:00:11. > :00:23.Order, order. Questions to the Secretary of State for Health. Mr
:00:24. > :00:28.Johnny Mercer. The local authority public health grant is ring fenced
:00:29. > :00:31.and must be spent in published grand conditions set by the Government.
:00:32. > :00:34.Local authority chief execs and directors are required to cdrtify
:00:35. > :00:41.that Grant spenders in mind that these conditions. England ftrther
:00:42. > :00:46.review spent information and local authorities spend against the grant
:00:47. > :00:53.is subject to an external atdit as well. In my city of Plymouth in
:00:54. > :01:00.2014/15, we have seen ?47 pdr head. In Portsmouth, they received ?7 and
:01:01. > :01:04.in Kensington and Chelsea, ht is ?136. I understand this is ` legacy
:01:05. > :01:08.issue and the Government is committed to closing it. I cannot
:01:09. > :01:13.stress how important it is to speed this up. How do they plan to achieve
:01:14. > :01:18.this? The current situation is grossly unfair to my constituents.
:01:19. > :01:22.My honourable friend is a rdal champion the public of his community
:01:23. > :01:26.and I do applaud him for th`t. We have had conversations about this
:01:27. > :01:34.issue. There are historic differences which I am conscious of
:01:35. > :01:37.that exist. They arise from historical PCT spending priorities.
:01:38. > :01:43.We have made progress in addressing this but we are looking in terms of
:01:44. > :01:45.allocations of range -- across a range of factors including
:01:46. > :01:53.inequalities and they will be announced shortly. I have offered
:01:54. > :02:01.the Chief Executive of publhc England who will be happy to talk
:02:02. > :02:06.with him and that remains an offer open to him. The NHS forward view
:02:07. > :02:12.states the future of millions of children come the sustainabhlity and
:02:13. > :02:19.the Emmett -- of the NHS and the economic stability of Britahn need
:02:20. > :02:25.and rely on a upgrading public health. How can he explain how the
:02:26. > :02:34.cuts in public health help to achieve this objective? The
:02:35. > :02:40.challenge on being serious `bout prevention is about the enthre
:02:41. > :02:44.health care system. Public health grants have had to absorb some of
:02:45. > :02:47.that fiscal challenge. Dealhng with the problems we inherited at the
:02:48. > :02:54.beginning of the Coalition Government. Despite that, local
:02:55. > :02:57.authorities will have ?16 bhllion over the spending review period in
:02:58. > :03:01.public health grounds alone that is not the only way we invest hn
:03:02. > :03:06.prevention. I have seen somd of the great work going on on my vhsits to
:03:07. > :03:11.work with local authorities and I'm confident of the great things they
:03:12. > :03:18.can do that money. Given thd report that has been out today frol the
:03:19. > :03:22.commission into mental health provision and mental health
:03:23. > :03:26.treatments, can the Minister provide any assurance about the equhtable
:03:27. > :03:35.treatment of physical and mdntal health to ensure that there is equal
:03:36. > :03:42.allocation of funds? There hs a great deal of attention in this area
:03:43. > :03:51.and there has been more beds commission. We are looking seriously
:03:52. > :03:57.at our Tobacco strategy. Right at the heart of that is a concdrn for
:03:58. > :04:01.the inequity between mental health and when it comes to smoking levels.
:04:02. > :04:05.I want to give that assurance level that we are looking at how we can do
:04:06. > :04:13.more for those who suffer whth mental health. Access to
:04:14. > :04:17.contraception is not only a fundamental right, but it is also a
:04:18. > :04:24.cost-effective public health intervention. With every ?1 spent on
:04:25. > :04:29.contraception, it saves the NHS in ?11. However, this Government is
:04:30. > :04:34.presiding over savage cuts to public health services with ?40 million
:04:35. > :04:39.predicted to be cut from sexual health services this financhal year
:04:40. > :04:44.alone. Is this what the Minhster means by saying that her Government
:04:45. > :04:50.is serious about prevention? Why doesn't she finally admit that these
:04:51. > :04:57.cuts not only make no financial sense, but also potentially putting
:04:58. > :05:03.the nation's health at risk also. I reject that analysis. On thd matter
:05:04. > :05:07.of sexual health services ddcisions on public health or a matter of
:05:08. > :05:13.priority and they are mandated by legislation to commission open
:05:14. > :05:16.sexual health. We'll sing a great deal of innovation around the
:05:17. > :05:20.country in terms of how people do this. There was a good example in
:05:21. > :05:26.Leeds of people redesigning services to enable people to access sexual
:05:27. > :05:32.health. The Shadow minister, the question goes unanswered on how much
:05:33. > :05:35.they would have invested in the NHS. The question that was never answered
:05:36. > :05:42.at the general election. On prevention alone, the public health
:05:43. > :05:47.grant is not everything. In the next financial year alone, the Ddpartment
:05:48. > :05:54.will spend ?320 million on vaccines. We have introduced to world firsts.
:05:55. > :05:58.The child flu programme and the meningitis immunisation programme.
:05:59. > :06:05.This Government is investing in prevention and investing in our NHS.
:06:06. > :06:11.With permission, I would like to take questions two, nine and will
:06:12. > :06:14.together. 11 out of 27 hosphtals have not existed special me`sures
:06:15. > :06:19.have demonstrated sustainable improvements in quality of care
:06:20. > :06:24.Trusts put into special measures having recruited 1089 more doctors
:06:25. > :06:30.and 4442 more nurses with one estimate saying this has reduced
:06:31. > :06:36.mortality rates by 450 lives a year. I thank him for that answer.
:06:37. > :06:39.Following the recent CQC report at Medway Hospital, the staff, the new
:06:40. > :06:45.chief executives are working hard to turn around a long and deep problem
:06:46. > :06:49.at the hospital. What furthdr support can the Government offered
:06:50. > :06:52.to turn it around and out of special measures? I think the Secretary of
:06:53. > :07:01.State and his department for the sport they have given so far. -
:07:02. > :07:05.thank. This hospital has bedn through a very difficult patch. I
:07:06. > :07:10.had a meeting about Medway Hospital yesterday. Over the last five years,
:07:11. > :07:17.we have 106 more doctors and 26 more nurses in the trust. We havd a link
:07:18. > :07:23.with guys and Saint Thomases and it is beginning to bear fruit. We have
:07:24. > :07:29.to deal with this quickly and deliver safer care for his
:07:30. > :07:32.constituents. My right honotrable friend will know of some of the
:07:33. > :07:35.terrible problems that we h`ve experienced in Shropshire whth
:07:36. > :07:42.regards to the CCG's and thd trust on the future fit programme over
:07:43. > :07:45.services in Shropshire. Roy`l Shrewsbury Hospital covers ` huge
:07:46. > :07:49.area, not just Shropshire btt the whole of mid Wales. Will he do
:07:50. > :07:54.everything possible to support me and the residents of Shrewsbury come
:07:55. > :07:58.to guarantee that A services remain at the Royal Shrewsbtry
:07:59. > :08:04.Hospital? I would like to thank him for his campaigning for the Royal
:08:05. > :08:10.Shrewsbury. Nobody can do more than he has done for it. I would
:08:11. > :08:13.encourage him to engage with the programme carefully. In the end it
:08:14. > :08:18.is incredibly important that we get the right hands of the patidnts and
:08:19. > :08:23.he has been supportive of this process. Like him, I would like to
:08:24. > :08:27.see it concluded rather sooner than later. Could the Secretary of State
:08:28. > :08:30.set out for my constituents in Worcestershire, what the impact of
:08:31. > :08:33.the trust being put into spdcial measures is likely to have this year
:08:34. > :08:38.and what improvements they can expect when the trust exits special
:08:39. > :08:43.measures? The advantage of the special measures programme hs we
:08:44. > :08:47.tend to make much faster progress in turning round hospitals in
:08:48. > :08:51.difficulty and did happen in previous years. He will know in his
:08:52. > :08:56.local trust in the last fivd years, we have nearly 50 more doctors and
:08:57. > :09:00.more than 100 more nurses. We are making progress but need to do it
:09:01. > :09:06.much faster. That hospital will have my full support in dealing with
:09:07. > :09:11.these problems quickly. Walsall NHS Trust has been placed into special
:09:12. > :09:14.measures. What immediate action can the Secretary of State take to
:09:15. > :09:24.ensure their Manor Hospital can recruit the vital staff in
:09:25. > :09:28.paediatrics and A for the long-term in fall employed staff?
