:00:00. > :00:00.Don't forget to join me for a round-up of the day at 11pm tonight.
:00:00. > :00:10.First, questions to the Health Secretary.
:00:11. > :00:13.The 150,000 EU nationals working in our health and care services do a
:00:14. > :00:18.brilliant job and we want them to continue doing it. I am in regular
:00:19. > :00:23.talks to inform them of domestic workforce plans and negotiations
:00:24. > :00:27.with the EU. I thank him for that answer. He will be aware that
:00:28. > :00:30.represents something in excess of 5% of the total workforce within the
:00:31. > :00:35.NHS. This is something which is done to have to be addressed, engaging
:00:36. > :00:38.with the recruitment sector, the employment sector and indeed the
:00:39. > :00:43.devolved administrations. Is that the way the Minister will handle
:00:44. > :00:47.this? We absolutely will be taking a UK wide approach cost of the actual
:00:48. > :00:52.numbers are slightly higher than the numbers he talks about for England,
:00:53. > :00:56.we are about 9% of doctors are EU nationals and about 19% of nurses
:00:57. > :01:01.are EU nationals. But we are still seeing doctors and nurses coming to
:01:02. > :01:04.the UK and we need to do everything on all sides of this House to
:01:05. > :01:13.reassure them that we see them as having a bright and vital future in
:01:14. > :01:16.the NHS. If students with four a grades at A-level continue to find
:01:17. > :01:19.it difficult to get into a medical degree in this country, is it any
:01:20. > :01:26.wonder we have to import them from Europe? Well, he makes a very
:01:27. > :01:31.important point, and that is precisely why last year we increased
:01:32. > :01:36.the number of medical school places by I think the second biggest hike
:01:37. > :01:38.in the history of the NHS, a 25% increase. Because we absolutely do
:01:39. > :01:46.believe that this country should be training all the doctors and nurses
:01:47. > :01:51.that we need. The truth is, EU staff no longer want to come here. Doctors
:01:52. > :01:55.and nurses are leaving in their droves. Thanks to the abolition of
:01:56. > :02:01.the NHS bursary, our nurses of tomorrow are going to have to pay to
:02:02. > :02:06.train. When is the Secretary of State going to understand that this
:02:07. > :02:10.staffing crisis has not materialised out of thin air, it is directly
:02:11. > :02:15.attributable to his actions and the actions of his government over the
:02:16. > :02:19.last century? -- the last seven years. She may have noticed a little
:02:20. > :02:27.thing called Brexit that happened last year, which is actually... Is
:02:28. > :02:33.actually because of understandable concern. But if she looks at the how
:02:34. > :02:41.many doctors came from the EU to the NHS in the year ending this March,
:02:42. > :02:49.in other words, post-Brexit? 2200. And how many nurses? 4000 nurses
:02:50. > :02:56.joined the NHS from the EU in the year ending March. One of the
:02:57. > :03:01.consequences of free movement from the EU is that proportionately we
:03:02. > :03:04.take in rather fewer doctors, particularly, but also nurses from
:03:05. > :03:09.the Indian subcontinent and other places. What assessment at the
:03:10. > :03:15.Secretary of State made of the capacity to revisit the strong
:03:16. > :03:20.relationship we did have with those workforces in the immediate post-war
:03:21. > :03:25.years? Well, he makes an important point, and I think that what we want
:03:26. > :03:27.to do is to attract the brightest and best into the NHS from all over
:03:28. > :03:33.the world, wherever they come from, if there is a need. The only caveat
:03:34. > :03:37.is that I think there are a number of doctors that we have imported
:03:38. > :03:41.from very, very poor countries that actually do need those skills back
:03:42. > :03:44.home, and I think we do have to recognise we have not in national
:03:45. > :03:49.responsibility to make sure we train the number of doctors and nurses we
:03:50. > :03:55.need ourselves. -- we have a national responsibility. It is also
:03:56. > :03:57.costing a lot more in Nottingham and elsewhere because of luck cost
:03:58. > :04:03.agency costs, isn't it clear that if we stop restricting access from the
:04:04. > :04:09.EU for staffing purposes, it will cost the NHS an absolute fortune
:04:10. > :04:15.more? Let me reassure him, there is no intention to restrict access for
:04:16. > :04:18.vital professions such as the clinical professions in the NHS
:04:19. > :04:21.post-Brexit. We have said many times we will have a pregnant -- pragmatic
:04:22. > :04:28.immigration policy. But the long-term solution is not having to
:04:29. > :04:33.import doctors and nurses from anywhere because the W H O says
:04:34. > :04:36.there is a worldwide shortage of about 2 million clinical
:04:37. > :04:40.professionals because we are not the only nation facing the challenge of
:04:41. > :04:43.an ageing population. I welcome his words and the deeds he is doing in
:04:44. > :04:48.terms of recruiting more doctors and nurses. Hospitals like mine in
:04:49. > :04:52.Basingstoke rely on the best and the brightest from around the world.
:04:53. > :04:56.What can he do to make sure that when we need to recruit nurses in
:04:57. > :04:59.particular, we have the travel permits are available and work
:05:00. > :05:03.permits are available for them to be able to move in swiftly rather than
:05:04. > :05:06.having to wait for long periods of time whiz-mac She is absolutely
:05:07. > :05:12.right to make that point and in fact nurses are on the Home Office tear
:05:13. > :05:15.to shortage occupation shortage list and they will remain so for as long
:05:16. > :05:19.as we need them to be. But the bigger issue here is that for a long
:05:20. > :05:24.time, we have relied on being able to import as many doctors and nurses
:05:25. > :05:30.from the EU as we need to, so we have not trained enough people
:05:31. > :05:40.ourselves. That is not only bad for EU countries but also bad for our
:05:41. > :05:43.own young people. I will take questions two and 12 together. Last
:05:44. > :05:48.year the stud-mac announced one of the biggest expansions of medical
:05:49. > :05:52.training places -- this Government, involving 1500 additional medical
:05:53. > :05:57.school doses of the year, of which 500 staff this September and reforms
:05:58. > :06:02.that will enable universities to offer up to 10,000 additional nurse
:06:03. > :06:07.training places every year. In Swindon, funding for a video
:06:08. > :06:12.campaign to recruit additional GPs to fill vacancies in our local
:06:13. > :06:15.community, will the Secretary of State committed to exploring further
:06:16. > :06:18.innovative ways to match newly qualified staff to vacancies that
:06:19. > :06:23.they may not have previously considered? I think he makes a
:06:24. > :06:28.really important point, and there are parts of the country where there
:06:29. > :06:33.are GP shortages that have been very successfully addressed as the CCG
:06:34. > :06:37.has done in Swindon. An overall part of this is persuading people who go
:06:38. > :06:41.into medicine that going into general practice is one of the most
:06:42. > :06:46.exciting and rapidly changing parts of medicine today, and we have seen
:06:47. > :06:53.a 9% increase in the number of medical students choosing to go into
:06:54. > :06:56.general practice since 2015. Further to the previous question, could I
:06:57. > :06:59.ask the Secretary of State what he is doing to ensure that there is
:07:00. > :07:06.enough doctors and nurses recruited, retained and developed at my local
:07:07. > :07:10.hostel dubbed hospital? I heard a lot about his hospital when I went
:07:11. > :07:13.to visit last year. I had the privilege of visiting them recently
:07:14. > :07:16.after the horrific terrorist attacks, and I want to commend the
:07:17. > :07:20.blade work done in that hospital, stepping Hill, in the wake of that
:07:21. > :07:25.bomb. They have done a very good job of recruiting, I think they got 93
:07:26. > :07:29.more doctors and nearly 300 more nurses since 2010. But we are having
:07:30. > :07:35.a national programme to help all trusts Britain the nursing staff. It
:07:36. > :07:43.has been launched by NHS Improvement in the last week. Thank you, Mr
:07:44. > :07:46.Speaker. In this country, we are short of approximately 40,000 nurses
:07:47. > :07:51.and applications were nurse faces have gone down by nearly 23%. Can
:07:52. > :07:58.the Secretary of State tell us why he and his Government think that is
:07:59. > :08:01.the case? Well, she happens to work in an NHS hospital that has had a
:08:02. > :08:06.big increase in the number of nurses and in fact across the country, the
:08:07. > :08:11.actual picture is that we have 13,000 more nurses working in our
:08:12. > :08:16.wards since 2010. But she is right, we do need more nurses and that is
:08:17. > :08:22.why we are expanding the number of nurse associates. This year we are
:08:23. > :08:26.for the first time opening up a route into nursing through the
:08:27. > :08:29.apprenticeship route, which means that people from nontraditional
:08:30. > :08:33.backgrounds, particularly banned three health care assistants, will
:08:34. > :08:40.find it easier to get into nursing, and that is how we will stand on it.
