Health Infrastructure Plan

Sarah Newton Excerpts

Monday 30th September 2019 Commons Chamber

[Edward Argar]

I will at least start by expressing gratitude to the hon. Gentleman for his kind words at the beginning of his remarks. As he says, we work closely together in our city and county, although I suspect that that spirit of co-operation might not extend across these Dispatch Boxes. None the less, it is a pleasure to stand opposite him. Although I would not agree with his characterisation of where the money has gone, is he, on the basis of that characterisation, suggesting that his own seat is a marginal constituency?

I find it extraordinary that the shadow Secretary of State takes opposition to a new level by opposing investment in our NHS, trying to cavil and challenge it. He will forgive me if I do not take his specific questions in the same order as he asked them, but I will run through as many of them as I can recall or as I noted down.

On mental health, I have to say that I find it very difficult to take lessons from the hon. Gentleman when this Government have invested huge additional sums in mental health care. As I mentioned in my opening remarks, we have allocated capital for Greater Manchester Mental Health NHS Foundation Trust—the announcement was made earlier this summer—and for Mersey Care NHS Foundation Trust, so I think the hon. Gentleman is perhaps being a little unfair in suggesting there is no investment in mental health from this Government.

This is an ambitious programme, but unlike the last Labour Government, we will not leave hospitals saddled with masses of private finance initiative debt. That programme was massively expanded under the Labour Government he served as a special adviser. Perhaps he should welcome this Government’s approach, which is to give hospitals the funding they need to deliver without saddling them with debt.

We have made it clear that the hospitals named in HIP 1 have the funding to go ahead, including the hospitals that serve his constituency and mine. I am a little surprised to hear the hon. Gentleman challenge the notion that anyone bidding for huge sums of public money should have to go through a business case. Surely when we are spending public money, it is reasonable of us to make sure it delivers value for money and better outcomes for patients. I know the Labour party does not pay much attention to value for money, but my party and this Government do. We are focused on patient outcomes and delivering investment in our NHS. We can say proudly that, with this raft of announcements, the extra £33 billion and the announcements made already, we truly are the party of the NHS.

[Sarah Newton (Truro and Falmouth) (Con)]

I very much welcome the allocation of £450 million to Royal Cornwall Hospitals NHS Trust. We are keen to work with the Department. Local NHS leaders are eager to work on producing a good business plan that meets the needs of patients and staff in Cornwall. When will the seed funding enabling them to develop those plans be available? If all goes as well, as I am sure it will, we will be able to start building those new facilities in 2025.

[Edward Argar]

I know that my hon. Friend’s local hospital trust and her constituents have no greater champion in this place than her. She is right to highlight the allocation to Royal Cornwall Hospitals NHS Trust. The seed funding was announced yesterday and is there now, so we hope that the trust will get to work using that money to develop plans to improve services at local hospitals.

Oral Answers to Questions

Sarah Newton Excerpts

Tuesday 23rd July 2019 Commons Chamber

[Sarah Newton (Truro and Falmouth) (Con)]

17. What progress has been made on implementing his Department’s strategy and action plan, “Improving lives: the future of work, health and disability”, published in November 2017.

[The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)]

I am pleased to say that we have made strong progress against the commitments in the Command Paper my hon. Friend refers to, and I thank her for her role in delivering those advances. I can advise the House that the number of disabled people in employment is now 400,000 higher than it was in 2017. There is, however, much more to do, and on 15 July we launched a consultation on measures to reduce ill health-related job loss. We are seeking views on how employers can best support people with disabilities and people with long-term health conditions to stay and thrive in work.

[Sarah Newton]

I thank the Minister for her really helpful response, and I congratulate her on the fantastic work she has done in her position. Last week, the next Prime Minister announced his intention to look again at the tax treatment of at-work referral health services as a benefit in kind to employees, given how crucial fast access to health and support is to so many people. Will the Secretary of State and the Minister work with the new Prime Minister in bringing forward an urgent review, as the current tax regime goes against our focus on prevention and reducing demand on the NHS?

[Jackie Doyle-Price]

Absolutely. We will continue with the emphasis on work being good for people’s health. We need to look at what we can do to make it easier for employers to help their employees, which is good for everybody—it means that everyone can still make an economic contribution, and that we retain the existing workforce, and it is good for people’s wellbeing. We absolutely will look at what we can do to incentivise best practice.

--- Later in debate ---

[Jackie Doyle-Price]

Yes is the short answer, and the hon. Gentleman will be pleased to know that I have regular discussions with colleagues in the DWP to see what we can do to humanise all our processes for benefits claimants, because it is important that when people suffering from mental ill health interact with organisations of the state, we are not causing them harm. I can assure the hon. Gentleman that that is very high on the list of things in my in-tray.

[Sarah Newton (Truro and Falmouth) (Con)]

I greatly welcome the publication of the prevention Green Paper. How will that strategy enable people to keep well by living in warm homes?

[Matt Hancock]

Clearly, the need for join-up across Departments of Government is a vital part of this agenda, as my hon. Friend knows from her work across different Departments; the specific point she raises is one example of that, and we must drive it forward.

Oral Answers to Questions

Sarah Newton Excerpts

Tuesday 7th May 2019 Commons Chamber

[Jackie Doyle-Price]

My hon. Friend is absolutely right. We have spent a lot of time encouraging donors from minority communities, but the real issue with regard to stem cell donation is that it is about genetic composition. We live in a wonderful society where we all have heritage going back in various, very complex ways, but that makes finding a suitable donor for stem cell donation extremely difficult. It is therefore important that we encourage people to take the test to establish their genetic heritage so that we can have more and more diverse people on the register.

[Sarah Newton (Truro and Falmouth) (Con)]

20. What recent steps Public Health England has taken to help ensure that the violence against women and girls service commissioning guidelines are implemented throughout the NHS.

