Mitochondrial Replacement (Public Safety)
Baroness Laing of Elderslie Excerpts(11 years, 5 months ago)
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Madam Deputy Speaker (Mrs Eleanor Laing)
Order. Before I call the next Member to speak, I should point out that although we have a four-minute time limit, it has been a lively debate with many interventions, so most people have taken five or six minutes. I will now have to reduce the time limit to three minutes.
Dr Sarah Wollaston (Totnes) (Con)
I rise to urge the Minister not to delay bringing forward the regulations, and I urge the House not to lose sight of the children and their families who are devastated by mitochondrial diseases. Of course it is absolutely right that the House debates the ethics, as so many Members have pointed out, but at times the language used has clouded those arguments. We have heard terms such as “eugenics”, “three-parent babies”, “designer babies”. This is not about wanting to create a child who is more beautiful or more intelligent. This is about wanting to spare families and children from a lifetime of devastating medical problems. We have the potential to do that. I fully respect those who oppose this on ethical grounds—they are entirely consistent in their view—but I am concerned that there has been selective misquoting from the scientific evidence. The House is not really qualified to examine the evidence in detail, and that is why we have expert panels, and bodies such as the HFEA, to advise and regulate this, and they do so with a great deal of thoughtfulness and expertise.
We have to be clear that the third scientific review, the expert panel, which I regret has been selectively misquoted, has looked at that evidence and has concluded that it does not show that the technique is unsafe. We will not know whether the technique is effective until we allow trials in a human context—it may be that there are complications; we have to be honest about that, and we have to be honest that this is not the same as a blood transfusion—but we do know absolutely for certain that families and children are suffering now from these diseases. That is why, on the balance of the safety issues and the advice from the expert panels, we should not reject this on safety grounds.
The point made by the hon. Member for North Antrim (Ian Paisley) about the child sitting in front of him in his surgery whose parents would not change that child was particularly powerful. No one is asking to change a child. What we are asking is for future generations of children to be spared that part of them that creates the suffering, but to keep within them all the personality and everything else in their genetic make-up that makes them who they are.
I am also concerned to point out that if I were to donate my mitochondrial—
Dr Sarah Wollaston (Totnes) (Con)
On a point of order, Madam Deputy Speaker. Is it in order to ask whether Professor Lord Winston was consulted before his name was added to the motion on the Order Paper?
Madam Deputy Speaker (Mrs Eleanor Laing)
It is in order to ask the question. I cannot give the hon. Lady an answer, but I have heard what she said, and I am sure that those who were involved in that have heard what she said. If the noble Gentleman was not consulted, I would consider that to be most discourteous.
Health
Baroness Laing of Elderslie Excerpts(11 years, 8 months ago)
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Madam Deputy Speaker (Mrs Eleanor Laing)
Order. The House will be aware that a great many colleagues desire to take part in the debate this evening and that time is limited. I am afraid that I therefore have to impose a time limit of eight minutes.
Mrs Emma Lewell-Buck (South Shields) (Lab)
Our national health service is undisputedly one of the greatest achievements of any Government, yet the crisis that the NHS has experienced under the Government’s disastrous privatisation, threatens the survival of services and the quality of patient care. I am proud that it was a Labour Government who created the NHS, and I am proud it is a Labour Government who will reverse the damage done by the Health and Social Care Act 2012. In our health service, more than 4,000 senior nursing posts have been lost since 2010. Accident and emergency performances in the year following the Government’s reorganisation were the worst in a decade. Last year, South Tyneside hospital in my constituency had to cancel operations because of unprecedented demand for A and E services. Only two weeks ago, it emerged that the NHS in England had failed to meet a performance target for cancer waiting times for the first time ever.
