Corby Urgent Care Centre

Philip Hollobone Excerpts

Wednesday 13th September 2017 Westminster Hall

[Mr Philip Hollobone (Kettering) (Con)]

I congratulate my hon. Friend on securing this debate and on his tireless efforts, not only in this House but locally in Corby, to fight this cause. It is a hugely popular facility. My constituents in Kettering know that without the Corby urgent care centre, the pressure on Kettering General Hospital would be even greater. The Minister knows how busy Kettering General Hospital is because he had the good heart to visit it recently. I am 100% behind my hon. Friend in his campaign.

[Tom Pursglove]

I am very grateful to my hon. Friend, who has been unstinting in his support for the Corby urgent care centre and the local campaign. He recognises, quite rightly, the pressures that the facility relieves Kettering General Hospital of. Kettering General Hospital is obviously a very important facility in our community. I will touch on those pressures a little bit later, but I very much appreciate his support for what we are doing.

I have talked about the short-term situation. In the longer term, the CCG appears to be committed to much more thorough consultation, first with a pre-consultation, and followed by a thorough consultation on options, which I understand would run between November and January. I welcome that, but I am clear that corners must not be cut in that process. The whole community must be engaged. It is not enough to engage with a group of 700 people in a patient participation group; that is just not good enough.

Worcestershire Acute Hospitals NHS Trust

Philip Hollobone Excerpts

Tuesday 11th July 2017 Westminster Hall

[Rachel Maclean]

My hon. Friend touches on the key point of recruitment, which my colleagues and I, and himself, have raised with the new trust leadership. The trust has brought forward some interesting and exciting measures to address that, such as a new Facebook recruitment video. We look forward to seeing how that progresses and delivers more staff into this much-needed trust.

I am extremely grateful for the Minister’s interest in this matter and for being granted the time to discuss it. I am especially grateful for the commitment shown during the general election campaign by his colleague the Minister of State, who visited me in Redditch. I call on him to lay to rest the pernicious rumour circulating in Redditch that our hospital is at risk of further downgrades or even closure. I am aware, as are some of my constituents, of the Naylor report, which contains in its numerous pages—they are too numerous to mention—proposals for selling unused NHS land to build affordable housing for NHS workers. That seems to me to be an eminently sensible suggestion, given the shortage of affordable housing in our country and the need for affordable homes for our public sector workers.

Some of my constituents have found suggestions in the report’s pages—suggestions that I have not personally been able to find, despite assiduous reading over a number of hours, which I can confirm is a great insomnia cure, should the Minister be interested—that the Alex Hospital might be sold off for building land. I would be grateful for his confirmation that no suggestion is hidden in the small print of the report or elsewhere in any Government document that the Alex Hospital faces that fate.

As the Minister has been so generous in attending this debate, I would like him to go further by guaranteeing my constituents that Redditch will have a hospital that serves its population and is fit for the size of the town both now and in the future. Thank you, Mr Hollobone, for allowing me time to make my points. I look forward to hearing from the Minister.

[Mr Philip Hollobone (in the Chair)]

It was a pleasure, and I congratulate the hon. Lady on her address. I call the Minister.

Kettering General Hospital

Philip Hollobone Excerpts

Thursday 29th June 2017 Commons Chamber

[Mr Philip Hollobone (Kettering) (Con)]

I am very grateful to you, Mr Speaker, for giving me permission to hold this important debate on the Floor of the House, because Kettering general hospital is perhaps the No. 1 issue for local people in Kettering.

This year, Kettering general hospital celebrates its 120th anniversary. It is one of the few hospitals that has been on the same site for 120 years. It is a much-loved local hospital. Thousands of local people have been born there, repaired there and, sadly, died there. Everyone has a special place in their heart for the hospital.

Some serious issues, however, need to be addressed. I welcome the Minister of State to his place to hear those concerns and respond. I am very grateful to him for making a personal visit to the hospital in April to meet the staff, including doctors and nurses, and also to my hon. Friends the Members for Wellingborough (Mr Bone) and for Corby (Tom Pursglove), whom I also welcome to their places in the Chamber. The Minister’s personal attention to Kettering general hospital is noted and much appreciated.

I thank all the staff at the hospital—the nurses, the doctors, the ancillary staff, the managers and the directors—for the wonderful work that they do. It is a massive team effort, with almost 4,000 people working on the site. There are just short of 600 beds in the hospital, and tens of thousands of patients go through the doors every year. Indeed, that is one of the issues that I want to remind the Minister about. Kettering general hospital is located in one of the fastest-growing parts of the country. In the last census, Kettering was sixth out of 348 districts for growth in the number of households and 31st for population increase. Just down the road, I believe Corby has the highest birth rate in the whole country. Thousands of houses are being built each year in Kettering, Corby and Wellingborough, in east Northamptonshire and over the border in Market Harborough, which means that there is growing pressure on the hospital.

The local population is not only growing in size but ageing rapidly. It is wonderful that we are all living longer, but the number of people over 75 in Northamptonshire is likely to go up by 33% in the next five years from 54,000 to 72,000. People over 75 bring with them a wealth of experience, but I think most of them would admit that they are not as young and fit as they used to be, and they require increasingly detailed medical interventions, often for multiple issues rather than just one. That is a real challenge for the hospital to get to grips with.

In the past 10 years, the number of in-patient consultant episodes in the hospital has gone up by 27%. Attendances at the accident and emergency department have gone up by 23% in the past five years, and some 83,000 people a year are now coming through the A&E, which was built 20 years ago to cope with an influx of 40,000 people a year—less than half the number who currently visit. Out-patient attendances at the hospital have risen by almost two thirds in the past 10 years.

