NHS Pay
Philippa Whitford Excerpts(6 years, 7 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Dr Philippa Whitford (Central Ayrshire) (SNP)
We have had many debates on the NHS in the House, and as I have said previously, the workforce is one of our biggest challenges, which is why it is so important to get this right. The debate is focused on NHS staff, but we are discussing all public sector workers. We are talking about all workers within the NHS: we must not only consider those at different grades, but not allow a separation between frontline and back-of-house staff. As a surgeon, if I turn up at a clinic and there are no case sheets and the patient has not been informed of their appointment, it is a totally pointless exercise. We need to realise that the NHS is a team, and if we do not look after the team, it will not work.
Obviously this all started with the crash. I will defend Members further along the Opposition Benches, because I get really bored with the Labour party being given responsibility for the crash. Labour did not have that degree of world domination. It was a world crash. At the time of the crash, it was right to look at public sector pay, because it is a big outlay. The reason given at the time was to avoid redundancies and keep people in their jobs. However, although in Scotland we have had no compulsory redundancies, there have been 20,000 NHS redundancies over the past seven years and more than 40,000 compulsory redundancies among public sector workers. That means that people in England had a pay freeze for three years and then a pay cap, but they still lost colleagues.
I still work in the NHS and, until the recent campaign, I would have heard comments from nursing colleagues about not money but staffing—people being on shifts and feeling thinly spread, unable to care, anxious about the danger to their patients. I would say that that is the No. 1 concern, but people in England have had a double whammy: they have had the pay freeze and the pay cap, yet they have still had redundancies. From what we read, there could be a lot more to come from the sustainability and transformation plans, and that is just plain wrong.
In Scotland, we focused what money we had in a different way. The people on less than £21,000 got 3% rises every year, with an absolute minimum in 2010 of £250, which has now risen to £400. If we focused only on percentages, a consultant like me would be sitting on a great pay rise, while the person who is cleaning the bedpans and making the beds would get a pitiful rise, so it is important that more of the money is pushed lower down. In Scotland, we pay the real living wage, not what we Scottish National party Members call the pretendy living wage—the national living wage. A living wage should be a wage on which someone can live. It is as simple as that. Our public sector workers demand no less than that.
Ian Paisley
I appreciate the points the hon. Lady makes. She has creatively reflected on how the Scottish Government have directed resources differently, which is exactly what we and the Northern Ireland Executive want to do with the £1 billion resource. It will allow us to direct resources differently so that we can then address the other critical issues. Does she agree that people who begrudge Northern Ireland’s getting that money are actually begrudging public sector workers their rights?
Dr Whitford
I do not begrudge people in Northern Ireland the money that they have gained from that deal. All that the rest of us are asking for is to have something similar elsewhere. Nurses in Scotland, Wales and England are struggling as much as those in Northern Ireland. To be honest, it is a distraction to keep focusing on that deal. I disapprove of it, but not because people in Northern Ireland are getting a bit more of the help that the rest of us would be glad to receive.
We had the pay freeze and then the pay cap, but there have even been times when the pay review bodies’ recommendations have not been carried through. That has resulted in a band 5 nurse in England being paid £300 less a year than a band 5 nurse in Scotland. We have pushed the money down the way, so for a healthcare assistant or nursing auxiliary, the difference is more than £1,100 a year. However, it is not just a matter of the people at the bottom. In a way, the people who have experienced the freeze the most are those at the top of their grade who are not getting any more increments and are not changing grades. In actual fact, their pay has not moved for several years, and then it has moved by only 1%. Other people’s pay has gone up by increments, so at least they have seen a change in their pay. Earlier, a Labour Back Bencher was talking about a senior nurse. Such senior staff, who are within 10 years of retiring and who carry the experience of the NHS, are looking at other jobs in which that kind of life experience would be much more highly rewarded, and they are thinking, “Can I even afford to stay in this job if I am to look after my family?” In Scotland and elsewhere, we have tried to tackle this appalling issue of low-paid staff in a caring public service such as the NHS, but now we must realise that, for people higher up the grades, the time is over.
Martin Whitfield (East Lothian) (Lab)
Following Audit Scotland’s report, which pointed out that in Scotland one third of NHS staff are over 50; that we have a vacancy rate of more than 4.5% for nurses and just under 7.5% for consultants; and that we have a Government in Scotland who put forward a 1% rise to the pay review body, does the hon. Lady agree that now is the time to say that the cap should go? The cap itself and the attitude towards it is driving people away from the NHS and out of the NHS, and it is doing a great disservice to our population on both sides of the border.
Dr Whitford
If the hon. Gentleman had been following what has been happening in Scotland over the summer, he would know that, following the debate in May, the Cabinet Secretary in Scotland had open discussions with NHS staff side. In June, the Cabinet Secretary for Finance and the Constitution said that our Budget at the end of this year would be looking to get rid of the pay cap. It did not just happen the other week when the programme for Government was announced; it has actually been there all summer. The vacancy rate in Scotland may be 4.5%, but, as the shadow Secretary of State said, it is more than twice that in England. We should be focusing on the fact that nurses and other NHS staff in England are getting almost the rawest deal, which is not right, because they are working just as hard as others.
Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)
Does my hon. Friend agree that it is also extremely important that, if we are to achieve parity between physical and mental health services, we address this issue, particularly for specialist mental health staff—nurses and allied health professionals—who want to work in the service but for whom the work is just not cost effective, as they then seek employment elsewhere?
Dr Whitford
That was exactly the point I made at the start of my speech. Although the Royal College of Nursing led the campaign and the image has been of nurses, the issue affects everyone. I echo what the hon. Member for Lincoln (Ms Lee) said—[Interruption.] Well, it was the RCN out at the front.
Madam Deputy Speaker (Mrs Eleanor Laing)
Order. I appreciate that the hon. Member for Lincoln (Ms Lee) is new to the House, but Members do not make interventions while they are sitting down. If you wish to intervene, you must stand up to do it. I have noticed this happening quite a lot. This is not a general discussion, but a debate.
Dr Whitford
It is very important that people recognise the role that everyone plays, but for nurses in particular this is not just a matter of pay. Last year, we spent a lot of time debating changes to working tax credits, which can leave a lone parent nurse very much worse off. We also spent a lot of time debating the imposition of tuition fees and the removal of the nursing bursary. The nursing bursary still exists in Scotland. It is a non-means tested bursary of £6,500, potentially with a caring supplement of £3,500. We know that the average age to take up nursing study is at the end of the 20s, which means that people often have family commitments. Such people will receive approximately £10,000 a year so that, at the end, they will not face what future nurses in England will face, which is a debt of more than £50,000. The repayment on that kicks in immediately, because graduate nurses start at around £22,000, which is over the limit. At the lower end of band 5, that is another £400 a year off. By the time a nurse gets to the top of band 5, it is another £1,000 a year off. They will never manage to pay off that £50,000 to £60,000, which means that their salary will be reduced by that amount throughout their careers.
