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 am grateful to my hon. Friend for her question, and I am happy to give her constituents an assurance that there has been no risk to patients at any point during this time. As for lessons learned, clearly we will need to look at some of the lessons, particularly what triggers a breach of contract. A series of contracts were held by a wide number of trusts with the supplier, and it is important that we look at what the notification periods are, what the monitoring and enforcement processes are, and what powers there are under the terms of the contract to ensure that the company is acting as it should.”
“That is the focus, and that is why, given the commercial negotiations and the contingency arrangements that have been put in place, we came to the House today, and not at an earlier point.”
“On the split to which the right hon. Lady referred between clinical waste and other waste at the Normanton site—she rightly focused on that for her constituents—just under a third of the flow of waste to the site is clinical. Just over two thirds, in my understanding, is non-clinical. It is not the case that all the waste on the Normanton site is clinical waste. As I have mentioned, some media reports about what the term “clinical waste” constitutes are slightly different from the reality. As for notification, I set that out in my written ministerial statement and in my comments today. The key focus is on maintaining the continuity of operations and service within the NHS trusts so that we are not in a position where clinical waste cannot be cleared from them.”
“My hon. Friend makes a valid point about the lessons to be learned from this. Part of what I would expect to look at as we move forward are questions about when the NHS was first made aware of this and what powers are available to enforce at an earlier stage. As I have mentioned, enforcement notices cover a spectrum of risk. Some of those risks are more technical in nature than others, so while there have been 13 notices, their enforcement encompasses a range of severity.”
“The first financial penalty it has suffered is the prompt action we took over the weekend, with 15 NHS trusts cancelling those contracts and moving across. There is a clear financial penalty in that loss of business. As for fines, that is a matter of legal process, through the Environment Agency, in the normal way. That is not an NHS matter. The focus for the NHS is on maintaining continuity of service.”
“The hon. Lady raises several points. On the 350 tonnes of waste, I clarified the flow of that waste in my comments to the right hon. Member for Normanton, Pontefract and Castleford (Yvette Cooper) and I said that not all of it is clinical. I was not personally told on 31 July. I set out in my written statement when the NHS and then Ministers were told. The question about whether there is any cost to NHS trusts is a very valid one for all constituency MPs who wish to understand the situation. The contingency cost—for example, from the additional capacity being put in place at trusts—will be borne centrally by the NHS family, and the cost of processing clinical waste will be borne by NHS trusts, as it has been to date.”
“I should clarify that it is not me personally who has terminated these contracts. These contracts with HES are held by the trusts themselves, and therefore it is a decision taken by those trusts. As I said earlier, there is significant additional capacity within the incinerator landscape to process the waste generated by this contract, and therefore the suggestion in some quarters that this is an issue of a lack of capacity is simply not valid. To be clear, HES produces 595 tonnes of waste a month that goes to incineration, and the NHS identified 2,269 tonnes of incineration capacity, so reports that there is a lack of capacity in the market are not valid.”
“We all learn things on a regular basis from the HSJ , but it seems misplaced to suggest that the hon. Gentleman should have been told about this when we were ensuring continuity of service and putting in place alternative arrangements to ensure that operations could continue at Barking and other hospitals. I have already addressed that point. As I said, some of the cost—the contingency cost—will be absorbed centrally. The normal cost of clearing clinical waste was borne by the trusts before and will continue to be borne by the trusts.”
“The key issue for performance under the contracts is what, contractually, the legal requirements on HES are and whether those contractual terms have been breached. Part of the lessons learned is to look at whether contractual enforcement powers are sufficient. In terms of moving forward in respect of the other HES sites, that will depend on the contracts that the supplier has and whether it is in breach of those contracts or of enforcement action from the Environment Agency. To date, the Environment Agency has served one partial suspension, on the Normanton site. As I referred to, the Environment Agency was at the other site over the weekend. This is an area of significant scrutiny, but it will be for the Environment Agency to determine whether the company is not in compliance with its permits.”
“I am not sure about the exact protocols for when Cobra should and should not be reported, but given that it usually deals with highly confidential matters, I would have thought that not every issue should necessarily be reported in the first instance. We have been focused not on contractual niceties, but on ensuring that the NHS continues to deliver first-class services. As I referred to earlier, this is the first opportunity we have had following the conference recess to notify the House, following the contractual arrangements being made.”
