Health Questions House of Commons


Health Questions

Live coverage of questions in the House of Commons to health secretary Jeremy Hunt and his ministerial team.


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Transcript


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Hello, welcome to BBC Parliament's

live coverage of the House of

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Commons. In an hour we will have an

emergency debate called by Labour MP

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Dame Margaret Hodge on tax

avoidance. This follows the release

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of the so-called Paradise Papers, a

Ligue two of financial documents

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which have shown the offshore

financial dealings of

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multinationals, celebrities and

public figures. The main business of

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the day will be the first day of the

committee stage of the European

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Union Withdrawal Bill. Brexit

Secretary David Davis announced

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yesterday Parliament will have a

vote on the final document. First,

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questions to the Health Secretary,

Jeremy Hunt, and his team of

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ministers.

Minister of state, Mr Philip Dunne.

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Local NHS organisations are

responsible for deciding the most

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appropriate structures needed to

deliver to their patients.

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Commissioners and regulators are

responsible to ensure that NHS

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providers act in the interest of

patients and taxpayers. A theme in

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review undertaken by Lord Carter

sought to drive efficiency through

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sharing administrative functions

across NHS bodies in an area. A

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number of trusts are creating the

right structures to do so. NHS

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improvement is aware of 39

subsidiaries.

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Does the Minister share my concern

that NHS trusts in Yorkshire are now

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lining up to follow the example of

Airedale Hospital trust, which

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recently, behind closed doors as

part of a VAT scam, said up

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subsidiary company to run many of

its activities, which will not only

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cost the Treasury but also mean that

new staff such as hospital porters

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will no longer be unable -- NHS

terms and conditions?

I can reassure

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the honourable gentleman that we

have no interest in allowing NHS

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trusts to avoid their tax

responsibilities, and guidance was

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sent to all trusts in September to

ensure that any to be transfers of

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staff would continue to be subject

to NHS pension rules. It should not

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be done for tax avoidance purposes.

What role does the Minister Sever

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the private and voluntary sector in

the provision of services and

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delivery in the future?

There have

been a continuing involvement of

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private provision of health services

since the origins of the NHS when GP

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partnerships came in to provide as

business -- Private businesses,

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their services. The introduction of

competitive tendering to NHS

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contract was introduced by the Last

Leg government, and the rate of

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private provision under that

government grew more rapidly than

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under this comment. -- the last

Labour government.

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If the NHS providers said up

wholly-owned subsidiary, would the

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minister expects to see all of those

papers in the public domain?

As I

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said in answer to the honourable

gentleman, the trust which would

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consolidate any subsidiaries in its

accounts would publish the accounts

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of subsidiaries as part of their

consolidated accounts each year.

Mr

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Speaker, on Sunday the Secretary of

State said good public services or

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part of the capitalist economy, yet

trusts are so strapped for cash they

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are providing... Several parts of

the NHS are subsidising these

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trusts. There are also members of

staff who find they no longer work

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for the NHS. This is another step

towards privatisation. What

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protections are in place to prevent

any these companies from being sold

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off to the highest bidder in the

future?

I'm afraid the honourable

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gentleman, for whom I have

considerable respect, is trying once

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again the tired old weaponising on

the NHS by alleging privatisation,

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seeing privatisation ferries were

there aren't any. This is about

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responding to Lord Carter... I may

remind him this is about responding

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to the review into efficiency, which

I know he supports, and finding the

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right structures to allow, for

example, back offices of different

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NHS bodies in an area to be

combined. That requires a scripture.

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And a number of trusts are providing

those services to each other through

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subsidiaries.

The NHS needs more doctors, which is

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why last year we announced one of

the biggest ever increases in

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medical school places, 25% increase,

500 additional students will start

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next year and a further thousand the

year after.

I'm pleased to hear the

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department is working on addressing

these issues. Can we also look at

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other difficulties specifically

facing rural areas? Local patient

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transport is one of these. With

rural boss Max links thin on the

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ground and struggling, will adequate

provision be made to ensure patients

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will always access services they

need?

He is right to raise the

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question. I visited Thornbury on

Friday and was discussing some of

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these issues. The NHS has an

obligation to make sure that people

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can access it services and indeed in

certain circumstances people are

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entitled to funding to help them do

that. I thank him for raising the

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issue and I know he will continue to

fight hard on that.

All four

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witnesses who gave evidence to the

health committee enquiry last week

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described the current situation as

unprecedented. Janet Davies, the

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head of the royal corals -- the

Royal College of Nursing, said of

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Brexit happens it would be

devastating. Does he accepted there

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is no deal next month on the future

of EU nationals, the current stream

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of workers in the NHS will become a

flood?

With respect, I don't think

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it helps to reassure the brilliant

NHS professionals from the EU

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working in the system when he asks

question like that. The reality is

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they are staying in the NHS. And at

every opportunity I make sure that

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they feel welcome, I try to stress

how important they are, how the NHS

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would fall over without them, and

the government continues to make

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every effort possible to secure a

deal for their future, which we are

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confident we will achieve.

A&E is important to my constituency

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and those of my neighbour. It is

also very important to me, having

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saved my husband's life on two

occasions. Last August, it was close

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overnight because there weren't

enough doctors to safely staff it.

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There are enough doctors to safely

staff it. Unfortunately, NHS

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improvement has interfered to stop

the reopening by at least one month.

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Should Grantham Hospital be reopened

in December?

I am completely clear,

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Leo said to her, I think in this

House, but I certainly said to her

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colleague, who I'm delighted to see

in his place after an incredibly

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brave battle against cancer, that

this was a temporary closure based

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on difficulties in recruiting

doctors. I will take that issue and

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look at it carefully.

Last winter,

we saw patients languishing on

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trolleys and A&E first 12 hours. We

had the Red Cross called in. We had

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people leaving A&E before their

treatment. Does the Secretary of

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State accept this is absolutely

unacceptable this winter, and what

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steps is he taking Miss Winter to

ensure this does not happen?

With

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respect, we didn't have the Red

Cross called in, we contract with

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the Red Cross throughout the year,

as she well knows as a senior

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doctor. What happened last year was

not acceptable. We have done a huge

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number of things. Perhaps the most

important thing is putting Annex £1

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billion into the social care budget

for this year and a further billion

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for next year. That is where

particular pressures war. We have

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also helped improve A&E facilities.

A shortage of nurses has led to the

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closure of the inpatient ward at

Shepton Mallet community Hospital

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this winter. Can the Secretary of

State say something about what the

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government has done to increase the

number of nurses Imrul areas, and

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also encourage the Somerset

political commissioning group to

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recommit itself to the future of

Shepton Mallet community hospital?

I

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congratulate him for the close

interest he shows in his local

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community hospital, because this

matters so much, not just to his

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constituency, but to the NHS,

because this is where we discharged

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a lot of people from busy district

General hospitals. He is right,

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there has been a shortage of

nursing, and that is why we have

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decided to increase the number of

nurse training places by 25%, the

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biggest increase in the history of

the NHS.

Would the Secretary of

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State consider bringing in a bursary

scheme by which young doctors would

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have their student debt wiped after

five years in areas which have a

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shortage of doctors?

Well, we have

introduced something similar, so

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where there are areas that I found

it difficult to recruit GP trainees

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for three years or more, we have

introduced a £20,000 salary

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supplement to attract people. It has

been very successful. We have

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expanded it to 200 places this year.