Norman Lamb
Does the hon. Lady agree that what appears to be happening is that many of the mature students who previously went into nursing often do not want to take on that debt? That means that we are losing people who seek to transfer from other professions, which is really damaging.
Dr Whitford
I totally thank the right hon. Gentleman for his intervention. That is absolutely the case. It has never been a negative—in fact it has always been a benefit—that we have attracted people who were a bit older to the role of student nurse. Perhaps they had another degree or a student loan to pay off, but they always had a bit more life experience under their belt.
As a very junior doctor in my first year, I remember what it was like when my hours alternated between 132 and 175, and I had no life that did not involve people who were dying or ill or who had been hit by a car. That is very difficult for a person who has just come out of uni, and who is used to going out for a pint and having parties. There is real advantage in training people who may have had a family and who have lived a bit of life. As the right hon. Member for North Norfolk (Norman Lamb) said, there are people who are attracted to nursing but who will not take it up because they will not put their family through it. We have seen that already with a 23% drop in applications.
Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
As a fellow NHS consultant, I entirely agreed with the hon. Lady when she said that this was about not just the nurses, but the NHS as a team and the value of the whole package of care. One cannot work effectively without the other. Yes, there is a debt accrued in doing a nursing career, but the Health Secretary has proposed a new technical route into nursing, which will mean that people can get an apprenticeship in nursing, allowing them to work and earn throughout their training. Therefore, nurses will be able to qualify while working and supporting their families without accruing any debt.
Dr Whitford
I welcome the hon. Lady’s intervention. I definitely welcome other routes into nursing. Of course when I was a wee doctor, we had two routes: the enrolled nurse and the degree nurse. That disappeared with Nursing 2000, but we are now coming back to that discussion. I have no problem with that, but we will need degree nurses. We have nurses in very advanced practitioner roles, which means that they require a more academic design—a more balanced and weighing-up-the-evidence kind of approach. It is important that we do not make it that the only route most people can afford to follow is the healthcare assistant route. I welcome it, but I certainly would not like to see people limited by it. The Secretary of State tells us that this is not an issue, because we still have more applicants than places—as yet, according to the universities, the number of places has not expanded by very much—but what we do not know is the talent that exists among that 23%. It may be fine numerically, but if we are excluding people who might have been absolute leaders in the nursing profession and in the NHS then we are the poorer for it.
We know that 40,000 vacancies need filling, and the pay cap is definitely making it harder to fill them. Brexit is not exactly helping either. Everyone here knows that my other half is a German GP in our NHS who, 15 months on, still has no idea what our rights and opportunities will be. The pay cap is definitely contributing to that problem and it is time for it to go, but it must be funded, or else it will mean a cut in services, which will hurt not just patients, but staff, who will feel that they are damaging the very service in which they work, and they will feel guilty about that. As that service is cut and contracts, their working day and working life will get worse.
The Government often talk as if spending on public service staff is money wasted. It is as if we cannot afford that money because we need to get the debt down, but in actual fact money that is put out by public sector workers is irrigating the economy—the money is spent. Some of it comes back in income tax—20% of everything all of us spend comes back. Money disappears when it is pushed at the top. It goes into banks and offshore, and is therefore outside our economy. Money that is in our economy encouraging commerce and business is helping us to recover.
After the tragedies of this summer—from the terrorist attacks to Grenfell—people right across this Chamber have quite rightly praised NHS staff and emergency workers. Now is the time for us to show not just what we think of them, but how we value them.
Andrew Selous (South West Bedfordshire) (Con)
I warmly congratulate the hon. Member for Portsmouth South (Stephen Morgan) on a polished maiden speech, and we all wish him the very best in his time in this House.
Conservative Members agree with what the hon. Gentleman said about the wonderful work that public sector workers do, not least in our NHS. The NHS saved my life when I was 24. I have two children heading to work in the NHS, one of whom worked as a healthcare assistant over the summer. Members of my family are also frequent users of the NHS.
Over the last few months, I have had the pleasure of spending a day at the Bassett Road GP practice in Leighton Buzzard, and I am full of admiration for the doctors and practice nurses I saw working there. I also spent time at my local hospital, the Luton and Dunstable, which has the best accident and emergency service in the country, and we are learning lessons from it all around the country, which are being spread by the Department of Health. Really importantly, I have also spent time with the social care staff of Central Bedfordshire Council and elsewhere, and seen the independent living schemes that will be key to the sustainability and transformation plans in my area.
In these debates, we seem to focus entirely on the top line of departmental budgets. In 2016-17, the Department of Health had a departmental expenditure limit of £120.6 billion and annually managed expenditure of £16.2 billion—£136 billion in total. We need to reflect on the words of Jon Thompson, a permanent under-secretary at the Ministry of Defence, speaking to the Institute of Government recently about the attitude, often, of Select Committee members from across this House:
“They seem to live in a resource unconstrained world…in the end I’ve got a limited amount of money and I have to prioritise.”
Those are words we need to hear.
There is another way to free up money within that £136 billion and improve outcomes for patients that could lead to our having more money for NHS staff— that is, to focus on improving quality, something that hardly ever gets a look-in in this House. If we look at the work that the Government are doing with the Getting It Right First Time programme, we see a 25-fold variation in infection rates for patients. Not only is going through that a deeply unpleasant experience for a patient, but the cost of surgical infections can vary from £75,000 to £100,000. If we get this right, not only do we treat patients better but there is more money to put into staff pay.
It goes on and on. Many hospitals are not using the right hip implants—they are using more expensive non-cemented hip implants. We get better outcomes with cemented implants that actually cost less.
Dr Whitford
It is really important that we are very careful about things that will be implanted permanently in a patient. We have had debates about mesh in this place, and we will be having debates about Essure, which is designed to obstruct the fallopian tubes and is also causing problems. Non-cemented implants are for younger people who may need another implant later on. I would be very careful—think of the PIP breast implants scandal—about cutting the quality of what is left in a patient.
Andrew Selous
I am talking about the data available in the national registry, now, for the first time ever, being properly compiled in every hospital. We should follow the evidence and look at the clinical outcomes, as the hon. Lady has done herself on the Health Committee.
