Social Care

Helen Whately Excerpts

Wednesday 25th October 2017 Commons Chamber

[Helen Whately (Faversham and Mid Kent) (Con)]

I am sure that all of us who have been out and about with care workers in our constituencies have found the experience not only informative but inspiring. I certainly had a brilliant experience when I went out and about with a care worker in my patch. I saw the enormous compassion in the care that she provided and how incredibly hard she worked. It was a tough job, but a rewarding one. As many Members have said, however, the work is not well enough paid, there is no career structure and there is not enough support for carers in their day-to-day work.

Everyone in the Chamber today recognises that the current system is not fair and not working. It is not fair that people can get care for free if they can stay living in their home, but if they have to go into a care home, they might be left with only £14,000 of savings. Most people would much rather be cared for at home, but that is not always possible. The present system therefore discriminates against those who cannot stay at home to be cared for, and that is simply not fair. We need to bear that in mind as we talk about potential solutions. Let us not pretend for a moment that the current system is fair.

The system is also not working. Around 30% of the people in hospital in my constituency do not need to be there. They would be better off out of hospital, but there is often no outside support available for them. Delayed transfers of care are an ongoing challenge. There are also people in care homes because of the shortage of domiciliary care. We have to address what is substantially a funding challenge: there is simply not enough money going into care.

The shadow Minister, the hon. Member for Worsley and Eccles South (Barbara Keeley), said that she was going to give us Labour’s solutions to the problem. I listened carefully to her speech, but I was disappointed that she spent only about one minute of her 24-minute speech talking about potential solutions. I am afraid that I did not really hear any solutions—

[Barbara Keeley]

Will the hon. Lady give way?

[Helen Whately]

I am really sorry, but I cannot take any interventions. I have been asked not to.

Most significantly, the hon. Lady does not have a plan for how to pay for all this. It all comes down to how we are going to pay for improving access to care, and the Labour party simply does not have a plan. As for cross-party working, that would be fantastic but judging by some of the language I have heard from Labour Members, I do not think that many of them are ready to work together on this. I encourage the Government to get on with the job of proposing a better, sustainably funded, care system so that our constituents can get the care that they need.

Oral Answers to Questions

Helen Whately Excerpts

Tuesday 10th October 2017 Commons Chamber

[Mr Hunt]

I welcome what I think is my first question from the hon. Lady, and I can give her some good news: the pay cap has been scrapped.

[Helen Whately (Faversham and Mid Kent) (Con)]

In the work that I have done in hospitals, staff have told me that they are most unhappy about too much reliance on temporary staff, rota gaps and not feeling valued, as opposed to issues around pay. The latter—not feeling valued—often goes hand in hand with poor management practices. What is my right hon. Friend doing about those causes of staff unhappiness?

[Mr Hunt]

My hon. Friend, who has a lot of experience of working in the NHS, is absolutely right. The new Care Quality Commission inspection regime is designed precisely to identify good, strong leadership, because that has the best impact on staff and, through that, the best impact on patients.

Autism Diagnosis

Helen Whately Excerpts

Wednesday 13th September 2017 Westminster Hall

[Helen Whately (Faversham and Mid Kent) (Con)]

I congratulate the hon. Member for Enfield, Southgate (Bambos Charalambous) on securing the debate, and I am pleased to see so many people in the Chamber; it reflects the level of concern about the waiting times for autism diagnosis.

First, I welcome the efforts that clearly are being taken by Governments and local authorities to provide more support for children and adults with autism. Just last week, the doubling of the number of health visitors since 2010 was brought to my attention in my constituency. That has had benefits in supporting young families and, in particular, parents, when their child is not behaving as they expected. There are good things going on, but I want to talk briefly about the gap between the NICE guidelines on waiting times and what appears to be happening on the ground.