[The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)]

I thank my hon. Friend for her important work on the whole issue of violence against women and girls. Clinical commissioning groups are the primary commissioners of NHS services, and, as such, play the lead role in ensuring that service commissioning guidelines on violence against women and girls are implemented through the NHS, as informed by evidence available and current guidance.

[Sarah Newton]

Public Health England is planning to update the public health outcomes framework this summer, but there are no planned outcome measures for victims of domestic abuse or sexual violence. Will my hon. Friend liaise with the Home Office and the clinical commissioning groups to consider measures so that we can all be confident that victims are getting timely access to appropriate services?

[Jackie Doyle-Price]

My hon. Friend is knocking on an open door, because this issue is very close to my heart. The public outcomes framework does include a measure of reported domestic abuse incidents and crimes that is intended to give an indication of the scale of the issue in each area, and we expect CCGs to commission services as a response to exactly those issues. I have written to CCGs to remind them to commission appropriate sexual violence services, as well as those already commissioned by NHS England so that we have proper support for people who have been victims of these terrible offences.

Mental Health Support: Young People

Sarah Newton Excerpts

Tuesday 9th April 2019 Commons Chamber

[Jackie Doyle-Price]

In the past we have treated ring fences as a ceiling and set CCGs the clear objective that they need to increase investment in CAMHS by more than what we have been giving them. [Interruption.] However, acknowledging the hon. Member for Worsley and Eccles South (Barbara Keeley), we will look at what more control we can give, and NHS England is keeping a very close eye on how that money is being spent. As I said at the outset, I am not complacent about the challenges we face. I have to say that we are on it. Direction of travel is one thing, but we have to make sure that we are managing expectations and that we can deliver the services that people expect. That includes investment in the workforce to deliver on very clear expectations.

[Sarah Newton (Truro and Falmouth) (Con)]

My hon. Friend is being characteristically generous in giving way. I would like to give her some feedback from Cornwall, where our CCG is spending more money on mental health services and I am seeing those services grow. Does she agree, however, that simple organisational changes can sometimes help? I have two universities in my constituency, Exeter and Falmouth. When young people leave home for the first time and arrive at university, it can take months for the NHS to get their records and services sorted out, but young people with existing poor mental health conditions need those services to be in place when they arrive.

[Jackie Doyle-Price]

My hon. Friend makes a good point. Transition is clearly an area that we need to address, and she is right to highlight the importance of this in universities.

The hon. Member for High Peak made a number of points in her speech. She referred to people with ADHD and ASD, and I could not agree with her more that there is a real issue with the failure to diagnose people with those conditions early enough. We know that those people are more likely to suffer from mental ill health, so early diagnosis is absolutely crucial if we are to equip those young people with the tools to look after themselves. I am pleased that that has been a target in the forward plan that we will roll out. The hon. Lady also rightly highlighted the issues surrounding county lines and knife crime, and there is no doubt that the increased incidence of trauma in communities will bring with it more demand for mental health services. That is something that we are very much tackling as part of the Prime Minister’s summit, which took place just last week.

I have been very pleased to work with the hon. Member for Ogmore (Chris Elmore) on this, and I welcome his all-party parliamentary group’s report on the impact of social media. The impact of social media brings with it a whole new set of pressures on children’s and young people’s mental health. It brings greater intensity to relationships, for example. We think our children are safe in their bedrooms, but they are not necessarily, and we need to be vigilant about how we hold social media and internet providers accountable for the content that they host on their sites.

Infant First Aid Training for Parents

Sarah Newton Excerpts

Wednesday 3rd April 2019 Westminster Hall

[Mr Philip Hollobone (in the Chair)]

Although the title of this afternoon’s debate is “Infant First Aid Training for Parents”, there is some debate about whether it should not be “parental first aid training for infants.” No doubt, all will be revealed. I call Sarah Newton.

[Sarah Newton (Truro and Falmouth) (Con)]

I beg to move,

That this House has considered infant first aid training for parents.

It is a pleasure to serve under your chairmanship, Mr Hollobone. You make a good point—I was never an excellent scholar, and I am sure my English can be improved upon. In the course of the debate, I hope to provide a good explanation of what I was seeking to achieve in securing it.

I would like to begin with Rowena’s story. Rowena had been shopping in a department store with her mother and her five-month-old daughter. They had stopped for coffee in the children’s section, where there were lots of mothers with their babies. Seated near their table was a mother feeding her nine-month-old baby girl some home-made food. Given that they both had little baby girls, they exchanged compliments on the girls and continued with their business.

Leaving her daughter with her mother, Rowena went off to buy some coffees. While in the queue, she heard screaming and a terrible commotion. Looking around, she realised it involved the mother she had just met. Rowena could see that something was wrong with the little girl, who was not moving and was very quiet. Instinctively, she left the queue and ran to the back of the café to see what she could do.

When Rowena arrived back at the table, she saw that two other customers had come to the mother’s aid. They were trying to calm the mother down while furiously patting the back of the baby girl. Rowena quickly realised that the baby was choking on the baby food that she had been fed. Fortunately, Rowena knew what to do. She told the women attempting to help to stop and that she had first aid training, and she took the baby. Because she had completed a baby first aid course, she felt confident enough to help.

Rowena sat on a chair and held the baby face down along the length of her left leg, with the head lower than the knee. She started to give her back blows, hitting her firmly between the shoulder blades. After Rowena delivered the second or third back blow, the baby girl started to cry, so Rowena realised that she could breathe and that the blockage in her throat had gone. She handed the girl to her mum and reassured both of them that everything was okay.

The mother was quite shocked and upset, and so was Rowena. She realised the significance of her intervention. She said:

“I didn’t fully realise until that point what had just happened and the gravity of it”.

She said it had a big impact on her. That day, Rowena had done something remarkable, yet so very simple. With a few simple actions, she had saved that baby’s life. I want to enable every new parent or carer to receive high-quality training.