Forty-five per cent. of surgeons are doing five or fewer complex hip and knee revisions, yet we know that clinical outcomes are better where surgeons do 35 or more a year. As a result of doing only a few operations with worse outcomes, which cost more, they also have to hire in expensive loan kits. Hospitals are spending, on average, some £200,000 a year on loan kits—some hospitals, £750,000 a year. Professor Tim Briggs, with whom I have had the honour of working over the past nine years on the Getting It Right First Time programme, said that
“there is no way right now I would ask for more money for the NHS. The waste and variation out there is unbelievable and we have got to get our act together across all the specialties to improve quality and unwarranted variation and complications. And it is not just orthopaedics.”
We are now, for the first time ever, looking at variations in litigation rates—huge amounts of money go out on litigation—in infection rates, and in revision rates. We are making progress, because litigation rates, which went up by 8% in orthopaedics in 2013-14, are down by 5% in 2014-15 and down by 8% in 2015-16.
This is a really powerful way to get better outcomes for patients and make sure that there is more money for NHS staff. That is exactly what the sustainability and transformation plans are there to do. As Simon Stevens has said, this is
“the biggest national move to integrating care of any major western country.”
If we can end our fragmented, silo-ed care through a massive expansion of out-of-hospital care, we will get better outcomes, save money, prioritise prevention, and keep patients out of hospital. If we do that, we will free up precious budget in order to pay NHS staff the decent rates we all want to pay them.
Trudy Harrison (Copeland) (Con)
I am grateful for the opportunity to speak in this debate. West Cumberland Hospital in my constituency has faced significant challenges over many decades in recruiting and retaining enough doctors and nurses. It was because of those challenges that our midwifery unit was under threat of losing 24-hour, seven-day-a-week consultant-led maternity care. In a rural area such as mine, abundant with farms—I am proud to support the National Farmers Union’s Back British Farming Day today—that could mean a two-hour journey on a single-carriageway road up to Carlisle hospital, often being held up by slow-moving vehicles. Having been through four childbirths myself, I simply cannot agree that having to travel an extra 40 miles is an acceptable modern-day service, especially if the mother experiences complications.
I was pleased that the Minister of State, Department of Health, my hon. Friend the Member for Ludlow (Mr Dunne), came to West Cumberland Hospital to see the challenges for himself, and that the Secretary of State came to the hospital in Carlisle, Cumberland Infirmary, to hear for himself the concerns of clinicians. Not one mentioned the 1% pay cap, but concerns were expressed about morale, recruitment and retention, and how to ensure that enough doctors and nurses join the health sector. In my role on the Education Committee, I look forward to considering how we can recruit doctors and nurses through technical and academic routes. I am really pleased by the huge investment that has been made in our hospital and our NHS trust.
Dr Whitford
The hon. Lady mentioned recruiting doctors and nurses through a technical route. Do she or the Government really propose that route into medicine, without a degree?
Trudy Harrison
I thank the hon. Lady; I should have been clearer in saying that I support technical and academic routes into all employment in the health sector, because I understand that it is a team effort.
Over the past seven years, more than £90 million has been spent on the brand-new hospital in Whitehaven—more investment than ever before. I am delighted that we have been awarded more than £40 million of extra capital investment to refurbish and rebuild parts of the hospital estate, to bring it up to date and improve the experience of patients and staff. The funding will help to deliver faster diagnosis of conditions including cancer, easier access to mental health services and an expansion of our A&E department, leading to shorter waiting times for operations and more services in GP surgeries. There has been huge progress in improving patient care, and the funding will help to secure the highest-quality, most compassionate patient care anywhere in the world. Some £30 million of new funding will be invested across south Cumbria to modernise mental health facilities and improve A&E facilities at our hospitals, and nearly £10 million of the new capital funding has been earmarked for modernising mental health in-patient services.
Ensuring that we have a full complement of doctors, nurses and other staff on wards is essential. We simply cannot run wards without the appropriate staff. Our public sector workers, including nurses and other healthcare staff, are some of the most talented and hard-working people in the UK. Like everyone else, they deserve to have fulfilling jobs that are fairly rewarded in their take-home pay. We now have 12,000 more nurses working in our hospital wards than we did under the Labour Government, and retaining hard-working nurses and doctors is vital to maintain the service that we all appreciate. I am pleased that yesterday the Treasury decided to remove the 1% pay cap across the board.
One point I would like to draw attention to is the need to assist our talented, highly qualified medical clinicians to be able to do what they are trained to do and experienced in practising. From speaking to midwives both at my local hospital and elsewhere in our trust, I know that they are regularly spending up to three hours of their eight-hour shifts ploughing through administration work, stuck at a computer screen, rather than being out on the wards doing the work that they are trained to do—assisting mothers in labour and delivering children safely. I ask Ministers to look at innovative ways in which our trained staff can use the skills that they have.
It is the 42-year record low unemployment rate and our seven-year track record on deficit reduction that have made the end to the pay freeze possible.
Access to NHS Dentists
Philippa Whitford Excerpts(6 years, 8 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Judith Cummins
I certainly do. I thank my hon. Friend for that intervention.
The physical damage is visible—it is easily understood—but just focusing on this physical damage would be to underestimate what we are facing in this country. Much of the damage is much less visible, as it is emotional, psychological and hidden beneath the surface, with a generation hobbled by insecurity and embarrassment. At a time when mental health parity receives the personal endorsement of the Prime Minister, I despair that so many, mainly young people, are facing emotional disorders for an entirely preventable reason.
It is difficult enough for adults left with irreparable damage, but when our children and young people are left embarrassed, deeply under-confident and self-conscious, the true scale of what is happening reveals itself.
Dr Philippa Whitford (Central Ayrshire) (SNP)
Is not the underlying problem that there is no preventive dental contract in England? That means that people are going when they are in crisis and dentists are unwilling to take them on. England needs something like the Scottish Childsmile scheme, which takes children right through childhood.
Judith Cummins
I thank the hon. Lady for that intervention.
As children and young people are starting off in life, with their careers, social lives, and everything else ahead of them, they are being left damaged for entirely avoidable reasons. Sadly, identifying a crisis in our health services is not a rarity, but what we see in this crisis is that it is unfairly hitting the least affluent the hardest—those who are struggling to make ends meet, and those living in working-class areas.
The BBC interviewed a Bradford resident, Nazreen Akhtar, a mother of two children. She said it had taken her five years to find a dentist who would accept both her children.
Judith Cummins
I am really sorry; I cannot give way because of the time.
One of the most shocking figures reveals that the number of children admitted to hospital for tooth extractions has risen by a quarter over the past four years. Some may think that tooth extraction is simply a part of growing up—a rite of passage for children. Some may recount their own personal memories of visiting the dentist. If anyone still holds that sentimental view, they should pause for a moment and rethink. The tooth extractions I am speaking of, which have gone up by a quarter in the last four years, mostly involve a general anaesthetic. A recent freedom of information request to Bradford hospitals sets out the scale of the crisis. In the short period from April to December 2016, 190 children were admitted to hospital to undergo a tooth extraction under general anaesthetic. What was also shocking about this request was the hospital’s admission that those figures were not available prior to April 2016. The hospital did not consider that the procedure warranted reporting.
