Oral Answers to Questions

Andrew Stephenson Excerpts

Tuesday 23rd April 2024 Commons Chamber

[Richard Burgon (Leeds East) (Lab)]

2. What steps her Department is taking to reduce waiting times for NHS treatment.

[The Minister for Health and Secondary Care (Andrew Stephenson)]

Happy St George’s day, Mr Speaker.

Cutting waiting lists is one of the Prime Minister’s top priorities. We are spending more than £8 billion on additional elective activity and investing in additional capacity including community diagnostics centres, one such centre being in the hon. Gentleman’s constituency. Since September 2023 overall waiting lists have fallen by almost 200,000—the biggest five-month fall in over 10 years, outside of the pandemic.

[Richard Burgon]

NHS waiting lists have risen threefold since the Tories came to power, and the Prime Minister’s pledge to cut waiting lists is in tatters. Rather than taking responsibility, the Tories first blamed NHS staff who were trying to get better pay, and now they have opened up a new round of media attacks on the sick and the disabled. Why do not the Government instead go after the tax dodgers, as Labour plans to do, to raise funds and help resolve the crisis in our NHS?

[Andrew Stephenson]

Once again the hon. Gentleman does not condemn the strikes. I would gently say that while we are getting waiting lists down in England, Welsh Labour has the longest hospital waits in Great Britain, putting patients at risk because it does not have a plan to clear the backlog. In December 2023 the Welsh Labour Government had the highest number of patients in Great Britain waiting over two years for treatments. It is an outrage; yet that is the blueprint for what the Labour party says it will implement here in England.

[Simon Fell (Barrow and Furness) (Con)]

I see increasing numbers of women coming to my constituency surgeries about chronic urinary tract infections, not for themselves but for their daughters. Unfortunately there seems to be no treatment pathway for chronic UTIs among girls. Does my right hon. Friend have any thoughts about that, and would he agree to meet me to discuss the issue further?

[Andrew Stephenson]

I would be very happy to meet my hon. Friend to discuss the issue.

[Mr Speaker]

I call the shadow Secretary of State.

[Wes Streeting (Ilford North) (Lab)]

Happy St George’s day, Mr Speaker.

Westminster is awash with rumours that the Prime Minister will call a July general election, presumably to avoid giving his Rwanda gimmick the time to fail. I have a very simple question for the Minister: will he repeat the pledge that the Prime Minister made last year and promise that NHS waiting lists will be lower at the time of the general election than when the Prime Minister came to office?

[Andrew Stephenson]

The Prime Minister has been very clear that getting waiting lists down is one of his top priorities, but he has also been clear that performance has been disappointing. One reason is that 1.4 million procedures have had to be rescheduled because of industrial action. I would gently ask the shadow Secretary of State whether he condemns those strikes.

[Anthony Mangnall (Totnes) (Con)]

3. What assessment she has made of the adequacy of oversight mechanisms for the General Medical Council.

[The Minister for Health and Secondary Care (Andrew Stephenson)]

The General Medical Council has been constituted by Parliament to ensure that decisions about individual doctors are independent of both the profession and the Government of the day. The Professional Standards Authority oversees the work of all United Kingdom professional regulators and reports to Parliament on their operational performance. Parliament continues to set and oversee the principles and scope of the regulators’ powers.

[Anthony Mangnall]

Good governance means ensuring transparency, and one concern of my constituents is whether GMC decisions can be appealed. Will the Minister reassure me that we can have better transparency in the GMC on the decisions that it makes?

[Andrew Stephenson]

The GMC and other professional regulators have a statutory duty to investigate any concerns about the fitness to practice of one of their registrants and to take appropriate action to protect the public when that is needed. The regulators are overseen by the Professional Standards Authority for Health and Social Care, which has the power to appeal cases where, in its view, a sanction imposed by a regulator is insufficient to protect the public.

[Jim Shannon (Strangford) (DUP)]

The GMC has seven principles of decision making and consent. How will the Minister ensure that GPs can fulfil their obligations when time constraints on appointments mean that they do not have time to listen to every complaint? People have to book a double appointment to talk about more than one issue. What further support can the Government give GPs to enable them to fulfil their GMC-ordered standards of care?

[Andrew Stephenson]

As the hon. Gentleman knows, the Government have committed to delivering 50 million more GP appointments and to making it easier throughout the country to see a doctor. In England in December, we delivered 25.77 million GP appointments compared with 23.31 million in December 2019—an increase of 2.46 million appointments each month. We need to continue to work with programmes such as Pharmacy First, and we are taking other steps to reduce the pressure on GPs so that they have more time to spend with their patients.

[Vicky Ford (Chelmsford) (Con)]

4. What recent progress she has made on retaining GPs.

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[Lee Anderson (Ashfield) (Reform UK)]

6. What steps she is taking to tackle medicine shortages for type 2 diabetes.

[The Minister for Health and Secondary Care (Andrew Stephenson)]

It is vital that people have access to the medicines they need. The Department has been working with the suppliers of medicines used in the treatment of type 2 diabetes to seek commitments from them to address the issues, expedite deliveries and boost supplies. As a result, the position is now much improved compared with a few months ago, with new patients now able to receive these critical medicines. We continue to work with industry to address remaining issues as quickly as possible.

[Lee Anderson]

We know that obesity in this country is costing the NHS about £20 billion a year, and it is a major contributory factor to type 2 diabetes, which is preventable in a lot of cases by having a healthy lifestyle. What more can we do encourage people to eat healthily and therefore save costs in the NHS?

[Andrew Stephenson]

The hon. Member raises a very important point. Obesity is linked to many health conditions, including type 2 diabetes. We are delivering an ambitious programme of work to create a healthy environment to support people in achieving and maintaining a healthy weight. This includes restricting the placements of less healthy products in shops and online, calorie labelling on food sold in restaurants and a tax on the sugary drinks industry, which has removed the equivalent of 45,000 tonnes of sugar from soft drinks.

[Mr Speaker]

I call the Scottish National party spokesperson.

[Kirsty Blackman (Aberdeen North) (SNP)]

A recent Nuffield Trust report shows that medicine shortages are a new normal in the UK. The Minister might claim that this is a global issue, but as the report highlights, shortages are being made worse by Brexit. For example, the creation of a requirement for customs checks at the border and leaving the European Medicines Agency have disrupted the previously smooth supply of medicines. What urgent action will the Minister take to help to tackle the disastrous effects of Brexit on UK medicine supplies?

[Andrew Stephenson]

The SNP, as usual, is a broken record. We all know that diabetes medicine shortages are a global issue affecting countries not just across the whole of the European Union, but across the whole world. Medicine supply chains are highly regulated, complex and global. Issues can occur for multiple reasons, including manufacturing difficulties, regulatory non-compliance, surges in demand, availability of raw materials, sudden spikes in demand, and issues related to the distribution of the product. But once again, as always, the grievance culture of the SNP is: blame everything on Brexit.

[Mrs Paulette Hamilton (Birmingham, Erdington) (Lab)]

7. What steps she is taking to increase levels of nurse recruitment and retention in GP practices.

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[Kenny MacAskill (East Lothian) (Alba)]

8. What steps she is taking to support the recruitment and retention of community and district nurses.

[The Minister for Health and Secondary Care (Andrew Stephenson)]

As the hon. Member may know, in September 2023, we met our commitment to deliver 50,000 more nurses working in the NHS compared with September 2019. As of January 2024, there are over 68,800 full-time equivalent community nurses working in NHS trusts and other core organisations across England, which is over 2,000 more than a year ago. However, we want to go further, which is why the NHS long-term workforce plan sets an ambition to increase training places for district nurses by 150%, to nearly 1,800. It also commits to improving retention in the NHS.

[Kenny MacAskill]

In Scotland, the vacancy rate for registered nursing posts in the community is 8.5%, and for registered district nurses it is 6.6%—in England, the situation is actually worse in most parts. However, these posts are fundamental, not just to care in communities and to our communities themselves, but to addressing bed blocking. It is obviously for the Scottish Government to address terms and conditions of employment, but their overall funding package is dictated by the block grant and Barnett consequentials. Is it not time that the Department stood up for the NHS? When there is money for weapons abroad, why can we not provide care at home? We were told during the referendum that we would be better together and that the NHS would be protected. Instead, it is being undermined.