[Andrea Jenkyns (Morley and Outwood) (Con)]

I commend my hon. Friend on bringing this debate to the Chamber. I had first aid training with the Red Cross over a decade ago, as did my father. My dad put it to use when my mum had a mini-stroke, and my mum ended up using it on my dad when he was dying. I am a mother of a two-year-old little boy, Clifford. I am sure most parents would agree that the most precious thing in any parent’s life is their children. My hon. Friend has prompted me to go and be retrained, especially now that I have my little one. If we can, cross-party, encourage as many parents as possible to do that, that will be a win-win for us and for parents across the country.

[Sarah Newton]

I very much welcome my hon. Friend’s intervention as a young mum. Rowena had her first aid training through the Red Cross, which can provide my hon. Friend with specialist training for babies and children. Administering first aid to a young child is quite different from administering it to an older person. I commend my hon. Friend, and I hope that, as a result of our work today, many more parents will do the same.

[John Howell (Henley) (Con)]

This is an excellent debate. The scale of the task we face is quite enormous. A survey published in The Daily Telegraph not so long ago showed that only 24% of parents thought they had the skills to be able to stop their child choking. That is a very small percentage. What can we do to encourage a vast number of parents to get the training?

[Sarah Newton]

My hon. Friend makes an extremely good point. I am blessed to say that I have three children, who are in their twenties; I remember how many times I was worried about them and went to my GP or to A&E unnecessarily. I wish I had done the training, because I would have felt much more confident as a parent—I certainly would have saved some valuable time in A&E and with doctors.

I was prompted to secure this debate to continue the work I have done to prevent avoidable deaths from sepsis. We have made huge progress, and the Government have done excellent work with the UK Sepsis Trust to make sure that parents are aware of the symptoms of sepsis, as are our healthcare professionals, from paramedics right the way through to people in hospitals, and professionals in nursery schools and primary schools. They are all having sepsis training. That is important, and now is the time to build on that and to empower parents to spot the signs of not only sepsis but all other serious illnesses.

[Mary Robinson (Cheadle) (Con)]

I thank my hon. Friend for securing this important debate and for sharing Rowena’s story. We all know that story could have turned out very differently. My constituents Joanne and Dan Thompson set up Millie’s Trust after their daughter Millie tragically passed away in a choking incident in October 2012. The trust provides paediatric courses for nurseries, emergency first aid courses for workplaces and first aid courses for families, including for young children between the ages of eight and 16—that may answer your earlier question, Mr Hollobone. Does my hon. Friend join me in recognising the wonderful work of Millie’s Trust and charities like it, which offer courses not only to give confidence and reassurance to professionals and parents, but to ensure a good grounding in first aid, potentially giving life-saving information to people in situations such as Rowena’s?

[Sarah Newton]

Rowena’s story might not have ended so well without the wonderful work of Millie’s Trust and all the other organisations that ensure that people have the training to empower them to take the right action at the right time.

That brings me neatly to the statistics from the Royal College of Paediatrics and Child Health, which suggest that 21% of child deaths involve a modifiable factor—something that could have been done to prevent that death. That is quite a significant number of lives that could have been saved if the appropriate action had been taken.

[Emma Little Pengelly (Belfast South) (DUP)]

I congratulate the hon. Lady on securing this important debate. The statistics that she outlines demonstrate how important first aid training could be—it could genuinely save lives. Given the number of agencies and organisations that young parents engage with, from schools and nurseries to GP practices, is there not a good opportunity to signpost the availability of existing courses to parents and raise their awareness of them? In my area, they are available through St John Ambulance and the Red Cross. That would encourage take-up. If parents heard the statistics, very many more would take up the opportunity.

[Sarah Newton]

The hon. Lady makes a very good point. I hope that in our small way—as a result of this debate, the people watching it from outside the Chamber and the media coverage we secure—we will encourage people to take up that opportunity. That is a really good idea.

I have been listening very much to healthcare professionals in my constituency. Dr Simon Robertson, a consultant paediatrician at the Royal Cornwall Hospitals NHS Trust, told me:

“I have been a consultant general paediatrician for the last 12 years. I see children referred into hospital from their GPs, and the emergency department.

From the view of a general paediatrician a child illness and resuscitation course for all parents makes practical sense for the families and NHS services.

Parents are expected to make important decisions about their children’s health and about seeking medical advice. But we know they find it difficult to work out if their child just has a minor viral illness, or something more serious. Unfortunately not all parents are educationally equipped to read instructions from their red book, NHS Choices or health advice apps like the ‘HandiApp’. For them, we know they really need time and practice in a supportive environment to learn these decision making skills. We repeatedly see this in the families we teach resuscitation to on the wards.

What is needed in my opinion, is a course for all parents and those in child care on how to manage the common emergency problems like choking, diarrhoea and vomiting, a seizure, recognising sepsis, managing a head injury, or in preventing accidents, drowning or cot death. These learnt skills could help keep children safe and healthy, so should be the skills highly valued by families. Vitally, early action may help prevent some medical emergencies deteriorating to life threatening illness.

This can only be good for the health of children, and for children’s acute NHS services.”

I completely agree.

In 2013, the Department for Education undertook a confidential inquiry into maternal and child health in England. It conducted a meticulous audit of deaths of babies and children, and reported identifiable failures in children’s direct care in just over a quarter of deaths, and potentially avoidable factors in a further 43% of deaths. The University of Northampton’s 2017 report “Before Arrival at Hospital: Factors affecting timing of admission to hospital for children with serious infectious illness” stated that parents often find it difficult to access relevant health information or to interpret symptoms, and that it can even be difficult for GPs to determine how serious a case is in the early stages.

