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Category: Health

  • Sajid Javid – 2023 Article on Charging for NHS Treatment

    Sajid Javid – 2023 Article on Charging for NHS Treatment

    A section of the article published in The Times, written by Sajid Javid, the former Health Secretary and the Conservative MP for Bromsgrove on 21 January 2023.

    Too often we hear doctors and nurses frustrated at people making unnecessary trips to frontline services, which takes time from other patients. Would the same level of demand exist here if this Irish model were adopted? This extends to GP appointments. In Norway and Sweden a visit to the GP comes with a contribution of about £20. For some people, just like my parents, that is a noticeable part of the weekly budget. But as demonstrated by so many other countries, it is possible to means-test this provision. Even a tiny fraction of patients reconsidering their visit to the GP (and perhaps visiting a community pharmacist instead), would save thousands of clinical hours.

    Co-payments are not the only alternative. Germany’s social health insurance model gives the structural benefit of a greater choice of providers, including non-profit community hospitals, and therefore less pressure on the public system. In the UK, more and more people are moving towards private healthcare (including within NHS Trusts). But provision is limited in comparison. Other systems with a contributory principle have seen a range of providers emerge. Patients in the UK are all directed towards the front door of the NHS, which only worsens the queueing.

    For patients, this is not cost free. More waiting can mean an increased risk of illness and discomfort. And for NHS staff, it also means a constant tide of pressure (and sometimes abuse). We have already instilled an element of contribution into the NHS: we ask people who can afford it to pay towards the cost of prescriptions, and dental and optical care. Labour and Conservative governments have had a role in this. We should look, on a cross-party basis, at extending the contributory principle.

  • Keir Starmer – 2023 Parliamentary Question on Ambulance Waiting Times

    Keir Starmer – 2023 Parliamentary Question on Ambulance Waiting Times

    The parliamentary question asked by Sir Keir Starmer, the Leader of the Opposition, in the House of Commons on 18 January 2023.

    Keir Starmer (Holborn and St Pancras) (Lab)

    I join the Prime Minister in his comments about the dreadful case of David Carrick.

    It is three minutes past 12. If somebody phones 999 now because they have chest pains and fear it might be a heart attack, when would the Prime Minister expect an ambulance to arrive?

    The Prime Minister

    It is absolutely right that people can rely on the emergency services when they need them, and that is why we are rapidly implementing measures to improve the delivery of ambulance times and, indeed, urgent and emergency care. If the right hon. and learned Gentleman cares about ensuring patients get access to life-saving emergency care when they need it, why will he not support our minimum safety legislation?

    Keir Starmer

    The Prime Minister can deflect all he likes but, for a person suffering chest pains, the clock starts ticking straightaway—every minute counts. That is why the Government say an ambulance should be there in 18 minutes. In this case, that would be about 20 minutes past 12. I know he does not want to answer the question I asked him, so I will ask him again. When will that ambulance arrive?

    The Prime Minister

    Because of the extra funding we are putting in to relieve pressure in urgent and emergency care departments, and the investment we are putting into ambulance call handling, we will improve ambulance times as we are recovering from the pandemic and indeed the pressures of this winter. But I say this to the right hon. and learned Gentleman again, because he makes my case for me: he describes the life-saving care that people desperately need, so why, when they have this in other countries—France, Spain, Italy and others—is he depriving people here of that care?

    Keir Starmer

    The Prime Minister obviously does not know or does not care. I will tell him: if our heart attack victim had called for an ambulance in Peterborough at 12.03 pm, it would not arrive until 2.10 pm. These are our constituents waiting for ambulances I am talking about. If this had happened in Northampton, the ambulance would not arrive until—[Interruption.]

    Mr Speaker

    Order. Mr Bristow, I hope you want to see the rest of the questions out. I want you to be here, but you are going to have to behave better.

    Keir Starmer

    I am talking about our constituents. If they were in Northampton, the ambulance would not arrive until 2.20 pm. If they were in Plymouth, it would not arrive until 2.40 pm. That is why someone who fears a heart attack is waiting more than two and half hours for an ambulance. That is not the worst-case scenario; it is just the average wait. So for one week, will the Prime Minister stop blaming others, take some responsibility and just admit that under his watch the NHS is in crisis, isn’t it?

    The Prime Minister

    I notice that the one place the right hon. and learned Gentleman did not mention was Wales, where we know that ambulance times are even worse than they are in England. Let me set out the reason that is the case, because this is not about politics; this is about the fact that the NHS in Scotland, in Wales, in England is dealing with unprecedented challenges, recovering from covid and dealing with a very virulent and early flu season, and everyone is doing their best to bring those wait times down. But again, I ask him: if he believes so much in improving ambulance wait times, why will he not support our minimum safety legislation?