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They have undertaken a consultation

to close the surgery on my

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constituency against the wishes of

the local committee. Does my right

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honourable friend agree that CCGs

have responsibilities to support

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rural practices and should do all

they can to recruit GPs into rural

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areas?

I do agree with her, and I

also know that in areas like

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Wealden, despite the fact they are

useful areas to live, it can be

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difficult to recruit people,

particularly to become new partners

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in GP practices. And this is an area

we are concerned about. Nationally,

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we have a plan to recruit 5000 more

doctors working in general practice

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by 2020, 2021. But we need to make

sure they go to rural areas like

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hers.

The Secretary of State will no there

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are huge vacancies across the NHS,

particularly in nursing, partly

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driven by pay restraint. He has said

the pay cap will be scrapped. Does

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he agree with Simon Stevens, who

said it would be an goal not to

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fully fund the scrapping of that pay

cap next week in the budget and

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expected to be paid for productivity

gains?

I have been very clear. The

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government is willing to be flexible

in terms of funding additional pay

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beyond the 1% for nurses. But we do

want some important reforms to the

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contracts they operate under. And if

those negotiations go well, and at

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the moment we have been having very

constructive discussions with the

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RCN, I'm hopeful we can get a deal

will

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Can I ask about Simon Stevens

comments last week? He said waiting

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list would rise to 5 million if this

continues, the cancer list would

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deteriorate, the mental health

pledge will not be met, the 18 weeks

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target will be permanently abandoned

and is it not the case in the budget

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next week, if the Chancellor does

not allocate at least a nectar £6

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billion per year for the NHS, he

will have failed in his

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responsibility as secretary of

state? -- extra £6 billion.

What we

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all noticed is when he came up with

his plan in 2014, Labour did not

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back it. In the 2015 election they

did not agree to fund it, to the

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June £5 billion more we were

prepared to put in and his refused.

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He is quoting Simon Stevens and when

the British economy sneezes, the NHS

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catches a cold and it would be far

worse than that for the NHS if we

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had Labour's run on the pound. This

government has changed policy so

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that all NHS patients will be able

to book routine GP appointments in

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the evenings and weekends. We think

that is very important for NHS

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patients. But also to relieve

pressure on accident and emergency

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departments.

In September Jubilee

surgery, starving to medical

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practice and Highlands practice

launched a same day access scheme

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based at Fareham community Hospital

which welcomed the Secretary of

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State on a visit last year.

Clinician led and supported by the

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task force. Will he join me in

congratulating the GPs, including

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Doctor Tom Bertram, leading this

scheme and the CCG and explain how

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patients will gain access to a GP in

Fareham?

I was honoured to meet

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them. I think Richard and his team

have done a fantastic job in

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transforming services in a way

reducing pressure on local hospitals

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and also really improving services

for local people. There was a real

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buzz and I noticed in neighbouring

Gosport they have made changes

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improving patient satisfaction to

90%, with 60% of issues dealt with

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on the same day. Really exciting

things happening.

Pointon has fewer

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queue -- full time GPs than 2010

despite a growth in population and

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many GPs have quit the service

because of the pressure on them.

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What will he do not only to attract

more people into the GP service, but

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to keep those already there?

Very

important questions. I had an

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excellent visit to Warrington

Hospital towards the end of the

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summer and there are fantastic bits

of work I have seen here,

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particularly on sepsis prevention.

The issues are firstly about getting

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more medical school graduates to go

into general practice. This year we

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think we will get 3019 medical

school graduates to go into general

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practice, a record, it has never

been that high. It is also about

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retention and looking at some of the

things frustrating GPs, including

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the cost of indemnity, that

insurance policy. We have announced

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we will move to a national scheme to

help control those costs.

One

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village medical practice in my

constituency in Slade Byrne was

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threatened some years ago and was

fortunately saved. It does

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tremendous service for the local

community. Without it elderly

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patients would tap to travel more

than 40 minutes to Clitheroe and is

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no capacity. What will he do to make

sure places like Slade Byrne have a

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future?

It is essential in rural

constituencies like his own we

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continue to have active GP

practices. I noticed those practices

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sometimes give the best care in the

whole of the NHS because they know

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the people, their families and is

continuity of care and they are very

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broad for the local community. I

congratulate him on what he did to

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say that practice.

Is it right

constituency in Stroud had to wait

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weeks to get an ordinary appointment

with their GP? Given the

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sustainability and transformation

plans are now saying they will be an

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acute sorted job GPs, what does he

intend to do about that?

-- shortage

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of GPs. Nobody should have to wait

weeks for an appointment in Stroud

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or anywhere else. We have a lack of

capacity in general practice, which

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is why we decided to embark on a

plan for 5000 more doctors working

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in general practice. One of the

biggest ever increases. I am afraid

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it will take time to feed through

the system. But we are comfortable

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we will deliver it.

Number four, Mr

Speaker.

Every week we have four

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claims against the NHS for a brain

injured baby. There is still far too

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much avoidable harm hand -- when it

comes to maternity services which is

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why I launched an ambition to halve

the neonatal injury, and

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stillbirths.

The Secretary of State

rightly focuses on the importance of

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reducing infant mortality. With the

police investigating the unusually

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high number of baby deaths in

Chester Hospital, can he update my

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constituents with the progress of

the investigation and the measures

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taken to make sure safety at the

Countess of Chester, which serves

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the northern part of my

constituency?

First of all I thank

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her for her campaign which I think

is something that has engendered

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huge respect on all sides of the

House. With respect to that

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particular investigation she will

understand I cannot comment on a

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police investigation. Nonetheless,

immediately after the issues were

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surfaced, safety measures were taken

so the hospital does not now provide

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care for babies born before 32 weeks

and they are implementing 24

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recommendations from the Royal

College of paediatrics and

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childcare.

The shortfall in midwives

and the financial crisis in the NHS

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threatens the safety, quality and

sustainability of midwifery

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services. The words of the Royal

College of Midwives. How will he

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with store -- restore the confidence

in the RCM and professional bodies?

0:19:180:19:27

He is right we need more midwives.

We have 6000 in training and 2000

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more than we had in 2010. It is also

important to recognise the progress

0:19:320:19:39

they made. Stillbirth rates are down

14% over the first, between 2010 and

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2015. Neonatal death down 10%. There

is important progress happening.

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Will my honourable friend join with

me in congratulating my constituents

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support group and the Royal College

of obstetricians and gynaecologists

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on the update to the green top

clinical guidelines? I'm sure he

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will agree they are a significant

step forward in preventing a wicked

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and wholly unnecessary neonatal

infection will stop I am very happy

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to offer my congratulations.

--. I

am very happy to. We have done very

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well on this but we do have other

infections like group B macro which

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are higher than they need to be and

I am in fact speaking on a

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conference this afternoon and I am

happy to pass on my congratulations.

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Only 57 set of maternity units in

England have accreditation compared

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to 100% in Scotland and Northern

Ireland and 79% in Wales. What plans

0:20:500:20:55

does he had to increase

accreditation for all hospital

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units?

