Health Questions House of Commons

Good afternoon at welcome to the live coverage of the Commons. There

are four ministerial statements on this first parliamentary day of 20

first the Prime Minister will be briefing MPs about the outcome of

the European Council summit in November. The Home Office will make

a statement on reports that a British national is believed to be

the main suspect in the latest Isis video and he fled written in 20

while on bail for terror offences. Liz Truss will be addressing MPs

about the recent severe flooding in the north of Britain and after all

of that comes the fourth statement concerning Britain's relationship

with Saudi Arabia following the execution last week of 40 people in

the country. Then there is the Housing and planning Bill. Join me

Keith Macdougall for a round-up of the day in -- when the Commons

debate are finally concluded tonight. First it is questions to

the Secretary for health Jeremy Hunt and his ministerial team. The first

question concerns the revision of care outside hospitals. -- provision

of care. Order! Order! Questions to the

Secretary of State for Health. Happy New Year Mr Speaker and happy New

Year to familiar faces in the Shadow Cabinet offices. Vista Speaker, the

government is committed to transforming out of hospital care

for everyone in every immunity by 20 we have seen excellent progress in

areas led by pioneers such as Torbay and Greenwich and the government

remains committed to programmes such as the Medicare fund and the

Vanguard. 70% of people would prefer to die in their own home. Should we

allow 60 to die in hospital it has to change. There should be better

social care provided outside hospitals. What message would he

give to Clinical Commissioning Group is like mine who are trying hard to

bring this about and two integrate services. I am grateful to my

honourable friend for raising this and we share his views that we

should see greater choice in end of life care so that people are able to

be cared for and die in the place that they choose and that is

appropriate for their needs, whether it is a hospice or hospital or their

own home. The review set out to enable greater choice at the end of

life and I am working on the NHS to see how this best can be achieved

and the government will comment on it soon. We recently received a

letter from a range of social care organisations and charities which

has really panned the spending review offer, saying it is not

sufficient to defend the care crisis and they warned of an increasing

number of older people without sufficient support increasing

pressure on the NHS. Will the health set churchy admit that the offer in

the statement is not good enough? Social care was an important part of

the spending review and that has been noted by all. Up to two will be

available through the social care preceptor that will be added to

council tax and there is another one point of by 2020 so over all three

point will be available by then. We all know social care is tight and we

need best practice everywhere to make the best use of resources which

many leading authorities are already doing. As my right honourable friend

to integrating and improving care outside hospitals will he discuss

with the secretary of state the medical system in China which brings

together Western medicine herbal medicine and acupuncture which is

bearing down on the demand for antibiotics and before he responds

on the report will he look very carefully at dispensing arrangements

for small-scale Assembly of herbal product, something that the People's

race public of China government is very interested in? Mr Speaker

herbal product 's are slightly beyond my normal portfolio re-met.

Anything that assists in social care and makes people feel better and dad

still a vitality and well-being is to be welcomed and I am sure that in

many local areas they are taken extremely seriously. I thank the

Minister for his response. Integration and improving care and

hospitals is just one way to improve the health service. Will the

Minister look at links between reducing pressure on a and E 's and

increasing provision outside of hospitals to reduce that pressure. A

number of the pilot and Pioneer programmes are doing just that. If I

could refer to one in Cornwall, a LivingWell programmes there has only

results that show a reduction in non-at two that mission is to

hospital and 50 reduction in advisers seat -- emergency admission

to hospital. Better social care and integration may have and should have

an impact on hospital admissions and make sure that people are receiving

the most appropriate care in the most appropriate place. I was

pleased to hear the Minister's reference to the integrated care

organisations in Torbay. Will he agree that the increasing challenges

of providing social care to those in later life this model needs to be

looked at and he will support it as much as he can indeed. Being able to

look at these pilot products and seeing what they can do in different

areas responding to different demographics is very good and Torbay

has come up very frequently and I am delighted to praise it again. Those

involved in our social care were much involved in the flooding

recently in the North of England looking after vulnerable people.