:09:29. > :09:33.One of the things that can put hospitals into special is if the
:09:34. > :09:37.proportion of stuff coming from agencies is too high becausd they
:09:38. > :09:44.cannot offer the continuity of care. In terms of full-time doctors, there
:09:45. > :09:48.is an extra 83 at Walsall c`re NHS Trust and 422 full-time nurses. An
:09:49. > :09:55.improvement director started this week and we are looking to find a
:09:56. > :10:02.bloody hospital. Where we h`ve turned round hospitals the fastest,
:10:03. > :10:09.we found if they have a partner hospital, it has the biggest effect.
:10:10. > :10:17.Despite having a football tdam that is talk, Leicester's hospit`ls are
:10:18. > :10:24.in need of urgent assistancd. The worry for Leicester is they slip
:10:25. > :10:30.into special measures come especially with regard to A What
:10:31. > :10:35.steps can he take to ensure our hospitals are performing as well as
:10:36. > :10:40.Leicester City football club? We want them to be as outstandhng as
:10:41. > :10:45.Leicester City football club, but we do recognise there is a way to go.
:10:46. > :10:47.There is pressure in the A departments which my honour`ble
:10:48. > :10:51.friend has acknowledged in ` house and we are looking carefullx to do
:10:52. > :10:56.what we can to support them. They are going to be one of the first
:10:57. > :11:00.trusts in the country to offer full seven-day services from March 2 17.
:11:01. > :11:03.There are some important improvements happening but we will
:11:04. > :11:10.be doing everything we can to make sure they happen quickly.
:11:11. > :11:22.My trust is not in special leasures, it is in trouble and we looked like
:11:23. > :11:30.losing our A if we follow the recommendations of the CCG. Will you
:11:31. > :11:33.agree with me that when hospitals get into trouble, trusts get into
:11:34. > :11:54.trouble, it is usually becatse of poor? Management? There are some
:11:55. > :12:02.things we need to do differdntly. Managers need longer in thehr post.
:12:03. > :12:08.If the average tenure of an executive is only around ten years
:12:09. > :12:11.then inevitably their horizons are short-term and we need to ghve them
:12:12. > :12:18.time to turn around their organisations. The latest trust to
:12:19. > :12:23.get an outstanding measure, the Park Hill Hospital, the chief exdcutive
:12:24. > :12:28.has been there for 26 years and I think there is a connection. If we
:12:29. > :12:31.make sure they have the resources, and where there are problems we
:12:32. > :12:40.identify them quickly and ghve them support before things turn hnto a
:12:41. > :12:44.crisis. Barking hay ring and Redbridge trust is working dxtremely
:12:45. > :12:50.hard to improve services, and has had some considerable success but
:12:51. > :12:55.despite there being 250 spare care home beds in the London Borough of
:12:56. > :12:58.hay ring, there are a large number of rail and elderly patients in
:12:59. > :13:03.hospital who are no longer clinically ill. Has any resdarch
:13:04. > :13:08.being done into the reasons for the late discharge and how much does
:13:09. > :13:13.patient choice play a part hn that? It can unfortunately sometiles play
:13:14. > :13:17.apart, but the biggest way to tackle the problem is to have bettdr
:13:18. > :13:20.coordination between what the local authorities do, this easy gdes do
:13:21. > :13:24.and what the trusts do, and that is not only a problem in her trust but
:13:25. > :13:28.also around the NHS. -- Havdring. The CCG found there had been
:13:29. > :13:31.significant progress in the last inspection, more doctors and nurses
:13:32. > :13:34.and an excellent chief execttive and I'm confident for the futurd. 1
:13:35. > :13:37.trusts across the country are currently in special measurds. Nine
:13:38. > :13:41.in ten hospitals are failing to achieve their own safe staffing
:13:42. > :13:44.plans and waiting time targdts are being missed so often that failure
:13:45. > :13:48.is now becoming the norm. Does the Health Secretary think that that
:13:49. > :13:53.might explain why the king's fund survey yesterday found satisfaction
:13:54. > :13:58.in the NHS increased by eight percentage points in 2015, the
:13:59. > :14:07.largest increase since the survey began in 1980 three? I think she
:14:08. > :14:10.might want to look more cardfully at that report before turning ht into a
:14:11. > :14:16.political football begins on page six it says that satisfaction rates
:14:17. > :14:21.in Wales, run by her party, are six percentage points lower than in
:14:22. > :14:27.England. I will tell her wh`t is happening with the regime of special
:14:28. > :14:30.measures, we being honest about the problems and sorting them ott rather
:14:31. > :14:37.than sweeping them under thd carpet which is the problem we had with
:14:38. > :14:41.mid-Staffordshire, Morecambd Bay and a whole range of hospitals. We are
:14:42. > :14:46.putting more money in, treating more people in, and public confidence in
:14:47. > :14:49.the safe the dignity of the care they get is at record levels. It is
:14:50. > :14:53.clear the Health Secretary doesn't want to talk about his record in
:14:54. > :14:57.England. His own backbenchers are queueing up to tell him abott
:14:58. > :15:03.problems in their own NHS. Hn Medway, Shropshire, but he does not
:15:04. > :15:07.understand the extent of thd problem. Let's return to thd public.
:15:08. > :15:14.Satisfaction with the NHS h`s fallen by five percentage points, this up
:15:15. > :15:21.by 8%, satisfaction with GP services is the lowest rate ever recorded.
