0:00:00 > 0:00:00for the health and social dear Secretary Jeremy Hunt and his team
0:00:00 > 0:00:04of ministers but the Speaker deal briefly with the Private Bill first.
0:00:04 > 0:00:12Order. The title of the Private Bill set down for consideration. Middle
0:00:12 > 0:00:23level Bill as amended and committed to be considered.Separation.Seven
0:00:23 > 0:00:35Thursday the 20th of February. I think people could hear that with
0:00:35 > 0:00:39the volume he said it. Questions at the Secretary of State for Health
0:00:39 > 0:00:42and social care.
0:00:44 > 0:00:51Question one,.Minister Jackie Doyle price.I'm very grateful to have the
0:00:51 > 0:00:55opportunity to pay tribute to the continued work of NHS staff continue
0:00:55 > 0:00:58to work tirelessly to support the victims of the fire and their
0:00:58 > 0:01:05families. So far, more than 4000 contact had been made, 400 adults in
0:01:05 > 0:01:11treatment and 96 have completed their treatment.
0:01:12 > 0:01:16We have heard the minister's words and litany of numbers. I have two
0:01:16 > 0:01:20further questions. Number one, is she considering long-term funding of
0:01:20 > 0:01:28mental health services around Grant felt our own factory plan for --
0:01:28 > 0:01:35Greenfell. She addressing the severe shortage of acute beds for those
0:01:35 > 0:01:39suffering mental health crises as is an entire ward lock and key due to
0:01:39 > 0:01:48lack of staff funding where there is a huge need for more.The honourable
0:01:48 > 0:01:53lady is quite right to press me on these issues, clearly they will be
0:01:53 > 0:01:57ongoing from a firm which we need to pay attention to make sure is
0:01:57 > 0:01:59adequately resourced. I can assure the honourable lady this is
0:01:59 > 0:02:03something very high on the list of priorities for ministerial group and
0:02:03 > 0:02:09I can say we have made 23.9 million national government funds committed
0:02:09 > 0:02:16to survive's needs with additional income on support. £28 million to
0:02:16 > 0:02:21support victims. I am in regular contact with the services to make
0:02:21 > 0:02:29sure we are doing our bit to address that need.Question two. In the
0:02:29 > 0:02:32last, the average waiting time for patients to start consultant led
0:02:32 > 0:02:38treatment at hospitals in northern Leticia was around nine weeks. We
0:02:38 > 0:02:40recognise that some trusts face particular challenges with waiting
0:02:40 > 0:02:44lists due to rising demand and that is why the package of support
0:02:44 > 0:02:50includes a systemwide improvement board and that has been established.
0:02:51 > 0:02:55It's interesting that statistic the minister had given, it's an average
0:02:55 > 0:03:01weight of 32 weeks. Longer than the nine weeks he has described and that
0:03:01 > 0:03:06a six-week longer in 2017 than it was in 2016. This is happening on
0:03:06 > 0:03:09his watch, what is he going to do because my constituents do not
0:03:09 > 0:03:15accept this is good enough?The honourable they prepared to follow
0:03:15 > 0:03:18up before hearing the answer. There is an improvement board established
0:03:18 > 0:03:23with the trust which is chaired by NHS improvement which is tasked with
0:03:23 > 0:03:27reducing waiting times and ensuring the standard is improved but the
0:03:27 > 0:03:31average in terms of time waited currently for patients is 11 weeks
0:03:31 > 0:03:40and four in patients is seven weeks. Can the Minister gave an assurance
0:03:40 > 0:03:44that the support that the NHS improvement and given to the trust
0:03:44 > 0:03:47will continue. He will now miss is the second time the trust has been
0:03:47 > 0:03:54in special measures and clearly we need continued support and will he
0:03:54 > 0:03:58reassure us that he will in fact visit the trust, a promise made by
0:03:58 > 0:04:05his predecessor.My right honourable friend is right and the need to give
0:04:05 > 0:04:09support to the specific trust and that's what a wider package of £6
0:04:09 > 0:04:14billion of funding has been given to the NHS to improve A&E and elective
0:04:14 > 0:04:19care performance. Specific work through NHS improvement in
0:04:19 > 0:04:21addressing some of the specific issues which he has alluded to with
0:04:21 > 0:04:26this trust.We might cheer from the honourable gentleman later. A
0:04:26 > 0:04:29friendly courtesy to the honourable gentleman, Kingswood has a great
0:04:29 > 0:04:33deal to be said for it, as does Congleton but both have one thing in
0:04:33 > 0:04:43common and that they are a long way from Northern Lincolnshire.The fact
0:04:43 > 0:04:46that this department has been renamed the Department for health
0:04:46 > 0:04:50and social care, both reflects their interdependence and our commitment
0:04:50 > 0:04:56to achieve coordinated care tailored to individual needs. The better care
0:04:56 > 0:05:00fund is a national integration programme which helps the NHS and
0:05:00 > 0:05:03local government deliver better and more joined up services.I can't
0:05:03 > 0:05:09thank the Minister for as a to her place. The proposal to build
0:05:09 > 0:05:15community health centres are at big part of drawing on social care in
0:05:15 > 0:05:21Gloucestershire, can the Minister make progress with the project as
0:05:21 > 0:05:27quickly as possible after years and years of unnecessary delays.I would
0:05:27 > 0:05:30like to thank the honourable gentleman for raising this important
0:05:30 > 0:05:34issue. He's absolutely right to do so and he is right that the proposal
0:05:34 > 0:05:37such as those for Thornbury health centre are crucial for ensuring
0:05:37 > 0:05:41health and social care that is truly integrated and centred around each
0:05:41 > 0:05:46individual and community. South Gloucester Joe Ceci duke remains
0:05:46 > 0:05:50committed to progressing these plans as soon as possible and that the
0:05:50 > 0:05:58local NHS is expected to be able to provide an update next month.Thank
0:05:58 > 0:06:02you Mr Speaker, is the Minister aware of the situation surrounding
0:06:02 > 0:06:08an infusion treatment and many of the 86 patients who lose this
0:06:08 > 0:06:11treatment and require increasing levels of social care. Consultants
0:06:11 > 0:06:17have written letters and said that if you remove this treatment, there
0:06:17 > 0:06:20is an increased risk of mortality for those patients. Will the
0:06:20 > 0:06:23Minister please meet with me marginally to discuss this and write
0:06:23 > 0:06:26to the
0:06:27 > 0:06:29to review the decision in the light of the evidence from the
0:06:29 > 0:06:36consultants. ?Blanket bans on treatment are unacceptable and
0:06:36 > 0:06:41decisions on treatment should with be made locally by based on clinical
0:06:41 > 0:06:43assessment. In this circumstance, these patients will be offered an
0:06:43 > 0:06:49alternative service and the CCG average for patients to need with
0:06:49 > 0:06:59the consultant to discuss their treatment.With my honourable friend
0:06:59 > 0:07:03agree with me that the integration of health and social care is so
0:07:03 > 0:07:08important to the future success of the NHS that really everything needs
0:07:08 > 0:07:15to be done to speed up the programme -- please join with me in
0:07:15 > 0:07:19encouraging in Sony -- will she join with me. A speedier approach to this
0:07:19 > 0:07:27method.My right honourable friend is absolutely right. This is having
0:07:27 > 0:07:34the better care fund, it is having a fantastic impact in the area, we are
0:07:34 > 0:07:41developing processes by to processes where health and social care is
0:07:41 > 0:07:45concerned and we have to proceed as rapidly as possible and with his
0:07:45 > 0:07:52backing in his local area, it will happen.