When I talk to parents in my constituency, it is clear that their experience does not involve a three-month waiting time. I have several accounts from parents who have experienced much longer waits. For example, one set of parents raised concerns when their child was four. That child is now 10 and they still do not have a diagnosis, despite many professionals seeing the child and indicating that they think that they are on the autism spectrum. In another family, the mother raised concerns when her son was 15 months old and the child was nearly four before she got a diagnosis. During that period, not only did the child regress and go, for instance, from talking to not talking and communicating to not communicating, but a lot of concern was raised about the mother’s mental health. Rather than her being given support to look after the child, it was all about whether she had mental health problems. She went for all the support that she could get, but it very much felt like the focus was not on supporting the child. I have a whole raft of such stories.

[Mike Amesbury (Weaver Vale) (Lab)]

Will the hon. Lady give way?

[Helen Whately]

We are very short of time, so I had best press on.

I draw on examples in part because we do not have regional data on waiting times. I asked the local clinical commissioning group and was told that it does not have easy access to those data, so I do not know what the waiting times are—I just have stories that make it clear that they are extraordinarily long. My first request is therefore for more transparency about the data, as well as addressing the problem of parents saying that they are waiting to wait—that is, that they are being passed from one list to another. Let us have transparency. Let us have people who are waiting getting seen sooner and then, following the diagnosis, let us have really good support services, because the story is very patchy in that area, too.

NHS Pay

Helen Whately Excerpts

Wednesday 13th September 2017 Commons Chamber

[Jonathan Ashworth]

The Labour party supports people taking legal industrial action, and if the hon. Lady supports public sector workers, she should be joining us in the Division Lobby later.

[Helen Whately (Faversham and Mid Kent) (Con)]

Does the hon. Gentleman agree that the pay restraint over the past few years has been uncomfortable but necessary, in order to bring Government spending—[Interruption.]

[Mr Speaker]

Order.

[Helen Whately]

None of us would want anyone to be paid any less, but it has been difficult but necessary, in order to control the overspending by Government and put right the financial mess that the country was left in after the last time the hon. Gentleman’s party was in government.

[Jonathan Ashworth]

I agreed with the hon. Lady’s comments at the time of the debate on the Gracious Speech, when she said:

“I’m of the view we need to look at public sector pay in the light of increasing inflation.”

If those were her comments then, she should be joining us in the Division Lobby this afternoon.

--- Later in debate ---

[Jonathan Ashworth]

I have given way to the hon. Lady once and I have been generous, so I hope she will forgive me if I do not give way again.

We have heard several examples of what vacancies in the NHS mean for services. We have heard about the walk-in centre in Wirral, but Macmillan Cancer Support warned last week that bigger workloads and vacancies in key roles are creating “unrelenting pressure” on the cancer care workforce and that some cancer patients are attending A&E because they cannot get help elsewhere. I have mentioned midwifery, and this summer we revealed that almost half of maternity units closed their doors to patients at some point in 2016, with understaffing often used as the justification. Earlier this year, I revealed FOI requests that showed a rising number of cancelled children’s operations, with 38% of trusts citing workforce shortages as the reason for those cancelled operations. Visit any hospital and doctors will talk about rota gaps, and the latest NHS staff survey reveals that 47% of staff view current staffing levels as insufficient to allow them to do their job properly.

Not only is the pay cap unfair on hard-working staff who are struggling to make ends meet, but it is unfair on patients, who suffer the direct consequences of under-staffed, overstretched services. We look forward to the Health Secretary telling us how he will use his newfound flexibility. We look forward to his telling us what remit he will set for the NHS Pay Review Body in the coming days. He has had all summer to think through his response to these demands. I know that he got into a big argument with Professor Stephen Hawking, but we will leave that there. The Health Secretary sets the remit—he tells the pay review body what it is able to provide—so we look to him to tell us what he is going to ask it to provide. We want him to tell us today when he will publish the remit letter.

[Helen Whately]

Will the hon. Gentleman give way?

[Jonathan Ashworth]

I have been very generous to Government Members, and the hon. Lady has already had a chance.

