minister look at links between reducing pressure on a and E 's and
:05:38. > :05:43.increasing provision outside of hospitals to reduce that pressure. A
:05:44. > :05:49.number of the pilot and Pioneer programmes are doing just that. If I
:05:50. > :05:54.could refer to one in Cornwall, a LivingWell programmes there has only
:05:55. > :05:59.results that show a reduction in non-at two that mission is to
:06:00. > :06:04.hospital and 50 reduction in advisers seat -- emergency admission
:06:05. > :06:08.to hospital. Better social care and integration may have and should have
:06:09. > :06:12.an impact on hospital admissions and make sure that people are receiving
:06:13. > :06:17.the most appropriate care in the most appropriate place. I was
:06:18. > :06:22.pleased to hear the Minister's reference to the integrated care
:06:23. > :06:26.organisations in Torbay. Will he agree that the increasing challenges
:06:27. > :06:30.of providing social care to those in later life this model needs to be
:06:31. > :06:39.looked at and he will support it as much as he can indeed. Being able to
:06:40. > :06:46.look at these pilot products and seeing what they can do in different
:06:47. > :06:50.areas responding to different demographics is very good and Torbay
:06:51. > :06:54.has come up very frequently and I am delighted to praise it again. Those
:06:55. > :06:57.involved in our social care were much involved in the flooding
:06:58. > :07:03.recently in the North of England looking after vulnerable people.
:07:04. > :07:08.They were very important and I am grateful to Ray James and all of
:07:09. > :07:11.those in local authorities in the area that contributed so well to
:07:12. > :07:19.looking after vulnerable people during that period. The report on
:07:20. > :07:24.the appalling failures at Southern health NHS foundation five and --
:07:25. > :07:27.trust highlighted over 1000 and the did deaths of mental health and
:07:28. > :07:34.learning disability patients. Many of them take lace outside hospital
:07:35. > :07:37.and they have not been investigated. Given that the Home Secretary did
:07:38. > :07:42.not allow the house to scrutinise the findings before Christmas, will
:07:43. > :07:47.the Minister respond to widely held concerns that the experience of this
:07:48. > :07:54.trust is not isolated and will he agree with me that a national hub
:07:55. > :08:02.licking is now needed? The honourable lady is quite right. This
:08:03. > :08:05.is a wider concern and that is why CQC is looking nationally at the
:08:06. > :08:08.picture of what has happened because these deaths have not been
:08:09. > :08:13.investigated appropriately in the past and it is something that must
:08:14. > :08:16.change. The government has a determination to change a raid of
:08:17. > :08:19.things in regards to mental health and learning disabilities and this
:08:20. > :08:22.area has been forgotten to long and it is now being brought to light and
:08:23. > :08:29.work is being done by this government. As part of our
:08:30. > :08:33.commitment to a seven day we want all patients to be able to make
:08:34. > :08:38.routine appointments with their GP surgeries in the evenings and at
:08:39. > :08:43.weekends. Two out of 8000 surgeries are currently running schemes to
:08:44. > :08:48.make this possible. Many working people were asked to phone GP
:08:49. > :08:52.surgeries very early in the morning to make a and it is not always
:08:53. > :08:56.convenient. Can my right honourable friend tell me whether priority will
:08:57. > :09:00.be given at weekends to people who are working during the week my
:09:01. > :09:04.honourable friend is absolutely right and this system does not work
:09:05. > :09:08.well for people who have to go to work and we want to make it easy for
:09:09. > :09:12.people to book appointments online through a nap on their phone and we
:09:13. > :09:16.want to make it possible for people in his constituency in more rural
:09:17. > :09:19.areas like North Cornwall to have health appointments so they can see
:09:20. > :09:24.someone without having to go to the surgery when it is appropriate.
:09:25. > :09:28.Given the increasing difficulty the public is having at getting a GP
:09:29. > :09:32.appointment at a time that is convenient to them and quickly does
:09:33. > :09:40.he believe his predecessor was wrong when he scrapped a Labour's 40 GP
:09:41. > :09:44.access guarantee? No, I do not because it had perverse consequences
:09:45. > :09:49.and when the target was in place the number of people having to wait to
:09:50. > :09:53.see a GP was actually increasing, not decreasing. What happened in the
:09:54. > :09:59.last parliament was at number of GPs actually went up, a five increase in
:10:00. > :10:05.the workforce and we had plans to increase it by 13 one of the biggest
:10:06. > :10:10.ever increases in their GP workforce in the NHS history on the back of a
:10:11. > :10:14.strong economy. The secretary of state will be aware from personal
:10:15. > :10:18.experience of the excellent work done by GPs in Herefordshire who ran
:10:19. > :10:23.one of the first seven week pilots. Can he give asked assurance that
:10:24. > :10:25.this work will be funded to continue because it has done an
:10:26. > :10:31.extraordinarily good job to help my constituents. We are very pleased
:10:32. > :10:34.with the progress made in Herefordshire and other areas and we
:10:35. > :10:39.are looking at how to maintain funding for those areas. Nearly 16
:10:40. > :10:43.people are benefiting from on access to GPs are evenings and weekends and
:10:44. > :10:50.we would not want to see the clock turned back on that. Today I
:10:51. > :10:53.received a letter from the chair of the Clinical Commissioning Group in
:10:54. > :10:59.Slough where he demote the fact that GP actresses make 90 of patient
:11:00. > :11:02.contact but only get eight of NHS resources and he told me that this
:11:03. > :11:08.had meant together with the reduction of 30 he claimed in the
:11:09. > :11:12.last five years of GP partner income, he was meaning that in
:11:13. > :11:16.Slough more and more GPs are turning to private practice. I have noticed
:11:17. > :11:21.that it means they are resisting the creation of new GP Pratt disses.
:11:22. > :11:30.What is he going to make sure that under doctored areas get more GPs?
:11:31. > :11:34.First of all can I ask her to congratulate GPs in Slough who have
:11:35. > :11:39.benefited from the Prime Minister's challenged fund which has had a
:11:40. > :11:42.significant impact on reducing emergency admissions in her area
:11:43. > :11:47.amongst other schemes. The answer to that is that we are investing over
:11:48. > :11:51.the course of this Parliament and extra eight in the NHS ten when you
:11:52. > :11:56.include the money going in this year. We have said that we want more
:11:57. > :11:59.of that money to go into general practice to reverse the historic
:12:00. > :12:08.underfunding of general practice. I agree that needs to be reversed.