    Keir Starmer

    The Prime Minister will not answer any questions and he will not take any responsibility. By 1 pm, our heart attack victim is in a bad way, sweaty, dizzy and with their chest tightening. [Interruption.] I am talking about a heart attack and Conservative Members are shouting—this is your constituent. By that time, they should be getting treatment. But an hour after they have called 999 they are still lying there, waiting, listening to the clock tick. How does he think they feel, knowing that an ambulance could be still hours away?

    The Prime Minister

    The specific and practical things we are doing to improve ambulance times are clear: we are investing more in urgent and emergency care to create more bed capacity; we are ensuring that the flow of patients through emergency care is faster than it ever has been; we are discharging people at a record rate out of hospitals, to ease the constraints that they are facing; and we are reducing the call-out rates by moving people out of ambulance stacks, with them being dealt with in the community. Those are all very practical steps that will make a difference in the short term. But I ask the right hon. and learned Gentleman this again and again, although we know why; the reason he is not putting patients first when it comes to ambulance waiting times is because he is simply in the pockets of his union paymasters.

    Keir Starmer

    This is not hypothetical; this is real life. Stephanie from Plymouth was battling cancer when she collapsed at home. Her mum rang 999, desperate for help. Stephanie only lived a couple of miles from the hospital, but they could not prioritise her. She was 26 when she died, waiting for that ambulance—a young woman whose life was ended far too soon. As a dad, I cannot even fathom that pain. So on behalf of Stephanie and her family, will the Prime Minister stop the excuses, stop shifting the blame, stop the political games and simply tell us: when will he sort out these delays and get back to the 18-minute wait?

    The Prime Minister

    Of course Stephanie’s case is a tragedy. Of course, people are working as hard as they can to ensure that people get the care that they need. The right hon. and learned Gentleman talks about political games. He is a living example of someone playing political games when it comes to people’s healthcare. I have already mentioned what has been going on in Wales. Is he confident that, in the Labour-run Welsh NHS, nobody is suffering right now? Of course they are, because the NHS everywhere is under pressure. What we should be doing is supporting those doctors and nurses to make the changes that we are doing to bring care to those people. I will ask him this: if he is so concerned about making sure that the Stephanies of the future get the care that they need, why is he denying those families the guarantee of emergency life-saving care?

    Keir Starmer

    So, that is the Prime Minister’s answer to Stephanie’s family—deflect, blame others, never take responsibility. Just like last week, he will not say when he will deliver the basic minimum service levels that people need.

    Over the 40 minutes or so that these sessions tend to last, 700 people will call an ambulance; two will be reporting a heart attack, four a stroke. Instead of the rapid help they need, many will wait and wait and wait. If the Prime Minister will not answer any questions, will he at least apologise for the lethal chaos under his watch?

    The Prime Minister

    The right hon. and learned Gentleman asks about the minimum safety levels. We will deliver them as soon as we can pass them. Why will he not vote for them? We are delivering on the people’s priorities. As we have seen this week, the right hon. and learned Gentleman will just say anything if the politics suits him; it is as simple as that. He will break promises left, right and centre. He promised to nationalise public services. He promised to have a second referendum. He promised to defend the mass migration of the EU, and now we are apparently led to believe—[Interruption.]

    Mr Speaker

    Order. I expect those on the Front Bench to keep a little quiet. If they do not, there is somewhere else where they can shout and make their noise.

    The Prime Minister

    If we are to deliver for the British people, people need to have strong convictions. When it comes to the right hon. and learned Gentleman, he is not just for the free movement of people; he also has the free movement of principles.

  • Neil O’Brien – 2023 Statement on NHS Dental Care in Blackpool

    Neil O’Brien – 2023 Statement on NHS Dental Care in Blackpool

    The statement made by Neil O’Brien, the Parliamentary Under-Secretary of State for Health and Social Care, in the House of Commons on 16 January 2023.

    The Government are aware of the challenges that areas such as Blackpool are facing in accessing NHS dentistry. Dentistry is an important part of the NHS and we are committed to improving access and other issues currently faced by patients and the workforce. This is why we announced a package of dental system improvements on 19 July and detailed in our plan for patients. These important first steps to reform NHS dentistry will improve access for patients and make NHS work more attractive to dentists, particularly in areas where there are access challenges. These changes include improvements to the 2006 contract to ensure dentists are remunerated more fairly for complex treatment, and patient access is improved, especially for those with higher oral health need. As part of this package, we will also enable dental practices to deliver 110% of their contract levels to help recovery from the pandemic and increase activity.

    We have taken action to implement these changes, including through regulations that came into effect on 25 November. NHS England will shortly publish additional guidance for dental professionals as part of this package.

