Health

Lord Redwood Excerpts

Tuesday 14th May 2019 Commons Chamber

[Matt Hancock]

We are honouring the pay rise proposed—of course we are. I love the HSJ, which is an absolutely terrific journal, but it was wide of the mark on that. We are putting in record funding.

[John Redwood (Wokingham) (Con)]

The Secretary of State has done well in getting the extra money that the NHS needs. Will he briefly summarise what extra service and capacity we will get for that money? It is important to spend it wisely.

[Matt Hancock]

My right hon. Friend anticipates my very next point. It is important to get value for the extra taxpayers’ money we put in. I always try to refer to it as taxpayers’ money, because there is no Government money or NHS money. Every single penny we put into the NHS—rightly, in my view—comes from the taxes that people pay, and it should be treated with the respect that that deserves.

Exiting the European Union (Medicines)

Lord Redwood Excerpts

Tuesday 19th February 2019 Commons Chamber

[Jackie Doyle-Price]

The regulations are determined to facilitate transfer with not only EU bodies, but internationally. We fully recognise that in bringing forward the regulations we are operating in an international landscape. The regulations are designed to facilitate that co-operation, as well as to establish the MHRA as the lead regulator. It is worth noting that, within the current system, the MHRA is the lead. In terms of the regulation we are transposing, rather less is coming to the MHRA given the existing ownership it has in this field.

[John Redwood (Wokingham) (Con)]

Given that our industry is a world leader and a very significant part of the European effort, does the Minister see opportunities in the future for us to have world-class regulation where we lead and differentiate in a way that would strengthen our efforts?

[Jackie Doyle-Price]

My objective this afternoon is to make sure we can continue with business as usual on exiting the European Union, but clearly once we have left the European Union that would be open to us. The ethos behind the regulations and the consultation we have had with the sector very much recognises that this is an international market place. We must ensure that in taking forward these requirements we remain competitive.

As I was saying, we will require the same information requirements as the EU for any new applications for multi-state trials in the UK. There is a requirement that a clinical trial sponsor should be based in the EU. There are a few areas where it has been necessary to add a new requirement, as a result of the UK no longer being part of the European regulatory framework, relating to the MHRA putting in place a new national IT system for safety reporting and submissions. In addition, investigational medicinal products, known as IMPs, imported from the European Economic Area will now require an import licence, as they would no longer be part of the single market. As the hon. Member for Central Ayrshire (Dr Whitford) said, they will be overseen by a qualified person to ensure that the products are appropriately certified. That builds on the existing import licensing system, which allows the transport of IMPs direct from the EEA to UK trial sites to continue. Recognising that this is a new system, we have provided stakeholders with a 12-month transition period from exit day before it comes into force.

While not specifically covered in this statutory instrument, I would like to reassure Members that the Government are engaging with organisations running clinical trials to ensure continuity of supply and that drugs continue to be received. The Government are undertaking a comprehensive deep dive into clinical trial supplies to gain detailed understanding of what is required, and are putting place contingency plans in case the sponsors need them. They will include access to the same prioritised shipping routes that will be available for all other medicines.

As I mentioned in response to the hon. Member for Cambridge (Daniel Zeichner), the Government are committed to ensuring that the UK remains one of the best places in the world for science and innovation. Members should note the Government’s commitment to aligning with the EU’s new clinical trials regulation as far as we can, without delay, when it does come into force, subject to the usual parliamentary approvals.

--- Later in debate ---

[Jackie Doyle-Price]

Being brutally honest with the hon. Lady, and perhaps more honest than some are in this debate, I do not think we can dictate terms to our EU partners; I think we can look forward to having constructive working arrangements with them and it is in all our interests to do so, but ultimately we would have to seek agreement about this. At this stage this SI can only really cover the things that are in the gift of this Government, and a lot will rest on good co-operation after the event, which again means it would be much more preferable to leave with a deal.

[John Redwood]

Given the great importance of joint venture companies and joint investment and joint activity across the Atlantic, will the Government also be looking at changes in American regulation to see if any of that would be appropriate—or maybe a UK version could be better than both the American and EU ones?

[Jackie Doyle-Price]

My purpose this afternoon is to ensure that we have business as usual post-exit day, and that we can maintain patient safety at that time. I would not want to encroach on any debate beyond that now.

Questions were raised regarding research funding. I should advise the House that before the Brexit vote the UK was involved in more EU-funded science projects than any other country. The UK secured 14.3% of the total share of the funding to date and is the second-highest recipient of grant funding. We are committed to remaining a world leader in science and research, and that is why, in our modern industrial strategy, we have committed to spending 2.5% of our GDP on research and development by 2027. We have invested an extra £7 billion in research and development as a first step towards that.