:12:09. > :12:13.Three quarters of trusts are reporting a deficit for the
:12:14. > :12:28.conclusion of the first off of this financial year.
:12:29. > :12:36.My own area of south Tees, the deficit for 2014-15 is nearly ?70
:12:37. > :12:42.million. Will the Minister accept that the gum and has totally lost
:12:43. > :12:46.control of NHS finance? The first point to make is that this
:12:47. > :12:52.government has provided money for the NHS that it has asked for. The
:12:53. > :12:56.second is that the new Chief Executive of NHS improvement, one of
:12:57. > :13:01.the best chief executives in the NHS, has said that he will help get
:13:02. > :13:04.hospital trusts in control next year and with the transformation fund
:13:05. > :13:08.announced by my right honourable friend, we are confident we will be
:13:09. > :13:14.able to get them into balance next year. Does the Minister agree that
:13:15. > :13:19.ramping down on expensive temporary agency staff is an important step to
:13:20. > :13:22.help sort out the NHS and allow them to balance the books question mark
:13:23. > :13:27.it is already having an impact on the fact is we had to bring in the
:13:28. > :13:32.needs for safe staffing rotors because of the catastrophe of Mid
:13:33. > :13:37.Staffs on the need to try and staff hospitals that. That had an
:13:38. > :13:40.immediate consequence. But unfortunately that has been taken
:13:41. > :13:45.advantage of by some companies and we have brought in measures to stop
:13:46. > :13:50.that and it has already had an impact across the service. The
:13:51. > :13:55.University hospitals of North Midlands face a deficit of ?90
:13:56. > :14:01.million for 2015-16 but until the NHS review is completed, they face
:14:02. > :14:08.uncertain prospects further out, not least having taken over Stafford
:14:09. > :14:12.County Hospital recently. Well the Minister made of hospital management
:14:13. > :14:16.and local MPs as soon as possible this year to discuss this uncertain
:14:17. > :14:21.situation and the progress with the whole of the Staffordshire review? I
:14:22. > :14:25.would be very happy to meet them and I would first of all congratulate
:14:26. > :14:31.them on a meet them on eliminating 12 hour trolley rates for the first
:14:32. > :14:33.issue. They are doing a great job but I am confident they will be will
:14:34. > :14:42.to get their deficit under control next year with the help of the
:14:43. > :14:50.transformation fund. Mr Speaker, a rare disease is a
:14:51. > :14:54.life-threatening... Research shows that one in 17 people will suffer
:14:55. > :15:03.from a rare disease at some point. In the UK, that equates to 3.5
:15:04. > :15:10.billion people. The organisation in my constituency is concerned about a
:15:11. > :15:14.number of... What support there is at the time of diagnosis,
:15:15. > :15:21.particularly the parents of children with rare diseases? With the
:15:22. > :15:25.minister gave some examination... Help and support for those who have
:15:26. > :15:30.been diagnosed? I am glad that the right honourable gentleman mentions
:15:31. > :15:35.that point. The house may not be aware that we recently added four
:15:36. > :15:39.new rare diseases to the newborn heel prick test which has helped to
:15:40. > :15:45.detect over 1400 children with a rare disease. We will look up into
:15:46. > :15:49.that -- look into that but the UK rare diseases strategy which has 51
:15:50. > :15:55.commitments from government published in 2013 covers that are
:15:56. > :15:58.the first report back, strategy is this spring and that has been done
:15:59. > :16:02.by the UK rare diseases forum. Happy to speak to him afterwards about
:16:03. > :16:10.whether the excellent organisation he names is part of that. One such
:16:11. > :16:13.rare diseases Musca dystrophy and I'm sure that the ministers aware
:16:14. > :16:18.that we are waiting for what we hope will be a positive decision from NHS
:16:19. > :16:25.England on a drugs called trans-Lada which could help these boys with the
:16:26. > :16:31.condition. I wonder if the Minister has got any further and if she could
:16:32. > :16:36.update test as to when we can expect an announcement and hopefully it
:16:37. > :16:42.will be a positive one? Mr Speaker, I know that my colleague is working
:16:43. > :16:47.very hard on this and hoping to be able to make announcements soon. And
:16:48. > :16:54.I am sure at that point to be able to write update -- update my right
:16:55. > :17:03.honourable friend. With regards to read diseases, I will be joining the
:17:04. > :17:08.family of Sam Brown. Could we also have an update on the possible at
:17:09. > :17:11.your funding for a dreadful to be the sclerosis which in the is
:17:12. > :17:25.another one of the drugs we have been campaigning for? With regard to
:17:26. > :17:28.the Matty just mentioned, I know that something NHS England looking
:17:29. > :17:33.at currently reviewing with a view to be coming forward with a view
:17:34. > :17:40.intercourse. Will my honourable friend join me in praising the work
:17:41. > :17:47.of the department at the University of Birmingham medicals? They are
:17:48. > :17:50.doing outstanding worldwide standard work in developing cures and
:17:51. > :17:59.treatments for such rare diseases and indeed more common diseases such
:18:00. > :18:04.of course as cancer. Well, absolutely do join with him in those
:18:05. > :18:11.very well-deserved congratulatory words. I know that my honourable
:18:12. > :18:16.friend the Minister for life sciences has visited and everyone is
:18:17. > :18:18.hugely impressed and I think I join with others in congratulating
:18:19. > :18:24.Charlie Craddock on his CBE in the New Year 's Honours list. Patients