Judith Cummins
I am sorry, I do not have time.
One core theme that emerges time and again, as borne out by Bradford hospitals’ admission, is that the Government are paralysed by inaction when it comes to oral health and NHS dentistry. They are indifferent towards even the simple task of requiring a countrywide collection of the most basic statistics on how many children are being subjected to the dangers of general anaesthetic. Time and again, the only sensible conclusion that can be drawn is that this Government are paralysed by inaction. Oral health and dentistry services truly are the Cinderella service of our NHS.
Across our country, tooth decay remains the leading reason for hospital admissions among young children, despite being almost completely preventable. The Government should be ashamed of the fact that almost 40,000 children were admitted to hospital to have multiple teeth extracted under a general anaesthetic because of tooth decay in the last year alone. On the Department of Health’s own figures, the average cost of a tooth extraction is £834. Overall, the NHS is calculated to have wasted more than £50 million on tooth extractions. This crisis is wasting the NHS millions upon millions of pounds each and every year in tooth extractions for our children. As the saying goes, prevention is better than cure. That was never truer than in oral and dental health. The Government should be ashamed of the fact that, on their watch, tooth extractions are up by 25%. It is beyond doubt that that £50 million would be better spent on prevention activities. Spending the money in that way would free up scarce NHS time and limited beds, while saving tens of thousands of our children from the trauma of hospital admission and general anaesthesia.
I want to touch upon the real scandal at the heart of those 40,000 hospital admissions. NHS dental treatment is free for our children and young people. Every child and young person should be receiving good quality NHS dental treatment, but recent figures published by the Royal College of Surgeons faculty of dental surgery reveal that 42% of children did not visit an NHS dentist in the year prior to 30 June 2017, and a staggering 80% of children between the ages of one and two did not visit a dentist at all. That may perplex some Members. Why are so many of our children and young people not receiving the treatment that they are freely entitled to access under our NHS? A recent survey published by the BDA reveals the truth. The survey found that 25% of parents did not know that routine dental check-ups were free for their children. More to the point, seven in 10 parents were not aware that treatment for their children would also be free of charge.
In theory and in name, we operate an NHS dental system for our children and young people—one that is based on need, not on ability to pay. It is free at the point of need and free at the point of delivery. In reality, however, when seven in 10 parents are not aware that treatment for their children is free; and when, on the ground, 40% of NHS dentists are unwilling to take on children as new NHS patients, I ask this question: can we really say with any certainty that we continue to operate a free NHS dental system for our children in this country? Is it not true that, following seven years of inaction, the Government have, de facto, displaced our NHS dental system with a burgeoning private system?
Although the working class are, beyond doubt, being hit the hardest, the crisis in dentistry transcends social class, ethnicity and age. Although the people in my home city of Bradford are being hit hard by the lack of access to an NHS dentist, evidence from the profession, patients and the British dental association makes it clear that the crisis is a national one, which is hitting all areas of this country. Therefore, I ask the Government to get on with dental contract reform and, more broadly, to bring forward a coherent strategy to tackle the inadequacies and inequalities I have set out this evening. Indifference is not an option; Government need to act now to stop this crisis.
The Parliamentary Under-Secretary of State for Health (Steve Brine)
I congratulate the hon. Member for Bradford South (Judith Cummins) on securing the debate, which has come significantly earlier this evening than perhaps we had expected. I am sure that that is one of the reasons for the increased turnout, but the main reason is that this is a very serious and important subject, which affects lots and lots of our constituents. I thank Members for being here.
Of course, everyone should have access to a dentist, and those who want it should have access to an NHS dentist. It is a fact that the two main dental diseases—dental caries or decay, and periodontal or gum disease—can be almost eliminated by the combination of good diet and correct tooth brushing, backed up by regular examinations by a dentist. Let me acknowledge from the outset, therefore, the vital role that dentists play in maintaining and improving the oral health of all our constituents.
As hon. Members may be aware, NHS England has a statutory duty to commission services to improve the health of the population and to reduce inequalities. The hon. Lady spoke passionately about that, as she always does. In this instance, NHS England’s statutory duty is to commission primary NHS dental services to meet local need. I appreciate that, as she has highlighted, there are of course areas with access difficulties—to put it mildly—such as her constituency of Bradford South, as well as those represented by other Members in the Chamber, but overall access continues to increase.
The January to March 2017 GP patient survey results were published in July, and I looked at them today. They showed that 59% of adults questioned had tried to get an NHS dental appointment in the past two years. Of those trying to get an appointment, 95% were successful. Looking, as I did today, at the latest figures for patients seen by NHS dentists, I can tell the hon. Lady that 22.2 million adult patients aged 18 and over were seen in the 24 months ending 30 June 2017. This equates to 51.4% of the adult population. The number of adults seen by an NHS dentist had increased by 19,000 compared with the period ending June 2016. To prove that I have indeed swallowed the numbers box, let me put it on the record that 6.8 million children were seen in the 12 months ending 30 June 2017. This equates to just over 58% of the child population. Again, this was an increase of 75,000 compared with the period ending June 2016.
Dr Whitford
It is not just a matter of seeing children if they are simply being seen for caries and fillings or other remedial work. The payment structure means that a dentist is paid only for a check, not for advice, cleaning or fluoride sealant, and the problem is that that structure does not drive prevention.
Steve Brine
I absolutely agree with the hon. Lady, and if she will bear with me, I will come on to that point.
Steve Brine
Yes, there should be a package, and I will come on to mention one or two of those points. This is as much about self-care as it is about interaction with the dental profession.
To conclude the point I was making, at a regional level in the period to 30 June, the north of England saw the highest percentage of patients seen—56.8% of adults and 63% of children. Although these access numbers are encouraging, I know that the hon. Member for Bradford South will not be sitting there thinking, “That’s all okay, then.” I know that more needs to be done to reduce the remaining inequalities in access, including in areas such as Bradford South, which she represents, and NHS England is committed to improving the commissioning of primary care dentistry within the overall vision of the five year forward view.
There are a number of national and local initiatives in place or being developed that aim to increase access to NHS dentistry. Nationally, the Government remain committed to introducing the new NHS dental contract, which the hon. Lady rightly referred to often in her speech. It is absolutely crucial to improve the oral health of the population and increase access to NHS dentistry.
