Oral Answers to Questions

Will Quince Excerpts

Tuesday 23rd April 2024 Commons Chamber

[Victoria Atkins]

The hon. Lady raises an important point, and I ask her to write to me, please, so that we can look into it.

[Will Quince (Colchester) (Con)]

Given the importance of the UK’s life sciences sector, could my right hon. Friend update the House on commercial clinical trial recruitment?

[Andrew Stephenson]

Thanks in part to the sterling work of my hon. Friend, monthly average patient recruitment to commercial clinical trials is almost five times the figure it was back in June 2023. That is hugely positive, but there is clearly more to do in this space.

Hospice Funding

Will Quince Excerpts

Monday 22nd April 2024 Commons Chamber

[Will Quince (Colchester) (Con)]

It is a pleasure to follow the hon. Member for Coventry North East (Colleen Fletcher) and her powerful speech. I also thank my hon. Friends the Members for Hastings and Rye (Sally-Ann Hart) and for Darlington (Peter Gibson) for securing such an important debate, and I pay tribute to my hon. Friend the Minister, who is an excellent Minister. I enjoyed working closely with her at the Department, and I know she will listen carefully and act where she can on the issues raised during the debate.

Hospices play a vital role in local communities and within the wider health and care system, providing care to those at the end of their lives, and support and comfort to their loved ones. St Helena hospice in my constituency is no different, and since its opening on 20 May 1985 it has supported countless families in and around Colchester and north Essex during their most difficult times. However, over the last two years it has been more challenging for it to carry out its vital work. St Helena has averaged a deficit of £l million per year over the past two years due to rising demand, increasing costs, and real-terms cuts to its NHS funding. Similar to cases raised by other colleagues, only 27% of St Helena hospice’s income comes from our NHS, which means that 73% of the income needed to run it is raised through the local community. As is unfortunately common across the country, that income stream has faced its own difficulties due to the increased cost of living.

East Anglia’s Children’s Hospices also plays a hugely important role in caring for families and children in my local area. During 2022-2023 it cared for 532 life-threatened babies, children and young people, and delivered more than 72,000 hours of care and wellbeing support for families. However, every year EACH faces the ongoing challenge of generating 85% of its income from non-statutory sources. It receives only 15% of its income—about £2.7 million—from the NHS and local authorities, mainly on a year-by-year basis via grants and zero-based contracts. Having seen at first hand the impact that hospices have on local communities, and the fondness with which St Helena and EACH are thought of in Colchester and more widely in our region, I can see that it is essential that hospices all over our country are not allowed to fail. That is not only because outcomes for patients will be arguably worse, but because, as a recent Sue Ryder report shows, adequate funding for hospices is more cost-effective than replacing services with the NHS.

As a former Health Minister I want to urge some caution in calling for national solutions for commissioning. Of course we should look at addressing postcode lotteries wherever they exist, but in doing so we must remember that every area is different. The needs of our populations are different, and hospice provision in and of itself is different in every one of our constituencies. ICBs were set up to make local, holistic, system-wide decisions based on their populations’ needs and priorities, always putting at their heart the needs and outcomes of patients, but also looking at system costs, so that there is not that silo mentality in working, and ultimately at what is in the best interests—in terms of outcomes and value for money—for our NHS and the taxpayer. Having said that, I think there needs to be more consistent commissioning. ICBs should commission against service specification.

To conclude, I will make a more general observation: we are not very good at talking about death. Notwithstanding what I said about ICBs, there is a national role here. I would like to see the Government support a population approach to end of life care, involving more people in their care planning, promoting choice and dignity, and supporting community care alongside that. Many people would rather spend their last days at home around their loved ones, their pets and their families, if possible, than die in hospital. Supporting hospices and community services is a way of helping to keep people at home if that is their preference, with not just better outcomes for patients but ultimately better value for our NHS and the taxpayer. I close by thanking all those at St Helena Hospice and EACH for the amazing work they do.