Despite the rivalry which

sometimes happens between our

0:20:580:21:03

nations I have a lot of respect for

the patient safety initiatives in

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Scotland and we will bad. We have

what we think is the most ambitious

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plan to improve maternity safety

anywhere. -- and we will look at

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that. It is one area where the

countries should work together.

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Number five, Mr Speaker.

Very last

one from me, Mr Speaker. On mental

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health, as you know, we have one of

the most ambitious plans to expand

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mental health provision in Europe.

That means we need to recruit for an

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extra 21,000 posts in the next three

years and plans are in place to do

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that.

I thank the Secretary of State

for his encouraging answer. But can

0:21:450:21:52

I ask what that means specifically

for mental health provision and

0:21:520:21:54

mental health funding in the London

Borough of Croydon?

He is right to

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challenge me on that. Because we are

asking all CCGs to increase funding

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in real terms going into mental

health year in and year out. 85% of

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CCGs are doing that and last year we

had an extra half £1 billion

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reaching the front line for mental

health. Regrettably Croydon is not

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among the 85%. Having listened to

his question I will take it away and

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find out what happened.

How does the

Secretary of State expect to achieve

0:22:280:22:34

these plans to increase the mental

health workforce when only last week

0:22:340:22:38

the head of NHS England Simon

Stevens said, quite, on the current

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outlook, it will be increasingly

hard to expand mental health

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services? -- and I quote.

It is hard

because of the financial pressure on

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the NHS to expand mental health

services in the last seven years but

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we have succeeded. We have 4300 more

people working in mental health

0:22:580:23:03

trust. 1.4 billion more being spent

on mental health than three years

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ago. We have a plan, it is a good

one and we will make sure it does

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happen.

Thank you, Mr Speaker. I am

sure he would welcome the fact

0:23:110:23:16

cancer survival rates are at a

record high. Can he explain how the

0:23:160:23:21

Government will fund the latest

technology so we can continue to

0:23:210:23:24

stay ahead of this terrible disease?

I am grateful for the question from

0:23:240:23:34

my friend from Hitchin and

Harpenden. Compared to 2010, 150

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more people are starting cancer

treatment every single day. That is

0:23:400:23:44

why there are 7000 people alive

today who would not have been if we

0:23:440:23:48

have the survival rates of five

years ago. But we are still behind

0:23:480:23:52

the Western European average. We

want to do something about this. A

0:23:520:23:57

big investment in capital equipment

is something we are prioritising

0:23:570:23:59

therefore.

Constituents in York have

experienced sexual trauma without a

0:23:590:24:05

clinical pathway in which to have

their psychological support address.

0:24:050:24:10

Therefore will be Secretary of State

take action in making sure we have a

0:24:100:24:14

national framework to support

particularly women as well has star

0:24:140:24:18

to provide that service?

These are

issues that have focused people's

0:24:180:24:26

minds at the moment. I will take

that away and come back with some

0:24:260:24:30

thoughts when I have looked into it

carefully.

Thank you, Mr Speaker.

0:24:300:24:36

Further to the response to my

honourable friend for Liverpool with

0:24:360:24:42

a tree I feel the Secretary of State

has not been clear with the House.

0:24:420:24:46

Will we get more money in the budget

Simon Stevens has asked for or not?

0:24:460:24:53

I'm afraid she will have to wait

until the Chancellor delivers his

0:24:530:24:56

budget. There are large financial

pressures on the NHS. What I would

0:24:560:25:03

say is if you look at the record of

this government, we inherited a

0:25:030:25:08

financial recession, but unlike her

party, we reviewed to cut spending

0:25:080:25:16

on the NHS. Now we are increasing

it.

Number six, Mr Speaker.

0:25:160:25:21

Me now on, Mr Speaker. Improving

Claire -- care for people with lung

0:25:260:25:30

disease is crucial and we want

continued action to increment the

0:25:300:25:36

existing plans, including the NHS

have come framework, detailing

0:25:360:25:39

extra-plural Sierras and including

reducing respiratory deaths as a key

0:25:390:25:44

indicator. That includes implement

in polity standards on fibrosis,

0:25:440:25:51

asthma and chronic disease and a

pilot to improve care of

0:25:510:25:54

breathlessness.

I think Rob Lee more

needs to be done. Last month I

0:25:540:26:00

launched the foundation report into

pulmonary fibrosis. -- probably more

0:26:000:26:05

needs to be done. It is still

commonplace for people with IPF. As

0:26:050:26:12

it is for people with other

conditions. Will he meet with myself

0:26:120:26:16

and the British Lung foundation, who

will lead a task force for long

0:26:160:26:20

health and establish what more can

be done to address the issue?

I

0:26:200:26:24

thank her for that. He speaks with

passion about this. I know she has

0:26:240:26:30

tragic special -- she speaks with

passion about this and I know she

0:26:300:26:34

has tragic personal experience. One

of the priority areas as I said is

0:26:340:26:40

set out in the outcome framework,

reducing early death from

0:26:400:26:44

respiratory disease such as IPF. I

understand the cases have risen in

0:26:440:26:49

recent years and it is rightly a

cause for concern. She is right to

0:26:490:26:52

raise it and I look forward to

meeting with her.

I have long

0:26:520:26:56

supported COPD related groups in my

constituency in Northern Ireland.

0:26:560:27:01

What help is he offering voluntary

groups and families? Especially for

0:27:010:27:07

the tens of thousands of young

children diagnosed as asthmatic in

0:27:070:27:11

terms of offering help and

assistance with their condition?

0:27:110:27:17

stop respiratory illness affects one

in five people in the UK. It is

0:27:170:27:23

responsible for a million hospital

admissions annually. It is in our

0:27:230:27:27

interest to implement the outcomes

framework. I look forward to further

0:27:270:27:32

discussions with him and very happy

to meet with him if he wishes.

Does

0:27:320:27:39

the Minister, who I know cares

deeply, share my concern that when

0:27:390:27:42

lung capacity is damaged in

childhood it can often never

0:27:420:27:46

recover? Isn't that a powerful

reason we need to make significant

0:27:460:27:50

progress on air quality issues?

Absolutely. I have just returned

0:27:500:27:56

from the G7 health ministers

meeting. One of the subject under

0:27:560:27:59

discussion was environmental factors

and climate change and its impact on

0:27:590:28:04

public health. There were many areas

in which we have challenging

0:28:040:28:08

discussions, but the air quality and

its impact on respiratory disease

0:28:080:28:12

was not one of them.

I gather it was

in Rome, is that correct?

Milan.

0:28:120:28:22

Sharon Hodgson.

Under this

government we have seen lung disease

0:28:220:28:28

admissions to A&E double, rise at

double the rate of general

0:28:280:28:35

admissions. This is more concerning

when the bulk of admissions happen

0:28:350:28:39

over the winter months, when A&E

department are under significant

0:28:390:28:43

pressure. Will the Minister

committed today, now, to introduce a

0:28:430:28:46

long disease strategy, and ensure

that we can reverse -- reverse these

0:28:460:28:52

worrying trends and the pressure on

people's lives and the NHS?

Indeed

0:28:520:29:00

Milan but we don't mention football

any more. I hear it is a touchy

0:29:000:29:04

subject. Very topical. There is no

new plan for any National strategy

0:29:040:29:11

on this but we work closely with

charities like the British Lung

0:29:110:29:15

foundation, and we have to remain

committed to implementing the

0:29:150:29:20

outcomes framework. We are better

prepared for a winter than we have

0:29:200:29:23

been before. She's right to raise

this.