0:07:53 > 0:07:58It's very important that the integration these two services but
0:07:58 > 0:08:02there is not enough money. Over a year ago, one of my predecessors
0:08:02 > 0:08:07praised as for the work we are doing but that is now on the big the money
0:08:07 > 0:08:11it has got to deliver statutory duties. Not enough money and the
0:08:11 > 0:08:18government keeps trying to avoid it. Mr Speaker, we have given £2 billion
0:08:18 > 0:08:23extra funding over the next three years to help councils commission
0:08:23 > 0:08:26high-quality services and that is in addition to giving councils access
0:08:26 > 0:08:36to up to £9.25 billion dedicated social care funding by 1920.Will
0:08:36 > 0:08:40the Minister look at the benefits of independent living schemes such as
0:08:40 > 0:08:46that of prior review pioneered by the council in terms of reduced
0:08:46 > 0:08:50hospital board admission and reduce demands on social care. Greater use
0:08:50 > 0:08:57of exercise classes in such establishments.My honourable friend
0:08:57 > 0:09:00is right to raise this independent living schemes because they can keep
0:09:00 > 0:09:06people living healthier and more independently much longer and
0:09:06 > 0:09:08provide the comradeship and camaraderie that keep people active
0:09:08 > 0:09:13and healthy. He is right to raise the importance and the government is
0:09:13 > 0:09:19very much in support of that.With referencing to the integration of
0:09:19 > 0:09:22health and social care, the Minister might be aware that I have two
0:09:22 > 0:09:30outstanding respite and rehab homes, they are both under threat of
0:09:30 > 0:09:32closure by the county council because they say central government
0:09:32 > 0:09:36isn't giving them enough money. This ever crucial purpose in supporting
0:09:36 > 0:09:41the local hospital. Will the Minister agree to meet with me and
0:09:41 > 0:09:43representatives from the county council so we can work out a way to
0:09:43 > 0:09:49find a fund to keep these vital homes open?The honourable gentleman
0:09:49 > 0:09:53is absolutely right to stand up for the good quality respite in his
0:09:53 > 0:09:57local area. The care act does require local authorities to ship
0:09:57 > 0:10:02local markets and ensure that they are giving a sustainable
0:10:02 > 0:10:08high-quality local offer. I am happy to meet with them to discuss this.
0:10:08 > 0:10:13And I welcome the Minister to her place. One model of integration
0:10:13 > 0:10:16which has raised considerable concern is the accountable care
0:10:16 > 0:10:20organisation. Many are concerned this means greater private sector
0:10:20 > 0:10:24involvement and given legitimate worries about Carillion going bust,
0:10:24 > 0:10:29capita not able to support GPs, these concerns are well founded, can
0:10:29 > 0:10:35she rule out any private sector involvement and will she also now
0:10:35 > 0:10:39delay blamed the relevant regulations to an ACL until after
0:10:39 > 0:10:47the two judicial reviews and the NHS England consultation.Thank you Mr
0:10:47 > 0:10:52Speaker, the honourable gentleman is right to raise this. NHS England are
0:10:52 > 0:10:55consulting on this at the moment and I can confirm that regulations will
0:10:55 > 0:11:04be laid until that as this has been complete. Can I ask the Minister
0:11:04 > 0:11:08about funding because integration of health and social care.It needs
0:11:08 > 0:11:12more funding. The NHS is going for the biggest financial squeeze in
0:11:12 > 0:11:18Sicily and social care has been cut by billions since 2010. The Minister
0:11:18 > 0:11:24said the funding is adequate but if funding is adequate, why are delayed
0:11:24 > 0:11:28discharges of care up 50% since 2010 and if funding is adequate hackers
0:11:28 > 0:11:32and other social good, why did NHS England on Friday say that for the
0:11:32 > 0:11:39rest of this year, the A&E target has been abandoned?
0:11:39 > 0:11:45We recognise that there are pressures on our social care of the
0:11:45 > 0:11:50population ages, in the short term we have made the extra £2 billion
0:11:50 > 0:11:52funding available to local authorities. In the medium time, we
0:11:52 > 0:11:59need to make sure that best practice is observed across all local
0:11:59 > 0:12:02authorities and NHS trusts and we will be coming forward with the
0:12:02 > 0:12:09Green paper on social care later this year.Question number four.Mr
0:12:09 > 0:12:12Speaker, the NHS needs more nurses which is why we are making big
0:12:12 > 0:12:19changes in terms of new entries into the profession including new
0:12:19 > 0:12:25apprenticeships.Thank you, Mr Speaker. I'm glad to hear that the
0:12:25 > 0:12:28Secretary of State values the degree of friendship as a way to provide
0:12:28 > 0:12:33further routes into nursing. Will he consider increasing the funding
0:12:33 > 0:12:38level for nursing courses which educational establishments received
0:12:38 > 0:12:50from the interview of a -- from the Department to further incentivise
0:12:50 > 0:12:53the universities?I thank him for his question which will strengthen
0:12:53 > 0:12:57my hand with it the Palme d'Or funding, but the department have
0:12:57 > 0:13:00given at the highest level of funding from the demand of
0:13:00 > 0:13:06education, but we never say no to any more.Will he not admit that he
0:13:06 > 0:13:12has made a basic error by scrapping nurse bursaries, which has led to a
0:13:12 > 0:13:1723% fall in the numbers of people applying to nurse courses? Why
0:13:17 > 0:13:22doesn't he look at that if he wants to widen the entrants into nursing?
0:13:22 > 0:13:29I am not sure if the honourable lady was listening to the answer I just
0:13:29 > 0:13:33gave, but the point about nurse degree apprenticeships... I am most
0:13:33 > 0:13:37grateful, she says she always listens to me. A very rare
0:13:37 > 0:13:42continent, Mr Speaker so I shall savour it. -- a very rare
0:13:42 > 0:13:45compliment. But I will say is the point about nurse degree
0:13:45 > 0:13:51apprenticeships is that it is possible it to transition from
0:13:51 > 0:13:58nothing into a health assistant -- to nursing without any fees.As she
0:13:58 > 0:14:02is sporting a very fetching suffragette rosette, it's timely to
0:14:02 > 0:14:10record that in the great success of our National Health Service, well
0:14:10 > 0:14:17over 70% of the people who make it great art women.Thank you, Mr
0:14:17 > 0:14:23Speaker. Following the health select committee was like recent inquiry
0:14:23 > 0:14:26into the nursing workforce, we absolutely welcome the new routes
0:14:26 > 0:14:30into nursing including the new role of nursing associate. However one of
0:14:30 > 0:14:33the issues that are strongly highlighted was the need to retain
0:14:33 > 0:14:38our existing workforce as well as recruit into it.Could he comment on
0:14:38 > 0:14:45that? My honourable friend speaks very wisely and we do need to be
0:14:45 > 0:14:50better at retaining our existing workforce, that is one of the
0:14:50 > 0:14:53reasons why the Treasury has given me extra latitude in negotiations
0:14:53 > 0:14:57over the pay rise and the discussions that are currently
0:14:57 > 0:15:01happening but we also need to be much better at flexible working and
0:15:01 > 0:15:04recognising the challenges that people have in their ordinary
0:15:04 > 0:15:09working lives.Thank you, Mr Speaker. Unlike Scotland where
0:15:09 > 0:15:13student nurses receive the free tuition under nursing bursary of
0:15:13 > 0:15:20over 6500 a year, nurses in England face debt of 50,000 on graduation.
0:15:20 > 0:15:27Nursing applications have dropped by a 30% and the new friendship only
0:15:27 > 0:15:36got 30 applications after they wanted 1000, will he not admit he
0:15:36 > 0:15:42was wrong to scrap the nursing bursary is?I notice that audit
0:15:42 > 0:15:48culture and say that in Scotland there a long -- audit Scotland say
0:15:48 > 0:15:52that there is a lack of a long-term plan for the pressures of workforce.