A new way of delivering care and paying dentists is being trialled in 75 high street dental practices. At the heart of the new approach is a prevention-focused clinical pathway. It includes offering patients oral health assessments and advice on diet and good oral hygiene, with follow-up appointments where necessary to provide preventive measures, such as fluoride varnish, that can help the prevention agenda. Importantly, and this is of most relevance in this debate, the new approach also aims to increase patient access by paying dentists for the number of patients cared for—let me restate that: cared for—not just for treatment delivered, as per the current NHS dental contract. Subject to the successful evaluation of the prototypes, decisions will be taken on wider adoption. The prototypes are being evaluated against a number of success criteria, but let me be clear that they will have to prove that they can increase dental access before we consider rolling them out as a new dental contract.
I appreciate that this is taking a long time. It is as frustrating for me as it is for right hon. and hon. Members and for the profession, but Members will understand that rolling out a new dental contract is complicated and complex. We have to make sure that it is right and that what we put in place is better than what was there before.
Dr Whitford
I am very grateful to the hon. Gentleman for giving way again. Has he looked at the Childsmile project in Scotland? It covers dental care from zero to 18, including advice and education in nursery and in school, and therefore provides a whole package. It has reduced dental caries in Scotland—frankly, we have much worse teeth than you—by 24% and saved £5 million. That information is already there and it might help in the assessment of the Government’s plans for England.
Steve Brine
I thank the hon. Lady for that. No, I have not looked at that, as I am still relatively new to the brief, but I will certainly do so. I will make some progress and then conclude because time is limited.
Contaminated Blood
Philippa Whitford Excerpts(6 years, 10 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Dr Philippa Whitford (Central Ayrshire) (SNP)
As the hon. Member for Kingston upon Hull North (Diana Johnson) said, 2,400 people have died following the worst disaster in NHS history. That was due to a shortage of blood and clotting factors, which led to the NHS sourcing products from America. The problem is that the factor IX concentrates for men with haemophilia or women with Von Willebrand disease are made from thousands of samples. The moment one or two people within that collection are affected is the start of the virus, and that was why these patients were affected at a much higher rate than those who had a single blood transfusion. The problem is that the issue goes back decades and it has not been properly dealt with, as has been said already.
There have been multiple debates, statements and urgent questions on the issue during the two years in which I have been in the House—I, too, pay tribute to the hon. Member for Kingston upon Hull North for keeping at it with the all-party parliamentary group—but most of them have been about support. It was only last July that the Government finally came forward with a strengthened support package for these people. It is important to recognise that the payments are not compensation; they are ex gratia support payments, and they do not recognise the loss and suffering of the victims of contaminated blood. This seemed to come about only after the Scottish Government came up with a much more generous package in the form of a much larger lump sum, ongoing payments and, in particular, a 75% pension to the spouse and bereaved families. Such people still do not get sufficient support here in England, but it is not right that someone who has lost a partner to this scandal is not compensated.
We heard in March this year—a mere seven months after the announcement of a support package—that the Government were consulting on perhaps restricting who would qualify for the highest payments, and that the payments would not be index-linked. The youngest remaining victim is approximately 35. They have a whole lifetime to go through. That might be a shortened lifetime in comparison with ours, but we cannot suddenly leave people in poverty further down the line. These things need to be dealt with. I welcome the Minister’s commitment that the payments will be linked to the consumer prices index. We may need a debate on support, but that is not what this debate is about.
Hywel Williams
I am reluctant to interrupt the hon. Lady’s remarks, but may I point out that the support also extends to Wales, not just to England? As far as I understand it, there is also a £10,000 payment for spouses in Wales. Is it the hon. Lady’s understanding that the inquiry’s terms of reference will include the actions of the Governments in Wales, Scotland and possibly Northern Ireland, as well as what has happened in England? I had intended to ask the Minister that question, but could not make an intervention.
Dr Whitford
The Scottish Government set up the Penrose inquiry, but I would assume that any inquiry will look at the whole UK, and the Minister has committed to that. It must be remembered that the decisions that led to the scandal were taken here and in Whitehall. This was before devolution. Governments such as the Scottish Government have tried to step up to support citizens who have been affected, but getting the answers to what caused the situation is a matter for this place.
Catherine West
Does the hon. Lady agree that the lack of trust has been enhanced by documents such as “Self-Sufficiency in Blood Products in England and Wales”? That was a Department of Health document, but many people felt it was inaccurate and contained outright lies?
Dr Whitford
The inquiry will have to look at all those things. Documents, patients’ records, things that were altered and hidden, and things that are hiding behind public interest barriers now all need to be opened up so that light can be shed on the matter, as with Hillsborough.
Penrose was a Scotland-only inquiry. The Department of Health was invited to take part and turn it into a UK-wide inquiry, but it declined. One of the key weaknesses of the inquiry was that Penrose did not have the right to summon documents or people.
I remember when the scandal started to unfold in the ’80s. As a surgeon who was, of course, using blood on her patients, I remember how shocked I was at the mere thought that an action I might have taken could have harmed a patient I was looking after. In my elective surgery, I set about chasing every single blood cell to avoid spilling blood. I used electrocautery and all sorts of modern techniques. If I were to wheel out the staff from my theatre now, they would moan about how long I used to spend doing that. If a clinician is dealing with someone who has been hit by a bus, however, they have no choice.
I remember a critic of Penrose in 2015 saying that they were surprised that clinicians showed so much trust in the quality of blood, but a clinician who is using hundreds of drugs, implants, machines and blood products must be able to trust them. We have no mechanism personally to check them. That is the role of the Government and all their agencies. It is why we have licensing and inspections, and it is why action must be taken when there is a suspicion of harm. Failing to act, hiding and not dealing with the situation at the time all happened pre-devolution, and this inquiry must take account of that.
At a conference in Glasgow in 1980, clinicians were already raising concerns about changes in the liver function of patients who were receiving blood concentrate for haemophilia. A 1981 meeting of the UK’s Blood Transfusion Research Committee, which we have all read about recently, recognised that about 50 patients a year developed some form of liver damage. Yet the decision at that meeting appeared to be to let that continue and simply to study the situation, using those patients as a way of developing a test for what was known at the time as non-A, non-B hepatitis. It is important that we ensure that this inquiry looks at all this. The official from the Department of Health and Social Security who was at that meeting would not attend Penrose. Such people need to be called by this inquiry.
Going forward, the inquiry must include the families and the victims so that we are sensitive to what they want to know. This is also about not just the Government but producers—and not just producers in America. We try to make ourselves feel better by blaming this on the States, where people bought blood, and where people with addictions, people living in poverty and prisoners were used. In the mid-70s, prisoners in this country were also used, and it is claimed that that was encouraged by the Home Office as part of prisoner rehabilitation. We need the documents on that; we need to understand if that decision was made. UK producers have often been found wanting in the quality of product they came up with, so we must not pat ourselves on the back and imagine that the UK product was somehow safe and that this was all due to the US. We need to follow this right down and get the answers.