I have been working with Cornwall Resus, which was established in 2012 by two paediatric nurses to give parents and carers the necessary skills to empower them to recognise when their baby or child is unwell and to respond appropriately. It runs courses for parents in community centres around Cornwall. Those courses last two to two and a half hours and include practical training on choking and resuscitation using lifelike dummies, with lots of time for questions and discussion at the end. I know that I would not be happy to undertake those actions unless I had practised them on a dummy first; having just looked at instructions or a diagram, I would still be very nervous about the amount of pressure to apply, so using dummies and having practical sessions and reassurance is really important.

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Lady for bringing this subject forward for consideration, and I commend her for the work she did as a Minister. I am very pleased to see her active on the Back Benches with the rest of us. I became a grandfather for the third time just before Christmas, when my grandson Austin—I already had two granddaughters—was born. I am very mindful that parents are immensely stressed after the birth of their baby, given the care babies require. For each parent to have just a bit of knowledge about these things at that time can be the difference between life and death. Does the hon. Lady agree that there is an opportunity, through the antenatal classes that mothers do with their local trust and GP, to instil in parents the basic skills she refers to?

[Sarah Newton]

I thank the hon. Gentleman for his contribution. I will come on to what I would like the Government to consider doing. I do not think we should be prescriptive about how this training is enabled. Lots of organisations provide such training—Kernow Resus is one such organisation, but we have also heard about the Red Cross, St John Ambulance and Millie’s Trust—and of course there is the NHS workforce themselves: maternity nurses, and healthcare professionals who visit families at home. We should not be at all prescriptive about how we might enable this training, but it is important that all parents have the opportunity to participate.

Most courses cost around £30, which will seem to most of us like a very modest investment, but not every parent will be able to afford that. That will be a real barrier for some families. That is why I would like the Government to enable universal access to high-quality, evidence-based training delivered by fully qualified providers. That would give us the opportunity to reduce morbidity and mortality and, importantly, family distress. It would also help tackle the associated costs of treatment, hospital admissions and even possible litigation. We have seen huge improvements in child and infant health in our country. The number of deaths of babies and small children has fallen significantly, but it is still far too high, so I really hope that the Minister will consider seriously how we might take forward this relatively modest, straightforward intervention.

The NHS is rightly focused on preventing ill health and injury, and I am delighted that the Government are investing so much in it. I am sure everybody in the Chamber is fully supportive of that investment. It would require only modest investment to pilot this training in a couple of geographical areas and work with a couple of local commissioning groups to see how they might go about delivering it. We have heard about a range of options they might pursue. By giving commissioning groups responsibility to see how they might go about that, we could collect proper evidence about not only the impact on families and the reduction of deaths and harm to children, but the impact on acute trusts and primary care in an area if, as a result of being more confident, parents do not engage with the NHS quite so much.

This would be a small but vital step. It would be such a positive contribution. We would have more Rowenas, and far fewer families would have to cope with the dreadful grief of losing a loved one.

[Several hon. Members rose—]

--- Later in debate ---

[Sarah Newton]

I hope, now that we are at the end of the debate, that the words on the Order Paper are beginning to make a bit more sense. It has been a fantastic debate, and I am grateful to the many Members who have come along today, particularly as there has been so much about Brexit in the main Chamber. That people have chosen to spend time here this afternoon underlines how important this issue really is.

It was great to hear from the parents in the room, including my hon. Friend the Member for Morley and Outwood (Andrea Jenkyns), and my hon. Friend the Member for Moray (Douglas Ross) and the hon. Member for Glasgow East (David Linden), who I congratulate on becoming new fathers and on being prepared to speak so personally and eloquently about their journey as parents. If as a result of this debate we have done nothing more than to make sure than they sign up to courses and tell all their friends who are also young parents to go out and do those courses, we will have achieved something.

I also thank the hon. Member for Burnley (Julie Cooper) for reminding us of the important contribution of grandparents. More than ever, grandparents care directly for babies and children, so it is important that they are also trained and feel confident, because things change over time. It is good to hear a grandparent’s point of view.

As my hon. Friend the Member for Henley (John Howell) rightly reminded us, we are all champions in this place, whatever our personal experience. Whether we are like my hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson), who brings huge professional expertise, or we are unqualified but passionate advocates for our communities, we have a very important role. I am sure that the my hon. Friend the Member for Henley will join my hon. Friend the Member for Cheadle (Mary Robinson) and the hon. Members for Belfast South (Emma Little Pengelly) and for Strangford (Jim Shannon) in leading campaigns in their constituencies to raise awareness of the courses and training that are available, so that more parents feel confident and able to identify the signs of serious illness or injury and to take appropriate action.

I am grateful to the Minister, whom I thoroughly enjoyed working with; I miss working with her. I will certainly take up her kind offer to follow up on the debate. I was particularly interested in her point about the NHS long-term plan and the important future for health visitors. I agree: when I was a new mum, the health visitor arriving each day was a really valuable service. That support from the health visitor was essential in starting me off on my parenting journey. I understand that the Minister is personally committed to developing that workforce, not only in numbers but in their range of skills, and that she is looking at what further roles they may play in providing this important training to new parents. Her suggestion that we work on that is really positive.

I will certainly take up the opportunity to evaluate the first aid courses that are available in my community in Cornwall and the impact that they are having not only on families, but on our local NHS. My hon. Friend the Member for Sleaford and North Hykeham warns me that the forms can be very long and that it can be an arduous process, but we will certainly give it a go. I look forward to working with my hon. Friend the Minister to do what all of us in this room want: to make sure that parents of any age get the best possible support in starting that amazing journey of being parents, so that all their children grow up to be healthy and happy, and we avoid all preventable deaths and injuries.

Question put and agreed to.

Resolved,

That this House has considered infant first aid training for parents.

Exiting the European Union (Food and Agriculture)

Sarah Newton Excerpts

Tuesday 19th March 2019 Commons Chamber

[Steve Brine]

I ask the hon. Gentleman to bear with me. I will definitely come on to that, in respect of all the SIs.