    To support the provision of urgent care, over 170 urgent dental care centres remain open across the country and one of these is located in Blackpool. There are a number of local initiatives within the area, including supported access after urgent care, commissioned until the end of March 2024. This initiative reduces the number of patients attending an urgent dental centre then requiring additional urgent care within the year. In Blackpool, dental practices are also piloting “protected sessions” for vulnerable families with council “Community Connectors” facilitating care. The pilot started in February 2022 and has now been formally commissioned until end of March 2024.

    In addition to this, an additional £50 million in funding was made available across England for additional activity and patient appointments in 2022. Of this £50 million, £1,633,000 was allocated to Lancashire and South Cumbria, which includes dental practices in Blackpool.

  • Steve Barclay – 2023 Statement on the Moderna Strategic Partnership

    Steve Barclay – 2023 Statement on the Moderna Strategic Partnership

    The statement made by Steve Barclay, the Secretary of State for Health and Social Care, in the House of Commons on 9 January 2023.

    The covid-19 pandemic has shown the importance of having the ability to develop and deploy vaccines rapidly to respond to a health emergency, as well as to mitigate the potential economic and health costs such an emergency can cause. It also demonstrated the need to establish resilience on UK shores to avoid supply chain disruptions which could have severe public health and economic consequences. While the future trajectory of the covid-19 virus is uncertain, delivering a consistent and resilient supply of covid-19 vaccines is critical in ensuring safe and effective vaccines are provided on at least an annual basis over the next decade, to protect those who are most vulnerable to covid-19.

    With these challenges in mind, in June 2022 Ministers signed non-binding heads of terms and a single tender case for a strategic partnership between HMG and Moderna. Since then, the Vaccine Taskforce and the UK Health Security Agency (UKHSA), has worked to negotiate a definitive agreement with Moderna. The execution of our contractual agreement for a 10-year partnership with Moderna was announced on 22 December 2022. The partnership will bring vaccine development onto UK shores, boosting our messenger RNA (mRNA) capability, strengthen our ability to scale up production rapidly in the event of a health emergency, and better equip the UK to respond to covid-19 and future health emergencies.

    Through this deal, Moderna will, at its own cost, establish a UK based manufacturing facility and global research and development (R&D) centre, as well as commit substantial investment into UK-based R&D activities over the 10-year period, bringing the UK a step closer to becoming the leading global hub for life sciences. The manufacturing facility will be capable of supplying up to 100 million doses of respiratory vaccine per year in normal circumstances, increasing to up to 250 million doses in the event of a health emergency. The UK will have priority access to these vaccines where they are demonstrated to be safe, effective, and authorised by the MHRA. These include both Moderna’s proven and highly effective covid-19 vaccine and others in its pipeline, including against flu and RSV, providing health resilience.

    Moderna has demonstrated expertise in mRNA development which has the potential to be a transformative breakthrough technology in several disease areas, including cancer, respiratory illnesses and heart disease. Also, mRNA vaccines have the potential to treat multiple pathogens in a single shot and be delivered in rapid timeframes.

    The new Innovation and Technology Research Centre will look to unlock this potential by developing revolutionary treatments in the UK, which will benefit NHS patients and people worldwide. This will include running a significant number of clinical trials in the UK. Moderna has also pledged to fund grants for UK universities, including PhD places, research programmes and wider vaccine ecosystem engagement. The industry-leading, future-proof design of the plant will permit the addition of capability to manufacture a wide range of medicines and will be a massive boost to the UK’s R&D capability, as well as creating more than 150 highly skilled jobs.

    The partnership, secured by the Vaccine Taskforce, will be taken forward by the Covid Vaccines Unit in the UKHSA. This will see the UKHSA working with Moderna to ensure early vaccine development, supporting the G7 mission to get from variant to vaccine in 100 days. Construction is expected to commence in early 2023, with the first mRNA vaccine expected to be produced in the UK in 2025.

  • Steve Barclay – 2023 Statement on the BioNTech Strategic Partnership

    Steve Barclay – 2023 Statement on the BioNTech Strategic Partnership

    The statement made by Steve Barclay, the Secretary of State for Health and Social Care, in the House of Commons on 9 January 2023.

    The UK’s response to the covid-19 pandemic demonstrated the power of Government collaborating with industry to accelerate life sciences innovation. We want to take this innovative approach to tackling the other major healthcare challenges we face, such as cancer.

    The Government have signed a Memorandum of Understanding with the Germany-based company BioNTech. This MoU aims to build a strategic partnership which will bring innovative immunotherapy research to the UK, with the potential to transform cancer patient outcomes and develop new vaccines for infectious diseases. This agreement will pave the way for a multi-year partnership between the Government and BioNTech, accelerating trials into the company’s ground-breaking pipeline of products targeted at major global diseases such as breast, lung and pancreatic cancer, malaria and tuberculosis.

    BioNTech is a biopharmaceutical company developing a pipeline of cutting-edge immunotherapies—including mRNA-based vaccines and therapies. The company became a household name in 2020 after developing a covid-19 vaccine in partnership with Pfizer, which went on to become the world’s first licensed vaccine to use novel mRNA technology.