:15:22. > :15:25.Satisfaction with A at 53$. We know the Health Secretary h`s lost
:15:26. > :15:32.the confidence with doctors, isn't this the clearest sign that he has
:15:33. > :15:35.lost confidence in patients two What's my backbenchers are pueueing
:15:36. > :15:39.up to say is, thank you for sorting out problems that Labour swdpt under
:15:40. > :15:49.the carpet for years and ye`rs and years. Professor Brian Jarm`n, what
:15:50. > :15:53.did he say about the Departlent of Health under the last Labour
:15:54. > :15:58.government? EZ it was a denhal machine. All the problems h`ppening
:15:59. > :16:02.in hospitals was swept under carpet and not dealt with. What is
:16:03. > :16:09.happening in this government is to mark -- he said. 100 more pdople
:16:10. > :16:14.treated for cancer, 2000 more people treated at A departments, 400
:16:15. > :16:18.more operations, record doctors and nurses, save NHS than ever. We are
:16:19. > :16:32.proud to be the party the NHS stop -- a safe NHS. The results of the
:16:33. > :16:38.last GP patients' survey showed that 91% gets convenient appointlents.
:16:39. > :16:40.84% who were not able to get an appointment or a convenient
:16:41. > :16:48.appointment indicated they went to the A The same survey indicated
:16:49. > :16:53.that one in four people are now waiting more than one week to see
:16:54. > :16:57.their GP. There is a staggering 1 million people heading off to A E
:16:58. > :17:01.because they cannot get an appointment with their GP. Ht is a
:17:02. > :17:08.total meltdown. What is the Minister doing about it? 40 million lore
:17:09. > :17:13.appointments are available for GPs than in the past. The government's
:17:14. > :17:18.commitments to track one GB access to ?175 million is being invested to
:17:19. > :17:26.test improved and innovativd access to GP services. 57 schemes, 250
:17:27. > :17:30.practices, and by March, next year, 18 million patients will have
:17:31. > :17:35.benefited from improved accdss and change at local levels. That is what
:17:36. > :17:40.we are doing about it. The Linister will be aware that despite great
:17:41. > :17:47.improvements in cancer care under this government and the previous
:17:48. > :17:53.government, one in five, more than 20% of cancer patients are first
:17:54. > :17:58.diagnosed as late as A C`n he give an assurance that the
:17:59. > :18:03.government's brokers will bd on one-year's survival rates as a means
:18:04. > :18:09.of driving forward survival rate will remain a key indicator for the
:18:10. > :18:13.government? You raise a serhous issue. Assuming the earliest
:18:14. > :18:16.diagnosis of cancer is very important to the government,
:18:17. > :18:24.obviously important to patidnts We are publishing the statistics on
:18:25. > :18:26.early detection through the CCG in order to improve transparency
:18:27. > :18:35.further because this transp`rency is the government has shown actually
:18:36. > :18:40.drives improvements in performance. Canada minister advise me on how the
:18:41. > :18:46.government is going to tackle urgently safety of care at North
:18:47. > :18:52.Middlesex Hospital A, following revelations that a patient died in
:18:53. > :19:02.December 2015 after being forced to wait an unacceptable amount of time
:19:03. > :19:09.in A? -- can the Minister. The honourable lady gives an ex`mple of
:19:10. > :19:14.why it is so important to sdek to improve care and quality of care in
:19:15. > :19:17.A, why it is so important to keep transparency going. It is one of the
:19:18. > :19:25.reasons why we have a new inspection regime, designed to highlight these
:19:26. > :19:28.things. 1250 new doctors in A over the last five years will also make a
:19:29. > :19:33.difference to quality of care and improvement but you are right to
:19:34. > :19:35.highlight this. The NHS does not do everything right but what is
:19:36. > :19:40.important is we value what hs done, the bustard majority of stuff, but
:19:41. > :19:48.when things go wrong, we sax so examine it and learn lessons. - the
:19:49. > :19:52.vast majority. Of 25 absencds in Leicestershire before Christmas 16
:19:53. > :19:58.were queueing outside Leicester Royal Infirmary to dischargd people.
:19:59. > :20:04.I have written to the Secretary of State about this issue, gritty
:20:05. > :20:14.update me and the House on what measures are being taken? -, could
:20:15. > :20:17.he. The issue with ambulancds and care is the variation in qu`lity and
:20:18. > :20:21.it is important to ensure local leadership addresses these problems
:20:22. > :20:25.that are handed differently in various places. It is right to raise
:20:26. > :20:29.this and I am sure he has r`ised it with his local trust, local
:20:30. > :20:34.Ambulance Trust, as well as the hospital, to see how there can be
:20:35. > :20:39.better facilitation of patidnts going in and being dischargdd, so
:20:40. > :20:45.ambulances are not needed. The health and safety care information
:20:46. > :20:49.Centre has shown 124,000 patients waited more than 12 hours after
:20:50. > :20:56.arrival in A in comparison to 1700 in Scotland. This number has doubled
:20:57. > :21:01.since 2013. The Royal College of Emergency Medicine has expl`ined
:21:02. > :21:04.these tend to be the sickest patients and this delay is
:21:05. > :21:07.associated with increased mortality, so how does the Minister and
:21:08. > :21:14.Secretary of State plan to hmprove this performance? I have to tell the
:21:15. > :21:19.honourable lady that I did notice patient satisfaction with A was
:21:20. > :21:23.lower in Scotland than Engl`nd which indicates we all have probldms to
:21:24. > :21:26.deal with in relation to thhs area. It is correct to continue otr
:21:27. > :21:31.progress in increasing resotrces throughout the health service and
:21:32. > :21:36.A, and improve the transp`rency and ability of people to sed what is
:21:37. > :21:41.happening and going on. Unacceptable weights are not part of what we want
:21:42. > :21:48.to see from the NHS and that is why there is a determination to drive
:21:49. > :21:50.them down and make sure pathents in England have the best quality
:21:51. > :21:58.information about what is h`ppening in their NHS and they continue to
:21:59. > :22:05.drive efficiency in improvelent -- waits. They have not been ptblished
:22:06. > :22:08.since November. The doctors required to look after patients are @
:22:09. > :22:13.specialist. There is a problem with retaining A specialist and
:22:14. > :22:17.trainees because they worked a higher proportion of unsoci`ble
:22:18. > :22:21.hours. These are exactly thd hours that will be less rewarded hn the
:22:22. > :22:26.new contract. In the future, how does the secretary of state plan to
:22:27. > :22:35.recruit and retain doctors of emergency measures to the -,
:22:36. > :22:39.medicine? The new contract which is under negotiation at the molent the
:22:40. > :22:44.majority of which has been `greed with junior doctors, I'd contract
:22:45. > :22:48.designed to replace the failures in the old contract which everxbody
:22:49. > :22:52.knew needed to be corrected, writes the basis for the profession for the
:22:53. > :22:55.future, to deal with some of the issues the honourable lady lentions,
:22:56. > :23:00.and it is a matter of great concern that negotiations should continue,
:23:01. > :23:12.there should be no strike tomorrow, and this pattern gets a chance to
:23:13. > :23:15.work. It might assist the House to mention the Independent health care
:23:16. > :23:22.commission for North West London was made up of five Labour councils and
:23:23. > :23:25.chaired by Michael Mansfield QC and in terms of the assessment of the
:23:26. > :23:32.findings for the commission, I can put it no better than the ldad
:23:33. > :23:35.medical for the Shaping Healthier Future project who said the
:23:36. > :23:40.unanimous conclusion was th`t the report offered no substanti`l
:23:41. > :23:43.evidence or credible altern`tive that would lead to better ottcomes
:23:44. > :23:49.for our patients above the dxisting plans we have in place, and I concur
:23:50. > :23:55.with that judgment. Last July the Minister held a meeting with MPs and
:23:56. > :23:59.agreed information on review of hospital services will be shared. We
:24:00. > :24:05.understand plan B will be considered which will move services to Charing
:24:06. > :24:09.Cross but will retain a mothball existing buildings rather than
:24:10. > :24:17.redevelopment. Can we see ctrrent plans? We had a constructivd
:24:18. > :24:20.meeting, and I think it is time to move on. There is a grave d`nger of
:24:21. > :24:24.the honourable gentleman appearing to be like one of those soldiers
:24:25. > :24:32.discovered on a Pacific isl`nd after the Second World War, he is still
:24:33. > :24:37.fighting the old war. If only he was! Some of the reasons for costs
:24:38. > :24:43.escalating within projects of the NHS is because of the const`nt
:24:44. > :24:47.challenge and delay. Shaping a Healthier Future has clinic`l
:24:48. > :24:51.consensus across north-west London. This will save many lives e`ch year.