As I said to the hon. Member for Stoke-on-Trent Central (Gareth Snell), the purpose of the SIs is to ensure that UK domestic legislation that implements directly applicable EU regulations continues to function effectively after exit day. The proposed amendments are critical to ensuring that there is minimal disruption to novel foods, feed additives and other regulated products collectively if we do not reach a deal with the EU.

The first SI, the Materials and Articles in Contact with Food (Amendment) (EU Exit) Regulations 2019—also known as Food Contact Materials—refers to all items that are intended to come into contact with food, both directly and indirectly. They include processing line machinery, transport containers—not vehicles, but the actual containers of food—kitchen equipment, packaging, cutlery as sold and dishes and utensils as sold, and can be made from a variety of materials including metal, paper, plastic, wood, rubber and, indeed, ceramics.

Let me say for the benefit of Members who do not live and breathe these regulations, in the unlikely event that there are any, that specific examples of food contact materials are tin cans for holding baked beans and plastic bottles for holding water. The regulations will ensure that those materials are robust enough to do the job, but safe enough to do it without transferring anything to the foodstuffs.

The instrument is critical in meeting our priority of maintaining after we leave the European Union the very high standards of food safety and consumer protection that we currently enjoy in this country. It will ensure that provisions in four main pieces of EU food contact materials legislation continue to function effectively in the UK after exit day. The first is European Commission regulation 1935/2004, which sets out the framework for all materials and articles intended to come into contact with food. The regulations then become progressively more specific. The second is regulation 10/2011, on plastic materials and articles intended to come into contact with food. The third is regulation 450/2009, on active and intelligent materials and articles intended to come into contact with food. The fourth is regulation 2023/2006, on good manufacturing practice for materials and articles intended to come into contact with food.

The instrument also makes relevant changes to other specific technical pieces of legislation on individual types of food contact material. It will ensure that regulatory controls for food contact materials continue to function effectively after exit day, that public health continues to be protected, and that high standards of food safety are maintained. Consumers must be protected against potential adverse effects of exposure to some substances used in the manufacture of materials and articles that are in contact with the food that we eat. The instrument will ensure that the effectiveness of the controls that we have is maintained.

This instrument, and the other SIs that we are debating today as part of the fourth and final bundle, will transfer responsibilities incumbent on the European Commission from Ministers in the European Council to Ministers in England, Wales and Scotland and the devolved authority in Northern Ireland. It will also transfer responsibility currently incumbent on the European Food Standards Authority to the relevant food safety authority: the Food Standards Agency, for which I hold ministerial responsibility in England, Wales and Northern Ireland, and Food Standards Scotland north of the border. The change will also ensure a robust system of control to underpin UK businesses’ ability to trade both domestically and internationally.

Let me now say something about the impact of this instrument on industry. The proposed amendments are expected to have a very minimal impact on businesses that produce or use food contact materials or articles. Existing provisions have received very positive feedback from our previous consultations, and there is no evidence that the changes required will be detrimental to industry. I was asked about the devolved Administrations. They have consented to the instrument. We liaise closely at official level with our opposite numbers, and, as with the instruments that we have already debated, throughout this month we have engaged positively with the devolved Administrations throughout the development of these instruments. Let me place on the record again my thanks to them for their positive engagement with me and my team.

[Sarah Newton (Truro and Falmouth) (Con)]

I am pleased by the Minister’s reassurance about the commitment to the extremely high standards of food safety that exist in our country, but will he consider making some improvements as we take on this responsibility in our sovereign Parliament? A number of my constituents are worried about claims that many of the plastic items used to store and protect food are biodegradable or recyclable when that is actually not true. Will the Minister consider improving the current standards in future, so that we can have proper regulation and proper communications about how biodegradable or recyclable plastics really are?

[Steve Brine]

It is good to see my hon. Friend here, but not so good to see her there. She knows what I mean.

Along with the shadow Minister, the hon. Member for Washington and Sunderland West (Mrs Hodgson), I chaired the all-party parliamentary group on breast cancer for many years. There is definitely talk in the lobbying community about plastics and their impact, and, as the hon. Member for Washington and Sunderland West knows, pieces of academic work make claims in that respect. Those claims are certainly not proven, and there is a wide range of scientific debate about them.

I take my hon. Friend’s point about biodegradable plastics, but it is not specifically a matter for me. The instruments deal with food standards and food safety. They do not make any degradations in our food safety, but neither do they make any improvements; they are housekeeping measures.

The second SI, the Genetically Modified Food and Feed (Amendment etc.) (EU Exit) Regulations 2019, is also crucial to meeting our objective of ensuring that the current high standards are maintained. It was made under the powers in the European Union (Withdrawal) Act 2018 to make necessary amendments to retained EU genetically modified food and feed law. It will ensure that regulatory controls for GM food and feed continue to function effectively after exit day, and that public and animal health and, crucially public confidence are protected. The EU law governing GM food and feed provides a harmonised regulatory framework, including transparent and time-limited procedures for robust risk assessment and authorisation before these products can be placed on the market, and we believe that those strict controls must be maintained.

Integrated Care Regulations

Sarah Newton Excerpts

Monday 18th March 2019 Commons Chamber

[Sarah Newton (Truro and Falmouth) (Con)]

Promoting integrated health and care services for my constituents in Cornwall has been a top priority for me since I was elected in 2010. I am delighted that promoting integrated care is a priority for the NHS long-term plan, enabling an NHS that is increasingly joined-up and co-ordinated, overcoming the traditional barriers between care institutions, teams and funding streams.

The NHS has been developing, testing and evaluating new models of care to integrate services for some time. I was delighted to support the Kernow clinical commissioning group to participate in the integrated care and support pilots, a precursor to the vanguard programme. The vanguard programme built on that work, and evaluation shows that the new models of care enabled more people to be cared for closer to home and at home, supported by joined-up services. That leads to fewer unplanned and emergency admissions to hospital.

