Oral Answers to Questions

Philip Hollobone Excerpts

Tuesday 13th October 2015 Commons Chamber

[Mr Hunt]

I must confess that I have not yet read that report, but my hon. Friend has reminded me of how important it is that I should do so. I will read it carefully while thinking about whether it could help us to get through the winter pressures this year.

[Mr Philip Hollobone (Kettering) (Con)]

Kettering general hospital, the local clinical commissioning group and the Government are all agreed that the best way to help the NHS in north Northamptonshire to cope with pressures all year round, including in the winter, would be to develop a £30 million urgent care hub at Kettering general hospital. That project is with Monitor. What can the Secretary of State do to encourage Monitor to speed up its deliberations?

[Mr Hunt]

Once again, I thank my hon. Friend for his persistent campaigning on behalf of Kettering general hospital. It is a very busy hospital under a great deal of pressure, and I know that people work very hard there. The Under-Secretary of State for Health, my hon. Friend the Member for Ipswich (Ben Gummer), who has responsibility for hospitals, met campaigners from Kettering recently to discuss this issue, and I will bring the matter up with Monitor as well.

Hospital Services (South Manchester)

Philip Hollobone Excerpts

Tuesday 8th September 2015 Westminster Hall

[Jeff Smith]

My hon. Friend makes an excellent point. Clearly, Wythenshawe was the public choice for a specialist hospital.

On working together, which I was just talking about, there is clearly a growing and improved relationship between Wythenshawe and the Manchester Royal Infirmary. Some people see that as a concern, but I think that it is very much to be welcomed and we need to see it as an opportunity.

In south Manchester, we have the opportunity to be an exemplar of partnership working. We have two fine hospitals in Wythenshawe and the MRI, which are on either side of my constituency. My constituency also houses the excellent—and, I believe, underused—facilities at Withington community hospital, which was established under the last Labour Government. I look forward to an expanded role for Withington community hospital in health provision in south Manchester, supporting the two major hospitals and providing joined-up services for all our communities.

We have an opportunity to use Withington community hospital to integrate community services, primary care, secondary care and mental health support, with health services and social care services working together for the benefit of all the community in Manchester Withington and the whole of south Manchester. I urge everyone involved to make the most of that opportunity to expand and improve services at Withington community hospital.

I agree with many comments that hon. Members have made about the Healthier Together process, but I welcome the opportunity to use all those hospital resources together—to use Withington as a thriving community hospital to improve health outcomes for people in south Manchester.

[Mr Philip Hollobone (in the Chair)]

Before I call the Front Benchers, I should say that we are going to have the pleasure of hearing Mike Kane sum up the debate for three minutes at the end. I would be grateful if the Front Benchers would be kind enough to leave him enough time to do that and if he would be kind enough to leave me 30 seconds at the very end to put the motion to the Chamber.

--- Later in debate ---

[Ben Gummer]

I am acutely aware of the huge spread of sensibleness on both sides of the Chamber, and I would not want any of my remarks to be construed as suggesting otherwise. On the contrary, I restate that it is not only reasonable but right that local Members respond to the views expressed by very experienced clinicians in their local hospital.

In my short discussions so far with local commissioners —I am sure there will be more discussions—I have impressed on them the need to engage fully with all clinicians. I understand that they began the process afresh before I made that request and that they will continue that engagement. We will only get good reconfigurations across the country if we have the general buy-in of clinicians and the public. We are now doing that better than we were five, 10 or 15 years ago, when every reconfiguration of every kind was fought tooth and nail by everyone. There is now a general move to an understanding that we need to make some changes to some areas. Indeed, the shadow Secretary of State for Health, the right hon. Member for Leigh (Andy Burnham), has made clear his desire to see some services centralised:

“If local hospitals are to grow into integrated providers of Whole-Person Care, then it will make sense to continue to separate general care from specialist care, and continue to centralise the latter. So hospitals will need to change and we shouldn’t fear that.”

I could not agree with him more on that general principle, but it does not change the fact that commissioners need to engage with every single party.

My hon. Friend the Member for Altrincham and Sale West, and every other Member, can be sure that I will pass back to commissioners their specific concerns about that engagement. In the discussions, which I am sure will continue between all of us, I hope that he and other Members will notice continued engagement between commissioners and clinicians at the hospital, and I hope that there will be a happier outcome than the one that might come about through judicial action.

The hon. Member for Blackley and Broughton (Graham Stringer) and the shadow Minister both spoke about Manchester airport and made interesting and valid points about the need for a stated relationship between important national infrastructure and centres of major trauma care. I will respond to the shadow Minister in writing on that specific question, if he does not mind sharing that response with his colleagues. This is an important matter, and I want to ensure that I can answer it in detail and in full.