They were very important and I am grateful to Ray James and all of

those in local authorities in the area that contributed so well to

looking after vulnerable people during that period. The report on

the appalling failures at Southern health NHS foundation five and --

trust highlighted over 1000 and the did deaths of mental health and

learning disability patients. Many of them take lace outside hospital

and they have not been investigated. Given that the Home Secretary did

not allow the house to scrutinise the findings before Christmas, will

the Minister respond to widely held concerns that the experience of this

trust is not isolated and will he agree with me that a national hub

licking is now needed? The honourable lady is quite right. This

is a wider concern and that is why CQC is looking nationally at the

picture of what has happened because these deaths have not been

investigated appropriately in the past and it is something that must

change. The government has a determination to change a raid of

things in regards to mental health and learning disabilities and this

area has been forgotten to long and it is now being brought to light and

work is being done by this government. As part of our

commitment to a seven day we want all patients to be able to make

routine appointments with their GP surgeries in the evenings and at

weekends. Two out of 8000 surgeries are currently running schemes to

make this possible. Many working people were asked to phone GP

surgeries very early in the morning to make a and it is not always

convenient. Can my right honourable friend tell me whether priority will

be given at weekends to people who are working during the week my

honourable friend is absolutely right and this system does not work

well for people who have to go to work and we want to make it easy for

people to book appointments online through a nap on their phone and we

want to make it possible for people in his constituency in more rural

areas like North Cornwall to have health appointments so they can see

someone without having to go to the surgery when it is appropriate.

Given the increasing difficulty the public is having at getting a GP

appointment at a time that is convenient to them and quickly does

he believe his predecessor was wrong when he scrapped a Labour's 40 GP

access guarantee? No, I do not because it had perverse consequences

and when the target was in place the number of people having to wait to

see a GP was actually increasing, not decreasing. What happened in the

last parliament was at number of GPs actually went up, a five increase in

the workforce and we had plans to increase it by 13 one of the biggest

ever increases in their GP workforce in the NHS history on the back of a

strong economy. The secretary of state will be aware from personal

experience of the excellent work done by GPs in Herefordshire who ran

one of the first seven week pilots. Can he give asked assurance that

this work will be funded to continue because it has done an

extraordinarily good job to help my constituents. We are very pleased

with the progress made in Herefordshire and other areas and we

are looking at how to maintain funding for those areas. Nearly 16

people are benefiting from on access to GPs are evenings and weekends and

we would not want to see the clock turned back on that. Today I

received a letter from the chair of the Clinical Commissioning Group in

Slough where he demote the fact that GP actresses make 90 of patient

contact but only get eight of NHS resources and he told me that this

had meant together with the reduction of 30 he claimed in the

last five years of GP partner income, he was meaning that in

Slough more and more GPs are turning to private practice. I have noticed

that it means they are resisting the creation of new GP Pratt disses.

What is he going to make sure that under doctored areas get more GPs?

First of all can I ask her to congratulate GPs in Slough who have

benefited from the Prime Minister's challenged fund which has had a

significant impact on reducing emergency admissions in her area

amongst other schemes. The answer to that is that we are investing over

the course of this Parliament and extra eight in the NHS ten when you

include the money going in this year. We have said that we want more

of that money to go into general practice to reverse the historic

underfunding of general practice. I agree that needs to be reversed.

Three quarters of trusts are reporting a deficit for the

conclusion of the first off of this financial year.

