Oral Answers to Questions

Dan Poulter Excerpts

Tuesday 24th February 2015 Commons Chamber

[Graeme Morrice (Livingston) (Lab)]

9. How many NHS staff have been made redundant and subsequently re-employed by the NHS since May 2010.

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

Over the four and a half years between May 2010 and October 2014, 5,210 people—equivalent to, annually, less than 0.1% of the NHS work force—have been made redundant and then returned to work elsewhere in the NHS.

[Julie Hilling]

But at a time when A and E is in crisis and there are not enough nurses, how on earth can the Minister possibly justify firing and rehiring thousands of NHS staff? What greater sign could there be of a Government with their priorities totally wrong?

[Dr Poulter]

I am not sure I recognise that picture of the NHS. We know that there are between 6,000 and 8,000 extra nurses, midwives and health visitors working in our NHS than there were under the previous Government. Also, in respect of A and E, the average length of stay in hospital has steadily come down from about eight days in 2000 to about five days now. So our NHS is getting better and improving under the current Government.

[Graeme Morrice]

Last year the Prime Minister promised to recover redundancy payments from people who have been rehired. Can the Minister tell us how many payments have been recovered and at what cost?

[Dr Poulter]

The hon. Gentleman will be aware that it was the previous Labour Government who in 2006 set these eye-watering redundancy payments for the NHS, and we have committed to making sure we reform and change that. Therefore, as part of our negotiations and pay offer to NHS staff we want to introduce a redundancy cap of £80,000. Since many Opposition Members are supported by trade unions, I hope they will encourage union members to back that pay and redundancy cap.

[Andrew Stephenson (Pendle) (Con)]

Can the Minister confirm that according to the latest figures there are more nurses working in the NHS now than there were in 2010, including an additional 391 at East Lancashire Hospitals NHS Trust and an additional 59 at Airedale NHS Foundation Trust, the two trusts that serve my constituency?

[Dr Poulter]

I am delighted to confirm that, and we have made a conscious decision to reduce NHS waste and bureaucracy. NHS administration spending is down from 4.27% under the previous Government to only 2.77% now, which has resulted in £5 billion of efficiency savings and meant we can invest in about 6,000 more nurses, midwives and health visitors.

[Maria Miller (Basingstoke) (Con)]

The extra NHS staff my hon. Friend talks about are welcome, but my constituents want to know that standards of care are the best as well. What progress is he making to ensure that hospital patients get the best possible care?

[Dr Poulter]

The most important thing we have done is support our front-line staff with additional investment in the NHS, which Labour called irresponsible, and there is about £13 billion more going into the NHS during this Parliament. We have also increased transparency to make sure that where there are isolated pockets of poor care, the Care Quality Commission can intervene and make recommendations to improve the quality of care for patients in those hospitals.

[Nic Dakin (Scunthorpe) (Lab)]

20. Given the significant challenges facing the NHS and the fact that this top-down reorganisation has led to this hiring and firing and therefore a distraction of energy and attention at crucial times, do not the Government now regret their top-down reorganisation?

[Dr Poulter]

A reorganisation of NHS services that results in administration spending being reduced from 4.27% under the previous Government to 2.77% under this Government, meaning that there is £5 billion more money for front-line patient care, is a good thing. That is something the Opposition should support, because it means that patients are getting a better service.

[Andrew Bridgen (North West Leicestershire) (Con)]

Can the Minister remind the House of the number of extra specialist A and E doctors working in the NHS in England now compared with 2010?

[Dr Poulter]

My hon. Friend is right to raise this important point. As part of our commitment to investing more money in the front line, we have been able to ensure that there are between 800 and 1,000 more doctors now working in A and E than there were under the Labour Government.

[Several hon. Members]

rose—

[Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

Those of us on the Public Accounts Committee have heard about the industrial scale of this revolving door of people going out of one job and into another with a fat redundancy payment. Does this not show that the Government have lost their grip on what is truly important in the NHS, which is paying front-line clinicians to serve patients?

[Dr Poulter]

That is extraordinary. The Public Accounts Committee will be aware that these redundancy terms were introduced by the previous Labour Government in 2006. We are committed to changing them and I hope that the hon. Lady’s party will support us in exerting pressure on the unions to support the pay deals on the table that will introduce an £80,000 redundancy cap.