:18:25. > :18:32.living with rare cancers often have fewer treatments available to them,
:18:33. > :18:36.often the only option is to use off label treatments. The Cancer Drugs
:18:37. > :18:40.Fund has helped patients gain access to these treatments but despite a
:18:41. > :18:43.Conservative Party manifesto commitment to continue investing in
:18:44. > :18:48.it, it is now under threat because of central government cuts. What
:18:49. > :18:53.assurances can the Minister provide to people living with rare cancers
:18:54. > :18:57.that off label drugs will still be funded and will she apologise for
:18:58. > :19:04.the uncertainty these cuts are causing to the thousands of people
:19:05. > :19:06.affected by cancer in England? Well, I certainly do not recognise the
:19:07. > :19:12.characterisation at all of the Cancer Drugs Fund, just given by the
:19:13. > :19:16.Shadow Minister. ?1 billion has been committed and the fund is currently
:19:17. > :19:19.being reviewed. This is being introduced by the Alaska men, of
:19:20. > :19:24.which we are very proud. It has made a big difference to the lives of
:19:25. > :19:32.over 80,000 patients. -- the last government. They made many
:19:33. > :19:34.recommendations which are particularly relevant to rare around
:19:35. > :19:49.blood cancers. Many of which focus on improving access to diagnostic
:19:50. > :19:53.testing. 75% are children. Unfortunately 30% of those will not
:19:54. > :19:58.reach their fifth birthday. What more can be done for Great Ormond
:19:59. > :20:05.Street Hospital and also the excellent work of Birmingham
:20:06. > :20:08.Children's Hospital? Well, as I said earlier, Mr Speaker, I think my
:20:09. > :20:11.honourable friend is quite right to highlight the number of people who
:20:12. > :20:17.will be affected. There are between six and 8000 rare diseases. Amongst
:20:18. > :20:21.the things that the government is doing which is I think going to make
:20:22. > :20:24.a really big difference to some of the institutions he mentioned and
:20:25. > :20:28.that there is an particular to suffer as is the 100,000 genomics
:20:29. > :20:32.project which the government is investing in. The creation of a
:20:33. > :20:36.network of genetic medicine centres will underpin that further
:20:37. > :20:40.development of genetic testing services because a very large
:20:41. > :20:43.proportion of rare diseases are genetically based and therefore we
:20:44. > :20:52.want to make significant progress without work. -- with that work. The
:20:53. > :21:02.health and care system is under extraordinary demand by aid rising
:21:03. > :21:15.population. Gina Brevard Oates needing care in the next ten
:21:16. > :21:21.years or... ?3.5 billion in social care by 2015 by the new adult
:21:22. > :21:27.preceptor and the extra funding for the NHS finding a forward view. In
:21:28. > :21:38.any given week at the John -- called as though there is the buzz... As we
:21:39. > :21:45.know that the gum and brokers pro promise pre-election and we know
:21:46. > :21:52.that the Kingsand is easily said that the settlement to which she
:21:53. > :21:56.refers will put even more pressure to... Willie now accept this
:21:57. > :22:03.continuing neglect and is broken promises is a fit because of the
:22:04. > :22:12.prizes -- crisis in our pay any term departments? We are leading the way
:22:13. > :22:15.in integration, and not before time, after 14 years in which the party
:22:16. > :22:19.opposite did nothing. We are leading the way on integration, but in the
:22:20. > :22:24.extra money. And then die did say that of the 3.8 billion fiscal mini
:22:25. > :22:28.under 10 billion we are funding the NHS five-year year transformation,
:22:29. > :22:32.it is this party investing in this 21st century NHS. The party opposite
:22:33. > :22:40.seems to want to dig is back to Midway. They are best placed to
:22:41. > :22:46.commission services were careful local publishers. Yes, my honourable
:22:47. > :22:49.friend make serial honourable excellent point. The key is of
:22:50. > :22:53.course more funding and of course more integration but crucially more
:22:54. > :22:56.local leadership. And we are actively making it easier for the
:22:57. > :22:59.devolution programme for local authorities and local health leaders
:23:00. > :23:07.to plan the degraded services that are appropriate for that area. Not
:23:08. > :23:10.all areas of the same. I'm afraid that having listened to what the Mr
:23:11. > :23:14.has the sake of the people in my constituency are going to be
:23:15. > :23:17.disbelieving. Been a rough days that patients are stuck in hospital but
:23:18. > :23:21.because they are set but because there is nowhere to move them on two
:23:22. > :23:27.has doubled under his command and he has took knowledge of that is due to
:23:28. > :23:32.the neglect of local government and adult social care specifically.
:23:33. > :23:35.Well, it is true that in different areas there are different measures.
:23:36. > :23:38.In my own area of Norfolk, there are pressures but let just remind the
:23:39. > :23:45.honourable lady that I A spreading has gone up to radically in the past
:23:46. > :23:48.decade. 900 billion in 2001 to 2.4 billion and if you look at the early
:23:49. > :23:54.evidence from the better care fund which we launched only this year to
:23:55. > :23:57.tackle this issue. The evidence is 84,000 fewer delayed transfers,
:23:58. > :24:00.12,000 more older people at home within three months of discharge
:24:01. > :24:03.annually 3000 people supported live independently. The truth is through
:24:04. > :24:07.more funding, greater freedoms and local devolution, we are supporting
:24:08. > :24:13.health leaders and council leaders to bring together health and care.