[Andrew Stephenson]

We hear from Opposition Members who love nothing more than to crow and criticise as their health system declines around them, despite record funding from the UK Government. Scotland has, sadly, some of the worst health outcomes in the western world. Earlier this year, when the UK Government stepped in to offer support, the SNP Health Minister rejected the offer. I reiterate that if the Scottish Government need help to reduce their waiting lists, we stand ready to provide such support.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

9. What steps she is taking to tackle health inequalities.

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[Gill Furniss (Sheffield, Brightside and Hillsborough) (Lab)]

10. What steps she is taking to improve bowel care for people with spinal injuries.

[The Minister for Health and Secondary Care (Andrew Stephenson)]

The hon. Member raises an important issue. It is vital that people with spinal injuries receive care in the most appropriate environment to support their care and rehabilitation. The NHS has developed a range of guidance on the subject, including NHS England’s excellent incontinence care guidance. In addition, guidelines from the National Institute for Health and Care Excellence set out the care that patients with spinal injuries should receive, including through a neurological bowel management programme.

[Gill Furniss]

There is a clear need for a national policy on bowel care in NHS settings for people with spinal injuries. I have listened to patients who have been left feeling abandoned and trapped in a hospital bed without the basic dignity of being able to use the toilet—all because of a lack of training for nurses in providing the necessary support. Will the Minister meet me and representatives of the Spinal Injuries Association to discuss how we can make the situation better and ensure that nobody is denied this basic level of care?

[Andrew Stephenson]

I pay tribute to the hon. Lady for the work that she and the all-party parliamentary group on spinal cord injury have done on the issue. I would be more than happy to meet them.

[Antony Higginbotham (Burnley) (Con)]

11. What steps her Department is taking to improve accident and emergency waiting times in east Lancashire.

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[Dr Rosena Allin-Khan (Tooting) (Lab)]

13. What assessment she has made of the adequacy of mental health support for NHS staff.

[The Minister for Health and Secondary Care (Andrew Stephenson)]

Every day, NHS staff do an extraordinary job for their patients, and it is vital that the NHS supports them in maintaining their mental health. The long-term workforce plan commits the NHS to supporting staff health and wellbeing and asks integrated care systems to develop plans to support them. I am pleased that NHS England is reviewing mental health services for all staff, to ensure that all staff in the NHS have the support that they need.

[Dr Allin-Khan]

Fighting to save a dying child’s life, telling families that their loved one will not make it through the night, and working desperately in substandard conditions—it will come as little shock to hear that all that takes a toll. Last year, 6.4 million mental health sick days were taken across the NHS. Instead of receiving support, our NHS heroes have a Tory Government who treat them with disdain and kick them to the kerb. Will the Minister commit to funding the NHS practitioner health service beyond the next 12 months, or will the Government just try to shut it down again?

[Andrew Stephenson]

As an NHS community first responder who served on the frontline during the pandemic, who had to see people say goodbye to their loved ones for the last time before being admitted to hospital, and who has dealt with cardiac arrests, I know the mental toll that working for or volunteering with the NHS can take on our workforce, and therefore we do give a very high priority to the subject. The NHS people plan sets out a range of actions to build a more modern, compassionate and inclusive culture, and includes a much stronger focus on the availability of quality health and wellbeing support. It is right that we keep services under review, so I will not make a commitment today to continuing to fund something that we have agreed to fund for another year while those services are reviewed.

[Lilian Greenwood (Nottingham South) (Lab)]

14. What steps she is taking to improve healthcare for women.

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[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (Con)]

T3. I refer the House to my entry in the Register of Members’ Financial Interests. The British Psychological Society has commended the benefit of Government support for staff mental health and wellbeing hubs and is keen to see that support continue. Will the Minister therefore give an update on the support being provided and the progress being made on the vital issue of staff mental health and wellbeing?

[The Minister for Health and Secondary Care (Andrew Stephenson)]

That is an important point. We know how vital it is to support everyone who is working so hard in our NHS to support patients. NHS England is reviewing mental health services for all staff who need them, to ensure that they can access the support they need. It is working collaboratively with regions and integrated care systems to agree the best approach to doing that.

[Helen Hayes (Dulwich and West Norwood) (Lab)]

T4. There is an increasing incidence of bowel cancer among younger patients, such as my constituent Emily, who received a late diagnosis after many months of attending her GP with iron deficiency anaemia. Younger patients often report that bowel cancer was dismissed as a possibility by their GP because of their age, and that symptoms such as iron deficiency anaemia are not taken seriously enough and are not included currently on the list of commons symptoms on the NHS website. What is the Secretary of State doing to ensure that NHS guidelines and practice are fit for purpose for younger patients, who far too often receive a late diagnosis of bowel cancer?

[Andrew Stephenson]

The hon. Lady makes an important point. As part of the NHS long-term plan, we have an ambition to diagnose 75% of all stageable cancers at stage 1 or 2 by 2028. That means that we need to make significant improvements on the harder-to-detect cancers such as bowel cancer. We are working across systems to deliver those improvements, not only with better screening programmes, but by improving patient pathways. However, I am more than happy to meet her if she wants to have a further conversation specifically about bowel cancer.

[Julian Sturdy (York Outer) (Con)]

Following discussions with constituents who are living with Parkinson’s and with Parkinson’s UK, I am concerned that North Yorkshire has only one dedicated Parkinson’s nurse. Given the complexity of the condition, what steps are being taken further to incentivise nurses to specialise in Parkinson’s and on long-term delivery?

[Andrew Stephenson]

My hon. Friend makes an important point. I know the huge value of Parkinson’s nurses to local patients in my constituency. Under the NHS long-term workforce plan, backed by more than £2.4 billion over the next five years, the NHS will focus on expanding the number of clinicians training for enhanced and advanced roles working as part of multidisciplinary teams with the right skills to meet the changing needs of patients.

[Richard Burgon (Leeds East) (Lab)]

T5. The main issue raised by residents at the community coffee morning at the Compton centre in Leeds yesterday was the difficulty in getting access to dentists. The Secretary of State struggled to give any credible answer on this question today. Is she aware of the “Dentists for All” campaign in The Mirror, and will she back it? Its three demands are: to provide access to an NHS dentist for everyone; to restore funding for dental services and recruit more NHS dentists; and to change the contracts, because they are simply not fit for purpose. Does the Secretary of State agree with that, and, if not, why not?

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[Will Quince (Colchester) (Con)]

Given the importance of the UK’s life sciences sector, could my right hon. Friend update the House on commercial clinical trial recruitment?

[Andrew Stephenson]

Thanks in part to the sterling work of my hon. Friend, monthly average patient recruitment to commercial clinical trials is almost five times the figure it was back in June 2023. That is hugely positive, but there is clearly more to do in this space.

[Bell Ribeiro-Addy (Streatham) (Lab)]

For over a decade, the Camberwell dialysis unit has provided high-quality NHS care to patients in south London, so my constituents were shocked to hear that these services are to be outsourced to Diaverum, a multinational for-profit health corporation, which has already had one of its clinics rated inadequate and put into special measures. Does the Minister accept that privatising the NHS bit by bit has disastrous implications for care, and will he listen to patients in my constituency and commit to maintaining our NHS dialysis provision?

[Andrew Stephenson]

That sums up the usual contradiction on privatisation between Labour Front Benchers and Back Benchers. Any service changes should be based on clear evidence that they will deliver better patient outcomes. In Lambeth, patients who receive dialysis at the new site in Brixton will receive care in a significantly improved environment with brand new facilities, in a great example of an innovative public-private partnership. NHS England has established the renal services transformation programme to reduce unwarranted variation in the quality of access to renal care.

[Stephen Metcalfe (South Basildon and East Thurrock) (Con)]

Will my hon. Friend join me in recognising the good work that the Essex Partnership University NHS Foundation Trust has been doing to improve mental health outcomes, including the creation of a pioneering 24/7 urgent mental health care centre, providing urgent help when it is needed. Is that a model that could be rolled out across the country to improve access to mental health for all?

