Kent & Canterbury Hospital

Helen Whately Excerpts

Thursday 22nd June 2017 Commons Chamber

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

I would like to start by welcoming Ken Rogers and campaigners from Concern for Health in East Kent, who have come here today to hear this debate. Ken was born in 1948, the same year as the NHS. He was diagnosed with chronic lymphatic leukaemia when his daughter was 15 months old and told that he would not live to see her fifth birthday. That was in 1981. Thanks to Kent & Canterbury hospital, he is here today, listening to this debate. There are thousands of people with similar stories—people who would not be here today if it were not for Kent & Canterbury hospital, a treasured hospital with a history going back over two centuries, and for many years a top destination for junior doctors and aspiring consultants.

The hospital has an outstanding reputation in specialties such as urology, providing dialysis for patients across east and west Kent, neurology, neuro-rehabilitation and surgery, with surgeons using a state-of-the-art robot to carry out manoeuvres impossible with human hands. Last week, the Taylor ward was providing fantastic specialist care for cardiac patients and the hospital serves around 200,000 people in Canterbury, Faversham and surrounding villages, but people across that area are worried—very worried—because there is a big question mark over the future of the hospital.

The building is out of date—frankly, it is crumbling—and the hospital is struggling to recruit staff. I said that last week the Taylor ward was providing specialist cardiac care because, this week, that is no longer the case. On Monday, junior doctors were withdrawn from Canterbury and relocated to neighbouring hospitals, after Health Education England said that there were not enough consultants to oversee their training and there was too much reliance on locums. The shift of junior doctors means the shift of emergency care. Heart attack patients in my constituency, who previously faced a journey of under 20 minutes to get to the hospital in Canterbury from Faversham, will now have to travel to Ashford—a longer drive on winding roads, one of which will be closed all summer—or Margate, 40 minutes away. In rush hour or by public transport, these journeys are far, far longer. People are scared that they or a loved one will not make it in time, and that visiting will be harder, or impossible for some. Added to that is the confusion about the transfer of services, and the risk that the pressure to free up acute beds will mean patients being transferred between hospitals before they are ready or ending up in corridors. Nurses, some of whom are here today, are desperately worried about the risk for patients.

Then there is the impact on the staff. Some are now making longer journeys to work. Others are staying at Kent & Canterbury but are at risk of losing their specialist skills. No commitment has been made on when acute services will return to Canterbury. There is great scepticism about the efforts being made to recruit consultants. Public trust has been lost. The point is that these temporary changes must not become permanent. We must not allow the hospital to crumble further and drift towards a downgrade, when there is a real opportunity to seize this moment of change to form an ambitious long-term vision for healthcare in Kent.

What patients really need is a new acute hospital providing world-class care and a medical school attracting the brightest and best doctors and nurses, making east Kent a centre of excellence in healthcare. As a university city and a major population centre with good transport links, Canterbury is the right place for a major hospital and a medical school. The Kent and Medway sustainability and transformation plan is proposing to reconfigure acute services across east Kent’s three major hospitals into one emergency hub with specialist care and a trauma unit, a second emergency hospital also carrying out planned care and, at the third site, a rehabilitation hospital and a primary care-led urgent care centre. The STP is not specific about what will happen where, but all the signs are that Canterbury is the most likely to lose acute services, despite it being the obvious place to centralise specialist services.

We are at a crunch point, but this should not, and must not, be treated as a foregone conclusion. This is not the time for another short-term compromise. It is time to reverse the direction of travel and make the case for a long-term, visionary answer to the challenges of healthcare in Kent. A new hospital is not a panacea; it is not the answer to all Kent’s healthcare problems. We still need to invest in primary care and bring more services out of hospitals and into places such as the Encompass Vanguard in Whitstable and Faversham cottage hospital.

[Charlie Elphicke (Dover) (Con)]

On behalf of all the MPs in east Kent, I absolutely support my hon. Friend in making a powerful case for a new, state-of-the-art acute hospital in east Kent. Does she agree that cottage hospitals such as Buckland hospital in Dover make a great deal of difference and that we ought to have more services locally, wherever possible?

[Helen Whately]

I completely agree with my hon. Friend. In addition to the fantastic acute hospitals, community and cottage hospitals are really important. Patients who do not need acute care can be looked after closer to home and be given a different sort of care in the environment of a local community hospital such as the one in his constituency or Faversham cottage hospital in my own, which is deeply loved and enormously valued by the community.

The new hospital that I am asking for will take time, so it will not fix the immediate challenges that the NHS is facing in Kent, but now is the time to look to the future. It has been suggested that the STP consultation is looking merely at the next five years. That is totally inadequate; it is far too short a timeframe. We need to put politics aside and think further ahead than the next parliamentary term, just as we are putting party allegiance aside for this campaign. I am pleased to be working with my colleague, the new hon. Member for Canterbury (Rosie Duffield). She is taking up this campaign from her predecessor, Sir Julian Brazier, who fought hard for many years for Kent & Canterbury hospital.