0:15:52 > 0:15:55We have a plan to dramatically increase the number of nurses that
0:15:55 > 0:15:58we employ in the NHS and I'm sure many people in Scotland would like
0:15:58 > 0:16:04to see the same.The secretary of state has claimed the removal of the
0:16:04 > 0:16:10bursary would fund 5000 places but the nurses will only horrify in
0:16:10 > 0:16:172021. With -- qualify in 2021. With more nurses leaving the joining and
0:16:17 > 0:16:22a 90% drop in EU nurses coming to the UK because of Brexit, who does
0:16:22 > 0:16:29he expect to care for patients in the meantime?By broadening the
0:16:29 > 0:16:33routes into nursing away from people who take traditional higher
0:16:33 > 0:16:35education courses including nurse apprentices, people able to train
0:16:35 > 0:16:40over four years in a hospital on the job, we hope there will be a group
0:16:40 > 0:16:43of health care assistants who currently find it very difficult to
0:16:43 > 0:16:47get into nursing who can become nurses, and I think that would be
0:16:47 > 0:16:50welcome in Scotland as well.Could the Health Secretary update the
0:16:50 > 0:16:57House on progress made to reduce the cost of agency nurses so it can be
0:16:57 > 0:17:00reinvested in full-time nursing?I'm happy to do that. It's one of the
0:17:00 > 0:17:06great successes that I think should be celebrated for NHS improvement,
0:17:06 > 0:17:10that they have brought down the amount spent on agency nursing by £1
0:17:10 > 0:17:14billion in the last couple of years. That's huge achievement, every penny
0:17:14 > 0:17:19of that goes back into front-line care.The government cut the number
0:17:19 > 0:17:25of nurse training places in 2010 and when it scrapped bursaries,
0:17:25 > 0:17:28applications from mature students have had particularly. What is the
0:17:28 > 0:17:35point of blaming trusts for hiring agency staff and the government does
0:17:35 > 0:17:39simply not train enough nurses to fill the vacancies?Perhaps I should
0:17:39 > 0:17:43set the record straight, we have 52,000 nurses in training now, more
0:17:43 > 0:17:47than was ever the case under the last Labour government, who were
0:17:47 > 0:17:52planning to cut nurse training places by 6%. What we are doing is
0:17:52 > 0:17:58planning to increase them by 25%. I think that shows our commitment to
0:17:58 > 0:18:05nursing.Thank you, Mr Speaker. Yesterday the RCN reported on the
0:18:05 > 0:18:08total failure of government policy to increase the nursing workforce.
0:18:08 > 0:18:12As we have heard, the government hoped to recruit 1000 apprentices
0:18:12 > 0:18:16but ended up with dirty. This year the numbers of university places
0:18:16 > 0:18:24being applied for have fallen by 33%. We have a workforce crisis
0:18:24 > 0:18:28exacerbated by badly thought out policies, so isn't it time that he
0:18:28 > 0:18:34admits that scrapping the bursary was a mistake?That's not the first
0:18:34 > 0:18:39time he has painted an incomplete picture of what's happening. We have
0:18:39 > 0:18:45a lot more nurses and the reason of the vacancies and the pressure is
0:18:45 > 0:18:52because we know under his last government, we had mid staffs which
0:18:52 > 0:18:56is under a crisis of low staff in which we are tried to put right
0:18:56 > 0:19:02under this government.Number five, Mr Speaker.I would like to take
0:19:02 > 0:19:06this with questions eight and 13. This week is children's mental
0:19:06 > 0:19:12health week and still too many children and young people wait too
0:19:12 > 0:19:15long for mental health provision in the NHS so by the end of next year
0:19:15 > 0:19:21we will have invested an extra £1.4 billion giving 70,000 extra children
0:19:21 > 0:19:27and young people the opportunity to be seen.A constituent's 14-year-old
0:19:27 > 0:19:32son had severe OCD resulting in self harm, treatment has not worked and
0:19:32 > 0:19:37his doctor recommends an intensive treatment programme residentially.
0:19:37 > 0:19:44He is now waiting for seven weeks and counting with 24 hour parental
0:19:44 > 0:19:48support and supervision. What more can be done to insure that
0:19:48 > 0:19:51adolescents in desperate need of help get the hell before it is too
0:19:51 > 0:20:00late?-- get the help before it is too late? I understand that
0:20:00 > 0:20:03clinicians are hoping to resolve those issues this week. We need to
0:20:03 > 0:20:10expand the number of beds available for young people, they are at record
0:20:10 > 0:20:17levels, 1440, it went up 81 last year. But no -- more needs to be
0:20:17 > 0:20:21done.I have been approached by another of my constituents in
0:20:21 > 0:20:26Leicestershire concerned about the weights between a referral to
0:20:26 > 0:20:30treatment and the allocation of eight caseworker and formal
0:20:30 > 0:20:34treatment. Can my right honourable friend in large on the steps that he
0:20:34 > 0:20:38has taken which would reduce weights in Leicestershire across the
0:20:38 > 0:20:45country?I am happy to do that, the simple truth is it's a tragedy when
0:20:45 > 0:20:53any child have to wait for mental health care, because half of the
0:20:53 > 0:20:57conditions are set in before they are 14 and they can get worst. So we
0:20:57 > 0:21:01are setting up services inside schools to spot these things earlier
0:21:01 > 0:21:12and we are setting up a waiting time targets for upon it.65% in of young
0:21:12 > 0:21:19people in England got treatment for eating disorders last day, the
0:21:19 > 0:21:27target is 95%, can he update us on how that is going to be reached, and
0:21:27 > 0:21:32can he agree with me that waiting time targets are very important?I
0:21:32 > 0:21:39agree and I join her in supporting having those waiting time targets
0:21:39 > 0:21:47introduced in Scotland and other part of the England. We are hitting
0:21:47 > 0:21:5279% in urgent dreams of eating disorders, we are on our way to 95%
0:21:52 > 0:21:57and -- in urgent treatment of eating disorders, we are on our way to 95%.
0:21:57 > 0:22:00I listened very carefully about the additional funding which is supposed
0:22:00 > 0:22:06to be getting to the front line, but the main service for young people's
0:22:06 > 0:22:11mental health in Liverpool has seen a 43% cut in this financial year.
0:22:11 > 0:22:15There are now 412 children in Liverpool waiting more than 28 weeks
0:22:15 > 0:22:19for an assessment, not even for treatment. It's absolutely shocking.
0:22:19 > 0:22:25How can he stand there this week and say that everything is rosy?I
0:22:25 > 0:22:29didn't, I said the opposite, I said we need to do a lot more and I told
0:22:29 > 0:22:33the House would we be doing. She looks at what's happening in her own
0:22:33 > 0:22:40CCG, she will see that the amount spent on the door health has gone
0:22:40 > 0:22:44up, this government has -- on mental health has gone up, this government
0:22:44 > 0:22:48has done a huge amount on mental health. In 13 years, we didn't have
0:22:48 > 0:22:52any waiting time targets for mental health, we did not have parity of
0:22:52 > 0:22:55esteem, a whole range of things which are now happening that she
0:22:55 > 0:23:00should be supporting.Will the government commissioned more
0:23:00 > 0:23:04extensive research into the causes of mental ill-health among children
0:23:04 > 0:23:07and young people, both pre-and postnatal, with a view to preventing
0:23:07 > 0:23:13as much ill-health as possible in the future?We are absolutely going
0:23:13 > 0:23:17to do that. And we have a big programme of expansion in terms of
0:23:17 > 0:23:21our perinatal mental health support because we think there is a lot of
0:23:21 > 0:23:26evidence that pressures on mothers around the time of birth transmit
0:23:26 > 0:23:33their children and can leave lasting damage.Mr Speaker, specialist
0:23:33 > 0:23:39mental health crisis care for young people in South Cumbria is only
0:23:39 > 0:23:43available between the hours of 9am and 5pm, Monday to Friday. Will he
0:23:43 > 0:23:47agree with me that in the light of the CQC damning report recently that
0:23:47 > 0:23:54this is not acceptable and he will join with me in asking the CCG in
0:23:54 > 0:23:57Morecambe Bay to ensure there is out-of-hours care for all people?I
0:23:57 > 0:24:02am happy to look into the issue and I would save that his colleagues,
0:24:02 > 0:24:08the Honourable member did a huge amount in terms of setting up crisis
0:24:08 > 0:24:13care around the country. We need to do that because if we are going to
0:24:13 > 0:24:16have parity of esteem, people need to get help in a mental health
0:24:16 > 0:24:21crisis just as they do with physical health as improving treatment of
0:24:21 > 0:24:26adolescent ill-health, does he agree that everything possible needs to
0:24:26 > 0:24:33done to prevent crisis in the first place?We are seeing a surge and
0:24:33 > 0:24:38clinicians with the best tailor their response.This is something
0:24:38 > 0:24:42that he had thought a lot about and a particular area of concern is the
0:24:42 > 0:24:45growth of mental health problems in young women between the age of 18
0:24:45 > 0:24:49and 24 and we are looking carefully as to whether this relates to social
0:24:49 > 0:24:52media use which is an additional pressure that many of us did not
0:24:52 > 0:24:56face at that age and I thank him for his campaigning.Figures show that
0:24:56 > 0:25:00on average children and young people have to visit their GP three times
0:25:00 > 0:25:04before a referral is made for a specialist mental health assessment.