Health and Wellbeing Services: Essex

Will Quince Excerpts

Tuesday 12th March 2024 Westminster Hall

[Will Quince (Colchester) (Con)]

It is a pleasure to serve under your chairmanship, Mr Henderson. I congratulate my right hon. Friend the Member for Witham (Priti Patel) on securing this important debate on health and wellbeing services in Essex. Her powerful speech raised a number of issues affecting all parts of Essex, including my own, in north Essex, and specifically Colchester. Understandably, I plan to focus on north Essex and my constituency, but given that I stood down as a Minister of State at the Department of Health and Social Care only in late November, I want to start with some reflections on our NHS more generally. May I say in passing that the Minister is doing a marvellous job with a difficult brief? As he knows, it is a privilege and an honour to be a Minister at the Department of Health and Social Care and to be part of our NHS’s story.

The NHS is a universal, comprehensive system that is free at the point of use and paid for through taxation—principles that remain intact and that receive strong public and political support today. At its heart, as my right hon. Friend the Member for Witham set out, the NHS is not about buildings and equipment—as important as those are, and we are of course passionate about health centres, hospitals and the latest technology—but about the circa 2 million people who work in it day in, day out to deliver and facilitate the high-quality care we rightly expect. I want to take this opportunity to thank everyone who works in our NHS, especially those working in north Essex and those serving patients and my constituents in Colchester.

We all have our personal experiences of our NHS and of the care that we and our families have received. When we think about the future of health and wellbeing services in Essex, we have to be mindful of the broader context, much of which my right hon. Friend set out in her powerful speech. Our NHS is under significant and considerable pressure and faces a number of challenges. We have increasing demand, particularly in primary care and in urgent and emergency care. We are living longer, which is brilliant, but it comes with challenges, including living with complex conditions and comorbidities.

Social care continues to be a challenge, especially around workforce, as my right hon. Friend set out. We have increasing demand on mental health services. We had the covid pandemic, with the backlog and the waiting lists, but also the resulting later diagnosis of cardiovascular disease and other conditions, as many people were unable to or did not come forward with symptoms or for regular check-ups.

We also have the at times seemingly intractable complexity of NHS structures and processes; the silo mentality that we sadly see so often; the multiple tiers and archaic processes; the challenges in rolling out the latest innovative technologies, such as tech, drugs, treatment and therapies, that are available in some parts of Essex or the country but not in others; and the issue of making sure that research and innovation is truly embedded in every single trust in the country.

That is not an exhaustive list, and I have not mentioned two of the biggest challenges—workforce and funding—one of which my right hon. Friend touched on in some detail. First, on funding, the NHS will always need increased funding to reflect the changing nature of medicine and the health needs of our population and, importantly, to ensure that we have the very latest and most innovative and cutting-edge medtech, treatments, drugs, procedures and therapies for our patients. Despite record revenue and capital budgets for our NHS, year-on-year real-terms increases in funding, and further significant funding—in fact, several billion pounds of funding—announced in the spring Budget, which I massively welcome, budgets remain a challenge for local systems and for trusts, not just in Essex but across the country.

Secondly, as my right hon. Friend pointed out, workforce is absolutely vital to our NHS, and she was right to mention the hugely important contribution that international staff make—they have contributed since its formation, and continue to do so. Regardless of the NHS long-term workforce plan, as important as it is, international recruitment will still have a hugely important role to play.

I was a Minister at the DHSC when the Government commissioned NHS England to produce the first ever NHS long-term workforce plan, which the Minister will no doubt elaborate on. The plan was then published, backed with £2.4 billion over the next five years by the Government. It included things like doubling medical school places, including at Anglia Ruskin University, which we are incredibly proud of; huge increases in nursing, midwifery and allied health professional training places; and a plan for retention—it is critical that it is about not just recruitment but retention and, of course, reform.

We talk about workforce and funding, but the truth is that addressing those two things alone will not tackle the challenges our NHS faces either nationally or locally. Only by innovating and transforming local systems and the delivery of health and care provision at a local level can we deliver on what we all aspire to across this House, which is our local populations living longer, healthier, happier and more fulfilling lives.

I firmly believe that integrated care systems, which my right hon. Friend touched on, are at the heart of achieving that. They are working holistically at a local level to get systems focusing relentlessly on patient outcomes and patient experiences, and breaking down the silo mentality that we have sadly so often seen in our NHS historically. Their other critical role is driving transformation and innovation at a local level, getting trusts and organisations to work together, and using all assets and capacity within health systems.