If I interpreted his remarks correctly, the shadow Minister also said that consultations had been taken out of the hands of clinical commissioning groups specifically to be conducted by a third party, such as health and wellbeing boards. Again, I have not previously heard that idea, but I am happy to respond to that specific point once I have been able to give it greater thought, with no implication for the current consultation.

I will now close in order to give the hon. Member for Wythenshawe and Sale East time to reply to my comments. We all agree that reconfiguration needs to happen. In this instance, there has clearly been support from those Members who have been the beneficiaries of the reconfiguration in their constituencies, but the most important beneficiaries will be the people of Manchester, who I expect will see world-leading trauma care connected to emergency stomach and bowel surgery as a result of these changes. We must be proud that clinicians are leading the review, we must be proud that clinicians have been prepared to make bold and difficult decisions and we must be proud that Members present have come forward to represent the concerns of some that clinicians have not made those decisions in the right way. Members have made those points with lucidity, care and passion.

I hope that in the next few weeks we will resolve this matter in a rather happier way than it might otherwise have been resolved, and I pledge to continue my discussions with Members on both sides of the House to ensure that that is the case.

[Mr Philip Hollobone (in the Chair)]

I will call Mike Kane to give a winding-up speech of two or three minutes. Members who are here for the next debate should get ready, because we will go straight on to that debate rather than waiting till 11 o’clock.

[Mike Kane]

Thank you for your excellent chairing of these proceedings, Mr Hollobone. I am grateful to the Minister for his reflective comments on the process and for bringing us up to date on the latest developments. I stress to him that the hon. Member for Altrincham and Sale West (Mr Brady), my hon. Friend the Member for Stretford and Urmston (Kate Green) and I are not behind the curve, as he can probably tell from the excellent contributions made by them.

I also thank the Minister for what he said about Paul Goggins, who worked with local elected members long before I did on the reconfiguration of Trafford services. In some ways, the assurances that he had about those reconfigurations and about working with NHS England are not being met through the process. It was also Paul Goggins, along with colleagues, who campaigned for the improvements in accident and emergency at Wythenshawe hospital. A £12 million scheme will begin there in November to create a new A and E village, a world-class facility. The Minister is right that this is a once-in-a-generation opportunity to integrate health and social care. It is also a once-in-a-generation opportunity to show that large conurbations such as Manchester, which is moving towards 3 million people, can take control of their powers to deliver their own health and social care.

I thank the Members who have turned up. What my hon. Friend the Member for Manchester, Withington (Jeff Smith) did not say about himself is that he was at the forefront of the campaign to build the new hospital in Withington all those years ago, when we reconfigured the services. We can make more of that hospital; we are already discussing 24/7 GP access there. If we can realise that vision to ease the pressures on A and E departments across the conurbation, it will be a major achievement, thanks in no small part to his campaigning activity long before he came to this place.

I am delighted that my hon. Friend the Member for Ashton-under-Lyne (Angela Rayner) is in her place. The hospital in her constituency has undoubtedly had a torrid time over the past six or seven years, but today NHS England lifted it out of special measures, which is cause for everyone to celebrate. My hon. Friend the Member for Blackley and Broughton (Graham Stringer) has been a constant defender of his local hospital, North Manchester General, and has been a visionary leader, in the sense that we are now getting to the point of being able to devolve powers on skills, housing, transport, business, investment and, eventually, healthcare to Greater Manchester. He has been at the forefront of that.

I thank the shadow Minister for his erudite contribution and for linking the issue to Manchester airport. We cannot consider health on its own. The decision on “The Northern Way”, or the northern powerhouse, can be pivotal in getting world-class inward investment in healthcare in Manchester. It will link to the airport next to the hospital, which had 23 million passengers this year, increasing to 40 million over the next couple of years. We have plans in our area to expand the Metrolink at some stage to connect Wythenshawe directly. Currently it connects to Manchester airport, but we want to send the loop around to connect with the High Speed 2 station and back to Wythenshawe hospital.

We in the north-west have had problems in the past, as hon. Members will know. I pay tribute to the hon. Member for Macclesfield (David Rutley), who has been considering life sciences across the region, including AstraZeneca and regenerating Alderley Park, and linking the issue to our vision of a life sciences institute medi-park on the Roundthorn industrial estate next to our hospital. That could be further linked to the Corridor project involving graphene and the life sciences, associated with Central Manchester hospital. We need more links with that in the future. That site also ties into Airport City, which is in development both south and north of the airport. We are expecting massive change in south Manchester and Trafford over the next 10 to 15 years. It will be generational change that will drive the northern powerhouse, with the addition of HS2 and possibly, given the discussions that the Department for Transport is having, of HS3.

