Julian Lewis debates involving the Department of Health and Social Care during the 2019 Parliament

NHS Strikes

Julian Lewis Excerpts
Monday 17th April 2023

(11 months, 2 weeks ago)

Commons Chamber
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Steve Barclay Portrait Steve Barclay
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It perhaps will not surprise the House to hear that the hon. Gentleman disagrees with his party’s leader on that, because the Leader of the Opposition says:

“I don’t think 35% is affordable”.

The hon. Member for Leeds East (Richard Burgon) is also wrong on the quantum, because the cost would be £2 billion, not £1 billion as he says. [Interruption.] Well, that has never been how departmental budgets operate—not when his party was in power, and certainly not now. He is wrong on the amount and wrong on the policy.

Julian Lewis Portrait Sir Julian Lewis (New Forest East) (Con)
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Given that the terms “emergency care” and “intensive care” imply that the life of those who need them is at risk, does my right hon. Friend share my dismay that people in that predicament are now clearly being targeted by strikers? Will he—and hopefully his Opposition counterpart—represent to the medical unions that whatever other strike action they take, they should not endanger the life of people in emergency or intensive care?

Steve Barclay Portrait Steve Barclay
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My right hon. Friend makes an extremely important point. Patient safety should come first for all parties in this dispute. That is why I urge the Royal College of Nursing to wait for the NHS Staff Council decision on the offer. Voting is still ongoing, and it would be premature to announce strike action ahead of that decision.

Urgent and Emergency Care Recovery Plan

Julian Lewis Excerpts
Monday 30th January 2023

(1 year, 1 month ago)

Commons Chamber
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Steve Barclay Portrait Steve Barclay
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As I said, we are not setting out that ambition in this statement, because the impact of the pandemic has been so severe. We need to set a target that is ambitious but achievable, which is what we have done. The president of the Royal College of Emergency Medicine said:

“This plan is a welcome and significant step on the road to recovery and we are pleased to see it released.”

It is about taking best practice from the areas that are working and ensuring that they are socialised across the piece. It is obviously concerning to hear about individual cases, such as the specific one that the hon. Lady mentioned, which are very traumatic for the families. That is why we have set out this plan and why we are putting in the extra funding.

Julian Lewis Portrait Sir Julian Lewis (New Forest East) (Con)
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From 2005 to 2006, there was a campaign within the NHS to close many in-patient beds in community hospitals. I was pleased by what the Secretary of State said earlier about beds in community hospitals having a role to play. In that connection, will he reconsider the future of the site of Fenwick Hospital in Lyndhurst in my constituency, where the in-patient beds were closed? The NHS is now proposing to sell it off, but I would have thought that, with a bit of imagination, such a site could increase capacity.

Steve Barclay Portrait Steve Barclay
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We are encouraging integrated care boards to take ownership of individual decisions, rather than trying to make all the decisions centrally from Westminster, so that those closer to the ground and to the issues are in power to make the trade-offs. I am sure my right hon. Friend will want to have those discussions with the chair and chief executive of his ICB. There is a wider issue of how we make greater use of community sites, not least given the workforce pressures and different staffing ratios that they have, and that is absolutely the way we help to get more people out of hospital who are fit to leave.

NHS Winter Pressures

Julian Lewis Excerpts
Monday 9th January 2023

(1 year, 2 months ago)

Commons Chamber
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Steve Barclay Portrait Steve Barclay
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That simply is not accurate. Let me give the hon. Lady some specific examples. Under the auxiliary contract with St John Ambulance, we invested an extra £150 million in the ambulance service, and we invested a further £50 million in additional capacity for call centres. Taxpayers spent £800 million on the new Royal Liverpool Hospital, and during 2018-19 a brand-new hospital was built at Aintree. However, this is not simply about investing in new hospitals; it is also about looking at the integration between health and care, and that was recognised in the autumn statement, which provided an additional £500 million. It is simply inaccurate to say that there were no measures in the summer. The St John Ambulance contract and the community first responders, and the service for frail and elderly people, will help with demand management and prevent people from going to emergency departments in the first place.

Julian Lewis Portrait Sir Julian Lewis (New Forest East) (Con)
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Do the Government recognise the danger of a major increase in pressure on the NHS as a result of any new variant of covid that may be imported from China? How quickly would we be able to identify such a variant and prepare a vaccine against it?