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[Greg Smith (Buckingham) (Con)]

As a practical measure to improve radiotherapy waiting times, will the Minister agree to further work on the radiotherapy dataset, to include the collection of data on delays at each stage of the radiotherapy pathway, and by tumour type, so that we can better understand pinch points in services?

[Andrew Stephenson]

We are working to improve radiotherapy services across the NHS, and I would be happy to meet my hon. Friend to discuss that in more detail.

[Daisy Cooper (St Albans) (LD)]

West Hertfordshire Hospital Trust is at the front of the queue for the new hospital programme. We have the land, planning permission, building design, political and staff support, and enabling works are under way. But, like many other trusts around the country, the hospital trust is being asked to submit business case after business case. Will the Secretary of State clarify whether those delays are down to bureaucracy and the new hospital programme, or are they deliberate delaying tactics by a Government who do not want to release funds to hospitals before the general election?

Health Services: Cross-border Co-operation

Andrew Stephenson Excerpts

Tuesday 16th April 2024 Westminster Hall

[The Minister for Health and Secondary Care (Andrew Stephenson)]

It is a pleasure to see you in the Chair, Dame Caroline. I congratulate my hon. Friend the Member for Ynys Môn (Virginia Crosbie) on securing this debate on cross-border healthcare. I know the performance of health services across the United Kingdom is a subject close to her heart, as it is for my hon. Friend the Member for Vale of Clwyd (Dr Davies) and the hon. Members for Strangford (Jim Shannon) and for Caithness, Sutherland and Easter Ross (Jamie Stone), who have all made important contributions to the debate. My hon. Friend the Member for Ynys Môn works tirelessly on improving local health services in her constituency, including by campaigning for an integrated health centre in Holyhead and championing the importance of mental health by pushing for 100 members of the public to undergo a mental health training course in Anglesey.

Although my hon. Friend rightly said that healthcare in Wales has been devolved for 25 years, as a representative of the UK Government and a proud Unionist, I feel it is important that all four nations work together where that is of benefit to the people we represent. For that reason, within my first few weeks in post, I was pleased to visit Wales, Scotland and Northern Ireland to look at the different approaches being taken to the shared challenges that we face.

During my visit to Wales, I heard directly from some GPs in the constituency of my right hon. Friend the Member for Vale of Glamorgan (Alun Cairns) and met some of the pioneering Welsh life sciences companies whose innovations have so much to offer the NHS across the whole United Kingdom. I would, of course, be delighted to visit the constituency of my hon. Friend the Member for Ynys Môn to learn more about the challenges that she faces there.

Without doubt, one of the biggest challenges facing all four nations is dealing with the legacy of covid-19, which has left us with record waiting lists. Cutting waiting lists in England is one of the Government’s top priorities, and by delivering on the actions set out in the delivery plan for tackling the covid-19 backlog of elective care, we are making good progress on tackling the longest waits. Thanks to the incredible work of NHS staff, as of February this year the number of patients waiting over 18 months had been reduced by almost 90% in England, which is a far faster reduction than we have seen in Wales or Scotland.

A core part of that approach has been empowering patients to make decisions on their care by choosing their provider. Improved choice can not only lead to shorter waiting times for patients and incentivise providers to offer appointments, but have a positive impact on the overall patient experience. However, as the former Health Secretary, my right hon. Friend the Member for North East Cambridgeshire (Steve Barclay), said last year, it is vital that the UK Government and devolved Administrations work together to ensure that no matter where they live, patients can access the care that they need when they need it.

As my hon. Friend the Member for Ynys Môn said, a genuine offer was made to the devolved Administrations, which remains open. We continue our commitment to working closer with the devolved Administrations on elective recovery and access to primary care, on top of the existing cross-border arrangements to allow patients who live in Scotland and Wales to access care in England under certain circumstances, which is paid for by the relevant Administration. That is important because when adjusted for data differences, the Welsh waiting list of 677,000 represents 21.6 patient pathways per 100 population compared with 13.3 per 100 in England. The magnitude of the difference between England and Wales cannot be accounted for by divergent definitions. That is why the current Secretary of State, my right hon. Friend the Member for Louth and Horncastle (Victoria Atkins), will be engaging with her counterparts as her predecessor did.

I am pleased to confirm that the next meeting of the inter-ministerial group for health and social care will take place on 24 April. Further, we have agreed to take forward those meetings quarterly. The inter-ministerial group includes Ministers from the UK Government and the devolved Governments who have health and adult social care matters in their portfolios. It provides a forum for strategic discussion between the portfolio Ministers on health and adult social care policy issues, enabling them to engage on areas of shared interest and, where possible, collaborate on policy development and address shared challenges. Moreover, officials have been working on sharing lessons and comparing approaches to demand management and supporting the patients who have been waiting the longest, including through the “Getting it right first time” programme. Those discussions have been constructive in highlighting the benefits of sharing approaches to elective recovery.

My hon. Friend the Member for Ynys Môn made some excellent points about how critical data is as a tool for improving health and tackling inequalities. This Government and the devolved Administrations have been doing important work to improve data comparability in the UK. Not only is it fundamental that citizens can scrutinise the performance of their health services, but a coherent picture of health across the UK is essential to policy evaluation so that we can provide robust challenge and support where it is needed, and build a deeper understanding of the health outcomes in the different parts of the United Kingdom. The Office for National Statistics has recently expanded its cross-Government work and partnered with health bodies in all four nations to ensure that data is coherent, accessible and meets users’ needs. Through that approach, we will enhance our collaborative working and ensure that health services work for every citizen, regardless of geography.

I pay tribute to my hon. Friend for the work that she has done to improve health services in Wales and promote the importance of cross-border health co-operation across the entire United Kingdom. She raises the concerns of her constituents with me and other Health Ministers week in, week out. Her constituents could wish for no better representative than her. I hope that what I have said today shows that we are committed to improving health services for everyone across the whole of our United Kingdom.

Question put and agreed to.

NHS England: Financial Directions

Andrew Stephenson Excerpts

Tuesday 26th March 2024 Written Statements

[The Minister for Health and Secondary Care (Andrew Stephenson)]

The Under-Secretary of State for Health and Social Care, my noble Friend Lord Markham, has made the following written statement:

“I am revising the 2023-24 financial directions to NHS England made on 30 March 2023 and setting the 2024-25 financial directions to NHS England. The amendment to the total revenue resource use limit for 2023-24 has been agreed with NHS England as required under section 223D(4) of the National Health Service Act 2006.

The directions include a number of transfers of funding between the Department of Health and Social Care and NHS England that are in addition to the headline spending review/autumn statement settlement for the NHS. This includes the outcome of the supplementary estimates process and the spring Budget 2024. Funding is being transferred for the voluntary scheme for branded medicines pricing, access and growth (VPAG), the covid-19 vaccination programme, 2023-24 pay awards, as well as to fulfil manifesto commitments on primary care, car parking and nursing recruitment.

The directions will be laid in Parliament and published on gov.uk. The existing NHS mandate remains unchanged by these publications.”

[HCWS388]

Access to Migraine Treatment

Andrew Stephenson Excerpts

Wednesday 20th March 2024 Westminster Hall

[The Minister for Health and Secondary Care (Andrew Stephenson)]

It is a pleasure to serve under your chairmanship, Mr Mundell.

I start by thanking my hon. Friend the Member for Bishop Auckland (Dehenna Davison) for securing this very important debate. I know that she has long been a champion for those living with migraine, and that her own ongoing struggle with chronic migraine, which she talked about, made it difficult, if not impossible, on some days to keep up with the demands of her ministerial role. Since leaving that role she has continued to shine a light on the impact of migraine at work and on what it means to live with migraine.

I also pay tribute to the outstanding charities that support the estimated 10 million people in the UK who live with migraine. For example, the Migraine Trust does fantastic work in empowering, informing and supporting patients, and in driving improvements in treatment and care.

I thank my right hon. Friends the Members for South Staffordshire (Sir Gavin Williamson) and for Romsey and Southampton North (Caroline Nokes), my hon. Friend the Member for Kettering (Mr Hollobone), and the hon. Members for South Antrim (Paul Girvan), for East Londonderry (Mr Campbell), for Midlothian (Owen Thompson), for Greenwich and Woolwich (Matthew Pennycook) and for Bristol South (Karin Smyth) for their contributions to the debate. In those contributions, almost all right hon. and hon. Members talked about the stigma around migraine, with many setting out their own personal experiences of it. We all know that awareness is key to addressing discrimination, so I very much welcome each and every contribution to this morning’s debate.