We have a wider vision for the site, and we do not want it to be set back by process issues. Let us all—people watching today and everybody in this Chamber—commit to the vision of making south Manchester and Greater Manchester a world-class place for economic investment and healthcare.

[Mr Philip Hollobone (in the Chair)]

Would all those who are not staying for the next debate please be courteous enough to leave quickly and quietly?

Contaminated Blood

Philip Hollobone Excerpts

Monday 20th July 2015 Commons Chamber

[Ben Gummer]

The hon. Gentleman raises the issue of English votes for English laws. That has been deferred, because the House wishes to discuss it further.

On the issue before us, a report was delivered in March, but the general election then intervened, which effectively took six weeks out of the time in which the Government could make decisions. We began work the minute we returned to government, and I have now provided an update and the prospectus for a consultation in the autumn. It will be the first consultation that the sufferers have ever been able to enjoy, and we will finish it as quickly as possible in order to arrive at a settlement. That is rapid progress, given that it has taken us more than 30 years to reach this point.

[Mr Philip Hollobone (Kettering) (Con)]

I have been listening very carefully to my hon. Friend. Will he be kind enough to make it crystal clear to the House exactly what his intentions are? I understand from what he has said that he expects a new scheme to be up and running by the end of calendar year 2015. If that is incorrect, by when does he expect such a scheme to be established?

[Ben Gummer]

We shall be consulting this year, the consultation will be concluded by the end of the calendar year, and we hope that a new scheme will be up and running as soon as possible after that. It will, of course, depend slightly on the outcome of the consultation, but I expect the scheme to follow very rapidly on the heels of its conclusion. None of us has an interest in delaying this any further.

Oral Answers to Questions

Philip Hollobone Excerpts

Tuesday 7th July 2015 Commons Chamber

[Ben Gummer]

Thank you Mr Speaker—helpful as ever.

The hon. Gentleman is entirely right that those who seek to access acute services on a regular basis require special treatment. That is why we issued guidance in the previous Parliament. I very much hope that his local hospitals will be looking at that with due care and attention.

[Mr Philip Hollobone (Kettering) (Con)]

Kettering general hospital is looking to develop a £30 million urgent care hub—one of the first of its type in the country—to replace and enhance the accident and emergency department, which is under growing strain. This project enjoyed the support of the previous Government. Will my hon. Friend agree to meet me and the two other MPs from north Northamptonshire to make sure that it remains on track?

[Ben Gummer]

I very much look forward to meeting my hon. Friend and his colleagues, and I have already committed to doing so. I hope that the lead he has taken with his colleagues in forging a cross-party consensus will be copied across the House.

NHS Success Regime

Philip Hollobone Excerpts

Thursday 4th June 2015 Commons Chamber

[Ben Gummer]

I repeat to my hon. Friend the observation that I made earlier: it is interesting that in his opening contribution, the right hon. Member for Leigh did not make a single statement about patients and their centrality to what we are trying to do. The NHS has devised its own plan for its own success over the next five years, and the safety and care of patients lie at the heart of it. Only one party is supporting that plan, and that is why the Conservatives are the only party backing the NHS.

[Mr Philip Hollobone (Kettering) (Con)]

I congratulate my hon. Friend on his response to the urgent question and the new Government on acting so swiftly. Having listened to the exchanges across the Floor of the House today, I think it would be particularly sensible and grown up for Her Majesty’s Government, first, to admit that there are geographical parts of our NHS that are not working as well as they might and, secondly, to seek local holistic solutions to put them right as soon as possible.

[Ben Gummer]

As so often, my hon. Friend is on the money. He has described exactly what NHS England is trying to achieve with the success regime.

Oral Answers to Questions

Philip Hollobone Excerpts

Tuesday 2nd June 2015 Commons Chamber

[Mr Hunt]

I am happy to ensure that inner-London MPs have a meeting with the Minister to discuss those issues. The underfunding of general practice has been an historical problem, because we have had very strong hospital targets, which have tended to suck resources into the acute sector and away from out-of-hospital care. We want to put that right.

[Mr Philip Hollobone (Kettering) (Con)]

The problem in Northamptonshire is that because of rapid population growth, the gap between the appointments required of GP surgeries and the slots available is one of the biggest in the country. There are 333 Northamptonshire GPs at the moment; Healthwatch Northamptonshire estimates that another 183 will be required within the next five years. How are we going to fill that gap?