:24:14. > :24:17.Despite his pressure, isn't it not excellent that 95% of patients
:24:18. > :24:21.presented at a and E are seen within the target time in England, unlike
:24:22. > :24:25.in Wales won only 81% are seen as a result of the fact that the NHS is
:24:26. > :24:36.run by members of the party opposite? My honourable friend makes
:24:37. > :24:39.a excellent bile that uses UNIX an important point. If you really want
:24:40. > :24:44.to get pressure on A down and we need to integrate and verses we are
:24:45. > :24:50.prevention and keeping people out of unnecessary Indian mission. The
:24:51. > :24:55.Health Foundation estimates that the gap in social care funding by 2020
:24:56. > :24:58.will be ?6 billion. Not taking into account the increasingly minimum
:24:59. > :25:02.wage. Although the spending review narrows the gap it is still leading
:25:03. > :25:07.an enormous gap will chew and resented further cuts in social
:25:08. > :25:10.care. How is the government going to avoid Italy and accept a situation
:25:11. > :25:15.that those with money will still get good care, those without money will
:25:16. > :25:19.get substandard care or no care at all? When eyed hatred into the
:25:20. > :25:31.honourable gentleman Hospital, who was a Norfolk colleague and when as
:25:32. > :25:33.Mr did as -- a lot of work in this. The government says three Hartman
:25:34. > :25:39.impound familial preceptor. Under that care fund it is a significant
:25:40. > :25:42.commitment that we will have to overcome years right. View the
:25:43. > :25:45.devolution programme and the integration programme and will have
:25:46. > :25:48.to develop more powers so that local leaders and care Council leaders can
:25:49. > :25:54.better integrate services to reduce a necessary pressure. In Scotland,
:25:55. > :25:59.A performance is published weekly but since June it England it has
:26:00. > :26:04.only been punished every month and with a. Since that time, the
:26:05. > :26:08.performances, and has risen and achieving Isaac 's percent of people
:26:09. > :26:12.seen within four hours in Christmas week. While the last data that is
:26:13. > :26:18.published from England was October and is below 90%. Does the Minister
:26:19. > :26:22.and the secretary of state not accept that improve performance we
:26:23. > :26:29.need to return to more tiny as an frequent analysis and publication. I
:26:30. > :26:32.share interesting data on proper information. We have to be careful
:26:33. > :26:35.about Scottish figures. Over winter, England publishes three times more
:26:36. > :26:39.in the performance measures than Scotland every week. We publish
:26:40. > :26:42.quality rankings on hospitals, care homes and GP surgeries, which
:26:43. > :26:48.Scotland does not do. What we do not hear about in Scotland is AMD
:26:49. > :26:51.closures, emergency admissions, Mr Speaker, I could go on. It is
:26:52. > :27:01.dangerous to compare data that is not prepared on the same basis. I'm
:27:02. > :27:04.aware that the renewed strike call from junior doctors has actually
:27:05. > :27:09.been called to meet the new rules created by ligaments on union laws
:27:10. > :27:13.and that the gauche Asians are still continually. To avoid an impact on
:27:14. > :27:18.hospital waiting times, can the Secretary of State talus what the he
:27:19. > :27:25.is good printer negotiation table to try and reassure junior doctors
:27:26. > :27:32.I am delighted to be able to announce that the secretary of state
:27:33. > :27:38.has appointed someone to lead on that. The right approach is not too
:27:39. > :27:45.strike but to come to the table and find an agreement. 300 fewer older
:27:46. > :27:53.people have publicly funded care packages than in 20 nearly half the
:27:54. > :27:58.record level of people I waiting for care packages at home and this will
:27:59. > :28:05.get worse. It is risky that the proposed better care packages are
:28:06. > :28:12.back loaded. The social care precept funding is uncertain because it only
:28:13. > :28:18.raises one point by 20 if every single council decides to raise the
:28:19. > :28:28.maximum amount possible social care is in crisis now. Mr Speaker this is
:28:29. > :28:31.the most extraordinary welcome for one of the most important
:28:32. > :28:34.announcements in the Autumn Statement. Having come under
:28:35. > :28:39.pressure to raise more money for social care the Prime Minister and
:28:40. > :28:42.the Secretary of State raised money for social care from the precept and
:28:43. > :28:46.the better care fund and now we are told it is not enough and it will
:28:47. > :28:52.fail. The data does not support that. If you look at the early data
:28:53. > :28:58.from the better care fund 80 fewer delayed transfers, 12,000 more older
:28:59. > :29:05.people at home and many more people supported to live independently. We
:29:06. > :29:08.are making real progress. 11 of the 20 hospitals that have been put into
:29:09. > :29:12.special measures have exited that regime because of good clinical
:29:13. > :29:18.progress the most recent being in Morecambe last September. The North
:29:19. > :29:21.Cumbria trust has been in special measures for two and a and there are
:29:22. > :29:28.serious concerns about the wider health economy in the Cumbria and we
:29:29. > :29:31.have the success regime in place so will be Minister give a commitment
:29:32. > :29:37.that the government will ensure that the acquisition of the North Cumbria
:29:38. > :29:40.trust will actually happen? I would like to thank him for the
:29:41. > :29:44.campaigning he does for his local hospital and he knows I support that
:29:45. > :29:48.merger and hope it will go out. It is worth paying tribute to the staff
:29:49. > :29:53.at the trust who brought down mortality work rates and the CQC
:29:54. > :29:58.says that plans to improve safety are working well. I think across the
:29:59. > :30:02.special regime we should celebrate the fact that even the trust in
:30:03. > :30:07.special measures have hired 7000 more doctors and 18 more nurses and
:30:08. > :30:14.are making real progress in improving patient safety. Private
:30:15. > :30:17.agreements are costly and damaging and can the secretary of state to
:30:18. > :30:24.tell us what percentage of hospitals in special measures have had
:30:25. > :30:28.significant PFI funding? I can write to him with the details of that but
:30:29. > :30:35.what I can also tell him is that we inherited as a government ?70
:30:36. > :30:42.billion of PFI debt which has caused enormous pressure throughout the
:30:43. > :30:47.NHS. Whilst not in special measures Southern health NHS Foundation Trust
:30:48. > :30:50.had its performance criticised in an independent report particularly in
:30:51. > :30:53.relation to pour in relation to poor investigation of deaths for people
:30:54. > :30:56.with learning disabilities and mental illness. I welcome the
:30:57. > :31:02.Secretary of State's rapid action under announcement of the CQC
:31:03. > :31:08.enquiry. Can he update the house on enquiry and when it expects to
:31:09. > :31:12.report the enquiry has only just started but I would like to thank
:31:13. > :31:15.her for her interest in this. We have drawn an important inclusion
:31:16. > :31:19.from what happened at Southern health and that is that this is an
:31:20. > :31:23.issue that goes much more broadly than one trust. We are not as good
:31:24. > :31:28.as we need to be on investigating unexpected mortality in the NHS and
:31:29. > :31:31.this was an extreme example but it is a much more widespread problem
:31:32. > :31:38.and a cultural change that we are determined to do some thing about.
:31:39. > :31:42.As Morecambe Bay moves out of special measures will the Secretary
:31:43. > :31:46.of State undertake to support that moved by confirming the commitment
:31:47. > :31:52.made by the Coalition Government to underwrite the capital cost of a
:31:53. > :32:01.radiotherapy unit and support the uplift in tariff needed to sustain
:32:02. > :32:05.that unit? I will happily look into that but we will do everything we
:32:06. > :32:09.can to support that trust and it has been a very difficult time with it
:32:10. > :32:17.making significant progress in we do want to support them on their way.
