Wuhan Coronavirus

Maria Miller Excerpts

Tuesday 11th February 2020 Commons Chamber

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order. I will spend approximately 20 more minutes on this statement, so I urge brevity in questions and answers.

[Mrs Maria Miller (Basingstoke) (Con)]

The Secretary of State said that this public health emergency is likely to get worse before it gets better, so will he reassure the House today that we are well prepared for any new cases in the UK and that the NHS has the capacity to cope with those new cases, wherever they occur across the country?

[Matt Hancock]

Yes, of course I can give that assurance. We have been clear all along that we have expected cases and that we are doing everything we can, but we also need to prepare for what might happen in future.

Innovation in Hospital Design

Maria Miller Excerpts

Tuesday 4th February 2020 Westminster Hall

[Mrs Maria Miller (Basingstoke) (Con)]

I beg to move,

That this House has considered innovation in hospital design.

It is a pleasure to serve under your chairmanship, Ms Nokes, and to hold this important debate. Last September, the Government gave the green light to 40 new hospitals, as part of the health infrastructure plan. For my Basingstoke community this means support for a hospital replacing a much-loved building, built over 40 years ago.

We wanted a new hospital six years ago. While it is important to refresh those plans, because we are now talking about a district hospital, not just a critical treatment hospital, we already have a great deal of work in place. The initial community consultation has identified widespread support. The ambulance service has identified the location that would save more lives. The local council has given planning consent for a hospital to be built.

What about the building itself? If we are to realise the full benefits of this once-in-a-generation opportunity for our healthcare infrastructure, we need not the fad of the moment, but the best design for our hospitals based on evidence and the needs of clinicians, patients, staff and the community, as well as research at home and abroad, to create the best blueprint for local trusts to use for the next generation of NHS hospitals.

Guidance on how to design a new hospital, provided by the NHS to hospital trusts, has been called “out of date” by Architects for Health, an organisation dedicated to improving healthcare design. That should concern us. I hope that the Minister will reassure me that any new hospital will benefit from the best design thinking based on the best evidence around the world.

Many of the crucial design factors identified through research by design experts are completely absent in many hospitals within the NHS estate. Many of our hospitals, including our hospital in Basingstoke, were built for a different era of medicine. The buildings have been modified, added to, partially knocked down and rebuilt, and prefabricated units have been built in front of old units. Any sense of coherence in the design of our hospitals has long been lost.

[Alex Davies-Jones (Pontypridd) (Lab)]

I hope the right hon. Lady agrees that, historically, hospitals have been built away from where those services were most needed, causing issues with the recruitment of consultants and doctors, who then have to work with a demographically and geographically diverse population. I hope that location is given full consideration when new hospitals are designed.

[Mrs Miller]

The hon. Lady is absolutely right. That is why I was pleased that the NHS trust in Hampshire went to the emergency services and asked where the best location for a hospital would be. They identified junction 7 on the M3—an area not unknown to you, Ms Nokes—as a fantastic location. It would be convenient not only for staff, but for the ambulance service, so that it could can save more lives. All these issues must be taken into account.

We have experience of building hospitals since Basingstoke and North Hampshire Hospital was built in the 1970s. Newer private finance initiative hospitals have often been debated in this place. Interesting research has been done on their design, showing that the innovative use design was inhibited because private finance saw those hospitals foremost as an investment vehicle, and tried to reduce risk by using conventional design and construction methods—looking to the past rather than the future. We cannot make the same mistakes again.

What makes a good hospital for now, or, better still, for 2060, when these hospitals will still be operating? Based on the past 40 years of experience, we know the next generation of hospitals must be flexible in their design, not only to accommodate change, but to be built with change in mind and not as an afterthought. I am sure that some elements can be standardised, but the overall design must be flexible. Some new hospitals are built with the intention that they may have an entirely different use in the future. In our communities there are successful examples of buildings that began with one intended use and have moved to another, but they are few and far between. We need to ensure these hospitals have that flexibility, to scale up, change, scale back and even change use entirely.

Patient treatment is the prime function of a hospital, but so is patient recovery. The prevalence of multimorbidity requires a different way of thinking. Perhaps people with mental and physical illness—indeed, those with both simultaneously—should be treated side by side. Rightly, our focus is on early detection and prevention, so part of any new hospital must be mobile, to take prevention of disease into the heart of our community, with the permanent migration of some services from hospitals to the community, including simple diagnostics and therapies.