:08:41. > :08:45.The latest NHS indicators published last week says that the number of
:08:46. > :08:50.GPs in the past 12 months is estimated to have fallen. Again it
:08:51. > :09:00.is expected to have fallen by March 20 17. Why is that? What we have had
:09:01. > :09:03.is a big increase in the number of medical students choosing to go into
:09:04. > :09:07.general practice, but we have also had an increase in the number of GPs
:09:08. > :09:13.retiring early, and that is a problem we are urgently addressing.
:09:14. > :09:19.May I congratulate my right honourable friend serving as Health
:09:20. > :09:25.Secretary in three parliaments, and say to him that the sides doctors
:09:26. > :09:31.and nurses, he should be looking to increase the use of properly
:09:32. > :09:34.regulated acupuncturists, herbalists, wholemeal parts,
:09:35. > :09:41.chiropractors and osteopaths, who would reduce the burden on doctors
:09:42. > :09:46.and nurses of the Health Service. Over those three parliaments, I have
:09:47. > :09:50.learned to expect questions in a similar vein from my honourable
:09:51. > :09:54.friend, and I do commend his persistence in championing that
:09:55. > :09:57.cause. As he knows, I think the most important thing in all of these
:09:58. > :10:05.issues is to follow the scientific advice. Thank you very much. When
:10:06. > :10:08.the Government removed the nursing bursary and introduced tuition fees,
:10:09. > :10:13.the Secretary of State said that this was, as he has repeated this
:10:14. > :10:16.morning, to fund 10,000 extra student nurse places. Yet the
:10:17. > :10:20.universities are saying that no extra bases have been commissioned
:10:21. > :10:23.so when will we see an expansion of student nurse training?
:10:24. > :10:33.I always well, the interest she shows but given Scotland has seen a
:10:34. > :10:38.fall in life expectancy in 100 years, she might want to think about
:10:39. > :10:44.her own constituents. With respect to the number of nurses, we have now
:10:45. > :10:49.over 50,000 nurses in training and we are confident we will deliver an
:10:50. > :10:56.increase in the supply of nurses to the NHS. We still have a nursing
:10:57. > :10:59.bursary and no tuition charges. The Secretary of State might want to
:11:00. > :11:10.explain why the university 's claim that are no additional places. In
:11:11. > :11:12.addition, we are losing almost half of junior doctors at the end of the
:11:13. > :11:15.foundation years. What action as the Secretary of State taking to find
:11:16. > :11:19.out why? I think the heart of this is that we need to open up avenues
:11:20. > :11:25.for flexible working, more flexible working for both doctors and nurses.
:11:26. > :11:30.I think if she followed what we have done in England, where we have
:11:31. > :11:36.actually pioneered the reduced agency spend by 19% in the year,
:11:37. > :11:42.while it is going up in Scotland, she might find they have more money
:11:43. > :11:46.to spend on their own constituents. At the Secretary of State confirm
:11:47. > :11:53.what specific actions she is taking to help trusts such as the Acute
:11:54. > :11:56.Hospital trust that runs on the Alex Hospital in my constituency of
:11:57. > :12:02.Redditch, that is in special measures. These types of trust fees
:12:03. > :12:10.special measures in retaining and recruiting staff. Can I welcome the
:12:11. > :12:15.first question I have received from my honourable friend and say to her
:12:16. > :12:21.that I am very aware of the issues faced by the Worcester search acute
:12:22. > :12:25.trust. I have been to visit it after the difficult period they have come
:12:26. > :12:30.through. We have a new leadership team who I think I've made a very
:12:31. > :12:34.promising start. We have found, because of the experience of other
:12:35. > :12:38.hospitals that have been through difficult patches, it was never
:12:39. > :12:42.about the commitment of staff, it is about getting the right leadership
:12:43. > :12:47.in place. I can assure her I did see outstanding commitment from the
:12:48. > :12:53.staff. The number of nurses has fallen for the first time in one
:12:54. > :12:57.decade. That is why we need fear pay now. I read in the newspapers that
:12:58. > :12:59.the Health Secretary now supports the Labour Party policy of scrapping
:13:00. > :13:08.the cup, although he did not put with us last week. When you set the
:13:09. > :13:13.remit soon, will he tell them to scrap the cap and will he published
:13:14. > :13:16.his instructions before the summer recess? I did not vote for his
:13:17. > :13:21.amendment because as usual libra taught us how they want to spend the
:13:22. > :13:27.money without the faintest idea how they know where it will come from --
:13:28. > :13:32.Labour taught us. I think he is ignoring the elephant in the room,
:13:33. > :13:39.if we followed the spending plans he campaigned for, the NHS would have
:13:40. > :13:44.2.6 billion less every year. That is the equivalent of 85,000 fewer
:13:45. > :13:50.nurses. I want to talk about the spending plans of 2017, were he can
:13:51. > :13:53.find 1 billion for Ireland but nothing for nurses in England. --
:13:54. > :13:58.Northern Ireland. Do not go ahead with further cuts to Corporation tax
:13:59. > :14:05.and put that money into giving our doctors and nurses a fair pay rise?