“I very much share my hon. Friend’s desire for the backlog to be cleared as speedily as possible. As I referred to a moment ago, this is an area of scrutiny for the Environment Agency, and it is important that the company complies with its legal requirements and ensures that the level of waste is in line with its permits as soon as possible.”
“The hon. Gentleman raises a fair point, and I want to be clear about the distinction. Additional cost arising from the contingency arrangement—for example, putting in place extra storage on the trust’s sites—will not be an additional cost on the trust. I hope that that will reassure him, although I do not want to suggest to him that there will be no financial impact on trusts, because the requirement to clear clinical waste sits with the trust. That is why the trusts themselves had contracts with the supplier. The ongoing arrangements are likely to mean some increased cost, as the new supplier comes on board. That will fall to the trust, but not the contingency element.”
“Member for Caithness, Sutherland and Easter Ross (Jamie Stone) also made the point very well that this issue affects the family as a whole, including grandparents.”
“I will address those shortly. She is right to recognise the higher profile that this issue has received in recent years, this being the third such debate in the last three years. That is very much testament to the work of the all-party group on baby loss and in particular my hon. Friends the Members for Eddisbury, for Colchester and for Banbury (Victoria Prentis), who is not in her place, the hon. Member for Washington and Sunderland West (Mrs Hodgson), to whom my opposite number correctly paid tribute and who very much moved the House in a previous debate, and the hon. Member for North Ayrshire and Arran (Patricia Gibson), who quite rightly spoke of Kenneth, who is very much in her thoughts and reflects much of the work that she has done in this place. The hon.”
“May I join colleagues across the House in paying tribute to my hon. Friend the Member for Eddisbury (Antoinette Sandbach) for securing this debate on Baby Loss Awareness Week? It is particularly appropriate, as today marks the start of the 2018 campaign. How we reduce the numbers of baby losses is an issue that unites the House, as has been very much reflected in the tenor of this evening’s debate. May I also say to my hon. Friend the Member for Colchester (Will Quince) that I am sure that all in the Chamber will be thinking of Robert and him on Friday, as he marks that particularly poignant fourth anniversary? My hon. Friend the Member for Eddisbury raised a number of important points in her speech, including about the national bereavement care pathway and the ongoing investigations at the three hospitals in England and Wales.”
“Friend the Member for Thirsk and Malton (Kevin Hollinrake). I would like to close by making it clear that the Government are actively listening to concerns on this issue. This issue unites the House. On behalf of the Government, I very much look forward to working with the APPG, and Members across the House, to ensure that the progress we have seen in recent years continues, so that we can all tackle the most appalling loss that the families we represent can face.”
“I think that was recognised in a number of the speeches this evening, particularly in respect of: the commitment to fund in full the national roll-out of the bereavement care pathway in 2018-19, for which guidance and resources have been released today; the ongoing pregnancy loss review, which is due to report in early 2019; the work being done by the Department of Health and Social Care and the Ministry of Justice regarding the role of the coroner in investigating stillbirths; the progression of the private Member’s Bill, which will have its Third Reading on 26 October, promoted by my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton) on those last two issues; and the recent passage of the Parental Bereavement (Leave and Pay) Act 2018, mentioned by a number of Members, through the work of my hon.”
“This is about ensuring that bereaved parents are given a full account of the events leading up to the loss of their baby and that important lessons are learned. The hon. Member for Nottingham South (Lilian Greenwood) in particular made a point on the role of coroners in an intervention. This work will continue over the coming months. In conclusion, progress is being made.”
“On pregnancy loss and the pregnancy loss review, which my Department commissioned earlier this year, the review has been considering the question of whether legislation should provide new rights to bereaved parents to register pre-24-week pregnancy loss, as well as investigating the impact of such losses on families and how care can be improved for parents who experience it. That review is currently scheduled to be completed in the new year. A number of very important points on that pre-24-week period were raised. The Department of Health and Social Care and the Ministry of Justice have been consulting with coroners, patients’ groups and charities to consider the role of the coroner in relation to stillbirths.”