I pay tribute, as my right hon. Friend did, to the leadership of the Suffolk & North East Essex Integrated Care System—Dr Ed Garratt and his team. I know how closely they work with Nick Hulme and his team at the East Suffolk and North Essex NHS Foundation Trust or, as it is known locally, Colchester and Ipswich Hospitals. Our health system more broadly, and our two acute hospital trusts in north Essex and east Suffolk, face many of the challenges I set out earlier, but to their great credit, they are continuously looking at innovative ways to address them.

For example, our system in north Essex and east Suffolk is consistently one the highest and best-performing in the country. It had the fastest roll-out of the covid-19 vaccine. It is a top performer for diabetes care. It has consistently low levels of delayed discharge, an issue my right hon. Friend the Minister and his fellow Minister, the Minister for Social Care, spent a lot of time focusing on, and rightly so, because of the continued pressure on urgent and emergency care and the importance of tackling delayed discharge.

Our local system has also led on innovation. It has developed the Care Tech Campus and the challenge fund, in particular, with the University of Essex and Essex County Council. My right hon. Friend the Member for Witham was right to praise the role that Councillors Kevin Bentley and John Spence have played in that, working in partnership with the health system to deliver innovation in care that is providing not just better outcomes, but a better experience for patients. Finally, our local system is leading the way on National Institute for Health and Care Research-funded research, which we want more trusts across the country to do.

Before I finish, I want to raise a handful of initiatives in north Essex and east Suffolk that I think deserve highlighting, because they are going to be transformational in terms of both patient experience and outcome. The first is the elective orthopaedic centre at Colchester Hospital, which I was fortunate enough to have a tour of recently. It is hugely exciting. It is an impressive £64 million facility serving north-east Essex and east Suffolk. It is the largest of its kind in Europe, at over 11,000 square metres, and will include eight theatres, three wards, a physio, a gym, a day surgery, a recovery centre and its own imaging department. Importantly—I know the Minister will be pleased to hear this—it will enable 10,000 procedures a year following its opening, which is due to take place this August.

The second initiative is the Clacton community diagnostic centre, in the constituency of my hon. Friend the Member for Clacton (Giles Watling). I am sorry he could not be here for the debate, but I want to reference it as it serves the wider area. The centre is a £25 million investment in state-of-the-art diagnostics, meaning that patients can access the full range of diagnostic services, including CT scans, MRI scans, X-rays, ultrasounds, blood scans and cardiorespiratory medicine. Importantly—I visited a lot of community diagnostic centres when I was in the Minister’s role—this facility has delivered more than 110,000 treatments in the past year. I would love it if the Minister could check this, but I think that it must be one of the highest performing centres—if not the highest performing centre—in the country.

I want to turn now to two mental health and mental resilience projects, which our integrated care system is leading on and which I think deserve a mention. The first is the north-east Essex mental health joint response vehicle, which was successfully commissioned as a three-year service following a successful pilot between January and March 2023. This unique service is a collaboration between the East of England Ambulance Service and the Essex Partnership University NHS Foundation Trust—our mental health trust—with a paramedic and mental health practitioner manning a 10-hour service seven days a week. That service has been so successful in ensuring that those experiencing a mental health crisis are seen by the most appropriate service. I am really keen that we extend those hours, and I know that the ICS is looking at securing additional funding to do so.

The data backs up why it is a good thing to do. In 2023, the joint response vehicle attended 757 patient calls for a variety of mental health-related presentations, including suicidal threat, self-harm, depression and psychosis, with 77% of patients being redirected to another service or provided with a care plan at home, reducing by 55% the number of attendances at emergency departments for mental health-related issues. I will not need to remind the Minister that mental health is not only one of the largest drivers of attendance at our emergency departments, especially involving conveyance via ambulance, but leads to some of the longest cubicle occupation in our emergency departments, as hospitals do not have the beds to move people up and into, and often takes up additional resource, such as police officers and others.

The second initiative I want to touch on involves primary school wellbeing hubs—these are more about mental resilience, but I think that that is an important area to highlight. When I was Schools Minister and Children’s Minister, we worked closely with the Department of Health and Social Care on investment in mental health resilience support with mental health support teams, on training for schools and on the support teams that would go into schools to provide that support.