:32:18. > :32:22.We have a drug routinely available for metastatic cancer but it is not
:32:23. > :32:29.licensed for use alongside hormone treatment or appraised by NICE for
:32:30. > :32:32.that. In the absence of that NHS are free to make their clinical
:32:33. > :32:40.decisions on available S -- evidence. A constituent of mine has
:32:41. > :32:44.prostate cancer and his doctor and his consultant at all a keyword
:32:45. > :32:48.would benefit from having this dark -- drug but it is not available in
:32:49. > :32:53.Northamptonshire even though it is available in parts -- other parts of
:32:54. > :33:00.the country. If he goes down the road to a private hospital he can
:33:01. > :33:14.have it at 2007 a cycle isn't that unacceptable? -- two cycle. He is a
:33:15. > :33:18.very diligent advocate of his constituent and I would like to say
:33:19. > :33:22.that the results of the clinical trial has been published and today
:33:23. > :33:26.NICE are publishing and evidence review and they will shortly publish
:33:27. > :33:39.a commissioning policy based on that evidence which is very encouraging.
:33:40. > :33:44.Digitisation of health is absolutely essential for 20 NHS for individual
:33:45. > :33:49.care and consistent performance and safety and research and Wi-Fi is an
:33:50. > :33:53.important part of that the doctors and nurses and hospital hospital
:33:54. > :33:58.management and others. I am delighted that the relevant funding
:33:59. > :34:01.has been secured to fully fund NHS plans for digitisation and trance
:34:02. > :34:05.formation and we have announced that we are implementing Martha Lane
:34:06. > :34:11.Fox's recommendation of free Wi-Fi in all NHS hospitals. I am very
:34:12. > :34:17.grateful to my honourable friend for that answer. The new chief executive
:34:18. > :34:22.of the Royal Shrewsbury Hospital has informed me that they can only get
:34:23. > :34:26.Wi-Fi in half of the area. Can he give me an assurance that everything
:34:27. > :34:32.will be done to ensure that Wi-Fi is throughout the Royal Shrewsbury
:34:33. > :34:36.Hospital? This is an important point and it is up to every hospital to
:34:37. > :34:41.implement digitisation in their own way. We have the series of steps to
:34:42. > :34:48.ensure that all parts of the NHS are supported and encouraged to drive on
:34:49. > :34:51.that delivery of a paperless NHS. We have an index to measure the
:34:52. > :34:56.digitisation of all healthy economies and we are launching a
:34:57. > :34:59.review of best practice. We are absolutely committed to driving
:35:00. > :35:10.digitisation so that the 20 NHS is not running on paper and cardboard.
:35:11. > :35:14.The five year review published by NHS England sets out a health
:35:15. > :35:20.strategy for the whole of England including rural areas. They have
:35:21. > :35:26.their own needs in planning health care systems. What specific research
:35:27. > :35:29.has the Minister taken to understand and what steps has it taken to
:35:30. > :35:33.address the very different rural needs and costs of rural communities
:35:34. > :35:38.in the south-west with disproportionately high numbers of
:35:39. > :35:48.over 80-year-olds and population distributions that make figures
:35:49. > :35:53.unobtainable? The review takes particular account of all areas but
:35:54. > :35:58.nor all rural areas are the same. Commissioning groups must judge the
:35:59. > :36:06.needs of their particular areas and judge the circumstances they find
:36:07. > :36:12.themselves in. Noninvasive prenatal testing is not currently offered for
:36:13. > :36:23.screening women in pregnancy for Downs syndrome and other conditions
:36:24. > :36:26.within the NHS. The UK National screening committee has reviewed the
:36:27. > :36:31.case for implementing and IPT as part of the existing screening
:36:32. > :36:39.programme and we will provide its advice shortly. At my 12 week scan I
:36:40. > :36:44.was told that I faced the risk of Downs syndrome in my child and I was
:36:45. > :36:49.given to options one was an invasive test available on the NHS which was
:36:50. > :36:54.the amnio test and carried the risk of miscarriage. This second option
:36:55. > :36:59.was noninvasive but not available on the NHS and cost four. Does the
:37:00. > :37:03.Minister agree that we should have the noninvasive test rolled across
:37:04. > :37:08.the country so that mothers regardless of wealth can have equal
:37:09. > :37:14.access to screening and do not have to face the unnecessary risk of
:37:15. > :37:17.miscarriage? I thank the Honourable lady for bringing her personal
:37:18. > :37:21.experience to the house and I hope that all is well. She will
:37:22. > :37:27.understand that screening has to be a nonpolitical matter and that is
:37:28. > :37:30.why we have a specific committee to look at whether a screening
:37:31. > :37:33.programme should be implemented or not. They have been looking at this
:37:34. > :37:37.over the past year and will make a decision very shortly. In principle
:37:38. > :37:47.I agree and it lies at the foundation of the NHS and one that
:37:48. > :37:50.we support. NHS England have assured local transformation plans that
:37:51. > :37:53.cover all Clinical Commissioning Group is ensuring that all the plans
:37:54. > :37:57.address the full spectrum of need for all children and young people
:37:58. > :38:01.including looked after children and those who have been sexually abused
:38:02. > :38:04.or exploited. Further thematic analysis has been carried out and
:38:05. > :38:13.the results will be available in March. I think it is a case of happy
:38:14. > :38:21.birthday to the honourable gentleman! Thank you very much.