Local people increasingly say to all three hon. Members from the area, “We love our local hospital, but what new investment and new facilities are being provided so that it can cope with the growth in the local population?” I ask the Minister that question directly this evening on behalf of those residents.

Our clinical commissioning group is still one of the most underfunded in the country. This year it crept up to 5% below the target funding. It has been worse in the past, but it is still pretty bad. Will the Minister urge those responsible to ensure that health funding is prioritised in areas of rapid population growth such as north Northamptonshire? Without that, we simply will not be able to cope.

The car parking situation at Kettering general hospital is critical, as the Minister experienced at first hand when he was caught in the traffic jam outside the hospital on his visit. It is good news that there will be 240 new spaces in the car park by the end of this November, and although that problem is difficult to fix, it is relatively straightforward compared with meeting the medical needs of the growing local population.

I must stress that, as the Minister will know, the hospital is now in special measures, which is not a happy situation. It is the result of a Care Quality Commission inspection in October, after which the CQC gave the hospital an “inadequate” rating in November, triggering the special measures. There have been a series of unannounced and focused inspections since—I think the last one was yesterday—and we await further news on when the CQC anticipates the hospital might come out of special measures. I welcome the special measures provisions provided by the Department. It is absolutely right to make sure that a hospital in some difficulty receives special attention. If that requires it being labelled “special measures” then so be it, but we must provide the help and assistance that such hospitals need.

It is not all bad news at Kettering general hospital. We must remember that it is treating a record number of local people with increasingly world-class treatments. It is hitting all its cancer targets. Its infection control, having some years ago been the very worst in the country, is now extremely good. The A&E target, which has been among the bottom 10 in the country, is now rapidly improving. I hope that figures to be announced soon will show that it is in the top third of type A A&Es.

My hon. Friends the Members for Wellingborough and for Corby would agree with me that one of the key priorities at the hospital is the provision of an urgent care hub. This is a fairly simple concept that requires funding of £20 million to £30 million. The idea is this: to have on one site, at Kettering general hospital, a one-stop shop for GP services and out-of-hours care, an on-site pharmacy, a minor injuries unit, facilities for social services and mental health care, access to community care services for the frail elderly, and a replacement for the A&E department, which, as I have said, is now more than 20 years old. Those services in a one-stop shop urgent care hub on site would enable the rapid assessment, diagnosis and treatment by appropriate health and social care professionals. Patients would be streamed into appropriate treatment areas to minimise delays and reduce the need for admissions. This is an example of best practice across the NHS and it is what we would like to see introduced at Kettering to relieve pressure on clinicians in the A&E department.

--- Later in debate ---

[Mr Peter Bone (Wellingborough) (Con)]

Will my hon. Friend give way?

[Mr Hollobone]

Well, it is very difficult for me to choose, but since our younger and fitter colleague was faster on his feet I am going to give way first to my hon. Friend the Member for Corby (Tom Pursglove).

[Tom Pursglove]

I am very grateful to my hon. Friend for giving way. I entirely share his sentiment about the importance of developing a new urgent care hub at Kettering. Would he be keen to visit the Corby urgent care centre with me and, I hope, my hon. Friend the Member for Wellingborough (Mr Bone)? Given that this is a first-class facility, clear lessons could be learned and taken forward when we move towards trying to develop the new urgent care hub. It is a class-leading facility that is hugely popular with local people. I would love him to come and visit it with me.

[Mr Hollobone]

I am very grateful for that most kind invitation. I have visited the urgent care centre and I would be happy to do so again. I offer my hon. Friend my 100% support as he advances the importance of the urgent care centre with local funding bodies. He knows that he can always rely on me to support him in his endeavours. I am happy to give way to my hon. Friend the Member for Wellingborough (Mr Bone).

[Mr Bone]

I am very grateful to my hon. Friend for giving way to the older and more experienced Member from Northamptonshire. I congratulate him enormously on securing the debate and on how he is speaking so powerfully for Kettering hospital. The one bit of the triangle that is not there is an urgent care centre or minor injuries unit at the Isebrook hospital in Wellingborough. That is part of the plan approved by several Ministers from the Department of Health. I have great trouble getting commissioners to engage with that, but we need it to relieve pressure on the A&E at Kettering.

[Mr Hollobone]

As so often in this place, my hon. Friend speaks words of great wisdom and insight. He represents his constituents extremely well in repeating that point. The current draft sustainability and transformation plan for Northamptonshire is simply not good enough, because it does not place enough emphasis on developing the facilities my hon. Friend is speaking about. Effectively treating people nearer to where they live so they do not have to come into Kettering general hospital makes sense. It would be better for the patients, it would mean that they received more appropriate treatment closer to home, it would be more cost-effective and it would relieve pressure on Kettering general hospital. I therefore urge the Minister, with the contacts he has with NHS England, to pay close attention to the development of the STP in Northamptonshire, which is not good enough yet. It needs to place more emphasis on primary care, urgent care centres and local facilities, as my hon. Friends the Members for Corby and for Wellingborough have both mentioned.

The A&E department at Kettering general hospital is under huge pressure, the bulk of which comes from the lack of bed space. Ninety-eight per cent. of people who present at Kettering A&E with minor injuries are seen within the target, while 96% of those who are not admitted to the hospital are seen within the four-hour target. However, somewhere between only 60% and 90% of those who require admission to the hospital are hitting the target. The problem is the number of beds occupied by people whose treatment has been completed but who have not yet been moved to rehabilitative or local social care.