The Government’s failed reorganisation has increased wasteful spending. The NHS now spends more on senior managers and management consultants than ever before, and it is increasingly bogged down in competition law, forcing it to spend money on lawyers that could have gone towards patient care. The pressures on our health service stretch well beyond hospital waiting rooms, as demand for NHS services is affected by trends in public health and the quality of social care. In those areas, we have seen massive cuts to local authority budgets of £2.7 billion. Faced with cuts of that scale, local authorities have been left with impossible decisions and have been forced to cut services, knowing that in doing so they would increase pressure on the health service.
Those who are lucky enough to be entitled to care find that their care worker can only stay with them for 15 minutes. These workers are poorly paid, with over 300,000 on zero-hours contracts. A third do not receive proper training. Unsurprisingly, staff turnover is high, so many clients do not manage to build a relationship with their carer. The Care Act 2014, which was passed in the last Session, presented an opportunity to address some of those issues, but unfortunately it was an opportunity that the coalition parties did not take. They rejected Labour amendments on low pay and zero-hours contracts that would have improved the standard of care that people receive. They also ignored charities that warned that the new eligibility criteria for support would exclude hundreds of thousands of people from the care system.
Of course, there are challenges facing social care, but we do not solve the problem by cutting support for those with moderate needs, only for them to end up in hospital. Last year’s QualityWatch report showed that about one in five hospital admissions could be prevented by better social care. The ultimate goal should be an integrated system like the one argued for by my right hon. Friend the Member for Leigh (Andy Burnham). The Government at least pay lip service to that idea, but in practical terms they have done very little. The better care fund announced last June was meant for that purpose, but it was actually just money diverted from existing NHS services, proving that the Government are not serious about promoting integration.
Underlying all of that are broader questions about public health. Poverty and ill health often go hand in hand, and malnutrition in particular has become a frighteningly normal part of life in Britain today. I know parents who skip meals so that their children can eat, and people for whom food banks are the only thing standing between them and starvation. Malnutrition affects an estimated 3 million people in the UK, which is a scandal in the fourth richest country in the world.
The previous Government left office with fewer people in poverty than when they arrived. Child and pensioner poverty fell even after the financial crisis took hold, and we were well on our way to eliminating child poverty by 2020. But under the coalition, this trend has been reversed, and instead of eliminating poverty by the end of this decade the Child Poverty Action Group estimates that the number in poverty will have risen to 4.7 million.
The coalition has allowed this crisis to develop, and the Queen’s Speech needed to recognise families’ desperation by delivering help with living costs such as food, energy and rent. Poverty, and food poverty especially, has a knock-on effect for our health system. Experts have warned that there is a public health emergency. We are beginning to see diseases such as rickets returning as children no longer receive the balanced diet they need. The symptoms of poverty pose serious challenges to our health service in the long term.
Our national health service survives in spite of this Government, not because of them. It is strong because of its work force and because of a public who resolutely believe in it and value it. In communities around the country, families are fed not because their country’s Government have helped them to find decent work, but because their fellow citizens give up their time to lend a helping hand. Our country faces some of its biggest challenges for generations, and people feel that Britain is no longer working for them. Worse yet, people feel that politics has no answers to the difficult questions of our time. All these challenges need a Government who are willing to be bold, but this Queen’s Speech gave no hope of that. It was more of the same from a coalition that has long outstayed its welcome.
Madam Deputy Speaker (Mrs Eleanor Laing)
And the prize for patience goes to Nic Dakin.
Sir Robert Peel Hospital
Baroness Laing of Elderslie Excerpts(11 years, 10 months ago)
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Andrew Griffiths (Burton) (Con)
I thank my hon. Friend for giving way and congratulate him on securing this debate and for being a doughty fighter on behalf of his constituents in the provision of health care. He will know that Queen’s hospital has a deficit of some £3.1 million. It has already saved £9.8 million but needs to save a further £10 million in 2013-14. Given that my own east Staffordshire clinical commissioning group inherited a deficit of £8 million—
Madam Deputy Speaker (Mrs Eleanor Laing)
Order. If the hon. Gentleman is making an intervention, I am sure he will wish to be brief. If he wishes to make a speech, he will have to have permission to do so.