Steve Barclay Portrait Steve Barclay
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Let me first congratulate my right hon. Friend—along with the whole House, I am sure—on the knighthood that he received from His Majesty.

According to the analysis we have received, the variant in China is the same as the one in the United Kingdom. On the other hand, the data shared by China is often not as clear as we would like. That is why, over the Christmas period, my right hon. Friends the Prime Minister and the Secretary of State for Transport announced proportionate measures involving covid tests for travellers and, in particular, sequence variant testing for those coming into the UK, in order to identify any new variant quickly.

NHS Industrial Action: Government Preparations

Julian Lewis Excerpts
Monday 12th December 2022

(1 year, 3 months ago)

Commons Chamber
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Will Quince Portrait Will Quince
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The hon. Lady is right that this issue is about more than just pay. That is what the unions are telling us. It is about things such as staffing levels and working conditions. If that is indeed the case, let me repeat: my door is always open, and I would be happy, as would the Secretary of State, to discuss those issues with the unions at any point they would like.

Julian Lewis Portrait Dr Julian Lewis (New Forest East) (Con)
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Would there not be more money available for relatively poorly paid frontline NHS staff if there were fewer layers of management bureaucracy paid at substantially higher rates within the NHS?

Will Quince Portrait Will Quince
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I thank my right hon. Friend for that question. I am sometimes staggered by the number of people on six-figure salaries within our NHS, but in an organisation of its size, management is also important. It is about getting the balance right, but we always continue—[Interruption.] The hon. Member for Ilford North (Wes Streeting) chunters from a sedentary position. The balance may not be right, and we always continue to look at the ratio of management to frontline staff to make sure we are getting that right.

Urgent and Emergency Care

Julian Lewis Excerpts
Monday 5th September 2022

(1 year, 6 months ago)

Commons Chamber
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Steve Barclay Portrait Steve Barclay
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This obviously involves debates with Treasury colleagues about pay—not just on the social care side, but in respect of the NHS and the interplay with pensions—but it is not just about that; it is also about ensuring that we have the right data, and through the integrated care systems we are acquiring much better data to improve our ability to join up what is being spent on delayed discharge within the NHS with what is being done in the social care setting. I am sure Members will agree that not only is it often very damaging for frail elderly patients to spend a long time in hospital, but hospital is usually the most expensive place in the system for them to be. It is not just a question of having more money, although that is often the default; it is a question of thinking about how to get flow into the system in a way that will deliver not only patient care, but a more efficient service.

Julian Lewis Portrait Dr Julian Lewis (New Forest East) (Con)
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On checking my website, I saw that it was in late 2005—not a period of Conservative government—that my right hon. Friend the Member for New Forest West (Sir Desmond Swayne), the then Liberal Democrat Member of Parliament for Romsey and I were complaining about the closure of in-patient beds in small community hospitals. Does the Secretary of State accept that there is a role for such beds in enabling appropriate discharge from the larger hospitals, thus dealing with one of the main causes of people being stuck in ambulances without being able to be given a bed?

Steve Barclay Portrait Steve Barclay
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That, I think, relates to the point that I just made about the need for flow in the system and an appropriate step-down capacity. Sometimes patients are not yet ready to be discharged to their homes, but some additional physio or other support may enable them then to go home, which is where they usually want to be. This is all part of taking a much more integrated approach, and part of that must be improving the quality of data in relation to the activity that takes place within community settings.

North East Ambulance Service

Julian Lewis Excerpts
Monday 23rd May 2022

(1 year, 10 months ago)

Commons Chamber
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Maria Caulfield Portrait Maria Caulfield
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I would like to hear more from the hon. Gentleman about his constituent’s case. I have concerns about what was reported in The Sunday Times. I am concerned that the process followed in investigating those concerns has not got to the bottom of some of the fundamental problems, so if he would like to meet me afterwards I would be very happy to take it further.

Julian Lewis Portrait Dr Julian Lewis (New Forest East) (Con)
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When senior managers and administrators are found to be directly involved in gross negligence and deliberate cover-ups, will they lose their jobs or will they be allowed to continue?