Research from the US demonstrates the importance of the right environment for patient recovery, including noise reduction, air quality, green space, daylight and seeing nature. Unsurprisingly, all those elements promote good health in well people, too. In 1984, a study by Roger Ulrich proved that a view through a window of a natural setting—perhaps the Hampshire countryside—would aid recovery. Those who had a view of a natural scene had a shorter stay and fewer complications and required less pain relief than those with a window facing a brick wall. Those are not new ideas. Florence Nightingale insisted on every ward being flooded with sunlight, with windows that opened to bring in light and ventilation lifting the spirits, but that is not the case for every ward in my hospital and hospitals around the country.

Staff retention is one of the most acute issues for the NHS. NHS staff are hugely loyal and dedicated. The hundreds of people in Basingstoke who work in my local hospital go above and beyond every day in bringing the best care to my constituents. However, where we work matters, and we should not rely on that loyalty and dedication but reciprocate it. We need to think about how design can improve everyday working lives.

Office design has evolved over the past 40 years, creating spaces that encourage creative collaboration. However, in hospitals things have not changed much at all, yet collaboration and creativity are just as relevant in medicine as in commerce, as are training and upskilling, which should be designed into these new buildings.

Of course, a hospital’s environmental impact also needs to be minimised. The importance of renewable energy and public transport links goes without saying, but we need to take account of the actual design of the hospital, to ensure that it is a design that the surrounding community can be proud of, and so the hospital does not look as if it has landed from outer space and instead fits with the natural setting; a hospital should be a building that will add to that natural setting and not detract from it.

For this new generation of hospitals to be truly sustainable, there needs to be a move away from the disposable hospital design of the 1970s, which was perhaps used when the hospital in Basingstoke was built back in 1972. A building that is flexible and that can be repurposed is a building that is sustainable, which is the approach that we must take.

Each and every one of the 40 new hospitals will be a huge investment for taxpayers, and it is right that approval procedures are rigorous. However, I hope that my hon. Friend the Minister can assure us that, despite that rigour, the long-term benefits of the best working environment for staff are not traded for a short-term reduction in cost.

Hospitals are absolutely extraordinary places that do extraordinary things on a routine basis. They are places where we experience the most emotional experiences in our lives; they are the places where new life is brought into the world and where we face our darkest moments. I will always remember the birth of my three children in Queen Charlotte’s Hospital in London, even though there was a decision to move the hospital after the birth of my second child and I had to go to a new location for my third child. Nevertheless, to be surrounded by experts in maternity and midwifery was an extraordinary experience, and we always have a debt of gratitude to hospitals that have served us in that way. Now Basingstoke hospital is looking after my mother and my father in an extraordinary way, and we should always recognise the incredible lengths that the NHS goes to, in order to ensure that we have the right support in place at the right time.

That is why communities have such a profoundly emotional attachment to their hospitals. That is a challenge that the Government face as they introduce their plans for 40 new hospitals, because they must recognise the impact of any change to a building with which people have an emotional bond and attachment, whether they have had a baby or visited a dying relative there. We need to understand that and take the community with us.

I hope that my hon. Friend the Minister can outline today how the Government will ensure that this once-in-a-generation opportunity—these 40 new hospitals for communities right across the nation—involves good design. That means design that helps to provide the best treatment, the best recovery, the best staff retention and the best for our environment, and such design should be at the heart of each and every new hospital, because we must build hospitals for the future and not simply replicate the past. We also need to recognise the emotional role that hospitals play in the lives of our families and our communities. We must work with the people the NHS serves to ensure that this groundbreaking development of the NHS estate is understood, embraced and welcomed.

[The Minister for Care (Caroline Dinenage)]

It is a huge pleasure to serve under your chairmanship for the first time, Ms Nokes.

I congratulate my right hon. Friend the Member for Basingstoke (Mrs Miller) on securing this incredibly important debate about innovation in hospital design, which I know is an important subject for her. She has worked tirelessly to secure a new and better hospital to serve her constituents in Basingstoke, who I know are grateful for the enormous amount of work that she done. I also know that she will continue to hold our feet to the fire in the Department of Health and Social Care, to ensure that the new hospital is the very best that it can be.