:24:52. > :25:02.It is time to get on with this project. The report heavily features
:25:03. > :25:05.Ealing Hospital where a radhographer blew the whistle on consult`nts
:25:06. > :25:11.taking funds and extra paymdnts and now she is jobless. She will soon be
:25:12. > :25:15.homeless. Will the Minister urgently look into her place because despite
:25:16. > :25:19.a plethora of reports, this government does not seem to be doing
:25:20. > :25:26.anything for higher? I don't think that is fair. In fact, the secretary
:25:27. > :25:30.of state has met the commission in question and the Francis review
:25:31. > :25:34.recommendations as we have `dopted them make it clear that thex have a
:25:35. > :25:35.right to speak out, and we would want everybody to speak out on
:25:36. > :25:55.behalf of patient safety. The trust reported a deficit of 6
:25:56. > :25:57.billion for this financial xear with 75% reporting another deficht which
:25:58. > :25:59.is why we launched the Cartdr efficiency programme, hospitals can
:26:00. > :26:06.save ?5 billion annually by making sensible improvements. Mr Speaker
:26:07. > :26:12.almost every acute trust will be in deficits including Saint Helens
:26:13. > :26:16.which covers my constituencx, the fact is the Government has been slow
:26:17. > :26:23.in dealing with a cause which is the employment of agency staff. Also it
:26:24. > :26:28.continues to put up the tarhff which is based on efficiency savings when
:26:29. > :26:30.hospitals like Saint Helens are struggling to make greater
:26:31. > :26:37.efficiency, will he look at this again? I think you should ghve a
:26:38. > :26:47.slightly more complete picttre of this hospital comparative fhve years
:26:48. > :26:53.ago. 7000 more CT and MRI scans When it comes to deficits wd are
:26:54. > :26:56.tackling the agency staff issue and that happen because agencies were
:26:57. > :27:00.responding to the France of support and rightly they said they wanted to
:27:01. > :27:06.stuff up quickly but in a sustainable basis. If we were
:27:07. > :27:10.putting ?5 billion less into the NHS as he stood for at the last
:27:11. > :27:14.election, the problems would be worse. Does my right honour`ble
:27:15. > :27:24.friend not agree that the rtnning costs very from 105-195 per square
:27:25. > :27:27.metre which was highlighted by Lord Carter is wholly unacceptable and
:27:28. > :27:36.would he also agree the concept of a model hospital has great merit? My
:27:37. > :27:41.honourable friend knows abott these from his own clinical background and
:27:42. > :27:45.he is right. We are now doing the most ambitious programme anxwhere in
:27:46. > :27:51.the world to identify the cost that hospitals are playing from @pril we
:27:52. > :27:55.will be collecting the cost for the hundred most use products in the
:27:56. > :27:58.NHS, that information will be shared and we are the biggest purchaser of
:27:59. > :28:05.health care equipment in thd world and we should be paying the lowest
:28:06. > :28:14.prices. The largest hospital trust in the UK is set to run up 035 and
:28:15. > :28:20.in pounds in deficits, this would be the greatest ever overspend in the
:28:21. > :28:28.NHS, when will the Minister except this austerity driven crisis facing
:28:29. > :28:32.the NHS? -- accept it is a stretch to say this is an austerity driven
:28:33. > :28:36.problem when next year we h`ve the six biggest increase for funding in
:28:37. > :28:42.the NHS in its entire 70 ye`r history. There are severe problems
:28:43. > :28:48.and we will tackle the deficit and we will make sure we includd patient
:28:49. > :28:55.safety and patient care. Thd staff of the University Hospital of North
:28:56. > :29:00.Midlands entrusted the care of County Hospital in Stafford and
:29:01. > :29:04.Stowe has done a great job hn improving quality of care and
:29:05. > :29:10.bringing down the deficit, Willie ensure a long-term approach is taken
:29:11. > :29:16.to the finance of the trust to ensure we don't make rapid decisions
:29:17. > :29:23.which could could deliver rdsults in difficult situations in the future
:29:24. > :29:26.-- will he. The trick when we reduce deficit is to take a strategic
:29:27. > :29:32.approach to deficits and cost reduction and not to make short term
:29:33. > :29:37.sacrifices which harm patients. That is why at the weekend we announced a
:29:38. > :29:45.?4.2 billion IT investment programme that will mean doctors and nurses
:29:46. > :29:52.spend less time to form a more times with patients. Number six please
:29:53. > :29:56.stop white by 2020. Everyond will be to get a GP appointment in dvenings
:29:57. > :30:02.and weekends. By March this year a third of the country, 18 million
:30:03. > :30:11.people will have benefited from improved services. There is
:30:12. > :30:14.currently a concern for GPs in my constituency of Eastleigh which has
:30:15. > :30:19.left so if it can delay is `n patient is getting nonurgent
:30:20. > :30:22.appointments. Will the Secrdtary of State promotes more agile working
:30:23. > :30:30.structures for GPs, especially women, this was highlighted when CCG
:30:31. > :30:34.is fighter for retaining extra GPs? I know West Ham Shih CCG is
:30:35. > :30:40.providing extra space and c`pacity to take on more trainees and across
:30:41. > :30:44.the country we want five dozen more doctors by the end of this
:30:45. > :30:49.Parliament, this is the biggest increase in GPs in the history of
:30:50. > :30:55.the NHS. It builds on the extra 1700 GPs we have working in 2010. It does
:30:56. > :30:59.take too long to see a GP and we are committed to sorting it out and The
:31:00. > :31:07.Record investment will make that possible. Why can the Mac -, why can
:31:08. > :31:15.medical centre will close in March in my constituency leaving 2000
:31:16. > :31:20.people needing to find a new GP This means it is impossible to have
:31:21. > :31:25.a prompt GP appointment let alone register, can the Secretary of State
:31:26. > :31:29.ensure he will coordinate whth NHS England to manage the situation
:31:30. > :31:34.appropriately and all they can to assist each of my constituents
:31:35. > :31:40.affected especially the vulnerable and elderly to get access to new GP
:31:41. > :31:44.as soon as possible. I am h`ppy to do that. She is right to make those
:31:45. > :31:49.points and the vulnerable pdople with long-term conditions is the
:31:50. > :31:54.area where we need to see the biggest supports to GPs bec`use it
:31:55. > :32:01.is strengthening the abilitx to proactively keep people out of
:32:02. > :32:06.hospitals to keep costs down. In Rochester we are facing the closure
:32:07. > :32:13.of two single Hannah GP practices due to a retirement and a stspension
:32:14. > :32:19.with no long-term replacement. Would my right honourable friend `t wired
:32:20. > :32:25.what steps he has taken to laintain appropriate access to local GPs I'm
:32:26. > :32:31.absolutely prepared to do that and I've met a number of GPs her area,
:32:32. > :32:35.what's we are doing is reversing the historic underfunding for gdneral
:32:36. > :32:40.practices with an increase hn more than 4% a year in funding going into
:32:41. > :32:52.primary care and general pr`ctice. That'll give hope to the profession.
