NHS (Government Spending)
Debate between Dan Poulter and Lord Walney(9 years, 3 months ago)
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Dr Poulter
As the hon. Lady will be aware, front-line staff use IT and understand the importance of joining it up to benefit patient care while also protecting confidentiality. On the point about district nurses, she is right that we need to transform the model of care, which is why the Government set up the £5.2 billion better care fund—to ensure we join up more effectively what happens between our acute hospitals, the wider NHS and adult social care. This approach will be transformative, delivering better care for the frail elderly and providing more care in people’s homes.
Of course, part of that is about changing work force models and ensuring that staff who have traditionally worked only in hospitals, supporting people with long-term conditions such as multiple sclerosis, can also work in the community. [Interruption.] The hon. Lady is chuntering away, but I have answered her question in an informed and sensible way, having spoken about how our work force models need to change as part of our investment in integrating and joining up care so that patients looked after now in a purely hospital environment can have access to staff across both community and hospital care, which is important for people with long-term conditions such as diabetes, multiple sclerosis and dementia. I hope she can support that.
It is also important to consider some of the equally important funding decisions we have made in maternity care. In 2013-14, we provided £35 million of capital funding for the NHS to improve birthing environments, which represents the single biggest capital investment in maternity care for decades. That has benefited more than 100 maternity units, including through the establishment of nine new midwifery-led birthing centres in eight areas, and transformed many local maternity services across the country. Improvements delivered by our maternity investment fund include: more en-suite bathroom facilities in more than 40 maternity units, providing more dignity and privacy for women; more equipment such as beds and family rooms in almost 50 birthing units, allowing dads and families to stay overnight and support women while in labour or if their baby needs neonatal care; and bereavement rooms and quiet areas at nearly 20 hospitals to support bereaved families after the thankfully rare but always tragic loss of a baby.
Our £35 million maternity investment has made a big difference to the experience mums and families have of NHS maternity services.
Dr Poulter
I have been very generous in giving way, but I must now make some progress.
Dr Poulter
No, on this occasion, the hon. Gentleman will have to forgive me.
Our capital investment in maternity services, which, as I said, is the biggest for decades, is making a big difference to mums, dads and new families. Thanks to our investment in the midwifery work force, we now have the highest ever number of midwives working in our NHS—about 2,000 more than in 2010—providing more personalised care and support for women and new mums. However, we must all recognise the challenges facing our health and care system in the months and years ahead. NHS England’s “Five Year Forward View” argued that we needed to do more to tackle the root causes of ill health through a radical upgrade in prevention and public health; to give patients more control over their own care, including through the option of combining health and social care, and new support for carers and volunteers; to ensure the NHS changes to meet the needs of a population that lives longer; and to develop and deliver new models of care, local flexibility and more investment in our work force, technology and innovation, some of which I have already outlined.
That is why the Government have provided additional funding for NHS front-line services in 2015-16, including £200 million to pilot new care models and £250 million for the first tranche of the new £1 billion fund, spread over the next four years, for investment in new primary and community care facilities to support our GPs and primary and community care work force in the important work they do. In community care, we are committed to undoing the terrible mistake that was Labour’s 2004 GP contract, which left so many people, particularly the frail elderly, without the GP care they needed at evenings and weekends. Our investment will support GPs to provide care for patients seven days a week so that patients will once more be properly supported during evenings and weekends. We are also training an extra 5,000 GPs, in addition to the 5,000 extra we have already seen under this Government, to provide that care.
We are clear, however, that if the NHS is to meet the challenge of increasing patient demand and expectations, it cannot stand still. By 2018, 3 million people in our country will have three or more long-term conditions, so we must continually adapt and change how we deliver care to support patients, families and carers, and deliver more care in people’s homes and communities. For our part, and as part of our plan for our NHS, not only are we delivering a strong economy so that we can protect our NHS budget, but we will continue to be ruthless in delivering greater efficiencies in estate management and procurement and in reducing back-office costs so that we can reinvest that money in front-line patient care. Furthermore, we will continue to back front-line staff with the training, equipment and new technology they need to do their job and provide high-quality patient care, which is why we have already made available an additional £2 billion down payment to deliver NHS England’s “Five Year Forward View” and why the Prime Minister has committed to continuing to protect our NHS and ensuring that it has the additional money it needs to deliver first-class patient care in the months and years ahead.