NHS 10-Year Plan

Lord Redwood Excerpts

Tuesday 19th February 2019 Commons Chamber

[The Minister for Health (Stephen Hammond)]

I beg to move,

That this House has considered the NHS Ten Year Plan.

Thank you, Madam Deputy Speaker. You will understand that I am pleased not to have to follow my predecessor’s responsibilities.

As last year’s 70th anniversary celebrations proved, the NHS is one of this country’s proudest achievements. That is clear from the number of people who want to contribute to the debate this evening, so I shall be as brief as I possibly can. The Government’s top funding priority is the NHS. By 2023-24, the NHS budget will increase by £33.9 billion in cash terms, which is the equivalent of £20.5 billion in real terms. This means that in five years’ time the total NHS budget will be £148.5 billion.

In January this year, the NHS published the long-term plan, which sets out the priorities for the next 10 years of the service. The additional funding has given the NHS the stability and certainty it needs to make that plan for the decade ahead. The plan represents a historic moment for patients across the country. It was developed by NHS leaders and clinicians, in consultation with patients and the public, and Members can be assured that it focuses on the biggest priorities for patients in the next decade.

[John Redwood (Wokingham) (Con)]

Will the plan ensure that areas such as mine, which has fast growth and lots of new housing, will receive adequate resources to put in new surgeries and additional capacity, which has not happened in the past?

[Stephen Hammond]

My right hon. Friend will note that the plan includes the transformation that we will bring to primary care, which will look not only at how primary care will be developed and delivered, but at ensuring that there is enough money to deliver the changes.

The plan sets out a scheme that will provide the best support for patients throughout their lives—from getting the best start in life to being supported into old age. The plan sets out the transformation needed at every level of the health system to ensure that it can continue to provide world-class care. Part of that, as I have just said to my right hon. Friend, is a fundamental shift towards primary care and prevention. The plan will keep people healthy and out of hospital by boosting services closer to home.

Mental Capacity (Amendment) Bill [Lords]

Lord Redwood Excerpts

3rd reading: House of Commons & Report stage: House of Commons
Tuesday 12th February 2019 Commons Chamber

[Caroline Dinenage]

I think that there must be some confusion. The case studies will be part of the code of practice. They will be gathered together in the document, and third-sector organisations will contribute to ensure that we cover every cohort. We must bear in mind that we are trying to cater for wildly different groups of people. The document will have to cover the young person with an acquired brain injury to whom the hon. Member for Rhondda referred, a 16-year-old who has had a learning disability since birth and the 97-year-old with dementia. It must not be the box-ticking one-size-fits-all exercise for which the current legislation provides.

We are aware that mental capacity assessments may be of particular concern to the group of people mentioned by the hon. Member for Rhondda. Assessing the capacity of people with acquired brain injuries can be particularly challenging, and will require skilled and careful consideration. Government amendments 28 to 37, which I shall discuss later, outline our intention to publish regulations in order to ensure that the assessors have the appropriate knowledge and experience.

We agree that the likelihood of capacity to fluctuate should be ascertained during the assessments, and we will expect that to be considered in the authorisation, in the length of authorisation and in the frequency of reviews. Fluctuating capacity is complex and fact-specific and deserves in-depth and detailed guidance, which is why we will include the details in the code of practice. I appreciate what the Opposition amendments are trying to do and I fully agree with their spirit, but I hope that my commitment to work with others on the code has given the hon. Gentleman and other members of the all-party parliamentary group the reassurance that they need.

Through the scrutiny of the Public Bill Committee and the ongoing engagement with stakeholders, we have identified a number of areas in which the Bill could be strengthened further. As I have said before, I firmly intend to introduce a more effective, efficient system of robust safeguards, moving away from the one-size-fits-all approach that no longer works. I am committed to doing this in a very collaborative way, and where possible to identify legislative improvements that can be made to work. I am committed to looking at this again, and as a result a number of Government amendments have been tabled that improve the Bill and the way in which liberty protection safeguards work.

Amendment 5 aligns the definition of a care home manager in Wales with that in England. The Bill as currently drafted defines care home managers in Wales as a registered manager. This amendment changes that so that it is linked to the registered service provider. Amendments 7 to 23 will remove any perceived conflict of interest where a deprivation of liberty occurs in an independent hospital. Under amendment 14 the responsible body in cases where arrangements are mainly carried out in an independent hospital would be the local authority in England and in Wales the local health board for the area in which the hospital is situated. This removes any potential misuse of power or conflict of interest in independent hospital settings. Amendment 22 outlines that in England the responsible body is the local authority responsible for the education, health and care plan or the care plan under the Care Act 2014. If a person does not have one of these, the responsible body is that in the area where the hospital is situated.