0:25:04 > 0:25:08And then they have to wait sometimes six months for treatment. In
0:25:08 > 0:25:15Lewisham, the budget is being cut which is likely to result in longer
0:25:15 > 0:25:17waiting times for treatment. The right honourable gentleman said that
0:25:17 > 0:25:22these waiting times were tragedy but how bad things have to get before
0:25:22 > 0:25:25the government takes action?With respect, we are taking action. Last
0:25:25 > 0:25:33year spending on mental health went up by 525 million, four out of five
0:25:33 > 0:25:36CCGs increased mental health spend by more than their overall spend.
0:25:36 > 0:25:39And this year all of them will do that so that will apply in Lewisham
0:25:39 > 0:25:45as it applies everywhere else in the country.Under plans announced by
0:25:45 > 0:25:48energies into an, child victims of sexual assault in Stoke-on-Trent
0:25:48 > 0:25:55would have to travel as far as Birmingham to get support. Will the
0:25:55 > 0:25:57Secretary of State agreed to look urgently into the proposals to
0:25:57 > 0:26:06remove child sexual assault services from the city?I will happily do so.
0:26:06 > 0:26:10Thank you, Mr Speaker. Research by the children's Commissioner revealed
0:26:10 > 0:26:14the spend on children and young people's mental health services are
0:26:14 > 0:26:19varied by CCG from 0.2% to 9% resulting in services in some areas
0:26:19 > 0:26:24being as shockingly poor. Can he therefore explain the reason for the
0:26:24 > 0:26:28variation, and will he today commits to match Labour's pledge to increase
0:26:28 > 0:26:35the proportion of mental health budget spent on these services?
0:26:35 > 0:26:38Wade she is right to shine a light on the variation. This government
0:26:38 > 0:26:45has introduced Ofsted ratings for all CCG to make sure we understand
0:26:45 > 0:26:48it is all mental health now we see that variation but specifically when
0:26:48 > 0:26:52it comes to children and young people's mental health. Last year,
0:26:52 > 0:26:58overall spending went up by 20% and the Green paper we published, and
0:26:58 > 0:27:02additional £300 million in investment.
0:27:05 > 0:27:08This government wants to see all children and young people get the
0:27:08 > 0:27:12best start in life. We are in fomenting a wide range of policies
0:27:12 > 0:27:17to improve child health, including most childhood obesity plan in the
0:27:17 > 0:27:21world, transformation of Jordan's mental health on maternity services,
0:27:21 > 0:27:30improving immunisation rate and tackling child sexual abuse.The
0:27:30 > 0:27:32Royal College of paediatrics recently praised NHS Scotland's
0:27:32 > 0:27:37innovations to improve children's health. The Scottish imitative has
0:27:37 > 0:27:42greatly improve children's mental health, reducing by 24% and cutting
0:27:42 > 0:27:49annual dental treatment by £5 million. It is now the UK
0:27:49 > 0:27:53Government. Why is this initiative not being rolled out to all children
0:27:53 > 0:27:59in England?The honourable gentleman is right to highlight this issue and
0:27:59 > 0:28:04we are always keen to response to any representations made on this
0:28:04 > 0:28:09very important issue and we are very keen to learn from the other nations
0:28:09 > 0:28:14in this area because it is quite clear that the more we can do with
0:28:14 > 0:28:17early intervention in childhood, the better we protect people's long-term
0:28:17 > 0:28:23health. I will look more specifically at the point.As
0:28:23 > 0:28:25children's., children's health is very important to me and the case
0:28:25 > 0:28:32children's Doctor, it worries me and doctors up and down this country. In
0:28:32 > 0:28:37NHS practice, I have seen the adverse effect in reflective
0:28:37 > 0:28:41practice and the impact it has on staff morale and it will ultimately
0:28:41 > 0:28:45impact on patient safety. By now the Secretary of State Schuurs concerns.
0:28:45 > 0:28:52What is he going to do about it?I wrote honourable friend will address
0:28:52 > 0:28:55this in a little while but it is important to know that the whole
0:28:55 > 0:29:00issue of reflexive learning is an important issue and shouldn't be, we
0:29:00 > 0:29:02shouldn't do this case prevent people from being honest about the
0:29:02 > 0:29:11experiences they have had.Mr Speaker, energy drinks packed with
0:29:11 > 0:29:16caffeine have been connected to problems with children's health.
0:29:16 > 0:29:20Tesco, Asda and Aldi have banned the sales of these drinks to under 16
0:29:20 > 0:29:26is. Will the government do the same? I thank the honourable gentleman for
0:29:26 > 0:29:30raising this issue. We are becoming increasingly conscious of drinks
0:29:30 > 0:29:37with additional unnatural stimulants and their impact on people's health
0:29:37 > 0:29:40generally. That becomes more acute when it comes to children's health.
0:29:40 > 0:29:44We will look more closely at this. I'm glad he has highlighted the
0:29:44 > 0:29:50initiative taken by individual retailers because it is up to them
0:29:50 > 0:29:55to implement good practice.Does my honourable friend agrees me that the
0:29:55 > 0:30:01best to achieve strong good mental health for children is at the very
0:30:01 > 0:30:05early stages and forming strong attachment between that child and
0:30:05 > 0:30:09their parent in the first thousand days in conception. Why isn't there
0:30:09 > 0:30:16more in the mental health green paper about postnatal health?And
0:30:16 > 0:30:19grateful to my honourable friend for raising this. The reason why there
0:30:19 > 0:30:23is not more than a Green paper is because the green paper is very much
0:30:23 > 0:30:27about what we are doing in skills but he is absolutely right, he is
0:30:27 > 0:30:31highlighting the earliest of earliest interventions and one of
0:30:31 > 0:30:36the reasons why we are so much admire more than perinatal mental
0:30:36 > 0:30:40health to ensure the bonds between the mother and baby are as strong as
0:30:40 > 0:30:49they can possibly be.To follow on from the question from my honourable
0:30:49 > 0:30:54friend and the answer she gave, can I just revisit the issue around
0:30:54 > 0:31:00energy drinks. She may know that a 500 millilitre can then energy drink
0:31:00 > 0:31:04has 12 teaspoons of sugar and has the same amount of caffeine as at
0:31:04 > 0:31:09double espresso. Energy drinks are being sold for as little as 25p to
0:31:09 > 0:31:15children as young as ten. And around one in three young people say they
0:31:15 > 0:31:19regularly consume energy drinks. Given the health risk associated
0:31:19 > 0:31:24with energy drinks, Kenji coming more about what steps she and her
0:31:24 > 0:31:27department are taken to reduce energy drink sales and consumption
0:31:27 > 0:31:29by children?
0:31:31 > 0:31:35The honourable lady will know that this is part of the whole childhood
0:31:35 > 0:31:40obesity plan that my honourable friend is taking forward in terms of
0:31:40 > 0:31:44the action against sugar. There is a lot more we can do to address the
0:31:44 > 0:31:49concerns about caffeine and it is high on my honourable friend's to do
0:31:49 > 0:31:54list and now that will have more exchanges on this in due course.
0:31:54 > 0:32:06Secretary of State. For we wanted to half still by 2030.The progress we
0:32:06 > 0:32:11have been making. We brought it forward to 2025.I'm glad to hear
0:32:11 > 0:32:16that progress has been made. The 20 16th world breast-feeding initiative
0:32:16 > 0:32:20highlighted several gaps and access to breast-feeding support including
0:32:20 > 0:32:23deficiencies in clinical training and lack of integration between NHS
0:32:23 > 0:32:26and voluntary sector services. What can be done through the maternity
0:32:26 > 0:32:30transformation programme to make sure women can access and health
0:32:30 > 0:32:35professionals can provide the best advice right across the country?She
0:32:35 > 0:32:39is absolutely right to highlight this area, one of six high impact
0:32:39 > 0:32:42areas we are focusing on throughout the country. We are making progress
0:32:42 > 0:32:46and we know we can do a lot better.