:14:06. > :14:11.Let me tell him what extra money is going into the NHS. Three years ago,
:14:12. > :14:16.1.8 billion, not asked for by Labour. 3.8 billion two years ago,
:14:17. > :14:20.nearly 1 billion more than they were promising and this year ?1.3
:14:21. > :14:27.billion. That is a lot of extra money. Why is it going and's we have
:14:28. > :14:32.more than 3 million jobs, that is strong economy that is improving the
:14:33. > :14:40.NHS. Question number three, Mr Speaker. Health education England is
:14:41. > :14:44.responsible for meeting workforce requirements for the NHS. The number
:14:45. > :14:48.of dermatologists and the NHS continues to grow, with 18% more
:14:49. > :14:56.consultants and 13% more doctors in training since 2010. In the latest
:14:57. > :15:00.workforce plan, 2% increase in training places for dermatologists
:15:01. > :15:04.over the previous year. It is a popular choice for doctors and it
:15:05. > :15:11.enjoys equal hundred percent rate. I am pleased to see that through a
:15:12. > :15:16.combined approach between hospitals it has been possible to prevent the
:15:17. > :15:22.long-term closure of the dermatology department and have fun in place
:15:23. > :15:25.with the full service reopening in 2018 but given the seriousness of
:15:26. > :15:28.the conditions, which include skin cancer, which is growing, with my
:15:29. > :15:34.right honourable friend give further insurances of how we're going to
:15:35. > :15:37.ensure sufficient supply of specialists in this area? Well, I
:15:38. > :15:42.know my honourable friend has campaigned actively to the
:15:43. > :15:45.dermatology services at the hospital in her constituency have been
:15:46. > :15:49.retained following consultant retirements, which I think prompted
:15:50. > :15:54.the temporary arrangements. I am pleased since the beginning of
:15:55. > :15:59.April, we have successfully commissioned dermatology clinics at
:16:00. > :16:02.Musgrove Park, using specialists from Bristol, with a view of
:16:03. > :16:07.restoring a full service by next April. We do recognise the
:16:08. > :16:11.importance of dermatology and are committed to encouraging the
:16:12. > :16:15.speciality in Somerset and nationally. Dermatology is one of
:16:16. > :16:26.those specialisms that this does boot determined on -- that is
:16:27. > :16:30.determined on EQ nationals. The extreme hard Brexit being pursued by
:16:31. > :16:35.the Prime Minister 's disastrous for our NHS. What is he and the
:16:36. > :16:39.Secretary of State doing to pool our Prime Minister back from this
:16:40. > :16:44.damaging cause? In relation to dermatologists, I think is what he
:16:45. > :16:48.had in mind. Mr Speaker, I cannot tell the honourable gentleman how
:16:49. > :16:55.many of the dermatologists come from the EU. What I can tell him is that
:16:56. > :17:05.since the referendum, 560 29 UK EU doctors have come to work in the
:17:06. > :17:11.NHS. The Secretary of State recently met the Chief Executive of St Helier
:17:12. > :17:15.University Hospital trust and was impressed by the fantastic work
:17:16. > :17:18.staff were doing, despite the surroundings and facilities which
:17:19. > :17:26.are clearly in need of improvement, as he has been campaigning for. Any
:17:27. > :17:29.significant service chains must be based on conical evidence, consider
:17:30. > :17:34.patient choice and has the support of GP commissioners. I thank him for
:17:35. > :17:37.that response. The Secretary of State did visit the hospital on the
:17:38. > :17:43.first day of the election campaign, nothing suspicious about the timing.
:17:44. > :17:47.He will have heard that 43% of the whole estate is unsuitable for the
:17:48. > :17:52.delivery of modern health care. Yet, thanks to the hard work of staff at
:17:53. > :17:55.St Helier Hospital, it is one of the few hospitals that managed to keep
:17:56. > :17:58.on top of the waiting time targets, would you like to be the beer of
:17:59. > :18:05.good news I confirm that the Government is going to reinstate the
:18:06. > :18:09.?290 million the Secretary of State cancelled to allow the new hospital
:18:10. > :18:14.to be built? As the honourable gentleman knows, the Southwest
:18:15. > :18:16.London area is in the process of turning the proposals into plans
:18:17. > :18:22.with public consultation when appropriate. It has yet to make any
:18:23. > :18:25.recommendation and, as he knows, they have set up for local
:18:26. > :18:31.transformation boards to consider how best to transform services,
:18:32. > :18:35.including at and Holly hospital and Epsom. -- St Helier Hospital. It
:18:36. > :18:42.would be wrong for me to prejudge those conclusion. Is it better than
:18:43. > :18:45.having emptied vertical campaigns, I wonder if my right honourable
:18:46. > :18:50.friend, my honourable friend, would have a sympathetic ear to having an
:18:51. > :18:54.alternative plan to health care that works clinically, financially and
:18:55. > :18:59.listens to all residents? A well thought out plan. My honourable
:19:00. > :19:03.friend is quite right that we do need to look to be proposals coming
:19:04. > :19:07.out of the commissioned on the ground who are responsible for
:19:08. > :19:09.running acute services for the whole south-west London. They have made it
:19:10. > :19:15.very clear that the intent to consult with the public once they
:19:16. > :19:21.have made their own recommendations transparent. The intent to retain
:19:22. > :19:28.all five hospitals, but to look at the configurations of services, that
:19:29. > :19:39.needs to be led by clinicians. Thank you. As I asked my first health
:19:40. > :19:46.question, can I thank the cardiac team in London where my
:19:47. > :19:51.father-in-law just retired. We did everything they could last week and
:19:52. > :19:55.showed the very best of the NHS. -- they did everything they could. We
:19:56. > :20:02.have committed to an extra 5000 doctors in general practice by 2020.
:20:03. > :20:05.NHS England and health education England are working together with
:20:06. > :20:10.the profession to increase the GP workforce. We believe this is an
:20:11. > :20:15.essential part of creating a strong general practice and NHS for the
:20:16. > :20:19.future. In recent years, the number of family doctors in Sunderland has
:20:20. > :20:24.plummeted. All of the evidence shows doctors are more likely to stay in
:20:25. > :20:27.the areas they have trained. Does the Secretary of State by the
:20:28. > :20:30.Minister accept that new medical school places should be created in
:20:31. > :20:37.places such as Sunderland reveals the greatest need to recruit and
:20:38. > :20:46.retain. I'm thank her for that. Since 2016, Sunderland's GP start
:20:47. > :20:48.scheme has created new GPs over the next three years. You understand
:20:49. > :20:54.that point about medical school provision. Through a partnership
:20:55. > :20:58.between Newcastle and Durham, there are currently 25 medical schools in
:20:59. > :21:02.England offering just over 6000 Government funded medical school
:21:03. > :21:07.places, we finding 1500 additional places each year and 500 have
:21:08. > :21:12.already been allocated, 24 of these two Newcastle. Recruiting more GPs
:21:13. > :21:18.in Cheltenham is vital to help the workload. Rising costs, and act as a
:21:19. > :21:25.disincentive. Does he agree with me that this is something that must
:21:26. > :21:28.meet addressed decisively? We recognise the role they play in the
:21:29. > :21:36.care and following the review, additional money was included in the
:21:37. > :21:39.contract last year to... We said we would ensure appropriate funding for
:21:40. > :21:45.GPs to meet the cost in the short term and work with the industry to
:21:46. > :21:49.create a longer term solution. Thank you, Mr Speaker. As numbers of GPs