My own area of south Tees, the deficit for 2014-15 is nearly ?70

million. Will the Minister accept that the gum and has totally lost

control of NHS finance? The first point to make is that this

government has provided money for the NHS that it has asked for. The

second is that the new Chief Executive of NHS improvement, one of

the best chief executives in the NHS, has said that he will help get

hospital trusts in control next year and with the transformation fund

announced by my right honourable friend, we are confident we will be

able to get them into balance next year. Does the Minister agree that

ramping down on expensive temporary agency staff is an important step to

help sort out the NHS and allow them to balance the books question mark

it is already having an impact on the fact is we had to bring in the

needs for safe staffing rotors because of the catastrophe of Mid

Staffs on the need to try and staff hospitals that. That had an

immediate consequence. But unfortunately that has been taken

advantage of by some companies and we have brought in measures to stop

that and it has already had an impact across the service. The

University hospitals of North Midlands face a deficit of ?90

million for 2015-16 but until the NHS review is completed, they face

uncertain prospects further out, not least having taken over Stafford

County Hospital recently. Well the Minister made of hospital management

and local MPs as soon as possible this year to discuss this uncertain

situation and the progress with the whole of the Staffordshire review? I

would be very happy to meet them and I would first of all congratulate

them on a meet them on eliminating 12 hour trolley rates for the first

issue. They are doing a great job but I am confident they will be will

to get their deficit under control next year with the help of the

transformation fund. Mr Speaker, a rare disease is a

life-threatening... Research shows that one in 17 people will suffer

from a rare disease at some point. In the UK, that equates to 3.5

billion people. The organisation in my constituency is concerned about a

number of... What support there is at the time of diagnosis,

particularly the parents of children with rare diseases? With the

minister gave some examination... Help and support for those who have

been diagnosed? I am glad that the right honourable gentleman mentions

that point. The house may not be aware that we recently added four

new rare diseases to the newborn heel prick test which has helped to

detect over 1400 children with a rare disease. We will look up into

that -- look into that but the UK rare diseases strategy which has 51

commitments from government published in 2013 covers that are

the first report back, strategy is this spring and that has been done

by the UK rare diseases forum. Happy to speak to him afterwards about

whether the excellent organisation he names is part of that. One such

rare diseases Musca dystrophy and I'm sure that the ministers aware

that we are waiting for what we hope will be a positive decision from NHS

England on a drugs called trans-Lada which could help these boys with the

condition. I wonder if the Minister has got any further and if she could

update test as to when we can expect an announcement and hopefully it

will be a positive one? Mr Speaker, I know that my colleague is working

very hard on this and hoping to be able to make announcements soon. And

I am sure at that point to be able to write update -- update my right

honourable friend. With regards to read diseases, I will be joining the

family of Sam Brown. Could we also have an update on the possible at

your funding for a dreadful to be the sclerosis which in the is

another one of the drugs we have been campaigning for? With regard to

the Matty just mentioned, I know that something NHS England looking

at currently reviewing with a view to be coming forward with a view

intercourse. Will my honourable friend join me in praising the work

of the department at the University of Birmingham medicals? They are

doing outstanding worldwide standard work in developing cures and

treatments for such rare diseases and indeed more common diseases such

of course as cancer. Well, absolutely do join with him in those

very well-deserved congratulatory words. I know that my honourable

friend the Minister for life sciences has visited and everyone is

hugely impressed and I think I join with others in congratulating

Charlie Craddock on his CBE in the New Year 's Honours list. Patients

living with rare cancers often have fewer treatments available to them,

often the only option is to use off label treatments. The Cancer Drugs

Fund has helped patients gain access to these treatments but despite a

Conservative Party manifesto commitment to continue investing in

it, it is now under threat because of central government cuts. What

assurances can the Minister provide to people living with rare cancers

that off label drugs will still be funded and will she apologise for

the uncertainty these cuts are causing to the thousands of people

affected by cancer in England? Well, I certainly do not recognise the

characterisation at all of the Cancer Drugs Fund, just given by the

Shadow Minister. ?1 billion has been committed and the fund is currently

being reviewed. This is being introduced by the Alaska men, of

which we are very proud. It has made a big difference to the lives of

over 80,000 patients. -- the last government. They made many

recommendations which are particularly relevant to rare around

blood cancers. Many of which focus on improving access to diagnostic

testing. 75% are children. Unfortunately 30% of those will not

reach their fifth birthday. What more can be done for Great Ormond

Street Hospital and also the excellent work of Birmingham

Children's Hospital? Well, as I said earlier, Mr Speaker, I think my

honourable friend is quite right to highlight the number of people who

will be affected. There are between six and 8000 rare diseases. Amongst

the things that the government is doing which is I think going to make

a really big difference to some of the institutions he mentioned and

that there is an particular to suffer as is the 100,000 genomics

project which the government is investing in. The creation of a

network of genetic medicine centres will underpin that further

development of genetic testing services because a very large

proportion of rare diseases are genetically based and therefore we

want to make significant progress without work. -- with that work. The

health and care system is under extraordinary demand by aid rising

population. Gina Brevard Oates needing care in the next ten

years or... ?3.5 billion in social care by 2015 by the new adult

preceptor and the extra funding for the NHS finding a forward view. In

any given week at the John -- called as though there is the buzz... As we

know that the gum and brokers pro promise pre-election and we know

that the Kingsand is easily said that the settlement to which she

refers will put even more pressure to... Willie now accept this

continuing neglect and is broken promises is a fit because of the

prizes -- crisis in our pay any term departments? We are leading the way

in integration, and not before time, after 14 years in which the party

opposite did nothing. We are leading the way on integration, but in the

extra money. And then die did say that of the 3.8 billion fiscal mini

under 10 billion we are funding the NHS five-year year transformation,

it is this party investing in this 21st century NHS. The party opposite

seems to want to dig is back to Midway. They are best placed to

commission services were careful local publishers. Yes, my honourable

friend make serial honourable excellent point. The key is of

course more funding and of course more integration but crucially more

local leadership. And we are actively making it easier for the

devolution programme for local authorities and local health leaders

to plan the degraded services that are appropriate for that area. Not

all areas of the same. I'm afraid that having listened to what the Mr

has the sake of the people in my constituency are going to be

disbelieving. Been a rough days that patients are stuck in hospital but

because they are set but because there is nowhere to move them on two

has doubled under his command and he has took knowledge of that is due to

the neglect of local government and adult social care specifically.