The pay cap must be scrapped, and it must be done by giving the NHS extra investment. The self-defeating nature of this policy means that we are already spending £3 billion on agency workers, and the Government have found billions for corporation tax and inheritance tax giveaways, so this new flexibility must mean more investment. We will not tolerate hospital bosses being forced to cut services to find these funds.

--- Later in debate ---

[Mr Hunt]

I will give way to some Conservative Members.

[Helen Whately]

Opposition Members are raising concerns about staff shortages and about recruiting staff from overseas. I am sure we all have hospitals serving our constituents that have had to go overseas to recruit. We do not want to see that; we want to see nurses trained in the UK and British nurses. I welcome the fact that the Secretary of State has taken action to remove the cap on nurses in training so that we can train more home-grown nurses.

[Mr Hunt]

My hon. Friend is right about that, because at the heart of this problem is getting the training of nurses right and making sure we train enough nurses.

--- Later in debate ---

[Helen Whately (Faversham and Mid Kent) (Con)]

It is a pleasure to speak in this debate. I will not try to compete with my right hon. Friend the Member for Broxtowe (Anna Soubry), but one reason why I am speaking today—and why I often speak on healthcare matters in this place—is that I, too, come from a family of doctors and nurses who work in the NHS. It was wanting to make the NHS better that first got me involved in politics, and I care very deeply about our national health service.

I welcome the Government’s decision to lift the pay cap, and to do it in a responsible way, but it has served a purpose. Back in 2010, the pay cap was necessary. Indeed, there was a pay cap in the Labour party’s 2010 manifesto as well. Labour also recognised that a level of pay restraint was necessary because of the financial situation in which the country found itself. Pay restraint was urgently needed, because wages are a significant driver of costs in the NHS and the wider public sector, and the public finances were running totally out of control. The pay cap was part of the restoration of financial discipline, of confidence in our economy and of growth, which we are now enjoying. Thanks to that growth, millions more people are now in work.

It is right to lift the pay cap now, but it must be done with caution because this country still has a sizeable deficit and increasing levels of debt. We are still paying off large amounts of debt interest. We therefore have to be responsible in the way we make commitments on public sector spending. I am very concerned about Labour’s plans for the pay increases that they would be willing to fund. They seem to involve an open promise and a potentially bottomless pit. Labour Members will not tell us how much the pay increases would be, but we know that the proposals in their manifesto would have cost between £6 billion and £9 billion extra. It was not clear where that money was to come from. Time and again, we heard that it would come from corporation tax, but we know that when we put up corporation tax we reduce the tax take, so that policy would not have funded the increases. I am concerned that Labour Members are making an irresponsible promise that they would not be able to deliver, were they in a position to try.

I welcome the more responsible approach taken by this Government. It will not involve a blanket pay rise; rather, it will draw on the guidance of the next pay review body for the health service and make pay rises where they are most necessary. In my constituency in the south-east, for example, I am aware that the high cost of living affects the people on the lowest pay in the public sector, and I hope that they will be recognised in the pay review. We should definitely draw on the expertise of that body when making proposals for public sector pay, rather than just trying to score debating points and get the right headlines.

In my experience of about a decade working in many parts of the NHS, including hospitals, and as an MP, I have spoken to people working in the NHS and found that pay is rarely, if ever, the No. 1 concern. The issues that come up much more frequently include having time to care—

[Darren Jones (Bristol North West) (Lab)]

I thank the hon. Lady for allowing me to intervene. She clearly wishes to champion nurses and their selfless desire to serve the public, but does she acknowledge that nurses in my constituency have to visit a food bank after a long shift at the hospital? Should not their selflessness in wanting to serve the public be recognised by their being paid what they deserve so that they can fund their families and their livelihoods?

[Helen Whately]

I genuinely believe that all members of the public sector should be paid a fair amount, and that is exactly what the pay review body will report on in its next report.