:38:22. > :38:25.Children who have suffered the trauma of abuse may range from
:38:26. > :38:30.therapeutic services but there was a lack of consistent data about the
:38:31. > :38:37.number of people available for error Puget support and the services
:38:38. > :38:41.available. As part of the plans the needs of abused children would be
:38:42. > :38:46.properly considered and monitored at every level? I am grateful to my
:38:47. > :38:53.honourable gentleman for this question and previous questions in
:38:54. > :39:02.this area. He is right. Nationally if you take the new survey the first
:39:03. > :39:09.since two and numbers of children looked after in that survey would be
:39:10. > :39:13.relatively small. We have asked static to look at relevant ways to
:39:14. > :39:16.address the data and the issue so I hope to report further on that later
:39:17. > :39:29.in the New Year after having the meeting. I would like to thank my
:39:30. > :39:32.honourable friend for asking this question and we have made
:39:33. > :39:37.significant steps in the last two years. I anticipate it will continue
:39:38. > :39:43.and we will see an increase in nurse training this year. We will have
:39:44. > :39:50.many additional nurses by 2019 and we expect there to be an additional
:39:51. > :39:56.10,000 training places as announced last year. I would like to thank the
:39:57. > :39:59.Minister for here is reply reply but as a nurse I would struggle to
:40:00. > :40:02.undertake my training with the proposed changes to the bursary
:40:03. > :40:07.scheme. Can the Minister outline what additional routes are into
:40:08. > :40:11.nursing to help mature students and those on a low income gain access to
:40:12. > :40:18.nursing training I know the Minister is working hard but could he
:40:19. > :40:20.outlined those are routes? The honourable ladies is right to point
:40:21. > :40:25.out that there are different ways into nursing and just a few weeks
:40:26. > :40:30.ago we are a massive expansion in apprenticeships across the NHS and I
:40:31. > :40:35.anticipate that a few of those will be significant ways into nursing and
:40:36. > :40:41.there will be a vocational route via an apprenticeship. Our reforms to
:40:42. > :40:45.bursaries will ensure a 20 increase in funding to recipients and it will
:40:46. > :40:51.bring it into line with the rest of the student cohort. A cohort that
:40:52. > :40:55.has seen a considerable expansion in the number of students coming from
:40:56. > :41:03.disadvantaged backgrounds as a result of reforms we took in 20 and
:41:04. > :41:07.2012 does the Minister access that it was his decision to cut alerting
:41:08. > :41:13.places from 20 onwards and that has led to a huge shortage of staff in
:41:14. > :41:16.the NHS and decreased -- increased reliance on staff from abroad and
:41:17. > :41:21.agency staff and it would get worse with the abolition of Bursaries
:41:22. > :41:27.isn't it a textbook example of a false economy by government? The
:41:28. > :41:33.honourable lady should look at the facts. The facts are that in March
:41:34. > :41:43.20 it was a record number of nurses in the NHS three and in the NHS. We
:41:44. > :41:46.are increasing the number of nurses and we are doing Mac considerably
:41:47. > :41:49.more than we could have done otherwise bags to the reforms and
:41:50. > :41:55.student finance which brings nurses into line with teachers and other
:41:56. > :41:59.professions. It would be good to hear the Minister can see that it
:42:00. > :42:04.was a bad idea back in 2010 at cut the number of nurse training places.
:42:05. > :42:11.Even today we have fewer are being trained than in 20 -- two and have
:42:12. > :42:15.failed to recruit enough nurses and failed to retrain them as well.
:42:16. > :42:19.There was an increase in nurses leaving hospitals and with staff at
:42:20. > :42:23.an all-time know -- staff morale at an all-time low wife must nurses be
:42:24. > :42:34.burdened with a lifetime of debt to pay for the mistakes of his
:42:35. > :42:40.government? The honourable gentleman raises a good point about attrition
:42:41. > :42:45.rates. We have had some success in some areas, but they want to see
:42:46. > :43:03.more students staying the course as many as possible. Thank you. Groups
:43:04. > :43:08.have produced transformation plans for improving young people to mental
:43:09. > :43:13.health. These will include collaborations with the people in
:43:14. > :43:18.question are those who care for them. NHS England have elaborated
:43:19. > :43:27.very real with young people to produce these plans. Last year, on a
:43:28. > :43:32.consultation on mental health services in Derby, one thing that
:43:33. > :43:38.was how late it was the disparity between services of the two groups.
:43:39. > :43:48.What is he making plans to make sure that trusts across the UK deal with
:43:49. > :43:50.this in a similar way. We talk about these radiation and performance
:43:51. > :43:56.around the country with these different issues. Two of three
:43:57. > :43:59.things will help. In relation to funding and resources, we have a
:44:00. > :44:07.tracking system to make sure money going into young person's mental
:44:08. > :44:11.health is spent appropriately. There is also an improvement team working
:44:12. > :44:17.across the NHS to make sure that these lesions are evened out so that
:44:18. > :44:26.the best practice in areas becomes standard for everyone. Yesterday
:44:27. > :44:29.evening, the British medical Association decided to walk away
:44:30. > :44:33.from talks about the new junior doctors contract and announce plans
:44:34. > :44:40.for strike action. We have made significant progress in talks on 15
:44:41. > :44:46.of the 60 areas of concern. We were doing everything we can to make sure
:44:47. > :44:56.patients are safe. We said we would the over 70 services and with study
:44:57. > :45:03.after study telling us that hospitals have higher mortality
:45:04. > :45:11.rates, no change is not an option. It is all gone rather quiet on tele-
:45:12. > :45:22.health and what funding is therefore not? I think we should thank him for
:45:23. > :45:25.his constant interest in this area. The technology has changed
:45:26. > :45:32.significantly in the past four years. We are committed to it. We do
:45:33. > :45:34.not want to isolate a few individuals who meet particularly
:45:35. > :45:41.benefit because we think everyone may be able to. The plans that will
:45:42. > :45:54.be known as for technology in the next few months will show how we can
:45:55. > :45:58.rule that out to an wider audience. Following the assisted dying baby,
:45:59. > :46:04.will the Minister joined us in thanking local hospital since --
:46:05. > :46:13.hospices which serve my constituency. I will certainly join
:46:14. > :46:20.my friend and pleasing the work which hospices do. He will know that
:46:21. > :46:25.I have a commitment to this and I hope to be making some announcement
:46:26. > :46:29.shortly in response to the review of last year. I have been talking to
:46:30. > :46:39.people from the sector about what can be done. It is a sad state of
:46:40. > :46:46.fears bring a new year starts with the prospect of industrial action in
:46:47. > :46:51.the NHS. Nobody wants strakes, not least the junior doctors, but they
:46:52. > :46:57.feel badly let down by a Health Secretary who seems to think
:46:58. > :47:01.contract negotiations are a game of brinksmanship. When will the Health
:47:02. > :47:08.Secretary admit that changing the definition of unsociable hours and
:47:09. > :47:14.associated rates of pay for junior doctors as a forerunner to changing
:47:15. > :47:22.a whole load of other NHS staff in contracts to save on the NHS budget.