Well, it is true that in different areas there are different measures.

In my own area of Norfolk, there are pressures but let just remind the

honourable lady that I A spreading has gone up to radically in the past

decade. 900 billion in 2001 to 2.4 billion and if you look at the early

evidence from the better care fund which we launched only this year to

tackle this issue. The evidence is 84,000 fewer delayed transfers,

12,000 more older people at home within three months of discharge

annually 3000 people supported live independently. The truth is through

more funding, greater freedoms and local devolution, we are supporting

health leaders and council leaders to bring together health and care.

Despite his pressure, isn't it not excellent that 95% of patients

presented at a and E are seen within the target time in England, unlike

in Wales won only 81% are seen as a result of the fact that the NHS is

run by members of the party opposite? My honourable friend makes

a excellent bile that uses UNIX an important point. If you really want

to get pressure on A down and we need to integrate and verses we are

prevention and keeping people out of unnecessary Indian mission. The

Health Foundation estimates that the gap in social care funding by 2020

will be ?6 billion. Not taking into account the increasingly minimum

wage. Although the spending review narrows the gap it is still leading

an enormous gap will chew and resented further cuts in social

care. How is the government going to avoid Italy and accept a situation

that those with money will still get good care, those without money will

get substandard care or no care at all? When eyed hatred into the

honourable gentleman Hospital, who was a Norfolk colleague and when as

Mr did as -- a lot of work in this. The government says three Hartman

impound familial preceptor. Under that care fund it is a significant

commitment that we will have to overcome years right. View the

devolution programme and the integration programme and will have

to develop more powers so that local leaders and care Council leaders can

better integrate services to reduce a necessary pressure. In Scotland,

A performance is published weekly but since June it England it has

only been punished every month and with a. Since that time, the

performances, and has risen and achieving Isaac 's percent of people

seen within four hours in Christmas week. While the last data that is

published from England was October and is below 90%. Does the Minister

and the secretary of state not accept that improve performance we

need to return to more tiny as an frequent analysis and publication. I

share interesting data on proper information. We have to be careful

about Scottish figures. Over winter, England publishes three times more

in the performance measures than Scotland every week. We publish

quality rankings on hospitals, care homes and GP surgeries, which

Scotland does not do. What we do not hear about in Scotland is AMD

closures, emergency admissions, Mr Speaker, I could go on. It is

dangerous to compare data that is not prepared on the same basis. I'm

aware that the renewed strike call from junior doctors has actually

been called to meet the new rules created by ligaments on union laws

and that the gauche Asians are still continually. To avoid an impact on

hospital waiting times, can the Secretary of State talus what the he

is good printer negotiation table to try and reassure junior doctors

I am delighted to be able to announce that the secretary of state

has appointed someone to lead on that. The right approach is not too

strike but to come to the table and find an agreement. 300 fewer older

people have publicly funded care packages than in 20 nearly half the

record level of people I waiting for care packages at home and this will

get worse. It is risky that the proposed better care packages are

back loaded. The social care precept funding is uncertain because it only

raises one point by 20 if every single council decides to raise the

maximum amount possible social care is in crisis now. Mr Speaker this is

the most extraordinary welcome for one of the most important

announcements in the Autumn Statement. Having come under

pressure to raise more money for social care the Prime Minister and

the Secretary of State raised money for social care from the precept and

the better care fund and now we are told it is not enough and it will

fail. The data does not support that. If you look at the early data

from the better care fund 80 fewer delayed transfers, 12,000 more older

people at home and many more people supported to live independently. We

are making real progress. 11 of the 20 hospitals that have been put into

special measures have exited that regime because of good clinical