“That is why the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Thurrock (Jackie Doyle-Price), the Minister with responsibility for maternity care, recently announced full funding of £106,000 to the charity Sands to continue the roll-out of the national bereavement care pathway. I hope that reassures my hon. Friend the Member for Eddisbury that the value of the care pathway is very much recognised within Government. As my hon. Friend mentioned, this initiative has seen a positive response from parents and medical professionals, with 77% of professionals saying bereavement care has improved.”
“Friend the Member for Eddisbury recognised, is on ensuring that in respect of the investigations at the specific hospitals she mentioned the appropriate lessons are learned. She will appreciate that, as they are live investigations, I cannot comment on them in detail. Evidence demonstrates that women who have a midwife-led continuity model of care are less likely to suffer baby loss. In March, the Secretary of State pledged that most women will receive such care throughout pregnancy, labour and birth by 2021, with 20%, or about 130,000 women, benefiting by 2019. This will help to bolster maternity safety and further improve care standards. It is positive to see the impact that many initiatives can have on reducing baby loss, but the Government recognise the need to improve the care bereaved families experience.”
“This is an area on which we would be very happy to work with the APPG. It is an issue of concern to Members on all sides of the House. A number of Members raised the role of the Healthcare Safety Investigation Branch and the importance of identifying where there are lessons to be learned. My hon. Friend the Member for Sleaford and North Hykeham is right that clinicians must be free to speak up where mistakes have been made. Indeed, the former Secretary of State championed that in his work on patient safety. It is also why we are improving investigations into term stillbirths. There is a role for the Royal College of Obstetricians and Gynaecologists in terms of the Each Baby Counts programme. Considerable work is under way, part of which, as my hon.”
“Many Members will be aware that multiple pregnancies are at greater risk of perinatal death, so I welcome the findings in a recent MBRRACE-UK report showing that the stillbirth rate for UK twins almost halved between 2014 and 2016, with a fall of 44%. In addition, neonatal deaths among UK twins has dropped by 30%. There are areas of progress, but as my hon. Friend the Member for Colchester rightly said, part of the focus of today’s debate is on the areas where we need to improve, not just on the areas where there has been progress. One key area relates to ethnic minority groups, where we know stillbirth and neonatal mortality rates are increasing rather than decreasing. The Government continue to work with others to develop and implement policies to tackle such inequalities.”
“Since the launch of the national maternity ambition in 2015, the Government have introduced a range of evidence-based interventions to support maternity and neonatal services, under the leadership of the maternity safety champions, who are responsible for promoting safety in their organisations. I am pleased to report that we remain on course to achieve our 2020 ambition. The stillbirth rate in England fell from 5.1 to 4.1 per 1,000 births between 2010 and 2017, representing a decrease of almost 20%, which equates to 827 fewer stillbirths. We currently have the lowest stillbirth rate on record. The neonatal mortality rate also fell from 2.9 to 2.8 per 1,000 live births between 2010 and 2016.”
“We recognise that the workforce do face pressure, as is reflected in the 25% increase in the number of midwifery training places that the Government are committed to. Indeed, numbers have increased in each of the last four years. But he makes a valid point and we are focused on dealing with the workforce pressures. As a number of Members have recognised, the Government have a clear ambition to halve the rates of stillbirths, neonatal and maternal deaths and brain injuries that occur during or soon after birth by 2025, and to achieve at least a 20% reduction in these rates by 2020.”
“The Patient Advice and Liaison Service can advise on eligibility for schemes, as this tends to be specific to individual trusts, but it can apply in certain instances, particularly when linked to benefit entitlement. My hon. Friend the Member for Gloucester (Richard Graham), who is no longer in his place, mentioned the important work of the hospital chaplaincy, and I think that Members on both sides of the House recognise the support that chaplains can offer following baby loss. Indeed, the bereavement care pathway guidance recommends offering parents contact with the chaplaincy team, so the role of the chaplaincy will be given greater visibility as the pathway is rolled out across more trusts. The hon. Member for Ellesmere Port and Neston (Justin Madders) rightly mentioned midwife numbers.”