:21:50. > :21:53.go down, there is increasing pressure on the time they have
:21:54. > :21:59.patience. One of the areas that has been missed as the area of suicide
:22:00. > :22:05.and self harm. We now know that there is an increased risk of
:22:06. > :22:12.suicidal behaviour for those on unstable, a regular zero-hour
:22:13. > :22:18.contracts and also those are likely to take their own life. I know the
:22:19. > :22:25.honourable lady does a huge amount of work in this area and chairs the
:22:26. > :22:34.whole tv-mac all-party group. 85% of respondents rated their GP care is
:22:35. > :22:40.good. ?13 million of taxpayer money, which we hope will increase the time
:22:41. > :22:47.GPs can spend with patients. I am very happy to meet with her. GPs are
:22:48. > :22:50.the first line of defence against antibiotic resistance, which has the
:22:51. > :22:54.potential to be an uncontrollable global new Black Death. With the
:22:55. > :23:00.Minister confirm that the UK will retain its position as world leader
:23:01. > :23:06.on this when the global fund will open applications and when the pilot
:23:07. > :23:10.while for drug development will begin operating? I thank him for
:23:11. > :23:16.that. We have committed ?50 million assistance towards setting up the
:23:17. > :23:22.innovation fund. I will say that quickly. We are one of the world
:23:23. > :23:25.leaders in that subject. I am meeting with him and the honourable
:23:26. > :23:32.member for Stafford and you're shortly you can take that forward. I
:23:33. > :23:36.spoke to one GP last week you told me that because he has been unable
:23:37. > :23:40.to recruit help, he has only been able to take one weeks leave in
:23:41. > :23:44.three years. This is not sustainable. The morale of GPs is at
:23:45. > :23:48.an all-time low, the number continues to fall, surgeries are
:23:49. > :23:51.closing and patience are finding it harder and harder to get an
:23:52. > :23:59.appointment. He has promised annex 5000 GPs bike 2020. Given it will
:24:00. > :24:04.take ten years to train a GP. Can you tell the House how he was going
:24:05. > :24:09.to deliver this promise? I look forward to our engagement. It is a
:24:10. > :24:12.landmark document published in April last year and sets out extra
:24:13. > :24:17.investment that people have been calling for four years of ?2.5
:24:18. > :24:22.billion per year for practice services. Investment is rising. More
:24:23. > :24:26.people are coming into general practice, that is the good news and
:24:27. > :24:29.we want to encourage that. We have to take action to prevent the early
:24:30. > :24:37.retirements and to bring people back to general practice and we are
:24:38. > :24:42.indeed doing that. Developing new routes into nursing is a priority
:24:43. > :24:45.for the Government. That is why we launched both the new nursing
:24:46. > :24:50.associate role and the nursing degree apprenticeship earlier this
:24:51. > :24:53.year, as the Secretary of State said earlier this afternoon. This will
:24:54. > :24:57.open new routes into the nursing profession for thousands of people
:24:58. > :24:59.from all backgrounds and will also allow employers to grow their own
:25:00. > :25:07.workforce from the local communities. My constituents welcome
:25:08. > :25:10.the manifesto commitment to expand the number of clinical staff in
:25:11. > :25:13.mental health. What more can I right honourable friend say about plans
:25:14. > :25:26.for mental health nurse training and have people will benefit? The
:25:27. > :25:30.workforce plan for England indicated a 3% increase in the number of
:25:31. > :25:35.mental health nursing training places. The current level is the
:25:36. > :25:42.highest of any nursing branch as a percentage of the workforce that
:25:43. > :25:46.serves, which sued allow for 22%, over 8000 full-time equivalent
:25:47. > :25:51.members of staff, growing in the mental health nursing workforce by
:25:52. > :25:59.2020. The fact is, when the Government chose to charge students
:26:00. > :26:03.record levels of student fees, the Secretary of State and his Ministers
:26:04. > :26:08.were warned that would lead to fall in applications. Applications for
:26:09. > :26:13.nursing degrees has fallen by 23%. Given he has already acknowledged
:26:14. > :26:17.that we can no longer rely on EU staff as a result of Brexit, when
:26:18. > :26:20.will Ministers understand the biggest challenge facing nursing
:26:21. > :26:25.recruitment is not our policy towards the EU, it is the
:26:26. > :26:31.I think he is right to draw attention to the fact that we
:26:32. > :26:34.continue to have a surplus of applicants for nursing degree
:26:35. > :26:38.courses in this country. The level of that surplus has come down
:26:39. > :26:41.somewhat as a result of the change in funding structures. We will have
:26:42. > :26:46.to see where it ends up because at the moment, universities are
:26:47. > :26:51.directly recruiting outside the UK system and we are confident there
:26:52. > :26:56.will be what in places this applicants year, some 2-1. Would the
:26:57. > :27:00.Minister agree there is opportunity for more mature students to be able
:27:01. > :27:03.to access courses easily and more must be done with adult learning
:27:04. > :27:07.institutions to provide courses that provide direct access? I think he is
:27:08. > :27:14.quite right to point out that the more mature workforce and in
:27:15. > :27:19.particular for people perhaps coming back into careers later in life or
:27:20. > :27:23.after, for women, after they have children, for example, is an
:27:24. > :27:26.important source of experience for professionals and we need to do more
:27:27. > :27:33.to encourage people to come back into the workforce later in life.
:27:34. > :27:37.Number seven. Last year, our A saw 1800 more people every day within
:27:38. > :27:43.the four hour target compared to 2010. We have also nearly 1500 more
:27:44. > :27:51.emergency care doctors and a verse 600 more emergency care consultants.
:27:52. > :27:56.I thank him for that answer. A handy departments -- in the departments at
:27:57. > :28:01.district hospitals are a critical part of the regional emergency
:28:02. > :28:04.infrastructure and ensure that the larger city departments can do with
:28:05. > :28:07.major trauma as well as day-to-day emergencies. Will he ensure that
:28:08. > :28:17.this vital emergency infrastructure is protected, enhanced and funded? I
:28:18. > :28:19.do absolutely agree with him that having an emergency care network
:28:20. > :28:25.that works well for his constituents is absolutely essential, and that
:28:26. > :28:32.will mean relying on a network of hospitals, as he fully understands.
:28:33. > :28:36.I do recognise the concern that his own hospital, which he campaigns for
:28:37. > :28:40.extremely vigorously, and I want to assure him I will be watching very
:28:41. > :28:47.carefully what happens there. Would he now confirm what the Minister
:28:48. > :28:50.said that it was scaremongering to talk of the closure of Huddersfield
:28:51. > :28:57.A, and will he now confirm that we should have a real plan with a gold
:28:58. > :28:59.standard university to have a new medical school in Huddersfield so we
:29:00. > :29:03.can attract talent and that would do a great deal for morale, which would
:29:04. > :29:08.recruit good doctors and nurses everywhere? Well, I do think he is
:29:09. > :29:12.right to say that it is time we had more medical schools, given that
:29:13. > :29:16.health and social care will be one of the fastest expanding areas of
:29:17. > :29:19.the economy over the coming years. And I do think that the Prime
:29:20. > :29:23.Minister was absolutely right to say there should be no scaremongering
:29:24. > :29:30.about important local plans that will improve services for patients.