In conclusion, I shall turn to the specific requests that I want to make of my hon. Friend the Minister. I ask him to note that Kent & Canterbury hospital has strong support in the community, represented here today by members of CHEK, and across the political parties. I ask him to look closely at the temporary changes to services, to challenge the hospital on its contingency plans and to make absolutely sure that, in the short term, these services are safe for patients. I ask him to ensure that these changes do not become permanent. I also ask him to look favourably on the case for a medical school in Kent, and to ensure that the STP consultation takes into account the connection between the medical school proposal and the decision about acute sites.

I have been told many times that one barrier to the idea of a new Canterbury hospital is a lack of capital. I ask my hon. Friend to help us here. More capital has been promised for the NHS, so will he make it clear to the local NHS leaders driving the process that if they, and we in Kent, can make the case, capital will be available. There is a risk that the consultation on Kent’s STP will be presented to the public with no option for an acute hospital at Canterbury. If none of the options propose keeping acute services at Canterbury, it cannot be called a true consultation.

Finally, will my hon. Friend please require STP leaders to look to the long-term, to be ambitious in their plans, and to aim for excellence? There is an opportunity here for Kent—specifically east Kent—to bring an end to the drift of services away from the area, to downgrading, and to the struggle to recruit and retrain staff. Instead, Kent could become a centre of excellence, making the most of the combined assets of the NHS, local universities and the strong life sciences research sector in east Kent to offer people in Kent brilliant patient care, to develop innovative treatments and pathways, and to set an example for the whole country of how we can provide excellent, sustainable healthcare.

[The Minister of State, Department of Health (Mr Philip Dunne)]

It is a pleasure to serve under your chairmanship as Deputy Speaker, Sir David. I hope that that will not necessarily be as temporary as suggested by Mr Speaker when he sought the leave of the House to appoint you. It is also a pleasure to respond to my hon. Friend the Member for Faversham and Mid Kent (Helen Whately), who has been on her toes in securing Mr Speaker’s consent to have this debate so early in the parliamentary Session. I am pleased that she has secured the support of many of her constituents, some of whom have come to witness her championing their interests in relation to Kent & Canterbury hospital. She has done that not just this evening, but consistently over the past few months with our mutual friend Sir Julian Brazier, who is sadly no longer with us in the House. However, I congratulate his replacement, the new hon. Member for Canterbury (Rosie Duffield).

I worked closely with Sir Julian when we were Ministers in the Ministry of Defence, and both he and my hon. Friend the Member for Faversham and Mid Kent have been doughty champions of the population of mid- Kent, particularly those in the areas surrounding Canterbury, in fighting for healthcare services given the challenges that she quite properly describes at Canterbury hospital. I pay tribute to them for that, and they are doing the right thing in ensuring that such issues are brought to Ministers’ attention. I know that she wrote to the Secretary of State only last week, and I am pleased to hear her arguments, which were so eloquently put today. I will say what I can in response to the questions and challenges that she posed, but I must say at the outset that I do not stand here tonight with all the answers to all the questions because, as she will appreciate, many of the things that she is calling for are decisions that will be taken and led by clinicians in Kent. It is not for Ministers to prescribe the provision of services in Kent. Many such decisions will take place over a period of time; it will not be instant decision making.

I will start my response by providing a little context for what has happened over the past few years, and this week in particular. As my hon. Friend pointed out, the board of East Kent Hospitals University NHS Foundation Trust agreed to relocate some services from its Canterbury site, Kent & Canterbury Hospital, this Monday. The change happened overnight from Sunday into Monday and came in response to legitimate concerns raised by both the General Medical Council and Health Education England over a period stretching back to as early as 2014, when they raised concerns about the standard of training available at the Canterbury site, in particular the quality and safety of junior doctor training.

The situation was brought to a head following a visit in March this year. The recruitment and retention of key medical staff has been an ongoing challenge for the trust, and there is a shortage of consultants to provide the required training and supervision of junior doctors posted to Kent & Canterbury hospital. On Sunday 18 June, 38 junior doctors were reallocated from Kent & Canterbury to other sites operated by the trust. The removal of these junior doctors has required the trust to relocate some of the services it provides, to ensure safe and sustainably staffed services for patients.

My hon. Friend’s constituents will still receive good service provision. The clinical commissioning group has facilitated this development by acquiring some 40 additional care packages to support effective discharge from the Ashford and Margate sites, to free up some 75 beds to allow for this temporary service change to take place, along with an additional 20 ambulances, supplied through SECAmb—the South East Coast Ambulance Service NHS Foundation Trust—to cover the additional journey times from the Canterbury area. Replacement services at nearby hospitals in Ashford and Margate are being monitored to ensure that they are safe and effective, given the additional pressure on those hospitals from the move.

Unfortunately, I cannot say today how long this temporary closure will last. The GMC has made it clear that

“if there is evidence that appropriate and sustainable action has been taken to make the Urgent Care Centre a safe environment for doctors in training once more, HEE will review reallocating trainees to the site”.

No decision has been made about the long-term future of the service and no decision will be made without full public consultation. I can give my hon. Friend that reassurance.