[Mr Hunt]

My hon. Friend is absolutely right to draw attention to that issue. We have plans to train another 5,000 GPs across the country. In the last Parliament, we increased GPs by about 5%. We need to go much further, as part of a real transformation of out-of-hospital care.

Kettering General Hospital

Philip Hollobone Excerpts

Tuesday 24th March 2015 Westminster Hall

[Mr Philip Hollobone (Kettering) (Con)]

It is a huge pleasure and privilege to serve under your chairmanship, Mr Gray. May I, through you, thank Mr Speaker for giving me the honour of debating what is an important subject for my constituents?

I welcome the Minister to his place. He has taken a keen personal interest in the future of Kettering general hospital. The hon. Member for Corby (Andy Sawford) and my hon. Friend the Member for Wellingborough (Mr Bone) are also here, and I hope they will make many interventions to stress the role they have played in working with me to secure the hospital’s future. Indeed, I am pleased to report that the three of us have been working closely together on a cross-party basis for the past few years, because we recognise that local people want party politics taken out of the future of our local hospital. It is a personal issue for the three of us, because we and our relatives use it, as do local people.

Kettering general hospital has been on its present site for 118 years. Local people have been born there and treated there, and they have died there. It is a much-loved district general hospital at the heart of the community of Kettering and north Northamptonshire. It is a key priority for local people that its future should be secure, so that it can continue to offer the best treatment to the increasing number of people living in the area. Kettering and north Northamptonshire are growing rapidly. Over the past decade the borough of Kettering had the sixth most rapid household growth out of 348 districts in the country, and that population increase is set to continue into the next decade.

[Andy Sawford (Corby) (Lab/Co-op)]

I thank the hon. Gentleman for his kind remarks about our cross-party working, which our constituents throughout north Northamptonshire welcome. It has helped us in our approaches to the Minister and local health partners, and in bringing them together.

On the point about population, does the hon. Gentleman agree that we should emphasise the fact that as well as having, like most of the country, an ageing population, we also have one of the highest birth rates? Indeed, my constituency has the highest, but the birth rate is high throughout north Northamptonshire. There is demand at both ends of the population, as well as, of course, from people of working age.

[Mr Hollobone]

That is very pertinent. Demographic pressures are hitting us from every angle. There is a high birth rate in Corby and east Northamptonshire. Increasingly, in my constituency as well as the hon. Gentleman’s and that of my hon. Friend the Member for Wellingborough, the population is ageing. Whereas 30 years ago an elderly patient might go to hospital with a particular condition, now it is even older people who are going there, with multiple conditions needing treatment at the same time. Kettering general hospital, like all hospitals, must raise its game when treating such vulnerable members of the community. It is not only population numbers, but the number of young and old patients that creates a challenge.

Although Kettering general hospital has difficulties and challenges, it is raising its game, and that is due largely to the tremendous dedication of the doctors, nurses, ancillary staff, management and clerical staff at the hospital, who are in a joint endeavour to deliver the best care they can. There is extremely good news to report. The Department of Health tells me that in 2012-13 there were 85,497 in-patient finished consultant episodes at the hospital, compared with 84,602 in 2011-12. There has been a focus on accident and emergency waiting time targets, and in the past few years Kettering general hospital has moved from being one of the worst in the country to one of the best. All hospitals in the country have been under pressure this winter, but it would be wrong to give the impression that fewer people are being treated at Kettering A and E. The reverse is true. In 2010-11 76,099 people presented themselves to A and E. In 2012-13 the number was 84,055. Record numbers of people are being treated there.

[Andy Sawford]

The hon. Gentleman will have been struck, as I was, at being told that the accident and emergency department was built for 20,000 patient visits a year, given that recent figure of 84,000. I endorse his remarks about change and progress in the past few years. To what does he attribute that? He mentioned the staff, and I agree. There has also been a change in the leadership of the hospital. However, perhaps it is also to do with the way the local health partners and organisations, including the clinical commissioning groups, have come together with the hospital more effectively through the work that we have been involved in with them, particularly with a view to improving A and E.

[Mr Hollobone]

The hon. Gentleman is right, of course. He gives a tantalising flavour of the climax of my speech, which will be about the urgent care hub proposal for Kettering general hospital, on which he, I and my hon. Friend the Member for Wellingborough have been working together.

[Mr Peter Bone (Wellingborough) (Con)]

It is a pleasure to serve under your chairmanship, Mr Gray. I congratulate my hon. Friend on securing this important debate. Before he moves on to the climax, which we are all waiting to hear, may I mention, in addition to the work of the hospital and its staff, the contribution of support organisations? One of those is Crazy Hats, a local breast cancer charity run by Glennis Hooper, who is a remarkable lady. All three of us MPs took part in the charity walk on Sunday.