That learning is enabling the further changes that this SI will make. I know from conversations that I have with local commissioners of health and care services that, too often, different funding streams, organisational structures and governance arrangements get in the way of commissioning patient-centred, joined-up services for people who need support from NHS primary and secondary care, as well as Cornwall Council. The integrated care contract that we are considering tonight has been carefully consulted upon and will give a new opportunity and more choice to local health and care professionals on how they can improve the services that they provide locally. No two communities are the same. Providing world-class health and care services to people in Cornwall needs a very different approach from the approach in Manchester. I welcome the intention of the SI to enable the right clinical, organisational and financial incentives for providers to collaborate to deliver preventive, proactive and co-ordinated healthcare for the communities that they serve. This is an important SI that will enable improved patient care and I am delighted to support it tonight.

Local Pharmaceutical Services

Sarah Newton Excerpts

Tuesday 3rd March 2015 Westminster Hall

[Caroline Nokes]

I absolutely agree with everything that my hon. Friend said. Small community pharmacies often know their patients well, so they are at the forefront of helping people to manage their conditions and know whether they are taking the right amount of medicine. They are often a useful place for people to go for an informal chat about the conditions that affect them.

Community pharmacies are at the heart of our communities. They dispense advice as regularly as medicine, and they help people to make healthier lifestyle choices. Pharmacy Voice, the organisation formed from the three largest community pharmacy associations, strongly advocated the role of the community pharmacy as part of the solution to pressures on accident and emergency and GP services. It has encouraged people to think, “Pharmacy first”, and it has described community pharmacy teams as being perfectly placed to care for patients with common winter ailments. We are coming out of winter and into spring, but pharmaceutical services are there all year round. They are just as adept at dealing with allergies, stings and hay fever as they are at dealing with winter colds.

Last year, Pharmacy Voice identified that up to 8% of A and E visits could have been dealt with by a high street pharmacy, and approximately one fifth of GP visits could have been avoided by visiting the pharmacist. Last year, NHS England reinforced the role of the community pharmacy with the “Feeling under the weather?” campaign. Many Ministers, including my hon. Friend the Minister, have emphasised in responses to written and oral questions that pharmacists have a great role to play in helping people to manage long-term conditions and in helping people with their medication.

None of the pharmacists I spoke to prior to this debate is sure when the role of the essential small pharmacy was first recognised, but I can say with certainty that the essential small pharmacy in the village of Wellow in my constituency has benefited from support, reflecting its small scale and relative remoteness from other pharmacies, since it opened in 1990. The national contract for such pharmacies was first introduced in 2006, and it has been extended a number of times since then. About 100 pharmacies receive support from the essential small pharmacy local pharmaceutical services scheme. Many are located in relatively remote rural areas, but some operate in inner-city communities. Over the years, they have provided services that have been relied upon by residents for their health care as well as their dispensing needs.

The current pharmaceutical needs assessment, published in 2011, supports the continuation of the scheme. It states:

“ESPLPS pharmacies are used to ensure that access to pharmaceutical services is achieved in certain locations in line with the model of access to pharmacy services in ‘Healthy Horizons in Primary Care’.”

Rural bus services are being reduced and it is increasingly difficult to access other pharmacies by public transport, so small pharmacies can easily be described as essential to local communities. Certainly, that is true of Wellow pharmacy.

What is the problem, and why have I requested this debate? These arrangements have existed for many years and have provided modest support for small pharmacies, where they are needed for patients, but where they might not otherwise be economically viable. The national contract was introduced in 2006, and negotiations by the Pharmaceutical Services Negotiating Committee have seen it extended a number of times. But what is an essential small pharmacy? The criteria for eligibility are that the pharmacy must be dispensing fewer than 26,400 items a year and must be more than 1 km from the next nearest pharmacy. Their benefit to communities was deemed to be so great that a minimum level of remuneration was set. It is currently just under £80,000 a year. From the pharmacy global sum, a top-up payment would be permitted to ensure the continued viability of the pharmacy. However, NHS England confirmed last autumn that it is not possible to continue national arrangements, leaving individual pharmacies to negotiate with their own NHS area teams. Support has been available from the PSNC, but many local pharmacists have found those negotiations difficult, time consuming and stressful. Although some have been successful, other area teams have not been able to provide certainty.

[Sarah Newton (Truro and Falmouth) (Con)]

I am grateful to my hon. Friend for securing this important debate. She is describing the situation faced by an essential small pharmacy in St Mawes in my constituency. We had a public meeting on 5 February with NHS England local area teams, and hundreds of people showed their support for that pharmacy, which is vital in serving the Roseland peninsula. We have not yet heard from NHS England about whether that funding is secure, but the pharmacy applied for an LPS contract. My hon. Friend is right to highlight the continuing uncertainty that the situation is causing for pharmacists and the communities that they serve.

[Caroline Nokes]

My hon. Friend has accurately outlined the situation in her constituency, which I am sure is mirrored across the country. I have received representations from community pharmacists, who have said that they are struggling with short time scales and no certainty from their NHS area teams.

Oral Answers to Questions

Sarah Newton Excerpts

Tuesday 24th February 2015 Commons Chamber

[Dr Poulter]

There is certainly a lot of benefit from having general practice co-located alongside A and E so that people with more minor ailments or concerns can be seen by GPs. That can often take the pressure off A and E services, but more senior expertise is also on hand when required.

[Sarah Newton (Truro and Falmouth) (Con)]

Will my right hon. Friend update the House on what steps he is taking to prevent avoidable deaths from sepsis?