[Helen Whately]

My hon. Friend mentions that there is monitoring of the provision of care for the services that have been moved to William Harvey and Queen Elizabeth the Queen Mother hospitals. May I ask him to take a personal interest in that monitoring? I have heard reports from staff who are really worried about how care is being provided following the transfer of the services. They are very concerned that patients might be at risk.

--- Later in debate ---

[Mr Dunne]

I was going to come on to the suggestion of my hon. Friend the Member for Faversham and Mid Kent about both allocation of capital and the possibility of a new hospital. I was starting to develop the point that this matter needs to be assessed in the light of the overall requirements of the healthcare economy of mid-Kent and the East Kent trust through the STP process. Capital is currently constrained throughout the NHS. As hon. Members will know, in the March Budget we announced a capital allocation of some £325 million over the next three years to support the first phase of STPs. Fairly shortly, we should have made sufficient progress in deciding which of the STP proposals should be supported to secure that capital. Other capital pots are available to the NHS for what we refer to as business as usual, and there are always opportunities for trusts to make capital proposals to the NHS.

Right now, it is not appropriate for me to explain the basis on which future capital allocation decisions will be made. One can look to the recent past to identify some significant new hospital builds that are now in progress. There is currently a significant capital investment not far around the coast from Kent, in Brighton, and there is another closer to my constituency, in Sandwell in Birmingham. Such builds are few and far between, and bearing in mind the kind of major capital investment we are talking about, I think both my hon. Friends from different parts of Kent are arguing for space to undertake a study to consider whether a major build is appropriate to meet the needs of the mid-Kent population.

Generally, as can be identified from the two significant builds that are currently under way, which have been allocated hundreds of millions of pounds of capital each, a certain density of population is required to be served. Such builds are therefore most likely to occur in major cities rather than in less densely populated areas. That said, it is not for me to make suggestions as to what would or would not be appropriate. I urge my hon. Friend the Member for Faversham and Mid Kent to discuss the matter, as I know she has already, with her STP leaders. If there is a desire among Kent MPs and the Kent community to consider whether in future a more holistic approach to satisfying healthcare needs should be taken in the county as a whole, perhaps my hon. Friend should work in conjunction with other hon. Members.

The right forums are the STPs, which are bringing together NHS providers and commissioners from throughout their regions to try to arrange provision to meet the future healthcare needs of their populations. Whether or not my hon. Friend is successful in persuading the STP that a new hospital in Canterbury is the right solution, that is a matter for her to take forward with the STP. Such an effort would carry more weight were it supported by other colleagues from the area.

[Helen Whately]

It needs to come from the top that, when a bid is put forward that makes the case for significant investment, capital will be forthcoming. That message is currently not coming through and it is deterring people from making that case. It needs to shift.

[Mr Dunne]

I am conscious that I am close to running out of time, and I want to address the other point my hon. Friend raised, but I will say that capital is allocated by the Department of Health on the basis of the strength of the proposals, which need to meet the criteria on meeting the needs of local populations. That has to be balanced against the amount of capital that is available throughout the country, where there are competing needs.

My hon. Friend also raised the idea of a medical school, which she has discussed with me previously. She is aware of the consultation the Department ran on allocating new medical school places. That consultation has completed and we are considering our response. I am grateful to her for her submission. We wish to encourage some development of new medical schools, but again, that is subject to regulatory approval by the General Medical Council and other bodies. Any universities that wish to establish a new school need to meet the regulators’ criteria. I encourage my hon. Friend to see what progress is being made in that direction.

In conclusion, I again congratulate my hon. Friend on securing this debate and reassure her that I will be taking a close interest in how events unfold in the East Kent trust. I expect we will have an opportunity to discuss this matter again before too long.

Question put and agreed to.

Oral Answers to Questions

Helen Whately Excerpts

Tuesday 21st March 2017 Commons Chamber

[Mr Hunt]

The one simple thing the Government are not going to do is refuse to listen to what the British people said when they voted on 23 June. We will do what they said—it is the right thing to do. However, the right hon. Gentleman is absolutely right to highlight the vital role that the around 10,000 EU doctors in the NHS play in this country. I can reassure him that the number of doctors joining the NHS from the EU was higher in the four months following the referendum result than in the same four months the previous year.

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

23. Does my right hon. Friend agree that Kent, with its excellent academic institutions and strong life sciences sector, would be an ideal location for a new medical school, and will he support emerging plans to establish one?

[Mr Hunt]

I can absolutely confirm that the garden of England would be an ideal place for a new medical school—alongside many other parts of the country that are actively competing to start medical schools as a result of the expansion in doctor numbers. It is an independent process run by the General Medical Council, and we will await what it says with great interest.

Oral Answers to Questions

Helen Whately Excerpts

Tuesday 7th February 2017 Commons Chamber

[David Mowat]

As a direct answer to the hon. Lady’s question on the improved better care fund, let me tell her that it will be allocated in such a way that the combination of the fund and the precept will address real need. That is what we will be doing during the remainder of this Parliament, starting from April. We spend more on adult social care in this country than Germany, Canada and Italy, but it is very important that we spend it well.

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

It was good to hear my hon. Friend referring to the University of Kent’s research.