[Mr Hollobone]

Yes—not only have we three north Northamptonshire Members worked on a cross-party basis to secure the future of our local hospital, but we all dressed up in funny outfits on Sunday to walk around Wicksteed park in Kettering in support of Glennis Hooper and the marvellous work she does for Crazy Hats, which raises money for cancer treatment and care for our constituents. I suppose that it is part of an MP’s job on occasion to dress up in a funny costume and look silly for the benefit of constituents, and we are all pleased to do that.

Some further good news about Kettering general hospital, from Department of Health statistics, is that finished consultant episodes when any procedure took place in the hospital—which I think is bureaucracy-speak for the number of operations—went up from 49,638 in 2010 to 53,869 in 2013. I am told that there are 43 more hospital doctors and 55 more nurses than in 2010 and there is a 24% increase in diagnostic tests, a one third increase in the number of people treated for cancer and a 71% increase in the number of MRI scans performed. Of course just two years ago the £30 million foundation wing was opened. It has a 16-bed intensive care unit, a 28-bed cardiac unit and a 32-bed children’s unit. That was massive new investment in our local hospital.

It should not be forgotten—and we three Members of Parliament for the area do not forget—that increasingly Kettering general hospital offers our constituents world-class health care. The latest example of that is the cardiac investigations department, which has received national recognition for its high standards in heart ultrasound scanning. Every year 8,000 of our constituents are patients through that unit, which provides ultrasound scans of the heart. Those can reveal diseases such as heart failure and valve diseases.

[Andy Sawford]

That shows what huge progress has been made. A little over 10 years ago, my granddad had a heart attack and had to wait in a bed in Kettering general for six weeks to be transferred to Glenfield hospital in Leicester for a stent. Such operations can now be done as a day case at Kettering general.

[Mr Hollobone]

The hon. Gentleman is right. That is a good example of the way Kettering general hospital has raised its game to tackle local health needs. Increasingly, our constituents do not have to go to Glenfield, because they can get better care at their local hospital. In the case in question, that is because of the £300,000 investment in three state-of-the-art ultrasound scanners, which can show the heart in three dimensions. The 16-strong cardiac investigations team has been awarded accreditation by the British Society of Echocardiography, which is an affiliate of the British Cardiovascular Society. That accolade is not given lightly. Kettering hospital is one of only 38 in the country to have achieved that accreditation; some specialist centres, such as Glenfield, Papworth, John Radcliffe and Coventry, have not yet attained it.

The £4 million upgrade of the maternity department at Kettering general hospital started in December. An average of 10 babies per day are delivered at the hospital—including the babies of Members who are here today. It is part of an £18 million investment in the hospital.

In coming to the climax of my remarks, I want to talk about the innovative proposal for an urgent care hub at the hospital—my colleagues will appreciate this, because we have been working on it together. Over the past few months, the hospital has been liaising with partners and developing a strategic case for an urgent care hub on the hospital site to tackle long-term, urgent care pressure relating to population growth, about which we have spoken; age and acuity; and increasing public demand for prompt access to urgent care.

In December, the trust shared its strategic case with the foundation trust regulator, Monitor, which is currently considering the proposal. If Monitor approves the case, it will go on to an outline business case and finally a full business case for approval by Monitor, the Department of Health and the Treasury. The key to its success is that the hospital has been working in close collaboration with its health and social care partners. It is developing what is essentially a one-stop shop for our constituents who need urgent medical care.

The aim is to develop a £30 million urgent care hub on the hospital site that will combine secondary care, hospital A and E and urgent care assessment with primary care—in other words, GP services, minor injury care and social and community care services. The proposal has arisen because there has been significant growth in demand for that type of urgent care in the local health economy of our three constituencies, partly due to a 30% population growth over the past 19 years, with another 9% expected by 2020, and a rise in the population of older people, about which we have spoken. There has also been a massive 83% increase in the use of A and E over the past 20 years as a means of accessing urgent care.

[Mr Bone]

My hon. Friend is outlining an exciting new project. The scheme will include a minor injuries and accidents unit at the Isebrook hospital, which will relieve up to 40% of my constituents from having to go to Kettering. It is bang next to a 24-hour GP service, so that is exciting for my constituents, too.