    Through this partnership with BioNTech, the Government aim to ensure trials into further promising vaccines and therapies are accelerated, to reach our patients faster. The agreement means cancer patients will get early access to trials exploring personalised mRNA therapies, like cancer vaccines. No two cancers are the same and mRNA vaccines will contain a genetic blueprint to stimulate the immune system to attack cancer cells. The collaboration will aim to deliver 10,000 personalised therapies to UK patients by 2030 through a new research and development hub, creating at least 70 jobs and strengthening the UK’s positions as a leader in global life sciences.

    BioNTech will also be the first industry partner in the new cancer vaccine launch pad which is being developed by NHS England and Genomics England. The launch pad will help to rapidly identify large numbers of cancer patients who could be eligible for trials and explore potential vaccine across multiple types of cancer. The partnership will aim to help patients with early and late-stage cancers.

    If successfully developed, cancer vaccines could become part of the standard of care.

  • Chris Grayling – 2023 Speech on NHS Winter Pressures

    Chris Grayling – 2023 Speech on NHS Winter Pressures

    The speech made by Chris Grayling, the Conservative MP for Epsom and Ewell, in the House of Commons on 9 January 2023.

    My right hon. Friend is absolutely right to highlight the fact that this is not purely an English issue but one affecting whole systems across the western world. I welcome many aspects of what he said, and I am grateful to staff at Epsom Hospital and those in the ambulance service in my constituency. So much of the time of those paramedics is spent taking frail elderly people from care homes to A&E where, frankly, they probably should not be. What steps can he take to divert some of those frail and elderly people from A&E to take some of the pressure off and get them to an environment where they will be much better looked after?

    Steve Barclay

    My right hon. Friend is absolutely right. That is where virtual wards have potential significant benefits in both demand management—avoiding elderly, frail patients coming to emergency departments in the first place—and releasing capacity in hospitals. The virtual ward at Watford General Hospital, equivalent to an additional ward of the hospital, is able to release patients with the comfort of knowing that they are still under supervision. Their medical information is being tracked and monitored and they get a daily phone call from a nurse. They also know that, if they need to come back to the hospital, they can do so much more quickly. That gives patients the comfort and confidence to recover at home, which is often where they want to be. Indeed, patient satisfaction from that trial at Watford was over 90%.

  • Steve Brine – 2023 Speech on NHS Winter Pressures

    Steve Brine – 2023 Speech on NHS Winter Pressures

    The speech made by Steve Brine, the Conservative MP for Winchester and Chair of the Health and Social Care Select Committee, in the House of Commons on 9 January 2023.

    There is no doubt that, in some places more than others, patient flow in acute hospitals is the issue gumming up the system, and the Secretary of State is right to say that demand far outstrips supply, in part because of the very high flu numbers. Today’s injection of funding is very welcome as is the additional surge capacity the Secretary of State spoke about in his statement. His mention of prevention is especially welcomed by me; let us do so much more on this. Another £250 million is a lot of the public’s money. What real-time oversight does he have to ensure that NHS England spends it wisely, and may I make a plea that domiciliary care is not overlooked, because the lack of care in people’s homes is every bit as much the enemy of patient flow as the lack of care home places that he has identified today?

    Steve Barclay

    My hon. Friend raises an important issue about getting flow into the system, not least because delays in ambulance handovers lead to the highest risk in what is a whole-of-system issue where the patient is not seen and treatment is delayed. That is why flow through discharge is so important, because, while that often concerns the back door of the hospital, it is actually the pressure at the front door that is most acute. The Government recognised that in the autumn statement and that is why there was additional funding with the £500 million for delayed discharge. That has taken some time to ramp up, but we recognise that because of the flu there is an immediacy in the pressure on A&E that we need to address.

    My hon. Friend’s point speaks to one of the key lessons from the covid period. It is not simply about releasing patients from hospitals who are fit to discharge; it is also about the wraparound services provided for those patients so that they do not get stuck in residential care for longer, and they are still able to go home and get the domiciliary care packages. NHS England is focused on that so that they have the wraparound services alongside that discharge.

  • Wes Streeting – 2023 Speech on NHS Winter Pressures

    Wes Streeting – 2023 Speech on NHS Winter Pressures

    The speech made by Wes Streeting, the Shadow Secretary of State for Health and Social Care, in the House of Commons on 9 January 2023.

    Happy new year to you, Mr Speaker, and to the rest of the House. I thank the Secretary of State for Health and Social Care for advance sight of his statement.