I was making the important point that pay has not been the No. 1 issue among nurses and other healthcare professionals when I have asked them what worries them most. Instead, they mentioned having time to care; being part of a stable team rather than having a high turnover of staff and lots of temporary staff; being listened to by the people they work with, particularly the senior people in the institution; and being valued. Being valued is not all to do with pay; it is much more to do with the way they are treated. In fact, I remember very well talking to one nurse whose line manager had not talked to her since the previous appraisal. To me, that is an extraordinary way of not valuing a member of staff; everyone should have regular conversations with their manager about how they are progressing.

Part of the problem in some NHS institutions is, therefore, in my view, not good enough management practices. If they were improved, we would have a much better environment for staff to work in, and I would very much like to see more attention paid to creating the right environment for healthcare workers, as well as ensuring that there is a fair and sensible pay settlement.

Adult Social Care Funding

Helen Whately Excerpts

Thursday 6th July 2017 Commons Chamber

[Steve Brine]

I will look into that. The hon. Gentleman makes an important point. I am sure that Members across the House take part in carers week events every year. I certainly do that in my constituency. It is at those events that we meet not only the staff who work in the system but the people who, day in and day out, do not have the life that they would like to have because they have caring responsibilities. We also meet young carers who do incredible work. The hon. Gentleman is right, and we should all say a clear thank you to those people for the work that they do.

[Helen Whately (Faversham and Mid Kent) (Con)]

The extra money in the last Budget for social care is helping Kent County Council to provide more people with access to care, particularly at home, but the cost of social care is going to keep rising. Does my hon. Friend agree that we as a society need to have an honest conversation about how we fund those growing costs fairly across the generations?

[Steve Brine]

Yes. This is no different from the conversation that we are having about the funding of every other public service. It is very easy to take to the streets with placards saying “Spend more!” Indeed, I think the Leader of the Opposition spent the national debt several times over just in his response to the Queen’s Speech. This is why we need a proper debate and a consultation on long-term funding. Ultimately, it could come out of general taxation, but we have to have a debate as a country on how much we can afford to do while funding all the other public services. I have not noticed us being short of requests to increase funding in other areas as well. We have to have that honest debate as a country.

Kent & Canterbury Hospital

Helen Whately Excerpts

Thursday 22nd June 2017 Commons Chamber

[Helen Whately (Faversham and Mid Kent) (Con)]

I would like to start by welcoming Ken Rogers and campaigners from Concern for Health in East Kent, who have come here today to hear this debate. Ken was born in 1948, the same year as the NHS. He was diagnosed with chronic lymphatic leukaemia when his daughter was 15 months old and told that he would not live to see her fifth birthday. That was in 1981. Thanks to Kent & Canterbury hospital, he is here today, listening to this debate. There are thousands of people with similar stories—people who would not be here today if it were not for Kent & Canterbury hospital, a treasured hospital with a history going back over two centuries, and for many years a top destination for junior doctors and aspiring consultants.

The hospital has an outstanding reputation in specialties such as urology, providing dialysis for patients across east and west Kent, neurology, neuro-rehabilitation and surgery, with surgeons using a state-of-the-art robot to carry out manoeuvres impossible with human hands. Last week, the Taylor ward was providing fantastic specialist care for cardiac patients and the hospital serves around 200,000 people in Canterbury, Faversham and surrounding villages, but people across that area are worried—very worried—because there is a big question mark over the future of the hospital.

The building is out of date—frankly, it is crumbling—and the hospital is struggling to recruit staff. I said that last week the Taylor ward was providing specialist cardiac care because, this week, that is no longer the case. On Monday, junior doctors were withdrawn from Canterbury and relocated to neighbouring hospitals, after Health Education England said that there were not enough consultants to oversee their training and there was too much reliance on locums. The shift of junior doctors means the shift of emergency care. Heart attack patients in my constituency, who previously faced a journey of under 20 minutes to get to the hospital in Canterbury from Faversham, will now have to travel to Ashford—a longer drive on winding roads, one of which will be closed all summer—or Margate, 40 minutes away. In rush hour or by public transport, these journeys are far, far longer. People are scared that they or a loved one will not make it in time, and that visiting will be harder, or impossible for some. Added to that is the confusion about the transfer of services, and the risk that the pressure to free up acute beds will mean patients being transferred between hospitals before they are ready or ending up in corridors. Nurses, some of whom are here today, are desperately worried about the risk for patients.