[Mr Speaker]

Ms Johnson, do you have a similar question?

[Diana Johnson (Kingston upon Hull North) (Lab)]

21. Yes, Mr Speaker; I am grateful. I want to ask about the number of nurses who have been made redundant. Lots of hospitals in my area are now recruiting from Spain, and I wonder whether an assessment has been made of the cost to the NHS of using nurses from abroad after making other nurses redundant.

[Dr Poulter]

Our NHS has always benefited from overseas staff bringing their skills and coming to work here, and we can all welcome that as long as they have a good standard of spoken English, which is something that we are putting right through the legislation that we are introducing. As I outlined earlier, there are now around 7,500 more nurses, midwives and health visitors working in the NHS than there were under the previous Government.

[Douglas Carswell (Clacton) (UKIP)]

2. What contingency plans his Department has formulated to cope with the expected increase in the number of GPs retiring before 2020.

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

In addition to the extra 1,000 GPs working in our NHS since 2010, our mandate to Health Education England will ensure that 50% of trainee doctors enter GP training programmes by 2016. This will enable the delivery of 5,000 additional newly qualified GPs by 2020.

[Douglas Carswell]

I am told that many young doctors are choosing not to go into general practice. That, coupled with the number of retiring GPs, is leading to real shortages in places such as Clacton. What more can be done to make general practice more attractive to young doctors, in order to offset the number of GPs who are retiring?

[Dr Poulter]

There have always been parts of our health service where it has been difficult to attract GPs to work; that is a long-standing problem. A new £10 million investment fund has been put in place, and a new 10-point plan is being delivered by NHS England to look at how we can better incentivise younger doctors to work in areas in which it has traditionally been difficult to recruit. I am sure that that will bring benefits to the hon. Gentleman’s constituency and elsewhere in the NHS.

[Sir Tony Baldry (Banbury) (Con)]

Does my hon. Friend agree that this is not just a matter of the total number of GPs? Quite a lot of GPs now want to work part time, and quite a lot now want to be salaried rather than being partners. Is he confident that the model that was set up in 1948, which effectively means that each GP practice is its own separate, private business, is still suitable in the 21st century?

[Dr Poulter]

My right hon. Friend asks an important question. We can of course support the existing model, and the innovation that comes with GPs being small businesses, and that is exactly what we are doing with the £1 billion investment fund for GP infrastructure and technology. We are supporting those GPs as small businesses to develop better patient services.

[Valerie Vaz (Walsall South) (Lab)]

On what is his last outing, will the Minister tell us how many GPs, in addition to those who have retired, have left the profession and how many have gone to work abroad?

[Dr Poulter]

It has always been the case—it was certainly the case among many of my medical contemporaries—that many people from our NHS go and work overseas for some time. They often come back to the NHS, bringing broader experience and skills. As I outlined earlier, there are now 1,000 more GPs working and training in our NHS than there were five years ago.

[Mr Philip Hollobone (Kettering) (Con)]

Following the retirement of a senior partner whom it has been impossible to replace, Dr Hadrian Moss of the Dryland GP surgery in Kettering has followed the advice of the British Medical Association and informally closed his expanded list of 2,500 patients on the ground of patient safety. He has now been taken to task by NHS England for a potential breach of contract. What is the Minister’s opinion on reconciling the views of the BMA on patient safety guidelines and those of NHS England on a potential breach of contract?

[Dr Poulter]

I am sure that my hon. Friend will understand that it is difficult for me to comment on an individual case, but I am very happy to look into the matter and get back to him about it.

[Ms Margaret Ritchie (South Down) (SDLP)]

Given that the needs of patients must come first and that young people are not choosing to pursue GP training as much as they used to, what discussions will the Secretary of State hold directly with the British Medical Association, the Royal Colleges, the training councils and his colleagues in the devolved Administrations throughout the UK to address this issue, to prevent further congestion in accident and emergency departments?

[Dr Poulter]

There is a lot of work going on in this area. First, we are encouraging and supporting GPs who have had career breaks, perhaps because they have started a family, to get back into the profession more easily than they have been able to do in the past. Secondly, we also have the commitment that 50% of medical students and doctors leaving foundation training will become GPs in future. That will make sure that we have 5,000 more GPs by 2020.