:29:31. > :29:33.Mr Speaker, can the Secretary of State reassure my constituents that
:29:34. > :29:37.the component parts of the NHS can communicate with each other
:29:38. > :29:44.sufficiently so that decisions of for example a medical deed to remove
:29:45. > :29:47.accreditation for anaesthetic training will not lead to the
:29:48. > :29:51.closure of a handy departments in places such as the court in general,
:29:52. > :29:58.where my father was treated so well last Friday? -- Horton General. He
:29:59. > :30:09.is a splendid fellow and he is now in another place! I am referring to
:30:10. > :30:12.another house of Parliament! I was concerned about the general
:30:13. > :30:17.laughter, Mr Speaker, but that comment! But I am delighted that my
:30:18. > :30:23.honourable friend was my father was treated so well. I enjoyed my visit
:30:24. > :30:26.to the hospital recently. And she is right that where there are changes
:30:27. > :30:31.in the patterns of training, we need to be very careful to make sure that
:30:32. > :30:38.they do not interrupt the way local services are delivered in a
:30:39. > :30:41.disadvantageous way. The boundaries of the sustainability and
:30:42. > :30:45.transformation partnerships is bound to cause concern about the future of
:30:46. > :30:49.a handy and other acute departments. Given the nature of them. My area,
:30:50. > :30:54.South Korea, relatively sparsely populated and rural, is lumped in
:30:55. > :31:01.with Lancashire, largely urban. Will he confirm that the voices of rural
:31:02. > :31:07.communities will not be dwarfed by those of the larger urban ones, and
:31:08. > :31:10.this week as we celebrate the 25th anniversary of Westmorland General
:31:11. > :31:13.Hospital, will he guarantees that were going to the hospital will not
:31:14. > :31:19.be close and not receive any downgrading? The hospital has a very
:31:20. > :31:23.important future in the NHS. I am happy to give him that assurance. I
:31:24. > :31:29.do not think that he should be concerned about STP footprints
:31:30. > :31:33.covering both rural and urban areas. However, I think where there is an
:31:34. > :31:37.issue in his constituency and many others is in the response times for
:31:38. > :31:42.ambulance is in the most remote areas. That is something we are
:31:43. > :31:45.looking at. Thank you, Mr Speaker. Another threat to A units is the
:31:46. > :31:50.capped expenditure process which will mean hundreds of million pounds
:31:51. > :31:53.cut from NHS budgets, sneak out during the election, so far we have
:31:54. > :31:58.had nothing but silence from this Government. It is time we had the
:31:59. > :32:02.truth. When did the Secretary of State sign of the plans and when
:32:03. > :32:06.will he publish them? The capped expenditure process is an NHS
:32:07. > :32:10.England initiative to meet its statutory duty to live in its budget
:32:11. > :32:15.and I do support the principle that in a period where real expenditure
:32:16. > :32:17.on the NHS is going up by ?5 billion, the benefits should be
:32:18. > :32:24.spread fairly amongst patients in all parts of the country. Number
:32:25. > :32:33.eight, Mr Speaker. Thank you, Mr Speaker. In July 2016, the
:32:34. > :32:37.Government published our commitment to end of life care. This set out
:32:38. > :32:40.what everyone should expect from their care at the end of life and
:32:41. > :32:44.the actions we are taking to make high-quality end of life care a
:32:45. > :32:47.reality for everyone. By 2020 we want to significantly improve
:32:48. > :32:51.pavement -- patient choice including an increasing the number of people
:32:52. > :32:56.able to die in the pace of their choice, at home. I thank her for her
:32:57. > :33:00.reply and it is welcome news that there is such a focus on and of life
:33:01. > :33:06.care. Would she agree to meet with me to discuss the bill that was
:33:07. > :33:10.presented in the other place to look at the way at how we can improve
:33:11. > :33:13.access to palliative care across the UK? I would be delighted to meet
:33:14. > :33:17.with my honourable friend, who is a very committed and passionate
:33:18. > :33:20.campaigner in this area. I am very keen to explore anything which
:33:21. > :33:27.improves care and choice for all patients at the end of their care.
:33:28. > :33:30.Croydon's NHS including end of life care has been funded below the
:33:31. > :33:33.London average every year since the Conservatives first came into
:33:34. > :33:37.government. That is leading to service closures in Croydon which
:33:38. > :33:41.are available elsewhere and longer waiting times for GPs or the A and
:33:42. > :33:47.Croydon. When will Croydon's funding be brought up to the London average?
:33:48. > :33:53.Well, the amount of resource dedicated locally is a matter for
:33:54. > :33:58.CCG is and we continue to make sure that funding is fair. As I suggest
:33:59. > :34:05.he takes it up with his CCG. Number nine. Clinical commissioning groups
:34:06. > :34:08.as statutory organisations have a duty to deliver the best possible
:34:09. > :34:14.services within the financial allocation. NHS England supports
:34:15. > :34:19.them in this by providing several sets of guidance, as do NICE and
:34:20. > :34:24.other arm's-length bodies. He will know that the clinically driven
:34:25. > :34:28.process in Shropshire could lead to hundreds of millions of pounds of
:34:29. > :34:33.investment in our local hospital. That is being jeopardised by Telford
:34:34. > :34:40.CCG and Telford cancelled. When there is this gridlock in between
:34:41. > :34:46.two local CCGs, what more can the Government do to break this
:34:47. > :34:50.deadlock? I am aware that he has been concerned about this for a long
:34:51. > :34:53.time. An independent review is taking place and people know that
:34:54. > :34:57.Professor Simon brick has been appointed as the independent chair
:34:58. > :35:01.of the joint committee of CCGs agreed between them both, the review
:35:02. > :35:05.will report in July and be considered by the local CCGs before
:35:06. > :35:09.next steps, including public consultation. Clear rules apply to
:35:10. > :35:14.any significant reconfigurations and I expect these to be followed in
:35:15. > :35:20.Shropshire as in anywhere else. Patients at the MRI in Manchester
:35:21. > :35:24.with serious congenital heart problems found out last week that
:35:25. > :35:29.the services will now no longer be provided in Manchester or in fact
:35:30. > :35:31.anywhere in the North West. Due to a government review of services,
:35:32. > :35:36.meaning that staff cannot be retained and recruited. What does
:35:37. > :35:40.the Minister had to say to those patients who now have to go to Leeds
:35:41. > :35:45.or Newcastle to get the lifelong surgery a need? -- life prolonging.
:35:46. > :35:52.I understand this is an independent review of services and it was -- it
:35:53. > :35:55.will report in due course. When political activists mislead and
:35:56. > :35:58.misinform my constituents about the future of our Princess Royal
:35:59. > :36:02.hospital, does my right honourable friend agree that the CCG could
:36:03. > :36:08.communicate directly and clearly with residents so they can be
:36:09. > :36:14.reassured that our A and our women and Children's Services are safe?
:36:15. > :36:17.Yes, I do. I think CCGs should communicate directly with patients
:36:18. > :36:23.and should do it clinically led. As I said, there are very clear
:36:24. > :36:27.guidelines set out that they must follow in order to do that. There
:36:28. > :36:30.are five tests that must be met before any reconfigurations are
:36:31. > :36:37.brought forward and that should be the same in our area is in anywhere
:36:38. > :36:44.else. Our community Hospital is a treasured asset and is try to find
:36:45. > :36:47.savings of ?176 million. The local commissioning group is launching a
:36:48. > :36:51.consultation into its future imminently. May I seek reassurance
:36:52. > :36:54.that the hospital will not close and further that as part of this
:36:55. > :37:01.consultation, their voices will be not just heard but also acted upon?