There have been problems with that in Northamptonshire, which I have raised before on the Floor of the House. However, I am pleased to say that I understand that closer co-operation between the hospital and the local county council is likely to mean that the better care funds allocated by the Government will be used more effectively, so that people can be moved more quickly out of the hospital and into more appropriate care in their local communities. This is an urgent priority, but I understand that we are about to see some rapid improvement.

Having said that, even if Kettering general hospital does everything right, I have to tell the Minister that I am being told that it has a structural deficit of £10 million a year. That means that even if it does everything right and meets all the targets that the Government set, the way in which the health service is structured in Northamptonshire means that it can do no better every year than to have a deficit of £10 million. In 2015-16 the deficit was £11 million and in 2016-17 it was £25 million. This year it is likely to be £20 million, so things have clearly not worked as they should have, but I have to tell the Minister directly that even if everything worked right, there would be a structural deficit of £10 million, which is clearly not sustainable. That needs to be looked at.

There has recently been a problem with referral to treatment targets. In the past, waiting list data have not been recorded correctly at the hospital. Everyone is agreed about that, and I am pleased that the Care Quality Commission is investigating and has referred the matter to NHS Protect. I think everyone agrees that the data are now being collected correctly, but historically they have been inaccurate, and patients may have been harmed as a result. I therefore ask the Minister directly whether he is satisfied that the issue is being investigated appropriately and that the investigation will be concluded as speedily as possible, so that local people can get to the bottom of what has been a historical problem.

Kettering general hospital is perhaps the most important facility to local people in Kettering. I know that it is important to my hon. Friends the Members for Wellingborough and for Corby as well, and we will not let any opportunity go by in this place without reminding Her Majesty’s Government how important the hospital is to local people. All is not well with the hospital, and these things can be put right. There has been a problem of the chief executive changing too often. We have lost some good people and replacements have not stayed for too long. The Minister has met Fiona Wise, the acting interim chief executive, but she will not be there for too much longer, because a more permanent replacement is being sought. There have also been leadership issues at the hospital in the past, which we need to tackle. The chairman, Graham Foster, is doing his level best—I commend him for his efforts—and there is tremendous team spirit at the hospital. It got extremely good marks in the CQC inspection for the quality of the care that all staff provide to local patients.

All is not well, however, and we need the Minister’s continuing attention to ensure that we can address the issues involved. In particular, will he urge NHS Improvement to prioritise its analysis of the urgent care hub proposals? I understand that NHSI, which used to be called Monitor, has now approved the funding for the preparation of the business case for the hub. That is likely to be submitted to NHSI in September, and I hope that it will be at the top of its in-tray so that we can get a move on with a project that everyone—the Government, the hospital, the patients and the CCG—agrees is the key development that needs to take place if we are to continue the distinguished history of a hospital that has been going for 120 years.

Oral Answers to Questions

Philip Hollobone Excerpts

Tuesday 21st March 2017 Commons Chamber

[David Mowat]

The hon. Lady is right. There have been issues with the Capita contract, and we have been let down by Capita. We are working hard to get that sorted, and my colleague the Under-Secretary of State for Health, my hon. Friend the Member for Oxford West and Abingdon (Nicola Blackwood), meets Capita weekly to get this fixed. We are making progress, and we believe that the issues that the hon. Lady refers to will be fixed in the foreseeable future.

[Mr Philip Hollobone (Kettering) (Con)]

There is a shortage of GPs across Northamptonshire, especially in Kettering, and the age profile of local GPs means that a very large number are about to reach retirement, which will make the problem worse. What can be done to encourage experienced GPs to stay on longer and to encourage those who have retired to come back?

[David Mowat]

My hon. Friend is absolutely right that one of the things we need to achieve is either to encourage older GPs to work part time or to make it easier for them to step down into more of a mentoring role. With the Royal College of General Practitioners, we have brought forward a scheme called GP Career Plus, which enables GPs in 10 pilot areas—the pilots are being rolled out now—to work as mentors across practice areas, and not to feel as though they have to retire, as GPs too frequently do at the moment.

Primary Care: North Essex

Philip Hollobone Excerpts

Tuesday 14th March 2017 Westminster Hall

[Mr Philip Hollobone in the Chair]

[Mr Philip Hollobone (in the Chair)]

Order. Would those who are not staying for the debate please leave quickly and quietly? Television sets are being switched on all over Essex to hear the hon. Member for Clacton (Mr Carswell) move the motion and start his debate. I call Mr Douglas Carswell.

O’Neill Review

Philip Hollobone Excerpts

Tuesday 7th March 2017 Westminster Hall

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Hollobone. I congratulate the hon. Member for Thirsk and Malton (Kevin Hollinrake) on bringing this important debate to the House. He gave an eloquent and knowledgeable speech clearly setting out the issue and the matters to be discussed following the O’Neill review. I thank him for that.

An estimated 50,000 deaths occur every year due to untreatable infections, rising to 700,000 globally. That is why it is only right that we do all we can to address antibiotic resistance. It is believed that the number of deaths will rise to 10 million a year by 2050 if no significant action is taken. As we have heard from a number of Members, deaths from drug-resistant infections could exceed deaths from cancer.

This is an incredibly timely debate. Only a couple of weeks ago, the World Health Organisation published a list of 12 bacteria for which new antibiotics are now needed. Some strains of bacteria have built-in abilities to find new ways to fight off treatments that can then be passed on to other bacteria via genetic material to make them drug-resistant too. I find it a bit scary to consider what we are up against. This is a battle that we have to win.