progress the most recent being in Morecambe last September. The North

Cumbria trust has been in special measures for two and a and there are

serious concerns about the wider health economy in the Cumbria and we

have the success regime in place so will be Minister give a commitment

that the government will ensure that the acquisition of the North Cumbria

trust will actually happen? I would like to thank him for the

campaigning he does for his local hospital and he knows I support that

merger and hope it will go out. It is worth paying tribute to the staff

at the trust who brought down mortality work rates and the CQC

says that plans to improve safety are working well. I think across the

special regime we should celebrate the fact that even the trust in

special measures have hired 7000 more doctors and 18 more nurses and

are making real progress in improving patient safety. Private

agreements are costly and damaging and can the secretary of state to

tell us what percentage of hospitals in special measures have had

significant PFI funding? I can write to him with the details of that but

what I can also tell him is that we inherited as a government ?70

billion of PFI debt which has caused enormous pressure throughout the

NHS. Whilst not in special measures Southern health NHS Foundation Trust

had its performance criticised in an independent report particularly in

relation to pour in relation to poor investigation of deaths for people

with learning disabilities and mental illness. I welcome the

Secretary of State's rapid action under announcement of the CQC

enquiry. Can he update the house on enquiry and when it expects to

report the enquiry has only just started but I would like to thank

her for her interest in this. We have drawn an important inclusion

from what happened at Southern health and that is that this is an

issue that goes much more broadly than one trust. We are not as good

as we need to be on investigating unexpected mortality in the NHS and

this was an extreme example but it is a much more widespread problem

and a cultural change that we are determined to do some thing about.

As Morecambe Bay moves out of special measures will the Secretary

of State undertake to support that moved by confirming the commitment

made by the Coalition Government to underwrite the capital cost of a

radiotherapy unit and support the uplift in tariff needed to sustain

that unit? I will happily look into that but we will do everything we

can to support that trust and it has been a very difficult time with it

making significant progress in we do want to support them on their way.

We have a drug routinely available for metastatic cancer but it is not

licensed for use alongside hormone treatment or appraised by NICE for

that. In the absence of that NHS are free to make their clinical

decisions on available S -- evidence. A constituent of mine has

prostate cancer and his doctor and his consultant at all a keyword

would benefit from having this dark -- drug but it is not available in

Northamptonshire even though it is available in parts -- other parts of

the country. If he goes down the road to a private hospital he can

have it at 2007 a cycle isn't that unacceptable? -- two cycle. He is a

very diligent advocate of his constituent and I would like to say

that the results of the clinical trial has been published and today

NICE are publishing and evidence review and they will shortly publish

a commissioning policy based on that evidence which is very encouraging.

Digitisation of health is absolutely essential for 20 NHS for individual

care and consistent performance and safety and research and Wi-Fi is an

important part of that the doctors and nurses and hospital hospital

management and others. I am delighted that the relevant funding

has been secured to fully fund NHS plans for digitisation and trance

formation and we have announced that we are implementing Martha Lane

Fox's recommendation of free Wi-Fi in all NHS hospitals. I am very

grateful to my honourable friend for that answer. The new chief executive

of the Royal Shrewsbury Hospital has informed me that they can only get

Wi-Fi in half of the area. Can he give me an assurance that everything

will be done to ensure that Wi-Fi is throughout the Royal Shrewsbury

Hospital? This is an important point and it is up to every hospital to

implement digitisation in their own way. We have the series of steps to

ensure that all parts of the NHS are supported and encouraged to drive on

that delivery of a paperless NHS. We have an index to measure the

digitisation of all healthy economies and we are launching a

review of best practice. We are absolutely committed to driving

digitisation so that the 20 NHS is not running on paper and cardboard.