In conclusion, I would like to thank the dedicated NHS staff working incredibly hard to keep us well looked after and safe in this busy winter period. As a practising doctor—I know Labour does not like it, given its dearth of real-life experience and the number of former special advisers on its Front Bench—I know how hard our NHS staff work and how dedicated they are to delivering the highest-quality patient care. I remind the House that we have been able to increase the money available to our NHS only because we have the growing economy to pay for it; because our long-term economic plan is working; and because, under this Conservative-led Government, there are more people in work than there were under Labour. Anybody who does not have an economic plan for the economy—and Labour has no plan for our economy, as has certainly been clear in today’s debate—does not have a plan for the future of our NHS. Through economic policies and by creating growth and jobs, we have been able to announce additional NHS funding for 2015-16 without having to raise taxes, including on people’s homes, as Labour would like to. This gives our NHS the funding it needs to begin implementing the plan set out in NHS England’s “Five Year Forward View”, so that it can continue to be a world-class, sustainable health service, delivered free at the point of need.
When we came into power, we took two big strategic decisions with our NHS: to increase funding and to cut bureaucracy and waste, and to reinvest that money in more doctors, nurses and front-line staff and to improve front-line patient care. That is exactly what we have done, so the choice on 7 May will be clear: between a Labour party that bankrupted Britain and would do so again, at the same time bankrupting our NHS, and a Conservative Government, committed to securing our NHS by delivering a strong, stable and growing economy.
University Hospitals of Morecambe Bay NHS Foundation Trust
Debate between Dan Poulter and Lord Walney(11 years, 3 months ago)
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The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)
It is a great pleasure to serve under your chairmanship, Mr Howarth. It is not the first time, but nevertheless it is a pleasure.
I pay tribute to the hon. Member for Barrow and Furness (John Woodcock) for his advocacy on behalf of his constituents and all those in Cumbria who are looked after by the local trust and to my hon. Friend the Member for Morecambe and Lunesdale (David Morris), whose constituency I recently had the pleasure of visiting, for his advocacy on the behalf of his constituents. I have indeed received a copy of the letter sent to him by the chief executive of the NHS trust, which says:
“Whilst it would be wrong of me to second guess the future, I personally find it hard to imagine Lancaster not having emergency services.”
I hope that that is reassuring to him and his constituents.
On the main issues raised in the debate, I have already paid tribute to the strong advocacy on behalf of his constituents by the hon. Member for Barrow and Furness. He was very kind to brand me an expert in obstetrics. I would not go quite that far, but he is right to say that I have considerable understanding of the issues involved and of the importance of ensuring that we provide safe and comfortable environments in which women can give birth. He is also right to read out the case that I advocated in a debate here in Westminster Hall some time ago, and it is important that we recognise that uncomplicated deliveries can become more complicated. We know that for women in some parts of the country, particularly those in more deprived areas, there are often higher risk rates of prematurity. These are all issues that need to be taken fully into account whenever services for the safe delivery of babies, and for the safe care of women during pregnancy, delivery and the period afterwards, are examined.
The hon. Gentleman is also right to highlight that there are geographical considerations in Cumbria, as in many rural areas, including the fact that there is only one main road and the problems that presents in respect of allowing the local trust to transfer patients effectively and safely from one site to another. It potentially creates difficulties at certain times of day if the road is busy, as he is aware. However, it also requires the availability of ambulances, and he was right to point that out.