Andrew Griffiths
I am grateful to you for that advice, Madam Deputy Speaker. I was just about to get to the crux of the matter. Given that the area is £12 million away from fairer funding, does my hon. Friend agree that the health care economy is incredibly fragile locally and that something needs to be done to help us bridge that gap in the short term?
Care Bill [Lords]
Baroness Laing of Elderslie Excerpts(11 years, 11 months ago)
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Madam Deputy Speaker (Mrs Eleanor Laing)
Order. The right hon. Gentleman was listened to with courtesy. The same courtesy must be shown to the Minister.
Dr Poulter
I have repeatedly read out supporting evidence from the previous Government and from the impact assessment that showed that they recognised that the regime had to take into account the wider health economy. It is not my fault or the fault of hon. Members on the Government Benches that Labour’s legislation was not properly drafted, and that it did not do what it intended—
Madam Deputy Speaker
Order. The Minister’s state of health is not a matter to be dealt with from a sedentary position. If he is not giving way, he is not giving way.
Dr Poulter
I must make progress. I want to address the points made by my right hon. Friend the Member for Sutton and Cheam (Paul Burstow). I will not give way until I have made better progress. On the point made by the right hon. Gentleman—and this is important—when he put forward the legislation on the TSA, he envisaged potentially turning it into a hospital closure clause. In 2009, on Second Reading of the Health Bill, he said:
“We believe these measures will provide protection against the possibility of NHS providers continuing indefinitely.”—[Official Report, 8 June 2009; Vol. 493, c. 544.]
That would suggest that the right hon. Gentleman thought that whole organisations might be shut down or closed as a result of the TSA regime. We do not believe that that is the case. We recognise that trusts, when they severely fail, may have to change the services they deliver. We want to protect trusts from the closure that the right hon. Gentleman envisaged in his remarks. His own words indicate that Labour had a hospital closure clause in the TSA regime. The Government, however, are making it clear that this is about service change in the interest of patients when all other avenues have been exhausted, which is a good thing.
Let me turn now to new clause 16, tabled by my right hon. Friend the Member for Sutton and Cheam, my hon. Friend the Member for St Ives (Andrew George) and other hon. Members.
Dr Poulter
I am happy to give my right hon. Friend that assurance. It will be for him to lead the review, and we look forward to the work he does.
New clause 16 would make a second key change: to prevent the Secretary of State or Monitor from making decisions about recommendations affecting other trusts. Instead, local commissioners would have to undertake a further process of consultation and make their own decision. The effect would be to completely undo the changes that clause 119 is seeking to make—
Madam Deputy Speaker (Mrs Eleanor Laing)
Order. If hon. Members across the Chamber wish to have private conversations, they should leave. The Minister is answering some important points and ought to be listened to.
Dr Poulter
It would take outside the administration process and the timetable recommendations that affect other trusts. It could mean that a complete solution for the trust in administration and local patients could not be found. As before, my right hon. Friend the Member for Sutton and Cheam said that examining in isolation a trust that is failing significantly would be like throwing it to the wolves on its own. New clause 16 would render the strict legal timetable for the regime ineffective by significantly delaying resolution. I know that it is not his intention, but the new clause would undo the core purpose of clause 119 and the very aims of the regime, which are to put in place sustainable and safe health care services for patients when a trust has significantly failed.
Care Bill [Lords]
Baroness Laing of Elderslie Excerpts(11 years, 11 months ago)
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Madam Deputy Speaker (Mrs Eleanor Laing)
Order. Before the shadow Minister considers taking further interventions, she may not have realised that although the House appreciates that she is making some important points on a complex matter, she has spoken for some 24 minutes. She will not be aware, but I am, that a very large number of colleagues wish to speak in this debate and there is a limited time, so she might consider bringing her remarks to a close.
Liz Kendall
Thank you, Madam Deputy Speaker. I have two more paragraphs. I agreed that I would speak for 25 minutes, so at 24 minutes I am almost in.