I also thank other hon. Members who have spoken in this debate. My hon. Friend the Member for Bristol East (Kerry McCarthy) gave a very knowledgeable speech about the use of antibiotics in farming; other hon. Members touched on the subject as well. I really think we need to get a firm grip on it internationally, with the UK leading the way. Ten other Members spoke in this very active debate: my right hon. Friend the Member for Rother Valley (Sir Kevin Barron), my hon. Friend the Member for Ealing, Southall (Mr Sharma), the hon. Members for Erewash (Maggie Throup), for Bosworth (David Tredinnick), for Glasgow North (Patrick Grady), for Sleaford and North Hykeham (Dr Johnson), for Mole Valley (Sir Paul Beresford), for Strangford (Jim Shannon) and for Stafford (Jeremy Lefroy), and the hon. Member for Linlithgow and East Falkirk (Martyn Day), who speaks for the Scottish National party. Their speeches were all thoughtful and knowledgeable, albeit brief because of time constraints.

I will touch on two key points: raising public awareness, and supporting research and innovation to combat antibiotic resistance. It is generally accepted that antibiotic resistance is a natural process—bacteria naturally evolve to become resistant to certain drugs used to fight them off—but it has been exacerbated by humans. As Dr Hsu of the Singapore Infectious Diseases Initiative has said, the causes come down to

“a single axiom—abuse and overuse of antimicrobial drugs.”

Concerns have also been raised that the development of new antibiotic drugs has dried up, contributing to the situation. According to the World Health Organisation, we are left in a precarious position. The WHO’s director general, Dr Margaret Chan, describes antimicrobial resistance as

“a crisis that must be managed with the utmost urgency.”

That urgency applies here in the UK, too. In 2014, the chief medical officer, Dame Sally Davies, said that

“we could be taken back to a 19th century environment where everyday infections kill us as a result of routine operations.”

We could be taken even further back: as the hon. Member for Thirsk and Malton said, this could be the new black death. That is not as melodramatic a statement as people may first think. Antimicrobial resistance is a really serious problem that we need to address here and now, so that those predictions do not come true.

I do not always do this, as I am sure you have noticed, Mr Hollobone, but I must give credit to David Cameron’s coalition Government, who were global leaders when they announced Lord O’Neill’s review into antimicrobial resistance. The review’s 10 recommendations show just how complex and multifaceted the issue is and how wide-scale the actions needed to address it are. The review’s final report was published in May 2016 and the Government responded at the end of last year, so now is a good time to ask the Government for an update.

One of the review’s key recommendations was to introduce a large-scale global awareness campaign to reduce the demand from patients to be prescribed antibiotics when they are diagnosed with an illness. I am a firm believer in public awareness campaigns relating to health issues, especially cancer. My hon. Friends and I fully support such a campaign for antimicrobial resistance and we want to see the Government working hard to achieve it. The review’s recommendation was for an international awareness campaign, but what does the Minister plan to do here in the UK to complement that international work? That is a pertinent question because a 2015 Wellcome Trust study found that people in the UK did not fully understand antibiotic resistance and how it affects their health. They did not understand that antibiotic resistance is to do with the bacteria in people’s bodies, rather than a lack of antibiotics or the cost of them; it is not just a case of doctors being awkward. I would therefore be grateful if the Minister told us what relatable public awareness campaigns she is planning to ensure that people understand more about the problem and about what they can do personally.

I have already mentioned the problems with combating antibiotic resistance caused by the drying up of innovative developments in drug technologies. The O’Neill review identifies that the low commercial return on research and development for antibiotics makes them less attractive to pharmaceutical companies and reduces the chance of new drugs being developed. To reverse that situation, it recommends considering market entry rewards to encourage companies to develop new or improved drugs, especially in areas of urgent need. I hope the Minister will explore that issue further in her reply.

Public and private funding is being made available to help to combat these issues. On 20 December, the Minister referred to

“international programmes to tackle AMR, including the Fleming fund and the Global AMR innovation fund, which represent more than £300 million of investment over the next five years.”—[Official Report, 20 December 2016; Vol. 618, c. 1294.]

There is also the incredible work of the Longitude Prize, which is in the middle of its competition to develop

“a cheap, accurate, rapid and easy-to-use point of care test kit for bacterial infections”

to help to address antibiotic resistance. That is important work and we support it.

In summary, we cannot afford to get antimicrobial resistance wrong. Millions of lives depend on our tackling it. It is not far away; it is happening right here, right now, and it affects us all, so it is important that we do all we can to address this growing problem, both in the UK and internationally.

[Mr Philip Hollobone (in the Chair)]

If the Minister will be kind enough to finish just after 4.30 pm, that will give Mr Hollinrake time to sum up the debate.

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[Nicola Blackwood]

I will close now but follow up later.

I thank all Members who have attended today. The high turnout and the quality of debate speaks to the fact that AMR is more than a domestic health challenge and more than a global development challenge. It is truly a global security challenge, of a scale that requires long-term political leadership to drive through the international change, the up-front investment to break the cycle of market failure in drugs development and the urgent action needed to improve diagnostics and cut inappropriate prescribing, and to ensure that patients complete their courses of medicines in an appropriate way.

We can be proud of the genuinely leading role that the UK has already taken, both domestically and on the international stage, but my commitment to all Members here today is that we shall not miss a step in driving forward on research and development, on stewardship and on international co-operation. As a science superpower with an integrated healthcare system, we are uniquely well placed to meet this challenge and we are determined to do so.