[Mr Jeremy Hunt]

I am absolutely happy to do that. Overall, we have 1,000 avoidable deaths every month by some estimates, and a number of those are from sepsis. We have launched a big campaign to prevent those deaths. Indeed, we will shortly have the results of the Morecambe Bay inquiry, from which I think we will hear more about the issue. I want to thank my hon. Friend for her campaigning and her work with the all-party group on sepsis to raise awareness of this very important issue.

GP Services

Sarah Newton Excerpts

Thursday 5th February 2015 Commons Chamber

[Sarah Newton (Truro and Falmouth) (Con)]

I am very proud to be part of a governing team that has spent more money on the NHS. We faced some incredibly difficult choices when the coalition was formed and protecting the NHS was at the top of our list. I have seen for myself some of the benefits of the reforms. Many more decisions about NHS services are now taken in Cornwall, led by clinicians and local people. That is very welcome.

I very much welcome the “Five Year Forward View” that NHS England has put together to cope with the considerable increase in demand on the NHS that is anticipated. Whoever is in government will face the challenge of how we can deliver the first-class services that everyone in this House wants for every constituent in every part of the country.

In the short time that I have, I will share with the House four observations that I have made from talking to staff in the NHS in Cornwall and to patient groups in my constituency, and we could usefully take them forward to help us to tackle some of the challenges we will face in the future.

The first is the role that women can play in addressing some of the work force challenges faced by the NHS as a whole and, in particular, by general practice. The second is how we can expand the services provided by GPs’ surgeries. The third is the role that GPs can play in A and E departments, and fourthly I wish to share some of the learning we have had from our great fortune in Cornwall in being part of the integration pioneer.

[Mr John Redwood (Wokingham) (Con)]

Does my hon. Friend agree that our party’s excellent policy of extending GP opening times and days is crucial, but it will require more GPs to work more flexible hours on an agreed basis?

[Sarah Newton]

My right hon. Friend makes a good point. The plan that NHS England has put forward is about shifting resources from the acute emergency care sector into primary care sectors, especially GP practices. The point that he makes about flexible working fits well with my point about enabling more women to stay in the NHS or to return to it. Many walks of life are addressing the issue of enabling women to combine their caring responsibilities with their desire to play a full part in society, whether that is in public service as a GP, as a Member of Parliament or in business. Much more work needs to be done by the NHS to look at ways to enable women to combine caring for children or elderly parents with being a GP or fulfilling other roles in the NHS.

Women often take a break to look after their families—it is something that I did myself—and it can be difficult for women in their late 30s or 40s to find the ladder back into their previous careers and occupations. I note that many former GPs could make excellent GPs again if they were given the opportunities to retrain and reskill. They could contribute enormously, through working flexibly, to enable GP practices to open more hours.

[Dr Poulter]

My hon. Friend makes an important point. I hope that she will welcome the opportunity we may have to revisit the issue of the annual performers list. At the moment that means that if a GP is out of practice for a year, it is very difficult to return. That is something that we need to address, and I hope that she will be supportive of the Government’s efforts to address it with NHS England.

[Sarah Newton]

I welcome the Minister’s intervention. That sounds like an excellent initiative and I am sure that more will follow, because we need to use the talents of everyone in our nation to address the challenges that we face. Women can play an enormously important role in the NHS, as they can in all other walks of life.

[Michael Fabricant]

I was very interested in the intervention from the Minister, who is of course also a GP. I was also impressed by some of the points made by the hon. Member for Walthamstow (Stella Creasy) about sole GP practices. If we are to have flexibility, so that people can go and see doctors quickly and to enable women and others to go back to work as GPs, it surely requires multi-GP practices, not sole practices. Otherwise, it is just not practical.

[Sarah Newton]

That is a good point. We have to look at how general practices are set up these days. Not all general practitioners want to be part of the old partnership model, which is a sort of small business. Many now would like to be salaried and work particular hours in particular settings. I would not want to prescribe a particular model: we need to look flexibly at different models of provision that meet patients’ needs, taking into consideration what the work force need to enable them to play their full part.

GP practices in my area are expanding the range of services that they are able to provide to the community. As hon. Members will know, I represent a large, remote, sparsely populated part of the country, and such expansion is especially important for rural areas. One example is the Probus surgery of GPs, which serves many villages in its rural community. It is expanding into many areas, including minor surgery. I have yet to come across anyone who has anything other than praise for the Probus surgery, which provides the normal services one would expect from a surgery, but also works closely with its primary care partners and district nurses. It also links up with care managers for people with chronic conditions and elderly people living at home.

By comparison, a very different group of GPs work at Penryn surgery. They serve a large campus that is home to Exeter university, Falmouth university and parts of Plymouth university. There is a growing student population and the surgery has been able to expand its services to provide mental health services, prescribing services and on-campus surgeries. In attracting additional funding for services to meet the needs of the young people—we welcome them into the constituency to study there—they have additional resources from which the whole community can benefit.

Those are two very different examples of how GPs are working positively and constructively with local commissioners to expand services, bring in additional resources and improve patient outcomes for the local community.

[Roger Williams (Brecon and Radnorshire) (LD)]

My hon. Friend represents a very rural constituency, as I do. We do not have any single GP practices, but many of our practices have fewer than five GPs. Our experience is that when one leaves and the practice has difficulty recruiting, it really puts the practice under pressure. Can anything be done to make rural GP practice more attractive to young doctors?

[Sarah Newton]

That is a very good point, and I was just about to make the point that although I have given two good examples of larger GP practices that are doing very well, I also have similar issues to my hon. Friend in more sparsely populated areas of my constituency, such as the Roseland peninsula. It has an older population and it is difficult for GP practices to innovate and bring in additional services to make their future sustainable. I am in regular correspondence with NHS England, which has taken away some of the specific funding that used to be available to support remote rural GPs, in the expectation that they will be able to attract additional funding for providing additional services. That is really not possible or viable. In order to maintain access for people living in sparsely populated areas, where the population is unlikely to grow rapidly, NHS England needs to look again at funding for GP practices in such areas. I hope that my hon. Friend will make common cause with me in writing to NHS England to ask it to reconsider that point as part of its five-year plan.