New clause 9 would help secure that shift in approach. I ask hon. Members to consider the new clause seriously because we need to introduce the up-front prevention, help and support, which requires a change in the way we look at the costs and benefits in the system.
Madam Deputy Speaker
Order. Before I call anyone from the Back Benches, let me say that the shadow Minister has been most courteous in bringing her remarks to a conclusion when I indicated that that might be a good idea. It would also be a good idea, if Members wish to be courteous to their colleagues, if they would limit their remarks to some five minutes. That way everyone will get to speak. If anybody speaks for more than 10 minutes, I will remind them of the fact.
Sir Tony Baldry (Banbury) (Con)
I am not quite sure who to be bad-tempered with. As the House knows, I am not characteristically bad-tempered, but I think my bad temper should probably be directed at the usual channels, given that the timetable motion went through on the nod. We have to deal with 21 new clauses and 20 amendments on an important Bill in two hours, which by my calculation allows three minutes per clause or amendment. The hon. Member for Leicester West (Liz Kendall) spoke perfectly reasonably, given the number of amendments that have been tabled, but it is impossible to do justice to all this in two hours. The usual channels should bear in mind that some of us feel rather bad-tempered about the time provision. These things, as we all know, are agreed between the usual channels; it is not one side or the other that is responsible.
I wish to speak briefly about new clause 3. The Bill does fantastic things for carers, and I think it would be a real tragedy if, once the Bill completes its passage, carers or their advocates felt that it was a missed opportunity. I shall not repeat what my right hon. Friend the Member for Sutton and Cheam (Paul Burstow) said. The Minister will doubtless say that clause 6 and the duty to co-operate deal with this point. Clearly, the duty to co-operate is very important for local authorities and the NHS. In the past, GPs may not have sought to identify carers as well as they could because they did not think there was much they could do for them. Now they will be able to ensure that there is a carer’s assessment. If the Minister intends to resist new clause 3, could he seek to ensure that we have statutory guidance for the NHS on the services that it should provide for carers?
I fully understand that for those aged over 75 the aim will be to have named clinicians, and those clinicians should, as part of their duty, ensure that carers are identified, but of course many carers, including young carers, are under the age of 75. It would be a real pity if the Bill missed this opportunity on carers. If we could have some statutory guidance on what the Minister, the Department and all of us expect the NHS to do to identify carers, we can then have a quick rendition of the “Hallelujah Chorus” and I will not be so grumpy.
Norman Lamb
I am sorry; I must ensure that I get through all the amendments.
On new clause 13, I am clear that the current lack of good information on deferred payment agreements is not acceptable, given the importance of the scheme. That is why we are working with national partners in local government and the National Association of Financial Assessment Officers to develop a range of questions that will improve and expand the data we already have. The new clause is therefore unnecessary as we already have plans under way to achieve a similar goal.
On new clause 4 on local authorities making “reasonable charges”, the Government’s proposal to set a clear amount beyond which a person’s income cannot be reduced is much clearer and provides stronger protection. I have written to my right hon. Friend the Member for Sutton and Cheam and other Committee members on this subject, and I would be happy to share the letter with other Members. I have nothing to add to that analysis and do not agree that the new clause is required.
On amendment 21 and new clause 15, the Bill makes it clear that local authorities must work to maintain a sustainable market that delivers a wide variety of high quality services for people who need care and support in the local area. Local authorities’ own commissioning is an important part of this process. Additionally, local authorities will have to have regard to the well-being of individuals when commissioning services. Therefore, any local authority that commissions inappropriately short care visits or does not consider the actual cost of care when setting fee levels is highly unlikely to be fulfilling their duties. These matters will be set out fully in statutory guidance. It would not be appropriate to have a nationally set formula that would lead to standard rates or “tariff prices” for care and support, as this is best left to local negotiations in the open market.