[Mr Hollobone]

My hon. Friend has rightly made that issue a priority for his constituents, and he has led an effective campaign on it. That facility will be similar to the facility currently in operation in Corby. The idea is to treat people as locally as possible so they do not have to present themselves at Kettering’s A and E department. It is all part of making local health care delivery more efficient and effective, and my hon. Friend is right to highlight it.

[Andy Sawford]

Does the hon. Gentleman agree about one of the things we have made progress on—particularly through the cross-party campaign and the cross-working of the organisations involved? Although there are sometimes particular interests in individual towns and communities, we have looked at the bigger picture for the whole of our area. There are benefits for individual towns. The hon. Gentleman is right to say that I want to build on the success of the urgent care centre, but, in the end, when A and E—in particular, trauma services—is needed, it is going to be there relatively locally for everybody in north Northamptonshire.

[Mr Hollobone]

The hon. Gentleman is absolutely right. Although we want to see far more local delivery of efficient NHS services in particular constituencies, all three of us accept that the vital part of the local health economy is the success of Kettering general hospital. If it were not there—if it were in Northampton, Milton Keynes, Bedford or Luton—local NHS delivery for our constituents would be far worse. We have to make Kettering general hospital a success. We can help it along its way with the innovative establishment of success stories such as the urgent care centre in Corby and the new facility at Isebrook, but the key to success for all our constituents is to make Kettering general hospital a success story for the future.

The hub concept developed by the trust and supported by all three of us is a partnership with the bodies that purchase NHS services, such as the clinical commissioning groups, the Northamptonshire Healthcare NHS Foundation Trust and the social care provider, Northamptonshire county council. If successful, the urgent care hub would effectively provide 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; a replacement for the hospital’s A and E department, which is now 20 years old; and a new A and E services area, which will provide even better acute emergency care and integrated assessment to ensure that patients see the right specialists right away.

The three of us have been to see the Minister with the hospital and the CCGs, so the Minister knows that we are all as one in believing that the urgent care hub concept is the right one for the health economy in north Northamptonshire. It mirrors the way in which NHS England would like to see pioneering health care delivered in the future. As David Sissling, the chief executive of the hospital, said,

“This integrated approach is also something that NHS England has highlighted is an important principle in its Five Year Forward View for the NHS and it also fits with”

the collaborative programme happening in Northampton- shire.

I hope that when the Minister responds to this debate, in which all three MPs have sung from the same hymn sheet and said with one voice that we need the urgent care hub for the betterment of our constituents’ health, he will reiterate his support for the proposal. Whoever wins the election in our three constituencies and whoever forms the next Government, this important proposal must happen, for all our constituents.

Nurses and Midwives: Fees

Philip Hollobone Excerpts

Monday 23rd March 2015 Westminster Hall

[George Freeman]

The hon. Gentleman makes a really good point; I was trying to make a similar point myself. We have encouraged the NMC and made it easier to speed up its processes. Anecdotally, I know from speaking to nurses and midwives that there is a lot of frustration about the slow pace of basic procedures, such as getting registration and coming back to the profession.

My hon. Friend the Member for Congleton (Fiona Bruce) cogently and clearly told the story of one of her constituents, a nurse, and spoke about the bureaucratic and clumsy registration processes. There is a common message for the NMC: it has a £70 million budget, so it ought to be able to run a less inefficient, quicker organisation and direct resources away from bureaucracy and towards dealing with fitness to practise, in which there is likely to be a growing public interest. It is good that the public want to drive up standards and be clear about patient safety across the professions.

On the issue of revalidation, we believe that nurses and midwives have some of the most important jobs in the NHS. They care for patients every day, so it is crucial to ensure that they are up to speed with the standards that the public and patients expect. We support the NMC in its drive to introduce revalidation, which will improve safety and the quality of care. It will reassure patients that nurses remain fit to carry out their vital work.

The challenges of the serious debt and structural deficit inheritance that we as a society are confronting mean that everyone in our public services has to deliver more for less within the current financial constraints and to ensure that standards continue to improve. Across our public services—indeed, across our general economy—there are extraordinary levels of productivity gain day in, day out. The general economy runs at 2% to 3% productivity growth every year with its eyes shut. The challenge is to create in the public sector the right climate and leadership conditions so that our great public servants can deliver similar productivity.

That said, we recognise the importance of the level of the NMC registration fee to all its registrants, which is why the Government have assisted the NMC to introduce rules that will allow registrants to pay their registration fee in instalments. Those rules came into effect on 9 March, and they enable the front-line nurses and midwives who have to pay the £3 extra fee to schedule payment of the total £120 annual fee across the whole year.

