Oral Answers to Questions

Ben Gummer Excerpts

Tuesday 5th January 2016 Commons Chamber

[Anna Turley (Redcar) (Lab/Co-op)]

3. What proportion of hospital trusts are in deficit.

[The Parliamentary Under-Secretary of State for Health (Ben Gummer)]

Three-quarters of trusts are reporting a deficit for the conclusion of the first half of this financial year.

[Anna Turley]

John Appleby, the chief economist at the independent think tank the King’s Fund, said recently that although the Government claim they will get an increase in funding in the NHS, they have

“in effect, already spent the money”

because of the scale of the hospital deficits. In my South Tees area, the deficit for 2014-15 is nearly £17 million. Will the Minister accept that the Government have totally lost control of NHS finances?

[Ben Gummer]

The first point to make is that this Government have provided the money for the NHS that it has asked for—this is money the Opposition refused to say they would pledge at the last election. The second point to make is that Jim Mackey, the new chief executive of NHS Improvement and one of the best chief executives in the NHS, has said that he will help to get hospital trusts in control next year, and that, with the transformation fund announced by my right hon. Friend the Secretary of State, we are confident we will be able to get hospital trusts into balance next year.

[Andrew Stephenson (Pendle) (Con)]

Does the Minister agree that clamping down on expensive temporary agency staff is an important step in helping to sort out the NHS and allowing it to balance the books?

[Ben Gummer]

My hon. Friend is entirely right, and we are already having an impact. We had to bring in the requirement for safer staffing rotas because of the catastrophe at Mid Staffs and the need to try to staff hospitals better, and that had an immediate consequence which called for agency workers. Unfortunately, some companies have taken advantage of that situation, but we have introduced measures to stop that and are already having an impact across the service.

[Paul Farrelly (Newcastle-under-Lyme) (Lab)]

The University Hospitals of North Midlands NHS Trust faces a deficit of £19 million for 2015-16, but until the NHS’s Staffordshire review is completed it faces uncertain prospects further out, not least as it has taken over Stafford county hospital recently. The hospital wrote to the Minister before Christmas, so will he meet hospital management and local MPs as soon as possible this new year to discuss this uncertain situation and the progress on the whole Staffordshire review?

[Ben Gummer]

I would be happy to meet them, I will meet them and I congratulate them on eliminating 12-hour trolley waits for the first time this year. They are doing a great job in difficult circumstances, as are many hospitals across the country. I am confident that they, too, will be able to get their deficit under control next year, with the help of the transformation fund, which is available for high-performing trusts.

[Mr David Hanson (Delyn) (Lab)]

4. How many people have diseases classified by his Department as rare.

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[Anne Marie Morris (Newton Abbot) (Con)]

10. What plans he has to publish a rural healthcare strategy.

[The Parliamentary Under-Secretary of State for Health (Ben Gummer)]

The “Five Year Forward View” published by NHS England sets out the healthcare strategy for the whole of England, including rural areas. Rural areas have their own health needs, which should be taken into account in planning and developing healthcare systems.

[Anne Marie Morris]

What specific research has the Minister undertaken in order to understand, and what steps has he taken to address, the very different needs and costs of rural communities in the south-west, which has disproportionately high numbers of over 85-year-olds and population distributions that make inflexible multi-speciality community providers and primary and acute care configurations unattainable?

[Ben Gummer]

The “Five Year Forward View”, written by Simon Stevens, takes particular account of rural areas, but of course not all rural areas are the same. It is down to clinical commissioning groups to judge the needs of their local areas and make sure that they are reflecting the specific circumstances in which they find themselves.

[Tulip Siddiq (Hampstead and Kilburn) (Lab)]

11. What progress his Department has made on expanding access to non-invasive pre-natal treatments in hospitals.

[The Parliamentary Under-Secretary of State for Health (Ben Gummer)]

Non-invasive pre-natal testing is not currently offered routinely for screening women in pregnancy for Down’s syndrome and other trisomy conditions within the NHS. However, it is available to detect genetic changes leading to specific skeletal abnormalities and certain forms of cystic fibrosis. The UK national screening committee has reviewed the case for implementing NIPT as part of the existing foetal anomaly screening programme and will provide its advice shortly.

NIPT is not currently offered for Down’s syndrome routinely within the NHS. Some NHS trusts have piloted the test for screening and a number of maternity units offer NIPT privately. NIPT is available through the NHS to detect genetic changes leading to specific skeletal abnormalities and also to detect certain forms of cystic fibrosis.

The UK national screening committee—UK NSC—which advises Ministers and the NHS in the UK about all aspects of screening policy, has reviewed the case for implementing NIPT as part of the existing NHS foetal anomaly screening programme and will provide its advice in the new year.

