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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“The hon. Lady says that she is not being listened to, but my understanding is that she is co-chair of the menopause taskforce, which has been set up to look at these issues. Indeed, she has also had meetings with officials on the subject of HRT. It is slightly remiss of her to suggest that she is not being listened to when Health Department officials are meeting with her and when we have a taskforce under way. There is much consensus around the points that she raises. She has highlighted, quite rightly, the importance of HRT, and we have acted on that. Part of the reason for the delay until April is that the IT systems need to be put in place.”
“My right hon. Friend is right that there is a need for care and compassion, and she highlights an extremely important point. She will be aware that the sexual health review is currently being conducted. That will report later this year and will look into the issue that she raises. [Official Report, 5 September 2022, Vol. 719, c. 2MC.]”
“Again, it is partly by having an ambassador that will be tasked with advocating in that space, by having the data to give visibility to that, and also by working in partnership with commissioning groups, with the NHS, and with the royal colleges on training, that much greater focus will be brought to these issues.”
“That was one of the key issues that came out of the consultation responses. Indeed, in my conversation with Dr Watson at Homerton, we looked at different pathways for treatment that avoid the need for theatre. Key to that is some of the innovation on pain management that physicians are looking at, and how, through NICE, we socialise that innovation across the NHS.”
“We are already doing so on things such as the 75 family hubs that we have put in place. Again, a key part of this strategy is to then look at having women’s hubs, particularly in those areas where there is greatest disparity.”
“I thank my hon. Friend for her warm welcome. I agree with her about empowering patients, women in particular, with information. That is why part of the strategy is to focus on the information provided on the NHS website. There is also the need to work with trusted partners—to look at where people go for their health information, and how we can better empower them. For example, in the consultation, we heard of patients being told that heavy bleeding was normal—that it was something that they had to accept. Again, that was an issue highlighted by respondents in the call for evidence. It is about making sure people realise that, where there are issues, their voices are heard. That is at the heart of the strategy that we have set out.”
“I thank the hon. Lady in particular for that tribute to the work Sir David contributed to this, and agree with her on the issue of same-sex couples having access to IVF. She is right about better research and how we highlight that; that is a key part of the strategy. It is also interesting from the comments of the health ambassador that services can be reconfigured in a way that gives better outcomes for the patient without leading to higher cost. By having centres of excellence where the woman’s voice is heard, treatment comes more quickly and that delivers better patient outcomes.”
“That ties in with the wider point about ensuring that patients have the right information and that, where issues and concerns arise, they are not fobbed off but taken seriously.”
“I am grateful to my right hon. Friend, who I know has campaigned for many years on this; mesh is a particular issue that he and I have spoken about in the past. On the quality of data I am very happy to work with him on any specific examples, and indeed with colleagues across the House, because I know there are others who have worked closely on the mesh campaign, to see how we get the right consistency and the right analysis of data, because that is a shared interest of all of us in the House today. In terms of the Department for Education, I am very happy to take the matter forward with my right hon. Friend the Education Secretary to look at what schools can do to raise awareness.”
“The heart of the whole House goes out to the hon. Lady, because the trauma of those experiences is so visible; I am hugely grateful for the powerful way she highlights them to the House. She will be aware that we have the pregnancy loss review reporting later this year, and we will be looking at the important issues she raises. I know she met recently with the Minister of State, my hon. Friend the Member for Lewes (Maria Caulfield), to discuss those and, as someone new to post, I will certainly look closely at the points she raises.”
“My hon. Friend is absolutely right about the importance of tackling domestic abuse. Indeed, last year the Government brought forward and the House passed the Domestic Abuse Act 2021 in recognition of that. There is an important read-across from issues of domestic abuse into the wider piece about data and how that in turn links into prosecutions, evidence gathering and empowering those who are victims with the support they need. It is an extremely important issue, and it is important that we take that legislation forward.”
“While this strategy sets out a number of future steps, there are also steps we have already taken, including on maternity services. The hon. Gentleman will be aware that we have announced an extra £127 million of support for the NHS maternity workforce and £95 million to recruit an additional 1,200 midwives and 100 consultant obstetricians. Steps have been taken, and more steps are set out in this strategy.”