On new clause 24, local authorities are already under a duty to work with their local clinical commissioning groups and others through the health and wellbeing boards to undertake joint strategic needs assessments and to develop joint health and well-being strategies. Statutory guidance published in March 2013 makes it clear that these must be published and have specific regard to
“what health and social care information the community needs, including how they access it and what support they may need to understand it”.
Awareness-raising will be an important part of the Bill’s implementation. The Department will co-ordinate involvement of wider interests, including local authorities and the private and voluntary sectors, to raise the public’s awareness of the new arrangements, specifically on the need for people to plan for care costs. We will add to what is already available to monitor the effectiveness of information and advice, public accessibility and public awareness.
On new clauses 22 and 23 about financial advice, the Financial Conduct Authority already has a responsibility to keep under review the financial advice market as regards how it is serving customers, and qualifications for advisers, and this includes those looking to fund long-term care costs. These requirements are published in FCA rules. Such an addition to the Bill would therefore be unnecessary.
I understand the intention behind new clauses 17, 18 and 32—it is to ensure fair payment for care sector workers. In response to the Cavendish review, statutory guidance for the Bill will include guidance to local authorities on commissioning services and arranging contracts that will explicitly require them to have regard to ensuring that provider organisations adhere to minimum wage legislation, including, crucially, the payment of travel time between social care visits. We are also working closely with Her Majesty’s Revenue and Customs to ensure that the national minimum wage guidance is appropriate to the care sector. We have amended the Bill to enable specified bodies to provide training standards for groups of workers, initially focusing on health care assistants and social care support workers. This will form the core of the new care certificate.
New clause 31 is outside the remit of Health Education England, which has a delegated duty under the National Health Service Act 2006. The duty relates to education and training in relation to persons working, or considering working, in connection with the provision of services as part of the health service in England. The duty does not extend to regulated social care, which is taken to mean social care delivered by providers registered with the Care Quality Commission.
On new clause 5, given the inherent complexity presented by the different legislative frameworks operating in the different territories of the United Kingdom, we will look to develop principles on cross-border continuity of care that achieve the same practical effect as further legislation. I absolutely agree with the hon. Member for Edinburgh East (Sheila Gilmore) about the importance of this issue. We have started discussions with colleagues in the devolved Administrations and we will aim to publish the principles by November. I hope that that helps her.
On new clauses 3 and 19 about NHS work to identify and promote the health of carers, I can confirm that the guidance will absolutely reinforce the importance of co-operation between the NHS and local authorities on local authorities’ duty to identify carers. NHS England is developing its own action plan for identifying and supporting carers. In addition, our vision for out-of-hours hospital care, which will be published in April, will build on changes to the GP contract for 2014-15. All patients aged 75 and over will have a named accountable GP with responsibility for their care, and we will consider how we can extend this approach to all people with long-term conditions. The plan will emphasise the importance of GPs identifying carers and supporting them in their caring role by directing them to information, advice and support.
On new clauses 20 and 21, a legislative approach that compels schools, universities and colleges to identify young carers and student carers would not be in keeping with the Government’s drive to reduce burdens. The Department for Education has already been doing a lot in this regard, and it is now working with the National Governors Association in raising awareness in schools. The Department of Health has invested in many initiatives to help to identify and support young carers. We have trained over 150 school nurses as young carers’ champions. Along with other Departments, we will also explore the factors that are challenging in young adult carers’ transition from school to college or university. Along with ministerial colleagues, I will shortly write to Universities UK and the Association of Colleges to seek their engagement in this work.
Amendment 20, tabled by the hon. Member for Islington North (Jeremy Corbyn), is not required because the scope of the new powers in clause 12 already allows for the collection of such information if we choose to require it.
On amendments 31 to 33, we have carefully considered the issue of time frames in the care planning process, including reviews. On balance, we feel that a flexible approach is best. It is important for local authorities to retain the ability to be proportionate to the needs to be met. For some people—[Interruption.]