To maintain the NMC’s independence from the Government, its registration fee must cover the full costs of its regulatory activity. I am sure that nobody in any corner of the House believes that we should downscale or curtail the quality of that regulatory work merely on the basis of members’ unwillingness to pay. The principle is that health care professionals should fund the regulation of their profession to maintain the confidence of the public and patients. However, it is for the NMC to decide how to meet its statutory functions and protect patients and the public, which is our paramount consideration. The NMC recognises that it needs to do more to maintain the confidence of registrants, patients and the public in its performance, and to continue to improve its operation, effectiveness and efficiency.

I am grateful for the chance to correct the record and clarify that the Government are prioritising the lowest-paid workers in the NHS; we applaud and support their commitment. I want to take this opportunity to reaffirm the Government’s gratitude, thanks and support for their work. Despite the difficult funding constraints, in this Parliament we have consistently supported the lowest-paid workers in the NHS, rather than the best-paid, and we have reflected that in the latest pay settlement.

At the heart of this measure are some important points that need to be reiterated. There is a long-standing convention that health care professionals pay their own professional registration fees. The reform will increase the registration fee paid by nurses and midwives, whose average salary is £31,000, by £3, against their annual registration fee of £120. The Government have given the NMC a £20 million grant to help to offset those costs. The NMC has made it clear that it is able to pay for a substantial element of the increases through its ongoing efficiency programmes. The principal driver of cost is the growing public interest in fitness to practise and the cost of handling such cases. We are helping the NMC, not least by helping it to deal with those cases much more quickly, as the hon. Member for Easington highlighted.

We should not hold back the public’s interest in fitness to practise. It is part of a new culture of transparency and accountability across the system, post the Francis report, and the Secretary of State and many others want to encourage it in the modern NHS. The NMC is an independent statutory body that is accountable to Parliament, not Ministers.

I welcome the chance to inform the debate, particularly for NMC workers and for the many nurses and midwives who have taken the time to sign the Government’s e-petition form and, through the Backbench Business Committee and Members in the Chamber, to bring this issue to the Floor of the House. We as Ministers are very aware of the needs of the lowest-paid NHS workers, who do an extraordinary job for us. That is why, in the latest pay deal, we reflected that, with a 5.6% increase for the lowest earners and a 1% pay rise, which equates to £300 in the pockets of the nurses and midwives we are talking about.

The measures in the Budget and the Chancellor’s wider tax reforms, such as raising the tax threshold for the lowest-paid workers, will take more than 4 million of the lowest-paid workers out of tax altogether. The lowest-paid nurses and midwives are now £900 a year better off as a result of the increase of the personal allowance to £11,000. That is a substantial sum, compared with the £3 fee increment. The hon. Members for Denton and Reddish (Andrew Gwynne) and for Blaydon are eloquent and persuasive men, but even they cannot suggest that a £3 fee on health care professionals earning £31,000 represents a crisis in the NHS. They rightly said that it is important that the NMC quickly develops its efficiency and upgrades its internal mechanisms, and they made a number of interesting points about how that can be done to maximise fairness for the lowest-paid workers. I want to take the opportunity to repeat that the Government are absolutely on the side of those workers.

[Mr Philip Hollobone (in the Chair)]

It was a real treat for me to have been in the Chair to hear the Minister’s response, but a great misfortune not to have been in the Chair to have heard the introductory remarks of the hon. Member for Blaydon (Mr Anderson). As recompense, he now has two or three minutes to pithily sum up the debate, largely for my benefit.

Oral Answers to Questions

Philip Hollobone Excerpts

Tuesday 24th February 2015 Commons Chamber

[Dr Poulter]

It has always been the case—it was certainly the case among many of my medical contemporaries—that many people from our NHS go and work overseas for some time. They often come back to the NHS, bringing broader experience and skills. As I outlined earlier, there are now 1,000 more GPs working and training in our NHS than there were five years ago.

[Mr Philip Hollobone (Kettering) (Con)]

Following the retirement of a senior partner whom it has been impossible to replace, Dr Hadrian Moss of the Dryland GP surgery in Kettering has followed the advice of the British Medical Association and informally closed his expanded list of 2,500 patients on the ground of patient safety. He has now been taken to task by NHS England for a potential breach of contract. What is the Minister’s opinion on reconciling the views of the BMA on patient safety guidelines and those of NHS England on a potential breach of contract?

[Dr Poulter]

I am sure that my hon. Friend will understand that it is difficult for me to comment on an individual case, but I am very happy to look into the matter and get back to him about it.