Then there is the impact on the staff. Some are now making longer journeys to work. Others are staying at Kent & Canterbury but are at risk of losing their specialist skills. No commitment has been made on when acute services will return to Canterbury. There is great scepticism about the efforts being made to recruit consultants. Public trust has been lost. The point is that these temporary changes must not become permanent. We must not allow the hospital to crumble further and drift towards a downgrade, when there is a real opportunity to seize this moment of change to form an ambitious long-term vision for healthcare in Kent.

What patients really need is a new acute hospital providing world-class care and a medical school attracting the brightest and best doctors and nurses, making east Kent a centre of excellence in healthcare. As a university city and a major population centre with good transport links, Canterbury is the right place for a major hospital and a medical school. The Kent and Medway sustainability and transformation plan is proposing to reconfigure acute services across east Kent’s three major hospitals into one emergency hub with specialist care and a trauma unit, a second emergency hospital also carrying out planned care and, at the third site, a rehabilitation hospital and a primary care-led urgent care centre. The STP is not specific about what will happen where, but all the signs are that Canterbury is the most likely to lose acute services, despite it being the obvious place to centralise specialist services.

We are at a crunch point, but this should not, and must not, be treated as a foregone conclusion. This is not the time for another short-term compromise. It is time to reverse the direction of travel and make the case for a long-term, visionary answer to the challenges of healthcare in Kent. A new hospital is not a panacea; it is not the answer to all Kent’s healthcare problems. We still need to invest in primary care and bring more services out of hospitals and into places such as the Encompass Vanguard in Whitstable and Faversham cottage hospital.

[Charlie Elphicke (Dover) (Con)]

On behalf of all the MPs in east Kent, I absolutely support my hon. Friend in making a powerful case for a new, state-of-the-art acute hospital in east Kent. Does she agree that cottage hospitals such as Buckland hospital in Dover make a great deal of difference and that we ought to have more services locally, wherever possible?

[Helen Whately]

I completely agree with my hon. Friend. In addition to the fantastic acute hospitals, community and cottage hospitals are really important. Patients who do not need acute care can be looked after closer to home and be given a different sort of care in the environment of a local community hospital such as the one in his constituency or Faversham cottage hospital in my own, which is deeply loved and enormously valued by the community.

The new hospital that I am asking for will take time, so it will not fix the immediate challenges that the NHS is facing in Kent, but now is the time to look to the future. It has been suggested that the STP consultation is looking merely at the next five years. That is totally inadequate; it is far too short a timeframe. We need to put politics aside and think further ahead than the next parliamentary term, just as we are putting party allegiance aside for this campaign. I am pleased to be working with my colleague, the new hon. Member for Canterbury (Rosie Duffield). She is taking up this campaign from her predecessor, Sir Julian Brazier, who fought hard for many years for Kent & Canterbury hospital.

In conclusion, I shall turn to the specific requests that I want to make of my hon. Friend the Minister. I ask him to note that Kent & Canterbury hospital has strong support in the community, represented here today by members of CHEK, and across the political parties. I ask him to look closely at the temporary changes to services, to challenge the hospital on its contingency plans and to make absolutely sure that, in the short term, these services are safe for patients. I ask him to ensure that these changes do not become permanent. I also ask him to look favourably on the case for a medical school in Kent, and to ensure that the STP consultation takes into account the connection between the medical school proposal and the decision about acute sites.

I have been told many times that one barrier to the idea of a new Canterbury hospital is a lack of capital. I ask my hon. Friend to help us here. More capital has been promised for the NHS, so will he make it clear to the local NHS leaders driving the process that if they, and we in Kent, can make the case, capital will be available. There is a risk that the consultation on Kent’s STP will be presented to the public with no option for an acute hospital at Canterbury. If none of the options propose keeping acute services at Canterbury, it cannot be called a true consultation.