0:32:49 > 0:32:52There are no plans to hold discussions with the Chancellor of
0:32:52 > 0:33:00the Exchequer on VAT status for NHS trusts.That ought to be
0:33:00 > 0:33:04reconsidered. NHS trusts desperate to avoid financial situation appear
0:33:04 > 0:33:09to have found a new magic money tree. Setting up subsidiaries to
0:33:09 > 0:33:13avoid paying substantial amounts of tax to the Treasury. Rather than
0:33:13 > 0:33:17encouraging this tax dodging and further fragmenting the NHS, why
0:33:17 > 0:33:21doesn't the Secretary of State and his friend the Chancellor ban this
0:33:21 > 0:33:28practice or agree to let them all have the VAT exemptions?The all NHS
0:33:28 > 0:33:32trusts in September 20 17th, we reminded them that tax avoidance
0:33:32 > 0:33:36scheme should not be entered into under any circumstances. She seems
0:33:36 > 0:33:42to be arguing that NHS hospitals are in essence paying too much tax to
0:33:42 > 0:33:45the Treasury. More than actually having that money within the NHS.
0:33:45 > 0:33:53These are subsidiaries that the 100% owned by the trust themselves. Mr
0:33:53 > 0:33:58Speaker, the government has already legislated for but not implemented a
0:33:58 > 0:34:04proposal to introduce 95,000 and £85,000 limit on exit payments for
0:34:04 > 0:34:12public servants in the NHS.Would it not be sensible in the meantime to
0:34:12 > 0:34:17charge NHS trusts VAT on any exit payments in excess of £95,000 in
0:34:17 > 0:34:24order to try to deter such waste of public resources?I admire the
0:34:24 > 0:34:27winner VAT element of that question was brought into a discussion about
0:34:27 > 0:34:30then exit payment. My honourable friend will be well aware that the
0:34:30 > 0:34:34issue of exit payments was one I visited very frequently as a member
0:34:34 > 0:34:37of the Public committee and it is one I'm very happy to discuss
0:34:37 > 0:34:44further with the honourable gentleman.Question number ten.The
0:34:44 > 0:34:50free Sanders agency unit is crucial to protecting consumers from serious
0:34:50 > 0:34:57criminal activity.That impacts on the safety. We will explore options
0:34:57 > 0:35:01for the unit's future funding and it's decision that is expected in
0:35:01 > 0:35:06late spring. The Food Standards Agency is answerable to the health
0:35:06 > 0:35:08department because of the safety of food and there are a lot of
0:35:08 > 0:35:12assurance schemes that Dovale answer to anybody. The FSA needs to be able
0:35:12 > 0:35:16to come together and that is where the crime unit can do a really good
0:35:16 > 0:35:21job. Anything you can do to get back a crime unit up and running would be
0:35:21 > 0:35:28very good.I thank the chairman of the environment group through the
0:35:28 > 0:35:32royal rural affairs Select Committee for his advice and this is something
0:35:32 > 0:35:37that he is very keen and astute on ensuring that the businesses are
0:35:37 > 0:35:41reaching their safety responsibilities.It is one of the
0:35:41 > 0:35:44most important roles of the Food Standards Agency. They are
0:35:44 > 0:35:48developing a new regulatory model and actively engaging with that
0:35:48 > 0:35:52party assurance scheme on us to determine how information and data
0:35:52 > 0:35:59can be shared and how there can be more effectively used by regulators.
0:35:59 > 0:36:02Businesses of congratulations for the Secretary of State for rapid
0:36:02 > 0:36:08response to President Trump on the values of the NHS. As chair of the
0:36:08 > 0:36:15Westminster autism commission, we will bring out a fig report -- big
0:36:17 > 0:36:20. Will he go very quickly to stop this dreadful trade of fake
0:36:20 > 0:36:27medicine? I'm not quite sure this is altogether related to the question.
0:36:27 > 0:36:31Possibly, but it is a worthy effort. I will give the honourable gentleman
0:36:31 > 0:36:36the benefit of the doubt. Let's hear the Minister.On the basis he has
0:36:36 > 0:36:39been so very charming to the Secretary of State, we will of
0:36:39 > 0:36:46course look at it.Today marks five years since the landmark publication
0:36:46 > 0:36:51of the Francis Report into mid Staffordshire warily NHS has made a
0:36:51 > 0:36:56huge number of changes, not least 34 trusts going to special measures and
0:36:56 > 0:36:5919 coming up and I want to congratulate West Hertfordshire
0:36:59 > 0:37:02trust on coming out of special measures in January and getting a
0:37:02 > 0:37:06good score for their care and a fantastic achievement for staff.
0:37:06 > 0:37:11Thank you Mr Speaker. With your get the local health service in special
0:37:11 > 0:37:14measures, the two funding in the budget for when to health pressures
0:37:14 > 0:37:19was very welcome Dawes additional funding.Yorked NHS has already
0:37:19 > 0:37:22received the tranche of this. The remainder of Yorkshire has not been
0:37:22 > 0:37:27released will stop discussions are ongoing with NHS improvement, sick
0:37:27 > 0:37:30or the Secretary of State committee looking into this matter as a matter
0:37:30 > 0:37:37of urgency.I will happily do so. The Secretary of State will be aware
0:37:37 > 0:37:42of the importance of Kings College Hospital to my constituents. In
0:37:42 > 0:37:462009, it was rated as excellent, one of the top hospitals the country.
0:37:46 > 0:37:52Now it is missing its A&E Widegren targets, missing its cancer
0:37:52 > 0:37:57treatment target and an increase in cancelled operations. And as an
0:37:57 > 0:38:03special measures. The government must step up to the plate and help
0:38:03 > 0:38:08this and including with the resources that it needs.Let me
0:38:08 > 0:38:10reassure The Right Honourable Aguillon we do not wash our hands of
0:38:10 > 0:38:14any trust that goes on to special measures. The point of this is to
0:38:14 > 0:38:18highlight where government intervention is necessary, needed.
0:38:18 > 0:38:22Kings is an example of the hospital and I know she will agree there is a
0:38:22 > 0:38:25huge and a very fine treatment that happens there every single day but
0:38:25 > 0:38:29also they are having some profound issues in terms of the management of
0:38:29 > 0:38:32finances and some of their waiting times and that is why we're doing
0:38:32 > 0:38:40everything we can to them.With a high delayed discharge rate of 10%,
0:38:40 > 0:38:44Kettering General Hospital, which is in special measures, 60 patients in
0:38:44 > 0:38:47any one day who have completed their treatment and await transfer out
0:38:47 > 0:38:51into the community. Northamptonshire County Council has given millions of
0:38:51 > 0:38:55pounds for a better care fund but is simply not up to the job. What can
0:38:55 > 0:39:01be done in that situation?I'm very aware of the pressures at Kettering
0:39:01 > 0:39:06and it's a very busy hospital and they have had a number of changes of
0:39:06 > 0:39:09management. I want to reassure my honourable friend that there is a
0:39:09 > 0:39:12very big improvement package in place to support that hospital and
0:39:12 > 0:39:19we want to get it out of special measures as soon as possible.The
0:39:19 > 0:39:23previous chair of King's College Hospital NHS Foundation Trust
0:39:23 > 0:39:26resigned because he concluded the funding provided to the hospital
0:39:26 > 0:39:29placed the trust in an impossible position for that the current
0:39:29 > 0:39:33interim chair has stated his view that the proportion of GDP spent on
0:39:33 > 0:39:38health and social care needs to rise to match other European countries in
0:39:38 > 0:39:42order for our NHS to be sustainable. One will the Secretary of State 's
0:39:42 > 0:39:47the morning and commit the funding that things needs and more widely
0:39:47 > 0:39:51our NHS needs to deliver the care for our constituents?Let me tell
0:39:51 > 0:39:55the honourable lady that we spend 9.9% of our GDP on health, that
0:39:55 > 0:40:01compares to the EU 15%, the richer EU countries who spend 9.6%,
0:40:01 > 0:40:04slightly less than us on average. The reason we are able to spend more
0:40:04 > 0:40:08is because this government that the economy back on its feet and that is
0:40:08 > 0:40:20why we're putting more into the NHS. Number 12.It is good to be back. I
0:40:20 > 0:40:24have repeatedly said that this dispatch .com pharmacies are a vital
0:40:24 > 0:40:28front-line service for NHS with over 1.2 million health-related visits
0:40:28 > 0:40:31every day. Community pharmacies have once again stepped up this winter
0:40:31 > 0:40:35period and I would like to thank them for their hard work vaccinating
0:40:35 > 0:40:41over 1 million people against seasonal flu since I saw -- October.