[Mr Philip Hollobone (in the Chair)]

Before I ask Kevin Hollinrake to sum up, I detect that there may be some Members in the Chamber who are here for the debate on social care in Liverpool. We have a half-hour debate on student loans before we get to that debate; everything has been held up by the Divisions in the main Chamber. I am just trying to be helpful to Members who might here for another debate.

Social Care (Liverpool)

Philip Hollobone Excerpts

Tuesday 7th March 2017 Westminster Hall

[Mr Philip Hollobone (in the Chair)]

Would those who are not staying for the next debate please be kind enough to leave quickly and quietly? I see we have some of Liverpool’s finest in the Chamber.

[Mrs Louise Ellman (Liverpool, Riverside) (Lab/Co-op)]

I beg to move,

That this House has considered social care in Liverpool.

It is a great pleasure to serve under your chairmanship, Mr Hollobone. This is the third occasion on which I have raised the issue of adult social care in Liverpool in this place over the past two months. That is because major cuts in Government funding combined with rising needs are creating a situation where too many people are left feeling vulnerable in their own homes. Scarce hospital beds are occupied by people who are clinically fit to be discharged but cannot leave the hospital because social care is not available. That is bad for those individuals and for the national health service.

I realise that this is a national issue, but the debate puts the focus on the specific challenges that Liverpool and the Liverpool city region face. Mayor Anderson and Liverpool City Council have done their very best to protect the people of Liverpool from the impact of unprecedented Government cuts, but adult social care has not escaped the consequences of the Government’s actions over a long period.

Adult social care covers a wide range of services, including domiciliary support—helping to dress, feed and bathe people in their own homes and, where appropriate, ensure that the correct medication is taken. Depending on the individual situation, that could involve several visits a day to an individual’s home. In other cases, it might require one visit a day, but whether it is one visit or several, it is absolutely essential to allow that individual to lead an independent life. The provision of adequate adult social care enables many people to remain safely and confidently in their own homes, rather than feeling vulnerable or having to move to more expensive and much less satisfactory residential care. Adequate adult social care can bring peace of mind and provide a lifeline.

Let us look at what has been happening to Liverpool City Council’s funding. Liverpool has now lost 60% of revenue support from the Government since 2010, and by 2020 that figure will have risen to 68%. Furthermore, having looked at revenue support systems, the Government plan to eliminate revenue support entirely under a new funding settlement. That will have serious consequences for a city with a low tax base and with 80% of its population in council tax bands A and B.

Liverpool council is a very responsible authority and has already identified £90 million of additional cuts that it is required to make in the coming financial year. The council continues to do its best to protect services, but it has not been able to stop substantial cuts to its spending on adult social care, which has been reduced from £220 million in 2010 to £154 million in 2016. It is anticipated that that figure will be reduced to £130 million by 2020.

Yes, the Government have their better care fund and yes, the local authority has a limited ability to raise an extra precept. The better care programme is expected to allocate £39 million to Liverpool when its funding is due to be reduced in such a significant way, but that will still leave a massive gap. Neither the Government’s better care fund nor the council’s ability to raise extra tax can fill the gap caused by the withdrawal of central Government funding. The scale of that withdrawal is unprecedented.

At the same time as the Government are reducing support, demographic pressures and costs are increasing. The Office for National Statistics estimates that the percentage of people in Liverpool aged 65 years or more will rise from 14.6% in 2015 to 16.1% in 2024. It is wholly unrealistic to expect people in the fourth most deprived local authority in the country to fill the gap. The sums simply do not add up. To illustrate the situation, a 1% increase in council tax in Liverpool will raise £1.4 million; a 1% cut in central Government funding means a loss of £3 million. That is a totally unacceptable situation and one that cannot continue without inflicting severe cuts on services that are very important to the people of Liverpool.

I said that Liverpool was the fourth most deprived local authority in the country, which is correct, and there is great poverty in the city, but Liverpool City Council, through its pioneering spirit, its enterprising approach and its ability and willingness to innovate and work with others has been able to move Liverpool from being the most deprived local authority in the country to that No. 4 position. It is bad to be the fourth most deprived authority, but it is a tribute to the city council and its partners that they have been able to make progress in Liverpool. Furthermore, that progress has been made without proper funding from Government—indeed, Government funding has reduced, and that is the critical feature.

Social care packages in Liverpool have already been cut from £14,000 to £9,000, which has affected many vulnerable people, and many more are anxious. Many people in great need are being reassessed to see whether the care they receive can be maintained, which often induces great anxiety and apprehension, even if ultimately their care remains similar to what it was. That, too, is an important factor that is not always considered.

On the day that I visited the Royal Liverpool university hospital, 135 patients who were clinically fit to be discharged remained in their beds because social care was not available for them at home. That was in spite of the efforts of hospital and local authority staff to find suitable care packages for them—the money was simply not there. That figure, the accurate one for the day I visited the hospital, reflects the general situation and shows one of the problems caused by the cuts to social care in Liverpool. Those cuts have arisen solely because of cuts in Government funding.

The situation affects many people, and it can only deteriorate unless action is taken. What should be done? Let us look at what is happening now. Mayor Joe Anderson, cabinet member Paul Brant and Liverpool City Council as a whole must be commended for their work to promote partnership with the NHS and innovation, which involves new work with the clinical commissioning group and GPs to integrate health and social care. “Step Up” centres for intermediate care are being pioneered and the council plans to promote innovatory joint work with community health services. A joint working party is considering new ideas.

All those things are extremely important and demonstrate the city council’s willingness to innovate and work with other partners. Such work should be supported better by central Government. Whatever innovation takes place in Liverpool and however much the council is willing to work with other people and for integration, Ministers cannot escape the fact that more funding is needed. The issue is long term, but the crisis is now and immediate action is required. It is a crisis that Liverpool City Council cannot resolve on its own, nor can the people of the city fill the financial gap unaided.