Question seven.

With

0:29:230:29:33

permission I will take question

seven and 20 together. We are fully

0:29:330:29:37

engaged with the highest level of

government work on Brexit. The

0:29:370:29:43

Secretary of State is a member of

the Cabinet committee on Brexit and

0:29:430:29:46

is engaged on all areas where Brexit

may impact health and social care.

0:29:460:29:51

We are actively considering

implications on the workforce,

0:29:510:29:56

medicine, equipment regulation, life

sciences, public health, research

0:29:560:30:01

and data.

I thank the Minister for

his reply. Is he aware of the latest

0:30:010:30:08

figures released this month from the

nursery and midwifery Council which

0:30:080:30:13

confronts a clear trend? The number

of nurses and midwives leaving the

0:30:130:30:19

register alongside a drop of those

coming to work from Europe. Does he

0:30:190:30:24

agree these dramatic figures should

set alarm bells ringing in Whitehall

0:30:240:30:28

and every UK health Department?

It

is the case that we have been

0:30:280:30:34

reliant for much of the increase in

this country, both doctors and

0:30:340:30:39

nurses, on doctors and nurses coming

from the EU. A reduction in that

0:30:390:30:45

increase is something we are

watching carefully. I gently say to

0:30:450:30:48

the honourable gentleman that the

last figures we had at the end of

0:30:480:30:55

June, there were three South -- 3000

more technicians working in the NHS

0:30:550:30:59

in England than in the gym before.

Brexit may well result in the loss

0:30:590:31:04

of both rights for people with

disabilities. Wembley release the

0:31:040:31:12

funds into the health and social

care sector? -- when will the

0:31:120:31:20

Minister release?

The honourable

gentleman is looking for answers

0:31:200:31:22

about the social care. My honourable

friend, the Minister for social

0:31:220:31:26

care, has made it clear they will be

a paper published in due course. I'm

0:31:260:31:30

afraid he will have to be more

patient.

0:31:300:31:36

My right honourable friend, the

Secretary of State, Eddie made a

0:31:360:31:38

welcome statement about the

contribution of EU citizens to the

0:31:380:31:41

health and social care sector. Could

the Minister kindly advise us what

0:31:410:31:46

is being done at a trust level to

support overseas workers from the EU

0:31:460:31:50

and elsewhere to ensure they feel

welcome, and that they are

0:31:500:31:54

encouraged to stay here as long as

possible?

I am very grateful to my

0:31:540:32:00

honourable friend forgiving me the

opportunity to reaffirm the

0:32:000:32:02

commitment of the NHS from the

centre right through every

0:32:020:32:06

organisation for whom EU citizens

are working, but they are welcome

0:32:060:32:10

here, my right honourable friend,

the member for Holden price

0:32:100:32:15

yesterday made it clear that we are

looking to have a simple,

0:32:150:32:20

straightforward and cheap means for

those who are here at the point of

0:32:200:32:23

departure to be able to register to

stay here. We want to encourage all

0:32:230:32:27

those working for the NHS to

continue to do so, wherever they

0:32:270:32:31

come from.

A visit to the hospital

in April to Kettering Hospital

0:32:310:32:43

confirmed that... Isn't it the case

and it has always been the case the

0:32:430:32:47

NHS has recruited from outside the

EU and will continue to do so after

0:32:470:32:50

Brexit?

My honourable friend is

quite right. There has been a

0:32:500:32:57

long-standing tradition of this

country welcoming professionals from

0:32:570:33:03

outside through various waves of

migration that go back over several

0:33:030:33:05

decades. It is important to point

out to my honourable friend that the

0:33:050:33:13

Secretary of State announced one

year ago a 25% increase in doctors

0:33:130:33:16

in training in this country, and

earlier this autumn a 25% increase

0:33:160:33:21

in nurses to be trained in this

country come so that we become less

0:33:210:33:25

reliant on overseas clinicians at a

time of some 2 million shortage

0:33:250:33:29

worldwide.

Being a member of the

European medicines agency has

0:33:290:33:35

allowed early access for UK patients

to new drugs. It also plays a

0:33:350:33:42

crucial role in quality control and

safety monitoring. So what solution

0:33:420:33:47

has the department come up with to

ensure timely access to new drugs

0:33:470:33:52

after Brexit? But also, that any

convocations are spotted early?

As I

0:33:520:33:58

indicated in my answer to the first

question earlier, finding an

0:33:580:34:03

appropriate relationship with the

DMA pulsed Brexit is one of the core

0:34:030:34:09

strands of work the Department is

doing. On Monday of next week the

0:34:090:34:14

other EU nations will vote to decide

which country will host the new EEM

0:34:140:34:19

eight. We have made clear we are

looking for mutual recognition.

With

0:34:190:34:27

the World Trade Organisation not

having updated its drug lists since

0:34:270:34:32

2010, all new drugs developed in the

last seven years could incur

0:34:320:34:36

tariffs. What contingencies have

been made to avoid shortages and

0:34:360:34:41

increase costs in the event of a no

deal Brexit?

We are looking for a

0:34:410:34:50

relationship with the EU to ensure

we have tariff free access to the

0:34:500:34:55

single market, including for drugs

and medicines, because that is such

0:34:550:34:58

a critical element of our economy

and the life sciences industry.

0:34:580:35:05

There are contingencies being put in

place in the event of no deal. She

0:35:050:35:08

will have to wait, as will the rest

of us, to see of that eventuality

0:35:080:35:14

happens. We don't want that to

occur. It is not our intent.

Adult

0:35:140:35:20

smoking prevalence is now 15.5%, the

lowest ever. In July, we published a

0:35:200:35:27

tobacco control plan for England

which sets out conditions to reduce

0:35:270:35:31

smoking still further and commits us

to a series of actions to deliver

0:35:310:35:34

those ambitions. Our end goal is a

smoke-free generation.

I thank my

0:35:340:35:41

honourable friend for that answer.

One of the most effective ways of

0:35:410:35:44

helping people to give up smoking is

the provision of smoking cessation

0:35:440:35:48

services. In Harrow, where the local

unit actually managed to help 4000

0:35:480:35:55

people attempt to give up smoking,

of which more than 50% did so, the

0:35:550:36:00

answer to that has been to close the

unit, which I think is very

0:36:000:36:05

ineffective. Will you take action to

ensure that doesn't happen across

0:36:050:36:08

the country?

He's right to raise it.

Local authorities are best placed to

0:36:080:36:14

take local spending decisions, not

ministers in Whitehall. But they

0:36:140:36:18

must be accountable for their

decisions. That is why we publish

0:36:180:36:23

information at local authority

level, so local decision-makers can

0:36:230:36:26

be held to account. We offered

expert support from Public Health

0:36:260:36:29

England. In holding Harrow to

account, I have a strong feeling he

0:36:290:36:33

will continue to do that.

I am a

reformed smoker. It was quite a

0:36:330:36:40

battle to do it. I wonder what

proposals Her Majesty's government

0:36:400:36:44

have to enlist people to help to

kick the weed. We know how to do it.

0:36:440:36:54

What an honourable gentleman he is.