Finally, will my hon. Friend please require STP leaders to look to the long-term, to be ambitious in their plans, and to aim for excellence? There is an opportunity here for Kent—specifically east Kent—to bring an end to the drift of services away from the area, to downgrading, and to the struggle to recruit and retrain staff. Instead, Kent could become a centre of excellence, making the most of the combined assets of the NHS, local universities and the strong life sciences research sector in east Kent to offer people in Kent brilliant patient care, to develop innovative treatments and pathways, and to set an example for the whole country of how we can provide excellent, sustainable healthcare.

[The Minister of State, Department of Health (Mr Philip Dunne)]

It is a pleasure to serve under your chairmanship as Deputy Speaker, Sir David. I hope that that will not necessarily be as temporary as suggested by Mr Speaker when he sought the leave of the House to appoint you. It is also a pleasure to respond to my hon. Friend the Member for Faversham and Mid Kent (Helen Whately), who has been on her toes in securing Mr Speaker’s consent to have this debate so early in the parliamentary Session. I am pleased that she has secured the support of many of her constituents, some of whom have come to witness her championing their interests in relation to Kent & Canterbury hospital. She has done that not just this evening, but consistently over the past few months with our mutual friend Sir Julian Brazier, who is sadly no longer with us in the House. However, I congratulate his replacement, the new hon. Member for Canterbury (Rosie Duffield).

I worked closely with Sir Julian when we were Ministers in the Ministry of Defence, and both he and my hon. Friend the Member for Faversham and Mid Kent have been doughty champions of the population of mid- Kent, particularly those in the areas surrounding Canterbury, in fighting for healthcare services given the challenges that she quite properly describes at Canterbury hospital. I pay tribute to them for that, and they are doing the right thing in ensuring that such issues are brought to Ministers’ attention. I know that she wrote to the Secretary of State only last week, and I am pleased to hear her arguments, which were so eloquently put today. I will say what I can in response to the questions and challenges that she posed, but I must say at the outset that I do not stand here tonight with all the answers to all the questions because, as she will appreciate, many of the things that she is calling for are decisions that will be taken and led by clinicians in Kent. It is not for Ministers to prescribe the provision of services in Kent. Many such decisions will take place over a period of time; it will not be instant decision making.

I will start my response by providing a little context for what has happened over the past few years, and this week in particular. As my hon. Friend pointed out, the board of East Kent Hospitals University NHS Foundation Trust agreed to relocate some services from its Canterbury site, Kent & Canterbury Hospital, this Monday. The change happened overnight from Sunday into Monday and came in response to legitimate concerns raised by both the General Medical Council and Health Education England over a period stretching back to as early as 2014, when they raised concerns about the standard of training available at the Canterbury site, in particular the quality and safety of junior doctor training.

The situation was brought to a head following a visit in March this year. The recruitment and retention of key medical staff has been an ongoing challenge for the trust, and there is a shortage of consultants to provide the required training and supervision of junior doctors posted to Kent & Canterbury hospital. On Sunday 18 June, 38 junior doctors were reallocated from Kent & Canterbury to other sites operated by the trust. The removal of these junior doctors has required the trust to relocate some of the services it provides, to ensure safe and sustainably staffed services for patients.

My hon. Friend’s constituents will still receive good service provision. The clinical commissioning group has facilitated this development by acquiring some 40 additional care packages to support effective discharge from the Ashford and Margate sites, to free up some 75 beds to allow for this temporary service change to take place, along with an additional 20 ambulances, supplied through SECAmb—the South East Coast Ambulance Service NHS Foundation Trust—to cover the additional journey times from the Canterbury area. Replacement services at nearby hospitals in Ashford and Margate are being monitored to ensure that they are safe and effective, given the additional pressure on those hospitals from the move.

Unfortunately, I cannot say today how long this temporary closure will last. The GMC has made it clear that

“if there is evidence that appropriate and sustainable action has been taken to make the Urgent Care Centre a safe environment for doctors in training once more, HEE will review reallocating trainees to the site”.