When decisions are made about changing services, whatever the reason may be for changing them, they cannot be taken in isolation. In this case––I will discuss this further later––I believe that the decision was made in good faith, although I share some of the concerns that the hon. Gentleman raised, given that we know that there have been a lot of problems at the trust with maternity services as well as the safety concerns he outlined. Those decisions cannot be taken in isolation. They need to be taken in collaboration and after discussion with local commissioners and indeed with the ambulance service, if they are to be made correctly and for the benefit of patients.
The hon. Gentleman was also right to outline the four tests for reconfiguration. In particular, he was right that reconfiguration must be clinically led, based upon evidence and always in the best interests of patients. Reconfiguration should never happen for cost reasons alone, and he was absolutely right to highlight that. Reconfiguration also needs to have the support of local GP commissioners. However, from what he has said today it appears that there are local concerns about the proposed changes, and that there has not been an integrated, joined-up approach in relation to this decision.
We have also discussed the concerns over the need to integrate ambulance transfers into any local decisions because of the travelling distance from Barrow to Lancaster. That is one of the issues that should have been take into account when these decisions about reconfiguration were being made, and I am very concerned to hear the hon. Gentleman say that he does not believe that they were taken into account and that local commissioners also have concerns about this matter.
I am very happy to meet the hon. Gentleman again in the very near future to discuss this; that would be very desirable. It is vital to ensure, as the hon. Member for Copeland (Mr Reed) said, that we do not see service reconfiguration by stealth or via the back door. We should have an integrated, joined-up approach to local decision making, particularly in view of what can only be described as the deficiencies of the past at the trust and the very sad cases that the hon. Member for Barrow and Furness and I have corresponded about, as well as the police investigations that are going on. He is aware that it would be inappropriate for me to comment directly on those.
There is a need to ensure that in the future decisions are made in a holistic way and in the best interests of patient safety. Such decisions are not just for the trust to make alone but must be made in conjunction with the local commissioners and the ambulance service, if we want to ensure patient safety. The hon. Gentleman and I can discuss that further when we meet.
The hon. Gentleman raised another important issue: the ongoing investigations at the trust. He was right to do so. As we know, tomorrow the Mid Staffordshire report will be published, which makes these sorts of issues all the more poignant and important. The NHS has sometimes had a history of covering up bad things that have happened to patients, and that is completely unacceptable. The result of that is bad care for patients, and cultural problems in trusts and hospitals. Those sorts of things cannot go on. When there are investigations, they need to be carried out transparently and openly, so that people feel the issues have been fully aired. It is also vital that those investigations have a degree of independence, as he suggested.
John Woodcock
I thank the Minister for giving way, and for the excellent and considered way that he is responding to my points. He referred to the Mid Staffordshire situation. Does he accept that that started as an internal inquiry, which was found to be insufficient to get to the bottom of the issues and required a greater degree of independence to be established? We are worried that the same thing may be apparent in Furness.
Dr Poulter
Absolutely. There will be a full response to the Mid Staffordshire inquiry tomorrow, so I will not pre-empt it or go into detailed discussion of that issue. However, it is absolutely right that we must encourage staff who have concerns about patient care to raise those concerns and air them in an open way. Moreover, when we know that there have been long-standing failings at a trust about the quality of care provided to patients and concerns raised about those failings—although Morecambe Bay NHS Foundation Trust, for example, has made some good progress in recent months, there are some long-standing issues there—it is important that, when an investigation is carried out, it is carried out in a transparent, open and independent way; there must be a great degree of independence involved.
If a trust sees fit to launch an investigation and a review of what has happened, it is important that the investigation and review pass the test of transparency. There may well be a role for local MPs and other interested parties in that process, and when the hon. Member for Barrow and Furness and I meet, that is an issue that I will be very keen to discuss further, to ensure that we can discuss with the local trust ways in which we can ensure that there is that transparency and independence in the process. That is very important to ensure that those patients, and their families who have had problems in the past—in some cases, there have been deaths at the trust—feel that the investigation addresses their allegations.
Obviously, this debate is not just about maternity services at the Morecambe Bay NHS Foundation Trust; there have been other issues around the trust, and any investigation will need to take account of all those issues. I understand that that is what will happen.