“I am grateful for the work that my hon. Friend did as a Health Minister in championing this agenda. She is right to highlight the difficulty, often, of accessing contraception, which is very much at the heart of the responses we had on the fragmented service that many women have experienced. She will be aware that a key part of our approach is the health and wellbeing funds and working with the voluntary and community sector on support in areas such as pregnancy loss. A key part of this is the visibility of the women’s health strategy. Putting that to the fore in terms of a women’s health ambassador is, as she says, part of these conversations with the integrated care systems to ensure that this gets greater prioritisation within commissioning. A key part of securing that is having the data to demonstrate its importance and benefits.”
“Through highlighting the tragic case of Nicola, the hon. Lady demonstrates very effectively why research in this area is so important and the fact that it has been insufficient in the past. The amount of funding is, to a large extent, shaped by the research proposals that come forward. A key part of the strategy is the clear signal that we are sending to the research community that we are encouraging those willing to do research in the areas that have not been focused on in the past so that funding can be prioritised to them.”
“I know from my own involvement in the mesh campaign just how central the hon. Lady’s role was in it, and I pay tribute the work that she has done on that and a number of other campaigns over recent years. In respect of mesh, she will be aware that an annual review is published. On the workplace issue, a key thing that comes out of the report is the significance of the time off work that many women are experiencing, with the difficulty, quite often, in having these conversations with employers. It is very welcome that the civil service has taken a lead, as has the NHS, in certain aspects of that, but there will clearly be more to do, and the point she raises will be part of that wider conversation.”
“I welcome the hon. Lady’s acknowledgement of the expertise that Professor Dame Lesley Regan brings as ambassador. I think she will be fantastic in that role. A key part of this strategy is addressing the fragmented health system and how that impacts on areas such as contraception. That is why we are having, for example, the women’s health hubs to provide a one-stop shop and centre of expertise so that we can better identify the services that people need.”
“We are working through the taskforce’s recommendations and will publish our response shortly. Part of the reason the taskforce was set up is the disparity in data, which we clearly need to address.”
“Part of the reason this is a 10-year strategy is that we do need a change of culture as well as a change of systems, and that is what the strategy maps out. A key component of that is how we empower patients through areas such as the NHS website, working with trusted partners who provide health information. The hon. Lady is also right about training, not just for new entrants into the medical profession but for existing clinicians. We will be working with the royal colleges and others to drive that forward.”
“One of the key issues highlighted in the response to the call for evidence was how areas such as the menopause were being dealt with by the NHS. That is why we have a menopause taskforce looking at specific recommendations, one of which concerns the training of clinicians.”
“During the pandemic, we took unprecedented action to protect NHS dentistry capacity, providing over £1.7 billion of income protection. We also ensured that those who needed it most could access the available care by establishing 700 urgent care centres nationwide. NHS dentists are now returning to 100% of their contracted activity.”
“My hon. Friend raises a very pertinent point. I recognise that there are significant challenges in NHS dentistry, including disparities across regions. Improving access for patients is a priority, and that is why just today the Government, together with NHS England, have announced a package of improvements to the NHS dental system, on which we have worked closely with the sector and the British Dental Association.”
“I am grateful for my hon. Friend’s campaigning on this issue; it is something she has highlighted on a number of occasions. The sorts of areas where the measures announced today will help include the management of NHS dental contracts, increasing the use of the skills mix in the dental workforce, and rewarding complex treatment to better reflect the complexity of that work.”
“As part of the Government’s wider commitment to levelling up, we are very interesting in taking a place-based approach. Indeed, the essence of the integrated care boards is to help facilitate that. I am very happy to have discussions with colleagues across the House on how we best deliver that.”
“I hope the hon. Gentleman will look at today’s announcement, because it shows that the Department has listened. That is why, for example, it will facilitate better contract management, better reflect the floor price for units of dental activity and reward complex treatment, which was one of the key concerns. Equally, I hope that the hon. Gentleman recognises that this Government, through the £1.7 billion of income protection during the pandemic, have done much to facilitate dentistry’s ability to bounce back.”
“The reimbursement of travel costs for NHS staff is covered by the NHS terms and conditions, which are agreed jointly by employers and NHS trade unions. The terms and conditions set out the process for reviewing the rate, and that process includes reviewing fluctuations in fuel prices.”