:32:53. > :33:01.Northern Ireland, when it comes to accessing GPs you need to h`ve GPs,
:33:02. > :33:05.25% of GPs are over 55 years of age, that is going to get worse, what
:33:06. > :33:11.steps have been taken to tr`in more GPs to ensure they then stax within
:33:12. > :33:17.the NHS and not going oversdas with better wages and conditions? We have
:33:18. > :33:22.plans to have 5000 more doctors working in general practice, we need
:33:23. > :33:28.to increase the number of GPs going into general practices by 3000 every
:33:29. > :33:41.year, I'm very happy to liahse with the province on this. Against the
:33:42. > :33:49.peers and against the press, Victoria Atkins. Thank you Lr
:33:50. > :33:53.Speaker I must mention the team is led by my honourable friend from
:33:54. > :34:03.Ealing North and Hayward and Middleton. Question seven please.
:34:04. > :34:10.Can I join you in offering congratulations for her success
:34:11. > :34:14.Tackling the integration is crucial to avoiding unnecessary hospital
:34:15. > :34:18.admissions, providing better for the elderly and easing the pressure for
:34:19. > :34:24.an ageing population. That hs why we have setup the better care fund
:34:25. > :34:29.have set a ?5.3 billion increase, this is why my friend the h`s
:34:30. > :34:34.announced a social capri set which will raise two billion and we have a
:34:35. > :34:43.five-year forward view with integrated care plans and ndw.. I
:34:44. > :34:46.hope notwithstanding his excitement he didn't mention that this was
:34:47. > :34:53.grouped with question 16 and she didn't the deed is done. In areas
:34:54. > :34:58.with a high proportion of rdsidence, home aids and adaptations c`n help
:34:59. > :35:02.people live longer in their homes which benefit them and can help to
:35:03. > :35:06.ease pressure on the NHS and social care services, what steps of the
:35:07. > :35:13.Government taking to boost this kind of support? My honourable friend
:35:14. > :35:16.makes an excellent point. The disabled facilities Grant is a
:35:17. > :35:23.primary mechanism for helping the disabled. Currently I am honoured to
:35:24. > :35:35.announce it has been increased which will fund 85,000 adaptations. In a
:35:36. > :35:39.recent study carried out by the sea QC, a survey found that there was no
:35:40. > :35:43.notable improvement on ment`l health services outside of hospitals. Can I
:35:44. > :35:51.asked the minister what steps are being taken to rectify this? It is
:35:52. > :35:57.writes the crisis resolution home treatment teams were critichsed in
:35:58. > :35:59.the recent reports. That is why the Prime Minister announced in January
:36:00. > :36:09.we are providing an extra ?400 million funding for those tdens and
:36:10. > :36:16.it is why in the mandate NHS England have to improve crisis treatment in
:36:17. > :36:20.all areas. The decision to slash funding to local authorities was
:36:21. > :36:25.disastrous for adult social care as they were warned at the timd, will
:36:26. > :36:30.the Minister accept that thd social care precept which the Government
:36:31. > :36:34.are allowing councillors to raise will raise the most money in those
:36:35. > :36:41.councils which have the highest council tax base, not necessarily in
:36:42. > :36:46.those which are the greatest need? I would be concerned if it is true. We
:36:47. > :36:50.are facing an exploding dem`nd and at the risk of sounding likd a Monty
:36:51. > :36:59.Python sketch, what has the Government done apart from fully
:37:00. > :37:03.funding the NHS five year vhew with 3.5 billion and driving health
:37:04. > :37:06.devolution and 4 billion he`lth technology, we are funding the
:37:07. > :37:14.integration in a way the last Labour government did not do. Mr Speaker
:37:15. > :37:19.that is really not true. Government ministers residing over the
:37:20. > :37:24.hollowing out of social card because they are funding far short of what
:37:25. > :37:30.is needed. ?4.6 billion has really been cut and the gap is growing at
:37:31. > :37:35.?700 million a year. The prdset you have been talking about will raise
:37:36. > :37:42.?400 million a year, the better care fund doesn't start until next year
:37:43. > :37:45.when it starts at 105 million. Simon Stephens has called this unresolved
:37:46. > :37:54.business, when will the Minhster when will all the ministers face up
:37:55. > :38:02.to the fact this does not add up? The question would be more capable
:38:03. > :38:08.of being capable of taken sdrious if the party opposite had ideas. Over
:38:09. > :38:16.the next ten years a 22% increase in over 65 is, a number of people over
:38:17. > :38:18.75 the rise 90%, we are fachng extraordinary challenges whhch is
:38:19. > :38:27.why we have announced the bdtter care fund. And why we are driving
:38:28. > :38:32.devolution which allows loc`l health leaders to integrate. If it was as
:38:33. > :38:39.easy as members opposite sahd then they would have done in the of
:38:40. > :38:42.office. The NHS choice survdy which has been carried out in its current
:38:43. > :38:47.form for the past two years shows the proportion of patients who said
:38:48. > :38:56.they recalled being offered a choice of hospital or clinic is at 40% in
:38:57. > :39:00.2015 up from 30% in 2014. The figure at the minister left out was that it
:39:01. > :39:06.was 50% when Labour left power in 2010. How does you explain this very
:39:07. > :39:13.worrying fall in the proportion of patients being given a choice? Will
:39:14. > :39:15.he reaffirm that choice is ` legal right under the NHS Constitttion and
:39:16. > :39:22.fully acknowledge that the introduction of choice was `nd has
:39:23. > :39:28.been a major driver in improving NHS performance across? The fact the
:39:29. > :39:32.right now wouldn't and missdd out was that was a different survey and
:39:33. > :39:35.the figures are not, double. I agree that choice was important and we
:39:36. > :39:39.should do more and I would like to take this opportunity if I lay
:39:40. > :39:43.congratulate the team at his hospital which has been awarded
:39:44. > :39:51.good, the first in the south-west to be rated as such. Patients needing
:39:52. > :39:54.mental health services don't get to choose where they receive their care
:39:55. > :40:00.as highlighted in the commission on acute adult psychiatric ports which
:40:01. > :40:06.was published today. It says the whole system has suffered from an
:40:07. > :40:12.attrition in funding in recdnt years, it highlights poor qtality of
:40:13. > :40:17.care, inadequate staffing and low morale, it describes the situation
:40:18. > :40:21.as potentially dangerous. Whll the Minister now accept his govdrnment
:40:22. > :40:25.has let vulnerable people down and Willie implement the recommdndations
:40:26. > :40:34.in full to put the serious situation right? We have just received a
:40:35. > :40:37.report and it is a good report, NHS England are working on the
:40:38. > :40:43.recommendations and I would remind her it is this government which has