[John Redwood (Wokingham) (Con)]

What provision does the Minister think should be made in the code for the families? Often the adult children or the parents know these people extremely well and have very caring approaches, and they may have wisdom to inform the decision, but there might be the odd occasion when the family member has their own agenda and not that of the vulnerable person. So what should the role of the family be?

[Caroline Dinenage]

The role of the family is much greater in this amended legislation than it is currently. A number of families have told us through our work on this Bill that they feel very disenfranchised by the current system. For example, in the new system a family member or a loved one can be an approved person.[Official Report, 13 February 2019, Vol. 654, c. 7MC.] That would be the person’s advocate through the process. That method brings family members and loved ones much closer into the decision-making around this whole system.

NHS Long-Term Plan

Lord Redwood Excerpts

Monday 18th June 2018 Commons Chamber

[Mr Hunt]

First, may I thank the hon. Lady for doing something that the shadow Health Secretary did not do, which is to welcome this £20 billion annual rise in the NHS budget? I completely agree with her about the importance of prevention, the importance of social care and the importance of making sure that we sustainably invest in transformation funding. The think tanks do disagree on what level of rise is necessary. Lord Darzi and the Institute for Public Policy Research said 3.5%; we are on 3.4%, which is not far off that. The IPPR went a little higher, but, like the hon. Lady, Paul Johnson said that this will stop the NHS going backwards.

With respect to overall funding levels for the NHS, the United Kingdom currently funds the NHS at the western European average as a percentage of GDP. That is not as high as France or Germany and it is true that, by the end of this five-year period, our funding will end up at broadly similar levels to those of France today, although of course it may change them over the five-year period.

I gently say to the hon. Lady that if that is a worry for her, she needs to explain to NHS users in Scotland why, when NHS spending has increased by 20% in England over the past five years, it has increased by only 14% in Scotland because of choices made by the Scottish National party. For every additional pound per head invested in the NHS in England only 85p has been invested in the NHS in Scotland. I hope that she makes a pledge, as I hope Labour does with its responsibility for Wales, that every extra penny that she gets through the Barnett formula will go to the NHS, because that is what the voters in Scotland want.

[John Redwood (Wokingham) (Con)]

As soon as we are fully out of the EU, there will indeed be a very big Brexit dividend, which a lot of us want to get on and enjoy here at home. Will the Secretary of State confirm that some of that money will be spent on training and educating and recruiting people already settled here into full-time NHS jobs to cut down on very expensive agency staff and to stop denuding the health services often of poorer countries around the world?

[Mr Hunt]

My right hon. Friend is absolutely right. One thing that we have historically got wrong in the NHS is not having a long-term workforce plan. Whatever Members’ views on the Brexit debate, it was always a false economy to say that we could get away with not training enough people because we could import them from other EU countries. The truth is that we are not the only country with an ageing population: France, Spain and Portugal need their doctors and nurses as well, as indeed, as he rightly says, do poorer countries.

Social Care

Lord Redwood Excerpts

Wednesday 25th April 2018 Commons Chamber

[Barbara Keeley]

Yes, indeed. My hon. Friend takes me ahead in what I was going to say, but I know she has been involved with Age UK in understanding the state of care in her own local area, and I applaud her for that. Cuts have resulted in providers giving poor-quality care, and that is having a serious impact on the lives of people who need care. It means people not being washed or going hours without receiving a meal or being given a drink; it means people being left without help to go to the toilet; and in some cases, as she just said, it means people not being given crucial medication.

Care quality has become so bad that Age UK’s recent report was entitled, “Why call it care when nobody cares?” Many Members went to the launch of the report and listened to the older carers who were there. The anger of those older carers who spoke at or attended the event was palpable. Some told me that they and their families were often at breaking point, that they felt betrayed by a system of care that left them with little or no affordable support, and that they faced rising care costs which they described as crippling, although the care for which they paid was often not good enough.

I know that the Minister was present at that event. She may have talked to one carer there, Elaine from Northamptonshire, whose council is battling insolvency. Elaine gave up her job to care and has cared full-time for her husband ever since, but rather than giving her any extra help, the council recently tried to increase the weekly cost of care support at home from £88 to £178 per week. That was another battle for a carer to fight to obtain the care support that she needed at a price that she and her husband could afford.

Labour Members recognise that unpaid family carers need more support. We understand how much families are doing to look after their family members, and how hard that is for many carers but the Government have not even developed an updated national strategy for carers, having scrapped the planned strategy back in October. Since then, they have even failed to publish the action plan that was promised for January. What does that say about their attitude to carers?

[John Redwood (Wokingham) (Con)]

The motion states that

“there is an unacceptable variation in the quality and availability of social care”.

Where in the country does the hon. Lady think it is really good at the moment?

