Steve Barclay
MP for North East Cambridgeshire · Conservative · United Kingdom
“I speak to my brief exchange earlier with the Minister. As the previous speaker, the hon. Member for Harpenden and Berkhamsted, said, the draft regulations are fairly benign and very welcome to help people who are struggling with their bills.”
“The issue is not the lack of will; the issue is the alignment between procurement, regulation and clinical leadership, particularly in the colleges, as well as the ability to scale innovation—it is not about having more ministerial pilots.”
“Just to localise it to my own constituency, the Cambridgeshire and Peterborough ICB alone paid out £14 million in redundancies last year. It merged with a number of other ICBs to form the Central East ICB, yet we know hear from the Government that it should align with metro mayors, which means going back to exactly what it was before: the…”
“My right hon. Friend is absolutely right: the Government are spending millions of pounds and there is no plan. The measure was announced without working that out, it came as a surprise to many within the system, and it has had a chilling effect on many decisions. That is not isolated.”
“I rise to speak to clause 1 on the abolition of NHS England and clause 6 on promoting innovation. What characterises the first of those is an announcement without any clear plan. That is what has driven the cost and confusion that a number of Members across the House have spoken about.”
“All this is around 18 months on from the actual announcement. The confusion seems to extend to the Government themselves, because they seem unable to answer pretty straightforward written parliamentary questions. Given the time limit, I will give just a few examples.”
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“I accept that pay is an important factor. It is not the only factor—the estate and technology are also important. There is a range of issues. That is exactly the conversation I had with the trade unions representing “Agenda for Change”. We discussed with them both changes to pay and the non-pay measures. There are a range of factors, and we stand ready to have those discussions with junior doctors. However, they have chosen to take a more political, militant stance, in contrast with the approach that other trade unions have pursued.”
“We recognise that the profession has faced huge pressure through the pandemic and we stand ready to work constructively with them in the same way that we have with the GMB, the RCN, Unison and many other trade unions.”
“I have already answered that question twice, but I am very happy to repeat at the Dispatch Box the fact that I checked with my officials in the Department this morning—with people who were in the room—and have also checked the minutes. That was the position that the junior doctors set out in terms of a precondition. Indeed, they have repeatedly stated in the media that they expect a 35% pay restoration—and not simply that, but additional things such as exam fees, parking fees, reform of the DDRB and so forth. That is the position the junior doctors have set out. I repeat that we want to work constructively with junior doctors.”
“It is just regrettable that some in the junior doctors committee of the BMA want, as they have said in media interviews, to take a more overt political agenda, rather than work with us to focus on the real issues that many junior doctors are concerned about.”
“There are two different things there—one on which the hon. Gentleman is correct and one on which he is not. He is correct that we have said that a precondition for meaningful and constructive talks is that the trade union suspends strikes. That is a precondition that the other trade unions were more than willing to accept, and it is applied in other sectors such as education. We have been clear on that. The hon. Gentleman is not correct on my point about militancy, which referred to the junior doctors committee specifically. We stand ready and recognise the real pressure that many within the junior doctors community have faced. The NHS has been under significant pressure coming out of the pandemic. We recognise that there are issues on which we want to work and have constructive engagement with them.”
“We stand ready to have exactly that meaningful and constructive engagement with junior doctors.”
“I am very happy to give the hon. Gentleman reassurance about our desire to have that constructive engagement, exactly as we had with colleagues on the NHS staff council. There are a number of issues on which we are keen to work with junior doctors: rostering; which he mentioned; holidays, which are sometimes cancelled at short notice—a range of issues have been raised with me. When I go on visits to hospitals, as I do frequently, staff raise a range of issues, and I am very keen to work through them with junior doctors. I think that people can see from the approach that we took not just with “Agenda for Change”, but with the pension changes that were announced in the Budget, that the Government are working constructively with the NHS to address those issues.”
“We are recruiting more mental health workers, with 7,400 more full-time equivalents in September 2022 compared with September 2021. That reflects the significant additional funding we are providing—the extra £2.3 billion going in by 2023-24.”
“The hon. Gentleman raises an extremely important subject. As well as the additional investment and extra workforce we are putting into mental health, we are looking at this issue as part of our strategies in other areas—for example, our suicide strategy—and examining our capital investment. There is a range of measures to address this very important issue.”