Maria Caulfield Portrait Maria Caulfield
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A statutory duty of candour is in place. As I said, if a mistake happens—mistakes can always happen, even with the best prevention methods in the world—there is a statutory duty to reveal it to the family and the patient involved, and to have a full investigation and learn lessons from it. I am concerned that that may not have happened in this case.

Elective Care Recovery in England

Julian Lewis Excerpts
Monday 7th February 2022

(2 years, 1 month ago)

Commons Chamber
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Edward Argar Portrait Edward Argar
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I join the hon. Lady in gratitude towards all those working in the NHS. I am sure that every Member of this House will receive correspondence from constituents who are in the position she outlined. Understandably, they will be distressed and often in pain. This plan is not a necessary precursor for work to be done to bring that waiting list down and get it under control; such work is already under way. As I said, not only is record investment in resources going into it but, while the Government focus to a degree on that, we also focus on what that taxpayers’ money does in delivering outcomes for people—hence why we have already announced the community diagnostic hubs and set out plans for surgical hubs. We are very grateful to all the charities and campaigning organisations that have, over recent months, engaged with us to help to advise on interventions that they think can make a genuine difference to waiting lists, but also to keeping patients informed and supported while they do wait.

Julian Lewis Portrait Dr Julian Lewis (New Forest East) (Con)
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How much greater would the backlog be if we had not successfully resisted the entreaties of those modellers, and indeed politicians, who wanted another shutdown over the Christmas period?

Edward Argar Portrait Edward Argar
- Hansard - - - Excerpts

It is always hard to prove a counterfactual, as my right hon. Friend will know, but we do know that the necessary measures we took during the pandemic to help to tackle this dangerous virus inevitably had a significant impact on waiting lists. Due to infection prevention and control measures and a range of other things, normal levels of surgery and planned surgery were not able to go ahead. He may be able to extrapolate from that, but, as I say, it is slightly difficult to come up with a detailed counterfactual.

Cumberlege Report

Julian Lewis Excerpts
Thursday 3rd February 2022

(2 years, 1 month ago)

Westminster Hall
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Julian Lewis Portrait Dr Julian Lewis (New Forest East) (Con)
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I pay tribute to everybody who has campaigned on this issue. I agree with every word of every previous speaker. I do not envy the Minister in having to reply to the debate, but I offer her an apology in that, because of an inescapable commitment that has been in my diary for many weeks, I will not be present for her reply. I gave my apologies to you, Mr Rosindell, in advance, and to our hon. Friend the Member for Altrincham and Sale West (Sir Graham Brady), who will be in the Chair later.

The issue was eloquently summed up by the hon. Member for Blaydon (Liz Twist) when she said that she could have reread her speech of 8 July word for word and it would have been as relevant today as it was then. Interrogating my own website on my contributions on this subject in preparation for the debate, I see that, apart from speaking on that occasion, my first effort on this topic was way back in a debate on 19 April 2018. I have to ask the Minister why, when terrible health disasters happen, it always takes so long to do the right thing. All that does is prolong the agony for the victims. I suppose the people responsible for trying to make recompense feel that they will be out of the picture by the time their successors have to pick up the pieces, but it smacks of the contaminated blood scandal all over again. Everybody knew that it was a horrible disaster, yet it took so many years, indeed decades, before compensation was finally paid.

I want to give a voice to three of my constituents, who have summarised their experiences for me, and if time permits to refer to just a few of the dozen or so multifaceted written questions that I have tabled, with differing success in terms of replies, between July 2020 and November 2021. Let me first précis the summary that my constituent Amanda, or Mandy, has prepared for me. She had a procedure in 2009 for the insertion of TVT—transvaginal tape. She says that

“the surgeons need to take responsibility and ensure that these failings are not perpetuated. The pain and suffering we have endured and continue to endure is traumatic physically, emotionally, and financially”.

She says that she has subsequently had to undergo many surgical episodes that would have been unnecessary, and that

“had I been aware of the risks and the fact that alternatives were available I would not have had surgery in the first instance. Partial removal surgery made things significantly worse. To date I have had 8 operations relating to the TVT.”