:37:02. > :37:06.Clinical commissioning groups have a statutory responsibility to consult
:37:07. > :37:09.the public and MPs have a key role and that to make sure that members
:37:10. > :37:13.of the public engage with those consultations, and I will be
:37:14. > :37:17.following her instances closely and she is more than welcome to come and
:37:18. > :37:24.see me about it. Number Ten, Mr Speaker. The UK is a world leader in
:37:25. > :37:30.tobacco control, we will publish a new tobacco control plan shortly,
:37:31. > :37:34.building on our success, that panel set out new national ambitions to
:37:35. > :37:38.further reduce smoking prevalence, particularly among disadvantaged
:37:39. > :37:43.groups. Mr Speaker, I need to declare an interest in Southwark --
:37:44. > :37:47.as Southwark County Council. Given the responsible it is of local
:37:48. > :37:52.government, can Peter Aldous House what more can be done to do with the
:37:53. > :37:54.situation where actuarial advice to local government and other public
:37:55. > :37:59.sector pension schemes is that they are not at liberty to disinvest from
:38:00. > :38:05.tobacco stocks? I will have to look into the exact point he raises, but
:38:06. > :38:09.can I first welcomed into his pace? I watch closely with his
:38:10. > :38:12.predecessor. When we published the tobacco control plan, there will be
:38:13. > :38:18.clear local tobacco plans that will be part of that, and there is no
:38:19. > :38:22.point did us in government, we need to recognise what is needed in each
:38:23. > :38:28.local area Andy he knows -- and he has specific needs in his area. Does
:38:29. > :38:34.he agree with me that it is vital that all those people that are
:38:35. > :38:39.affected by smoking-related diseases and approach the NHS are pointed to
:38:40. > :38:45.smoking cessation services, and it is vital that local authorities
:38:46. > :38:49.continue to run these services? Yes, absolutely. Local authorities have
:38:50. > :38:54.an obligation to do so. But as I said to the member for Ipswich, it
:38:55. > :38:57.is important that local plans come forward alongside the national plan
:38:58. > :39:01.because the local solutions needed in different areas and it will be
:39:02. > :39:09.the same in his borough as in my area of Hampshire. Thank you very
:39:10. > :39:14.much, Mr Speaker. Last week marked the tenth anniversary of the smoking
:39:15. > :39:18.ban across the UK. Sadly, this celebration was dampened by the fact
:39:19. > :39:25.we have yet to see the Government's new tobacco control plan. It was
:39:26. > :39:29.promised back in December 20 15. The previous two shadow Health Minister
:39:30. > :39:35.is repeatedly said we would see it shortly, but we failed to set out an
:39:36. > :39:40.updated strategy to work towards a smoke-free society. I know the
:39:41. > :39:44.Minister is new in his post and I welcome him to his post. We have
:39:45. > :39:48.worked well together in the past on the best cancer all party group. So
:39:49. > :39:53.I hope that he will, I know he has not given us a date yet, but if he
:39:54. > :39:58.can give us an indication, will it be before Christmas? I am grateful
:39:59. > :40:03.to the honourable lady. We have worked closely in the past, I am a
:40:04. > :40:07.new minister in the post, I have been through the plan but it is me
:40:08. > :40:10.who has to defend it and I want to be sure it is right and that I am
:40:11. > :40:13.happy with it as much as anybody else in government. My intention is
:40:14. > :40:20.that it be published before summer recess. Within East Sussex, that are
:40:21. > :40:24.the highest number of smoking-related deaths and I welcome
:40:25. > :40:27.the update on the tobacco control plan but how will he raise awareness
:40:28. > :40:35.and provide equal access to rural communities? Well, rural communities
:40:36. > :40:39.are as important as any other and it will be up to East Sussex County
:40:40. > :40:43.Council to come forward with a local tobacco control plan, and they know
:40:44. > :40:46.she will be taking a close interest in that, as she does with all
:40:47. > :40:52.matters relating to her constituents. Question number nine,
:40:53. > :40:55.Mr Speaker. Public Health England leads a wide ranging programme to
:40:56. > :40:58.improve children's oral health and that oral health strategy published
:40:59. > :41:01.last year showed a marked improvement across the country in
:41:02. > :41:10.proportion of children with no obvious tooth decay, which rose from
:41:11. > :41:13.six to 9% in 2008, 2/70 5% in 2015. -- 69%. NHS in England are
:41:14. > :41:17.publishing plans for a starting well programme which will target high
:41:18. > :41:23.needs errors to improve oral health of children under the age of five.
:41:24. > :41:32.Prevention in early intervention is absolutely crucial. We have five
:41:33. > :41:36.times the national average level of tooth decay. I have asked for help
:41:37. > :41:43.for this over two years and absolutely nothing has been done.
:41:44. > :41:50.Why is the dental health of children in Dewsbury so unimportant to this
:41:51. > :41:56.government? NHS England do recognise there are significant challenges
:41:57. > :42:01.with dentistry in Yorkshire. They had a pilot scheme from January that
:42:02. > :42:08.closed last week to improve access to primary care dentistry in and
:42:09. > :42:14.around Bradford. This pilot will inform wider work the NHS is
:42:15. > :42:17.considering across Yorkshire. I declare an interest which is
:42:18. > :42:21.probably fairly well-known. The answer is the Minister will be
:42:22. > :42:28.aware, early year prevention. There is a huge campaign going on that's
:42:29. > :42:32.been led by the Chief dental officer, for whom I have
:42:33. > :42:38.considerable admiration. Would he be prepared to meet me with the Chief
:42:39. > :42:44.dental officer to discuss progress. Would he look at the possibility of
:42:45. > :42:49.funding, additional funding, from the dental claw-back that happens
:42:50. > :42:56.annually? The honourable gentleman is a dentist. I believe he's the
:42:57. > :43:02.only dentist in the house, and he's practising occasionally. I would be
:43:03. > :43:16.delighted to meet my honourable and experienced friends to discuss the
:43:17. > :43:23.issues on dentistry. In 2016, NT 5% of patients -- 85% of patients
:43:24. > :43:29.across England reported satisfactory service. In Newcastle it was higher,
:43:30. > :43:36.88%. Newcastle has fantastic GPs, but many of my poorest constituents
:43:37. > :43:39.suffer from GP on availability and constantly change suppliers because
:43:40. > :43:42.of the requirement to read tender every couple of years to a market
:43:43. > :43:52.that quite frankly doesn't want them. They are poor or marginalised
:43:53. > :43:57.to a point where they cannot be made money from. How can we make sure we
:43:58. > :44:06.get quality and consistency of GP services -- they deserve. My
:44:07. > :44:11.constituencies have had to do without a GP surgery over the last
:44:12. > :44:15.two years because it was closed. Proposals are in place for a new one
:44:16. > :44:21.to be opened next summer. Will the time in set out by NHS England be
:44:22. > :44:23.met? I will ask NHS England, but if that is what they told the
:44:24. > :44:32.honourable member, then that's what will happen. We are investing a
:44:33. > :44:36.record 1.4 billion in children's mental health services. We know
:44:37. > :44:40.transition from children to adult services can cause distress. NHS
:44:41. > :44:43.England has prioritise conditions to offer financial incentives and we
:44:44. > :44:48.will look at that the forthcoming paper. There is a growing crisis in
:44:49. > :44:52.young people's mental health in Plymouth and the far south-west.