What an offer! Plans in all areas

0:36:540:37:02

are two draw up local plans across

the NHS, including the public health

0:37:020:37:07

prevention agenda. I suggest he

volunteered his services and I

0:37:070:37:10

suspect they will take his hand off.

Jackie Doyle-Price.

On November the

0:37:100:37:21

3rd we published our response to the

accelerated access review. We set

0:37:210:37:24

out to give patients quicker access

to life-saving treatments. We are

0:37:240:37:31

delighted that Sir Andrew witty will

chair the group, which will

0:37:310:37:39

fast-track products each year.

The technologies used at the new

0:37:390:37:45

Natal unit are now considered

essential by my constituents

0:37:450:37:51

Invergordon. It serves 500,000

people within 90 minutes of

0:37:510:37:55

Aberdeen. What assessment has the

Minister made of the importance of

0:37:550:37:59

proximity to local communities?

I'm

pleased to hear that. It is good to

0:37:590:38:06

know we are on track to achieve our

ambition to reduce the rates of

0:38:060:38:10

stillbirth, neonatal and maternal

deaths, as well as perinatal 20% by

0:38:100:38:16

2020. Innovations like Aberdeen have

contributed to this. It is important

0:38:160:38:20

that our regional committees have

access to specialist care of the

0:38:200:38:24

kind he describes.

Is the Minister

aware that over 60% of health

0:38:240:38:35

innovation research funding goes to

the Golden Triangle, and less than

0:38:350:38:39

13% goes to the North? Given that

Manchester and the north-west has

0:38:390:38:44

got a life sciences hub and we have

got an evolution of health, isn't it

0:38:440:38:51

about time we got our fair share to

ensure we can close the gap with

0:38:510:38:54

some of those health outcomes?

I

can't disagree with the point of the

0:38:540:39:00

honourable lady makes. One of the

reasons that we have said up this

0:39:000:39:04

accelerated access review and

Patrick is to make sure we do invest

0:39:040:39:08

where innovation is taking place,

and there is no reason why

0:39:080:39:12

Manchester cannot be a part of this.

Mr Speaker... It goes back a long

0:39:120:39:23

way. Mr Speaker... One of the

innovative treatments being offered

0:39:230:39:36

in my own constituency, which

concerns me, is that of puberty

0:39:360:39:41

blockers and hormone replacement

therapy for children identifying

0:39:410:39:45

themselves as transgender. Does the

Minister agree that an improvement

0:39:450:39:49

would mean restricting these two

under 18s? --?.

At the risk of

0:39:490:39:59

prolonging the hilarity, my

honourable friend does in fact

0:39:590:40:03

raises serious point. Health is a

devolved matter in Wales. The NHS in

0:40:030:40:09

England has strict guidelines

regarding the restrictions on

0:40:090:40:13

puberty blockers and hormone

replacement therapy. They may only

0:40:130:40:15

be prescribed by a multidisciplinary

team and careful assessment of the

0:40:150:40:21

individual, and we keep a watching

eye on these matters.

Liberal

0:40:210:40:25

Democrat competition.

Jo Swinson.

Thank you, Mr Speaker. A strong UK

0:40:250:40:37

pharmaceuticals industry is

important for ensuring the NHS can

0:40:370:40:41

access innovative treatments, but

there is uncertainty over whether UK

0:40:410:40:44

qualified persons, people who

certified medical products and

0:40:440:40:48

devices as safe, would be able to

continue to do so for European

0:40:480:40:51

countries post Brexit Allsup I would

ask the Minister will when will

0:40:510:40:57

there be clarity about the future

European relationships regarding

0:40:570:41:01

medical advice approval?

I can

confirm we have actual offered

0:41:010:41:06

mutual recognition but she is right

to raise this very important

0:41:060:41:09

subject. It is central to this that

we maintain safety across the NHS

0:41:090:41:16

and access to pharmaceuticals is

part of this.

0:41:160:41:20

Ministers have had no such

discussions. The procurement of

0:41:200:41:23

local health services by means of

competitive tendering is a matter

0:41:230:41:28

for the local clinical commissioning

group. Greenwich clinical

0:41:280:41:32

commissioning group is an

independent statutory organisation

0:41:320:41:34

responsible for commissioning

services from local people. To

0:41:340:41:38

ensure the best outcomes...

That is an incredibly complacent

0:41:380:41:49

response from the Minister. This has

gone up by 14% in six months, the

0:41:490:41:53

cost of this contract allocated to a

private divider. They claimed that

0:41:530:41:59

the Greenwich scrutiny committee was

due to a 14% increase in the tariff

0:41:590:42:03

costs of health services. My local

health care trust says that is 0.6%.

0:42:030:42:08

How does he explain that increase

and why isn't the department looking

0:42:080:42:11

into these private companies that

are naming their price when they

0:42:110:42:15

have won the contract?

0:42:150:42:21

It is a factual answer and I think

it is an important one to make.

0:42:210:42:28

Actually it increases in tariff and

it would have applied any provider

0:42:280:42:31

and not just circle. I'm Sapporo --

I am sorry he does not support this.

0:42:310:42:36

I understand previous services were

delivered by a number of providers.

0:42:360:42:44

And different patient experience. I

think it is a step forward.

Question

0:42:440:42:49

11, Mr Speaker.

After the Prime

Minister announced an independent

0:42:490:42:56

enquiry into the effects of blood,

the department consulted on that

0:42:560:43:01

enquiry and the Cabinet office

updated the House on the 3rd of

0:43:010:43:04

November and said it would be a

statutory enquiry under the 2005 act

0:43:040:43:08

and the Cabinet office would be the

sponsoring department. The business

0:43:080:43:12

service authority started

administering the new blood payment

0:43:120:43:16

support scheme on the 1st of

November.

Mike Amesbury.

From April

0:43:160:43:24

next year those affected by

contaminated blood, including people

0:43:240:43:31

in my constituency, could face

considerable cuts in discretion of

0:43:310:43:35

support as the business service

authorities could not reveal this.

0:43:350:43:39

Will the Minister give a guarantee

that absolutely nobody will be left

0:43:390:43:43

worse off as part of this review?

I

can give the honourable gentleman

0:43:430:43:49

that assurance and that will form

part of the statement I gave on the

0:43:490:43:53

response to the consultation we

undertook earlier.

Discretionary

0:43:530:43:57

payments will be maintained. The

Minister will be aware the integrity

0:43:570:44:02

of blood products is underpinned by

a common European agreement on

0:44:020:44:05

standards. Can she assure the House

she has spoken to other ministers

0:44:050:44:09

across Europe to make sure whether

or not there is a deal that

0:44:090:44:13

standards will be fully maintained

subsequent to Brexit?

I can confirm

0:44:130:44:19

that is very much part of the

discussions we are having. In truth,

0:44:190:44:24

the common standards are shared

across Europe in any case and we

0:44:240:44:27

will continue.

Question number tell

world, Mr Speaker. -- number 12.

The

0:44:270:44:37

response of the expert working group

on hormone pregnancy tests will be

0:44:370:44:41

published tomorrow. There will be a

ministerial statement with a copy of

0:44:410:44:44

the report. It follows a review of

all available data by a panel with

0:44:440:44:50

expertise in science and health

care.

