Health Questions

20th December 2016
Philip Dunne answers questions from MPs.

​Hospitals in Special Measures


6. What progress he has made on improving hospitals in special measures. [907977]


We want the NHS to offer the safest, highest quality care anywhere in the world, so we are now tackling unacceptable performance. That is in contrast to the Labour party, which ignored failures for so long. Since introducing the rigorous special measures inspection regime, 31 provider trusts have gone into Care Quality Commission special measures, of which 15 have been turned around as a result of significant quality improvements. I congratulate again the staff of Sherwood Forest, Wye Valley, Norfolk, and Suffolk trusts, all of which have come out of special measures in recent months.


Medway Maritime Hospital has made significant improvements since it was put into special measures: mortality rates and length of patient stay are down; leadership is excellent; and there has been extensive investment in the A&E. Does the Minister agree that it is the right time for the hospital to come out of special measures? Will he join me in paying tribute to the excellent work of the hospital’s staff?


I congratulate my hon. Friend on his role in championing Medway Maritime Hospital, which I visited earlier this autumn. The CQC is in the process of re-inspecting Medway and will publish its findings in the new year. I congratulate the trust on its improvements thus far that were highlighted by my hon. Friend, which include reducing its average length of stay on admission wards from 11 days to only 3 days.


A recent damning report on maternity care from the Pennine Acute Hospitals NHS Trust care referred to appalling neglect that lead to the avoidable deaths of mothers and babies. The trust has implemented an improvement plan, but plans for maternity services under the “Making It Better” scheme were based on a predicted birth rate of 3,500 a year, and the reality is that the trust deals with 10,000 deliveries a year. What action will the Minister take to address that situation?


I am grateful to the hon. Lady for raising some of the issues at the Pennine trust. We are well aware that it needs improvement, which is why we have buddied it up with the outstanding Salford Royal NHS Foundation Trust next door. The Salford trust is led by Sir David Dalton and the Secretary of State referred to it earlier. I will take up the matter raised by the hon. Lady directly with Sir David.



NHS: Financial Recovery

9. What progress the Government are making on recovering money from overseas visitors and other chargeable NHS patients. [907980]

The NHS is a national, not an international, service. This Government were the first to introduce tough measures to clamp down on visitors accessing free NHS care, including introducing the immigration health surcharge. The steps we have taken have meant that income raised from visitors and migrants has risen three-fold in three years, from £97 million in 2013-14 to £289 million in 2015-16.


I thank the Minister for that answer, but does he agree that recovering more money from chargeable patients requires a culture change among NHS staff? Does he therefore share my dismay that the leader of the doctors union dismisses the need even to address this issue, while calling for additional investment in our NHS?


I agree with my hon. Friend that we need increased awareness and appropriate participation by all NHS staff in achieving this policy, but I also agree with one thing that Dr Mark Porter said—that sick and vulnerable patients must not be put off seeking necessary treatment, as this may be bad for their health and for that of the public in general. This has always been a clear feature of our policy, so to be clear, this policy does not withhold immediately necessary or urgent treatment, but it makes sure that the NHS is fairly reimbursed by those who are not entitled to free care.


As the Minister will know, the Public Accounts Committee has looked in detail at this issue, and we were rather shocked to discover that the Government themselves are woeful at collecting money from EU citizens who use our hospitals and for whom the Government are then responsible for getting the money from their home Government. When will the Government get their act together to make sure that this money comes into our NHS?


I am always grateful for advice from the Public Accounts Committee, which looks into areas where the Government can recover moneys to which they are entitled. There was an article in today’s Times which referred to outstanding sums, and we are taking steps to try to increase recovery rates in the years ahead.


Sustainability and Transformation Plan: South-west London

10. What assessment he has made of the potential effect of the implementation of the sustainability and transformation plan for south-west London on the provision of health services in that area. [907981]


The sustainability and transformation plan for south-west London sets out how the area will implement the NHS’s five year forward view. The local NHS is looking to strengthen primary care and ensure closer working across NHS bodies, with more sustainable acute services, developing centres of expertise to ensure high-quality service, as well as closer co-ordination with social care providers.


The Epsom and St Helier Trust is a high-performing trust, hitting A&E and cancer treatment referral targets. It is confident that it can deliver sustainable and transformed care services, but will struggle to do so in St Helier hospital, built in the 1930s. The trust has previously secured a commitment from two Governments that funding would be available. Will the Minister give the same undertaking and confirm that once the STP process is complete, funding will be available to the trust to enable it to continue delivering excellent sustainable services from a new hospital?


I am aware of the right hon. Gentleman’s campaign on this matter. It would be wrong for me to pre-empt the work that is being done in reviewing both the STP process and the policy priorities of NHS England. Once those plans have been put forward to Ministers, we will be able to consider which we can prioritise.


The STP for south-west London includes mental health crisis needs, but there is a current crisis of lack of in-patient facilities for mental health patients. Will the Minister look into extra immediate funding to increase the number of in-patient mental health beds?


As my hon. Friend is well aware, given her experience in this area, mental health is a priority of the Government and of the STP process. I will take away what she says in relation to in-patient beds.


Topical Questions

T3. Last week, a 76-year-old man with diabetes in my constituency took a fall and had to wait almost two hours for an ambulance. I then wrote to the Health Secretary after it emerged that not a single ambulance trust in England met its response time targets in October, including for the most critical of cases. Will he explain the reasons for these unacceptable ambulance delays and what he intends to do as we approach Christmas? [907964]


I am aware of the case that the hon. Lady refers to. In the week of the incident, the London ambulance service received 40,433 emergency calls—an 8% increase on the previous week. We are trying to do something about this. We have recruited 2,200 more paramedics since 2010 and increased the number of paramedic training places by 60% in this year alone. The London ambulance service has recruited 107 more paramedics since September 2015 to help with this increased demand.

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With acute hospital bed blocking at a record high, do Ministers agree that it is a great pity that so very few of the 40 sustainability and transformation plans now in the public domain deal directly with step-down care and, in particular, with community hospitals?


As my hon. Friend has confirmed, 44 areas are working on their STPs, all of which are charged with looking at improving integration between hospitals and social care in order to improve discharge. In order for STPs to be taken forward, they have to address that issue.


My constituency has been waiting some time for the go-ahead for a new critical treatment hospital providing 24/7 care for the sickest patients, which is very much in line with Government policy. The hospital’s chief executive, Mary Edwards, retires this month after 21 years of exceptional service. Will the Secretary of State give her a retirement present and help me to secure a decision from NHS England?


I join my right hon. Friend in congratulating her chief executive on her commitment to the NHS. As I said in answer to a previous question about the STP for my right hon. Friend’s area, the issue is being reviewed at the moment by NHS England, and I am afraid that I am not in a position to give her any advance notice of the outcome.

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In the east midlands, the average ambulance arrival time for life-threatening cases has almost doubled in the last three years, and Nottingham’s A&E waiting times are the worst in a decade. Will Ministers apologise to my constituents, including hard-working NHS staff, for their failure to fund health and social care adequately?


I would like to add my tribute to the work of ambulance staff up and down the country, particularly over the busy Christmas period ahead. As I have already said today, we have increased funding for ambulance services. We have increased the number of paramedics, both in training and employed. Earlier this month we announced that we had increased the payments to paramedics to move them from band 5 to band 6, to help to retain and recruit more staff.

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