“I am happy to write to the CQC to request that this becomes part of the inspection regime. I think that can build on the point my hon. Friend the Member for Eddisbury made about recent progress in Medway. My hon. Friend the Member for Colchester also suggested a training module for midwives on bereavement. Again, I am happy to write to Professor Ian Cummings, the chief executive of Health Education England, on that point and to share the correspondence with the all-party parliamentary group. One of the objectives of the pregnancy loss review is to recommend options to improve maternity care practice for parents who experience baby loss, so that is part of that work. My hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson), who so often brings her clinical expertise to debates, raised the issue of travel costs.”
“The hon. Gentleman makes a valid point. He will have noticed that my colleague the Minister for Women and Equalities was in the Chamber for part of the debate, and I am sure that those sentiments are very much reflected in the work that she is doing. I am very happy to work with him to ensure that the Government’s approach takes those points on board. Before coming to the wider areas of progress and considering what still needs to be done to deliver the improvements that we all want to see, I will address some of the specific comments made by Members across the House. My hon. Friend the Member for Colchester rightly mentioned the inconsistency between trusts. I understand that Sands is asking for the national bereavement care pathway to be included in the CQC’s inspection framework for maternity.”
“I very much welcome the Committee’s conclusion that fears that integration might lead to privatisation are unfounded. Indeed, the Chair of the Committee said, “The evidence to our inquiry was that ACOs,”— now referred to as integrated care partnerships— “and other efforts to integrate health systems and social care, will not extend the scope of NHS privatisation and may effectively do the opposite.” That relates to some of the points I will make on pre-legislative scrutiny and points to the value of the work done by the Health and Social Care Committee to provide a cross-party view of proposals, which has allowed us to address some of the myths built up in the past. The Committee has done the House a service by slaying some of those misconceptions.”
“Thank you, Dame Cheryl, it is a pleasure once again to serve under your chairmanship. I join the hon. Member for Ellesmere Port and Neston (Justin Madders) in paying tribute to my hon. Friend the Member for Totnes (Dr Wollaston) as Chair of the Health and Social Care Committee, and to all the members of the Committee, for a very good report and for raising important issues regularly on behalf of the NHS and the wider health fraternity. As a country, we are living longer, which clearly is to be celebrated. However, it means that people live with multiple long-term and more complex conditions. For the NHS to continue to deliver high-quality care as it has done for the last 70 years, it is increasingly important for NHS services to work closely with social care. We got a flavour of that from a number of the remarks made in the debate.”
“Although we welcome the Committee’s work on testing the NHS proposals as part of the long-term plan, we will wait for the NHS proposals before confirming the specific pre-legislative scrutiny arrangements. I hope the approach I have taken in discussions with members of the Committee underscores the importance I place on working in a cross-party way. The approach we have set out very much reflects that.”
“The tone of the debate was one of broad consensus, and we will realise that first by asking the NHS itself to lead on the legislative changes required. The NHS will bring forward its proposals through the 10-year plan. We will not mandate, but let local areas decide what fits their locality best. That will be informed, for example, by health and wellbeing boards. I met the chair of the Lancashire health and wellbeing board yesterday—that speaks to the concern raised about the need for Health Ministers to take a wider approach rather than, as the hon. Member for Stockton South said, looking purely at the NHS element. We are looking much more widely and bringing in local authorities. Indeed, the Department’s name has changed, and the work of the Care Minister reflects the wider integration in our approach.”
“She will be aware that the up to £20 billion a year that will go into the NHS as part of the Prime Minister’s commitment to funding the service will be front-loaded—there is more in the first two years in recognition of the importance of the double-running to which the Chair of the Committee referred. According to past National Audit Office reports, there have been a number of cross-party initiatives under successive Governments. As she and other Committee members set out, sustainability trumps transformation, which is one of the key challenges for the NHS family as it brings forward its 10-year plan. For the first two years, an extra £4.1 billion will go in, with front-loading of 3.6% compared with the average over the five years of 3.4%, which very much reflects the concerns she articulated.”