Migraine is one of the most common neurological conditions, affecting about 10 million people in the UK, yet in this House we very rarely speak about it and its impact. Many of us have first-hand experience of migraine, or at least some insight into the enormously debilitating effect that it can have on people living with it. Indeed, my own sister, Andrea Stephenson, who I know you know, Mr Mundell, and who many other Members may know, suffers from migraine and I have seen the impact that it has had on her over the years.

As we have heard this morning, migraine is a severe and painful long-term health condition and, as my hon. Friend the Member for Bishop Auckland so eloquently said, it is so much more than just a really bad headache. Anyone who lives with migraine knows that it can have a very significant and negative impact on quality of life. Perhaps the cruellest aspect of the condition is its ability to strike with little or no warning, disrupting people’s ability to perform even the most basic daily tasks. Migraine symptoms can last for days, affecting all aspects of life, including family and work life and the ability to engage in social activities. Even between attacks, migraine can impact on quality of life, especially when people try to limit daily activities to prevent another migraine.

Although the human cost is important—it is the most important factor—it is worth reflecting on the economic cost, which my hon. Friend the Member for Bishop Auckland and my right hon. Friend the Member for South Staffordshire set out so well in their speeches. That is why timely access to appropriate and effective care and treatment is so important. Accurate, timely diagnosis can ensure that people can access migraine treatments as early as possible, helping them to get the care that they need to treat attacks when they strike and prevent future ones. There is no specific test to diagnose migraines; for an accurate diagnosis, GPs must identify a pattern of recurring headaches along with the other associated symptoms. Migraines can be unpredictable, sometimes occurring without the other symptoms normally associated with the condition, so obtaining an accurate diagnosis can take some time.

The NICE guidelines on headaches and the diagnosis and management of headaches in young people and adults, last updated in December 2021, set out best practice for healthcare professionals in the care, treatment and support of people who suffer from headaches, including migraine. They aim to improve the recognition and management of headaches and migraine with more targeted treatments to improve the quality of life for people with headaches and reduce unnecessary investigations. NICE has also produced a clinical knowledge summary on migraine. Clinical knowledge summaries are concise, accessible summaries of the current evidence for primary care professionals, focusing on the most common and significant presentations in primary care. They give trusted information to support safe decision making and improve standards of patient care.

The usual treatment approaches to migraine are designed to either stop or prevent attacks. Treatment for acute migraine includes medications such as analgesics, triptans and antiemetics. Treatments to stop or reduce the frequency of migraine attacks include medications such as beta blockers, tricyclic antidepressants and anti-epileptics. We are committed to supporting timely and consistent access to new, effective medicines for NHS patients, so I am pleased that in October 2023, NICE published technology appraisal guidance recommending Rimegepant for the acute treatment of migraine. Rimegepant is recommended where patients have tried at least two triptans but they did not work well enough; where patients cannot take triptans or where they were not tolerated; or where other medication has been tried but did not work well enough. In separate guidance, last year NICE also recommended Rimegepant as an option for preventing episodic migraine in adults where at least three previous preventive treatments have failed, opening a way for 145,000 people in England to choose that option.

[Sir Gavin Williamson]

I appreciate the Minister’s setting out all that has been done. A few hon. Members mentioned CGRP blockers. I am sure that an exciting announcement may be coming, but if not, can the Minister reassure us that they can be looked at, to ensure that something emerges and is done about them?

[Andrew Stephenson]

My right hon. Friend anticipated my next point. Several hon. Members mentioned the difficulties experienced by some patients in accessing CGRP blockers. That issue was raised by the hon. Member for East Londonderry in his intervention. I note my right hon. Friend’s concern, and the comments of my hon. Friend the Member for Bishop Auckland about the NICE guidelines being reviewed to allow specialist treatment such as CGRP blockers to be made available as a first-line therapy.

NICE develops its recommendations independently, based on an assessment of the available evidence of clinical effectiveness and cost-effectiveness and through extensive engagement with interested parties. It is right that those decisions are taken independently on the basis of the available evidence, so it would not be appropriate for me to intervene directly. However, NICE keeps its recommendations under active surveillance, and if significant new evidence emerged it would review its guidance. I very much hope that NICE has been listening to what has been said by hon. and right hon. Members in this debate and looks at the emerging evidence from charities, such as the Migraine Trust, which might prompt it to review the guidance.

The NHS in England is legally required to make funding available for treatments that have been recommended by NICE. If there are any concerns about the availability of a NICE-recommended treatment in a particular area, it is important that hon. and right hon. Members raise those with their local integrated care boards in the first instance. However, I would be more than happy to look into situations where Members still have concerns.

My hon. Friend the Member for Bishop Auckland raised the issue of CGRPs and prescribing rights in primary care. That is an interesting point. I have asked the Medicines and Healthcare products Regulatory Agency to look into this matter and I will write to my hon. Friend in the coming days.

Similarly, I will take away the point made by my right hon. Friend the Member for South Staffordshire about what more we can do to better utilise our local pharmacies. The Under-Secretary of State for Health and Social Care, my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom), is responsible for pharmacy policy. She has already overseen the roll-out of Pharmacy First, ensuring that more conditions than ever before can be addressed by pharmacists, rather than people having to wait to see a GP.

At the moment, we expect that patients suffering from migraine would normally be treated first by their GP. If this failed to resolve the problem, patients would be referred to a consultant neurologist for further investigations and tests. We recognise the challenges within secondary care, in terms of waiting list size and the length of wait, with patients waiting far too long to access the specialist care they need. Neurology is particularly challenging at the moment, with a need for more neurologists, specialist nurses and allied health professionals.

We are committed to reducing waiting lists. To this end, we commissioned NHS England to develop a long-term plan for the NHS workforce for the next 15 years, which was published in June 2023. This sets out how we would deliver the doctors, nurses and other professionals that will be needed, also taking into account improvements in retention and productivity. The plan looks at the mix and number of staff required and has set out the actions and reform across the NHS that are needed to reduce the supply gap and improve retention. The plan will help ensure that we have the right number of staff with the right skills to transform and deliver high-quality services for the future.

My hon. Friend the Member for Bishop Auckland, the hon. Member for Greenwich and Woolwich and my right hon. Friend the Member for South Staffordshire all raised the issue of awareness amongst GPs. UK medical schools determine the content of their own curricula. The delivery of these undergraduate curricula must meet standards set by the General Medical Council. The standards require the curriculum to be formed in a way that allows all medical students, by the time they complete their medical degree, to meet the GMC’s outcomes for graduates, which describe the knowledge, skills and behaviours they must show as newly registered doctors. Therefore, whilst not all curricula will necessarily highlight specific conditions, they all nevertheless emphasise the skills and approaches that a healthcare practitioner must develop to ensure accurate and timely diagnoses and treatment plans for patients, including for migraine.

All healthcare professionals, including GPs, are responsible for ensuring that their clinical knowledge remains up to date and for identifying learning needs as part of their continuing professional development. The Royal College of General Practitioners has developed e-learning resources to update primary care clinicians on the nature of migraine, the different diagnoses and how to approach a patient with headache.

Through NHS England’s getting it right first time—or GIRFT—programme, we are also offering practical solutions for managing the demand for services within secondary care. There have been major advances in treating neurological conditions, including migraine, but services often struggle to keep pace with innovation, which has a significant impact on outcomes for people living with those conditions. GIRFT is a national programme which is designed to improve the treatment and care of patients through in-depth, clinically led review of specialties to examine how they are currently being done and how they could be improved. The GIRFT national specialty report for neurology, published in September 2021, makes a number of recommendations applicable to migraine. For example, the report highlights that providing support and advice to GPs in diagnosing and managing patients with headache can improve management of patients without a patient necessarily having to be seen as an out-patient. GP access to CT and MRI imaging would also enhance GPs’ ability to manage headaches in the community using appropriate guidelines.