GP Services

Philip Hollobone Excerpts

Thursday 5th February 2015 Commons Chamber

[Derek Twigg (Halton) (Lab)]

I beg to move,

That this House notes the vital role played by local GP services in communities throughout the UK, with an estimated one million patients receiving care from a family doctor or nurse every day; believes that the UK’s tradition of excellent general practice provision is a central factor in the NHS being consistently ranked as one of the world’s best health services by the independent Commonwealth Fund; expresses concern, therefore, that the Royal College of General Practitioners (RCGP), through its Put patients first: Back general practice campaign, is warning that these services are under severe strain, with increasing concerns raised by constituents about access to their GP and 91 per cent of GPs saying general practice does not have sufficient resources to deliver high quality patient care; further notes that the share of NHS funding spent on general practice has fallen to an all-time low of 8.3 per cent, and that over 300,000 people across the UK have signed the campaign petition calling for this trend to be reversed; welcomes the emphasis placed in NHS England’s Five Year Forward View on strengthening general practice and giving GPs a central role in developing new models of care integrated around patients; and calls on the Secretary of State for Health to work with NHS England and the RCGP to secure the financial future of local GP services as a matter of urgency.

I am grateful to the Backbench Business Committee for providing the House with the opportunity to debate the important subject of sustainable GP services. I am also grateful for colleagues’ support for the debate application. Some of those Members are here, including the hon. Member for Brighton, Pavilion (Caroline Lucas), who spoke in the Committee in support of the application as a co-sponsor.

The debate is timely, given the increasing pressures on the NHS and its hard-working staff. I put on record my appreciation for the hard work and dedication of doctors, nurses and all the staff who work in our health service. Their dedication is keeping the health service going at a particularly difficult time. I also want to put on the record my thanks to the Royal College of General Practitioners for its support, the information it has provided and its campaign.

One of the key reasons for seeking the debate is that, increasingly, constituents have been contacting me to tell me that it is becoming more difficult to get an appointment with a GP of their choice without having to wait many days or even weeks. Sometimes they are not able to see the GP of their choice at all. That, of course, varies between practices. There is no doubt that the overwhelming majority of GPs do an excellent job. That has been demonstrated by patient surveys, but there is always room for improvement.

There is little doubt about the growing demands on general practice caused by demographic changes and more complex health needs, exacerbated by an ageing population. Increasingly, a large part of GPs’ daily work load is on mental health, which would probably merit a debate in itself. That matter needs to be addressed continuously.

[Mr Philip Hollobone (Kettering) (Con)]

I am enjoying the start of the hon. Gentleman’s speech immensely. He has raised an important issue for my constituents. Does he agree that there are also demographic pressures within the GP service in that many of them are in their 50s and about to reach retirement? All of a sudden, we will have a dearth of experienced GPs, which will be a difficult gap to fill.

[Derek Twigg]

The hon. Gentleman raises an important point and he is absolutely correct. I will refer to that later in my speech.

There can be no doubt that GP recruitment has not kept up with the demands of our population. That is the key problem today. In addition, the pressure on hospitals has increased massively because if people cannot see their GP they often go to A and E. That has been a problem in areas such as mine. There is also the inability of hospitals to discharge frail, elderly people from wards into the community because of the shortage of care in the community. Councils face massive budget cuts, so there are pressures all round. There are pressures on GPs in relation to access and there are pressures on hospitals and elsewhere.

I want to raise a particularly important point with the Minister that I have raised before. The Government are proposing to demand a 3.8% efficiency saving in the national tariff for 2015-16. That will push many hospitals to breaking point and possibly endanger patient safety. I hope that the Minister will look at that again. Members should read the briefing on that from NHS Providers.

There is clearly a view among many that general practice is heading for some sort of crisis. One GP in Halton told me recently:

“The overwhelming problem is the manpower crisis and the rock bottom morale of the Profession, which are interlinked. We are unable to recruit new GPs into practice or medical students into our specialty, training places are left unfilled and there are vacancies all over the country with very few applicants.”

It is hardly surprising we have that problem when we consider what the RCGP has said:

“Funding for general practice has fallen to an all-time low of only 8.3% of the overall NHS budget…GP surgeries are now seeing 372 million patients a day, compared to 300 million a day in 2008.”

Some family doctors are seeing 40 to 60 patients a day. That is unsustainable in the long term. Some 49% of GPs say that they can no longer guarantee safe care to their patients.

The RCGP tells me that the average coverage is 6.9 GPs per 10,000 of population. That is the lowest level of coverage since 2011. The RCGP estimates that up to 543 practices in England could face closure due to the fact that 90% of GPs working in those practices are 60 or over or are likely to retire soon. The hon. Member for Kettering (Mr Hollobone) made that point.