Madam Deputy Speaker (Mrs Eleanor Laing)
Order. The Minister must be heard. Hon. Members are being rude in speaking.
Norman Lamb
Thank you very much, Madam Deputy Speaker.
For some people, the care planning process may be relatively simple, but for people with complex needs it is important that the plan is carefully produced and agreed with the person in order to meet their care and support needs effectively and appropriately.
Children and Families Bill
Baroness Laing of Elderslie Excerpts(12 years ago)
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Madam Deputy Speaker (Mrs Eleanor Laing)
I must draw the House’s attention to the fact that financial privilege is involved in a large number of Lords amendments, which are listed in the notes on the Order Paper. If the House agrees to any of them, I will cause an appropriate entry to be made in the Journal.
New Clause
Protection of Children’s Health: Offence of Smoking in a Private Vehicle
The Parliamentary Under-Secretary of State for Health (Jane Ellison)
I beg to move, That this House agrees with Lords amendment 125.
Madam Deputy Speaker
With this it will be convenient to discuss the following:
Lords amendments 121 to 123.
Lords amendment 124 and amendments (a), (b) and (c) thereto.
Lords amendment 150.
Jane Ellison
I am very pleased to speak to this package of Government amendments aimed at protecting young people from tobacco and nicotine addiction. I will also speak to the amendment on smoking in cars carrying children, which was agreed in another place.
I am sure that I need not remind hon. Members that tobacco use is a leading preventable cause of death, accounting for nearly 80,000 premature deaths per year in England alone and being a contributory factor in many other aspects of poor health. Taking action to prevent young people from taking up smoking in the first place is vital in our efforts to reduce rates of smoking.
When I first became the Minister responsible for public health I was made very aware of just how critical the teenage years are in smoking addiction, and that came up repeatedly in a Backbench Business Committee debate at the time. Almost two-thirds of smokers take up smoking regularly before they are 18—that is, they were addicted before becoming adults. That is a shocking reality, which many hon. Members have spoken about in this Chamber.
Stopping smoking can be extremely difficult because the addiction is so powerful. While two-thirds of smokers say that they want to quit, only a small fraction succeed in doing so. That is why we must stop young people taking up smoking in the first place. We want to see our young people enter an adulthood that is healthy and long-lived, but half of all long-term smokers will die from a smoking-related disease.
The amendments we have introduced seek to do the following: introduce regulation-making powers to enable the Government to bring in standardised tobacco packaging, if such a decision is made; introduce regulation-making powers to prohibit the sale of nicotine products to people under the age of 18; and to create a new offence of the proxy purchasing of tobacco. Also returning to this House from another place is an amendment which would provide the Government with regulation-making powers on smoking in cars carrying children, which is for hon. Members to consider.
Ian Paisley
The Minister has touched on two important points. One involves the packaging rights of companies. Is there anything in the legislation that would enable compensation to be granted to those companies if the Government chose to remove their trademarks and branding rights? I understand that, under European law, billions of pounds of compensation could be payable in those circumstances. Secondly, will the Minister clarify whether the Chantler review—
Madam Deputy Speaker (Mrs Eleanor Laing)
Order. The hon. Gentleman is making an important point, but I am sure that he will wish to be brief, as many people wish to speak in the debate.
Ian Paisley
I apologise for the longevity of my intervention, Madam Deputy Speaker, but these important issues affect many jobs in my constituency. My second point involves the illicit trade in tobacco products. Will the Minister tell us whether that will be covered by the Chantler review?
NHS
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Alison Seabeck (Plymouth, Moor View) (Lab)
On a point of order, Madam Deputy Speaker. Members will have heard the concern during Prime Minister’s questions about the loss of the main line between London and Penzance. We understand locally that the rest of the Dawlish sea wall might go tonight. Has the Secretary of State for Transport given any indication that he intends to update the House on the current situation and on the measures that he is putting in place to ensure that the economy of the south-west is protected and the rail line kept open?