The five year review published by NHS England sets out a health

strategy for the whole of England including rural areas. They have

their own needs in planning health care systems. What specific research

has the Minister taken to understand and what steps has it taken to

address the very different rural needs and costs of rural communities

in the south-west with disproportionately high numbers of

over 80-year-olds and population distributions that make figures

unobtainable? The review takes particular account of all areas but

nor all rural areas are the same. Commissioning groups must judge the

needs of their particular areas and judge the circumstances they find

themselves in. Noninvasive prenatal testing is not currently offered for

screening women in pregnancy for Downs syndrome and other conditions

within the NHS. The UK National screening committee has reviewed the

case for implementing and IPT as part of the existing screening

programme and we will provide its advice shortly. At my 12 week scan I

was told that I faced the risk of Downs syndrome in my child and I was

given to options one was an invasive test available on the NHS which was

the amnio test and carried the risk of miscarriage. This second option

was noninvasive but not available on the NHS and cost four. Does the

Minister agree that we should have the noninvasive test rolled across

the country so that mothers regardless of wealth can have equal

access to screening and do not have to face the unnecessary risk of

miscarriage? I thank the Honourable lady for bringing her personal

experience to the house and I hope that all is well. She will

understand that screening has to be a nonpolitical matter and that is

why we have a specific committee to look at whether a screening

programme should be implemented or not. They have been looking at this

over the past year and will make a decision very shortly. In principle

I agree and it lies at the foundation of the NHS and one that

we support. NHS England have assured local transformation plans that

cover all Clinical Commissioning Group is ensuring that all the plans

address the full spectrum of need for all children and young people

including looked after children and those who have been sexually abused

or exploited. Further thematic analysis has been carried out and

the results will be available in March. I think it is a case of happy

birthday to the honourable gentleman! Thank you very much.

Children who have suffered the trauma of abuse may range from

therapeutic services but there was a lack of consistent data about the

number of people available for error Puget support and the services

available. As part of the plans the needs of abused children would be

properly considered and monitored at every level? I am grateful to my

honourable gentleman for this question and previous questions in

this area. He is right. Nationally if you take the new survey the first

since two and numbers of children looked after in that survey would be

relatively small. We have asked static to look at relevant ways to

address the data and the issue so I hope to report further on that later

in the New Year after having the meeting. I would like to thank my

honourable friend for asking this question and we have made

significant steps in the last two years. I anticipate it will continue

and we will see an increase in nurse training this year. We will have

many additional nurses by 2019 and we expect there to be an additional

10,000 training places as announced last year. I would like to thank the

Minister for here is reply reply but as a nurse I would struggle to

undertake my training with the proposed changes to the bursary

scheme. Can the Minister outline what additional routes are into

nursing to help mature students and those on a low income gain access to

nursing training I know the Minister is working hard but could he

outlined those are routes? The honourable ladies is right to point

out that there are different ways into nursing and just a few weeks

ago we are a massive expansion in apprenticeships across the NHS and I

anticipate that a few of those will be significant ways into nursing and

there will be a vocational route via an apprenticeship. Our reforms to

bursaries will ensure a 20 increase in funding to recipients and it will

bring it into line with the rest of the student cohort. A cohort that

has seen a considerable expansion in the number of students coming from

disadvantaged backgrounds as a result of reforms we took in 20 and

2012 does the Minister access that it was his decision to cut alerting

places from 20 onwards and that has led to a huge shortage of staff in

the NHS and decreased -- increased reliance on staff from abroad and

agency staff and it would get worse with the abolition of Bursaries

isn't it a textbook example of a false economy by government? The

honourable lady should look at the facts. The facts are that in March

20 it was a record number of nurses in the NHS three and in the NHS. We

are increasing the number of nurses and we are doing Mac considerably

more than we could have done otherwise bags to the reforms and

student finance which brings nurses into line with teachers and other

professions. It would be good to hear the Minister can see that it

was a bad idea back in 2010 at cut the number of nurse training places.

Even today we have fewer are being trained than in 20 -- two and have

failed to recruit enough nurses and failed to retrain them as well.

There was an increase in nurses leaving hospitals and with staff at

an all-time know -- staff morale at an all-time low wife must nurses be

burdened with a lifetime of debt to pay for the mistakes of his

government? The honourable gentleman raises a good point about attrition

rates. We have had some success in some areas, but they want to see

more students staying the course as many as possible. Thank you. Groups

have produced transformation plans for improving young people to mental

health. These will include collaborations with the people in

question are those who care for them. NHS England have elaborated

very real with young people to produce these plans. Last year, on a

consultation on mental health services in Derby, one thing that

was how late it was the disparity between services of the two groups.