[Tulip Siddiq]

At my 12-week scan, I was told that I faced a risk of Down’s syndrome in my child. I was given two options. One was an invasive test available on the NHS—the amniocentesis test, which carried a risk of miscarriage. The second was a non-invasive test, which was not available on the NHS and cost £400. Does the Minister agree that the non-invasive test should be rolled out across the country so that mothers, regardless of wealth, can have equal access to screening and do not have to face the unnecessary risk of miscarriage?

[Ben Gummer]

I thank the hon. Lady for bringing her personal experience to the House, and I hope that all is well. She will understand that screening has to be a non-political matter. That is why we have a specific, clinically led committee to look at whether a screening programme should be implemented. It has been looking at NIPTs over the past year and will be making its decision very shortly. On the principle, though, I completely agree with her; it lies at the foundation of the NHS and we support it.

[Philip Davies (Shipley) (Con)]

12. What assessment he has made of the adequacy of clinical commissioning group transformation plans in addressing the needs of (a) all vulnerable children, (b) children in the care system, and (c) children who have been abused.

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[Maria Caulfield (Lewes) (Con)]

13. What steps he plans to take to increase the availability of nurse training in the NHS.

[The Parliamentary Under-Secretary of State for Health (Ben Gummer)]

I thank my hon. Friend for asking this question. I can tell her that we have made significant steps. In the past two years, there has been an 11% increase in nurse training places, and I anticipate that that increase will continue this year. We are providing over 23,000 full-time-equivalent additional nurses by 2019. We expect there to be an additional 10,000 nurse training places as a result of the announcements made by my right hon. Friend the Chancellor last year.

[Maria Caulfield]

Speaking as a nurse, I would struggle to undertake my nurse training given the proposed changes to the bursary scheme. I know that the Minister is working very hard on this, but will he outline what additional routes into nursing are planned to help mature students and those on a low income to gain access to nurse training?

[Ben Gummer]

My hon. Friend is right to point out that there are different ways into nursing. Just a few weeks ago, we announced a massive expansion in apprenticeships across the NHS, and I anticipate that a significant number will be for those going into nursing. The new post of nursing associate is a vocational route into nursing via an apprenticeship. In addition, our reforms to bursaries will ensure that there is a 25% increase in funding to recipients, bringing it into line with the rest of the student cohort. That cohort has seen a considerable expansion in the number of students coming from disadvantaged backgrounds as a result of the reforms that we undertook in 2011 and 2012.

[Helen Jones (Warrington North) (Lab)]

Does the Minister accept that his Government’s decision to cut nurse training places by 3,000 a year since 2010 has led to the huge shortage of nursing staff in the NHS and an increased reliance on nurses recruited from abroad and expensive agency staff, and that that will get worse with the abolition of bursaries? Is not this a textbook example of a false economy from the Government?

[Ben Gummer]

The hon. Lady should look at the facts. March 2015 saw a record number of nurses in the NHS—319,595. We are increasing the number of nurse training places. We are able to increase them by considerably more than we could have done otherwise, as a result of the reforms to student finance that bring nurses into line with teachers and other public sector professionals.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

It would be good to hear the Minister concede that it was a bad idea back in 2010 to cut the number of nurse training places. Even today we are still training fewer nurses than we were in 2009. Not only have this Government failed to recruit enough nurses, they have failed to retain them too: last year there was a 12% increase in the number of nurses leaving hospitals. With staff morale already at an all-time low, why does the Minister think it is right that nurses should be burdened with a lifetime of debt to pay for his Government’s mistakes?

[Ben Gummer]

The hon. Gentleman raises a reasonable point about attrition rates: they have remained too high for too long. One of the things we are undertaking at the moment is to talk intensively with universities to see how we can reduce attrition rates. We have had some success in some areas, but I want to see far more. It is important that students stay on their courses as much as possible. Of course, many go into community nursing. I would be prepared to write to the hon. Gentleman about further actions we are taking on attrition rates.

[Amanda Solloway (Derby North) (Con)]

14. What steps his Department is taking to involve young people in plans for improving children and young people’s mental health.

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[Michael Tomlinson (Mid Dorset and North Poole) (Con)]

T4. Following the assisted dying debate, will the Department set out what steps it is taking to improve end-of-life care, and will Ministers join me in praising local hospices such as Forest Holme hospice in Poole, which serves my constituents?

[The Parliamentary Under-Secretary of State for Health (Ben Gummer)]

I will certainly join my hon. Friend in praising the work of hospices. It is a unique contribution in the world of healthcare and we should be proud of their efforts. He will know that I have a commitment to end-of-life care and to improving it. I hope shortly to make announcements in response to last year’s NHS Choices review. I have been talking intensively to people from the sector about what might or might not be possible.