I will come the minister's

0:44:500:44:57

statement. But there are some

questions about the opaque nature of

0:44:570:45:00

the enquiry and many constituents of

mine have had lives blighted as have

0:45:000:45:07

many others by the hormone pregnancy

drug. Will he appeared before the

0:45:070:45:11

select committee and look at the way

that enquiry was conducted? Will he

0:45:110:45:16

consider a public enquiry so

families can get truth and justice

0:45:160:45:20

about how they had been affected by

this drug?

I thank her for that. I

0:45:200:45:28

think it would be premature to

consider issues of liability before

0:45:280:45:32

considering the strength of evidence

and seeing the report which we will

0:45:320:45:35

study carefully. The report will

conclude whether there is a casual

0:45:350:45:42

association and if it had adverse

outcomes to pregnancy and we look

0:45:420:45:46

forward to seeing its outcomes and

recommendations.

Number 13, Mr

0:45:460:45:49

Speaker.

There is no fixed timetable

for STPs to become accountable care

0:45:490:45:56

systems. Evolution into one or more

is dependent on an STP demonstrating

0:45:560:46:03

it is working in a locally

integrated health system.

0:46:030:46:07

Commissioners and providers in

partnership with local authorities

0:46:070:46:09

would need to choose, to assume

collective responsibility, for

0:46:090:46:14

resource and public health and the

criteria will be set out in the NHS

0:46:140:46:19

England next steps forward review.

Last week NHS doctors set out to

0:46:190:46:26

account for a judicial review

against plans to use secondary

0:46:260:46:28

legislation to enable private

companies to run large parts of the

0:46:280:46:35

ACOs. The county care organisations.

I think the Government understands

0:46:350:46:41

that doctors, nurses, patients and

the public would like an NHS run for

0:46:410:46:44

the public by the public, using

public funding. Ultimately will you

0:46:440:46:49

make sure we have time in this place

for members to discuss and

0:46:490:46:56

scrutinise the ACOs which are a

drastic change to our NHS?

I think

0:46:560:47:00

the best thing he can do in getting

to understand what STPs are really

0:47:000:47:06

about is to talk to the recently

appointed chair of the Norfolk and

0:47:060:47:10

Waverley STP covering his local

area. It will find the former Labour

0:47:100:47:14

Secretary of State can give him very

good advice, Patricia Hewitt.

Number

0:47:140:47:19

14, Mr Speaker.

Thank you again, Mr

Speaker. NHS England has a duty to

0:47:190:47:27

commission dental services to meet

local needs, including for the most

0:47:270:47:30

deprived groups. Nationally access

continues growing with 1.9 million

0:47:300:47:34

more patients seen between 2010 and

2016. The starting well programme,

0:47:340:47:39

I'm sure she is aware of, will help

children under five and in 13, high

0:47:390:47:44

need areas, the programme is also

working to improve access and oral

0:47:440:47:47

health.

In my constituency seven

people per day are going into

0:47:470:47:54

accident and emergency because of

toothache. The poorest among stars

0:47:540:47:58

are twice as likely to be

hospitalised for dental care. Yet

0:47:580:48:03

there is no mention of dental care

in the five-year forward planning

0:48:030:48:06

and funding has fallen by 15% since

2010. Why is the minister leaving my

0:48:060:48:13

constituents in pain and burdening

accident and emergency by neglecting

0:48:130:48:18

dental care?

I am interested to hear

the honourable lady say that.

0:48:180:48:24

According to the survey the January-

March 2017 survey, they were

0:48:240:48:29

published in July this year those

trying to get a dental appointment

0:48:290:48:33

in Newcastle and Gateshead, 97% were

successful compared to 95% England

0:48:330:48:36

average.

Topical questions, Stuart C

McDonald.

As well as congratulating

0:48:360:48:46

the Minister for Public health for

being an excellent ambassador for

0:48:460:48:49

the United Kingdom happy health

Summit in Milan, I would also like

0:48:490:48:52

to congratulate Colchester NHS

foundation trust for exiting special

0:48:520:48:59

measures. They are the 23rd trust to

do so. They were in special mazes

0:48:590:49:03

longer than any other trust and the

fact they got a good rating for

0:49:030:49:08

compassion and the effectiveness of

their care and leadership is a huge

0:49:080:49:11

tribute to the hard-working staff.

Back in July ministers said they

0:49:110:49:16

would make sure patient access to

innovative medicine was protected

0:49:160:49:20

through strong regulatory framework

and sharing data. Can he confirm the

0:49:200:49:23

UK will definitely sign up to the

clinical trial regulation system so

0:49:230:49:27

we do not have to seek

pharmaceutical companies moving

0:49:270:49:30

trials overseas?

That is absolutely

our intention. We have signalled to

0:49:300:49:37

the European Union and European

countries we want the closest

0:49:370:49:39

possible relationship after Brexit.

We have made the big and generous

0:49:390:49:43

offer and we hope it will be

accepted.

Thank you, Mr Officer

0:49:430:49:50

Dibble Speaker. In my constituency

we had the outstanding rated wording

0:49:500:49:55

hospital and practices and also the

Sussex and Surrey STP, rated in

0:49:550:50:00

category four, needs most

improvement. Part of the problem is

0:50:000:50:04

it is too big and does not follow a

natural footprint. Will he bought a

0:50:040:50:08

local call for it to be withdrawn

and make it fit for purpose and

0:50:080:50:12

sustainable? -- will he support a

local call.

STP footprints were as a

0:50:120:50:18

result of discussion with NHS

England and reflect patient flow,

0:50:180:50:24

the location of different

organisations in the health economy

0:50:240:50:26

and natural geography. We stayed at

the next steps that it was open to

0:50:260:50:31

discussion between ourselves and NHS

England about adjusting boundaries

0:50:310:50:34

where there was a collective request

by local organisations and we mean

0:50:340:50:37

that.

Thank you, Mr Speaker. Last

month there was a closure of 190

0:50:370:50:47

community pharmacies. It was clear

that this action was a result of

0:50:470:50:53

pharmacy budgets. Does the Minister

had any idea how many community

0:50:530:50:56

pharmacies are at risk of closure

because of government cuts? What

0:50:560:51:01

assessment has he made of the likely

impact of a closure on the patience

0:51:010:51:04

and wider NHS? Will he joining me in

asking the Chancellor to adequately

0:51:040:51:09

fund this vital service? -- will he

be joining me.

She will have to wait

0:51:090:51:16

for the budget as everybody else. We

monitor the market carefully in the

0:51:160:51:19

community pharmacy sector. Access to

pharmaceutical services is very good

0:51:190:51:24

in England, with 88% of people

falling within a 20 minute walk of a

0:51:240:51:28

community pharmacy. For areas with

fewer pharmacies, the access scheme

0:51:280:51:32

continues to provide more protection

and a growing number of Internet

0:51:320:51:37

pharmacies offer greater choice.

Pharmacies are a critical part of

0:51:370:51:41

the primary care infrastructure in

the country.

Thank you, Mr Speaker.

0:51:410:51:45

Months ago a hospital came out

special measures with improvements

0:51:450:51:49

to patient safety being among the

most notable highlights in the

0:51:490:51:51

report. Given the success in my

local area can my honourable friend

0:51:510:51:56

and former house of progress E is

making to boost patient safety

0:51:560:51:59

across the rest of the country?