Under the guidance of the vanguards and the sustainability and transformation plan, NHS and social services in Kent are working closer together than ever before, although there is still further to go. Does my hon. Friend agree that it is vital that we overcome the barriers between social services and the NHS so that they operate more as one system, meaning that patients can get the sort of care they need in the right place, preferably at home?

[David Mowat]

My hon. Friend makes a good point about the success of the vanguard in Kent. Last week I visited the care home vanguard in Sutton, which has achieved a 20% reduction in A&E admissions due to better integration and the sort of things that she mentions as being successful in Kent.

NHS and Social Care Funding

Helen Whately Excerpts

Wednesday 11th January 2017 Commons Chamber

[Jonathan Ashworth]

My hon. Friend speaks passionately, as she always does, on behalf of her constituents and, more broadly, on mental health provision. Again, I hope the Secretary of State will respond to her on the specifics of that case.

My hon. Friend talks about patient care, and she is absolutely right. All of us, or at least many of us, in this House will have been getting stories from constituents telling us of their recent experiences in hospitals. I have been given a few, and I will share some heart-breaking examples with the House. Again, I will not reveal the names of trusts and hospitals, but I will pass them on to the Secretary of State after the debate.

Example No. 1 is of a mum of four children under 10 years old who has a secondary tumour in her liver. She was due to go into hospital this Thursday to have the tumour removed. Her surgery has been delayed for at least two weeks, so that the hospital could cope with the winter crisis and because no beds are available. She has not yet been given a new date.

Someone else got in touch with me this morning. Their wife has been on the waiting list for a knee replacement since April last year. An appointment for early December was cancelled owing to the hospital being on black alert. A few weeks later, the hospital phoned with an appointment for today, which was cancelled yesterday.

Again, these patients are not trying to score political points or to politicise matters. They are decent, hard-working people who are simply desperate for something to be done.

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

Conservative Members care deeply about patients. I personally follow up on the individual stories and challenges experienced by my constituents, but the hon. Gentleman has surely seen the guidance this week from NHS Providers, which is not always a friend of the Government, that said that we need to be careful when extrapolating from individual incidents in hospitals that are under particular pressure and implying that they constitute a wider trend. Yes, times are tough in the NHS, and there are winter pressures, but he should not make inappropriate use of individual stories.

--- Later in debate ---

[Mr Hunt]

My right hon. Friend is right. That is the worst kind of gesture politics, because it may get the Leader of the Opposition a few votes or a few more Momentum supporters, but it would damage the NHS.

[Helen Whately]

Does my right hon. Friend agree that Opposition Members, rather than making meaningless and totally unfunded promises of more money for the NHS, contrary to their manifesto back in 2015, would do better to recognise demographic changes, such as the ageing population, and the need for the NHS to change, and support the locally developed plans for change in the national health service—the sustainability and transformation plans?

[Mr Hunt]

My hon. Friend is absolutely right. I think people in the country will find it hugely ironic that the party that spent so much energy in the last Parliament campaigning against top-down reorganisations is now campaigning against locally driven changes.

--- Later in debate ---

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

It is a pleasure to speak in this debate and to follow hon. Members who have made very thoughtful contributions. The hon. Member for Bristol West (Thangam Debbonaire) spoke about loneliness, which is a problem across the country, and the very important work that is being done on that. It is also a pleasure to follow colleagues who have spoken about their personal and family experiences. My hon. Friend the Member for Wells (James Heappey), the hon. Member for Chesterfield (Toby Perkins), who is no longer in his place, and the hon. Member for Workington (Sue Hayman) spoke about their experiences, both good and bad, of the national health service.

I, too, have personal experiences both good and bad. Three years ago, I spent Christmas night in A&E with my son, who was five at the time, and who had his appendix taken out first thing in the morning on Boxing day. He had absolutely exemplary care and was home within two days, eagerly making up for the quantity of sausages that he had omitted to eat on Christmas day because of his tummy ache. Last Christmas, my grandmother, then aged 100, was in hospital—she was there for several months—and she had a much, much worse experience; it was not the NHS at its best. We all have good and bad experiences to draw on. We hear from our constituents, as well, about these good and bad experiences. It is important to recognise what the NHS does well, and is doing well, but also where the system is failing, and to focus on supporting the good and tackling the bad.

I very much understand why this debate has been called, because there is no question but that the NHS is under extraordinary pressure this winter. We have heard that last week it had the busiest week ever. However, I am quite disappointed by the tone of some of the contributions and more significantly by the lack of proposals from those who just said that that there is no money and made no suggestions as to where the money will come from. That is fundamentally unhelpful.

[Barbara Keeley]

It is very clear where the money is to come from—we are asking for £700 million to be brought forward from the better care fund from 2019. It is already allocated.

[Helen Whately]

I appreciate the hon. Lady’s point, but bringing money forward still requires it to be found. This is set against a backdrop of Labour, in 2015—less than two years ago—not committing to fund the NHS with the money that it was asking for, as this Conservative Government are now doing. Labour is in rather a shocking position.

I want to seize this opportunity to say a very heartfelt thank you to all members of NHS staff—nurses, doctors, allied health professionals, porters, care assistants—and those in social services, particularly those in and around my constituency in Kent, who I know are working extremely hard to deal with the pressure on the frontline. I also thank patients and their families who are being thoughtful and taking care to make the best use of the NHS.