[Heidi Alexander (Lewisham East) (Lab)]

It is a sad state of affairs when a new year starts with the prospect of industrial action in the NHS. Nobody wants strikes, not least the junior doctors, but they feel badly let down by a Health Secretary who seems to think that contract negotiations are a game of brinkmanship. When will he admit that changing the definition of unsocial hours and the associated rates of pay for junior doctors is a forerunner to changing a whole load of other NHS staffing contracts to save on the NHS pay bill? That is what all this is really about, isn’t it?

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[Pat Glass (North West Durham) (Lab)]

T2. The Health Secretary just tried to tell us why we have 8,500 more nurses in the NHS. Let me tell him why it is. It is because we have record recruitment from abroad. Since the Chancellor announced the scrapping of bursaries for trainee nurses and midwives, there has been a worrying reduction in the number of applications for next year’s training, compared with what we would expect to see at this time of year. That can only have a negative impact on the number of trained nurses from this country and on net migration. Was there any discussion between the Department of Health, the Home Office and the Chancellor before this idiocy was introduced?

[Ben Gummer]

We have record levels of nurses in training and a record number of nurses in practice because of the decision by my right hon. Friend the Health Secretary to increase nurse training by 11% over the past two years. We can expand that significantly due to our reforms to the funding of nurse training. As regards nurses from abroad, part of the reason we are undertaking this change is so that every putative nurse in this country can have the opportunity of having a nursing position. At the moment, we have to limit those positions because of the funding regime that is in place.

[Jake Berry (Rossendale and Darwen) (Con)]

T8. Will my right hon. Friend join me in paying tribute to the first responders in Rossendale, who support the ambulance service by attending 999 calls to very serious cases, including one involving a friend of mine over Christmas? Will he in particular pay tribute to Brian Pickup, who is stepping down as team leader of the first responders after 11 years of unpaid public service?

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[Mark Garnier (Wyre Forest) (Con)]

T10. The Worcestershire Acute Hospitals NHS Trust now finds itself in special measures, and today its chairman has resigned, largely as a result of an over-extensive and highly complex review of clinical services in the county that has so far failed to reach an agreed conclusion. Given the complexity of the review process, and the apparent impossibility of it reaching an agreed conclusion, what steps can the Government take to untie the Gordian knot that created that situation and help the trust to get back on a stable footing?

[Ben Gummer]

My hon. Friend is right and there is a particularly complex series of circumstances in Worcestershire. I am determined to do something about that, and I want to meet him and his colleagues in the next few days to discuss possible options. I will then discuss those issues in turn with NHS England.

[Andy McDonald (Middlesbrough) (Lab)]

T5. The management at James Cook university hospital in Middlesbrough is seeking to increase nurses’ current 30-minute meal break, which they struggle to take, to a compulsory unpaid 60-minute break that will result in nurses effectively working one shift a month unpaid. In their judgment that will do nothing to address the real issues of staff shortages and patient safety, but will merely disadvantage patients and nurses alike. Will the Secretary of State investigate the matter and write to me?

[Ben Gummer]

I thank the hon. Gentleman for bringing that issue to the attention of the House. All contracts should be governed by the “Agenda for Change” contract, and I would be concerned if there were deviations from that. I would welcome further detail on that so that I can respond to him.

[Dr Sarah Wollaston (Totnes) (Con)]

Nobody wants to return to the days of exhausted junior doctors being forced to work excessive hours, and the Secretary of State will know that that is why junior doctors have expressed concern about the potential impact of removing financial penalties from trusts. Will the Secretary of State set out what has happened during the negotiations to reassure the public and doctors about patient safety?

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[Mr Robin Walker (Worcester) (Con)]

May I thank the Minister for his helpful answer to my hon. Friend the Member for Wyre Forest (Mark Garnier)? Further to that question, having recently met the clinical leadership at Worcester Royal hospital, they are adamant that they want permanent management in place at the hospital. The Care Quality Commission report said that the number of interim directors was one reason why it was put into special measures. Can the Minister reassure me that he will be doing everything he can to put in place permanent long-term management at the Worcestershire Acute Hospitals NHS Trust as quickly as possible?

[Ben Gummer]

I can assure my hon. Friend of precisely that.

[Paula Sherriff (Dewsbury) (Lab)]

Mid Yorkshire Hospitals NHS Trust is planning to implement a significant reconfiguration plan 12 months earlier than was agreed by the Secretary of State. Dewsbury hospital will be significantly downgraded before infrastructure is in place to ensure that patients still receive vital care safely. Will the Secretary of State meet me to discuss this premature move, which appears to be purely financially driven and not in the best interests of my constituents?

[Ben Gummer]

I thank the hon. Lady for bringing that issue to the notice of the House. The reconfiguration she mentions is the responsibility of local commissioners, but I am very happy to meet her, and anyone she wishes to bring with her, to discuss the planned changes.

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

My local mental health trust recently reduced its psychiatric liaison cover in A&E and is now considering the level for the coming year. Will my right hon. Friend provide an update on what the Government plan to do to ensure specialist mental health care in A&E?