As several right hon. and hon. Members said, research is key. Investing in research is a key component of supporting people living with migraine. It plays a vital role in providing those working in the NHS with the evidence they need to better support patients and provide access to pioneering treatments, diagnostics and services. The Department of Health and Social Care funds research through the National Institute for Health Research, which has funded and supported a range of research projects on migraine over the past five years, including studies to assess the efficacy and cost-effectiveness of drugs to prevent and treat migraines, and resources and training on self-management. For example, a study that is close to completion is looking at the comparative clinical cost-effectiveness of pharmacological treatments for adults with chronic migraine.

I once again thank right hon. and hon. Members for their insightful points. I hope they and my hon. Friend the Member for Bishop Auckland are reassured by some of the measures I have outlined today. I recognise that we must go further, and I assure them that I will continue to support people living with migraine through system transformation, NIHR research and exploring and investing in new treatments to ensure we are delivering real results for patients on the ground.

Defibrillators

Andrew Stephenson Excerpts

Wednesday 20th March 2024 Westminster Hall

[The Minister for Health and Secondary Care (Andrew Stephenson)]

It is a pleasure to serve under your chairmanship, Dame Maria. I start by congratulating my hon. Friend the Member for Stoke-on-Trent North (Jonathan Gullis) on securing this important debate. I know that he is a passionate and vocal supporter of increasing access to life-saving public defibrillators and first aid training. I pay tribute to the work of the all-party parliamentary group on defibrillators and look forward to reading its report in due course. I also pay tribute to the hon. Member for Strangford (Jim Shannon), my hon. Friends the Member for Havant (Alan Mak), and my right hon. Friend the Member for South Staffordshire (Sir Gavin Williamson) for their contributions to this short debate.

Public defibrillators can really be the difference between life and death for people who suffer what are known as out-of-hospital cardiac arrests. According to the British Heart Foundation, automated external defibrillators, AEDs, are used by bystanders in around only 10% of these types of incidents, but early defibrillation—within three to five minutes of collapse—can increase survival rates by as much as 50% to 70%. That is why we are working hard to increase the number of community defibrillators, increase public awareness and tackle the wider causes of heart attacks. I am proud that we have introduced the community automated external defibrillators fund. The £1 million match fund allows communities across England to bid for AEDs in places with high footfall, in more remote areas that have longer waiting times for emergency medical responses, in areas with high numbers of vulnerable people, and in areas that host activities that mean they are more likely to be needed.

[Sir Gavin Williamson]

I congratulate the Department of Health and Social Care on that fund. My hon. Friend the Member for Stoke-on-Trent North (Jonathan Gullis) and I referred to the charity AED Donate. There is a lot of charitable work going on in this sector. I wondered whether it would be possible for the Minister to arrange for the charity to meet up with suitable officials, so that it can best understand how it can deliver the Department’s aims and so that the Department has an understanding of what it is delivering in communities across the country.

[Andrew Stephenson]

My right hon. Friend makes a very important point. I join him in paying tribute to that organisation. I would be happy to arrange a meeting with relevant officials in the Department.

Our partners on the programme of rolling out defibrillators are Smarter Society and the London Hearts charity. They have been assessing applications for delivering additional AEDs, working with a wide and diverse range of groups. The first hundred devices that Smarter Society distributed were fully funded, and our partners at the University of Warwick helped us to prioritise the areas of greater deprivation without an AED in situ.

I am delighted to update hon. Members and tell them that, as of 12 March, Smarter Society and London Hearts have now delivered 1,590 AEDs and are working to deliver more. I would also like to pay tribute to the work of my hon. Friends in the Department for Education, who are ensuring that every state school has access to a defibrillator. I am told more than 20,000 devices have been delivered to almost 18,000 schools. That will drastically increase the chances of surviving cardiac arrest for pupils and school staff across England.

The Department for Education has supported schools in making the defibrillators available to the community, having offered external heated defibrillator cabinets to primary, special and alternative provision schools in areas of deprivation, where access to defibrillators is typically lower. It has also provided internal cabinets to secondary schools with two or more defibrillators, so one device can be placed at a sports facility where cardiac arrest is more likely to happen.

All state-funded schools are required to teach first aid as part of the mandatory relationship, sex and health education curriculum—another positive change made by the Conservatives since 2010—since we have been in government. That involves children over 12 being taught CPR and the use of a defibrillator. The Department for Education has also provided awareness videos showing how simple the defibrillators are to use, and it is encouraging schools to share the videos in staff meetings and assemblies. That will ensure that as many people as possible are able to respond in an emergency.

I know that making defibrillators as affordable as possible is important to my hon. Friend the Member for Stoke-on-Trent North, as he set out in his speech. The Government and I agree, although we have to keep these matters under review. He will appreciate that matters relating to VAT are for my right hon. Friend the Chancellor of the Exchequer.

Although having access to defibrillators is important, just as important is knowing where they are, so that they can be used in a time of crisis. That is why the NHS is working in partnership with the British Heart Foundation, the Resuscitation Council UK and the Association of Ambulance Chief Executives to set up The Circuit, which my hon. Friend talked about. The Circuit is a national database that will make it easier for ambulance services quickly to identify the nearest defibrillator when assisting someone who is having an out of hospital cardiac arrest.

As of 1 March, there were 86,337 defibrillators in the UK—68,509 in England— registered on The Circuit. We encourage everyone with an AED to register it. I can assure the House that all defibrillators granted by the community automated external defibrillator fund must be registered on The Circuit. The registration is completed by what is known as a defibrillator guardian—someone nominated by the organisation hosting the device. That role involves registering it on The Circuit, regularly checking the defibrillator to ensure that it can be used, and keeping the record updated. As I hope my hon. Friend appreciates, that is both an effective and a pragmatic approach to ensuring that defibrillators are where we think they should be, and that they continue to be ready for use in times of crisis.

I reinforce the fact that defibrillators are designed for ease of use. If there is one message I want to land in today’s debate, it is that these simple devices are easy to use, yet life-saving. Anyone can use them without formal training. That said, training is actively helpful in increasing the confident use of defibrillators in a community setting. For that reason, the NHS has partnered with St John Ambulance to help people gain the skills they need. That includes a national network of community advocates championing the importance of first-aid training, and training up 60,000 people, which will save up to 4,000 lives a year by 2028.

I would like to take the opportunity to pay tribute to those organisations and others that work tirelessly to improve defibrillator access and first aid training in communities across the country. Their contributions are crucial in getting help for people in some of the toughest moments of their lives and I cannot thank them enough.

My hon. Friend the Member for Stoke-on-Trent North has raised the idea of requiring defibrillator training as part of driving tests. My hon. Friend the Member for Colchester (Will Quince) was a strong supporter of that as my immediate predecessor in this role. While this is primarily a matter for the Department for Transport, I know that my hon. Friend the Member for Stoke-on-Trent North will continue to make representations in this area. I assure him that the Government are always happy to engage in those discussions.

I am also aware of my hon. Friend’s interest in ensuring that all emergency vehicles carry AEDs as a matter of course. While the Government fully recognise that the equipment carried by emergency vehicles is an operational matter, I encourage all services to consider the benefits of carrying AEDs as a matter of routine.

On a personal note, I would like to pay tribute to David Brown, the incredible team leader of the Pendle, Padiham and Burnley community first responder team, of which I am part. I was backed up by David on the first ever cardiac arrest I attended as a community first responder almost 10 years ago. He does incredible work delivering CPR training across Pendle, as well as putting in thousands of hours as a volunteer with the North West Ambulance Service.

I would also like to pay tribute to my late constituent, Ruth Sutton. In 2016, Ruth saw a photo of me in the local newspaper unveiling a new community defibrillator in the Pendleside village of Blacko. She contacted me to see how we could get even more defibrillators across Pendle. Over the following months, she worked with me and the North West Ambulance Service, investigating possible locations to install new defibrillator cabinets. By 2018, Pendle had the best coverage for public access defibrillators in Lancashire, with 20 cabinets installed: a real, lasting legacy of a remarkable lady.

I hope that our prevention and treatment work, including the forthcoming major conditions strategy, which my Department is in the final stages of drawing up, will act as a guiding light for a faster, simpler and fairer NHS. In combination with our efforts to increase defibrillators and increase first aid training across the country, we will improve our ability to intervene in an emergency situation and to save lives.