:44:53. > :44:55.Despite 75% of mental health problems starting before the age of
:44:56. > :45:01.18, only 8% of funding is allocated to young people. Will the Minister
:45:02. > :45:04.consider ring fencing young people's mental health funding? The
:45:05. > :45:12.honourable gentleman raises a very good point. We have to to balance
:45:13. > :45:19.the need to give CCGs the need to prioritise and allocate in our own
:45:20. > :45:23.way. The safeguards for physical health are more rigorous than mental
:45:24. > :45:27.health, we need to keep that under review, but we have additional
:45:28. > :45:30.targets that are being met. Can I commend the government for its work
:45:31. > :45:34.on mental health over the last few years, but when the government comes
:45:35. > :45:38.to publish its Green paper jointly with the Department for Education
:45:39. > :45:42.and Department of Health, can I urge the Minister to focus on the
:45:43. > :45:45.evidence of what works for young people and children, which is early
:45:46. > :45:51.intervention, rigorous early intervention, often with enduring
:45:52. > :45:55.psychotherapeutic interventions. Can she reassure me that they will look
:45:56. > :46:00.at the evidence of what actually works for young people? I can give
:46:01. > :46:06.my honourable friend that assurance and the CQC are undertaking thematic
:46:07. > :46:10.reviews to see what works. He's right to identify early intervention
:46:11. > :46:15.as key, but also the need to highlight transition as well. The
:46:16. > :46:20.honourable member for Norfolk North wasn't exactly standing, he was
:46:21. > :46:25.perched like a panther about to pounce. Mr Norman Lamb. Thank you
:46:26. > :46:30.for the encouragement. I have been alerted to an online posting on the
:46:31. > :46:34.social network next door yesterday, from the father of a teenager who
:46:35. > :46:42.suffered awful trauma, witnessing the horror at Grenfell Tower. He was
:46:43. > :46:46.after therapy for his daughter. Clearly there is an absolute need to
:46:47. > :46:50.ensure everyone who might be in need knows how to get it. What is the
:46:51. > :46:54.government doing to ensure that the case, and what is the government
:46:55. > :46:57.also doing to make sure there is sufficient funding locally for
:46:58. > :47:02.mental health services to provide ongoing needs that will clearly be
:47:03. > :47:05.there. I thank the honourable gentleman for his intervention and
:47:06. > :47:09.will be grateful to receive more details so we make sure that support
:47:10. > :47:14.going where it's needed. I can advise him that in the event of the
:47:15. > :47:17.very recent and too frequent disasters we have had recently, we
:47:18. > :47:23.have been relying on more intervention on the ground, and Ella
:47:24. > :47:33.worked in mental health first aid, we are prioritising those areas. NHS
:47:34. > :47:36.improvement offers tailored support to organisations that they oversee,
:47:37. > :47:44.particularly those that have gone into special measures as a result of
:47:45. > :47:46.the CQC review. And then the department has responsibility for
:47:47. > :47:52.holding NHS improvement to account. It does that threw me. North
:47:53. > :48:00.ligature and cool foundation trust are in special measures for quality
:48:01. > :48:03.and foundation reasons. The support to date has been neither timely nor
:48:04. > :48:11.effective. What will the government do about it? We are clearly
:48:12. > :48:15.disappointed that it has gone into special measures again. It's one of
:48:16. > :48:21.the small number that have emerged and then reverted. It's something we
:48:22. > :48:24.are taking a lot of interest in. NHS improvement has appointed an
:48:25. > :48:29.improvement director and also arranged for nearby trusts, is in
:48:30. > :48:34.the process of arranging for a nearby trusts to provide support. I
:48:35. > :48:41.can assure him it is receiving weekly updates into the Department
:48:42. > :48:53.stubbly topical questions. Yesterday I updated the house. Since February
:48:54. > :49:03.there has been an increase in delay on discharges,. Yesterday we set out
:49:04. > :49:11.further measures including specific reductions required in all local
:49:12. > :49:16.areas, and immediate CQC reviews and all the worst performing areas. The
:49:17. > :49:19.latest figures from the BMA show a huge rise in the number of patients
:49:20. > :49:24.with mental health conditions being sent hundreds of miles away from
:49:25. > :49:28.home for treatment. Isn't any talk of parity of esteem meaningless
:49:29. > :49:35.unless and until patients can access the support they need close to home?
:49:36. > :49:40.I agree that it's a very important issue. It's particularly important
:49:41. > :49:42.because people with mental health conditions need regular visits from
:49:43. > :49:47.friends and family to help them get over a crisis and their chances of
:49:48. > :49:52.getting discharged and being able to go home are higher when they are
:49:53. > :49:56.closer to home. She will be aware we have a commitment to eliminate all
:49:57. > :50:07.out of area placements for children by 2020 and we're making progress
:50:08. > :50:12.with adults as well. United with local people, patients and medical
:50:13. > :50:17.professionals in opposition to NHS England's badly thought out and
:50:18. > :50:25.wrong proposals to close Glenville hospitals heart unit. Will he ensure
:50:26. > :50:33.that the eventual decision reflects the responses they received to the
:50:34. > :50:38.consultation? My honourable friend with other Leicestershire MPs have
:50:39. > :50:40.made their views very clear to me. I hosted a number of Leicestershire
:50:41. > :50:46.members from both sides of the house on this issue. He's also aware the
:50:47. > :50:50.public consultation on congenital heart disease services continues
:50:51. > :50:53.until the 17th of July and we will obviously take all comments made
:50:54. > :51:01.into account in to conclusions from that report. Today is the sixth
:51:02. > :51:07.anniversary of the publication of the Dilnot commission's report on
:51:08. > :51:11.the funding of social care. In those six years ministers have legislated
:51:12. > :51:19.for a cap and then abandon those measures. In their manifesto they
:51:20. > :51:24.brought forward disastrous measures on the so-called The Minch attacks.
:51:25. > :51:32.Can ministers confirm those policies have been abandoned, and when he
:51:33. > :51:36.expects to have new proposals for reform? I have great respect for the
:51:37. > :51:38.honourable lady who campaigns consistently on this issue. I don't
:51:39. > :51:44.think that's a fair reflection on what has happened. In the last year
:51:45. > :51:48.of the last Labour government, 45,000 people had to sell their
:51:49. > :51:51.homes to pay for care costs. Under this government we have made it the
:51:52. > :51:55.law that nobody has to sell their home. There is more work to do but
:51:56. > :52:04.we have made important progress and will continue to do so. Nothing is
:52:05. > :52:08.more important than people being able to access a GP when they need
:52:09. > :52:14.one. With that in mind will the Minister join me in welcoming the
:52:15. > :52:18.move taken by South Tees CCG so there are 19,000 more appointments
:52:19. > :52:21.for people in Middlesbrough, Redcar and Cleveland by making sure there
:52:22. > :52:27.are appointments available on evenings, weekends and bank holidays
:52:28. > :52:31.and. I welcome that. The access improvements have been put in place.
:52:32. > :52:35.Patients can now benefit from accessing GP appointments at a time
:52:36. > :52:39.convenient for them seven days a week, exactly as should be. Will the
:52:40. > :52:43.Scottish Government is now committing to a soft opt out system
:52:44. > :52:47.for organ donation, a system implemented in Wales in 2015, isn't
:52:48. > :52:51.it time the UK Government followed the Wales and Scottish Government 's
:52:52. > :52:55.lead and introduce a similar system south of the border? I think there
:52:56. > :53:01.is a lot of merit in the opt out systems that have been developed for
:53:02. > :53:03.some time in Wales and is now happening in Scotland. We are
:53:04. > :53:08.looking closely at the evidence but we do have a lot of sympathy. If it
:53:09. > :53:12.leads to an increasing organ donations, it's something we would
:53:13. > :53:16.want to pursue. One-year cancer survival rates are now at a record
:53:17. > :53:21.high of 70%. Does the Minister agree with me that we should and can go
:53:22. > :53:26.further by improving early diagnosis and screening? Yes, progress is
:53:27. > :53:32.really encouraging and I'm sure members across the house will be
:53:33. > :53:37.encouraged to seek the progress report today from the Chief Medical
:53:38. > :53:41.Officer. The age of position is here. The NHS has always been at the
:53:42. > :53:46.forefront of new technology. So it must be with this. Will a minister
:53:47. > :53:49.be willing to meet with the all-party Parliamentary group on
:53:50. > :53:53.blood donation after it reconvenes next week. Can it provide an update
:53:54. > :53:58.on the safety of blood tissues and organs to lift or appease the