Mandy lists some of the costs that it has meant for her:

“Left in ongoing chronic pain

Loss of some independence

No intimacy possible

Relationship with husband negatively impacted which has an impact on work as we run a business together

Negative impact on my family and friends. I used to be happy and cheerful person, but this is now a constant struggle

Emotional stress of trying to appear ‘normal’ takes its toll

Feeling of being a failure as a woman and in my work life”.

The list goes on. Then she comes to the topic of the failure of the surgeon. There are three entries here:

“Failure to discuss risks prior to surgery

Failure to suggest alternatives to TVT

Failure to obtain informed consent”.

On the financial loss, I will not quote from her list, because others have set out the cost to them, but Members can be sure that it applies to Mandy as well.

My second constituent Helen, or Ellie, had two implants, in 2009 and 2011. This is what she has to say about the effects of these unnecessary procedures:

“Mesh has restricted my ability to work full time, due to constant pain, which has impacted negatively on my family…Mesh has cost me financially to travel for hospital appointments out of area. I’ve had to travel to London three times, staying in a hotel twice. Travelling to Bristol 9 times, staying in a hotel 7 times, as I am not able to sit to drive home on the same day due to pain. So not only fuel costs but hotel fees as well…Mesh has impacted negatively as I was told one operation would fix me, so one day’s lost wages, which ultimately has resulted in 9 more operations, each requiring weeks off work, each resulting in loss of income and now ending with one more surgery which could also require more follow up surgeries.”

She says that mesh, as in the case of Mandy,

“has cost me my sex life”

for

“which there is no financial recompense”

and adds:

“Mesh has cost me the ability to care adequately for my disabled husband, who now has to try to care for me…Mesh costs me monthly for my pain medication.”

If time permits, I will refer to the brush-offs I have had when asking if Government would make it their policy to at least exempt these victims of NHS failure from prescription charges, with no success so far.

Helen goes on:

“Mesh costs me the price of a cleaner twice a week as I can no longer manage it all myself…Mesh costs me the pain of sitting in a car for over a two hundred mile round trip each time I go to see my consultant, as I can’t see my local butcher.”

That leads me on to something that has been hinted at before: it is all well and good to set up specialist mesh removal centres, but if the only choice people are given is to go to the surgeon who put the mesh in, who has now, after repeated failures, been appointed to take it out, would they seriously put themselves in his or her care again?

Finally, I want to talk about Emma, who is not only a victim of this herself, but someone for whom I am lost in admiration. She has acted, in a sense, as a focal point and a support for the other victims. Every so often she thanks me for what I have done to support them. I feel a complete fraud when she does that, because we should be thanking her for what she is doing as someone who is suffering from this and reaching out to support other victims. I know she is watching this debate on the feed today, and I express publicly my total admiration for her.

Emma says:

“Mesh has cost me my career. I am no longer able to fulfil the driving element of my job and have lost my Class 1 HGV licence as I cannot pass a medical…Mesh has cost me the ability to work at a desk, in an office, therefore restricting my earning potential, and in turn my pension contributions. It also restricts my ability to find alternative work…Mesh has cost me thousands of pounds in travel, subsistence, accommodation and parking…loss of earnings & annual leave…days off for appointments, surgery, recovery, and mesh-related ill health.”

That has all taken its toll. I could go on, but I will just pick one or two examples from the long list of the consequences of this disaster for Emma. She says:

“The battle to get any form of PIP was traumatic and stressful. The evidence was ignored, the condition insight report was not recognised (despite it being a DWP authored document).”

She goes on to say that PIP

“was only awarded (eventually) at an Independent Tribunal; which means I will have to reapply again, from the beginning, in just over 12 months’ time…All told, the entire situation is extremely draining mentally, emotionally and physically.”

Emma has also communicated with me while this debate has been under way, thanks to the wonders of modern technology, to point out that—as Southampton has been mentioned—there is, as yet, no named surgeon at University Hospital Southampton NHS Foundation Trust’s so-called specialist centre.

I conclude by saying that I have been disappointed with the series of responses I have had to my dozen questions, which are all easily accessible for anyone who cares to look on the written questions section of my website. I was most disappointed by the response to question 31274, from 12 July 2021, which asked, in part, what steps the Secretary of State

“plans to take to research new and improved techniques for removal of eroded surgical mesh implants; and if he will make it his policy to establish a unit for developing such techniques in order to train a new generation of mesh-removal specialists to treat people who experience the effects of failed mesh implants in the future.”