Madam Deputy Speaker (Mrs Eleanor Laing)
I thank the hon. Lady for her point of order, although she and the House will appreciate that it is not a point to be dealt with by the Chair at this moment. I have received no indication that the Secretary of State for Transport intends to come to the House today, but the hon. Lady has ingeniously used the moment to draw attention to a serious matter that is, I am sure, appreciated as such by the Ministers concerned. I am certain that her point, albeit that it is not a point of order, will be noted by those by whom it ought to be noted.
Accident and Emergency
Baroness Laing of Elderslie Excerpts(12 years, 1 month ago)
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Andrew Percy
The Montague medical centre in Goole had to close its lists down, but if we ask why, we find that it was due to the large uncontrolled immigration we had from the A8 countries. [Interruption.] That is a fact. That is why the lists had to be closed—due to the previous Government’s failure to plan for the number of people coming here—so I thank the hon. Gentleman for that helpful intervention.
Let me deal with a couple of issues in my own constituency. [Interruption.] If Labour Members want to intervene, I am happy to take an intervention rather than be chuntered at. I want to refer to some positive moves locally, which I hope can be rolled out nationally.
First, I called on the NHS ambulance trust in my area to provide advanced paramedics, so that we could use our ambulance service better—a point I have made through the Health Committee—not just to convey people, but to treat them in their homes. We established an emergency care practitioner in Goole, which in the first six to eight weeks saved 56 double-crew manned hours and numerous transfers to Scunthorpe A and E. That has proved to be an effective use of our ambulance services, and I hope that we can start to see it moving through. [Interruption.] Am I running out of time? I am just looking at the clock, Madam Deputy Speaker, and following the time indicated there. I will conclude if the Front Benchers need to sum up—
Madam Deputy Speaker (Mrs Eleanor Laing)
Order. The hon. Member is quite right in his watching of the clock, but I am sure that he will have a mind to other hon. Members who wish to speak this afternoon.
Andrew Percy
Because it is Christmas, I am willing to forgo my remaining minute.
Madam Deputy Speaker (Mrs Eleanor Laing)
Order. The Minister is not giving way. He has limited time, and we will hear him.
Norman Lamb
Thank you, Madam Deputy Speaker.
The then Secretary of State, now the shadow Secretary of State, missed the target in this very week when he was in charge. We know that the winter is tough, and that performance always dips at this time of year. We also know that the staff are under a lot of pressure. The truth is that we inherited a dysfunctional system that was crying out for reform, with too many people ending up in hospital because of crises in their care, as my hon. Friend the Member for Bracknell (Dr Lee) made clear. For years, I have argued the case for a different approach.
We are supporting the NHS to enable it to manage better in the short term. For this winter, we are investing an additional £400 million in total—more than ever before. In the longer term, we need to look afresh at how we organise urgent care. That is why Bruce Keogh’s report into urgent and emergency care is so important, and I hope that the hon. Member for Mitcham and Morden (Siobhain McDonagh) will accept the case for a clinically led review in order to achieve the right approach. We will work closely alongside NHS England in putting these reforms into practice. The hon. Member for Stretford and Urmston (Kate Green) was absolutely right to say that we have to communicate better with the public and ensure that the process is a good one.
In the longer term, we need to do more to prevent people from ending up in hospital as a result of avoidable crises. As my hon. Friend the Member for St Ives (Andrew George) said, we need to make two big shifts. The first involves a move to a much greater focus on preventing ill health and the deterioration of health. The second involves a shift from a fragmented system to one that is integrated and joined up. That is the approach that we must follow.
Integrated pioneers around the country, such as those in south Devon and Torbay, Greenwich and Labour-led Barnsley, are doing great work, joining up care, collaborating with the voluntary sector, providing better care and keeping people out of hospital. That is the vision of the health service for the future. These pioneers will help the rest of the country to make the best possible use of the £3.8 billion better care fund. The fund will encourage organisations: to act earlier to prevent people from reaching crisis point; to offer seven-day services; and to deliver care that is centred on people’s needs. I am grateful to my right hon. Friend the Member for Sutton and Cheam (Paul Burstow) for welcoming that important new fund. We are also introducing named, accountable GPs for the over-75s and improving access to general practice.