I once again thank my hon. Friend the Member for Stoke-on-Trent North for securing this incredibly important debate. I look forward to working with him long into the future to make progress on this vital issue.

Question put and agreed to.

Modern Slavery Regulations

Andrew Stephenson Excerpts

Thursday 14th March 2024 Written Statements

[The Minister for Health and Secondary Care (Andrew Stephenson)]

Today, I am pleased to announce that we will be continuing the Government’s goal of introducing robust regulations to ensure the eradication of modern slavery in NHS supply chains in England. This is in line with our Government’s world-leading ambition to tackle modern slavery. These regulations will support continued efforts to build an ethical and reliable UK health system.

The Department of Health and Social Care has pledged to put an end to modern slavery in NHS supply chains. As is set out in the National Health Service Act 2006, we will create regulations to eradicate the use in the health service of goods and services which are tainted by slavery and human trafficking. These regulations will place legal duties on public bodies to assess modern slavery risk in procurement and contract activities and take reasonable steps to address and, where possible, eliminate that risk.

My hon. Friend Lord Kamall committed to introducing these regulations within 12 to 18 months of the enactment of the Health and Care Act 2022. Since that commitment was made, a large amount of work has happened on both modern slavery and procurement policy both within the DHSC and the NHS, and across Government. The introduction of these regulations has therefore been delayed so that we can ensure they are fit for purpose and interact with the current legislation and updated policies.

The DHSC, supported by NHS England, delivered a review in December 2023 into the risk of modern slavery within NHS supply chains. The review showed a significant amount of commitment from our suppliers to tackling modern slavery in their supply chains, and made a recommendation to lay the regulations.

Other work has been ongoing to reform procurement rules in the UK. The Procurement Act 2023 will be enacted on 1 October 2024 and will set out the new laws the public sector is required to follow when a procurement is within the duties prescribed. The Procurement Act 2023 created specific means for debarment, including “professional misconduct” where a serious breach of ethical standards is found; our regulations will operate compatibly with this requirement. Further, in January 2024, the provider selection regime also came into force, which sets out procurement rules for the procurement of clinical services; the NHS is now implementing these new procurement regulations.

The developments to understand modern slavery risk in NHS supply chains and the introduction of new procurement laws are relevant to our modern slavery regulations. The regulations will introduce legal duties to assess modern slavery risk in supply chains and to take reasonable steps in a proportionate and relevant way when buying goods and services for the NHS. They will include duties requiring public bodies to first assess the extent of the modern slavery risk in relation to that procurement and then take reasonable steps to address and, where possible, eliminate that risk. Reasonable steps include:

ensure robust selection and award criteria is built into their tenders to respond to identified risks;

include specific contract terms to monitor and require mitigation where instances of modern slavery are discovered.

This spring, the Department will launch a public consultation to further support the development of the modern slavery regulations. It is with this consultation that we will publish our draft regulations for the first time. We will welcome the views and contributions of a wide range of stakeholders, including public bodies, suppliers, trade associations, interest groups and the public. Subject to the outcome of the consultation we intend to lay draft regulations before Parliament in due course.

Modern slavery has no place in our society, and the DHSC has a duty to eradicate the use of goods and services tainted by modern slavery in NHS supply chains. This is also a global effort—that is why we will be working collaboratively across Government to ensure that our work reflects these priorities and the duties of public bodies within our regulatory framework.

[HCWS343]

Health and Wellbeing Services: Essex

Andrew Stephenson Excerpts

Tuesday 12th March 2024 Westminster Hall

[The Minister for Health and Secondary Care (Andrew Stephenson)]

It is a pleasure to see you in the Chair, Mr Henderson—I think this is the first time I have responded to a debate while you have been in the Chair. It is a pleasure to respond to the debate, and I congratulate my right hon. Friend the Member for Witham (Priti Patel) on securing a debate on such an important subject. My further thanks go to my esteemed predecessor, my hon. Friend the Member for Colchester (Will Quince), not only for his work supporting his own constituency, but for his tireless efforts as a Health Minister and as my immediate predecessor in the Department. I also thank my right hon. Friend the Member for Maldon (Sir John Whittingdale) for his thoughtful contribution and the powerful advocacy that he always conducts on behalf of his constituents.

We all know that much of the continued recovery of the NHS following the pandemic is entirely dependent on the people who work in our NHS. I commend my hon. and right hon. Friends for the tributes they have paid to NHS staff. Our long-term workforce plan, which was raised by my hon. Friend the Member for Colchester, sets out the Government’s vision and commitment to ensuring that we have an NHS that can deliver for the future. Our plan commits to improving retention by improving culture and leadership to ensure that up to 130,000 fewer staff will leave the NHS over the next 15 years. It also sets out an aim to double the number of medical school places in England to 15,000 by 2031-32. That is our commitment to the future of the NHS moving forward, and there is cause for optimism now too. In recent months, the rate of staff leaving active service in the NHS has returned to pre-pandemic levels. In the east of England, the rate of staff leaving active service in the NHS has followed a similar pattern and is now below pre-pandemic levels. We know there is more to be done, but the plan is working.

The number of doctors and nurses is also on the rise. There are almost 6,800 more doctors and more than 21,500 more nurses in the NHS than last year. In the east of England, there are almost 740 more doctors and almost 1,700 more nurses in the NHS than last year. My hon. and right hon. Friends mentioned Anglia Ruskin University. I had the huge privilege of visiting the university on 4 March to meet some of the medical students. If there is anything that gives a person optimism about the future of the NHS, it is sitting down and having a roundtable with some of the medical students in a university such as Anglia Ruskin, which has gone from strength to strength over recent years thanks to the campaigning of local MPs who have championed investment in that university.

Medical training at our best medical institutions is an essential part of delivering the long-term workforce plan. I therefore welcome Anglia Ruskin University’s commitment to the medical degree apprenticeship and recognise that it is a trailblazer. The university can bid for additional Government-funded places, in common with all existing medical schools across England, and I look forward to continuing to work with it and local MPs to secure more investment in the university.

We know that the NHS faces pressures all over the country, including in Essex and the east of England more broadly. As a Government, we are committed to working every day to improve the outcomes and experiences of patients. A huge part of that is making sure that patients get to talk to a GP. I am glad to say that since 2019 we have recruited more than 36,000 additional staff into general practice, covering a range of roles including pharmacists. We fulfilled our commitment to recruit 26,000 additional staff a year ahead of the March 2024 target, and we have also delivered on our manifesto commitment of 50 million more general practice appointments a year, with 367.7 million booked appointments across the past 12 months.

Looking more closely at the constituency of my right hon. Friend the Member for Witham, I am pleased to say that there are now approximately 105 full-time equivalent members of the clinical general practice workforce. That is an increase of 62% since September 2019, when there were about 65 full-time equivalent staff in the clinical workforce. In the east of England, there are now approximately 3,909 full-time equivalent GPs and an estimated 3.7 million general practice appointments took place in January 2024, with 72% of those face to face. In Witham specifically, 76% of appointments in January 2024 were face to face, up from 68.5% in January 2023. All the same, I commend my right hon. Friend for her tenacious advocacy of a new health hub for Witham. Her constituents are fortunate to have such a doughty champion, with a deep and genuine care for their access to the health service.

Mid and South Essex ICB has confirmed that GP practices in Witham are working together to help meet the health needs of local residents by sharing staff, teams and services. However, as my right hon. Friend acknowledged in her speech, the financial complexities of bringing GP estates together can be multifaceted and challenging. Mid and South Essex ICB has confirmed that transitioning to a new building would involve complex considerations surrounding property ownership, leasing arrangements and financial investments. The ICB is also concerned that while section 106 monies serve as a valuable contribution to local NHS healthcare provision, the money available may fall short in sustaining the entire development of a new healthcare centre. I hope my right hon. Friend and the ICB can continue to work together to think carefully through those challenges and find the best solution that meaningfully responds to the needs of Witham’s patients.

I also thank my right hon. Friend for her comments about the future of St Peter’s Hospital, which I know is a subject dear to her heart and to the heart of my right hon. Friend the Member for Maldon. As she said, it is generating an unprecedented reaction from her constituents. I will keep my comments on this issue brief, knowing that another debate on it will take place on Thursday. That will provide a longer opportunity for my right hon. Friends, particularly my right hon. Friend the Member for Maldon, to build and expand on the concerns that my right hon. Friend the Member for Witham has set out today.