I call on the Government to recognise their responsibilities and to announce an immediate allocation of targeted funding for adult social care in Liverpool. I recognise that that must be part of a national approach, but funds must be targeted to meet the needs of local communities. That will enable vulnerable people to live independently and safely in their own homes, as well as enabling the NHS to deploy its resources efficiently. Liverpool City Council should be congratulated on the resilience, innovation and flexibility that it has displayed, but it cannot resolve the crisis alone. I call on the Minister to act as a matter of urgency.

[Mr Philip Hollobone (in the Chair)]

I am required to call the Front Benchers at 5.40 pm and the debate may run until 6.03 pm. That gives us 32.5 minutes of Back-Bench time and three Members have given me their names, the first of whom—who wrote a very nice letter—is Maria Eagle.

--- Later in debate ---

[Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)]

It is a pleasure to serve under your chairmanship, Mr Hollobone. I apologise for being a moment late in coming over from the Select Committee on Health. I congratulate my hon. Friend the Member for Liverpool, Riverside (Mrs Ellman) on securing this important and timely debate on behalf of all our constituents.

[Mr Philip Hollobone (in the Chair)]

Order. If the hon. Lady would like to sit, she is most welcome to do so.

[Luciana Berger]

That is kind, but I am fine. Thank you so much.

This is a pertinent and serious issue that affects thousands of people across the area that my hon. Friends and I are privileged to represent. I also endorse the comments made by my hon. Friend the Member for Garston and Halewood (Maria Eagle). I will seek not to reiterate but to add to the comments that have already been made. I will raise some of the additional pressures that Liverpool has faced in the nearly seven years since the cuts were first introduced in 2010 and add some personal reflections from constituents who are experiencing those cuts at first hand. We are ultimately here on behalf of our constituents, and we should share their experiences with the House so that we understand the tragic human element and implications of the cuts. I will also reflect on my own experience of being in an accident and emergency department in Liverpool on a Friday night just a couple of weeks ago and seeing the number of ambulances waiting there. At least 10 paramedics were waiting to book people in, many of whom were older people. We know from the figures that delayed discharge is a significant challenge, and I believe that issues in accident and emergency departments are compounded by cuts to social care.

As we heard from my hon. Friends the Members for Liverpool, Riverside and for Garston and Halewood, 5,000 fewer people in Liverpool are receiving support via care packages than in 2010. I have connected with two constituents about that issue in the past week alone. One, a lady called Sobia, is paralysed. She used to receive overnight care, but despite her condition becoming worse and even though her children are now of an age when they are going to university and are not as available to care for her as they were previously, she has seen that care stopped because of the cuts to social care in Liverpool.

In the past few weeks I have intervened on behalf of one of my constituents called Veronica, who had additional support to help her with various things. She is still waiting for some of that care to be reinstated. I have every sympathy with Liverpool City Council for the difficult decisions it is having to make in the current circumstances; the council is under significant pressures, as we have heard. Those pressures do not look set to get any easier. In particular, in the Liverpool city area we have demographic pressures—as many places do across the country—with the growing, ageing population. We know that the 65-plus age group is set to grow by 50% in the next 20 years. That is a significant challenge for any area to contend with, particularly given the cuts that have been incurred so far.

Liverpool City Council faces financial pressures as a result of the introduction of the national living wage. It is to cost £13.9 million in 2017-18, rising to £24.7 million by 2019-20, which is not an insignificant sum for the council to contend with. The Law Commission is also reviewing a specific piece of legislation, and I hope that changes will come forward soon to help Liverpool City Council cope with the 400% increase in deprivation of liberty safeguards applications, which cost £1 million a year. We know that that needs some attention, and I hope that changes to the legislation will have some impact, because that is £1 million of the significantly larger sum that the council has to contend with.

The demand pressures we see locally are also significant. We know that every week Liverpool City Council is arranging care packages for up to 100 people leaving hospital, which is a 51% increase compared with last year. There are also a lot more complex home care cases, which cost a significant sum and may require two carers calling four times a day. We know that adult social care assessment requests have risen by 15% since 2010, up from 18,000 a year to 21,000, and are expected to rise to nearly 23,000 by next year. There were also 5,715 requests for support from new clients, which was a 10% increase on the previous year.

We as constituency MPs, on behalf of our constituents, are contending with the challenges today. I have shared just a few of the additional challenges—financial pressures, demand pressures and demographic pressures—that mean that Liverpool City Council faces even more challenges as the years progress. It is on that basis that I endorse the comments made by my hon. Friends. We need the Government to give serious attention to this matter.

Social care cannot be dealt with separately from our wider health service. The two go hand in hand. It is no surprise that more people are turning up to our accident and emergency departments or our GP surgeries when 5,000 fewer people get care packages today than did in 2010, given that we know need has increased. The Chancellor will give the Budget tomorrow, and I look forward to hearing in the Minister’s response what representations he and his Department have made to ensure that social care is given the attention and resource that it desperately needs and deserves on behalf of the thousands of constituents who do not receive care but deserve it and the thousands more elderly people who will need it in the future.

I have not reflected specifically on constituents who might need mental health support but are not getting what they need and deserve today and going into tomorrow. This situation cannot be allowed to continue. We see and experience in our surgeries and weekly visits constituents who have to contend with the daily realities of not getting the support they need and deserve. We anticipated something in the autumn statement but there was nothing. On behalf of all our constituents, I sincerely hope that the Minister will give us some glimmer of hope that tomorrow there will be something that positively impacts on all of our constituents’ lives.