[Andrew Gwynne (Denton and Reddish) (Lab)]

But the Government’s reorganisation took billions of pounds away from the NHS front line. Figures released last week show that fewer than a quarter of medical students now enter general practice, because they can see the pressure that Ministers have put on it, while GP morale has collapsed. Should the Minister not now admit that the reorganisation was a mistake and instead match Labour’s pledge to invest an extra £2.5 billion a year to recruit 8,000 more GPs and guarantee appointments within 48 hours?

[Dr Poulter]

I know that the Labour party is full of professional politicians, but medical students do not just leave medical school and straight away become GPs; they become foundation doctors. As I have outlined, 50% of the people leaving their foundation training will become GPs in future, which will increase the number of GPs by 5,000. Under this Government the number of GPs in education, training and working in the NHS has increased by 1,000, which is a move in the right direction.

[Stephen Mosley (City of Chester) (Con)]

3. How many CT scans were performed at the Countess of Chester hospital in (a) 2010 and (b) 2014.

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[Steve McCabe (Birmingham, Selly Oak) (Lab)]

11. How many nurses per million population were working in the NHS in each of the last five years.

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

The full-time equivalent number of nurses, midwives and health visitors working in the hospital and community health services in England per million population from September 2010 to September 2014 inclusive has remained broadly constant at 5,872, 5,768, 5,703, 5,712 and 5,781 respectively.

[Steve McCabe]

In response to 11 parliamentary questions that I submitted in the past year, the Minister has admitted that he does not know how many part-time, agency and locum GPs are in the health service, the number of agency and part-time nurses, the number of part-time doctors in our hospitals, or how many working nurses and midwives are also drawing their pensions. Given that he has so little detail on staffing, where did today’s figures come from, and what faith can anyone have in them?

[Dr Poulter]

They are in the monthly staff statistics survey. As the hon. Gentleman would like some detailed information, I am sure he will be pleased to hear that in his constituency there are now 386 more nurses than there were in 2010 under the previous Government, and nationally there are 7,500 more nurses, midwives and health visitors working in the NHS.

[Andrew George (St Ives) (LD)]

Does my hon. Friend agree with me and with the nursing profession that if nurse staffing levels on acute hospital wards fall below one registered nurse to seven acutely ill patients, excluding the registered nurse in charge, it will significantly increase the risk to patient care and result in avoidable excess deaths?

[Dr Poulter]

My hon. Friend and I have discussed this many times and I do not agree with him, as he knows. What is important is that patients are assessed on their clinical needs. A rehabilitation ward will need a different number of nurses—indeed, it may need physiotherapists and occupational therapists—from intensive care nursing, which often requires one-to-one care, so setting arbitrary staffing ratios is not in the best interests of patients.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

Does the Minister accept that the issue is not just broad numbers, but the shortage of specialised nurses in many departments, certainly in Calderdale and Huddersfield, where we are finding it difficult to recruit the right qualified nurses for very specialist tasks, as well as the doctors to go with them?

[Dr Poulter]

In many parts of the country we are seeing more specialist nurses working, particularly in areas such as diabetes, and supporting patients with complex care needs. As we need better to support people with those complex care needs at home in their own communities, the Government will continue to invest in specialist nurses not just to provide care in hospital, but to work in the community at the same time.

[Ian Austin (Dudley North) (Lab)]

Russells Hall hospital is being forced to lose one in 10 staff, which could include midwives, to deal with Government efficiency savings of £12 million every year. This morning the hospital’s chief executive has written to me and says that these

“excessive efficiency requirements place care at risk”.

She goes on to say that

“the financial challenge has reached unviable levels”

and that NHS providers

“can no longer guarantee sustainable and safe care”.

What will it take for Ministers to listen not just to us, but to NHS staff, and ensure that hospitals such as Russells Hall have the resources they need to provide care for local people?

[Dr Poulter]

I am sure the hon. Gentleman will be pleased that, as part of our winter pressures funding, Dudley received £3.5 million to support the hospital during a difficult winter period. There are now 69 more doctors and 324 more nurses, of whom 29 are extra midwives, working in the area than in 2010.

[Mr Bernard Jenkin (Harwich and North Essex) (Con)]

12. What discussions he has had with (a) the Haven project in Colchester and (b) NHS bodies in north Essex on the need for continuing funding for support for people with moderate to severe personality disorder.