The Tendring and Colchester wellbeing hubs are a pilot project with 22 primary schools in Colchester and Tendring, which aims to improve children’s mental health and wellbeing through a prevention and early intervention approach. This programme has delivered across 22 schools, with 19 of them completing a number of questionnaires that have been evaluated by the University of Essex to demonstrate the impact and evaluate the programme over the 12 months in which it has run.

Overall, pupils who attended the wellbeing hub sessions had significant increases in their levels of resilience, wellbeing and happiness and decreased anxiety. The initiative was supported by more than 80% of parents, who said that their children communicated better, while more than 60% of children said they had more confidence and were more resilient and less stressed or anxious. I know that such programmes are happening to varying degrees across the country, but our integrated care system is really leading the way and demonstrating things that could be replicated and rolled out to other parts of the country.

In conclusion, I thank again all those involved in the delivery of healthcare across north Essex, as well as the leadership of the Suffolk & North East Essex Integrated Care System and the East Suffolk and North Essex NHS Foundation Trust for driving the innovation and transformation of health and care provision locally. We know that that is the future of delivering not just better a patient experience, but better patient outcomes. I once again thank my right hon. Friend the Member for Witham for giving us the opportunity to talk about health and wellbeing services in Essex, which, as she rightly said, we all care so passionately about. We all know that the challenges both locally and nationally are significant, and we all want and expect world-class care for our constituents. I know that I and all my Essex colleagues will continue to work with our local NHS bodies in all their guises to support them to deliver it.

Oral Answers to Questions

Will Quince Excerpts

Tuesday 5th March 2024 Commons Chamber

[Helen Whately]

I am very sorry to hear about what happened to the hon. Gentleman’s constituent. I send my condolences to her family and loved ones. Clearly, it is very important that discharge decisions are led by clinicians, who can make a clinical decision about whether somebody is medically ready to be discharged. I have no doubt that the family may well take up that decision with local NHS organisations.

[Will Quince (Colchester) (Con)]

No doctor wants to be on strike, so I welcome the new deal with the consultant unions. It shows that by being reasonable, pragmatic and acting in good faith, unions can deliver for their members. Does my right hon. Friend agree?

[Victoria Atkins]

My hon. Friend knows only too well the importance of industrial action and the impact it can have on patients and on the NHS as a whole. I am pleased that the BMA has announced today, following the previous settlement that was narrowly rejected in its ballot, that it has been able to get back around the table with my officials and me. We have been able to find a fair and reasonable settlement that the BMA will advocate for and recommend to its members. We hope that that shows those who are choosing to strike that constructive negotiations, and trying to sort out some of the concerns that we know clinicians have, can be dealt with in a reasonable manner, which is of benefit not just to staff, but to patients.

Oral Answers to Questions

Will Quince Excerpts

Tuesday 23rd January 2024 Commons Chamber

[Helen Whately]

One reason we distributed discharge funding back in April last year was to give more advance notice to organisations, so that they could put in place what is needed to speed up discharges. I say to the hon. Lady that our plan is working. That is why, in her own trust, discharges at the end of December were down by a third compared with the previous year.

[Will Quince (Colchester) (Con)]

I note the progress that my hon. Friend referenced, but delayed discharges are still a major issue. Patient flow through a hospital is a critical factor, especially at the front door through emergency departments. We know the role that electronic bed management systems can play in helping that flow. What steps is my hon. Friend taking to ensure that more hospitals roll out that technology?

NHS Winter Update

Will Quince Excerpts

Monday 8th January 2024 Commons Chamber

[Victoria Atkins]

I hope the hon. Gentleman will be interested to know that we have made cancer treatment waiting times a key focus of our elective recovery plan, which has been backed by an additional £8 billion in revenue funding across the spending review period. We have made progress by delivering record numbers of urgent cancer checks, with more than 2.9 million people seen in the 12 months to October last year. Of course there is more to do, and I would be very happy to meet him and colleagues across the House to discuss the practical ways by which treatment can reach our constituents. He will not be surprised to know that cancer is a priority not just for me personally, but for the Government as a whole.

[Will Quince (Colchester) (Con)]

I welcome my right hon. Friend’s statement; there is a lot in it to welcome, but I particularly welcome the additional 11,000 virtual ward beds. Hospital at home is hugely popular and we know it takes pressure off our hospital. I thank all of the clinicians who helped to make that possible. Can she confirm that it is her intention now to go further and roll it out to more hospitals and more specialties, so that more patients can recover at home?