--- Later in debate ---

[Barbara Keeley (Worsley and Eccles South) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Hollobone. I congratulate my hon. Friend the Member for Liverpool, Riverside (Mrs Ellman) on securing the debate and on the excellent way in which she opened it. We have heard about the real pressures on social care in Liverpool from my right hon. Friend the Member for Knowsley (Mr Howarth) and my hon. Friends the Members for Garston and Halewood (Maria Eagle), for Liverpool, Wavertree (Luciana Berger) and for Liverpool, Walton (Steve Rotheram). We have heard about the 5,000 people who have lost care packages, about cancelled surgeries and about patients stuck in hospital.

To be clear, the funding crisis in social care is, in my view, one of the Government’s own making. The Chancellor failed to recognise the crisis and provided no extra social care funding from central Government at the autumn statement. Indeed, Ministers continued what they had already started in shifting the burden on to councils and council tax payers through increases in the social care precept. I will say more about that, but we have heard very well in the debate how that is not a sustainable solution.

As my hon. Friend the Member for Liverpool, Riverside said, Liverpool still has to make a further £19 million of cuts by 2020, taking the cuts to its Government funding to a staggering £420 million—the equivalent of a 68% reduction since 2010. The cuts to grants and the increased reliance on council tax have hit cities such as Liverpool very hard; we have heard about some of the impacts. As my hon. Friend the Member for Liverpool, Walton said, a serious weakness of using council tax to fund social care is that both demand for social care and the relative value of the council tax base vary so much across the country.

[Mr Philip Hollobone (in the Chair)]

Order. I am sorry to interrupt the hon. Lady when she is in full flow, but there is a Division in the House. We will come back in 15 minutes and carry on where we left off.

--- Later in debate ---

On resuming—

[Mr Philip Hollobone (in the Chair)]

Welcome back. The revised finish time is now 6.18 pm.

[Barbara Keeley]

As I said, a weakness of using council tax to fund social care is that both the demand for social care and the relative value of the council tax base vary across the country. Census data show that in Surrey 40% of over-65s have a long-term condition that limits their day-to-day activity, but in Liverpool that figure is much higher, at 62%, and there is a strong link between long-term conditions that limit day-to-day activity and care needs. A 1% increase in council tax would raise £6.2 million in Surrey, whereas an equivalent rise for the same size population in Liverpool would raise only about half that sum—£3.4 million. Therein lies the problem.

As we heard in the debate, this year the 2% social care precept raised £2.8 million in Liverpool. That is not enough to cover the £9 million that Liverpool reports is needed in the care sector just for increases in the national living wage. Liverpool’s Mayor did some months ago suggest a 10% council tax increase to pay for social care, which would have needed a referendum. That proposal was similar to the one for a 15% increase from Surrey County Council. As we know, Surrey appears to have got a sweetheart deal from the Government when it suggested that increase in council tax, so I would like the Minister, when he responds, to tell us where Liverpool’s deal is.

As we heard, last month Liverpool’s director of adult social care resigned, stating that councils are in danger of failing to meet their statutory requirements. He said:

“People are struggling, people are suffering, and we’re really only seeing the tip of the iceberg.”

Only those with the highest needs are getting help. I worry that financial pressures in social care are now leading to failures and serious reductions in the quality of care that people receive. That was underlined by the Care Quality Commission bringing prosecutions against the owners of Mossley Manor, in the constituency of my hon. Friend the Member for Liverpool, Riverside. The neglect and poor care of residents at that care home was shocking. The CQC said that there was

“a continued and serious risk”

to the lives, health and wellbeing of residents. It is welcome that the owners have been prosecuted by the CQC, but I am worried that failures such as that are now a symptom of a wider problem.

The number of care home providers forced to cease operations because of deregistration has increased from 34 two years ago to 54 this year. A recent BBC “File on 4” programme reported that 23,000 allegations of abuse had been made against care staff working in people’s homes. In the programme, the new local government ombudsman, Michael King, said that there is a growing problem with standards of home care. The CQC says that more than one quarter of care homes require improvement or are inadequate, and that figure rises to 41% for nursing homes. The King’s Fund has said that adult social care is rapidly becoming a “threadbare safety net” for the poorest and most needy older and disabled people.

Falls in the quality or availability of social care are clearly having a knock-on effect on the NHS. We heard, rightly, about examples of that from Liverpool. My hon. Friend the Member for Garston and Halewood talked about sustainability and transformation plans and the need for STPs to make savings, which is the ridiculous position we seem to be in, but as the Health Foundation has said:

“The vision contained in many STPs…on preventing ill health and deterioration of illness, of care delivered closer to people’s homes…will be impossible without a vibrant social care sector.”

As we heard in the debate, it is impossible to have a vibrant social care sector with the funding issues in Liverpool. The Government have tried to shift the burden of funding social care on to councils. In the Budget tomorrow, I hope that the Chancellor of the Exchequer takes responsibility and both makes available the £2 billion needed immediately and suggests a longer-term plan, which is needed to put social care on a more stable footing.

Those who lose out are the thousands of people who need social care in cities such as Liverpool, but are now living with unmet care needs. That also hits their families, particularly the unpaid family carers, and the thousands of people in the care workforce, who are now working under very poor terms and conditions. A very large proportion of them are on zero-hours contracts; often, they are not even paid the minimum wage, are not paid for their travel time and have very poor prospects or no pension.