0:40:41 > 0:40:45Pharmacists will be wider accepted into the health
0:40:47 > 0:40:50the Minister for that answer. I wonder if my friend had come to
0:40:50 > 0:40:56Derby to meet my constituents who has a number of pharmacies working
0:40:56 > 0:41:00very hard to keep patients out of hospital and therefore saving the
0:41:00 > 0:41:09NHS money. By their innovative ideas. I will very much do that, we
0:41:09 > 0:41:12have that provision date in the diary for early month.We continue
0:41:12 > 0:41:19to promote pharmacy first next month we want to seek a £2 million
0:41:19 > 0:41:21pharmacy campaign which continues to promote the idea of community
0:41:21 > 0:41:26pharmacies as the first port of call for so many minor health concerns. I
0:41:26 > 0:41:34was there at a pharmacy last began pleased to call and see her.
0:41:34 > 0:41:37The Minister will be aware that at the moment there are a
0:41:37 > 0:41:44disproportionate amount of GPs heading toward retirement. The need
0:41:44 > 0:41:49for support for primary care services is vital. What steps can be
0:41:49 > 0:41:52taken for pharmacists to increase their use but also more generally to
0:41:52 > 0:41:57see alternatives to GPs?There are on record number of training places.
0:41:57 > 0:42:01We know that one of the main reasons that GPs relieve practice is
0:42:01 > 0:42:06retirement so we put content measures in place to meet our
0:42:06 > 0:42:10commitment of extra 5000 GPs by 2020, so retention schemes and
0:42:10 > 0:42:15another refresher scheme will get valuable and experience to GPs back
0:42:15 > 0:42:20into our NHS to doing the work that our constituents benefit from.
0:42:20 > 0:42:31Number 14.Thank you, Mr Speaker. We recognise the acute shortages in
0:42:31 > 0:42:36general practice which is why we remain committed to delivering
0:42:36 > 0:42:38additional doctors working in general practice by 2020 will stop
0:42:38 > 0:42:45many of patients have been able to access evening and weekend
0:42:45 > 0:42:50appointments, we picked everyone to have access by March 20 19.-- we
0:42:50 > 0:42:55expect everyone to have access. I'm very fortunate to work closely with
0:42:55 > 0:42:58GPs in my constituency and for a variety of reasons, it would appear
0:42:58 > 0:43:02that the younger GPs are not as likely to either the partnership
0:43:02 > 0:43:05model as their predecessors. Would he agree with me that we need a
0:43:05 > 0:43:10mixed model of both private partnership contract and direct NHS
0:43:10 > 0:43:15state provision, if we're going to get GPs to the places where the
0:43:15 > 0:43:18public need them?I know my honourable friend works very closely
0:43:18 > 0:43:24with GPs and commissioning groups in his constituency. We back the
0:43:24 > 0:43:30partnership model of the Secretary of State said last month at the
0:43:30 > 0:43:34Royal College of GPs. We believe its many benefits as the cornerstone of
0:43:34 > 0:43:42primary care which is why we are exploring other models to look at
0:43:42 > 0:43:49the partnership model within the care system at scale.Doctor
0:43:49 > 0:43:55Williams, you wanted to speak? Can be abandoned the idea? Very well.
0:43:55 > 0:43:59There is an alarming decline in the number of family doctors working
0:43:59 > 0:44:01across the north-east so I am supporting the University of
0:44:01 > 0:44:10Sunderland's bid to a stab at -- to establish a new medical school.
0:44:10 > 0:44:15There are record numbers in training, I take note of her bid for
0:44:15 > 0:44:22the training school. One of the reasons why we have placed such
0:44:22 > 0:44:27importance in the department and in my brief for recruiting new GPs into
0:44:27 > 0:44:32the NHS England and making sure that people can stay working in the NHS
0:44:32 > 0:44:35is because we seek general practice as the cornerstone of the health
0:44:35 > 0:44:44service.Topical questions, and a Subaru. -- and a Subaru. You wear it
0:44:44 > 0:44:52well. I don't know if she means by age or the rosette? I thought she
0:44:52 > 0:44:57meant the rosette!On the day we mark the 100th anniversary of giving
0:44:57 > 0:45:09a voice on women, I want to update the House on concern to my not be
0:45:09 > 0:45:19able to give voice to doctors. I have announced Professor Sir Norman
0:45:19 > 0:45:24Williams, former president of the Royal College of surgeons, to
0:45:24 > 0:45:28conduct a rapid review into the application of gross negligence
0:45:28 > 0:45:32manslaughter in health care, working with senior lawyers, reviewing how
0:45:32 > 0:45:36we insure the vital role of reflective learning, openness and
0:45:36 > 0:45:41transparency is protected so that mistakes are learned from a not
0:45:41 > 0:45:50covered up. How we each other is clarity between Great slippers and a
0:45:50 > 0:45:55human area -- between gross negligence and human error, and any
0:45:55 > 0:46:01lessons that need to be learned by the general medical practice Council
0:46:01 > 0:46:04and others. I will involve the professional standards authority for
0:46:04 > 0:46:07health and social care in this vital review which will report to me
0:46:07 > 0:46:13before the end of April 20 18.Can I thank the Secretary of State for
0:46:13 > 0:46:18that answer. Or at least that statement. And also for his very
0:46:18 > 0:46:25robust tweets he makes and other issues. Would he be amenable to
0:46:25 > 0:46:32following on Twitter the Oliver King foundation? I have written to all
0:46:32 > 0:46:37schools in my area urging them to install the platers. What assistance
0:46:37 > 0:46:44in the Department of Health giving such an admirable charity -- install
0:46:44 > 0:46:50defibrilators.I think a fantastic charity and the boy concerned would
0:46:50 > 0:46:58have been 19 shortly, so it's a very sad story. I thank her for her
0:46:58 > 0:47:02campaigning on this issue and we need to make sure that we have a
0:47:02 > 0:47:07grocery everywhere necessary to save these tragedies.-- that we have
0:47:07 > 0:47:11defibrilators. Can I start by welcoming the review that the health
0:47:11 > 0:47:14and social care secretary has announced and welcome the addition
0:47:14 > 0:47:19of social care to the Health Secretary's roll? I welcome the
0:47:19 > 0:47:21government belatedly realising that social care should be a Cabinet
0:47:21 > 0:47:28level role, as Labour has done since 2010. Yesterday the Alzheimer's
0:47:28 > 0:47:32Society reported that care homes are turning away people with advanced
0:47:32 > 0:47:36amateur, or even evicting them because care providers do not get
0:47:36 > 0:47:43enough money -- with advanced dementia. Will the secretary now the
0:47:43 > 0:47:48arguing with Treasury colleagues to insure that people with dementia are
0:47:48 > 0:47:54not evicted from care homes due to lack of funding?She always vary
0:47:54 > 0:47:59powerfully speaks about the social care system and I would say to her
0:47:59 > 0:48:02that one of the key parts of the social care paper we are currently
0:48:02 > 0:48:07working through is around market stabilisation. We have seen a number
0:48:07 > 0:48:11of care homes going under, the number overall of birds has remained
0:48:11 > 0:48:18stable but our concern -- the amount of beds, but the particular concern
0:48:18 > 0:48:21is people at the advanced stages of dementia who could not get the care
0:48:21 > 0:48:29that they want so this is welcome.I have had concerns highlighted to me
0:48:29 > 0:48:31over the National Cancer patient experience survey in light of the
0:48:31 > 0:48:37introduction of a new national opt out model. Can the Minister confirm
0:48:37 > 0:48:43that the survey will continue to deliver the same high-quality data
0:48:43 > 0:48:51annually and give a final decision on how it will be made?I have been
0:48:51 > 0:48:53listening to cancer charities, commissions and patients on how
0:48:53 > 0:48:57important the patient experience survey is. Whatever form it takes in
0:48:57 > 0:49:02the future as a result of the changes to how data is shared, we
0:49:02 > 0:49:06want this survey to continue, with methodologies as close to the
0:49:06 > 0:49:14current survey as possible.Last week at PMQs, the Prime Minister
0:49:14 > 0:49:18made an inaccurate statement about emergency health services in Wales.