    This winter has seen patients waiting hours on end for an ambulance, A&E departments overflowing with patients, and dedicated NHS staff driven to industrial action—in the case of nurses, for the first time in their history—because the Government have failed to listen and to lead. I notice that the Secretary of State did not talk about the abysmal failure of his talks with nurses and paramedic representatives today. Let me say to him: every cancelled operation and delayed appointment, and the ambulance disruption due to strikes, could have been avoided if he had just agreed to talk to NHS staff about pay. Today, he could have opened serious talks to avert further strikes. Instead, he offered nurses and paramedics 45 minutes of lip service. If patients suffer further strike action, they will know exactly who to blame.

    Of course, the Prime Minister has already shown that he is not interested in solving problems; he resorts to the smokescreen of parliamentary game playing by bringing in legislation to sack NHS staff for going on strike. I ask the Secretary of State, in his sacking NHS staff Bill, how many nurses is he planning to sack? How many paramedics will he sack? How many junior doctors will he sack? The Government have the audacity to ask NHS staff for minimum service levels, but when will we see minimum service levels from Government Ministers and the entire Government?

    After arriving at the Derriford Hospital in Plymouth, an 83-year-old dementia patient waited in the back of an ambulance outside A&E for 26 hours before being admitted. That was on 23 December, when no strikes were taking place; the Secretary of State should listen. The patient’s family found him in urine-soaked sheets, and since arriving in hospital, he has contracted flu. His daughter said of the hospital staff:

    “They’re polite, they’re caring, and they are trying their best. It’s just impossible for them to do the work they want to do.”

    Let me say what the Health Secretary and Prime Minister refuse to admit: the NHS is in crisis—the biggest crisis in its history. That is clear to the staff who have been slogging their guts out over Christmas and to everyone who uses it as a patient; the only people who cannot see it are the Government.

    What has been announced today is yet another sticking plaster when the NHS needs fundamental reform. The front door to the NHS is blocked, the exit door is blocked, and there are simply not enough staff. Where is the Conservatives’ plan to fix primary care, so that patients can see the GP they want in the manner they choose? After 13 years of Conservative government, they do not have one. Where is the plan to recruit the care workers needed to care for patients once they have been discharged from hospitals, and to pay them fairly so that we do not lose them to other employers? After 13 years of Conservative government, they do not have one. Where is the plan to train the doctors, nurses and health professionals the NHS needs? After 13 years of Conservative government, they do not have one.

    Well, we do. The Secretary of State is welcome to nick Labour’s plan to abolish non-dom tax status and train 7,500 more doctors and 10,000 more nurses and midwives every year; to double the number of district nurses; and to provide 5,000 more health visitors—a plan so good that the Chancellor admitted that the Conservative Government should nick it. After 13 years of mismanagement, underfunding and costly top-down reorganisations, however, all the Conservatives have to offer the NHS is a meeting and a photo op in Downing Street.

    The collapse of the health service this winter could be seen coming a mile away—health and social care leaders were warning about it last summer—so why is the Secretary of State announcing these measures in the middle of January? Why have care homes and local authorities been made to wait until this month for the delayed discharge fund to reach them? It is simply too little, too late for many patients.

    In fact, this Government are so last minute that, after announcing this plan last night, they found an extra £50 million and sent out another press release. I know most of us are happy to find a spare fiver lying around the house that we did not know was there, but this Prime Minister seems to have 50 million quid stuck down the back of the sofa. What on earth is going on? No wonder they cannot get money to the frontline: the left hand does not know what the right hand is doing.

    It is intolerable that patients who are fit and ready to leave hospital are then stuck there for months because the care they need is not available in the community. They are not bed blockers, and they are not an inconvenience to be dropped off at a hotel and forgotten about. They need rehabilitation at home, rather than a bed in a care facility. Vulnerable patients deserve proper support suited to their needs, or they will fall ill again and go back to hospital. What about all these beds the NHS is procuring, and what about the capacity that families need? I will tell hon. Members what will happen: they will not get the care, and they will be coming right back through the front door of A&E, with the cycle of broken systems repeating itself again and again. Where is the choice and control for patients and their families who may not want to be discharged to a hotel?

    I am afraid that, after 13 years, this just is not good enough. The Prime Minister might not rely on the NHS, but millions of ordinary people do. They are sick and they are tired of waiting. There have been 13 years of Conservative Government now—13 years—and look at what they have done to the NHS. Did the Health Secretary listen to himself as he described the situation in hospitals of people waiting on chairs for discharge, the trolleys in the corridors and people waiting longer than ever? Whose fault is it? It is not that of the NHS staff he is threatening to sack, but of the Conservative Ministers who have made disaster after disaster. After 13 years of Conservative Government it is clear that the longer they are in power, the longer patients will wait. Only Labour can give the NHS the fresh start and fresh ideas it needs.