My hon. Friend the Member for Liverpool, Walton has offered to convene, if he is elected Mayor—I wish him all the best in the forthcoming election—a health and care summit to look at the issues and explore solutions. I hope that he is able to do that, but I know that my hon. Friends and I are not happy to accept a threadbare safety net. We want a decent and fair social care system, and we want it to be funded.

[Mr Philip Hollobone (in the Chair)]

If the Minister would be kind enough to conclude his remarks no later than 6.15 pm, that would allow Mrs Louise Ellman three minutes to sum up the debate.

--- Later in debate ---

[Barbara Keeley]

I do not know whether the Minister watched last week’s Channel 4 “Dispatches”, “Under Lock and Key”, which showed some serious cases of young people who were not better off in their institution, a private hospital. It seemed very difficult to get them moved out into the community. I know that it was a different part of the country, but there were young people in that institution from across the country. It is great to have a plan, but we see programmes week in and week out showing failures, as I have highlighted.

[Mr Philip Hollobone (in the Chair)]

In responding to the intervention, the Minister needs to make his last point.

[David Mowat]

Mr Hollobone, are we finishing at 6.18?

[Mr Philip Hollobone (in the Chair)]

You have until 6.15.

[David Mowat]

I beg your pardon. I will finish at 6.15.

I saw the programme, and it gave us great food for thought. It is a Government priority to get those people moved. We have done some 1,500, but yes, there are 3,000 left in places like the one in Northampton, and it is not good enough. It is a long process, and it is not something that any of us from either side of the House can do just by clicking our fingers.

I will now sit down. This has been a good debate. I will write to all Members here with the figures that I have given, because the figures are right. It is fair to have this discussion, but it must be had on the basis of correct numbers. Even with those correct numbers, I accept that some of the pressures that we have heard about exist.

NHS Shared Business Services

Philip Hollobone Excerpts

Monday 27th February 2017 Commons Chamber

[Mr Hunt]

Let me gently remind the hon. Gentleman that, because of the decisions this Government have taken, we are actually now investing more than the European average in the NHS, which would have been much more difficult to do if we had followed his party’s spending plans. He tries to characterise our approach as one of suggesting that the NHS does not have problems. We think the NHS has some very big problems—it is working very hard to tackle them—but we are providing more doctors, more nurses, more funding and more operations than ever before in its history.

[Mr Philip Hollobone (Kettering) (Con)]

May I commend the Secretary of State for his response to the situation once he was told about it and welcome his pledge to provide constituency-wide data to the House? However, my constituents in Kettering will be amazed that, for five years, no one spotted that 700,000 records had gone missing. How was that discovered, and why in the three areas did such a large amount of data in effect disappear from public view?

[Mr Hunt]

I wish I could give my hon. Friend the answer to that question. I think it is completely extraordinary that for such a long period it was not noticed that the data had gone missing. It was discovered towards the end of the SPS contract. There are lessons for the NHS—this relates very closely to what other hon. Members have said—about the dangers of over-reliance on paper rather than electronic systems, with which it is much easier to keep track of what is happening. [Interruption.] Let me say to the hon. Member for Leicester South (Jonathan Ashworth), who continues to make comments from a sedentary position, that when it comes to making the NHS electronic, people will compare his Government’s records and ours and will say which is better.

Oral Answers to Questions

Philip Hollobone Excerpts

Tuesday 7th February 2017 Commons Chamber

The Secretary of State was asked—

[Mr Philip Hollobone (Kettering) (Con)]

1. What steps he is taking to ensure that foreign nationals who are not entitled to free NHS treatment pay in full for the treatment they have received.

[The Secretary of State for Health (Mr Jeremy Hunt)]

Under this Government, the amount recovered from international visitors has trebled from £81 million to £289 million. Yesterday, I announced that we were going further by introducing upfront ID checks and payment for elective care, stopping IVF being available for those who pay the health visa surcharge and asking GPs to help to identify European citizens at the point of registration so that we can recharge their costs to their home country.

[Mr Hollobone]

My constituents in Kettering welcome the Government’s latest crackdown on this abuse of our national health service at a time when we are struggling to find enough money to pay for the care of elderly people who have paid into the NHS all their lives. We simply cannot afford to provide a free international health service.

[Mr Hunt]

My hon. Friend is absolutely right. It is a national health service, not an international health service. I was disappointed to see comments from the Opposition yesterday that the money this would raise would be a drop in the ocean—[Hon. Members: “It is.”] We are seeking to raise £500 million. That is enough to finance 5,000 GPs, who could help the constituents of everyone in this House.

Agenda for Change: NHS Pay Restraint

Philip Hollobone Excerpts

Monday 30th January 2017 Westminster Hall

[Catherine McKinnell]

My right hon. Friend makes an important point. There was a two-year pay freeze from 2011-12 and a 1% increase in 2013-14 and 2014-15, followed by confirmation in the Budget of summer 2015 that the Government would fund an average public sector pay award of only 1% for the four years from 2016-17. As has been pointed out, the Government decided to reject the independent NHS Pay Review Body’s recommendation of a further 1% uplift to all pay scales from 2014-15, stating that there would be an annual increase of at least 1% for Agenda for Change staff in England through either contractual incremental pay or a non-consolidated payment.

[Mr Philip Hollobone (Kettering) (Con)]

I congratulate the hon. Lady on her excellent speech, which I am following closely. Is there not very thin moral justification for the Government rejecting the review of an independent pay body when each of us as MPs has our pay independently assessed and awarded? I can see no justification for saying to hard-working nurses in Kettering, “You can’t have the pay rise that an independent pay body said you should have” when I, as an MP, automatically get a pay rise awarded by our independent body.