We know that there is great variation in how the NHS is coping. I have just been told that the waiting time in Maidstone A&E is—as we speak—only 37 minutes, so Maidstone is coping pretty well right now, but at the nearby William Harvey hospital in Ashford it is over four hours, so there is variation. I do not say that so that people listening can divert from where they are going; there may be a case for that and for greater transparency, but that is for another day.

We talked earlier about money. There is no question but that this issue is partly about the need for more funding and more staff, but the Government are doing exactly that: they are giving the NHS more money and investing in significant increases in the workforce. However, money is not the whole answer. If the NHS just continued doing all it does in the way that it does without any change, we would find ourselves with a system that was unaffordable and that used a proportion of GDP for which there would not be public support. We know that we have an ageing population—people are living longer and have multiple complex conditions—and that high-cost treatments are becoming available that people want, so the NHS itself recognises that this is not just about more money but about changing the way in which services are delivered.

Such changes are being worked on and are actually happening at the moment. Earlier today, I spoke to the hospital trust chief executive who is the lead for the Kent and Medway sustainability and transformation plan. STPs have come up several times today. As I have seen, under him and the group around him, there has been a coming together across Kent and Medway of NHS organisations that have not tended to work closely together. The coming together of the NHS and social services is so important, so necessary and so right if we are to work out how to provide a better health service in a more sustainable way. We need to break down the barriers between organisations, as it just does not make sense to have a split between the NHS and social care in who provides what. We should look at how we can genuinely move care out of acute hospitals and closer to home, which we know is good for patients. It is exactly what the hon. Member for Workington hoped for her father and what we wanted for my grandmother as she neared the end of her life.

We need to enable people to be looked after closer to home or preferably at home, and to improve prevention and—I feel particularly strongly about this—mental health care. The Prime Minister has taken a personal lead on mental healthcare with her announcements on Monday. In the light of the pressure on A&E, I particularly value the commitment to psychiatric liaison in A&E departments, which we know is helpful in the prevention of suicide, is good for people who go to A&E with mental health problems and helps A&Es look after the people who need to be seen for physical health problems. I welcome the fact that my area of Kent is looking at bringing that forward and having psychiatric liaison in all A&Es by 2018. Really important work is therefore going on at local level.

I encourage Labour Members not to make the knee-jerk or even tear-jerk speeches that some have made, but to take a longer view of the situation. That would help us to have a more mature conversation about what the NHS needs and to talk about policies and concrete proposals, rather than just about having more money, to solve the problems. It would also enable us to get behind what the NHS is doing at local level, where the NHS and local authorities are coming together to draw up plans across their areas for better care for patients in an affordable and sustainable way.

Mental Health and NHS Performance

Helen Whately Excerpts

Monday 9th January 2017 Commons Chamber

[Mr Hunt]

If the hon. Lady is worried about funding, she might explain why funding for the NHS in England went up by double the rate of funding for the NHS in Scotland over the last Parliament—[Interruption.] I will get her the figures on Northern Ireland, but I say that by way of reference. I apologise for my error.

I agree with the hon. Lady that it is not just about the ageing society; it is about changing consumer expectations and the fact that people want access to healthcare 24/7 today in a way that was not the case 10 or 20 years ago. That in itself is the cause of a lot of the additional pressure.

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

I welcome today’s announcement on mental health. It is absolutely clear that the Government are serious about improving mental health treatment and prevention. The challenge is to translate ambitions into action. Will my right hon. Friend assure me that he will put in place mechanisms to ensure that the proposals and those in the five-year forward view for mental health become reality? Specifically, will he look at ensuring that no sustainability and transformation plan is signed off without clear plans and funding for improving mental healthcare?

[Mr Hunt]

I can assure my hon. Friend that that is happening. Indeed, one of the key metrics by which we will judge STPs is their progress on delivering our mental health targets. She is absolutely right to say that ambitions need to turn into action, but she will find that, because of the comments that she and many other hon. Members have made over the past few years, there is much more understanding in the NHS that mental healthcare is a big priority, and more understanding that we need to stop resources constantly being sucked into the acute sector, as has happened over many years.

Social Care

Helen Whately Excerpts

Wednesday 16th November 2016 Commons Chamber

[Barbara Keeley]

It is, and I agree with my hon. Friend that care costs are just running away with themselves, making the situation much harder for people.

The bulk of the extra funding that the Government promised to social care from the better care fund comes in 2018-19 and 2019-20. We have had six years of cuts to local authority budgets, and the extra funding promised for social care is backloaded to those later years in this Parliament.

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

The hon. Lady mentioned the most common causes of delayed transfers of care. However, I know that in hospitals in Kent near my constituency, around 30% of the delayed transfers of care are attributable to delays in social care and the majority are for other reasons. Does she not agree that it is important for the NHS to take its own steps within its own organisations to improve people’s discharge from hospital?

[Barbara Keeley]

That is what we are debating. Of course the NHS should put its own house in order, too, but delays should not happen on account of social care. People should not be stuck for weeks or months in hospital, waiting for a care home placement or a nursing home placement. I shall go on to say why.