“This is an important issue, and it affects different parts of the workforce in different ways. The 56p is higher than the rate approved by Her Majesty’s Revenue and Customs, and, as the hon. Lady said, it drops to 20p after 3,500 miles have been travelled. Of course, the Government are taking other measures more widely in their fiscal response to the cost of living, such as cutting fuel duty, but there is a review mechanism in respect of the NHS specifically, which involves looking at these issues in the round.”
“We know that general practices are still under significant pressure and demand for their services is high. We are investing at least £1.5 billion to create an additional 50 million appointments a year by 2024, and of course not all appointments are, or should be, with GPs.”
“The number of face-to-face appointments is increasing and in May 2022, excluding covid-19 vaccines, 64% of appointments were face-to-face, up from 55%. But the hon. Lady is right to say that patients should have the choice, and that is why the NHS access improvement programme has been supporting practices experiencing greater access challenges. Indeed, one of the first visits I did in my new role was to a GP practice to look at the practical measures it was putting in place to facilitate greater access for its patients.”
“I know this is an issue of concern that the hon. Lady wrote to my predecessor about, and indeed she raised its impact on her constituency in the House last month. There are specific programmes such as the targeted enhanced recruitment scheme that was launched in 2016, and the one-off financial incentives to attract GPs to the more deprived areas. We are also looking at how we can have the right skills mix to boost not just the number of GPs but wider access to appointments.”
“I always welcome solutions from colleagues on both sides of the House. From memory, Tim Ferris, who leads on tech within the NHS, is looking at a tech solution—I think it is in beta testing, although I would have to check. Appointments made shortly after a person has been discharged from hospital are often quite complex cases and create additional pressure on GPs. Another issue I am keen to explore is GP appointments that can be done through either better use of technology or the wider skills mix so that we can better focus GPs’ time on more complex cases where their expertise delivers the best patient outcomes.”
“I am very happy to look into that specific issue, which I know my hon. Friend has raised with the Department. I am happy to have further conversations with him.”
“Far from blaming anyone else—notwithstanding the fact I have been in post for less than two weeks—I have set out a range of things we need to do, because this is a shared challenge that affects all our constituents, and it is within the context of increased demand. The May figures show a significant increase in appointments—1.31 million appointments per working day this year compared with 1.24 million last year. There is increasing demand, and we need to harness GP time, the skills mix and better use of technology.”
“My hon. Friend will be aware that, through this Government’s funding, we have opened five new medical schools and, from memory, 1,500 additional undergraduate places. That is thanks to the work of the former Secretary of State, my right hon. Friend the Member for South West Surrey (Jeremy Hunt), who championed this specific initiative to address workforce pressure. More widely, I am always happy to meet my hon. Friend the Member for Worcester (Mr Walker) to discuss issues in Worcester.”
“The hon. Lady raises a valid and important point about getting the right service to patients, which can often best be delivered by a pharmacist. That is why, as I signalled earlier, we need better use of tech to support patients in understanding where they can best access the advice they need.”
“I have had quite a few meeting requests this morning, and I am always keen to meet colleagues. My hon. Friend will be well aware that part of the reason for having integrated care boards within the place-based approach is that commissioners can determine the best mix of services in the locality, including in Burton.”
“While the virus has not gone away, we are able to enjoy our freedoms, thanks to the incredible vaccine roll-out. I have accepted the Joint Committee on Vaccination and Immunisation’s advice for a covid and flu autumn and winter booster campaign, in which we will roll out that vaccine further.”
“I am honoured to have taken on the role of Secretary of State for Health and Social Care, and to have responsibility for incredibly important services that touch all our lives. I pay tribute to my predecessor, my right hon. Friend the Member for Bromsgrove (Sajid Javid), for everything he achieved in this role, and for the dedication he showed. I also welcome my new ministerial team. Since my appointment, I have been relentlessly focused on the urgent pressures facing health and care, including this week’s extreme weather. Yesterday I updated the House on the strong support we are giving, including extra ambulance capacity and more call handlers, and we will stay vigilant so that we can make sure our health and care system is there for those who need it. Today marks one year since we lifted covid restrictions.”