These people have been failed so many times, over and over, and it is crucial that that does not happen again. We need to keep the Government on their toes. We need to have reports back from this inquiry as it is set up, so that we know what it is actually going to look into. If we fail to get answers this time, and particularly if we fail to deliver compensation for the lives lost, the suffering, the failure to get a mortgage or insurance, and the costs of care, we will have failed these people all over again.
Mims Davies (Eastleigh) (Con)
I congratulate the hon. Member for Kingston upon Hull North (Diana Johnson) on securing this important debate. I was in the Chamber when the former Member for Leigh raised these very concerning issues, which need to be looked at in the inquiry. That struck a chord with me, so I am delighted to be back in the Chamber to see this debate.
Like many Members on both sides of the House, I have been contacted by constituents who have told me about their experiences and about how contaminated blood has affected them, their family life and their friends. Every so often as a constituency MP, we meet the saddest constituents who tell us the most heartbreaking stories. We sit there week in, week out, and those stories resonate with us, but they are not stories for the victims—they are daily life. These are wrecked lives, but the people have done nothing wrong of their own accord—it is pure injustice.
It is clear that the contaminated blood products that were used decades ago have continued daily to affect people’s lives in a devastating and destructive way. When I have heard the stories of how people have been affected, they have lived with me, and I can understand the campaigning that has been done by Members on both sides of the House. I am therefore delighted to talk about my constituents’ experiences.
Today, we finally recognise what has happened, and the Government are ready to tackle this injustice. I am delighted that that is being done in the name of the victims and their families, who did nothing to bring this on themselves.
After I became the MP for Eastleigh in May 2015, I met one of my constituents from Bishopstoke, Gary Webster, who has been left coping with HIV, hepatitis C and possibly variant Creutzfeldt-Jakob disease as a result of the NHS blood products that were used during a routine procedure in the 1980s to treat his haemophilia.
Dr Whitford
It will be important that the inquiry goes far enough back. The decision to heat-treat albumin for hepatitis B was made in the mid-60s, but we did not treat concentrates. We need to make sure that all these conditions are included.
Mims Davies
I thank the hon. Lady for that input. It is absolutely right that she, like all our constituents, brings her experience to this. We need to make sure that we do go back far enough.
Last year, Gary attended a debate we had here once again to discuss this heartbreaking issue. He attended a specialist school in Alton, where he was one of many haemophiliacs. He told me that he kept in contact with around 100 other students, all of whom had been affected by contaminated blood, although only around 20 were still alive. These students all contracted illnesses through blood products they had received because of their haemophilia. Tragically, Gary’s story is similar to that of thousands of others across the country.
Other constituents, some of whom wish not to be named, have had grave financial burdens placed on them and their families as a result of the diseases they contracted from contaminated blood, which have affected their lives. It is only right that we support those whose lives have been significantly affected by these contaminated products. I am therefore pleased to hear about the additional support that the Government will provide to those who have been roundly affected. I am particularly pleased that the annual payments for those with hepatitis stage 2 will increase to £15,500, and then to £18,500 in 2018-19. Payments to those co-infected with HIV and hepatitis stage 2 will also go up, to £36,500 by 2018-19. I am pleased to see that these payments will be linked to CPI.
That will help to support all our constituents we know have been affected. I know from speaking to Gary and others about the real hardship and challenges these conditions have brought to their lives, and about the difficulty they face in working, and in bringing up and supporting their families in the way they would have liked had they not been affected.
Almost £400 million has been paid out to those affected by five different organisations, which have been funded by the Department of Health. I am delighted to hear about the £125 million the Government have committed as additional funding for the reformed scheme, which will double the Department’s annual spend on the scheme over the next five years. That money must go to the people who really need it—that should absolutely be noted—because the daily-life decisions they have made have been really difficult because of their financial impact.
Adult Social Care Funding
Philippa Whitford Excerpts(6 years, 10 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Urgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Steve Brine
I thank my hon. Friend for that. I think she knows that I will be in the vicinity of her constituency at some point over the next few months, and I would like to take her up on her offer. I wish her well in her current campaign.
The workforce is critical. Adult social care is a rapidly growing sector, and there are about 165,000 more adult social care jobs than there were in 2010. It is imperative that we get the right people into the right jobs, to deliver the improved quality of care and services that we all want to see. We are working closely with our delivery partner Skills for Care to improve the level of skills in the adult social care workforce, and we are making the profession more attractive with the introduction of the national living wage, from which up to 1.5 million people in the social care sector are expected to benefit. I might point out that that policy has come in only as a result of this Prime Minister and this Government.
Dr Philippa Whitford (Central Ayrshire) (SNP)
I want to point out that the report rates 92% of services as good and 3% as outstanding on caring. That comes from the commitment of staff, who, sadly, have not been given a breaking of the 1% cap. The issue of safety has been raised, with one in four providers failing to provide safe care. That comes down to workforce and funding. Brexit threatens the workforce; as the hon. Member for Totnes (Dr Wollaston) said, there is a turnover of one in four. Funding has been reduced by 9%, and that has to be tackled.
Does the Minister recognise that one in five emergency admissions could be avoided if alternatives were provided? Although the measures are different in Scotland, delayed discharges are falling in Scotland while they are rising in England. Will he get rid of fragmentation and look at real integration of health and social care in the sustainability and transformation plan reorganisation?
Steve Brine
I said at the very start of my response, did I not, that we should salute the 1.4 million people who work in this country’s social care sector? We should also salute the families who support people who are in and out of care settings all the time. I did also say—I am grateful that the hon. Lady responded to this—that it does not surprise me that the caring side of the sector came out as one of the good bits in the report.
The hon. Lady spoke about keeping people out of the emergency setting, and that is absolutely what the STP process is about. We are one NHS, and there is one public sector. This is about the NHS getting delayed transfers of care right, but it is also about the work of local government. The STP process works at upper tier authority level as well as across the NHS—in my area of Hampshire, the NHS is working closely with Hampshire County Council—to deliver a one-system response. She is absolutely right, as usual, to point that out.
Oral Answers to Questions
Philippa Whitford Excerpts(6 years, 10 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Mr Hunt
Over those three Parliaments, I have learned to expect questions from my hon. Friend in a similar vein, and I commend him for his persistence in championing that cause. As he knows, I think the most important thing, with all such issues, is to follow the scientific advice.