“A number of Members referred to information sharing, leadership and the lessons from Liverpool Community Health NHS Trust—the hon. Member for West Lancashire (Rosie Cooper) performed a great service by highlighting that. That is reflected in the work I have commissioned from Tom Kark on the fit-and-proper test. [Ms Karen Buck in the Chair ] Members focused on the need for a patient-centred approach, which the hon. Member for Kingston upon Hull North (Diana Johnson) emphasised in her intervention. In our approach to integrated care, we seek to build a healthcare solution around what is best for the patient and, in the words of the Chair of the Committee, why it matters to patients. That is very much the Government’s intention. As the Committee Chair said, financial pressure can both incentivise and impede integration.”
“The Chair of the Committee is absolutely right. We have always been clear that integration is about improving patient care, and that the NHS will remain free at the point of delivery. A number of key points arose from the debate. Remarks were made about ensuring that the service is patient-centred, and concerns were expressed about whether transformation funding may be diluted. I will come to pre-legislative scrutiny, to which the Chair of the Committee referred, and primary legislation. The hon. Member for Central Ayrshire (Dr Whitford) raised concerns about private firms and the role of GP-led organisations. The hon. Member for Stockton South (Dr Williams) and my hon. Friend the Member for South West Bedfordshire (Andrew Selous) referred to focusing on prevention and taking a wider needs-based approach.”
“The Prime Minister has set out that it will be for the NHS itself to come forward, rather than for the Government to specify legislative change in a top-down way. As part of the long-term plan, the NHS will determine what can be done within the existing framework and whether change is needed. That will flow from the work that comes forward later in the autumn from Simon Stevens, Ian Dalton and others in the NHS, who are best placed to lead.”
“It is not the Government’s intention for private firms to run ICP contracts.”
“Indeed I will, Ms Buck. I draw the hon. Gentleman’s attention to the Committee report, which states: “There is also little appetite from within the private sector itself to be the sole provider of…contracts…There are several reasons why the prospect of a private provider holding an ACO contract is unlikely…Integrated care partnerships between NHS bodies looking to use the contract to form a large integrated care provider would have an advantage over non-statutory providers that are less likely to have experience of managing the same scope of services”. The hon. Gentleman himself referred to the desire not to rule out GP-led organisations, which are independent. He also mentioned GP-led organisations becoming NHS bodies. I am happy to meet him to explore exactly what he means.”
“These arguments were explored at the Committee, which addressed that question. The fear of privatisation has been overplayed. We are taking a people-centred approach and letting the NHS lead on shaping it. We have said we will respond to the points the NHS raises and act on them, but integration will enable services holistically to deliver better care for patients—as the hon. Member for Strangford (Jim Shannon) said, that includes better data sharing—and put the needs of patients front and centre. That is reflected in the report and in the cross-party consensus on how we want to take integration forward.”
“Friend the Secretary of State when he set out his three key priorities for the NHS after taking over that post. He particularly emphasised the importance of the workforce within those priorities.”
“I pay tribute to my hon. Friend the Member for South Dorset (Richard Drax) for his assiduous campaigning on behalf of his constituents and for securing the debate. Its importance is reflected by the fact that my hon. and learned Friend the Solicitor General and the Under-Secretary of State for Wales, my hon. Friend the Member for Eastleigh (Mims Davies), were in the Chamber to listen to the points that my hon. Friend the Member for South Dorset raised. My hon. Friend spoke passionately about the training of nurses in England and the pivotal role of training in ensuring that we have a workforce to deliver first-class services in the NHS. With a budget in which two thirds of our spend goes, quite rightly, on our workforce, the importance of that workforce is absolutely critical. Indeed, that was reflected by my right hon.”
“As patients present with more complex needs and multiple conditions, we need to look at how we address that and how we deliver care more in the community, which is what patients want and is better for them, as well as how we better embrace technology, which is a key priority of my right hon. Friend the Secretary of State.”
“Clearly there is a benefit for patients if twice as many of those using the hospital are from Weymouth and the beds move to Weymouth. On average, four beds are taken by islanders, so it is a relatively small number, but I appreciate that it is an issue for those on the island. However, there is a wider patient benefit, particularly for those from Weymouth. There is a benefit for all patients who move to Weymouth, because they can access a wider suite of services, including the services of a consultant with specialist expertise in elderly medicine, as part of a wider range of professional support. It is also important to emphasise to my hon. Friend’s constituents that the site is not closing; services are being reconfigured to reflect changes in the way in which healthcare is delivered. Again, that is happening nationally.”