0:49:18 > 0:49:23The chair of the UK Statistics Authority concluded that the Prime
0:49:23 > 0:49:28Minister's comparison was not valid. Comparisons on the performance of
0:49:28 > 0:49:32our NHS are important, so can government ministers check their
0:49:32 > 0:49:40figures in the future?What is interesting is looking at the
0:49:40 > 0:49:43comparisons and the fact that the NHS in Wales appears to have changed
0:49:43 > 0:49:46another of the comparisons to make it more difficult to compare
0:49:46 > 0:49:51performance between England and Wales. The more screeching Greek
0:49:51 > 0:50:00there is before -- the more scrutiny there is between the performances
0:50:00 > 0:50:03where the best performance in Wales equates to the worst performance in
0:50:03 > 0:50:08England, the more we will see changes in how the NHS delivers its
0:50:08 > 0:50:15services in Wales.We have a huge exciting plan for a Cancer hub in my
0:50:15 > 0:50:21constituency, providing a global centre for cancer innovation which
0:50:21 > 0:50:25will provide a huge boost for the local economy including 13,000 new
0:50:25 > 0:50:29jobs. Will he join me to see the opportunity first-hand and will heed
0:50:29 > 0:50:36tell us how the comment life sciences strategy will be good by
0:50:36 > 0:50:43this?I'm keen to visit him, let's fix it up. I like the idea of these
0:50:43 > 0:50:48one-stop shops and the hub he talks about could be exciting.The
0:50:48 > 0:50:50delivery of the sustainability and transformation plans is too
0:50:50 > 0:50:59dependent on the estate strategy and there is great concern that our NHS
0:50:59 > 0:51:03assets will be sold off quickly and cheaply without transparency to make
0:51:03 > 0:51:06up for government underfunding. Will the Minister agree to pause the
0:51:06 > 0:51:10process to accommodate the urgent need for Parliamentary scrutiny?It
0:51:10 > 0:51:17is the King 's fund that said that these offer the best hope for the
0:51:17 > 0:51:23NHS to sustain and transform health care. As the honourable lady
0:51:23 > 0:51:28Woolnough, in the spring budget we announced an additional £305 million
0:51:28 > 0:51:33of capital funding to invest in local areas, and in the autumn
0:51:33 > 0:51:36budget, there was an extra 10 billion in capital investment over
0:51:36 > 0:51:42the course of this armament.Last week our former colleague Tessa
0:51:42 > 0:51:49Jowell gave an inspiring speech on her battle with brain cancer and I
0:51:49 > 0:51:53hope that colleagues will join me in paying tribute to her work and spoke
0:51:53 > 0:51:59with grace and the ability to make others not go through what she is
0:51:59 > 0:52:05suffering. The report that was produced last week by the brain
0:52:05 > 0:52:10cancer task force be taken seriously, and do everything to make
0:52:10 > 0:52:15sure this cancer receive the funding it deserves so that Tessa Jowell's
0:52:15 > 0:52:20words do not go in vain?I would like to thank my Honourable friend
0:52:20 > 0:52:24for the wiki did in this subject, I the Secretary of State was in the
0:52:24 > 0:52:28other place to listen to the speech, her speech was very moving and a
0:52:28 > 0:52:32very brave piece of work. We take it very serious, I know that my
0:52:32 > 0:52:35colleagues have the report and we are going through it line by line
0:52:35 > 0:52:39and we will jointly chair a Round Table on the subject in the next few
0:52:39 > 0:52:45weeks.Will the Secretary of State give an assurance that any
0:52:45 > 0:52:49accountable care organisations he establishes will not be able to use
0:52:49 > 0:52:57commercial conventionality excuses to evade scrutiny under FOIA
0:52:57 > 0:53:07legislation?Public money is public money and people in this house have
0:53:07 > 0:53:11the right to know how it's spent so we will make sure those contracts
0:53:11 > 0:53:16are signed in the fairway.The Secretary of State as he is carrying
0:53:16 > 0:53:19out a review into social care funding, I would urge him to look
0:53:19 > 0:53:24carefully as to whether we should look again at implementing the
0:53:24 > 0:53:26commission proposals given that we have legislated for them will stop
0:53:26 > 0:53:32my judgment is that it is the only way we will tackle this issue with
0:53:32 > 0:53:39urgency.The Dell not proposals was the idea of risk pooling, the idea
0:53:39 > 0:53:44that there is a randomness that affect us in our later years, but we
0:53:44 > 0:53:49would want as a civilised society to do something about. I would confirm
0:53:49 > 0:53:55that we will consult on a cap on social care costs.I was shocked
0:53:55 > 0:54:04that my local hospital in Southport has unused bed and theatre capacity
0:54:04 > 0:54:09despite the huge winter crisis and the pressure in the NHS locally.
0:54:09 > 0:54:14That same trust last night, the virgin run walk-in centre had a
0:54:14 > 0:54:19computed glitch so told everyone to go to A&E or come back tomorrow.
0:54:19 > 0:54:24Have the Secretary of State made any assessment of the number of beds and
0:54:24 > 0:54:28theatre hours which could be resourced to relieve the winter
0:54:28 > 0:54:33pressures and save lives?The Honourable Lady brings up an
0:54:33 > 0:54:36important point which is the variance of performance between
0:54:36 > 0:54:43trusts, how we look at some of the lessons on efficiency, on rotors and
0:54:43 > 0:54:47how we maximise value for funding and I'm happy to look at the
0:54:47 > 0:54:52specific point she raises. How we manage the patient pathway and the
0:54:52 > 0:54:5843% of beds occupied in hospitals by 5% of patients is a key challenge we
0:54:58 > 0:55:04are looking at.For the first time ever in Devon and Plymouth, GP
0:55:04 > 0:55:09practices are struggling to recruit new doctors especially new partners.
0:55:09 > 0:55:12They are spending a fortune on glow comes as a result. I know the
0:55:12 > 0:55:19government has at -- on low,s. What can be done in the meantime to make
0:55:19 > 0:55:24sure that my constituents can access primary care services?There are two
0:55:24 > 0:55:28things, we have succeeded in increasing the number of medical
0:55:28 > 0:55:33school graduates who go into general practice. The second thing and I
0:55:33 > 0:55:36know this because we had conversations in my Honourable
0:55:36 > 0:55:44friend's constituencies with GPs is to do what I can to invigorate the
0:55:44 > 0:55:46partnership model. Since meeting with them, I have agreed with the
0:55:46 > 0:55:53Royal College of GPs that we will do a full review of how the partnership
0:55:53 > 0:56:00model leads to evolve in the modern NHS.Does he agree with me that as a
0:56:00 > 0:56:03consequence of creating a council of care organisations, it would be
0:56:03 > 0:56:07wholly unacceptable if private companies gained control over
0:56:07 > 0:56:12strategic decisions for local health services?I just point the
0:56:12 > 0:56:19Honourable gentleman to what the King's Fund says, which is that
0:56:19 > 0:56:24these make massive differences in care to patients. This is not a
0:56:24 > 0:56:26pro-government organisation, they regularly hold the government to
0:56:26 > 0:56:31account at election time and throughout the year. But just to
0:56:31 > 0:56:36them, Polly Toynbee, many other people.