    Steve Barclay

    The hon. Member talks about a fresh start, but even his own shadow Cabinet colleagues do not seem to agree with his plans. His own deputy leader seemed to distance herself from his plans to use the private sector, and his own shadow Chancellor seems to have distanced herself from his plans for GPs. Perhaps he can share with the House exactly how much his unfunded plans for GPs will cost, because the chief executive of the Nuffield Trust has said:

    “It will cost a fortune”,

    and is

    “based on an out of date view”.

    The point is that he has no plans that his deputy and his own colleagues support, and he has not set out how he would fund those plans in a way that does not divert resource from other parts of the NHS.

    The hon. Member talked about pressure, yet there was no mention of the fact that the NHS in Wales, the NHS in Scotland and, indeed, health systems across the globe have faced significant pressure as a result of the combination of covid spikes and flu spikes, particularly in recent weeks. This is not a phenomenon limited to England and the NHS; this is a pressure that has been reflected internationally, including for the NHS in Wales.

    The hon. Member refers to talks with the trade unions, and it is right that we are engaging with the trade unions. I was pleased to meet the staff council of the NHS today. Indeed, the chair of the NHS staff council, Sara Gorton, said the discussions had made “progress”, notwithstanding one trade union leader who was not in the talks giving an interview outside the Department to comment on what had and had not been said in those talks. We want to work constructively with the trade unions on that.

    The hon. Member says that we are only announcing measures today, but again, he seems to have written those comments before he got a copy of the statement. The integrated care boards took operational effect in July last year—[Interruption.] Because they are scaling up, we are putting control centres in place and we are integrating health and social care. In the autumn statement, we announced £500 million for discharge, a further £600 million next year and £1 billion the year after, recognising that there is significant pressure, and that is ramping up. NHS England set out its operational plans in the summer, including the 100-day discharge sprint. That, for example, set out the greater use of virtual wards, which is new technology being rolled out at scale. It also announced the extra 7,000 community beds. Indeed, we also set out the additional measures in our plan for patients.

    What is clear when we have a sevenfold increase in flu in a month—50 cases admitted last year compared with 5,100 this year—is that there is a combination of a surge in demand on top of the existing high-level position, and the surge in demand corresponds with a constraint on supply as staff absences also increase because of flu, so during the Christmas period community services are more constrained. Those two things together have created significant pressure on our emergency departments. That is why in the engagement I have had with health leaders the two key messages they gave to me were the importance of getting flow into hospitals, which is constrained by the high bed occupancy—that is why getting people out of hospital is so central to relieving pressure—and, within the emergency departments specifically, the need to decompress those services with same-day emergency treatment and having short stay post-emergency departments. That is a better way to decompress those emergency departments—through the triaging and bringing other clinical specialties closer to the front door. We have listened to the NHS frontline and those were the two key requests made to me, alongside other issues such as care quality inspections and how to make them more flexible. However, alongside those immediate pressures, we need to recognise that we had pressures last summer during the heatwave and we had pressures in the autumn, which is why we have announced a wider set of measures today.

    So we have listened and we have acted; we have taken measures to deal with the immediate pressure, but we have also set out how we will build further capacity that will go through into the autumn. Alongside that, we have signed deals, for example with Moderna and BioNTech, and we are bringing forward the life science investment so that that has a better impact on pressures on the frontline.

  • Steve Barclay – 2023 Statement on NHS Winter Pressures

    Steve Barclay – 2023 Statement on NHS Winter Pressures

    The statement made by Steve Barclay, the Secretary of State for Health and Social Care, on 9 January 2023.

    Mr Speaker, I wish to take this first opportunity to update the House on the severe pressures faced by the NHS since the House last met. I and the Government regret that the experience for some patients and staff in emergency care has not been acceptable in recent weeks. I am sure that the whole House will join me in thanking staff in the NHS and social care who have worked tirelessly throughout this intense period, including clinicians in this House who have worked on wards over Christmas. They include my hon. Friend the Member for Lewes (Maria Caulfield), the Minister for mental health, and the hon. Member for Tooting (Dr Allin-Khan), the shadow Minister for mental health.

    There is no question but that it has been an extraordinarily difficult time for everyone in health and care. Flu has made this winter particularly tough: first, because we are facing the worst flu season for 10 years—the number of people in hospital with flu this time last year was 50; this year, it is over 5,100. Secondly, it came early and quickly, increasing sevenfold between November and December. It also came when GPs and primary and community care were at their most constrained. When flu affects the population, it affects the workforce too, leading to staff sickness absence that constrains supply just as it also increases demand.

    These flu pressures came on top of covid. Over 9,000 people are in hospitals with covid, while exceptional levels of scarlet fever activity and an increase in strep A have created further pressure on A&E. All that comes on top of a historically high starting point. We did not have a quiet summer, with significant levels of covid, and delayed discharges were more than double what they were during the pandemic. I put that in context for the House: in June 2020, there were just 6,000 cases per day of delayed discharge—patients medically fit and ready to leave hospital—whereas throughout last year the figure was between 12,000 and 13,000 per day. The scale, speed and timing of our flu season have combined with ongoing high levels of covid admissions in hospital and the pandemic legacy of high delayed discharge to put real strain on frontline services.