Bearing in mind what has been said about the intense difficulty of extracting degraded mesh from the flesh that has grown around it, I have often wondered whether there might be a technique to melt it away, rather than trying to extract it. However, if we do not do the research, we cannot possibly find a solution. The answer came, bluntly, from the then Minister of State, who is now the Secretary of State for Digital, Culture, Media and Sport:

“There are no current studies specifically relating to new and improved techniques for the removal of eroded surgical mesh. However, there are five studies ongoing on surgical mesh implants and the National Institute for Health Research welcomes funding applications for research into any aspect of human health, including on the removal or implantation of vaginal mesh. There are currently no plans to establish a unit in order to train mesh removal specialists.”

We know that only a tiny handful of people have successfully specialised in this field. They ought to be empowered to train up a new generation to help these people, whose suffering will otherwise continue indefinitely.

Vaccination: Condition of Deployment

Julian Lewis Excerpts
Monday 31st January 2022

(2 years, 1 month ago)

Commons Chamber
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Sajid Javid Portrait Sajid Javid
- Parliament Live - Hansard - - - Excerpts

Where I agree with the right hon. Gentleman is on the importance of persuasion in vaccination. Where I am afraid I disagree with him is on the idea that public ownership of patents connected with vaccinations or drug development in general would help. In fact, I think it would be a backward step and we would not see the innovation that has saved lives.

Julian Lewis Portrait Dr Julian Lewis (New Forest East) (Con)
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Many patients in hospital will presumably be protected by having undertaken their own vaccination process, but some will be clinically extremely vulnerable because of compromised immune systems. Is the Secretary of State saying that these people are at no greater risk of being made seriously ill or dying as a result of coming into contact with unvaccinated frontline staff? If they are at greater risk, is there something else that can be done to lessen that risk, such as a testing regime, before that contact takes place?

Sajid Javid Portrait Sajid Javid
- Parliament Live - Hansard - - - Excerpts

That is another good question from my right hon. Friend. I will say two things. First, this is not about zero risk; it is about less risk. What I am saying is that, based on the advice that I have received and for the reasons that I set out in my statement, whether or not someone is immunosuppressed, omicron, in general, represents less risk. It is also right to ask whether other measures could be taken to provide additional support. Yes, they can, which is why I have asked the NHS to review its own policies on the deployment of staff in certain settings, and that would include interaction with the most vulnerable patients.

Public Health

Julian Lewis Excerpts
Tuesday 14th December 2021

(2 years, 3 months ago)

Commons Chamber
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Wes Streeting Portrait Wes Streeting
- Hansard - - - Excerpts

I strongly endorse what the hon. Gentleman said. Infection control is going to be a real challenge this winter because of the nature of the omicron variant. By ensuring that the NHS workforce is fully vaccinated, we will protect not only patients but staff, who already put themselves in harm’s way enough. As the hon. Gentleman, who speaks with real knowledge and expertise, said, this is not a new precedent: NHS staff are already required to inoculate themselves against other diseases. It is a professional duty. The NHS clearly believes that the April deadline gives sufficient time to persuade the workforce to protect themselves, their patients and their loved ones without there being an exodus of staff.

Julian Lewis Portrait Dr Julian Lewis (New Forest East) (Con)
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I supported the requirement for people working with vulnerable people in care homes to be vaccinated or, if they would not be vaccinated, to be removed from direct contact with vulnerable people. Can the hon. Gentleman tell me—I did not get a chance to ask the Secretary of State—whether this proposal for members of the NHS who have not been vaccinated will affect only frontline staff who interact with the vulnerable, or whether it will apply to people throughout the NHS who might have no contact with the vulnerable? That will affect the way I cast my vote today.

Wes Streeting Portrait Wes Streeting
- Hansard - - - Excerpts

I hope I can reassure the right hon. Gentleman that it will not be a case of saying to people, “If you don’t take up the jab, that’s it—you’re out.” There will also be the opportunity for redeployment to other roles where vaccination would not be mandatory. I hope that gives him the reassurance that he needs.