Let me be clear that no decision has yet been made about the future of St Peter’s. Any decision regarding the future configuration of NHS services in Mid and South Essex should be made locally, following engagement with local communities. I am sure that local views are being listened to and, as my right hon. Friend the Member for Witham said, an NHS consultation is currently live. I urge both her and my right hon. Friend the Member for Maldon, and their constituents, to participate in it actively.

I expect any subsequent decision taken by the local NHS to demonstrate improved outcomes for patients, having taken into account all of the many issues that my right hon. Friend the Member for Witham has outlined today, which I am sure will be further expanded upon on Thursday.

I want to reassure both my right hon. Friends. In my constituency, an unpopular reorganisation of local health services in east Lancashire under the last Labour Government in 2007 removed a significant number of health services in my constituency and transferred them to Blackburn, so I am very conscious of the potential impacts of hospital reorganisations and I always look at these matters very closely and pay close attention to the views of local Members of Parliament.

I turn to the subject of urgent and emergency care. We absolutely recognise the pressures that these services are facing and we are working to ensure that people receive the care they need when they need it. Although we recognise that there is more to do, we have seen performance improve this year.

For example, at the Mid and South Essex NHS Foundation Trust 67.3% of accident and emergency patients were seen within four hours in January 2024, which was better than the trust’s performance in January 2023. At the East Suffolk and North Essex NHS Foundation Trust, 72.2% of A&E patients were seen within four hours in January 2024—performance above the national average. Ambulance handover delays, which have a big impact on response times, have reduced significantly this winter compared with last year. At the Mid and South Essex NHS Foundation Trust, delays of over 60 minutes have fallen by 48%. Nationally, we have seen progress on ambulance response times, with the average ambulance waits for category 2 incidents down by over a third this winter.

We have heard today about the continuing difficulties that patients have in accessing a dentist. That is deeply unfortunate and it is essential that we give patients access to the dental care that they deserve. That is why, on 7 February, we published our plan to recover and reform dentistry, to make dental services faster, simpler and fairer for patients. The plan will fund around 2.5 million additional appointments; our plan to recover and reform NHS dentistry is backed by £200 million.

Hon. Members also mentioned the important role of community pharmacy. Community pharmacy is delivering healthcare, which makes an extremely valuable contribution to patients’ lives. That is why we are continuing to support the sector financially, and we are providing over £2.6 billion every year to support community pharmacy. To go further, we are now investing up to £645 million across this financial year and the next in Pharmacy First, which will allow for more blood pressure checks and more contraception consultations in pharmacy.

I will now address some of the concerns expressed regarding the Lampard inquiry, which is an issue of the utmost importance and sensitivity. I completely recognise the desire of families and other stakeholders that the terms of reference of the inquiry be finalised as soon as possible, so that the inquiry can make progress with its investigations. Let me update my hon. and right hon. Friends on the most recent discussions.

Following consultation with families and other stakeholders, the chair of the Lampard inquiry has shared her initial views on potential changes to the terms of reference. On 5 December, my right hon. Friend the Secretary of State for Health and Social Care agreed to meet families and local MPs in Essex to discuss the terms of reference. On 6 March, as referred to by both my right hon. Friends today, the local MPs and I met to discuss the inquiry. We agreed that my right hon. and hon. Friends across Essex would put forward names of family members to attend a meeting with the Secretary of State, so that she could hear directly from the families herself.

We have now identified a potential date for that meeting, and that will be communicated very shortly to local MPs, if it has not been already; the date will be emailed out by my office. I hope that the meeting can take place on that date, and that we can make the swift progress that we all want to see. Families have been waiting far too long. Again, I commend my hon. and right hon. Friends for their work to shine a light on what has gone on and to ensure that the inquiry was established, and I hope that it can finally get on with its work and deliver the outcomes and justice that the families all want to see.

I will wrap up by addressing one of the most important elements in the future of healthcare: prevention. I reiterate the Government’s commitment to our levelling-up mission to narrow the gap in healthy life expectancy by 2030 and to increase healthy life expectancy by five years by 2035. To do that, we are tackling health inequalities through programmes such as the NHS’s Core20PLUS5, which focuses on improving health outcomes for the poorest 20% of the population as well as other groups.

Furthermore, we will publish our major conditions strategy this year, a direction-setting document aiming to pave the way for further action towards integrated care, co-ordinated around the needs of people. It aims to improve healthy life expectancy, reduce pressures on the NHS and reduce ill health-related labour market inactivity. Together, those programmes will help us shift the dial, both nationally and in Essex, on NHS pressures.

I thank my hon. and right hon. Friends for their contributions, and once again thank my right hon. Friend the Member for Witham for securing the debate. I hope my answers have helped to assure all those who have attended that we are firmly committed to delivering for the health and wellbeing needs of people in Essex and across the country.

Equity in Medical Devices

Andrew Stephenson Excerpts

Monday 11th March 2024 Written Statements

[The Minister for Health and Secondary Care (Andrew Stephenson)]

The NHS is committed to upholding high standards in medical device safety. In response to emerging evidence of potential ethnic and other unfair biases in the design and use of some medical devices commonly used in the NHS, an independent review was commissioned by former Secretary of State for Health and Social Care, my right hon. Friend the Member for Bromsgrove (Sajid Javid).

Today, I am pleased to publish the final report of the independent review into equity in medical devices, alongside the Government’s response.

I would like to place on record my gratitude to the review chair, Dame Margaret Whitehead, and the panel who conducted this review. They embraced a comprehensive approach, involving stakeholders, fostering collaboration with clinical experts, NHS planners and policy advisors, engaging with health professionals on the frontline, educators and crucially, patients and the public. This deliberate approach underscores the importance and impact of the panel’s findings, and their recommendations are integral to our commitment to fostering a fair and healthy future for all.

The panel made 18 recommendations, taking these recommendations in turn:

Recommendations 1 to 3 focus specifically on pulse oximeters and cover immediate mitigation measures to ensure existing devices can perform to a high standard and improvements in international standards for approval of new device models.

Recommendations 4 to 7 focus on prevention of potential for harm through improved detection of bias in optical devices, including better research and testing, more robust monitoring and auditing and refreshed education for health professionals.

Recommendations 8 to 14 focus on enabling the development of safe and equitable artificial intelligence (AI) medical devices.

Recommendation 15 underscores the urgency of preparing for the transformative impact of large language and foundation models on healthcare and regulatory systems.

Recommendations 16 to 18 address equity concerns and societal challenges related to polygenic risk scores (PRS) in genomics. They emphasise the need for regulation in response to the influx of commercial PRS tests in the UK.

The Government’s response has been published alongside the final report. The Government welcome and acknowledge the importance of the outlined recommendations, endorsing its main argument that, unless appropriate actions are taken, biases can occur throughout the entire medical device life cycle.

We are dedicated to ensuring equitable medical device practices, spanning from design through to use. The Government have already initiated substantial efforts addressing many of the essential elements of the report’s recommendations, as detailed in the Government response. As we continue to drive progress, we welcome ongoing collaboration with industry partners, which is paramount to embedding best practices and supporting the NHS in delivering optimal and equitable care for all.

Both the final report from the independent review into equity in medical devices and the Government’s response will be deposited in the Libraries of both Houses, and published on www.gov.uk.

[HCWS329]

Hereditary Tyrosinemia Type 1

Andrew Stephenson Excerpts

Monday 11th March 2024 Written Statements

[The Minister for Health and Secondary Care (Andrew Stephenson)]

I would like to inform the House that I have accepted the UK National Screening Committee’s recommendation to introduce a new condition, tyrosinemia type 1, to the newborn blood spot screening programme in England.

Hereditary tyrosinemia type 1 is a rare genetic condition that affects approximately seven babies in the UK per year. Left untreated, this condition can lead to severe complications such as liver, kidneys and nervous system damage, and in some cases requires liver transplant. Without treatment, children with tyrosinemia type 1 often do not survive past the age of 10. There is no cure for this condition but treatment can help prolong life.