0:56:36 > 0:56:43It is very positive that Corby CCG have announced that urgent care
0:56:43 > 0:56:47services will be protected in Corby along with new GP access and primary
0:56:47 > 0:56:51care facilities. Will my right honourable friend join me in keeping
0:56:51 > 0:56:54a close eye on the CCG as they design you access arrangements
0:56:54 > 0:56:58because people must be able to access those urgent care services in
0:56:58 > 0:57:02the right place at the right time. You are right to draw attention to
0:57:02 > 0:57:09the funding going into Corby, and it is a tribute to his campaigning as a
0:57:09 > 0:57:12constituency MP that that measure is being taken. I'm happy to look at
0:57:12 > 0:57:16the specific issue and it's important that the CCG continued to
0:57:16 > 0:57:19consult with both members of Parliament and the public as take
0:57:19 > 0:57:27this forward.GP services are in crisis, practice after praxis is
0:57:27 > 0:57:32closing, more GPs leave the service every day. When will the Secretary
0:57:32 > 0:57:35of State listened to the BMA GP committee chair who says current GB
0:57:35 > 0:57:42funding is nowhere near enough?We have been listening to the Royal
0:57:42 > 0:57:46College of GPs and BMA, that's why last year funding for GPs went up by
0:57:46 > 0:57:51340 million. Over the five-year period it will be going up by £2.4
0:57:51 > 0:57:57billion which is a 14% real terms increase.A magnificent array of
0:57:57 > 0:58:02rosettes on both side of the chamber, which today, today only I
0:58:02 > 0:58:09will allowed to influence me.Thank you, Mr Speaker, it is a proud day
0:58:09 > 0:58:15to be a woman in this House. In Midlands South Essex there are plans
0:58:15 > 0:58:18for a hyper acute stroke unit at Basildon Hospital. Can the Secretary
0:58:18 > 0:58:23of State or one of the ministers confirmed this will be an
0:58:23 > 0:58:26improvement of services for my constituents in Chelmsford and not a
0:58:26 > 0:58:35downgrade?I'm happy to confirm this observation. It is absolutely about
0:58:35 > 0:58:39improving services, this proposal for a new hybrid acute stroke unit
0:58:39 > 0:58:43in Basildon will ensure there are specialist doctors and nurses
0:58:43 > 0:58:46available to manage patients at all time. The lessons we have seen in
0:58:46 > 0:58:50London where we consolidate drug services and health outcomes and
0:58:50 > 0:59:00lives were saved.Valerie and Colin Hindmarch in my constituency were
0:59:00 > 0:59:02prescribed Premadasa at eight months pregnant, their child Colin would
0:59:02 > 0:59:06have been 50 on the 12th of this month however died at five months
0:59:06 > 0:59:12old. Most of Valerie's medical records are missing. When will the
0:59:12 > 0:59:19Secretary of State offer an enquiry into this, and acknowledge crucially
0:59:19 > 0:59:22that trust and confidence of the victims can only come to this judge
0:59:22 > 0:59:29led public enquiry?The honourable lady will know we are currently
0:59:29 > 0:59:33implementing the findings of the expert working group and we are
0:59:33 > 0:59:35continuing our discussions with the all-party groups to see how much
0:59:35 > 0:59:41further we can go with actually answering peoples questions and
0:59:41 > 0:59:46responding to the moving cases, one of which she has just explained. I
0:59:46 > 0:59:49will be happy to have further conversations with any honourable
0:59:49 > 0:59:54member who wants to discuss this further.In Shropshire, we have had
0:59:54 > 0:59:59four years of confusion around the future of our two hospitals. Will
0:59:59 > 1:00:02the Secretary of State tell the people of Shropshire whether there
1:00:02 > 1:00:04is government funding for the proposed reconfiguration of the
1:00:04 > 1:00:13county 's hospitals?As you will be aware, we have announced by the
1:00:13 > 1:00:16funding in the budget and Autumn Statement on the specific case here,
1:00:16 > 1:00:20which I know the honourable lady has raised often, I am happy to have
1:00:20 > 1:00:27further discussions with her.In my constituency, Sheldon medical Centre
1:00:27 > 1:00:33and half the Richardson Hospital are empty, yet patients services are
1:00:33 > 1:00:39being cut because the rent charge by NHS property services are too high.
1:00:39 > 1:00:46When will the Secretary of State sort out this waste of resources?
1:00:46 > 1:00:50While not aware of the specific case the honourable lady highlights, I'm
1:00:50 > 1:00:55happy to look at that and understand why she feels the rents are
1:00:55 > 1:00:58disproportionately high. What she refers to really is the point I made
1:00:58 > 1:01:03earlier to the Member for West Lancashire, which is the variance in
1:01:03 > 1:01:07the system and how we sure we obtain best value for money. The reality of
1:01:07 > 1:01:10the debate on health is that the party opposite simply see the debate
1:01:10 > 1:01:15in terms of how much money is put in. On the side of the House, we
1:01:15 > 1:01:20recognise we need to invest more in the NHS and ensure we get the best
1:01:20 > 1:01:28outcomes. That is the key dividing line between parties.For six years,
1:01:28 > 1:01:32the people of Redditch have enjoyed a painful consultation into the
1:01:32 > 1:01:36hospital the Alex which has dragged on and on, as a result they have
1:01:36 > 1:01:39lost maternity and children's emergency services, something nobody
1:01:39 > 1:01:43wanted even though they were consulted. People have taken the
1:01:43 > 1:01:47pain, when will they get the game? When will they see the urgent care
1:01:47 > 1:01:53centre, when will the £29 million be spent on the Alex?There are good
1:01:53 > 1:01:58funds in place for getting the Alex special measures, a packet of
1:01:58 > 1:02:02support is in place to enable the trust to improve its quality of
1:02:02 > 1:02:07care. Delivery of the acute service redesign plan is a key driver to
1:02:07 > 1:02:10sustaining services in the medium term and 29.6 million of STB funding
1:02:10 > 1:02:19has been agreed to support this.At the weekend, NHS England gave up on
1:02:19 > 1:02:24the key A&E waiting time targets. Does the Minister agree that it's
1:02:24 > 1:02:28very important that when people go to A&E, they don't have to wait
1:02:28 > 1:02:31longer than four hours as more than two and a half million did last
1:02:31 > 1:02:40year?I have great respect for the honourable gentleman but he is
1:02:40 > 1:02:44saying something that is a big exaggeration. What the NHS has
1:02:44 > 1:02:48committed to is that by the end of this year, the end of the year
1:02:48 > 1:02:51coming up, more than half the trust in the country will meet the A&E
1:02:51 > 1:02:54target and we will go back to meeting it across the whole country
1:02:54 > 1:02:59in the following year. We are absolutely committed to this target.
1:02:59 > 1:03:02We recognise there are real pressures which is why it will take
1:03:02 > 1:03:09time, but we will get there.Can I congratulate my honourable friend
1:03:09 > 1:03:12for securing the £10 billion capital commitment in the budget at the end
1:03:12 > 1:03:16of last year to spend on the NHS, and could I take advantage of my
1:03:16 > 1:03:21position on these benches to urge him for the next allocation of STB
1:03:21 > 1:03:26funding to adopt the advice of my honourable friend for Telford and
1:03:26 > 1:03:29ensure that Shropshire Shrewsbury and told the hospital trust gets the
1:03:29 > 1:03:34future fit funding it needs.Can I first pay tribute to my honourable
1:03:34 > 1:03:39friend for the work he did in the Department of Health, and the high
1:03:39 > 1:03:44esteem he was held by those working in the NHS. In terms of Shrewsbury
1:03:44 > 1:03:49in Telford, I appreciate the importance of reconfiguration to the
1:03:49 > 1:03:52trust, we do expect a decision shortly on that the one not in a
1:03:52 > 1:03:58position to announce that position today.The Secretary of State will
1:03:58 > 1:04:01be aware there was huge disruption at Manchester hospitals this week
1:04:01 > 1:04:06because water supplies and a big water leak. Emmeline Pankhurst's
1:04:06 > 1:04:10home is on the site of the Manchester hospitals as well, but
1:04:10 > 1:04:13what conversations has he had with United Utilities and other water
1:04:13 > 1:04:18companies to ensure we have six supplies, constant supplies of water
1:04:18 > 1:04:22to allow hospitals to ensure these disruptions don't happen?I know NHS
1:04:22 > 1:04:26improvement are aware of the situation and imported conversations
1:04:26 > 1:04:29are ongoing to improve the resilience of all our hospitals, but
1:04:29 > 1:04:37I will happily write to her on the issue.I will call on the gentleman
1:04:37 > 1:04:43for East Worthing and his question is shorter than his tie.10% of
1:04:43 > 1:04:47women in this country, many without a diagnosis, so why is it an
1:04:47 > 1:04:52increasing number of my constituents say they cannot get any therapeutic
1:04:52 > 1:04:56interventions by the CCG and will he meet a delegation of those people?
1:04:56 > 1:05:02Of course I will meet my short tide friend with a delegation he
1:05:02 > 1:05:07requests.We are well over time but don't the honourable gentleman feel
1:05:07 > 1:05:18isolated.Thank you. Suicide calls are at a record high. The NHS
1:05:18 > 1:05:22currently spends only 11% of their budget on health issues, could be
1:05:22 > 1:05:29secretary indicate what he will do to prevent suicides?We are very
1:05:29 > 1:05:35focused on reducing all suicides, as the gentleman will know, we have a
1:05:35 > 1:05:40plan to reduce suicide rates by 10%. Last week we announced a plan to
1:05:40 > 1:05:43reduce inpatient suicides to zero which is a