I am

happy to do that. I had a very good

0:51:590:52:05

visit to Medway recently. Leslie

Dwyer and her team are doing a

0:52:050:52:09

fantastic job. They had real

challenge is to turn the trust

0:52:090:52:14

around but succeeded and the staff

did amazingly well. In truth we

0:52:140:52:18

still have far too high levels of

avoidable harm across the NHS. I

0:52:180:52:24

want us to be the safest in the

world and that is why the next few

0:52:240:52:28

months we will have campaigns to

improve maternity safety, deal with

0:52:280:52:30

medication error and improve the

transparency when there are

0:52:300:52:35

avoidable deaths.

Can I raise the

issue of mesh implants? It has been

0:52:350:52:43

great with me by constituents. A

report in the United States

0:52:430:52:48

indicates associated pain, headaches

and aching pains and joints, can I

0:52:480:52:51

ask if he is looking at this issue

and incident giving the announcer

0:52:510:52:54

saying it is a matter for the

devolved administration, it would be

0:52:540:52:58

instructive if I could get an answer

because it would help inform the

0:52:580:53:00

Scottish government, Aggie.

He

raises an issue which is of concern

0:53:000:53:06

to many women up and down the

country. -- thank you. Nobody could

0:53:060:53:10

not be moved by the injuries they

are experiencing. We now have 18

0:53:100:53:16

centres of specialist care which can

treat those women. The advice we

0:53:160:53:20

still receive is within narrow cases

are stressing, mesh remains the best

0:53:200:53:28

possible string that. It will be

kept under review and I know my

0:53:280:53:31

honourable friend is meeting the

all-party group to consider this in

0:53:310:53:35

greater detail.

The James Paget

Hospital at Gholston are doing great

0:53:350:53:40

work under great pressure and have

highlighted the Clinical

0:53:400:53:44

Commissioning Group have got two

different regulators. Does my

0:53:440:53:47

honourable friend agree it would be

sensible to have one body overseeing

0:53:470:53:50

both organisations, to avoid

duplication and redirect funding to

0:53:500:53:54

the front line?

He makes a very

important point. We have no plans

0:53:540:54:00

for legislative change. But we do

want closer working between NHS

0:54:000:54:06

improvement and NHS England on the

ground so people working in

0:54:060:54:11

constituencies in areas such as his

are only getting one set of

0:54:110:54:14

instructions and we are making good

progress.

I have repeatedly asked

0:54:140:54:20

and yet again I ask the Secretary of

State if he will visit my area to

0:54:200:54:24

see for himself the damaging impact

the downgrades and closure of local

0:54:240:54:29

hospital services in Dewsbury and

Huddersfield will have on my

0:54:290:54:31

constituents will stop I'm very

happy to -- --.

I'm happy to accept

0:54:310:54:40

our invitation to visit her area and

I will do. What I know I will see

0:54:400:54:45

when I go there is the right 8300

more people being treated within

0:54:450:54:49

four hours at her local hospital.

There are 42 more doctors and 56

0:54:490:54:54

more nurses than 2010.

Thank you.

Can I thank the Secretary of State

0:54:540:55:01

for the help he gave for my hospital

in my constituency? One problem is

0:55:010:55:07

Somerset pays the lowest amount of

money to keep people in homes in the

0:55:070:55:10

peninsular. That is putting more

people into the hospital. Can he

0:55:100:55:15

offer advice on how we can get round

this issue?

I am happy to do that.

0:55:150:55:20

It is very straightforward. We

listened hard when local authority

0:55:200:55:24

said they needed more support for

the social care budget and put an X

0:55:240:55:29

to £2 billion into this year's

budget. -- extra £2 billion. Expect

0:55:290:55:34

all local authorities to play their

part in reducing pressure on

0:55:340:55:37

hospitals.

If the health secretary

does visit Huddersfield and

0:55:370:55:43

Dewsbury, can I join the party? I

know he wants... I will not spoil

0:55:430:55:52

his visit but I would remind him I

would liken to meet our local Vice

0:55:520:55:58

Chancellor, at the teaching hospital

in Huddersfield, they would be

0:55:580:56:01

interested if the money was

available to start one up. Will he

0:56:010:56:05

meet my Vice Chancellor when he

comes you Dewsbury and Huddersfield?

0:56:050:56:09

I met him on June the 24th last

year. He is a splendid chap.

I would

0:56:090:56:14

be delighted to meet his Vice

Chancellor in principle but the

0:56:140:56:19

decision of where the medical

schools will be based will be

0:56:190:56:22

independent of me, because I have a

constituency interest in that issue,

0:56:220:56:26

as well.

Rural communities and towns

like new without an accident and

0:56:260:56:33

emergency desperately need a high

performing ambulance service.

0:56:330:56:36

Midlands ambulance services across

the country are generally missing

0:56:360:56:40

their targets. It is not a new

problem. It began when Labour's

0:56:400:56:45

disastrous regionalisation of Andy

Lynch and services was put in place.

0:56:450:56:48

But it needs to end an improvement

is replied. -- required. -- of

0:56:480:56:55

ambulance services was put in place.

I am aware the performance of east

0:56:550:57:01

Midlands ambulances is not what we

would like at present. The strategy

0:57:010:57:05

being adopted is to introduce the

new and villains response programme

0:57:050:57:10

and at present there is a

consultation with staff going on to

0:57:100:57:15

introduce new working models to

bring that into effect. -- the new

0:57:150:57:20

facilities response programme.

Does

he share my concern that Lloyds

0:57:200:57:26

pharmacy is announced 190 branch

closures across England because of

0:57:260:57:29

funding cuts, exacerbated by rising

drug costs and cash row problems --

0:57:290:57:37

flow problems? And why is it 30% of

pharmacies in one constituency can

0:57:370:57:44

get the access scheme but only 1.3%

in Hull can do the same?

0:57:440:57:53

It is a rural constituency. She

asked me about the Lloyds pharmacy

0:57:530:57:57

announcement. When I first heard

that news my thought was not to play

0:57:570:58:03

politics but for the staff affected.

As I said at the all-party group,

0:58:030:58:08

Lloyds have made a commercial

decision. We don't yet know which

0:58:080:58:13

pharmacies will close. We do know

that 40% of promises within a timid

0:58:130:58:19

walk -- ten minute walk of two or

others.

0:58:190:58:24

There were GPs who prescribe

homoeopathy and acupuncture and the

0:58:240:58:28

system we have is that we allow GPs

to decide whatever they think is in

0:58:280:58:32

the clinical interest of their

patients. Is that still his position

0:58:320:58:36

and is he aware of the Parliamentary

petition in favour of homoeopathy?

0:58:360:58:44

Consistency personified. It is the

responsibility of local NHS

0:58:440:58:47

organisations to make decisions on

the commissioning and funding of any

0:58:470:58:51

health care treatments for NHS

patients, including homoeopathy.

0:58:510:58:56

Alternative medicine can in

principle feature in a range of

0:58:560:58:59

services offered including those by

GPs.

What safeguards will be

0:58:590:59:06

Secretary of State put in place to

ensure that NHS trusts do not

0:59:060:59:09

finance the lifting of the pay cap

by making staff cuts, downgrading

0:59:090:59:16

roles are reducing terms and

conditions under the guise of

0:59:160:59:18

reforms?