Dr Philippa Whitford (Central Ayrshire) (SNP)
When the Government removed the nursing bursary and introduced tuition fees, the Secretary of State said that it was being done, as he has repeated this morning, to fund 10,000 extra student nurse places. The universities are saying that no extra places have been commissioned, however, so when will we see an expansion of student nurse training?
Mr Hunt
I always welcome the hon. Lady’s forensic interest in matters south of the border, but given that Scotland has just seen its first fall in life expectancy for over 100 years, she might want to think about her own constituents. With respect to the number of nurses, we now have more than 50,000 nurses in training, and we are confident that we will deliver a big increase in the supply of nurses to the NHS.
Dr Whitford
We still have a nursing bursary and we have no tuition charges, so the Secretary of State may want to explain why universities claim there are no additional places. In addition, we are losing almost half of junior doctors at the end of their foundation years. What action is the Secretary of State taking to find out why?
Mr Hunt
At the heart of this is the need to open up avenues for more flexible working for both doctors and nurses. If the hon. Lady followed what we have done in England—by successfully pioneering such working, we have reduced agency spend by 19% in a year, whereas it is still going up in Scotland—she might find the NHS in Scotland has more money to spend on her own constituents.
Health Service Medical Supplies (Costs) Bill
Philippa Whitford Excerpts(7 years ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Madam Deputy Speaker (Mrs Eleanor Laing)
Order. I thank the hon. Gentleman for his extremely kind words, and for his courtesy, which he always shows at the Dispatch Box and in the Chamber.
Dr Philippa Whitford (Central Ayrshire) (SNP)
Like the hon. Member for Ellesmere Port and Neston (Justin Madders), this will be my last time speaking in the Chamber before Dissolution, and as a newbie I also want to pay tribute to the staff of the House, who made coming here much easier than we had expected it to be. I am also glad that my final speech before Dissolution is on a Bill that, despite some of our disagreements, we have worked on on a cross-party basis to produce a piece of work that we all agreed needed to be done.
I, too, welcome Government amendment (b), although I would have laid out the three paragraphs the other way around, because the whole point of the NHS, and the whole reason we are discussing this, is patient access: that is the No. 1 concern. I would have put patients first, not third. The fear of not getting access to drugs is a great issue for patients. As the hon. Gentleman mentioned, we have a significant delay that is measurable in comparison with other countries. For certain types of cancer, our performance in relation to patients with early disease is as good as anywhere, but we fall down in dealing with people with difficult or advanced disease. That is because of the delay.
I want briefly to mention the interaction of the budget impact assessment with our no longer being part of the European Medicines Agency. I am not talking about the United Kingdom losing the agency itself; I am talking about our no longer being part of the scheme. We know that there is a danger that drugs are presented for licensing in the United Kingdom at a later date than in the United States and the European Union, which are major markets. It is likely that we could also be behind Japan. I am not suggesting that we should simply hand over any amount of money, but if we were also seen as a hostile market in which there was an expected delay of three years for expensive drugs, there would be a danger that international pharma would simply say, “You know what? We’ll license everywhere else, then we’ll come back to the UK in a few years.” That could result in significant delayed access for our patients.
We need to think about how all this feeds into trials and research, and into the life sciences system. If we are not using what is considered to be the gold standard drug at the time of a new international trial, we will not be able to take part in the comparison of the gold standard with the new drug. The UK has led the EU research network, which is the biggest research network in the world. We have been a major player in that, and it is important to realise how building in this delay from NHS England could undermine that. Surely this should be part of the NICE process. It should be clear to pharma, when it comes with a drug at a price, what process it will have to go through, what evidence it will have to bring forward and how it will have to negotiate a price. I fear that there will be delays in drugs being licensed.
This will affect us in Scotland even though NICE decisions do not apply to us. If a drug were simply not licensed here, it would be irrelevant that the Scottish Medicines Consortium chose to fund it—as it did the other week with Kadcyla—because it would still be an unlicensed medicine. We need to look at how the loss of the European Medicines Agency will work in this regard. There should not be a separate procedure after NICE that could suddenly hit pharma with another barrier to jump over. This will hit new cancer drugs, because they are expensive. It will particularly hit drugs for rare diseases, which the EMA has led on, because they are bespoke and therefore inevitably expensive. The £20 million limit would mean that if someone came up with a fabulous cure for dementia, for example, a budget impact assessment would be triggered.
Mr Jim Cunningham (Coventry South) (Lab)
I agree with what the hon. Lady says about the European Medicines Agency. I have had a lot of letters from people who are very concerned about that issue. There is another factor involved in the delays that can occur in the Government agreeing a price. I think that the drugs companies often take the Government to the cleaners.
Dr Whitford
I thank the hon. Gentleman for his intervention. That is obviously why the Government are introducing the Bill. They are trying to achieve a degree of control and to prevent runaway drugs costs. Of course we agree with that objective, which is visible in the Bill. The Government are trying to establish a predictable system of licensing in the UK, so that a pharmaceutical company knows what it has to bring to the table. That might mean a bit more flexibility during the NICE process, because we could appear hostile if a drug goes through that process and is defined as cost- effective, only to be hit with another, less predictable, barrier. The danger is that that will affect Scotland just as much as England, regardless of our drug funding decisions, because licensing is a reserved matter. The Government need to take that into account, because patients come third in the order set out in the amendment, and I believe that they should come first.
Contaminated Blood
Philippa Whitford Excerpts(7 years ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Dr Whitford
I know that the Penrose inquiry is always cast up as having dealt with this issue, but that was a Scottish inquiry and it was not able to summon people from the rest of the UK who did not want to attend. Therefore, the idea that Penrose has dealt with this is fallacious. We must have a system where we can summon people to give evidence right across the United Kingdom.
Several hon. Members rose—
Oral Answers to Questions
Philippa Whitford Excerpts(7 years, 1 month ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Mr Hunt
I absolutely welcome that, and I know my right hon. Friend has personally championed it as a local MP. The historical mistake that those on both sides of the House have made is not to do long-term workforce planning for the NHS, and that is something we want to put right.
Dr Philippa Whitford (Central Ayrshire) (SNP)
Plans to train more UK doctors are absolutely welcome, but the Secretary of State knows that it takes at least 10 years to train a doctor, so what is his response to the surveys by the British Medical Association and the GMC showing that, having been left hanging for nine months, 40% to 60% of EU doctors are thinking of leaving?
Mr Hunt
My response is the one I give many times in this House, which is to stress to all those doctors how valued they are as critical parts of the NHS. We do not see any evidence of the number of doctors joining from the EU going down. The NHS is one of the best health services in the world, and it is a great place for people from other countries to work and train.