[Victoria Atkins]

I thank my hon. Friend for all his work in making that happen. He worked very hard on virtual wards when he was a Health Minister, and they represent a real step change in how we treat people with long-term conditions who can be monitored safely at home. They mean that people do not have to spend time in hospital, with all the pressures that can mean for us as individuals. Importantly, that also frees up beds for other patients who need them. I am keen to roll the scheme out further. Indeed, we have not just met but exceeded our initial ambition, which is why I can confirm that we have delivered 11,000 places in the virtual bed ward category.

Oral Answers to Questions

Will Quince Excerpts

Tuesday 5th December 2023 Commons Chamber

[Helen Whately]

The hon. Member is right that our hospitals are busier; we are seeing more patients in A&Es. That is why we are doing two things with our work on urgent and emergency care. One is providing more capacity—more hospital beds, more hours of ambulances on the road, and more capacity in social care to help with discharges. We are also doing things differently by seeing more people out of hospital, avoiding people coming to hospital unnecessarily, and providing more care at home; for instance, our 10,000 “hospital at home” beds are helping people recover at home, which is better for them and better for the system.

[Will Quince (Colchester) (Con)]

I know the considerable work the Department and NHS England have done preparing for winter. Given the importance of the NHS workforce, who do such an incredible job, and noting that there are still a few months to go, will the Minister update the House on the delivery of our manifesto commitment for an additional 50,000 nurses?

[Helen Whately]

I pay tribute to my hon. Friend for the excellent work he did as a Health Minister. It was a real pleasure to work alongside him and see what a difference he made for our constituents across the country. He asks a very good question about the work we are doing to increase the capacity of the NHS and ensure that it has the workforce it needs, including by delivering on our manifesto commitment to 50,000 more nurses for the NHS, which we have achieved.

Ambulance Services: Minimum Service Levels

Will Quince Excerpts

Wednesday 8th November 2023 Written Statements

[The Minister for Health and Secondary Care (Will Quince)]

The Government are focused on making the hard but necessary long-term decisions that are in the best interests of the country, to put the UK on the right path for the future. The Government’s priority is to ensure that when strike action takes place in the NHS, the safety of patients is protected as far as possible.



Minimum service levels are in place in a range of countries in Europe and beyond, as a way of balancing the ability of employees to strike with the needs of the public. The International Labour Organisation (an agency of the United Nations) recognises that this is justifiable for services where their interruption would endanger citizens’ life, personal safety or health. Disruption to ambulance services puts lives at immediate risk.



On 6 November 2023, the Government published the response to the consultation on “Minimum service levels in event of strike action: ambulance services in England, Scotland and Wales”. In it we confirmed that, subject to parliamentary approval, we will introduce regulations which set minimum service levels and cover the 10 NHS ambulance trusts in England, as well as the ambulance services provided by the Isle of Wight NHS Trust. While the UK Government think that people across the UK should be able to be confident about what types of situations the ambulance service will respond to on strike day, they recognise that responsibility for the operation of these services in Scotland and Wales lies with the devolved Administrations. We therefore intend for the regulations to apply to England only at this time, rather than also including Scotland and Wales.



The services included in the minimum service levels will be the 999 and healthcare professional (HCP) call handling and emergency ambulance response to those calls, inter-facility transfers (IFT) and non-emergency patient transport services (NEPTS). The overarching principle is that those cases that are life-threatening, and those for which there is no reasonable clinical alternative to an ambulance response, should receive a response as they would on a non-strike day. In the case of NEPTS, patients for whom there is no reasonable clinical alternative to the patient receiving health services on the strike day should have their transportation provided as they would on a non-strike day.



Our response to the consultation reaffirms our commitment to ensuring that patients can access ambulance services when they need them during a strike. We have laid regulations which will address the inconsistency and uncertainty of relying on the unions to agree arrangements on a case-by-case basis, by giving employers the power to issue work notices should they need to. This will increase public confidence in the service and better protect patient safety during periods of industrial action.