Returning to the issue of the backloading of funding, in view of what was happening to social care, the Local Government Association and the Association of Directors of Adult Social Services appealed before the last autumn statement for £700 million of the promised better care funding to be moved forward to this year and next year. That appeal was ignored. Reacting to that, Ray James of ADASS said:

“Ministers must know that their proposals do not deliver sufficient funding to meet the growing number of older and disabled people requiring increasingly complex care and support…The Council Tax precept will raise least money in areas of greatest need which risks heightening inequality. Councils in deprived areas will have greatest social care needs, yet they will raise less than a third of what more affluent areas do through this approach.”

He went on by clarifying that ADASS does

“not believe that the funding for the next couple of years will anywhere near meet the costs of the national living wage and the increasing demand for social care.”

--- Later in debate ---

[Mr Hunt]

I want to conclude the section about the role of social care staff.

Whatever disagreements we have in this afternoon’s debate, I want the message to go out loud and clear to all social care staff that Members from all parts of the House recognise the work that they do, and that they value it and support them to do that work better. That is part of the definition of a civilised society.

[Helen Whately]

On the point about the need for a long-term sustainable health and social care system, is it not the case that the Secretary of State is driving through work in devolution deals and sustainability and transformation plans, which aim to achieve exactly that—bringing together health and social care to create a much more sustainable system?

[Mr Hunt]

My hon. Friend is absolutely right. Although this afternoon’s debate is about the social care system, the sustainability and transformation plans are a critical part of the long-term solution for financial efficiency and for improving the quality of care.

I congratulate the hon. Member for Worsley and Eccles South (Barbara Keeley) on introducing this debate, which is the first Opposition day debate that she has led. I also pay tribute to the fact that she has had a long-standing interest in these issues. She has asked me questions about the social care system on many occasions. She was particularly right to focus on the impact on the NHS, which is real, and on the impact on family carers, which is also real. She talked about Susan and about the impact on people who are finding that they are giving more hours of care than they were planning or are sometimes even able to give. That is something of which we must all be aware. She asked me to answer a direct question: do I recognise the scale and seriousness of the issues faced by the social care system? The answer is, yes, I do. I want to try to address, as comprehensively as I can, some of the substantive issues faced in the social care system.

Let me start by saying that, although today’s debate and the majority of the hon. Lady’s comments were around funding, the issue is not only about funding. The hon. Member for Chesterfield (Toby Perkins) mentioned that social care is not just about older people. In 2011, we had the shock of what was uncovered at Winterbourne View by a BBC “Panorama” programme. We have had a number of examples of horrific abuse at care homes. The Ash Court Care Home case in Kentish Town was one that came to light in 2012. The abuse there was filmed by a relative on a hidden camera. Those issues were primarily not about funding, but about cruelty—a strong word—that we have tolerated in our system. We have had some very significant policy responses since then, which are making a real difference. The first is that this Government, under the coalition, introduced the toughest system of care home inspection in the world.

We often talk in this House about the work of the chief inspector of hospitals, but I wish to pay tribute today to the work done by the chief inspector of adult social care, Andrea Sutcliffe, and her team. She has completed the inspection of nearly 90% of care homes and domiciliary care services. It is encouraging that, despite the pressures that we have been talking about this afternoon, 72% of the places that she inspected were good or outstanding. More importantly, the 28% that are not are the 28% that we know about and are therefore able to do something about.

I take issue with the way the shadow Health Minister presented her findings. She said that a quarter of the inadequate places were unable to improve following re-inspection. However, the reality is that more than three quarters of places that got an inadequate inspection did improve, which is a huge step forward from where we were a few years ago when we did not know where those places were and when there was no change happening at all.

--- Later in debate ---

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

A while ago, I spent a week in intensive care—not, I assure Members, as a patient—and I remember well how the unit was unable to admit a seriously sick patient because there were no beds free, and there were no beds free in the intensive care unit because there were none free in the hospital. The ward sister told me that that was because patients, particularly elderly patients, could not be discharged because there were no care home places for them. She described that as bed blocking. That is a familiar story, particularly to hon. Members in the Chamber, but I should tell the House that that was 20 years ago. Delayed transfers of care, as we now call them, are nothing new.

The fact that this is nothing new is a reminder that the problem will not be easily solved; there are no easy answers, but that is not to say that we should not try. In fact, I believe that we should and must try. We must address the problem of delayed transfers of care, not only because NHS hospitals need to use their beds for acutely sick people who need acute hospital care, but because hospital is a very bad place for patients to be, particularly older patients, if they are ready to go home. It is absolutely the worst place for older patients, when they could be at home regaining their mobility, as opposed to losing it stuck in a hospital bed. A few weeks confined to a bed in an acute hospital can mean that an older person never walks again, even though they went in perfectly able to walk and live independently. I say that from the experience of my own grandmother.