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[Glyn Davies (Montgomeryshire) (Con)]

T3. Not enough GPs want to practise in rural Wales. I am told that one of the reasons is that GPs registered in England have to go through a bureaucratic process to be able to work in Wales. Will my hon. Friend the Minister work with the Welsh Government to ensure that we have a common registration process so that GPs can move between England and Wales without having lengthy, time-wasting new bureaucracy?

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

I am very happy to look into that issue and to do what we can to support our NHS work force to move as freely as possible between England, Scotland, Wales and Northern Ireland. GP numbers in England have increased because we have protected the NHS budget, unlike in Wales, where it has been cut by the Labour Administration.

[Karl Turner (Kingston upon Hull East) (Lab)]

T2. A recent Ashcroft poll shows that only 15% of the public think that this Government have the best approach to running the NHS. Will the Secretary of State stand up at the Dispatch Box and apologise for his top-down reorganisation of the NHS and his Tory privatising Health and Social Care Act, and accept that the public will never trust the Tories with the NHS?

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[Paul Blomfield (Sheffield Central) (Lab)]

T8. When I asked the Minister last June what guarantees he would give to GP practices at risk because of the withdrawal of the minimum practice income guarantee, I was told that NHS England would ensure threatened practices “get to the right place.”—[Official Report, 10 June 2014; Vol. 582, c. 400.]Over the past seven months, those discussions have not alleviated the threat to two highly regarded practices in my constituency that face closure. Will the Minister agree to meet me and representatives of the practices to discuss what is really happening, and to consider what can be done to save them?

[Dr Poulter]

I am very happy to meet the hon. Gentleman, but he will be aware that the move away from the historical funding formula towards a per head or capitation formula is a move in the right direction. If there are certain local concerns, I am very happy to meet him to discuss them.

[Robert Jenrick (Newark) (Con)]

May I commend the Government on raising the priority for dementia in their announcement last week? Will the Secretary of State and the Department of Health put all their resources behind towns such as Newark, which are trying to establish themselves as dementia-friendly towns and are working with shopkeepers, banks and the business community to make it easier for older people with dementia to lead fulfilling lives?

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[Mark Reckless (Rochester and Strood) (UKIP)]

Medway clinical commissioning group is looking at putting GPs at the front of our accident and emergency department to help relieve pressures on emergency doctors. Do Ministers believe that that is a promising way forward?

[Dr Poulter]

There is certainly a lot of benefit from having general practice co-located alongside A and E so that people with more minor ailments or concerns can be seen by GPs. That can often take the pressure off A and E services, but more senior expertise is also on hand when required.

[Sarah Newton (Truro and Falmouth) (Con)]

Will my right hon. Friend update the House on what steps he is taking to prevent avoidable deaths from sepsis?

[Bridget Phillipson (Houghton and Sunderland South) (Lab)]

GPs across the north-east say that they are facing a work force crisis, with falling numbers of family doctors. Does the Secretary of State not recognise the connection between people being unable to get an appointment to see their GP and the rising and major pressure on our A and E department?

[Dr Poulter]

I am sure that the hon. Lady would like to support the plans we have put in place to ensure that we increase the number of GPs by 2020, and to ensure that 50% of doctors leaving foundation training go into careers in general practice.

[Mr Adrian Sanders (Torbay) (LD)]

In order to combat fraud, the previous Government quite rightly introduced five-year prescription charge exemption certificates. Now that the certificates are coming up for renewal, people are finding that they have to pay for their medicines once their certificate has expired, and they have even been fined. Unlike for a TV licence, there is no renewal reminder. Will the Government look at how to ensure that people are told they need to renew their prescription exemption certificates?

[Dr Poulter]

As my hon. Friend will be aware, 90% of patients receive free prescriptions either because they are older—over the age of 60—or because of long-standing or other factors. If his constituents are running into difficulties and have problems with renewing their certificate, I am very happy to look into that and to meet him to discuss it further.

[Mr David Anderson (Blaydon) (Lab)]

Despite assurance from the Prime Minister, it is now clear that the drug Translarna will not be available until after NHS England has concluded its internal consultations. The Secretary of State and others have told me repeatedly that they have no control over the issue, but can the Minister give the House any idea when the drug will be available for young boys suffering from Duchenne muscular dystrophy in this country, in the same way as it is across Europe? The drug is saving young boys from going into wheelchairs earlier. Does the Minister have any idea when it will be available?