The Government will shortly lay a statutory code of practice in Parliament for approval on the reasonable steps trade unions should take in order to meet the legal requirements under the Act. This follows a commitment made during the passage of the Act through Parliament to bring forward such a code of practice and the recent conclusion of a public consultation on the draft code. Separate non-statutory guidance will also be published shortly on the issuing of work notices by employers, where the regulations apply, to secure minimum levels of service on strike days. The consultation response has been published on gov.uk. The Government wish to thank everybody who took the time to provide feedback as part of the consultation process.

[HCWS20]

Osteoporosis

Will Quince Excerpts

Thursday 26th October 2023 Commons Chamber

[The Minister for Health and Secondary Care (Will Quince)]

I commend the hon. Member for Bradford South (Judith Cummins) for bringing this issue to the House’s attention. As chair of the all-party parliamentary group on osteoporosis and bone health, she has long been a champion for those with osteoporosis. She will know that many of the points raised today echo arguments made in the other place only last month. As ever, she articulately and eloquently made a powerful and persuasive case, and I very much look forward to working with her and the charities that specialise in this area to improve service provision and support for those with osteoporosis.

As the hon. Lady set out in her speech, osteoporosis represents a growing challenge in this country as our demographics shift, particularly for older people. It is estimated that in the UK more than 3 million people have osteoporosis, including approximately one in 10 women aged 60 and one in five women aged 70, with more than 500,000 fragility fractures occurring each year. As she rightly pointed out, this silent disease does not just affect older people. Many people of working age suffer preventable fractures, with an estimated 2.6 million sick days taken every year in the UK due to osteoporotic fractures. Studies suggest that over 22% of the population aged 50 to 64 will suffer a fracture.

Impassioned calls have been made of late for increased Government support for FLS, both within Parliament, not least from the hon. Lady, and in the media. I thank colleagues across both Houses and the Sunday Express, which has led on this issue, for helping to raise the profile of these important services, which have long been recognised as best practice for secondary fracture prevention by both the Department of Health and Social Care and NHS England. Indeed, in our “Major Conditions Strategy: A case for change and strategic framework”, published this summer, we made it clear that we would continue to explore supporting the provision of FLS.

As the hon. Lady will know—indeed, she raised this in her speech—fracture liaison services are locally commissioned. My hon. Friend the Member for Southend West (Anna Firth) rightly pointed out, first in her intervention and then in her short speech, the importance of FLS. I thank her for drawing attention to and championing the service in Southend, which is an exemplar that we hope other integrated care boards will follow.

For local systems requesting support to review and improve their secondary fracture prevention pathways, NHS England is producing system-level data packs, which include data from a variety of sources. That includes the FLS database to highlight where there may be unwarranted variation; the impact of, and upon, existing health inequalities, which we should always be concerned about; and where there are opportunities for transformation. The Royal Osteoporosis Society outlines that, for every £1 spent on FLS in the UK, the taxpayer can expect to save £3.28. So by levelling up provision to cover everyone over the age of 50, we could prevent just under 5,700 fragility fractures every year. If that is the case, it is only right that NHS England continues to support ICBs to develop their secondary fracture prevention services. As the hon. Lady rightly pointed out, the benefits are clear and I trust that commissioners will be exploring how best to support the needs of their patients in this important area.

The major conditions strategy is not the only headline workstream that we are taking forward to improve osteoporosis care. The first ever Government-led “Women’s Health Strategy for England” was published in July 2022, marking a reset in the way in which the Government are looking at women’s health. As part of that work, we are investing £25 million in women’s health hubs, with each ICB set to receive £595,000 over the current and next financial year to establish a women’s health hub within their system. As we have outlined in the women’s health hubs core specification, specific services will vary depending on population health needs, the existing set-up of services and the workforce skills in a local area. The core specification outlines osteoporosis assessment and care. For example—the hon. Lady rightly alluded to this —DEXA bone density scanning or FLS are areas that local systems could consider when establishing their hub.

As important as FLS is, it is not the only way in which we can ensure that people with osteoporosis receive the care they need. NHS England’s “Getting it Right First Time” programme has a specific workstream on musculoskeletal health and is exploring how best to support integrated care systems in the diagnosis and treatment of osteoporosis. There is also, alongside that, a range of NICE guidelines to support equity of care for people with osteoporosis, which healthcare professionals and commissioners should absolutely note.