:53:59. > :54:03.referral period for gay men who want to give blood. I would be happy to
:54:04. > :54:06.agree to such a meeting. I know it's an issue that has support on all
:54:07. > :54:12.sides of the house and I would be happy to have that meeting. Last
:54:13. > :54:15.week I met with doctors and nurses is an excellent small hospital
:54:16. > :54:19.serving a rural publishing spread over 1000 square miles. Will my
:54:20. > :54:29.right honourable friend urged the South Tees trust to do everything it
:54:30. > :54:32.can to ensure continued provision of services at this vital local
:54:33. > :54:38.hospital? I'm aware the honourable gentleman has taken a strong
:54:39. > :54:41.interest in the number of consultants and anaesthetists
:54:42. > :54:46.available at the hospital. I would be happy to meet him with his
:54:47. > :54:49.concerns in person. At the height of the recent election campaign NHS
:54:50. > :54:55.England took forward plans to effectively merge six South London
:54:56. > :55:01.CCG 's including Greenwich under one senior chief officer. Wouldn't this
:55:02. > :55:04.be a retrograde step at a time when primary care has been devolved
:55:05. > :55:09.downwards and all the emphasis is his on integration of the local
:55:10. > :55:18.borough level? I think the answer is it varies from area to area. The
:55:19. > :55:29.CCGs grew up organically following the 2012 act. There are areas where
:55:30. > :55:35.they can in addition to the welcome focus on mental health first aid, we
:55:36. > :55:37.can have equal focus on mental health keep fit, so we can all keep
:55:38. > :55:49.a mental health in good condition? I think every child should leave
:55:50. > :55:57.school is knowledgeable about how to main mentally resilient as they do
:55:58. > :56:02.as to how to be physically healthy. A recent assessment, what recent
:56:03. > :56:10.assessment has he make of the financial sustainability of
:56:11. > :56:16.commentary and rugby CCG? I think our view is that like all CCGs, it
:56:17. > :56:20.is under a great deal of pressure, but given increases in funding we
:56:21. > :56:27.have seen recently, it should be entirely possible for it to be
:56:28. > :56:31.sustainable. Could I return to the issues facing the Northern
:56:32. > :56:36.Lincolnshire and cool trust? It is clearly of concern to my
:56:37. > :56:39.constituents that both Grimsby and Scunthorpe hospitals are in Special
:56:40. > :56:43.Measures for the second time in as many years. Will he meet with me and
:56:44. > :56:50.neighbouring MPs to discuss the situation? I am more than happy to
:56:51. > :56:53.meet my honourable friend but he should be confident that we have put
:56:54. > :56:56.a substantial support package in place, including a budding
:56:57. > :57:03.relationship with another trust and special teams from NHS Improvement
:57:04. > :57:07.to turn things around. Well the Secretary of State say what action
:57:08. > :57:14.he intends to take to address the link between suicide and socio-
:57:15. > :57:17.economic depression, highlighted in the report from the Samaritans, as
:57:18. > :57:25.he seeks to reduce suicide by 10% by 2020? We will look very carefully at
:57:26. > :57:28.what the Samaritans report say and we always do look very carefully at
:57:29. > :57:32.what they say but I think this is an area where the signs are that our
:57:33. > :57:34.policies are having an impact and we are seeing significant in reduction
:57:35. > :57:44.in suicide rates, but it is still the biggest call Villard cause of
:57:45. > :57:48.death in men under 50. Funding and international Health Service open to
:57:49. > :57:52.the world is another thing. Does he have any other indication whether
:57:53. > :58:00.the advance charging of nonemergency treatment for overseas patients is
:58:01. > :58:05.putting more money into our NHS? He has been a great campaigner to
:58:06. > :58:09.ensure that those who come to visit this country should contribute for
:58:10. > :58:13.health care received here if they are not resident. We have put in
:58:14. > :58:18.place a number of measures to increase the appropriate charging
:58:19. > :58:25.structures. We will increase the funding received by the NHS from ?89
:58:26. > :58:28.million to ?289 million and we will be getting the results of similar
:58:29. > :58:35.action which we would expect to see further increase shortly. -- we
:58:36. > :58:38.increased the funding. NHS property services have just signed a new ?1
:58:39. > :58:43.million lease on a Central London location. Could I suggest other
:58:44. > :58:46.properties are available? Would you like me to enquire into my own
:58:47. > :58:52.constituency where NHS property services increased mental threefold?
:58:53. > :58:56.Better value to the taxpayer is available. I am happy to look into
:58:57. > :59:01.those issues if she sends me the details. I know the Secretary of
:59:02. > :59:04.State and Minister of State share my passion for ensuring we have a
:59:05. > :59:08.bereavement Sweet attached to every maternity unit in the country.
:59:09. > :59:15.Pretty currently set at what steps he can take to make this reality?
:59:16. > :59:20.Once again, I congratulate my honourable friend for the dedicated
:59:21. > :59:22.work he has made in this area. The Government does understand the
:59:23. > :59:30.importance for bereaved parents to have a dedicated base to be, where
:59:31. > :59:34.bereaved parents cannot hear other babies crying. We have funded such
:59:35. > :59:43.spaces in nearly 40 hospitals and continue to work to see what more we
:59:44. > :59:47.can do to improve their position. The honourable member has parabola
:59:48. > :59:50.to come on side of the chamber to another! But she has here and I
:59:51. > :00:01.suppose we should hear her. Did she have a question on the paper? Your
:00:02. > :00:12.opportunity is now, get in there! Thank you, Mr Speaker.
:00:13. > :00:20.Mr Speaker during the election, a lady in my constituency told me that
:00:21. > :00:25.she had waited nearly four hours for an ambulance to come to her home to
:00:26. > :00:31.pick off the floor. I was wanting to ask the Secretary of State if you
:00:32. > :00:34.have the confidence in the handle and sewers, both in London and
:00:35. > :00:38.elsewhere, we have seen targets consistently missed, and whether he
:00:39. > :00:42.would now look at extra resources for the Ambulance Service across the
:00:43. > :00:51.country so urgently needed by all of our constituents? If I may say, that
:00:52. > :00:56.was a brilliant recovery! And she is absolutely right to focus our
:00:57. > :01:01.attention on the performance of ambulance services. They are under
:01:02. > :01:06.pressure, they are heading around 71% for the category A calls and the
:01:07. > :01:09.target is to hit 75%. But there are some bigger issues with the way
:01:10. > :01:14.those targets work, which we are looking at, and in the days of her
:01:15. > :01:20.Ambulance Service it has just had a CQC inspection. As a result of the
:01:21. > :01:24.capped expenditure process, the wider Devon STP is being asked to
:01:25. > :01:28.make ?78 million of savings at short notice within the next nine months.
:01:29. > :01:32.Does the Secretary of State share my concern about this and the impact on
:01:33. > :01:36.patients, the short time frame and also the undermining of already
:01:37. > :01:43.agreed savings by the STB? Will he meet with me to discuss this and the
:01:44. > :01:47.wider CEP? Are more than happy to meet with her. I think the principle
:01:48. > :01:50.behind the capped expenditure process is that we should have
:01:51. > :01:54.fairness between patients in different parts of the country and
:01:55. > :01:58.we should not see patients in one part disadvantage because in the
:01:59. > :02:01.neighbouring area the NHS has overspent. But the way we implement
:02:02. > :02:08.it must be sensitive and fair and many to make sure we get that right.
:02:09. > :02:14.Thank you, Mr Speaker. What advice would the Secretary of State give my
:02:15. > :02:20.constituents who received urgent care from Virgin care, who are told
:02:21. > :02:25.that wounds should only be dressed once and they should purchase
:02:26. > :02:30.further dressings from the local chemist, free at the point of
:02:31. > :02:35.delivery? What I would suggest is that she gets in touch with the
:02:36. > :02:39.details, but I would say that where the care is not satisfactory,
:02:40. > :02:42.whether it is delivered by both the public sector or the independent
:02:43. > :02:46.sector, that is why we have an independent inspection regime to
:02:47. > :02:51.root out those problems. I am delighted to hear the Minister
:02:52. > :02:58.answer the member from Boston with a positive move forward. On a recent
:02:59. > :03:01.visitor Nottingham University I saw similar techniques applied to
:03:02. > :03:06.Alzheimer's Research UK will he back that as well as cancer diagnosis and
:03:07. > :03:11.treatment? The chief medical officer has reported today and it is fear
:03:12. > :03:14.that this is an exciting new innovation in medicine. Wibble
:03:15. > :03:19.tackle cancer first but there is real potential for rare diseases and
:03:20. > :03:24.every other that she mentions. Low-mac order, we must now move on.
:03:25. > :03:25.Urgent question, Angela