I appreciate the efforts being made across the system to solve this problem. I know that hospitals and the social care system across the country are working together to speed up discharges; to put in place packages of care; to identify who needs single-handed versus double-handed care; and to try to make best use of limited resources. I know that that work is being done in Kent in my constituency. A few months ago, I convened a meeting between East Kent NHS hospital and Kent County Council specifically to talk about what they were doing to reduce the number of delayed transfers of care. I should give Kent some credit, as this year the number has fallen significantly: it approximately halved between last June and this June, so it really is possible to make progress, even in a tight financial situation.

At the regional level, the STPs, the devolution deals in places such as Greater Manchester, emerging accountable care organisations and vanguards such as Encompass in east Kent are really working on how to bring health and social care together and how to improve the situation with delayed transfers of care. They must prioritise this and they have to go beyond questions of whose budget the money comes from, whose money it is, whose problem it is and whose patient it is. Instead, they need to look at the problem as a whole and take account of the patient as an individual. They should simply look at what care the patient needs, not whether it is part of one system or another. I would like to thank all those working on this across the country for their efforts. They are working not just to free up much needed beds, but for the sake of individual patients who need better care outside hospital.

That brings me to the question of money. As a society, we face the challenge of people living longer, needing more care and rightly expecting better care. Thanks to the work of the CQC inspecting care homes and care providers, we are seeing some transparency in the quality of care, and we are identifying where there is poor care. Thankfully, the vast majority—70% or so—of care providers are either good or outstanding, but a significant minority is not good enough. It is good to see, though, that the majority of those are, in turn, improving.

I welcome the improvements to care, driven in part by the CQC and greater transparency, but we cannot get away from the need for more money in the system. We all know that the Government have recognised that. Despite the large deficit and debt left by the Labour party in 2010, the Government have committed to funding the NHS through the five year forward view and to increasing funding to social care. Social care funding is rising in real terms. I enormously welcome the social care precept—the extra 2% that Kent and other councils are levying to increase the funding for social care. I have not heard a single person in my area complain about that levy—that increase in the amount of council tax that has to be paid—which I think shows widespread support for funding more care.

It is good to spend money where we can on social care as well as to maintain the commitment to funding the NHS, but there is a case for work to be done so that we know what any extra money spent on social care will achieve. To what extent might it achieve savings for the NHS? When I asked the experts questions in this area, I encountered a lot of vagueness about what could be achieved for the NHS by increased spending on social care.

Finally, I emphasise the importance of having a system that truly joins up health and social care, so that each pound is spent most effectively across both those areas and so that each person gets the right care for them. It should not depend on whether they are in the NHS or social services spheres; it should be the right care for every individual person.

NHS Funding

Helen Whately Excerpts

Monday 31st October 2016 Commons Chamber

[Mr Hunt]

I do recognise the pressures in the social care system, but, in an era of very constrained national finances, funding for the social care system is going up by £3.5 billion a year by the end of this Parliament, which is a significant and important rise. I say to the hon. Lady that it is this Government who have set the CQC free to tell us the honest truth about the quality of care in our hospitals, GP surgeries and social care system, and it is because of that that we are able to have the kinds of questions and answers we are having today.

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

This Government have shown their commitment to the NHS, promising and delivering increases in funding, unlike the Opposition parties. My right hon. Friend recognises the connections between health and social care and is driving the integration of those two areas. May I urge him to continue looking at both the funding and performance of health and social care in the round?

[Mr Hunt]

I congratulate my hon. Friend on her excellent question. I absolutely agree with her, as someone who worked in healthcare before she came to this House, that it is vital to nurture the links between the health and social care systems if we are to deal with some of the issues that concern Members on both sides of the House. There are some very good examples of where this is working well, but it is not happening in as many places as it needs to, and we all must focus on that.

Young People’s Mental Health

Helen Whately Excerpts

Thursday 27th October 2016 Commons Chamber

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

I commend the hon. Lady for securing this debate on this very important subject, which often comes up in my constituency work. She makes a point about schools struggling to find support. That is certainly something I have experienced in my constituency, so I want to reiterate the point that primary and secondary schools know they have children who could really benefit from more specialist support and it is very hard for them to access it.

[Helen Hayes]

I agree with the hon. Lady completely. As we focus on prevention and early intervention, we need to think about early intervention in terms of age, as well as the stage of mental ill health.

As a consequence of the lack of early intervention support, the number of young people attending A&E because of a psychiatric condition has more than doubled since 2010. I have spoken to many doctors who tell me that when this happens and a seriously unwell young person presents at A&E needing a CAMHS in-patient bed, they frequently wait a very long time—sometimes days—for a bed to be identified. Often that bed is hundreds of miles away from home. One south London hospital has provided me with data that show a 37% year-on-year increase in the number of under-16s being seen in A&E with a mental health condition, and a 193% year-on-year increase in the number of those children being admitted to an in-patient bed.

Community Pharmacy in 2016-17 and Beyond

Helen Whately Excerpts

1st reading: House of Commons
Thursday 20th October 2016 Commons Chamber

[David Mowat]

I do not wholly understand the thrust of that question. I assume that the hon. Gentleman, like others in this House, is welcoming the fact that we are rolling out a national system on ailments, delivered by pharmacists. As the hon. Member for Central Ayrshire (Dr Whitford) said, that is the future.