“This is something that the Government have been prioritising nationally, and I pay tribute to the NHS Improvement’s work in placing a cap on agency spend in 2015, which very much addresses his point. Indeed, we have seen agency costs come down nationally by £1.2 billion since 2015, which shows the progress made under this Government. My hon. Friend also understandably put on record his concerns about local beds moving from Portland Community Hospital to Weymouth. He mentioned the chief executive, Ron Shields. As he will be aware, Ron Shields has pointed out that twice as many patients using those Portland Community Hospital beds come from Weymouth, 6 miles away in my hon. Friend’s constituency, than from Portland.”
“That is one of the measures that we put in place to address the hon. Gentleman’s very valid point, but I am not suggesting that that alone fully deals with the issues that we need to look at, and we are paying very close attention to the situation. I now turn to some of the specifics in the very well-put speech made by my hon. Friend the Member for South Dorset. He quite rightly highlighted the cost of agency staff within the NHS, suggesting that there could be more than half a billion pounds of savings if those staff were permanent. It is fair to say that the cost of agency staff is a key issue, and he was very fair in putting on record that Dorset HealthCare has reduced its agency staff spend over the past three years from £12 million to £4 million. That has not happened by accident.”
“The hon. Gentleman makes a valid point. I think that we all recognise that learning disability has traditionally been one of those areas in which it is harder to recruit, compared with, for example, midwifery, where the number of applicants to training places is a lot higher. I do recognise that there is an issue. Let me give just one example of what we are doing. When we looked at the situation in postgraduate training, particularly for more mature applicants, one of the issues was the possible impact on the area of learning disability. That was why we put in place golden hellos, with a budget of up to £10 million, to provide an incentive for applicants taking the postgraduate route into nursing to go particularly into the areas of learning disability, mental health or district nursing.”
“We should also look at the measures the Prime Minister has taken on tier 2 visas—removing the cap—and recognise that attracting talent from overseas is an important part of addressing the concerns about recruitment raised by my hon. Friend. We are looking at measures to give giving staff greater flexibility, such as through e-rostering, and using technology to provide greater certainty. There are also measures in relation to returning to work. Since 2014, 4,800 nurses have started on the return to practice programme to bring that talent back into the NHS. The Government are taking a whole suite of measures, because we recognise that there is a need for more nurses, exactly as my hon. Friend said.”
“Friend referenced. There are 5,000 places this year and 7,500 next year. The programme enables people who perhaps thought they would not have the opportunity to be a nurse and were trapped in a particular role to have a ladder of opportunity and to move from roles such as healthcare assistant into that of nursing associate, with the option of then progressing into a nurse role. We need to look at the nursing degree apprenticeship, and we are using the apprenticeship levy that the Government have introduced through the tireless work of the Minister for Apprenticeships and Skills. Again, that provides a great opportunity for people to progress within the NHS.”
“Even so, there can be muscle deterioration, or what one clinician called “PJ paralysis”. Staying in acute hospitals is often not in the best interests of an elderly patient, so treating them at home or in a community setting with the right support to reduce their length of stay is in their interests. The crux of my hon. Friend’s remarks was a challenge as to what the Government are doing to tackle the need to recruit more nurses as we face a growing demographic. I remind him, as he is well aware, that the Prime Minister has committed to more funding for the NHS—a £20 billion-a-year additional funding package. There is a commitment to staff in the NHS through “Agenda for Change”, and the Government are introducing an increase in pay for nurses. We are looking at additional pathways such as the nursing associate programme, which my hon.”
“My hon. Friend is right that being cared for close to home is in patients’ interests. I would actually go a step further and say that most patients want to be cared for and supported at home, if possible, because they are more likely to be mobile and to get up to make a cup of tea in their familiar surroundings. If that is not possible, they want to be in a community setting, but in that community setting it is better that they have access to a wider suite of services, including a consultant specialist, so that we can avoid the 43% of patients on average who are currently being treated in probably the most expensive part of the NHS family, the acute setting, where they are, for example, at greater risk of infection, notwithstanding the fact that since 2010, under this Government, the rate of hospital infections has halved.”