:40:44. > :40:47.put mental health on an equ`l esteem within the NHS within the
:40:48. > :40:50.constitution for the first time The position front and say it is
:40:51. > :40:54.meaningless but if it were, why did they not do it when they were in
:40:55. > :40:59.office? We have done it for the first time and are acting on it not
:41:00. > :41:00.just in terms of the constitution but the funding which is gohng up in
:41:01. > :41:14.real terms. The CCG expects to publish hts
:41:15. > :41:17.internal review by the end of February. The independent rdview is
:41:18. > :41:22.expected to be completed by the middle of the month. The monitor is
:41:23. > :41:29.assessing the project from the providers' perspective and will
:41:30. > :41:32.reveal findings soon. The United clear contract in temperature was an
:41:33. > :41:36.attempt to join up disintegrated services. Now we seem to have a
:41:37. > :41:42.series of disintegrated revhews What is needed is a overarching
:41:43. > :41:47.review that looks at the role of NHS England and the role of an Lonitor,
:41:48. > :41:52.the strategic project team `nd the ministers. When will we get that
:41:53. > :41:57.review? As I have indicated, there are reviews going on which concern
:41:58. > :42:02.the responsibilities of each individual part but there is no
:42:03. > :42:07.doubt that this was a seriots matter and a serious failure, which raises
:42:08. > :42:11.serious concerns. We want to know what went on as much as the
:42:12. > :42:14.honourable member. Once the reviews have been completed, I will be happy
:42:15. > :42:20.to talk to the honourable gdntleman about the consequences of those
:42:21. > :42:30.reviews. I call the victorious team leader, Mr Stephen Pound. Qtestion
:42:31. > :42:32.11, Mr Speaker. Mr Speaker ht is my considerable honour to respond to
:42:33. > :42:43.the honourable gentleman in his victorious mode. Community pharmacy
:42:44. > :42:47.is a vital part of the NHS. We want to see a high-quality community
:42:48. > :42:50.pharmacy service properly integrated into primary care and public health
:42:51. > :42:54.and the proposed changes will help us in conjunction with the pharmacy
:42:55. > :42:58.profession to do just that. I am grateful to the Minister for that
:42:59. > :43:02.question. The result was a place for him in our team next year although
:43:03. > :43:08.we are actually taking trials over the next few weeks. -- therd is
:43:09. > :43:12.always a place. Will he accdpt that community pharmacists are of great
:43:13. > :43:16.and growing importance to otr constituents, providing an
:43:17. > :43:19.increasing range of health care and advice in accessible High Street
:43:20. > :43:23.locations. What message does the Minister have for these dedhcated
:43:24. > :43:26.professionals who are now fdaring for their future due to the
:43:27. > :43:33.uncertainty arising from thd announcement of a 6% cut in funding
:43:34. > :43:38.for the NHS pharmacy servicd? I am grateful to the honourable
:43:39. > :43:41.gentleman. The message is that community pharmacy does and is doing
:43:42. > :43:50.an extraordinary and import`nt job but it will change. In 2013, the
:43:51. > :43:52.Royal pharmaceutical servicd, any publication said that the
:43:53. > :43:58.traditional model of communhty pharmacy needs to change because of
:43:59. > :44:02.economic austerity, increashng use of automated technology to tndertake
:44:03. > :44:05.expensing, and the use of online prescribing. It pointed to the
:44:06. > :44:12.massive potential of communhty pharmacists to do more and sees
:44:13. > :44:17.pharmacy as ideally placed to play a crucial role in the new moddls of
:44:18. > :44:20.care. With the consultation going on, there was a great futurd for
:44:21. > :44:29.pharmacies, but like so much else, it will be different. Number 13 Mr
:44:30. > :44:38.Speaker. The UK continues to play a global leadership role on -, roll on
:44:39. > :44:42.antimicrobial resistance. Wd created the Fleming fund to help poorer
:44:43. > :44:49.countries tackle drug resistance and we are promoting action. Our review
:44:50. > :44:55.is helping to galvanise global awareness. I welcome that answer.
:44:56. > :44:58.Antibiotic resistance is ond of the biggest challenges for glob`l
:44:59. > :45:03.health, making routine oper`tions impossible with in ten or 14 years.
:45:04. > :45:10.I welcome the government's `ction on this. Antibiotic research UK is the
:45:11. > :45:19.world's first organisation set up to tackle this. Thank you. I wdlcome
:45:20. > :45:23.the fact that my my honourable friend is becoming a champion for
:45:24. > :45:26.this important international agenda. I am aware of the work of the
:45:27. > :45:32.charity he mentions. I belidve they have had some contact with the
:45:33. > :45:37.Department already and I am happy to look at the issue he mentions. I
:45:38. > :45:42.don't make decisions on the sort of issues but I'm happy to it `nd meet
:45:43. > :45:46.with him. UK health and medhcal research projects benefit htgely
:45:47. > :45:50.from EU funding with the UK at the top of the table for approvdd
:45:51. > :45:54.grants. This funding is vit`l if we are to tackle global health
:45:55. > :45:58.challenges. Does the Ministdr accented that pulling Britahn out of
:45:59. > :46:03.the EU may have a detriment`l impact on the UK's role as a world leader
:46:04. > :46:08.in health and development? H can give the House the reassurance that
:46:09. > :46:18.the funds she mentions are protected by the Spending Review. Mr Simon
:46:19. > :46:28.Burns. Number 14. NHS England advises that in Chelmsford, there
:46:29. > :46:34.are 1927 patients, slightly lower than the mid Essex clinical
:46:35. > :46:36.commissioning area. Eight of the practices have been inspectdd and
:46:37. > :46:43.seven were rated good with one outstanding. Does the Minister think
:46:44. > :46:49.it is possible that the NHS review of the PMS scheme to ensure that
:46:50. > :46:55.good and innovative work is promoted by PMS as example five by Sttherland
:46:56. > :47:01.Lodge surgery can be sustained? I hope so. And I appreciate the
:47:02. > :47:06.honourable gentleman's visit to my office yesterday with members of
:47:07. > :47:13.that surgery and also present lives of the NHS. The ?1.4 million release
:47:14. > :47:16.from PMS in Essex will be rdinvested within the area but it is ilportant
:47:17. > :47:20.that there is an opportunitx for all practices to bid for that money so
:47:21. > :47:25.that some of the work already done under PMS, if it is still ndeded,
:47:26. > :47:32.gets the chance to continue and certainly with services ratdd
:47:33. > :47:40.outstanding. If the Secretary of State... Number one. Number one
:47:41. > :47:44.Significant progress has bedn made in our negotiations on a new
:47:45. > :47:47.contract with junior doctors but the agreement has not been reached on
:47:48. > :47:52.the issue of Saturday play despite assurances from the BMA.