“I recognise the close interest my hon. Friend takes in this matter, and he is right to draw the House’s attention to international best practice. I agree that we should take an evidence-based approach in which we look at the data shared with regulators in other countries, such as Australia. I am happy to draw the point he makes to the attention of our regulators.”
“My right hon. Friend raises an important issue, and I am happy to look into the individual case she describes. Our wider objective in providing extra funding is to ensure that we treat more people, with 2 million more people accessing NHS-funded mental health support by 2023-24 and the number of patients in talking therapies last year up by a fifth from the year before.”
“It is always good to find a plan that the hon. Lady actually agrees with the shadow Health Secretary on. As we know from her questions, that is not always the case, not least on the use of the independent sector. What we do know is that she has a habit of writing her questions before she hears the previous answer. I just reminded the House of the 7,400 more staff in mental health in September 2022 compared with September 2021. Obviously she had written her question before that point.”
“We have opened five new medical schools in Sunderland, Lancashire, Chelmsford, Lincoln and Canterbury as part of our wider drive to increase the number of doctors.”
“I agree with my hon. Friend, and that is why we had a 25% increase in the total number of medical school places. On the specific point he raises, we have developed the new apprenticeship route for medical doctors so that we can start to have more training through that route and not just through the undergraduate route.”
“It is worth pointing out to the House that the vacancy rate for doctors has fallen compared with where it was before the pandemic. That is often not the narrative that is put out there, but the right hon. Lady is right to highlight the importance of retention. It is obviously better to retain a doctor, given the cost and time it takes to recruit, and that is about looking at a combination of pay issues, about which we are talking to trade union colleagues, and non-pay issues, which are often a real factor in the quality of work that doctors are doing and often shapes retention issues.”
“First, as I said a moment ago, we are funding a 25% increase in medical undergraduate places, and we have given a commitment to a workforce plan, as the Chancellor set out in the autumn statement. The question that the shadow Secretary of State should address is his party’s opposition to international recruitment. We have more than 45,000 doctors who have been recruited internationally, yet the Leader of the Opposition says he wants to move away from international recruitment, which is an important source of additional doctors.”
“The Government are committed to building 40 new hospitals, which is why we have confirmed an initial £3.7 billion for the first four years of the new hospital programme.”
“As my hon. Friend knows, I have been to Hillingdon to look at the scheme. I am aware of how essential it is to his local area. He will know that on 22 February, the Prime Minister spoke at Prime Minister’s questions of the Government’s commitment to building 40 new hospitals, and I hope to announce something on that very shortly.”
“I or another member of the ministerial team will, of course, meet the leader of Manchester council to discuss this. We are making progress. The hon. Gentleman will have seen progress, for example, at the Royal Liverpool and the Northern Centre for Cancer Care, but I confirm our commitment to the 40 hospitals programme and hope to say more on that shortly.”
“The Government have committed an initial £3.7 billion, which indicates our commitment to the new hospital programme. As I said, I will have more to say on that shortly.”
“It is. As my hon. Friend will know from another of my visits, which was with him to Kettering, the enabling works are progressing. That is in no small part a tribute to the work that he and neighbouring MPs have done to strongly make the case for Kettering. I know that he will continue to do so, and I look forward to working with him on that.”
“We published the urgent and emergency care recovery plan, which set out a number of measures to improve patient flow within hospitals, which has an impact on ambulance performance. In addition, we are purchasing 800 new ambulances, which will be on the road this year.”
“My hon. Friend is right to highlight the consequences of closures such as that, PFI or other issues that are still felt in communities such as Burnley. He will also know that it is for the integrated care board to look at commissioning decisions and I know that he will make his case powerfully to that board.”
“My hon. Friend raises an extremely powerful point. It is not only those targets in Wales that are being missed. She will know that people are almost twice as likely to be waiting for treatment in the Labour-run Welsh NHS than they are in England: 21.3% in Wales compared with 12.8% in England. She will also know that the number of two-year waits for operations in Wales, at over 50,000, is considerably higher than that in England, which is below 2,000.”
“Since March 2019, GPs have recruited over 25,000 staff such as pharmacists, physiotherapists and mental health practitioners, and we are on track to hit our 26,000 additional staff commitment.”
“My hon. Friend is absolutely right, which is why I commissioned through NHS England a review of 111. It was initially designed for a different purpose. That allows the GP service to be the front door it has become in the NHS. Through the chief executive of Milton Keynes University Hospital, we have done significant work on the NHS app, so it can better enable patients to get to the right place for the care they need.”