As my right hon. Friend said, the Department has invested heavily in the NHS, providing large amounts of capital investment to hospitals, as announced last year by the Prime Minister and the Secretary of State for Health and Social Care. Ensuring that this investment delivers innovation in health infrastructure is absolutely vital, as we move forward towards a health estate that is fit and able to face the challenges of the future.

We announced a new health infrastructure plan, or HIP, to deliver a long-term programme of investment in our NHS estate, buildings and equipment. This will be the biggest and boldest hospital-building programme in a generation, supporting our health service so that dedicated NHS staff, who are quite marvellous, can give patients world-class care in world-class facilities.

Under the new HIP, we have made a long-term commitment to build 40 new hospitals over the next decade, including to the Hampshire Hospitals NHS Foundation Trust in my right hon. Friend’s constituency. As she knows, the trust will receive £5 million in seed funding to develop plans to renew the ageing estate and better align services at the hospitals in Basingstoke and Winchester.

The 20 hospital upgrades that we previously announced are already under way. That is on top of a capital commitment, amounting to around £3.3 billion, provisionally awarded to over 170 sustainability and transformation plans since July 2017. That capital investment is going into a wide variety of programmes right across the country, including new urgent care centres and integrated care hubs—which bring together primary and community services—and, of course, new mental health facilities.

This investment programme will totally transform the health infrastructure in this country. It presents a unique and exciting opportunity to implement the latest innovation in healthcare design, with all the benefits and advances of modern methods of construction. Getting this right will ensure that patients receive the right treatment—treatment that speeds up their recovery and makes the most of the working environment, ensuring that our wonderful NHS staff can work in facilities that support them to deliver the very best in patient care.

The impact of the built environment on patient outcomes and staff satisfaction is increasingly clear. My right hon. Friend has already referred to it, but academic research conducted by the University of Sheffield shows that patients make significantly better progress in new, purpose-built and designed buildings than in old ones. There are a range of impacts, including reductions in pain medication needs and shortening hospital stays. In the mental health sector, treatment times were reduced by 14%, and in the general medical sector, non-operative patient treatment times were reduced by a staggering 21%. That is the prize here.

There is also growing evidence that access to and visibility of green space is vital to promoting therapeutic environments that aid recovery, with positive health outcomes including reductions in stress and anxiety, increased social interaction and, of course, an improved healthcare experience.

There has been some really interesting recent work in this space, which the Department welcomes. For instance, the Royal Horticultural Society donated its feel-good garden from the 2018 RHS Chelsea Flower Show to Camden and Islington NHS Foundation Trust. Its permanent home is now at Highgate mental health centre, one of the trust’s two in-patient psychiatric sites, and it is dedicated to improving the care of older adults with acute mental illness.

As my right hon. Friend said, there is nothing new about that approach. Florence Nightingale—who I know is deeply ingrained in your constituency, Ms Nokes—had it right from the beginning. My constituency of Gosport houses Haslar, a military hospital built in 1756 that has long, well-lit buildings, beautifully landscaped gardens overlooking the Solent and, critically, many out-buildings—smaller structures where the war-wounded would be wheeled out to take the air and look at the beautiful views of the Solent that we still enjoy today. Buildings designed to maximise natural light and views of green space, with increased natural ventilation and reduced noise levels, make for a much more pleasant environment, not only for the patients, to aid recovery, but for the staff going about their work.

As my right hon. Friend said, there is mounting evidence that there are strong links between the design or layout of buildings and the job satisfaction of staff, thereby improving staff retention. Buildings should be designed in a way that makes it easier for staff to do their job. For instance, designing the layout of a health building in a way that aligns with patient flow and clinical pathways also contributes to increased staff satisfaction, which makes sense. Staff can dedicate more time to patients because the time spent walking between linked wards and clinical services is reduced.

Naturally, we want to ensure that the modern clinical design of buildings is also cutting-edge in the way it supports environmental sustainability. The large hospital projects selected for phases 1 and 2 of the Department’s health infrastructure programme have been instructed to ensure that they combine and contribute to the reduction in the NHS carbon footprint by following the framework developed by the UK Green Building Council on net zero carbon buildings.

As well as seeing innovation in hospital buildings, we want to see environmentally conscious design. The NHS has led a new-for-old programme, which improves delivery of local community-based infrastructure as well, so these things are not only for the big new acute hospitals. The new-for-old programme is adopting a variety of sustainability measures, including something called BREEAM, which stands for the Building Research Establishment environmental assessment method—that slips off the tongue. It will be incorporated as standard, as independent third-party verification of sustainability performance in infrastructure.