    Since the NHS began preparing for this winter, there was a recognition that this year had the potential to be the hardest ever. That is why there was a specific focus on vaccination. There were 9 million flu shots and 17 million autumn covid boosters. We extended eligibility more widely than in the past, to cover the over-50s, and became the first place in the world to have the bivalent covid vaccine, which tackles both the omicron and the original covid strain.

    NHS England also put in place plans for the equivalent of 7,000 additional beds, including the introduction of virtual wards of a sort that one can see at Watford General Hospital. That innovation is still at an early stage of development, but has the potential to be significant in reducing pressure on bed occupancy in hospitals; in Watford alone, it has saved the equivalent of an extra hospital ward of patients. In addition, our plan for patients put £500 million specifically into delayed discharge, with a further £600 million next year and £1 billion the year after. Although the funds are already starting to make a difference, efforts have taken time to ramp up operationally with local authorities and the local NHS.

    In addition, our 42 integrated care boards, recognising how bed occupancy in hospitals and social care are connected, will fully integrate health and care in the years to come. But likewise, they are at an early stage of maturity, with ICBs having become fully operationalised only in July 2022, less than six months ago.

    Our plans involving the integration of hospital care and social care, additional funding for discharge, increased step-down capacity, the equivalent of 7,000 additional hospital beds and a vaccination programme at scale have provided the groundwork for the Government response, but it is clear we need to do more right now in light of the level of flu and covid rates and given that hospital occupancy remains far too high and emergency departments are too congested. Recognising that, we launched the elective recovery taskforce on 7 December, and in the coming weeks, we will publish our urgent and emergency care recovery plans. NHS England and the Department of Health and Social Care have been working intensively over Christmas on these plans, which were reviewed with health and care leaders at an NHS recovery forum in Downing Street on Saturday.

    The recovery falls into three main areas of work: first, steps to support the system now, given the immediate pressures we face this winter; secondly, steps to support a whole-of-system response this year to give better resilience during the summer and autumn—as we have seen with the heatwave this summer and with the levels of covid, pressure is now sustained throughout the year, not just, as in the past, during autumn and winter; and, thirdly, our work alongside those two areas on prevention, on maximising the step change potential of proven technologies, such as virtual wards, and on the wider adoption of innovations such as operational control centres and machine reading software to treat more conditions in the community, away from someone reaching an emergency department in the first place.

    Let me first set out the measures I can announce today to provide support to the NHS and local authorities now. First, we will block-book beds in residential homes to enable some 2,500 people to be released from hospitals when they are medically fit to be discharged. When that is combined with the ramping up of the £500 million discharge funding, which will unblock an estimated 1,000 to 2,000 delayed discharge cases, capacity on wards will be freed up, which will in turn enable patients admitted by emergency departments to move to wards, which in turn unblocks ambulance delays. It is important, however, that we learn from the deployment of a similar approach during the pandemic by ensuring that the right wraparound care is provided for patients released to residential care. I have asked NHS England to particularly focus on that, so that it is the shortest possible stay on patients’ journey home and into domiciliary care, and indeed it is in the NHS’s own interests for those stays to be as short as possible. Taken together, this is a £200 million investment over the next three months.

    Next, our A&Es are also under particular strain. From my visits across the country I have seen and heard how they often need more space to enable same-day emergency care and short stays post emergency care. Our second investment is in more physical capacity in and around emergency departments. By using modular units, this capacity will be available in weeks, not months, and our £50 million investment will focus on modular support this year. We will apply funding from next year’s allocation to significantly expand the programme ahead of the summer. We are giving trusts discretion on how best to use these units to decompress their emergency departments. It might be for spaces for short stays post A&E care, where there is no need for a patient to go to a ward for further observation, or for discharge lounges that previously have not been able to take a patients in a bed—many of those are often simply chairs—or for additional capacity alongside the emergency department at the front end of the hospital.

    The third action we are taking to support the system right now is to free up frontline staff from being diverted by Care Quality Commission inspections over the coming weeks, and the CQC has agreed to reduce inspections and to focus on high-risk providers in other settings, such as mental health. Those are the actions we are taking that will have an immediate effect.

    I turn to the measures we are taking now that will give greater resilience into the summer and next winter. We now have 42 NHS system control centres in operation across England, staffed 24 hours a day, seven days a week, tracking patients on their journey through hospitals, helping us to identify blockages earlier and getting flow through the system. Where we have implemented these systems, such as the one I saw in operation in Maidstone, they have had a clear impact. We will therefore allocate funding in next year’s settlement to apply these systems more widely.