“The hon. Member is right to highlight the pressure on primary care, which is why, in the answer I gave a moment ago, I said it is also about looking at the wider skills mix within primary care. She mentions doctors specifically. We have 2,200 more doctors in general practice than before the pandemic. It is about having the right skills mix alongside the doctors to meet the significant increased demand since the pandemic.”
“My hon. Friend highlights an absolutely brilliant point, one I am extremely seized of, which is: how do we get detection much sooner, looking at genomics, screening and identifying issues before the patient is even necessarily aware that they have a condition. Early care delivers far better patient outcomes but it is also far cheaper to deliver. That prevention, as he highlights, is extremely important.”
“The hon. Gentleman reasonably highlights that the commissioning is a decision for the ICB, but also rightly draws attention to the opportunity to look at different models, for example, how we look across communities at economies of scale, and how we combine that with modern methods of construction to deliver projects far more quickly. I am happy to look, with Devon ICB, at the issue he raises.”
“My right hon. Friend is a very experienced parliamentarian and will know that issues of tax are a matter for my right hon. Friend the Chancellor, but I draw her attention to “Our plan for patients”, which sets out a package of NHS pension scheme measures.”
“We will set out to the House in due course a recovery plan to deal in particular with primary care but also dentistry. We recognise that, notwithstanding the fiscal support that was offered to protect dentistry through the pandemic, it is an area of acute interest across the House. The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Harborough (Neil O’Brien), will be saying more on that very shortly.”
“On Friday I was proud to announce the winners of the third round of the artificial intelligence in health and care award. Winners included projects within the NHS that identify women at risk of stillbirth, help with neurological conditions, find lung blockages and assess the quality of transplant organs, as well as a number of projects focused on cancer, identifying people’s predisposition and its presence. Since its inception in 2019, the AI in health and care award has invested more than £123 million in 86 promising projects, supporting more than 300,000 patients. AI will come to save countless lives in the NHS in the years to come, and that begins with the investment today.”
“I am very aware of the hon. Lady’s work as chair of the APPG, so I am not surprised that she asks about that important issue, which she has been assiduous in raising. I will flag up the follow-up with my ministerial colleague. I draw the hon. Lady’s attention to the fact that the National Institute for Health and Care Research remains open to research proposals in this area. I encourage her to ensure through her work on the APPG that bids are made to generate the evidence that the clinicians who make decisions on prescribing need.”
“We are always happy to assist colleagues across the United Kingdom as part of our commitment to the Union. My hon. Friend is right to highlight current performance in Wales. As I have said, patients are waiting twice as long for hospital treatment in Wales as in England, and more than 50,000 people in Wales are waiting for more than two years for their operation.”
“What the hon. Gentleman omits to remind the House is that at the time the demand from trade unions was for a 19% consolidated pay rise, which is very different from the basis on which talks have been entered into. The point is that we are in discussions with trade union colleagues. Trade unions and the Government have a shared purpose—to address the very real challenges that we recognise the NHS workforce have faced, particularly in the context of the pandemic—and a shared desire, which is to focus on patients and ensure that they get the right care to support them.”
“I have come to the House literally from a meeting with the trade unions: I met the NHS Staff Council this morning. Once again, hon. Members on the Opposition Front Bench are writing their questions before they see what is actually happening.”
“As we heard earlier from the Parliamentary Under-Secretary of State, my hon. Friend the Member for Harborough (Neil O’Brien), the major conditions strategy report will deal with those issues. However, it is also important to consider the variation in performance between integrated care boards and how we can raise the bottom quartile to the level of the top quartile—there is far too much variation within the NHS—and to be data-driven, so that when it comes to genomics and screening we can target the outliers more precisely. That is what is behind the issue to which my hon. Friend has rightly drawn attention.”
“My right hon. Friend’s question was so good that I was eager to answer it early. He is right to highlight this issue, which is being dealt with as part of a wider thrust within Government work on prevention, which is how we can empower the patient. That means getting more data to patients and using genomics and screening to ensure that they are better informed and can therefore opt to take decisions on healthy eating, rather than the state trying to impose those decisions on them in a top-down manner.”
“I am happy for a member of the ministerial team to meet the hon. Lady, who has made a compelling case about the return on investment. We will obviously need to scrutinise it in more detail, and I am sure that my colleagues will look forward to doing so.”