The design of estate has a massive part to play in achieving net zero carbon targets, and carbon efficiency measures can have a positive effect on both patients and staff. For example, installing energy-efficient LED lighting in every hospital will produce average energy cost savings of up to £33 million and, importantly, improve the clinical environment for patients and staff. Adopting renewable energy solutions in the design of clinical facilities also contributes to cleaner air for our communities and better health outcomes.

Our building programme will take advantage of innovative design and innovative construction methods, and we are encouraging the NHS to take advantage of a range of modern construction approaches, including off-site manufacturing and standardisation, such as repeatable room design. Such methods can enable new and better buildings to be built quicker than otherwise would be possible. They can open their doors to patients sooner.

[Mrs Miller]

The Minister rightly talks about new and innovative methods to build buildings quicker, and that is very important, but my concern about getting these things finished is not about the building; it is about the approvals processes. Given the benefits that she so eloquently outlines in having the additional 40 new hospitals—benefits to patients, but also to the taxpayer—what space is there for the NHS to speed up the programme? It is clearly long overdue and to the benefit of all our constituents.

[Caroline Dinenage]

My right hon. Friend is absolutely right to raise that point, and I will come to it later in my speech. The key thing is to ensure that all the relevant stakeholders and partners are brought to the table very early so that everybody understands exactly what the plan is and has a feeling that they have bought into and invested in how that plan unfolds.

Earlier, I mentioned the importance of innovation, repeatable room design and standardised components, which very much lead to the flexibility that my right hon. Friend talked about. That means that the NHS can adapt to future advances in delivering modern patient care, and it delivers time, cost and efficiency benefits. For example, the Wrightington Hospital orthopaedic centre uses repeatable rooms, and that is already delivering benefits to patients and staff, but it also means that the rooms can be changed in future as modern innovation delivers changes. It is also critical that innovative building design integrates the benefits of technology and infrastructure to make full use of its transformative potential for service delivery and patient care.

As my right hon. Friend says, it is important to ensure that the designs are delivered fast. The schemes must be built in a way that works with the local community. The buildings must be easily accessible, sustainable and integrated with the local planning infrastructure, and scheme proposals and business cases developed in partnership and in alignment with sustainability and transformation plans, integrated care systems and clinical and estate strategies. They need written commissioner support, alongside evidence of engagement with local stakeholders and their support for the plans. We hope that will speed up delivery of the buildings.

I hope that goes some way towards reassuring my right hon. Friend that the Government are absolutely committed to maximising innovation in the high-quality hospitals that we are delivering. We are going to seize this once-in-a-generation opportunity, and we will work tirelessly to ensure that the people of this country are receiving the care they deserve in buildings that are modern, functional and beautiful. I thank her for securing this debate, because it has given me an opportunity to outline how we intend to do that, but I am sure she will continue to hold us to account when it comes to delivering on that commitment.

Question put and agreed to.

NHS Funding Bill

Maria Miller Excerpts

Legislative Grand Committee & 3rd reading: House of Commons & Legislative Grand Committee: House of Commons & Programme motion: House of Commons & 3rd reading & Programme motion
Tuesday 4th February 2020 Commons Chamber

[The Chairman]

I fully appreciate the point that the hon. Gentleman raises, and there may well be Barnett consequentials—[Hon. Members: “Ah!”] There may be further opportunities when further legislation about these matters comes before the House, but this particular Bill is a very narrow one, and therefore the ruling is quite clear. I appreciate what the hon. Gentleman says about protecting the Chair and rulings from the Chair. In this case, there is no grey area. Under Standing Order No. 83W, no matter who passes through the Division Lobby in these three Divisions before us—or however many Divisions there might be—only the votes of Members sitting for English constituencies will be counted.

[Mrs Maria Miller (Basingstoke) (Con)]

On a point of order, Dame Eleanor. I know that Mr Speaker has strict rules about the use of promotional material in the Chamber of the House of Commons, and I am sure that, quite unintentionally, some Members might be displaying material that perhaps would be inappropriate. Will you point out that there are strict rules on that, and that it should not be done in the way that it has been done?