There is currently an inequitable situation whereby families with a known history of this condition can seek early screening and access treatment before their child shows symptoms, when treatment is most effective, while parents without a known history will only discover their child’s condition when symptoms become evident and when treatment is less effective. Introducing tyrosinemia type 1 to the newborn blood spot screening programme will create a fairer, faster, and simpler route to diagnosis and treatment. NHS England have started the work needed to ensure this programme can be implemented next year.

I would like to take this opportunity to thank the UK National Screening Committee for continuing to provide invaluable expert advice on screening programmes. I would also like to pay tribute to all those who work in delivering high-quality screening across the country. The addition of this new condition will maintain the Government’s commitment to improving equity of access to effective treatments for rare diseases.

[HCWS328]

Oral Answers to Questions

Andrew Stephenson Excerpts

Tuesday 5th March 2024 Commons Chamber

[The Minister for Health and Secondary Care (Andrew Stephenson)]

At Buckinghamshire Healthcare NHS Trust, the number of gynaecology patients waiting more than 52 weeks reduced by over 30% between August and December, but I sympathise with the many women who are still waiting too long. NHS England has been doing targeted work to help trusts with the most long waiters to support gynaecology patients in the community where appropriate, and to find specialist services that can treat them as quickly as possible.

[Sarah Green]

My local NHS trust recently stated that the average wait for a gynaecology appointment is 18 weeks, with patients starting treatment within 24 weeks, but that does not include those on cancer pathways. One of my constituents who had been identified as having abnormal cells in her cervix waited more than 60 weeks for a diagnostic assessment. She is one of many contacting me with tales of long delays for gynaecology appointments and paying to go private out of desperation. What steps is the Department taking to reduce waiting times for gynaecology assessments and treatment for those on cancer pathways?

[Andrew Stephenson]

Significant investment is going in to reduce both general wait times and cancer wait times. More patients on the cancer pathway have been seen than ever before; nearly 220,000 patients were seen last December following an urgent GP referral for suspected cancer, representing 117% of December 2019 levels. We continue to keep this under review and continue to strive to make the system go faster and reduce the elective backlog.

[Mr Speaker]

I call the shadow Minister.

[Abena Oppong-Asare (Erith and Thamesmead) (Lab)]

NHS figures from December show that the number of women waiting for gynaecological treatment reached another record high of nearly 600,000. That number has tripled since 2012. A Labour Government will cut NHS waiting lists in England by funding 2 million more appointments a year. What can the Minister say to the women waiting urgently for treatment?

[Andrew Stephenson]

I would say that we are sticking to our plan to back the NHS to cut waiting lists and make our NHS fairer, simpler and faster. When there is no strike action, that plan is working. We already eliminated the longest waits, and, in November, we saw the biggest fall in waiting lists outside of the pandemic in more than a decade, alongside record investment in things like women’s health hubs. We are prioritising women’s health.

[Julie Marson (Hertford and Stortford) (Con)]

7. What steps her Department is taking to improve access to primary care.

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[Neale Hanvey (Kirkcaldy and Cowdenbeath) (Alba)]

12. What steps she plans to take to improve the recruitment and retention of community and district nurses.

[The Minister for Health and Secondary Care (Andrew Stephenson)]

We have delivered our manifesto commitment of 50,000 more nurses six months early. There are now almost 361,000 nurses working across the NHS. As part of that, community nursing has grown by over 9% since 2019.

[Neale Hanvey]

There has been a crisis brewing in community-facing nursing over the past decade, with the number of district nurses down by 40% and health visitor numbers in England and Wales falling by almost a third. What guarantees will the Minister provide that this vital workforce will be supported, when health budgets in all the nations of the UK are under increasing strain and NHS funding faces a £2 billion black hole, and cuts to spending in England have a consequential impact on budgets in Scotland?

[Andrew Stephenson]

Record funding is going into our NHS. In addition to the 9% increase in community nursing since 2019, we are investing over £2.4 billion in education and training through the NHS long term workforce plan, which commits to increasing training places for district nurses by 41% by the end of the decade. Since 2010, we have delivered over 63,300 more nurses and midwives into our NHS.

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[Vicky Ford (Chelmsford) (Con)]

T8. I thank the Health and Secondary Care Minister for visiting the new medical school in Chelmsford yesterday. This is the first time that students have ever been able to train as doctors in Essex in its history, and the results are phenomenal. This is living proof of the Government’s commitment to train the NHS staff of the future. What progress is he making to increase work placements for students so that we can train even more doctors, nurses and people for important roles such as physician associates?

[The Minister for Health and Secondary Care (Andrew Stephenson)]

I thank my right hon. Friend for her question and her kind invite to visit her constituency. I pay tribute to all the work she has done to secure investment in Anglia Ruskin University. She is right to highlight the importance of delivering clinical placements as part of the long-term workforce plan. I assure her that we are working closely with NHS England and partners in health and education to ensure that happens.

[Alan Brown (Kilmarnock and Loudoun) (SNP)]

Medicine shortages have doubled in the UK in the last two years. There might be some global pressures, but two issues have particularly affected the UK: first, the post-Brexit regulatory framework; and secondly, the fact that the pound has tanked, making it more expensive to buy medicines. What are the Government doing to undo that Brexit dividend?

[Andrew Stephenson]

The hon. Gentleman sounds like a broken record, as usual. The Department has no evidence to suggest that EU exit is leading to sustained medicine shortages. Shortages occur for a wide range of reasons and are affecting countries all over the world.

[George Freeman (Mid Norfolk) (Con)]

Rural Norfolk is experiencing a dental crisis and a generation of children are in danger of going without dental care. I welcome the dental recovery plan, but I notice that it will be four or five years before we get more dentists. Last week, NHS Norfolk and Waveney integrated care board announced a £17 million underspend on dentistry. Will the Minister agree to meet with me and the ICB to work out how we get more money out now to help dentistry in Norfolk today?

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[Sir Jacob Rees-Mogg (North East Somerset) (Con)]

Will my right hon. Friend explain an anomaly in the “Agenda for Change” pay deal as it affects non-NHS providers? People working in the NHS for non-NHS providers may be eligible for extra money if the organisation they work for is in financial difficulties, but not if it is not. So badly run organisations are being rewarded and well-run organisations are being penalised, which seems to me to be perverse.

[Andrew Stephenson]

I am happy to meet my right hon. Friend to discuss the matter. We have reached pay settlements with the “Agenda for Change” unions, and we continue to reach pay deals with other unions. We are also supporting non-NHS providers whose contracts are dynamically aligned. It is a complex area, so I am more than happy to meet my right hon. Friend to discuss his concerns.

[Florence Eshalomi (Vauxhall) (Lab/Co-op)]

The Secretary of State will know that NHS England is expected to announce the decision about the primary children’s centre for cancer treatment in south London and south-east London. Evelina London Children’s Hospital in my constituency is one of the only specialist centres in south London. Does she agree that the final decision should be made as soon as possible in order to benefit staff, patients and families? Will she join me in visiting Evelina London?

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[Paul Bristow (Peterborough) (Con)]

I remind Members of my entry in the Register of Members’ Financial Interests. The Medicines and Healthcare products Regulatory Agency’s international recognition procedure will ensure faster access to innovative treatments, but it will realise its full potential only if it is matched by the National Institute for Health and Care Excellence’s evaluation process. What is my right hon. Friend the Minister doing to ensure that the two processes are aligned?

[Andrew Stephenson]

My hon. Friend will be aware that there have been delays with approvals by the MHRA and NICE. We are keen to ensure that those delays are reduced, and I am delighted to tell the House that significant progress has been made in both organisations. I am happy to work with my hon. Friend and both organisations to ensure that progress continues to be made.

[Sarah Dyke (Somerton and Frome) (LD)]

Figures obtained by the British Dental Association project that £8 million of the NHS budget in Somerset is going unspent. Will the Minister explain to my constituent, who is suffering in dental agony, why that is happening?

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[Sir Chris Bryant (Rhondda) (Lab)]

How many people were treated for acquired brain injury last year?

[Andrew Stephenson]

The hon. Gentleman has caught me off guard—I will write to him. I am keen to continue working with him on that issue. As he knows, we have already shared draft details of the acquired brain injury strategy with him and members of the all-party parliamentary group, and I am very keen to continue working collaboratively on that issue with him.