[Barbara Keeley]

It tends to be outstanding in the independent sector. Charities in particular can be outstanding, although they are not always so.

The care sector’s funding crisis also has an impact on the growing number of people who need care but are given none at all. More than 1.2 million people are now living with unmet care needs, many of them isolated and lonely, and that number rises to 1.5 million with the addition of people who need assistance with taking medication. Unmet needs can lead to people being forced to wear incontinence pads overnight because there is no one to help them to get to the toilet, which takes away their dignity. The number of older people living with unmet care needs will inevitably rise without an injection of new funding, because of the growing demand for care in our ageing population.

It is clear that the social care system needs sustainable funding from central Government, but the Government’s response to the crisis so far has been to push the funding problem on to hard-pressed councils and council tax payers through the social care levy. The only increase in Government funding has been the paltry £150 million extra for social care in the local government finance settlement. That is nowhere near enough to avert the crisis that the Government have created in social care. Moreover, it was not the new money that councils desperately needed. The Government admitted that the increase would be funded through an expected underspend in existing departmental budgets.

It is clear that local authorities are now facing some of their greatest challenges just to make ends meet. I want to highlight the heroic efforts of Labour councils to protect adult social care in the face of swingeing budget cuts from the Government.

--- Later in debate ---

[Caroline Dinenage]

I do welcome it. I recognise the very hard work of local councils that have managed to reduce delayed transfers of care. Indeed, I also recognise the very hard-working NHS staff, such as my hon. Friend, who have also helped to make that a reality.

We know that the NHS is busier than ever before, with hospital admissions rising by 33% since 2007, yet we have set clear expectations for reducing delayed discharges. Despite these challenging circumstances, both the NHS and social care have been working hard to free up beds. Since February 2017, more than 1,600 beds per day have been freed up nationally. I need slightly to take exception to the way the hon. Member for Worsley and Eccles South described people being discharged before they are medically fit. If someone is experiencing a transfer of care that has been delayed, it is because a multi-agency team have already assessed them as being medically fit for discharge.

[John Redwood]

Following on from the point about the big variations in how much per head councils get, may I point out that some time ago West Berkshire and Wokingham were cut back because they were very efficient and doing a good job? Will the Minister make sure that in the new formula good conduct is taken into account and does not lead to penalties?

[Caroline Dinenage]

I will certainly take that into consideration.

NHS Winter Crisis

Lord Redwood Excerpts

Wednesday 10th January 2018 Commons Chamber

[Mr Hunt]

That is completely unacceptable, but it is disappointing that the hon. Lady stands up and runs down the NHS when her own trust, which received £3.4 million before Christmas to help with winter, has managed to improve its performance: last November’s figure was 91.8% compared with 77.7% a year earlier. That is a huge achievement for Mid Yorkshire Hospitals NHS Trust. Why will she not praise what is happening, rather than running the NHS down?

[John Redwood (Wokingham) (Con)]

I support the leadership that the Secretary of State has offered during this winter crisis and the tone he has adopted in this debate. As a result, there is not the kind of crisis we have had in past years. Now that he has widened responsibilities for social care, will he help West Berkshire and Wokingham, which have had problems with past formulas and do not have enough money to take pressure off the hospital in the way he would like?

[Mr Hunt]

I will certainly revisit the issues in my right hon. Friend’s local authorities because I have looked at them before and know that there are particular pressures there. He alights on something else that the Opposition have not wanted to talk about, but which is very significant: the Prime Minister’s commitment to the integration of health and social care, which eluded the previous Labour Government over 13 years, despite their talking about it a lot. We are starting to see that happen in this country. Monday’s decision means that policy leadership will come back to the Department of Health, which will help us to make even faster progress.

NHS Shared Business Services

Lord Redwood Excerpts

Tuesday 27th June 2017 Commons Chamber

[Mr Hunt]

I gently say to the hon. Gentleman that it is totally inappropriate to try to make political capital from this incident. The facts of the case are that the NAO today published a report saying that patient safety was the primary concern of both the Department of Health and NHS England throughout. There were some problems with the assurance of that contract, but the contract and the relationship with SBS in particular dates back to 2008. Both sides of the House need to learn the lessons of properly assuring NHS contracts, and I dare say the same is true in Scotland.

[John Redwood (Wokingham) (Con)]

I fully support the Secretary of State’s actions, which were quite right in the difficult circumstances in which he found himself, but what action will be taken against the executives who presided over this shambles? Is there any enforcement mechanism under the contract against the other owner of the company?

[Mr Hunt]

The company has been stripped of that contract; it was relieved of the contract back in 2015. We are very clear that it will have to fulfil all its contractual requirements, including paying its fair share of the costs that have been incurred as a result of this wholly regrettable incident.