Dr Whitford
The workforce is one of the biggest challenges right across the nations of the UK, and particularly in rural areas, as we heard earlier. With a 92% drop in the number of EU nurses coming to the UK and a 60% increase in the number who left last year, how does the Secretary of State plan to avoid an NHS staffing crisis immediately post-Brexit, before there is time to train anybody extra?
Mr Hunt
The hon. Lady needs to be very careful in her use of statistics, because she will know that one reason for the drop in the number of nurses coming from the EU is that prior to the Brexit vote we introduced much stricter language tests, as that is better for the safety of patients and a very important thing that we need to get right. We are very confident that nurses will continue to want to work in the NHS, because it is a great place to work.
Health Service Medical Supplies (Costs) Bill
Philippa Whitford ExcerptsWednesday 15th March 2017
(7 years, 1 month ago)
Commons ChamberRead Full debate Health Service Medical Supplies (Costs) Act 2017 View all Health Service Medical Supplies (Costs) Act 2017 Debates Read Hansard Text Read Debate Ministerial Extracts Amendment Paper: Commons Consideration of Lords Amendments as at 15 March 2017 - (15 Mar 2017)
Dr Philippa Whitford (Central Ayrshire) (SNP)
I, too, welcome the principle of the Bill. We have discussed it in a lot of detail as it has gone through Parliament, and the legislative consent motion was passed by the Scottish Parliament last month. I welcome the fact that the Minister listened to our previous discussions, and I therefore welcome Lords amendment 1, which deals with specials—individually produced medicines, usually within dermatology. While the numbers involved may be small, the costs are often eye-watering. In Scotland, that process is controlled through a procurement method, but it was certainly clear that NHS England was simply being ripped off, and I am glad to see that that is being addressed.
I also welcome Lords amendment 6, which will bring in, as I suggested, a consultation on how to maintain the quality of products. We discussed surgical gloves as a perfect example. People talk about quality marks, but they are often simply manufacturing quality marks, not necessarily a mark of suitability for the task. The Medicines and Healthcare Products Regulatory Agency could be involved, or there could be some other process, but it is important that we do not drive down quality by trying to drive down price.
The main thing that we are discussing is the Government’s plan to disagree with Lords amendment 3, which would insert a new clause. The NICE board is today discussing this extra layer behind NICE. We are talking about drugs that NICE has already decided are cost-effective, and giving NHS England the ability to delay them further without negotiation. The amount of antivirals such as sofosbuvir for hepatitis C that hepatologists can prescribe is rationed, even though we know that the most important group to treat are those who are well—not those who are almost bed-bound or near the end of life with cirrhosis—because they are the ones out in society spreading hepatitis C to other people.
It is important to consider the delay, which has two aspects. The first relates to very expensive drugs, which are usually for rare diseases. Looking back, almost none of the drugs that have got through in recent years would pass the new limit. Secondly, the total of £20 million means that regardless of how effective a drug is, perhaps for a common disease, it would not get through. If someone comes up with a wonder drug for type 2 diabetes, it would hit the slowing mechanism if it cost more than £20 million because of the sheer number of people that we would be dealing with.
The hon. Member for Ellesmere Port and Neston (Justin Madders) mentioned the impact of our withdrawal from the European Medicines Agency, but while he focused on the impact on the pharmaceutical industry, the impact on the patient is much bigger. Drugs are launched in America and Europe due to the sheer scale of the market, and countries such as Canada and Australia wait longer. The UK will also wait a little longer because we will no longer be part of a market of 500 million people.
The UK may also be seen as a hostile market, because it takes three to five years for cancer drugs to get into the NHS. As other doctors in this place will know, our patients face a delay in accessing new drugs, and anyone who thinks otherwise is fooling themselves. Pharmaceutical companies will simply think, “Well, we’re not going to get into the NHS for five years, so let’s go and do Australia and Canada. We’ll come back and deal with the UK later.” That delay to licensing in the UK would be a real problem, and it would extend to Scotland, too, because at the moment licensing is a UK-wide process. The drugs would therefore not be available to us outside the European Medicines Agency.
This issue is also important to UK research. If we fall so far behind that we do not use what is considered standard treatment, we will not be able to take part in trials of standard plus new. There is an absolute need to control the cost of drugs, but perhaps we need different discussions with pharmaceutical companies about how drugs come on. We need something more radical than this to find the sweet spot between the companies getting a return on their money, the NHS controlling the cost and patients getting access.
We also need to think about realistic medicine. Not every patient even wants access to the newest chemotherapy, and perhaps we need some hard discussions, and to be much more open with patients about what a drug will and will not do.
Question put, That this House disagrees with Lords amendment 3.
NHS Shared Business Services
Philippa Whitford Excerpts(7 years, 2 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Urgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Mr Hunt
I thank my hon. Friend for her sensible contribution. She is right that, although the process of sending on these particular documents has been taken in-house, other parts of the contract were taken on by a company called Capita—[Interruption.] The hon. Member for Leicester South (Jonathan Ashworth) cannot stop, can he? Let me repeat that the work in question has been taken in-house. The other work, which is being done by Capita, has had some teething problems, of which we are very aware. We know it has been causing problems for GPs. The Under-Secretary of State for Health, my hon. Friend the Member for Oxford West and Abingdon (Nicola Blackwood) has been meeting Capita and people relating to that contract on a fortnightly basis to try to identify the problems.
My hon. Friend the Member for Totnes (Dr Wollaston) is right that the aim in the long run is to give people control of their records. I am proud that, under this Government, we have become the first country in the world to give every patient access to their own records online. From September, people will be able to do that without having to go to their GP’s surgery.
Dr Philippa Whitford (Central Ayrshire) (SNP)
I am sure that everyone across the House is glad that these 750,000 incidents have not, so far, resulted in patients suffering. Frankly, that is luck, rather than plan, for which we should all be grateful. This is yet another situation similar to that of Concentrix and others we have seen. When we are outsourcing and taking on these companies, what is the basis of the contract and what is the governance? The Secretary of State mentioned the other incidents of transferring data when a patient moves to another GP’s surgery, and that has also been an issue. When will data in England become more digital so that things are not sent by post? We have not used that method for several years in Scotland, and it is holding back the entire primary care and hospital system here. When will the Secretary of State’s vision for that come about?
Mr Hunt
The hon. Lady is always very good at telling the House things that Scotland does better than the NHS in England; there are, indeed, some. She is a little bit coyer about things that Scotland does less well than the NHS in England. If we put aside those issues, I think we can both agree that the sooner the NHS across the whole UK goes electronic, the better. That has been a big priority for this Government, and we have made big progress. More than two thirds of hospital A&E departments can now access a summary of people’s GP records, and we are going further every month.