:47:23. > :47:28.That is what all of this is really about, isn't it? No it is not. I
:47:29. > :47:33.wish her every success in our continuing post in the Shadow
:47:34. > :47:38.Cabinet. It would be a shame to lose her having got to know her. This is
:47:39. > :47:42.a difficult issue to solve, but at least the country knows what the
:47:43. > :47:47.government is trying to do. She has spent the last six months avoiding
:47:48. > :47:51.telling the country what she would do about these flawed contracts.
:47:52. > :47:58.Chance. Which she changed the contracts of the junior doctors to
:47:59. > :48:06.improve seven-day services? Junior doctors do not need words from me on
:48:07. > :48:10.the opposition benches. They need action from the secretary of state
:48:11. > :48:16.to stop the strakes and give patients the care they deserve. Mr
:48:17. > :48:21.Speaker, not content with eliminating one group of staff, the
:48:22. > :48:26.Health Secretary know has another target -- student nurses. The
:48:27. > :48:34.disastrous decision in the last parliament to cut not training
:48:35. > :48:40.places has driven the raising agency staff bill. They ask this, why
:48:41. > :48:47.should the trainee nurse who spends half of her dignity caving for
:48:48. > :48:51.patients, not received a bursary? If they are working at three o'clock in
:48:52. > :48:57.the morning, why should he be expected to pay for the privilege?
:48:58. > :49:02.She cannot have it both ways. She cannot stand here and criticise cups
:49:03. > :49:06.and streaming and then oppose this government to make changes which
:49:07. > :49:12.meant we will be able to train 10,000 more nurses over the course
:49:13. > :49:15.of this Parliament. Let me tell you why we have 8500 more losses in our
:49:16. > :49:23.hospital since I became Health Secretary. It is this government
:49:24. > :49:30.which recognises good enough strength in our hospitals. She
:49:31. > :49:35.should give us credit credit is due. In my constituency, as many as one
:49:36. > :49:44.in four children are categorised as obese. Can the Minister assure me
:49:45. > :49:48.that the government will acknowledge that children and families have to
:49:49. > :49:56.take control over their own lifestyles, rather than in any other
:49:57. > :50:04.way. My honourable friend is great to say there is an onus on families
:50:05. > :50:10.on this. Young children are not in control of all the food environment
:50:11. > :50:14.around them. The government strategy is focused on children. It is a
:50:15. > :50:19.complex issue and the family needs everyone to play the part,
:50:20. > :50:24.government, local government, health professionals and industry and, of
:50:25. > :50:30.course families. The Health Secretary has just tried to tell us
:50:31. > :50:38.why we have 8500 more nurses in the National Health Service. We have got
:50:39. > :50:41.many of them from abroad. There has been a worrying reductions in the
:50:42. > :50:46.number of applications from people that we would expect to see at this
:50:47. > :50:52.time of year. This will have a negative impact on the number of
:50:53. > :50:56.trained nurses and also on net migration. Was that any discussion
:50:57. > :51:01.between the Department of Health, the Home Office and the Chancellor
:51:02. > :51:07.before this idiocy was introduced? The reason why we have record levels
:51:08. > :51:12.of nurses in training and practice, was because of the decision taken by
:51:13. > :51:20.my honourable friend to increase not training by 100% over the past two
:51:21. > :51:23.years. We did this because of the reforms to nurses training funding.
:51:24. > :51:29.We are undertaking this change so that every nurse in this country who
:51:30. > :51:33.wants a position can have the opposite opportunity of having one.
:51:34. > :51:41.At the moment that is limited because of the funding regime in
:51:42. > :51:46.place. Would my honourable friend join me in congratulating the first
:51:47. > :51:55.responders in my constituency. With TP tribute to the team leader of the
:51:56. > :52:02.first response team, who is stepping down after 11 years as an unpaid
:52:03. > :52:07.public servant. Yes, first responders have been a valued
:52:08. > :52:11.addition to the front Allied health professionals. We are delighted to
:52:12. > :52:16.pay tribute to his friend and from the work he has done. I am sure I
:52:17. > :52:21.speak for everyone in the house when I give a warm thank you to all those
:52:22. > :52:27.who are part of the first responders team around the country. I'm too
:52:28. > :52:37.many occasions, children and my constituency need to be admitted to
:52:38. > :52:42.a psychiatric bed need to read more than one day to get one. Sometimes,
:52:43. > :52:50.even people in London are having to travel many males, to the likes of
:52:51. > :52:55.Nottingham and even Glasgow. We'll keep it in measures in place so that
:52:56. > :52:58.it is immediately available and will he do something to make sure that
:52:59. > :53:04.children are not sent such a long way away from home for their
:53:05. > :53:10.treatment? That it is why there has been a drive to find more beds for
:53:11. > :53:14.children and young people involved in serious crisis, but there is also
:53:15. > :53:18.support going into community services to prevent that in the
:53:19. > :53:24.first place. There will be a need for specialist beds to be regionally
:53:25. > :53:28.and nationally available. Not everything can be treated locally.