What is he making plans to make sure that trusts across the UK deal with

this in a similar way. We talk about these radiation and performance

around the country with these different issues. Two of three

things will help. In relation to funding and resources, we have a

tracking system to make sure money going into young person's mental

health is spent appropriately. There is also an improvement team working

across the NHS to make sure that these lesions are evened out so that

the best practice in areas becomes standard for everyone. Yesterday

evening, the British medical Association decided to walk away

from talks about the new junior doctors contract and announce plans

for strike action. We have made significant progress in talks on 15

of the 60 areas of concern. We were doing everything we can to make sure

patients are safe. We said we would the over 70 services and with study

after study telling us that hospitals have higher mortality

rates, no change is not an option. It is all gone rather quiet on tele-

health and what funding is therefore not? I think we should thank him for

his constant interest in this area. The technology has changed

significantly in the past four years. We are committed to it. We do

not want to isolate a few individuals who meet particularly

benefit because we think everyone may be able to. The plans that will

be known as for technology in the next few months will show how we can

rule that out to an wider audience. Following the assisted dying baby,

will the Minister joined us in thanking local hospital since --

hospices which serve my constituency. I will certainly join

my friend and pleasing the work which hospices do. He will know that

I have a commitment to this and I hope to be making some announcement

shortly in response to the review of last year. I have been talking to

people from the sector about what can be done. It is a sad state of

fears bring a new year starts with the prospect of industrial action in

the NHS. Nobody wants strakes, not least the junior doctors, but they

feel badly let down by a Health Secretary who seems to think

contract negotiations are a game of brinksmanship. When will the Health

Secretary admit that changing the definition of unsociable hours and

associated rates of pay for junior doctors as a forerunner to changing

a whole load of other NHS staff in contracts to save on the NHS budget.

That is what all of this is really about, isn't it? No it is not. I

wish her every success in our continuing post in the Shadow

Cabinet. It would be a shame to lose her having got to know her. This is

a difficult issue to solve, but at least the country knows what the

government is trying to do. She has spent the last six months avoiding

telling the country what she would do about these flawed contracts.

Chance. Which she changed the contracts of the junior doctors to

improve seven-day services? Junior doctors do not need words from me on

the opposition benches. They need action from the secretary of state

to stop the strakes and give patients the care they deserve. Mr

Speaker, not content with eliminating one group of staff, the

Health Secretary know has another target -- student nurses. The

disastrous decision in the last parliament to cut not training

places has driven the raising agency staff bill. They ask this, why

should the trainee nurse who spends half of her dignity caving for

patients, not received a bursary? If they are working at three o'clock in

the morning, why should he be expected to pay for the privilege?

She cannot have it both ways. She cannot stand here and criticise cups

and streaming and then oppose this government to make changes which

meant we will be able to train 10,000 more nurses over the course

of this Parliament. Let me tell you why we have 8500 more losses in our

hospital since I became Health Secretary. It is this government

which recognises good enough strength in our hospitals. She

should give us credit credit is due. In my constituency, as many as one

in four children are categorised as obese. Can the Minister assure me

that the government will acknowledge that children and families have to

take control over their own lifestyles, rather than in any other

way. My honourable friend is great to say there is an onus on families

on this. Young children are not in control of all the food environment

around them. The government strategy is focused on children. It is a

complex issue and the family needs everyone to play the part,

government, local government, health professionals and industry and, of

course families. The Health Secretary has just tried to tell us

why we have 8500 more nurses in the National Health Service. We have got

many of them from abroad. There has been a worrying reductions in the

number of applications from people that we would expect to see at this

time of year. This will have a negative impact on the number of

trained nurses and also on net migration. Was that any discussion

between the Department of Health, the Home Office and the Chancellor

before this idiocy was introduced? The reason why we have record levels

of nurses in training and practice, was because of the decision taken by

my honourable friend to increase not training by 100% over the past two

years. We did this because of the reforms to nurses training funding.

We are undertaking this change so that every nurse in this country who

wants a position can have the opposite opportunity of having one.

At the moment that is limited because of the funding regime in

place. Would my honourable friend join me in congratulating the first

responders in my constituency. With TP tribute to the team leader of the

first response team, who is stepping down after 11 years as an unpaid

public servant. Yes, first responders have been a valued

addition to the front Allied health professionals. We are delighted to

pay tribute to his friend and from the work he has done. I am sure I

speak for everyone in the house when I give a warm thank you to all those

who are part of the first responders team around the country. I'm too

many occasions, children and my constituency need to be admitted to

a psychiatric bed need to read more than one day to get one. Sometimes,

even people in London are having to travel many males, to the likes of

Nottingham and even Glasgow. We'll keep it in measures in place so that

it is immediately available and will he do something to make sure that

children are not sent such a long way away from home for their

treatment? That it is why there has been a drive to find more beds for

children and young people involved in serious crisis, but there is also

support going into community services to prevent that in the

first place. There will be a need for specialist beds to be regionally

and nationally available. Not everything can be treated locally.