“On NHS pay, I expect to announce a response to the integrated pay review bodies shortly. We are putting more funding into the NHS, as I signalled in my statement yesterday.”
“My hon. Friend will be aware that the matter is devolved to the Welsh NHS, but I can say that in the last financial year, the Government allocated £70 million to NHS England to specifically address dementia waiting lists and increase the number of diagnoses. To further support recovery of the dementia diagnosis rate and access to post-diagnostic support, NHS England is funding two trusts in each region to pilot the diagnosing advanced dementia mandate tool, which will improve access to diagnosis.”
“The Government are committed to putting increased funding into our NHS. I set out yesterday the position on the resource departmental expenditure limit. Just to remind the House of the capital departmental expenditure limit, capital investment in the spending review was £32.2 billion between this year and 2024-25. The Government are committed to putting record funding into our NHS. We are also committed to funding 40 new hospitals and have allocated £3.7 billion to that programme.”
“We will respond shortly to the independent pay review body, which, as part of its recommendations, weighs up the pressures on the cost of living and the other factors within its remit. The Government are delivering more doctors, more nurses, more appointments and more treatments, investing in our estate and planning for the future. That includes investment in research and development, and in future technology through our life sciences. That not only delivered the vaccine that allowed us to lift the covid restrictions that the Opposition wanted to retain, but will unlock the technologies of the future.”
“I think my right hon. Friend knows me well enough to know that I will have a close interest in reading anything over the summer that is data driven. He highlights an extremely important issue. Just yesterday, I met with Andrea and Simon Brady, whose daughter tragically died of cancer at the age of 27. One of the key concerns that they raised with me was the lack of consistency when it came to the GP that Jessica went to see, and the fact that she kept seeing different people, and there was not continuity of care. Specific cases that I am looking into speak to this issue, and I am happy to look at the data that my right hon. Friend can share.”
“I am not sure that I will urge my predecessor to do so, but if indeed there is a successor, I will be happy to share that with them. The hon. Lady raises an important point, and I am happy to look into it.”
“May I take the opportunity to thank my hon. Friend for his service as Minister of State? I think he was one of the longest-serving Ministers in that role; in fact, I think he took over from me, or shortly after me. He carried out the role with great distinction, as I am sure the whole House recognises. I am very happy to reconfirm our commitment. I think the number is at about a third of a million, and great progress is being made. That enlarged measure is down to my hon. Friend’s work as Minister of State.”
“I am very sorry, as I am sure the whole House is, to hear of the circumstances that the hon. Lady sets out. I am happy to look at the case, as I said to her ahead of this sitting, when I discovered that she had written to my predecessor. As I also flagged earlier, the number of face-to-face appointments is increasing. Telephone consultations are not a new thing; they have been around for a long time and are an important part of the mix—indeed, some patients prefer the flexibility that they offer. But of course I am happy to meet the hon. Lady in due course.”
“Again, as I am sure my hon. Friend will appreciate, these decisions should not be run from Whitehall and the centre. We should take a place-based approach, letting local decision-makers and commissioners make the decisions to shape the best services through their integrated care boards. My hon. Friend the Minister of State or I will engage with him to ensure that his representations are very much at the heart of any decisions that are taken.”
“That is why we have launched a range of initiatives, such as surgery hubs and diagnostic centres, to address the very real backlog resulting from the pandemic. Indeed, the NHS has published its delivery plan for tackling the covid-19 backlog of elective care, and that is focused on four areas: increasing health service capacity, prioritising diagnosis and treatment, transforming the way that NHS provides elective care, and providing better information and support to patients.”
“The House recognises how my right hon. Friend has championed this issue over many years. There can be few more emotive issues than the one she draws to our attention. Of course, in keeping with my predecessors, I would be very happy to engage with her on this important issue.”
“The Government have committed to giving NHS workers a pay rise this year, on top of last year’s 3% rise when pay was frozen in the wider public sector. The independent pay review bodies base their recommendations on a number of factors, which include but are not limited to the cost of living and inflation, as well as the economic context and issues such as recruitment and retention. The Government are considering carefully the content of the pay review body’s report and will respond shortly.”
“As my hon. Friend recognises in her question, that is a decision for Her Majesty’s Treasury, but I am very happy to highlight with the Chancellor the case that she brings to the attention of the House.”