    Similarly, we have also seen how the use of artificial intelligence and data can demonstrably reduce demand and release patients sooner. NHS England has been tasked with clarifying and simplifying the procurement landscape, taking on board best international practice, so that a small number of scalable interventions are taken forward where international experience shows they can deliver meaningful benefits to patients.

    Next, we will capitalise on the incredible potential of virtual wards. Last week at Watford General Hospital, I saw how patients who would have been in hospital beds were treated at home through a combination of technology and wraparound care. Patients released sooner are often much happier, knowing that they are receiving clinical supervision and always have the safety net of being able to quickly return to hospital should their condition deteriorate. There is scope to expand these measures to many more conditions and many more hospitals in the months ahead.

    We are also opening up more routes for NHS patients to get free treatment in the independent sector and offering even greater patient choice. The elective recovery taskforce is helping us to find spare operating theatres, hospital beds and out-patient capacity.

    We must also take steps in primary care. We are clear that our community pharmacists can support many more things to ease pressure on general practice. From the end of March, community pharmacists will take referrals from urgent and emergency care settings; later this year, they will also start offering oral contraception services. But I want to do even more, as they do in Scotland, and work with community pharmacists to tackle barriers to offering more services, including how to better use digital services. The primary care recovery plan will set out a range of additional services that pharmacists can deliver.

    Finally, notwithstanding very severe pressures, we know that to break the cycle of the NHS repeatedly coming under severe pressure, the best way to reduce the numbers coming through our front doors is to address problems away from the emergency department. On Friday, we signed a memorandum of understanding with BioNTech —a global leader in mRNA technology—to bring vaccine research to this country, which will give as many as 10,000 UK patients early access to trials for personalised cancer therapies by 2030. This builds on the 10-year partnership we struck with Moderna in December to also invest in mRNA research and development in the UK and build state-of-the-art vaccine manufacturing here.

    We are also reviewing our wider care for frail, elderly patients in care homes long before they ever get to A&E or our hospitals. Take the brilliant work being done in Tees valley, where community teams are being used to help with falls to prevent unnecessary ambulance trips to hospitals. We have looked at what more support we can offer elderly patients further upstream. With an ageing population, and many more people with more than one condition, it is clear that we have to treat patients earlier in the community and go beyond individual specialties to better reflect patients with multiple conditions to give the right support to people where they are, which is often at home or in residential homes.

    Today’s announcement provides a further £250 million of funding, which recognises the spike in flu on top of covid admissions and high delayed discharge numbers from the pandemic. The funding will provide immediate support to reduce hospital bed occupancy and decompress A&E pressures, and, in turn, unlock much-needed ambulance handovers. This funding builds on the £500 million announced in the autumn statement specifically for discharge, which is ramping up, and the additional funding for next year.

    All this work ultimately builds on the much-needed greater integration of health and social care through the 42 integrated care boards, which we will strengthen through the Hewitt review, and through a step change in capability, including operational control centres.

    This immediate and near-term action sits in parallel with our wider life science investment, such as the deals with BioNTech and Moderna, and underscores our commitment to recognising the immediate pressures on the NHS and investing in the science that will shift the dial on earlier, upstream treatment at scale, particularly for the frail elderly, long before a patient reaches an emergency department. This is a comprehensive package of measures, and I commend this statement to the House.

  • Andrew Selous – 2023 Parliamentary Question on New Developments Without Sufficient GPs

    Andrew Selous – 2023 Parliamentary Question on New Developments Without Sufficient GPs

    The parliamentary question asked by Andrew Selous, the Conservative MP for South West Bedfordshire, in the House of Commons on 9 January 2023.

    Andrew Selous (South West Bedfordshire) (Con)

    If he will make a statement on his departmental responsibilities.

    The Minister of State, Department for Levelling Up, Housing and Communities (Lucy Frazer)

    On 28 December, we announced an historic devolution deal between the Government and the local authorities of Northumberland, Newcastle, North Tyneside, Gateshead, South Tyneside, Sunderland and County Durham. A new Mayor for the north-east will ensure that local priorities are at the heart of decision making and will provide £1.4 billion to level up the area over the next 30 years. We have now struck deals with eight of the 11 areas identified for devolution in the levelling up White Paper, putting more power in the hands of local leaders representing over 7 million people in England.

    Andrew Selous

    Will the Government remedy the completely unacceptable situation whereby thousands of homes are built in areas such as mine—and in Rugby and elsewhere—without adequate general practice capacity? What will the Government do to put that right in areas where that has happened?

    Lucy Frazer

    My hon. Friend has a great deal of experience on this issue in his area, as well as having raised it nationally. I was very pleased to discuss it with him and the relevant Minister in the Department of Health and Social Care today. It is important that all the necessary infrastructure for a housing development is built, whether in relation to education or GP surgeries. The infrastructure levy will facilitate that even further—[Interruption.]—but it is important that we work together.