As we know, the economic burden of fragility fractures can be significant. That is why in this year’s spring Budget we announced a package of measures to support individuals at risk of, or experiencing, musculoskeletal conditions to live and work well. Those include: making best use of digital health technologies to support people to better manage symptoms and increase mobility; designing and scaling up MSK community hubs, expanding access to community-based services delivering physical activity interventions; and alongside that, integrating employment advisers into musculoskeletal pathways, building on the success of the NHS talking therapies programme.

Finally, I would like to highlight some of the exciting work that we are supporting on the future of osteoporosis care, and that is about research. Valuable research into MSK conditions such as osteoporosis is being funded by the Department of Health and Social Care, through the National Institute of Health and Care Research. NIHR has awarded £173 million for research into MSK conditions in the last five years. That includes studies into understanding and improving patient experience of diagnosis for vertebral fracture, physiotherapy rehabilitation for osteoporotic vertebral fracture and other treatments for MSK conditions.

In addition, in 2021-22 alone over £30 million has been spent on NIHR infrastructure supported studies and, alongside that, trials into MSK conditions, and six of the NIHR biomedical research centres have MSK conditions as a research theme. NIHR, in collaboration with Versus Arthritis—I referenced earlier some of the fantastic charities working in this space—also funds a dedicated UK musculoskeletal translational research collaboration, which aligns investment in MSK translational research and creates a UK-wide ambition and alongside that a focus to drive cutting-edge research and improve outcomes for patients.

I do not for a second underestimate how painful and debilitating this silent disease is, but I am confident that real advances have been made. I know that we have further to go, but I am confident that, working together, such advances will continue to be made.

This Government are committed to improving the provision of osteoporosis treatment and support. I once again extend my sincere thanks to the hon. Lady for bringing forward this really important debate, and I especially thank the individuals, and indeed the charities and other organisations, who do so much to support people with osteoporosis.

World Arthritis Day

Will Quince Excerpts

Wednesday 25th October 2023 Westminster Hall

[The Minister for Health and Secondary Care (Will Quince)]

It is a pleasure to serve under your chairmanship, Ms McDonagh. Let me first congratulate my hon. Friend the Member for Gedling (Tom Randall) on securing a debate on this hugely important issue. I know that he is a tireless campaigner for those living with arthritis, in particular axial spondyloarthritis, and his experience is invaluable in bringing a voice from that community to this place. He made a very emotive and powerful case in his usual articulate and eloquent way. I would also like to thank him for sharing his constituent Elizabeth’s experience, which shows how much further we still have to go in supporting people with this condition.

I would also like to pay tribute to the outstanding charities that support the 10 million people living with arthritis in the UK. I know that my hon. Friend works closely with the National Axial Spondyloarthritis Society—the NASS—and many other charities, such as Versus Arthritis and the National Rheumatoid Arthritis Society, which do such fantastic work to support patients and drive improvements in care. He referenced arthritis week—those charities have collectively made arthritis week a resounding success and do stellar work raising awareness not just during that week, but all year round, as my hon. Friend rightly pointed out.

My hon. Friend is also absolutely right to point to the impact that arthritis has on not only people suffering from the condition, but their families and carers. I know from my own experience of growing up with my grandmother, who lived with rheumatoid arthritis, the impact it had not only on her, but on my mother and the wider family. He is also right to highlight the difference that early diagnosis, the quality of care and proper support can make. He raised a number of important points in this debate; I will turn to each one now.

My hon. Friend made a hugely important point about early diagnosis of the condition and set out some of the challenges. He is right to stress the difference that early diagnosis can make to long-term quality of life. Research from charities shows that one year, rather than eight years, to diagnose inflammatory arthritis can save individuals over £150,000 in lost income and medical expenses. I know that NHS England is working hard to improve early diagnosis rates through its GIRFT—getting it right first time— rheumatology programme, which is designed to improve the diagnosis, treatment and care of patients, but I appreciate and recognise that we have further to go on this. I would be very happy to work with my hon. Friend to see what further improvements we can make alongside NHS England.