[The Chairman]

I am grateful to the right hon. Lady. I must say to her and to the Committee that I was hoping that I would not see any promotional materials—[Interruption.] Oh no! I see one! I was hoping that such an occurrence would not happen right now. No promotional materials should ever be displayed in the Chamber. For the avoidance of doubt, I refer hon. Members to paragraph 21.29 of “Erskine May”—Mr Blackford, you will like this one—which states clearly that

“all Members should be sufficiently articulate to express what they want to say without diagrams”.

I will now proceed to amendment 3 to clause 1, which I have selected for a separate decision.

The Chair then put forthwith the Questions necessary for the disposal of the business to be concluded at that time (Standing Order No. 83D).

Amendment proposed: 3, in clause 1, page 1, line 18, at end insert—

“and that the sums set out in the table are not permitted to be augmented by or composed of any virements from NHS capital budgets.”—(Justin Madders.)

The amendment would stop the Secretary of State meeting the NHS England allotment for resource spending by using funds from NHS capital budgets.

The Committee proceeded to a Division.

Health Infrastructure Plan

Maria Miller Excerpts

Monday 30th September 2019 Commons Chamber

[Edward Argar]

The hon. Gentleman makes his point forcefully but courteously. I will take away what he said and I will write to him.

[Mrs Maria Miller (Basingstoke) (Con)]

May I welcome my hon. Friend’s announcement that the Government are backing Basingstoke’s plan for a new hospital to serve not just north Hampshire but across mid-Hampshire? It has the support of our local council and local residents. However, the 1970s buildings in which my incredible doctors and nurses and chief executive Alex Whitfield work are already creaking at the seams and are very expensive to maintain. What can my hon. Friend do to support the hospital’s bid and to ensure that a new hospital is in place as swiftly as possible, so that the money is not patching up the old but building the new?

[Edward Argar]

My right hon. Friend makes an important point. This money will be hugely important to doing exactly what she says: investing in our NHS buildings for the long term, so reducing the reliance on expensive capital repairs.

With this plan, we are also looking to deliver a step change in how we deal with capital in the NHS, which is also hugely important. Instead of stop-start investment, we are looking for a rolling programme of investment to make sure we get those facilities up to standard in order to reduce the day-to-day spend on repairs. I will happily talk to my right hon. Friend about what we can do to ensure that we go through due process as swiftly as possible so that her hospital trust can get on with it.

Learning Disabilities Mortality Review

Maria Miller Excerpts

Tuesday 8th May 2018 Commons Chamber

[Caroline Dinenage]

We are looking very carefully at the issue of sleep-ins, and are communicating with social care providers and others. It is important to recognise that we need to support not only the sector as a whole, but the many low-paid workers within it. We will present more proposals on sleep-ins shortly.

[Mrs Maria Miller (Basingstoke) (Con)]

The biggest challenge that many learning-disabled people have is simply making their voices heard. Their legal entitlement to advocacy is not always upheld by health professionals, who often misunderstand that entitlement. Will the Minister look into the commissioning of advocacy services, and, indeed, the understanding of the Equality Act 2010 among NHS staff, to ensure that more learning-disabled people have access to organisations such as Speakeasy Advocacy in Basingstoke, which supports more than 600 people with learning disabilities in north Hampshire, helping to give them the voice that they so badly need?

[Caroline Dinenage]

My right hon. Friend is a fantastic champion for equality issues in her role as Chair of the Women and Equalities Committee. I take on board everything that she has said, and I will certainly look more closely at the issue that she has raised.

Breast Cancer Screening

Maria Miller Excerpts

Wednesday 2nd May 2018 Commons Chamber

[Mr Hunt]

I do not know the answer to that question, but I will look into it. If we find that the uptake was lower than expected in that age group, it will be a very important clue about something that may have gone wrong, and I am sure that the review panel will want to examine it. The overall uptake rate is about 80%, but I agree with the hon. Gentleman that we should look into what the rates were in specific age cohorts.

[Mrs Maria Miller (Basingstoke) (Con)]

I thank the Secretary of State for his measured statement, and for all he is doing to ensure that the women affected are given the treatment and support that they need. I particularly welcome his independent review of the NHS screening programme. Will he also be looking at quality assurance programmes more widely within the NHS in relation to screening programmes? It is deeply worrying that the NHS did not identify this error for more than a decade, and there may be a need to review those programmes.