No decision has been made about the long-term future of the service and no decision will be made without full public consultation. I can give my hon. Friend that reassurance.

[Helen Whately]

My hon. Friend mentions that there is monitoring of the provision of care for the services that have been moved to William Harvey and Queen Elizabeth the Queen Mother hospitals. May I ask him to take a personal interest in that monitoring? I have heard reports from staff who are really worried about how care is being provided following the transfer of the services. They are very concerned that patients might be at risk.

--- Later in debate ---

[Mr Dunne]

I was going to come on to the suggestion of my hon. Friend the Member for Faversham and Mid Kent about both allocation of capital and the possibility of a new hospital. I was starting to develop the point that this matter needs to be assessed in the light of the overall requirements of the healthcare economy of mid-Kent and the East Kent trust through the STP process. Capital is currently constrained throughout the NHS. As hon. Members will know, in the March Budget we announced a capital allocation of some £325 million over the next three years to support the first phase of STPs. Fairly shortly, we should have made sufficient progress in deciding which of the STP proposals should be supported to secure that capital. Other capital pots are available to the NHS for what we refer to as business as usual, and there are always opportunities for trusts to make capital proposals to the NHS.

Right now, it is not appropriate for me to explain the basis on which future capital allocation decisions will be made. One can look to the recent past to identify some significant new hospital builds that are now in progress. There is currently a significant capital investment not far around the coast from Kent, in Brighton, and there is another closer to my constituency, in Sandwell in Birmingham. Such builds are few and far between, and bearing in mind the kind of major capital investment we are talking about, I think both my hon. Friends from different parts of Kent are arguing for space to undertake a study to consider whether a major build is appropriate to meet the needs of the mid-Kent population.

Generally, as can be identified from the two significant builds that are currently under way, which have been allocated hundreds of millions of pounds of capital each, a certain density of population is required to be served. Such builds are therefore most likely to occur in major cities rather than in less densely populated areas. That said, it is not for me to make suggestions as to what would or would not be appropriate. I urge my hon. Friend the Member for Faversham and Mid Kent to discuss the matter, as I know she has already, with her STP leaders. If there is a desire among Kent MPs and the Kent community to consider whether in future a more holistic approach to satisfying healthcare needs should be taken in the county as a whole, perhaps my hon. Friend should work in conjunction with other hon. Members.

The right forums are the STPs, which are bringing together NHS providers and commissioners from throughout their regions to try to arrange provision to meet the future healthcare needs of their populations. Whether or not my hon. Friend is successful in persuading the STP that a new hospital in Canterbury is the right solution, that is a matter for her to take forward with the STP. Such an effort would carry more weight were it supported by other colleagues from the area.

[Helen Whately]

It needs to come from the top that, when a bid is put forward that makes the case for significant investment, capital will be forthcoming. That message is currently not coming through and it is deterring people from making that case. It needs to shift.

[Mr Dunne]

I am conscious that I am close to running out of time, and I want to address the other point my hon. Friend raised, but I will say that capital is allocated by the Department of Health on the basis of the strength of the proposals, which need to meet the criteria on meeting the needs of local populations. That has to be balanced against the amount of capital that is available throughout the country, where there are competing needs.

My hon. Friend also raised the idea of a medical school, which she has discussed with me previously. She is aware of the consultation the Department ran on allocating new medical school places. That consultation has completed and we are considering our response. I am grateful to her for her submission. We wish to encourage some development of new medical schools, but again, that is subject to regulatory approval by the General Medical Council and other bodies. Any universities that wish to establish a new school need to meet the regulators’ criteria. I encourage my hon. Friend to see what progress is being made in that direction.

In conclusion, I again congratulate my hon. Friend on securing this debate and reassure her that I will be taking a close interest in how events unfold in the East Kent trust. I expect we will have an opportunity to discuss this matter again before too long.

Question put and agreed to.