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

The Government are right to require pharmacies to make efficiencies, as the NHS is. I welcome the pharmacy access scheme, which I hope will help my local village pharmacies. I urge the Government and NHS England to press ahead with rolling out the minor ailments service, because it is important to make the most of the skills and capacity of pharmacies, in order to provide valuable services to patients and to relieve the burden on GPs.

[David Mowat]

I thank my hon. Friend for that comment, and I reinforce what I said earlier: NHS England plans to have this rolled out nationally by April 2018.

NHS Sustainability and Transformation Plans

Helen Whately Excerpts

Wednesday 14th September 2016 Commons Chamber

[Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)]

I beg to move,

That this House notes with concern that NHS Sustainability and Transformation Plans are expected to lead to significant cuts or changes to frontline services; believes that the process agreed by the Government in December 2015 lacks transparency and the timeline announced by NHS England is insufficient to finalise such a major restructure of the NHS; further believes that the timetable does not allow for adequate public or Parliamentary engagement in the formulation of the plans; and calls on the Government to publish the Plans and to provide an adequate consultation period for the public and practitioners to respond.

I am glad to open this debate on the NHS sustainability and transformation plans. As the whole House knows, the NHS has a special place in the affections of our constituents. No other public service engages with us all when we are at our most vulnerable—in birth, death and illness—and the public and NHS staff are increasingly aware that the NHS is under severe financial pressure, a matter I will return to.

In that context of financial pressure and concern about the availability of services, the sustainability and transformation plans are arousing concern. They sound anodyne and managerial, and there is undoubtedly a case for bringing health and social care stakeholders together to improve planning and co-ordination. But the concern is that, in reality, the plans will be used to force through cuts and close hospitals, will make it harder for patients to access face-to-face consultations with their GPs, and, above all, will open the door to more privatisation. It tells the public how little the Secretary of State cares about their concerns that he is not in the Chamber to listen or respond to this debate. We know that recently he has missed all seven recent meetings of the NHS board. The public are entitled to ask how much he cares about their very real concerns.

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

The hon. Lady mentioned cuts, but this Government are putting more money into the national health service—an extra £10 billion a year. The Labour party had no intention of making that sort of financial commitment to the NHS, as we saw in its failure to do so before the last election.

[Ms Abbott]

The NHS was never better funded than under the last Labour Government and the public know that. That is why they trust us with the NHS.

--- Later in debate ---

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

I welcome the new ministerial team to their places. I also welcome the shadow Secretary of State, the hon. Member for Hackney North and Stoke Newington (Ms Abbott), but may we have a more constructive debate about healthcare in future? She should not talk about cuts. She knows perfectly well that this Government will be putting an extra £10 billion a year into the NHS by 2020. That is not a cut. That is £10 billion extra of taxpayers’ money. Will she please not mislead people by talking about cuts? As she well knows, her party did not commit to spending anything like that on the NHS.

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

I do not think that an hon. Member would try to mislead another. That is not a word that we would use.

[Helen Whately]

My apologies, Mr Deputy Speaker. I did not mean to use that word. The hon. Lady mentioned the £22 billion shortfall set out in the “Five Year Forward View” analysis, so will she clarify whether her party is now planning to make that up? If so, where will it find the money from? That was not entirely clear in her comments.

I will move on, because I sincerely believe we need a far more constructive debate about the real challenges the NHS faces and how to improve the care it provides to our constituents. The NHS is under pressure—no one here is denying that. I know it as well as anyone, as my grandmother spent five of the last six months of her life recently in hospital, and if the system had been better she would not have been there and would have had a much better end to her life. We know that people are living longer, with multiple conditions: about 70% of NHS spending goes on dealing with long-term conditions. The treatments available have increased vastly and are therefore more expensive than they were in the past, and patients expect far more of the NHS.

The NHS should not constantly be criticised, as is so often the case, as it is seriously rising to the challenge. It is performing thousands more operations, with thousands more patients being seen every day. In addition, in response to what happened at Mid Staffs and other such incidents, tens of thousands more doctors and nurses are working in the NHS. Skilled staff do not come about overnight; training takes years. A lot is therefore being done also to address the pressures on the NHS workforce. None of that should be overlooked, although it is also costly.

I ask us all to focus on talking about how the NHS rises to the challenges it faces, doing so in a financially sustainable way. We do not have a blank sheet of paper for this; the “Five Year Forward View” was published in 2014. As you may well know, Mr Deputy Speaker, I have previously asked questions about what was happening to drive forward that review at the pace and scale needed. The STPs are a vital part of the process, as across the country they are about putting the five year forward view into practice. They are doing that in an important way, looking at the place and the whole population, bringing together a diversity of organisations across the NHS and involving local authorities. We are talking about organisations that are rarely in the same room. In Kent, organisations have come together where previously people have literally not spoken together—chief executives have not previously been in the same room together. This is really important. The STPs are also putting public health at the core of the future plans for health and care across the region, and they are looking not just at treatment but at how the population can be healthier and how we can reduce health inequalities.

Finally, I urge all colleagues to do what I am trying to do, which is make sure that the STP in their area rises to the challenges and delivers the care that we all want for our patients in future.