[Mr Hunt]

I am afraid that my right hon. Friend is absolutely right. The truth is that we do have a quality assurance programme, and it failed to pick up this problem for far too long. We need to understand why that happened. We think that a single IT mistake was made at the very start of the programme, and we understand that sometimes such mistakes are devilishly difficult to identify. None the less, as was suggested by the hon. Member for Stockton South (Dr Williams), there must have been clues that could have been picked up—or so one would think—and we need to get to the bottom of that.

Oral Answers to Questions

Maria Miller Excerpts

Tuesday 19th December 2017 Commons Chamber

[Mr Hunt]

I will absolutely consider the sensible recommendations of that report. People on both sides of the House, such as the hon. Gentleman, who were GPs before being elected do a fantastic job of flying the flag for general practice. We are making some progress. Some 3,157 medical school students have gone into general practice as a specialty—the most ever—but there is lots more work to do.

[Mrs Maria Miller (Basingstoke) (Con)]

I very much welcome the additional funding this Government have put into the NHS, but constituents tell me that they can better manage chronic conditions and illnesses if they have consistent care from general practitioners, which is something they find difficult to access in some surgeries in my constituency because of problems with recruitment and retention. What is the Secretary of State doing with his team to make sure we can lessen that problem in future?

[Mr Hunt]

I totally agree with my right hon. Friend. One of the best things about the NHS is that people have a GP who knows them and their family. There is a lot of evidence that that is the best way to manage people with long-term conditions, as she rightly says. The truth is that, for a very long time, successive Governments have not invested as much as they should in general practice. We are trying to put that right, and part of that is flying the flag for what an exciting career general practice is. It is the one part of medicine where doctors have an ongoing relationship with patients and their families over their whole lives, which is very motivating.

Adult Social Care Funding

Maria Miller Excerpts

Thursday 6th July 2017 Commons Chamber

[Steve Brine]

I cannot comment on that individual case, but if the hon. Lady writes to me about it I will be more than happy to look into it and meet her.

[Mrs Maria Miller (Basingstoke) (Con)]

I welcome the Care Quality Commission inspections of care homes in my constituency as it is helping to drive up standards and highlight problems, but many older residents tell me that they want to stay in their own homes for longer. What is the Minister doing to help make that happen?

Oral Answers to Questions

Maria Miller Excerpts

Tuesday 4th July 2017 Commons Chamber

[Mr Hunt]

Let me reassure the hon. Gentleman that there is no intention to restrict access to vital professions such as the clinical professions in the NHS post-Brexit. We have said many times that we will have a pragmatic immigration policy. The long-term solution is not to depend on being able to import doctors and nurses from anywhere, because the World Health Organisation says that there is a worldwide shortage of about 2 million clinical professionals; we are not the only people facing the challenge of an ageing population.

[Mrs Maria Miller (Basingstoke) (Con)]

I welcome the Secretary of State’s words and his deeds in terms of recruiting more doctors and nurses domestically, but as he said, hospitals such as mine in Basingstoke rely on the best and the brightest from around the world. What can he do to make sure that when we need to recruit nurses, in particular, we have the travel permits and work permits available to enable them to move in swiftly rather than having to wait for long periods of time?

[Mr Hunt]

My right hon. Friend is absolutely right to make that point. Nurses are, in fact, on the Home Office’s tier 2 shortage occupation list, and they will remain so for as long as we need them to do so. The bigger issue is that for a long time we have relied on being able to import as many doctors and nurses from the EU as we need to, and that has meant that we have not trained enough people ourselves. That is bad for EU countries and for our own young people.

Oral Answers to Questions

Maria Miller Excerpts

Tuesday 20th December 2016 Commons Chamber

[Mr Jeremy Hunt]

The hon. Lady is right to highlight this issue and I agree with her. I am not happy with the service that we provide through CAMHS at the moment. It is a big area of focus for the Government. We are putting a lot of investment in, but there is lots more to be done.

[Mrs Maria Miller (Basingstoke) (Con)]

My constituency has been waiting some time for the go-ahead for a new critical treatment hospital providing 24/7 care for the sickest patients, which is very much in line with Government policy. The hospital’s chief executive, Mary Edwards, retires this month after 21 years of exceptional service. Will the Secretary of State give her a retirement present and help me to secure a decision from NHS England?

[Mr Dunne]

I join my right hon. Friend in congratulating her chief executive on her commitment to the NHS. As I said in answer to a previous question about the STP for my right hon. Friend’s area, the issue is being reviewed at the moment by NHS England, and I am afraid that I am not in a position to give her any advance notice of the outcome.