NHS trusts are under

pressure to make very ambitious

0:59:180:59:24

efficiency savings anyway. We have

listened carefully to the case that

0:59:240:59:30

they would not be able to make

further efficiency savings to

0:59:300:59:33

finance an increase in pay beyond

the 1%.

Congratulations for noticing

0:59:330:59:39

it is actually me behind this

extremely impressive facial growth

0:59:390:59:46

for Alzheimer, which is extremely

serious Bremain's mental health.

0:59:460:59:51

Three out of four suicides... Willie

Minister commit to renew this

0:59:510:59:58

government's relentless pursuit of

parity in mental health and physical

0:59:581:00:02

health?

Yes, indeed. The moustache

is impressive. I am a big supporter

1:00:021:00:09

of the cause because I think it has

a positive mindset. It is very

1:00:091:00:13

honest. One in eight men in the UK

have experienced mental health

1:00:131:00:17

problems, three adults four suicides

are men. We welcome the which

1:00:171:00:23

focuses on prostate cancer,

testicular cancer and the

1:00:231:00:29

partnerships they build with mental

health services in the NHS and

1:00:291:00:32

across the charity sector. I wish my

honourable friend well with his

1:00:321:00:35

growth.

Wildie department urgently

review waiting times targets for

1:00:351:00:45

children to access mental health

services? Even if cams in my

1:00:451:00:53

constituency wrist -- achieves its

targets, more than 100 children need

1:00:531:00:56

to make more than nine weeks for

their first appointment.

She is

1:00:561:01:01

absolutely right. That is totally

unacceptable for anybody who is a

1:01:011:01:06

parent. It is far too long. That is

why we decided to have a Green paper

1:01:061:01:12

on children's mental health and we

hope to publish it soon.

In their

1:01:121:01:18

annual State of care report, the

Care Quality Commission have

1:01:181:01:21

highlighted there are 4000 fewer

nursing home beds in England than in

1:01:211:01:26

2015. What plans does the Secretary

of State have to address the

1:01:261:01:30

workforce and funding issues that

lie behind this? Will he meet with

1:01:301:01:34

me to discuss the situation in my

own constituency and nationally?

I

1:01:341:01:39

would like to congratulate her on

becoming chair of the liaison

1:01:391:01:42

committee. I am always happy to meet

her. That is a very important issue.

1:01:421:01:47

Our figures show the number of

nursing home beds as distinct from

1:01:471:01:51

the number of nursing homes is

broadly stable. But there is real

1:01:511:01:56

pressure, there are real issues

around market failing.

The South

1:01:561:02:03

Cumbria area is one of the few

places in England where patients

1:02:031:02:09

needing the least complex

radiotherapy must travel longer than

1:02:091:02:11

the maximum 45 minutes recommended

by the advisory group. In the

1:02:111:02:18

consultation, which will close on

the 18th of December, will you make

1:02:181:02:22

sure that access to radiotherapy

within 45 minutes is a Greek

1:02:221:02:25

criteria in allocating resources? --

a key criteria.

I'm grateful to the

1:02:251:02:33

honourable gentleman for raising

this point. I would just say to him

1:02:331:02:36

that we are absolutely aware of the

need for more radiographers and

1:02:361:02:41

stenographers are available to

support facilities right across the

1:02:411:02:43

country. We currently have some 200

radiographers in training and I

1:02:431:02:49

would like him to write to me so we

can flag up the specific point he

1:02:491:02:54

raises.

Local A&E serving my

constituents in Kent now have 24-7

1:02:541:03:04

mental health services thanks to

this government's determination to

1:03:041:03:07

improve mental health care. Can my

right honourable friend assure me

1:03:071:03:11

that the government will fulfil its

commitment to increase mental health

1:03:111:03:14

spending by at least 1 billion by

2020?

We are absolutely committed to

1:03:141:03:21

that. We're spending 1.4 alien more

than three years ago. There is more

1:03:211:03:25

we need to invest. -- 1.4 million.

For people who believe in parity of

1:03:251:03:31

esteem, being able to get help

quickly in a mental health crisis as

1:03:311:03:34

quickly as you can go to A&E for a

physical health crisis, is one of

1:03:341:03:39

the big gaps we have to fill.

I know

the Secretary of State will be

1:03:391:03:45

impressed and will eventually...

However, I am very, very proud of

1:03:451:03:52

the collaboration going on between

Saint St Helens Council and the CCG

1:03:521:03:58

and the hospitals. What is needed is

additional resources. You will see

1:03:581:04:02

the good news that is made of it.

But they cannot deliver everything

1:04:021:04:06

required without the additional

resources. Will you help us, please?

1:04:061:04:13

I recognise the picture. I did have

an excellent visit to the hospital.

1:04:131:04:18

They are doing some fantastic work

on patient safety. Collaboration is

1:04:181:04:21

better than it has been before

between the partners and the local

1:04:211:04:24

health economy but there are

financial pressures. We will have a

1:04:241:04:27

million more over 75s in ten years

in this country, that is why we have

1:04:271:04:33

committed to increase resources

going into the NHS and the social

1:04:331:04:35

care system.

The NHS STP review in my region

1:04:351:04:45

recently recommended all acute

services be maintained at North

1:04:451:04:49

Devon Hospital, a welcome decision

and a victory for the community.

1:04:491:04:52

With the minister work with me and

local NHS managers to ensure the

1:04:521:04:56

clinical need identified can be

fully delivered?

I share the

1:04:561:05:04

ambition of the honourable

gentleman. I much enjoyed visiting

1:05:041:05:08

his hospital in Barnstable during

the summer. I have been impressed by

1:05:081:05:11

the way in which the four trust? In

Devon providing acute services have

1:05:111:05:17

decided to come together and provide

a collaborative tool of their ED

1:05:171:05:23

staff to ensure each hospital is

adequately covered. That is a model

1:05:231:05:28

we can adopt.

The health committee

heard attaining a diagnosis of

1:05:281:05:38

autistic spectrum disorder can often

be a postcode lottery. Wildie

1:05:381:05:41

department now seek to publish data

to ensure we know where trained

1:05:411:05:49

clinicians are positioned across NHS

England, to ensure that workforce

1:05:491:05:53

planning is undertaken

appropriately?

I can give the

1:05:531:05:58

honourable lady and assurance we

will be publishing that data in the

1:05:581:06:01

New Year. It is very important that

we work hard to make sure that

1:06:011:06:06

people can get a timely diagnosis.

That means we are working to get

1:06:061:06:11

referrals seen more promptly, but

recognising that actually the time

1:06:111:06:14

taken to give a full diagnosis will

take some time.

Recruitment and

1:06:141:06:20

retention is just one reason why my

hospital trust is currently going

1:06:201:06:26

through the special measures

process. With the Secretary of State

1:06:261:06:31

pay tribute to the staff in

Lincolnshire, and will you agree

1:06:311:06:33

that part of the challenge they face

on recruitment and retention will be

1:06:331:06:37

solved via medical School in

Lincolnshire?

If I may say, that

1:06:371:06:43

question was absolutely beautifully

put! I have met the staff at Lincoln

1:06:431:06:49

Hospital, having been to all the

hospitals in the trust. Very nice to

1:06:491:06:54

see the lady in her place! But

indeed, one of the key priorities,

1:06:541:07:01

wherever the new medical schools

1:07:011:07:04