The third point I wish to make is the positive work I see at the accident and emergency department at Treliske. The Royal Cornwall hospital is the only acute hospital in Cornwall and I am proud to have it in my constituency. The head of the A and E department at Treliske has worked innovatively with his primary care partners to introduce GPs into that setting. As people arrive at the hospital, a triage system is in place so that if people would be better served by seeing a GP, they can do so, which takes pressure off the A and E department.

Finally, I wish to share some of the learning from the integration pioneer work that is happening in Cornwall. The Government designated 14 areas of the country as pioneer areas to look at how we can better integrate care services with the NHS. GPs in Cornwall have provided an essential foundation for that work. Our pioneer bid is led by Volunteer Cornwall and Age UK Cornwall—I think it is the only voluntary sector pioneer bid in the country, and it is very much supported by the NHS right across Cornwall, and by Cornwall council.

By working carefully with GPs to identify frail, elderly and vulnerable groups of people with chronic conditions who tend to use the NHS a great deal—GP services, care services or the acute sector—the pioneer discovered that having a trained volunteer attached to a GP surgery to work alongside families, linking up all available support and enabling them to reintegrate into the community around them, leads to a huge reduction in the use of acute and GP services, and, most importantly, significant increases in self-reported well-being.

There are a lot of lessons that can be learnt from the reforms we have put in place. I am confident that if NHS England’s five-year programme learns the lessons from the pilots and the past five years and puts proper resources into primary care, we can see the improved health outcomes I know we all want.

[Several hon. Members]

rose—

--- Later in debate ---

[Dr Poulter]

The hon. Gentleman and I do not often agree, but I agree with him on this. We have to do more to support medical students and to encourage people from all backgrounds to become medical students. It was a sad indictment of the previous Government that social mobility into many degree courses was falling, and that was particularly the case in medicine. We have been working with the medical schools to look at the importance of early engagement, supporting people from a much younger age, and universities engaging with local communities, as is the case at my medical school, Guy’s, King’s and St Thomas’, where people from more deprived backgrounds are supported and encouraged into medicine by the medical school’s engagement with schools and with pupils from an early age. That is the sort of approach that works.

One of the challenges is the distribution of medical schools and medical places often around our larger cities. The challenge is to support smaller and important medical schools, such as Lancaster, which does a great job of supporting local young people to become medical students and then into medical careers. We need to support those universities to expand where that is appropriate. Many of our traditional models of medical training at medical schools tend to focus from day one on encouraging people to become surgeons. We know that we need to support more people to become general practitioners. What works well and what Lancaster and Keele universities in particular do through their syllabus is to encourage more young people to undertake more placements in general practice. That has a good effect in encouraging those medical students to want to become GPs in their later medical careers.

[Sarah Newton]

Does my hon. Friend agree that the university of Exeter medical school at the Royal Cornwall hospital is an important medical school because it enables people to see general practice in remote rural communities? We know from previous contributions to the debate that that is important in attracting people into remote rural areas.

[Dr Poulter]

My hon. Friend is right. I spoke to medical students and those teaching them in Cornwall on a visit earlier this year. It is important, particularly for rural areas, to encourage more placements in rural areas in general practice. Often at my hon. Friend’s medical school and other medical schools in remote rural areas, there is a good track record of recruiting more local young people so that they are being educated locally. The hope is that those people will stay and work in the local work force and contribute to the local NHS after they graduate. I hope all hon. Members will agree that that is a good thing, particularly in more deprived areas.

I must make progress as I do not want to intrude upon the House’s time for too much longer. There are two or three important points that I want to make. I mentioned that in the health education mandate in 2014 we mandated to increase the number of GP trainees from 40% to 50% of all trainee doctors. That will make 5,000 extra GPs available by 2020. It is important to note, however, that as well as having the appropriate size work force, we must plan for the future shape of the work force. The new models of care set out in the NHS England “Five Year Forward View” will require different models of staffing, and we need to plan with that in mind. That is why Health Education England has established an independent primary care work force commission, chaired by Professor Martin Roland of the university of Cambridge.

In line with the contributions to the debate from a number of hon. Members, including my right hon. Friend the Member for Sutton and Cheam (Paul Burstow), the commission will identify models of primary care that will meet the needs of the future NHS, including a greater emphasis on community and primary services and the more integrated delivery of care, which will involve the better use of multidisciplinary teams. We have been talking about GPs today, but delivering better care in the community is also about nurses, physiotherapists, occupational therapists, pharmacists, speech and language therapists and the many other health care professionals who play a part in delivering high-quality care to patients in general practices and in the community every day through our NHS.

In response to concerns raised by hon. Members about access to services, GP services need to be available to patients in a convenient place and at a convenient time. Achieving improved access to general practice not only benefits patients, but has the potential to create more efficient ways of working, which benefits GPs, practice staff and patients. The previous Government attempted to improve access to GP services by establishing a 48-hour access target. We know now that that target did not work. From 2007 to 2010, the proportion of patients who were able to get an appointment within 48 hours when they wanted one declined by 6%.

A 48-hour target can make it more difficult for some of the more vulnerable patient groups who GPs look after, particularly people with complex medical co-morbidities, to get the important routine appointments that they need. We should bear in mind that targets can be perverse. That target did not work in its own right, and could make it more difficult for people with complex needs and the vulnerable and frail elderly to get the routine appointments that keep them well and properly supported in the community.

Many points have been made about Labour’s disastrous 2004 GP contract. I do not need to rehearse those. The single biggest barrier to access to care is not being able to see their GP when people need to, in the evenings and at weekends. We have put together the Prime Minister’s fund with £100 million to back it to improve access to GP services in the evenings and at weekends, to make sure that patients receive the better service that they deserve.