:47:53. > :47:58.Regrettably, 2884 operations have been cancelled ahead of tomorrow's
:47:59. > :48:03.industrial action which will affect all nonemergency services. H urge
:48:04. > :48:08.the BMA to put the interests of patients first and reconsiddr their
:48:09. > :48:13.refusal to negotiate. At PMPs in February of 2014, I raised with the
:48:14. > :48:19.Prime Minister might serious concerns about the bullying culture
:48:20. > :48:25.at Liverpool community trust. I understand that the enquiry into
:48:26. > :48:29.parts of this is complete so I will ask the Secretary of State, in the
:48:30. > :48:34.spirit of honouring his stated commitment to openness and
:48:35. > :48:41.transparency, to ensure that report is available from the 23rd of
:48:42. > :48:45.February. I will happily look into that matter and I know my honourable
:48:46. > :48:48.friend has had a roundtable on bullying and harassment and can I
:48:49. > :48:55.thank her for raising it because over the last decade, none of us
:48:56. > :49:00.should be proud of this, but the number of NHS staff suffering from
:49:01. > :49:04.bullying and harassment has gone up from 14% to 22%. We need to make it
:49:05. > :49:09.easier for doctors and nursds to speak out without worrying `bout
:49:10. > :49:13.being bullied and harassed. Demand always exceeds supply here. We need
:49:14. > :49:18.short questions and short answers. I'm sure the Minister will dnjoy me
:49:19. > :49:22.in congratulating the surgery in Bath for being ranked among the top
:49:23. > :49:26.ten GP practices in the country Does the Minister agree with me that
:49:27. > :49:30.patient satisfaction will increase if patients have a choice of where
:49:31. > :49:34.they are treated? Yes, it whll, and that is another reason why we are
:49:35. > :49:39.hoping to have 5000 more doctors working in general practice and 5000
:49:40. > :49:51.more health professionals expanding the primary care service by 202 . It
:49:52. > :49:54.has been reported that a potential deal on the junior doctor contract
:49:55. > :49:56.was put to the government which would resolve concerns without
:49:57. > :50:01.costing any more money and `voiding the industrial action tomorrow. A
:50:02. > :50:05.source close to the negotiation told the newspaper that one person who
:50:06. > :50:10.would not agree was the Health Secretary. Even though the NHS
:50:11. > :50:15.employers and health teams thought this was a solution, he said no Let
:50:16. > :50:18.me ask the Health Secretary a direct question, as the government at any
:50:19. > :50:25.point rejected a cost neutr`l proposal from the BMA on thd junior
:50:26. > :50:29.doctor contract, yes or no? The only reason that we do not have `
:50:30. > :50:34.solution on the junior doctors is because in December on the one
:50:35. > :50:41.outstanding issue, about Saturday play, the BMA said they would
:50:42. > :50:44.negotiate but last month sahd they would refuse to negotiate. Hf they
:50:45. > :50:54.are prepared to negotiate and be flexible, so are we. What is
:50:55. > :50:59.noticeable is that despite 3000 cancelled operations, no-ond in the
:51:00. > :51:07.Labour Party is condemning these strikes. Can my honourable friend
:51:08. > :51:12.update us on the progress of decriminalisation of dispensaries
:51:13. > :51:16.for pharmacists. I'm aware of my honourable friend's keen interest in
:51:17. > :51:20.the rebalancing programme and dispensing errors. We are committed
:51:21. > :51:26.to making this change. Therd are a number of measures related to this
:51:27. > :51:29.in a section 60 order and ghven that timetable, it is likely the order
:51:30. > :51:39.will be laid in the Westminster and Scottish parliaments in the autumn.
:51:40. > :51:45.The Secretary of State will be aware that there is currently a
:51:46. > :51:49.recruitment for junior doctors for the DWP. They are offering ?72, 00 a
:51:50. > :51:56.year, up to twice the salarx they would get in the health service Is
:51:57. > :51:58.he concerned this will result in inexperienced medical staff making
:51:59. > :52:02.judgments that will relate to people's livelihoods and also is he
:52:03. > :52:06.not concerned that this will result in a drain in staff resourcds out of
:52:07. > :52:11.the NHS and out of general health care for the public? What I would
:52:12. > :52:15.say to the honourable gentldman is that as a result of the changes this
:52:16. > :52:25.government has made on welf`re reform, we have 2 million more
:52:26. > :52:28.people in work. We have half a million fewer households whdre
:52:29. > :52:35.nobody works, and part of that is making important reforms, including
:52:36. > :52:39.making assessments of peopld in the benefits system. Everyone should
:52:40. > :52:43.welcome that. Comparative rdsearch has shown that proton therapy is as
:52:44. > :52:46.effective as radiotherapy for certain cancers but with less side
:52:47. > :52:50.effects. Does the government accept the use of comparative eviddnce in
:52:51. > :52:58.deciding the availability of emerging treatments on the NHS such
:52:59. > :53:03.as proton therapy? I will rdflect on the wider point that my honourable
:53:04. > :53:08.friend makes but the House will be keen to know that we are investing
:53:09. > :53:14.in building two proton beam therapy facilities in Manchester and London.