Really can commonly should be and we are working that. Worcester Acute

Hospital trust finds itself in special measures. This is largely

because of a review of clinical services in the county which has

failed to deliver. Given the impossibility of it reaching its

targets, what steps can the government take to help prevent this

situation and help the trust get back on its feet? My friend is

right. The are a particularly complex series of circumstances and

was stuck. I am determined to do something about it. We will meet to

discuss options that they will consult with NHS England with regard

to Worcs. There is talk of a compulsory 60 minute lunch break

being imposed on losses. This will do nothing to address the issue of

staff shortages, and will disadvantage nurses and patients

alike. Will the honourable gentleman investigate this? All contract

should be governed by his a central organisation they would be worried

if there was any deviation from. Nobody wants to return to the days

of junior doctors forced to work extra hours. The Secretary of State

will know that they could remove financial penalties from trust. What

has happened during negotiations to reassure the public and doctors

about patient safety? I hope I can reassure her that we will refuse

financial penalties when doctors are asked to work excessive hours. I

have reiterated our offer to the British medical Association. Mr

Speaker, the Chancellor pledged to match the charitable fundraising of

Great Ormond Street Hospital to the maximum of ?1.5 million. It is one

of only four specialist children's trusts in the United Kingdom. Does

he agree that the government funding should be extended to all four of

these and will he make their case to the Chancellor? I am happy to work

but this without making any guarantees.

The daughter of the constituent of mine was admitted with mental health

issues and she was kept any cell overnight. Police stations are not

appropriate places. What is he doing to assure adequate places are

available locally and police, should they be involved, know how to deal

with traumatic mental health patients? My honourable friend is

right. The has been a 54% reduction in the use of police cells in the

past three years. This is being helped by work in the sector. We

want to prevent young children and people being held in police cells at

all. It has been reduced dramatically and we will continue

that process. Yesterday the ministers and junior

doctors had not fully dealt with the issue of weekend working and

compensation. Doctors will be forced to strike. Instead of attacking

consultants and junior doctors will give followed the example of the

Scottish Government and face the challenges of increased demands?

Project, man! Project to! We wish to hear the full gist of what you have

to say to the house. We will work with the NHS profession to provide

full seven services throughout the NHS in England. I hope you will

follow that lead in Scotland where they have the same issue with

weekend mortality rates. Further to that question, having recently met

with a clinical leadership at the Royal Worcester Hospital they are

adamant they want to see permanent management in place but the number

of interim directors is one of the reasons it has been in special

measures. Will the Minister be doing every he can to put in long term

management soon as possible. I can assure him precisely that. There is

a significant reconfiguration plan act Dewsbury Hospital and it will be

downgraded before infrastructure is in place to ensure that patients

will receive vital care safely. Wilbur the secretary of state meet

with me to discuss this premature move which is financially driven and

not in the best interests of my constituents? I thank the honourable

lady for bringing this to the house but I would be very happy to meet

her and anyone she wishes to bring with her to discuss the changes that

they plan. My local mental health trust recently reduced its

psychiatric liaison cover in a and E and it is now considering the level

for the coming year. Could my honourable friend provide an update

on what government plans to do to ensure specialist mental health care

in a Andy? A? The mental health task force is shortly to bring

forward its Bretton -- recommendations. I know it is

looking very carefully at what is provided in a and it was the subject

of a review by CQC earlier last year and I am looking specifically at

psychiatric liaison and I have seen your written question very recently.

What demographic interest -- impact assessment has his department made

on the withdrawal from the European Union on health and social care and

the consequent result that will have on demands for the services? None

whatsoever. In the previous parliament many people who suffer

from a rare disease were pleased with the publication of the rare

disease strategy but what progress is being made on the ultra-rare

disease strategy? I am happy to look at that but in regard to the

recommendations made in the rare diseases strategy there will be a

report on that to spring and I will take up the other issue with him

privately. I know health has devolved but when it comes to the

expensive red diseases and diagnoses, it is possible that

devolved governments may choose not to spend on it. What more health can

-- help can Westminster be to help my constituents to afford? One

example I can give is that I am sure he will welcome the example that for

health departments are jointly funding a network of 18 experimental

cancer medicine centres which is about driving development and

testing of anti-cancer treatments and levering a real benefit to

patients including those with rarer cancers and it is one example of how

we can work together. Order! I am pleased to be able to announce to

the house that following fair and open competition Her Majesty The

Queen has graciously accepted my recommendation for the person to be

appointed to the post of Sergeant at Arms as of the 1st of February. He

has been