“My hon. Friend is right to highlight the issues in Medway and those in Kent as a whole. When I met the chief executive of Maidstone Hospital yesterday, we discussed some of the innovation that it has introduced and the benefits of that innovation across the board. As for the new hospitals programme, I remind my hon. Friend of the comments made by my right hon. Friend the Prime Minister on 22 February, when he confirmed the Government’s commitment to that programme.”
“My hon. Friend is right to highlight the community services that we are doing as part of our urgent and emergency recovery plan, looking at how we deliver care quicker through innovative models. One of those involves better co-operation with the fire service.”
“My hon. Friend is right to highlight the fact that a number of services that GPs currently offer could be performed by pharmacists, and we are looking at that in the context of the primary care recovery plan. This is also about looking at how we can relieve some of the workload pressure within primary care, and that is why we have recruited 25,000 additional staff to support GPs. It is also why we have over 2,000 more doctors in primary care.”
“It is for schemes such as those that my hon. Friend highlights that we are investing a further £2.3 billion a year in mental health services, and that in turn is facilitating an extra 2 million patients accessing NHS-funded mental health support.”
“My hon. Friend is right to draw the House’s attention to the extremely important work of hospices and to the fact that commissioning decisions are devolved to the integrated care boards so that they can target funding in the way that best serves local communities. He is quite right to lobby on their behalf and I am sure that his relevant ICB will take note of that.”
“Taken together with all the other vital work happening across health and care, including our plan to cut elective and primary care waiting times, today’s plan will enable better care in the community and at home, for that care to be more integrated with hospital services and for existing practice to be more widely adopted. I commend this statement to the House.”
“Finally, we are improving patient experience by making it easier to access the right care, including a better experience with NHS 111 and better advice at the front door of A&E, so that patients are triaged to the right point in the hospital without always needing to go through the emergency department—this new approach can currently be seen at Maidstone Hospital, as I saw earlier this month. These are just some of the practical improvements already being delivered in a small number of trusts that, through this plan, we will adopt more widely across the NHS and, in doing so, deliver greater resilience ahead of next winter. I am pleased that NHS Providers has welcomed today’s plan, and that the Royal College of Emergency Medicine has called it “a welcome and significant step on the road to recovery”.”
“This includes a new falls service, so that more elderly people can be treated without needing admission to hospital. Virtual wards are also showing the way forward for hospital care at home, with a growing evidence base showing that virtual wards are a safe and efficient alternative to being in hospital. We aim to have up to 50,000 people a month being supported away from hospital, in high-tech virtual wards of the sort that Watford General Hospital has been pioneering, as I saw last month.”
“We are on track to deliver on our manifesto commitment to recruit more than 50,000 nurses, with more than 30,000 recruited since 2019. The NHS will publish its long-term workforce plan this year. We are also boosting capacity and staff in social care, supported by investment of up to £2.8 billion next year and £4.7 billion in the year after. Thirdly, we are speeding up the discharge of patients who are ready to leave hospital, including by freeing up more beds with the full roll-out of integrated care transfer hubs, such as the successful approach I saw this morning at the University Hospital of North Tees. Fourthly, we are expanding and better connecting new services in the community, such as joined-up care for the frail elderly.”
“More than that, we are backing our plan with the funds we need, and the Government are committing to additional targeted funding to boost capacity in acute services and the wider system. That is why this package includes £1 billion of dedicated funding to support hospital capacity, building on the £500 million we have provided over this winter to support local areas to increase their overall health and social care capacity. Taken together, this plan will cut urgent and emergency care waiting times by, first, increasing capacity with 800 new ambulances on the road, of which 100 are new specialised mental health ambulances. This comes together with funding to support 5,000 new hospital beds, as part of the permanent bed base for next winter. Secondly, we are growing and supporting the workforce.”
“Dr Adrian Boyle, the president of the Royal College of Emergency Medicine, has previously said: “The full publication of this data will be an immensely positive step that could be the catalyst for transformation of the urgent and emergency care pathway that should help to improve the quality of care for patients.” I hope this transparency will be welcomed across the House. Our plan focuses on five areas, setting out steps to increase capacity in urgent and emergency care; grow the workforce; speed up discharge; expand and better join up new services in the community; and make it easier for people to access the right care. Action in each area is based on evidence and experience, learning lessons from the pandemic and building on what we know can work.”