:53:29. > :53:34.Really can commonly should be and we are working that. Worcester Acute
:53:35. > :53:43.Hospital trust finds itself in special measures. This is largely
:53:44. > :53:50.because of a review of clinical services in the county which has
:53:51. > :53:52.failed to deliver. Given the impossibility of it reaching its
:53:53. > :54:00.targets, what steps can the government take to help prevent this
:54:01. > :54:05.situation and help the trust get back on its feet? My friend is
:54:06. > :54:08.right. The are a particularly complex series of circumstances and
:54:09. > :54:16.was stuck. I am determined to do something about it. We will meet to
:54:17. > :54:31.discuss options that they will consult with NHS England with regard
:54:32. > :54:35.to Worcs. There is talk of a compulsory 60 minute lunch break
:54:36. > :54:41.being imposed on losses. This will do nothing to address the issue of
:54:42. > :54:49.staff shortages, and will disadvantage nurses and patients
:54:50. > :54:56.alike. Will the honourable gentleman investigate this? All contract
:54:57. > :55:02.should be governed by his a central organisation they would be worried
:55:03. > :55:08.if there was any deviation from. Nobody wants to return to the days
:55:09. > :55:17.of junior doctors forced to work extra hours. The Secretary of State
:55:18. > :55:22.will know that they could remove financial penalties from trust. What
:55:23. > :55:26.has happened during negotiations to reassure the public and doctors
:55:27. > :55:34.about patient safety? I hope I can reassure her that we will refuse
:55:35. > :55:44.financial penalties when doctors are asked to work excessive hours. I
:55:45. > :55:57.have reiterated our offer to the British medical Association. Mr
:55:58. > :56:01.Speaker, the Chancellor pledged to match the charitable fundraising of
:56:02. > :56:10.Great Ormond Street Hospital to the maximum of ?1.5 million. It is one
:56:11. > :56:15.of only four specialist children's trusts in the United Kingdom. Does
:56:16. > :56:19.he agree that the government funding should be extended to all four of
:56:20. > :56:25.these and will he make their case to the Chancellor? I am happy to work
:56:26. > :56:35.but this without making any guarantees.
:56:36. > :56:46.The daughter of the constituent of mine was admitted with mental health
:56:47. > :56:52.issues and she was kept any cell overnight. Police stations are not
:56:53. > :56:55.appropriate places. What is he doing to assure adequate places are
:56:56. > :57:02.available locally and police, should they be involved, know how to deal
:57:03. > :57:08.with traumatic mental health patients? My honourable friend is
:57:09. > :57:13.right. The has been a 54% reduction in the use of police cells in the
:57:14. > :57:22.past three years. This is being helped by work in the sector. We
:57:23. > :57:27.want to prevent young children and people being held in police cells at
:57:28. > :57:28.all. It has been reduced dramatically and we will continue
:57:29. > :57:39.that process. Yesterday the ministers and junior
:57:40. > :57:45.doctors had not fully dealt with the issue of weekend working and
:57:46. > :57:48.compensation. Doctors will be forced to strike. Instead of attacking
:57:49. > :57:53.consultants and junior doctors will give followed the example of the
:57:54. > :58:03.Scottish Government and face the challenges of increased demands?
:58:04. > :58:08.Project, man! Project to! We wish to hear the full gist of what you have
:58:09. > :58:14.to say to the house. We will work with the NHS profession to provide
:58:15. > :58:18.full seven services throughout the NHS in England. I hope you will
:58:19. > :58:26.follow that lead in Scotland where they have the same issue with
:58:27. > :58:30.weekend mortality rates. Further to that question, having recently met
:58:31. > :58:35.with a clinical leadership at the Royal Worcester Hospital they are
:58:36. > :58:38.adamant they want to see permanent management in place but the number
:58:39. > :58:43.of interim directors is one of the reasons it has been in special
:58:44. > :58:49.measures. Will the Minister be doing every he can to put in long term
:58:50. > :59:00.management soon as possible. I can assure him precisely that. There is
:59:01. > :59:03.a significant reconfiguration plan act Dewsbury Hospital and it will be
:59:04. > :59:08.downgraded before infrastructure is in place to ensure that patients
:59:09. > :59:12.will receive vital care safely. Wilbur the secretary of state meet
:59:13. > :59:20.with me to discuss this premature move which is financially driven and
:59:21. > :59:25.not in the best interests of my constituents? I thank the honourable
:59:26. > :59:29.lady for bringing this to the house but I would be very happy to meet
:59:30. > :59:36.her and anyone she wishes to bring with her to discuss the changes that
:59:37. > :59:39.they plan. My local mental health trust recently reduced its
:59:40. > :59:43.psychiatric liaison cover in a and E and it is now considering the level
:59:44. > :59:47.for the coming year. Could my honourable friend provide an update
:59:48. > :59:57.on what government plans to do to ensure specialist mental health care
:59:58. > :00:00.in a Andy? A? The mental health task force is shortly to bring
:00:01. > :00:03.forward its Bretton -- recommendations. I know it is
:00:04. > :00:09.looking very carefully at what is provided in a and it was the subject
:00:10. > :00:14.of a review by CQC earlier last year and I am looking specifically at
:00:15. > :00:22.psychiatric liaison and I have seen your written question very recently.
:00:23. > :00:25.What demographic interest -- impact assessment has his department made
:00:26. > :00:29.on the withdrawal from the European Union on health and social care and
:00:30. > :00:38.the consequent result that will have on demands for the services? None
:00:39. > :00:42.whatsoever. In the previous parliament many people who suffer
:00:43. > :00:46.from a rare disease were pleased with the publication of the rare
:00:47. > :00:53.disease strategy but what progress is being made on the ultra-rare
:00:54. > :00:58.disease strategy? I am happy to look at that but in regard to the
:00:59. > :01:02.recommendations made in the rare diseases strategy there will be a
:01:03. > :01:09.report on that to spring and I will take up the other issue with him
:01:10. > :01:15.privately. I know health has devolved but when it comes to the
:01:16. > :01:19.expensive red diseases and diagnoses, it is possible that
:01:20. > :01:25.devolved governments may choose not to spend on it. What more health can
:01:26. > :01:32.-- help can Westminster be to help my constituents to afford? One
:01:33. > :01:36.example I can give is that I am sure he will welcome the example that for
:01:37. > :01:42.health departments are jointly funding a network of 18 experimental
:01:43. > :01:45.cancer medicine centres which is about driving development and
:01:46. > :01:50.testing of anti-cancer treatments and levering a real benefit to
:01:51. > :01:56.patients including those with rarer cancers and it is one example of how
:01:57. > :02:02.we can work together. Order! I am pleased to be able to announce to
:02:03. > :02:16.the house that following fair and open competition Her Majesty The
:02:17. > :02:23.Queen has graciously accepted my recommendation for the person to be
:02:24. > :02:25.appointed to the post of Sergeant at Arms as of the 1st of February. He
:02:26. > :02:26.has been