We are addressing both the short-term and long-term challenges, giving the NHS the support it needs. I want genuinely to thank the excellent staff throughout our health and care services who are tackling these issues head-on. The measures and changes we have outlined today will support staff to deliver the best possible care, even in the most difficult of circumstances.
Question put.
The House proceeded to a Division.
Madam Deputy Speaker (Mrs Eleanor Laing)
I ask the Serjeant at Arms to investigate the delay in the No Lobby.
Care Bill [Lords]
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Madam Deputy Speaker (Mrs Eleanor Laing)
Order. As hon. Members will be aware, many people have indicated that they would like to contribute to the debate, but we have limited—albeit a long—time available. I must therefore impose a 10-minute time limit on Back-Bench speeches.
G8 Summit on Dementia
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Tracey Crouch
I agree entirely with my hon. Friend. It is important to note that society has made much progress in the past 20 years and that dementia is not the taboo subject it perhaps used to be. We have changed how we think about it and now treat people with dementia much better, but we still need to get away from the idea of saying, “Nan’s gone a bit dotty.” We have to understand that something can be done about dementia and that proper care pathways exist to ensure that people can live well with it, and we have to support carers as best we can.
On the G8 summit, I turn to my final but no less important point: long-term strategies. The Prime Minister’s challenge on dementia for England has provided a welcome focus on the treatment and care of people living with dementia and the search for a cure, but there is a danger that the focus will be lost, especially as the initiative is not UK-wide but covers only England. Many countries have dementia strategies or brain bank initiatives, and the UK needs a new long-term strategy, because the current one is due to expire in 2014. I would be grateful if—not today but soon—the Minister could outline his plans to evaluate the national dementia strategy for England and tell the House when he will commit to a new strategy following the current strategy’s expiration next year. Notably, the US has a dementia strategy in place until 2025, which means that we could be left in the embarrassing situation of the UK Government leading the G8 in a discussion on dementia without a national long-term commitment comparable with that of many of their international partners.
In conclusion, it is fantastic that the UK Government, under the Prime Minister’s personal commitment, are using the G8 summit to champion a more collaborative approach to preventing, treating and curing dementia, but it is essential that the legacy of this summit goes further than the G8 and that the declaration and communiqué of the summit makes firm long-term commitments to the doubling of research funding, to sharing best practice, and to delivering an international ongoing collaboration on defeating this devastating disease, which affects so many people and their families.
Madam Deputy Speaker (Mrs Eleanor Laing)
Order. Several hon. Members have indicated that they wish to speak, but we have only one hour remaining, so I shall impose a limit of six minutes on Back-Bench speeches.
Madam Deputy Speaker (Mrs Eleanor Laing)
Order. Hon. Members ought to note that if they wish to hear what the Minister and the Opposition Front-Bench spokesman have to say about the debate, they should not take any further interventions.
Sarah Newton
I am a member of the Science and Technology Committee, and I am delighted that my Chairman, the hon. Member for Ellesmere Port and Neston (Andrew Miller), is here and has intervened. I would like to draw the Minister’s attention to some excellent work that our Committee has been doing this year. I think that some of the reports we have published will help him to prepare for the summit. We undertook a very good investigation into clinical trials and also produced a report called “Bridging the valley of death”. Both reports highlighted a very significant issue facing research, not only in the UK but globally.
As Members will know, we have an absolutely world-class science base in our country. The main challenge facing it is to overcome regulatory environments, many of which are international, to enable it to take its first-class research across the valley of death and into the development of ways of diagnosing dementia and therapies for treating it. It is very important to learn the lessons from our very extensive inquiries to enable more of this research to be commercially developed in order to find its way into the marketplace.