In terms of treatments for arthritis, the Government are committed to supporting timely and, vitally, consistent access to effective new medicines for NHS patients with arthritis. The National Institute for Health and Care Excellence has recently recommended several new medicines for arthritis and other rheumatological conditions, including Rinvoq, Tremfya and Skyrizi. These allow patients to benefit from pain reduction and an improved quality of life and are now, I understand, routinely available for clinicians to prescribe to eligible NHS patients in line with NICE recommendations.

My hon. Friend was generous in setting out details about the major conditions strategy, and I agree with so much of what he said. In January of this year, we announced our plan to publish the major conditions strategy, which is designed to tackle the key drivers of ill health in England. We have now published our initial report, “Major conditions strategy: case for change and our strategic framework”, which sets out our plan to promote prevention of non-pharmaceutical interventions. The idea is to create a truly personalised approach for patients. I can assure my hon. Friend that my firm commitment is to continue engaging with charities such as Versus Arthritis and the NASS as we develop that strategy going forward. That is absolutely right; in fact, it is critical that we work with those charities to ensure that we are getting it right as we develop the strategy.

I would also like to touch on gene and cell therapies. In my view, having looked into this not just in relation to arthritis but more broadly, they have huge potential. I am passionate about the UK’s status as a life sciences superpower, and I am really pleased that the Medicines and Healthcare products Regulatory Agency has launched the innovative licensing and access pathway to reduce the time it takes to get innovative medicines to market. In April of this year, the National Institute for Health and Care Excellence recommended Upstaza for aromatic L-amino acid decarboxylase deficiency, which is a horrific genetic disorder affecting children. That is the first gene therapy for children with that condition, which is administered directly into the brain through a minimally invasive procedure.

My hon. Friend touched on elective recovery, and he is right to do so, because we know the size of the waiting list and the impact that has on patients. He rightly raised the waiting times for operations that patients often need, such as joint replacements. Of course, alongside that, it will not have escaped his notice that cutting wait lists is one of the Prime Minister’s five priorities. That is why we are putting record staffing numbers and record levels of funding into our health service. We are spending over £8 billion from 2020 to 2025, plus an additional £5.9 billion specifically for capital projects: funding for new beds; new tech and equipment; community diagnostic centres; and surgical hubs. We have virtually eliminated 18-month waits, and from this month patients waiting over 40 weeks will be informed of their right to be treated somewhere with a shorter waiting list—which of course includes those with arthritis and other musculoskeletal conditions. Patient choice is going to be at the heart of that.

My hon. Friend and I have previously had conversations about prescriptions—particularly free prescriptions—the charges for people with arthritis, and the need to review the current medical exemption list. I believe there has been only one addition to the list since 1968, which was specifically for cancer. I apologise for what may be a disappointing response, but we do not have any plans to make another exemption at this time. However, I would say to my hon. Friend and all those raising this issue that around 89% of prescription items are currently dispensed free of charge, and there are already a wide range of exemptions from prescription charges for those who meet the eligibility criteria.

My hon. Friend has also raised the issue of mental health with me in the past, and we know that about 30% of people with rheumatoid arthritis develop depression within five years of their diagnosis, and that 20% of people with osteoarthritis experience depression or anxiety. Of course, those statistics should concern us. That is why we have made it centrally clear to commissioners at the local level that we expect NHS talking therapies to be integrated into physical healthcare pathways. It is absolutely critical that, alongside their physical health, we also support the mental health of patients. Our NHS long-term plan commits to an additional £2.3 billion a year for the expansion of mental health services by 2024, so that an additional 2 million people can access NHS-funded mental health support.

I hope that my hon. Friend will be reassured by some of the measures that I have outlined today. I recognise that we have to go further, and my hon. Friend made a powerful case for that. To respond to his request for me to work with him, alongside NHS England, to explore how we can do that, my door is of course always open to him and other colleagues on this issue. I would like to thank him again for giving me the opportunity to reiterate our commitment to the very highest standards of care for the 10 million people living with arthritis in this country. I will of course look at what more can be done to address the needs of those affected by arthritis. I will take his points away and give them further thought, so that together we can continue to create the kind of care that patients deserve, to allow them to live their lives to the fullest. I would like to close by again thanking my hon. Friend and the charities for all their work in keeping a spotlight on this issue so that arthritis awareness remains constant in the public eye, not just for one week but every day of the year.

Question put and agreed to.