:53:15. > :53:17.Work has already started. That is a ?250 million project on the first
:53:18. > :53:24.facility will become operathonal in 2018. Could the secretary of state
:53:25. > :53:30.provide an update on efforts and contingencies to combat these Zika
:53:31. > :53:34.virus. Effort is being coordinated with all the administrations,
:53:35. > :53:37.including Scotland. Yes, thhs is something that the government is
:53:38. > :53:41.taking seriously and we havd got under active review. Up-to-date
:53:42. > :53:48.medical guidance has been c`scaded to the NHS in England and the UK is
:53:49. > :53:52.at the forefront of some of the world's response. We are a lajor
:53:53. > :53:56.fund of the WHO and we are investing, we have people on the
:53:57. > :53:59.ground in Brazil in particular. I can assure him that we are
:54:00. > :54:04.maintaining close links with the devolved administrations at the
:54:05. > :54:08.official level and I am verx happy to speak to colleagues. We take it
:54:09. > :54:16.seriously, keeping those links alive. As the Minister seen the
:54:17. > :54:20.comments of Angus Dalglish, reported in the papers today, which suggested
:54:21. > :54:24.that EU rules are forcing us to spend billions of pounds trdating
:54:25. > :54:27.health tourists and preventhng us from undertaking important clinical
:54:28. > :54:34.trials? Has he made any assdssment of the comments made by Professor
:54:35. > :54:40.Dalglish? This government h`s made huge assessment of the cost of
:54:41. > :54:44.overseas people using the NHS, and we think there is ?500 millhon of
:54:45. > :54:49.recoverable costs that we do not currently recover. When it comes to
:54:50. > :54:53.the EU, the biggest problem we have is that we are able to recl`im the
:54:54. > :54:57.costs of people visiting thd UK but we do not do it as much as we should
:54:58. > :55:05.because the systems are not as efficient as they need to bd. And we
:55:06. > :55:09.are sorting that out. Despite the prevalence of pancakes in P`rliament
:55:10. > :55:16.today, I am pleased to be asking a food related question. It is
:55:17. > :55:24.concerning a recent opinion poll by Diabetes UK which showed th`t 7 % of
:55:25. > :55:27.British adults think that food and drink manufacturers should reduce
:55:28. > :55:31.the amount of fat and sugar in their products. Does the Minister support
:55:32. > :55:39.introducing mandatory targets for industry to reform the food, and
:55:40. > :55:43.help people drink more -- e`t more healthily and will that forl part of
:55:44. > :55:47.their strategy going forward? We have made considerable progress on
:55:48. > :55:50.this area in the last Parli`ment, under the responsibility de`l. We
:55:51. > :55:53.have always said there is more to do and the challenge to industry
:55:54. > :55:56.remains. We will be saying lore about that when we published the
:55:57. > :56:00.childhood obesity strategy hn due course.
:56:01. > :56:09.The midwife led unit in my constituency of world and is key to
:56:10. > :56:16.the high quality of passion in maternity care. Last year this get
:56:17. > :56:20.100% -- scored 100% satisfaction, can the Government outlines plan
:56:21. > :56:31.critically given this weeks launch of the safe of the campaign. These
:56:32. > :56:38.have increased in number whhch is a greater advantage to more choice, I
:56:39. > :56:45.hope the next review will m`p out the future of maternity services and
:56:46. > :56:57.show what midwife led units would do within the NHS and I'm excited and I
:56:58. > :57:01.know she be too. Ministers will be aware by a call for concertdd action
:57:02. > :57:04.to promote and protect breast-feeding, will he meet with me
:57:05. > :57:09.and these organisations to discuss with these proposals further? I m
:57:10. > :57:15.aware of the Lancet review `nd it makes important points. It hs of
:57:16. > :57:18.note that in Scotland and W`les and Northern Ireland progress h`s been
:57:19. > :57:28.made where we should get a copy in England. We have made progrdss but
:57:29. > :57:34.there is a considerable difference between rich and poor we nedd to
:57:35. > :57:38.fix. I'm pleased to support the NSPCC it is time campaign to ensure
:57:39. > :57:41.children who have been victhms of abuse receive ongoing support.
:57:42. > :57:49.Cannot seek assurances from the Government that this initiative will
:57:50. > :57:54.be actively helped? Thank you Mr Speaker, yes indeed we support the
:57:55. > :57:58.initiative and our work looking after those children who nedd extra
:57:59. > :58:06.care, especially in relation to health and emotional needs hs being
:58:07. > :58:15.helped by local authorities and vulnerabilities are certainly a
:58:16. > :58:25.matter of great concern. Ovdr 1 million elderly people can laintain
:58:26. > :58:32.independence, what discussions are being made to ensure the allowance
:58:33. > :58:41.will be left at the same level? This consultation is ongoing. Thdre is
:58:42. > :58:48.now a committee to look at ` range of issues, the actual details has
:58:49. > :58:55.not been finalised but it is a matter of concern and discussion
:58:56. > :58:59.between departments. In askhng about mental health can I remind the House
:59:00. > :59:07.that I am married to an NHS forensic scientists, can I ask whethdr the
:59:08. > :59:10.Government has looked careftlly at the report today from the
:59:11. > :59:15.independent commission in ilproving mental health services, and in
:59:16. > :59:20.particular they are finding nationally there is an inaddquate
:59:21. > :59:22.level of provision for the lost severe ill patients and can the
:59:23. > :59:28.Government sets out what me`sures they will take to make sure we
:59:29. > :59:37.really do see progress and hmprove access? Can I thank my honotrable
:59:38. > :59:42.friend for this and thank the Royal College of psychiatry for the work
:59:43. > :59:47.on the commission of launch Nigel crisp which we have supporthve. The
:59:48. > :59:51.report and the recommendation has only just comfort it goes in the
:59:52. > :59:56.direction the Government is still going, we want to reduce out of area
:59:57. > :00:00.placements and the NHS is working on this team moved to a definitive
:00:01. > :00:06.target to reduce that and hopefully eventually scrap it. I was hn Hull
:00:07. > :00:11.looking at problems and the recommendations on waiting times are
:00:12. > :00:14.important. This area has bedn undervalued and is under grdater
:00:15. > :00:17.scrutiny now and there is more investment going into the
:00:18. > :00:23.Government. The reports will help this in relation today. I whll call
:00:24. > :00:30.the honourable gentleman if his question consist of one sentence. A
:00:31. > :00:44.Leeds we have pressure on acute services, will the secretarx of
:00:45. > :00:54.state... Bell was, Mr Speakdr,. . While the CCG provides the loney? I
:00:55. > :01:01.am happy to look at that. Wd will come to points of order but not yet.
:01:02. > :01:04.By refusing to condemn the junior doctors strike, the lady opposite
:01:05. > :01:14.has shown she shows little regard for patient safety, that shd
:01:15. > :01:22.repeated condemnation for the strike which will endanger patient safety
:01:23. > :01:30.and can he Kante... Guarantde a contract for better patient care? I
:01:31. > :01:33.think that was a reaction. The party opposite are saying if a negotiated
:01:34. > :01:38.settlement can not be reachdd then we should not impose a new contract,
:01:39. > :01:42.in other words we should give up on a seven day care for the most
:01:43. > :01:45.honourable patients, there was a time when the Labour Party tsed to
:01:46. > :01:53.speak up for vulnerable pathents but now it is clear that unions matter
:01:54. > :02:01.more than patient. Demand is so high, last but not least. The
:02:02. > :02:08.pharmacy budget comes in in October in the next financial year can the
:02:09. > :02:15.Minister say what the fall cuts will be in a full financial year?
:02:16. > :02:21.Negotiations are ongoing with the pharmaceutical services, thd amounts
:02:22. > :02:25.that have been set up cover this financial year and settlements are
:02:26. > :02:29.moved from year to year so that discussion is ongoing, the future
:02:30. > :02:34.for pharmacy is very good and will be different, there is a grdat
:02:35. > :02:42.future bright for high-stredt shops, shops and areas where we nedd the
:02:43. > :02:47.bottle so an improvement in services and health care, improper c`re, in
:02:48. > :02:48.primary homes around the