Health Questions

4th July 2017

Philip Dunne answers MPs' questions on behalf of the Department for Health.


3. What steps he is taking to increase the number of dermatologists in the NHS. [900176]
Health Education England is responsible for meeting the workforce requirements of the NHS in England. The number of dermatologists in the NHS continues to grow, with 18% more consultants and 13% more doctors in training since May 2010. HEE’s latest workforce plan shows a 2% increase in funded training places for dermatologists compared with the previous year. Dermatology remains a popular choice for doctors, and it typically enjoys 100% fill rates.
I am pleased to say that, through a combined approach by the clinical commissioning group and Musgrove Park hospital in my constituency of Taunton Deane, it has been possible to prevent the long-term closure of the dermatology department and to put in place an interim service, with a full service reopening in 2018. Given the seriousness of the conditions of people coming through this department—including an increasing number of cases of skin cancer—will my right hon. Friend give further assurances about how we can ensure there is a sufficient supply of specialists in this area?
I know that my hon. Friend has campaigned actively to ensure that dermatology services at Musgrove Park hospital in her constituency have been retained following a consultant retirement, which prompted the temporary arrangements. I am pleased that, since the beginning of April, Somerset CCG has successfully commissioned regular dermatology clinics at Musgrove Park using specialists from Bristol, with a view to restoring a full service from next April. We recognise the important service that dermatology clinics provide and are committed to encouraging that specialty in Somerset and nationally.
Dermatology is one of the specialisms that is particularly dependent on doctors from other EU countries. Is it not becoming clearer by the day, whether on the staffing crisis in the NHS or the threat to our pharmaceutical industry highlighted by the Health Secretary in his letter today, that the extreme hard Brexit being pursued by the Prime Minister is disastrous for our NHS? What are the Minister and the Secretary of State doing to pull the Prime Minister back from that damaging course?
Order. In relation to dermatologists is, I think, what the right hon. Gentleman had in mind.
I cannot tell the right hon. Gentleman precisely how many of the excellent dermatologists come from the EU, but I can tell him that, since the referendum, 562 non-UK EU doctors have come to work in the NHS.

St Helier Hospital

4. When he last discussed the future of St Helier Hospital with the Epsom and St Helier University Hospitals NHS Trust. [900177]
The Secretary of State recently met the chief executive of Epsom and St Helier University Hospitals Trust and was impressed by the fantastic work staff are doing despite the surroundings and facilities, which are clearly in need of improvement, for which the right hon. Gentleman has been campaigning. Any significant service change must be subject to consultation with local people, be based on clinical evidence, consider patient choice and have support from GP commissioners.
Indeed the Secretary of State did visit the hospital on the first day of the election campaign—nothing suspicious about that timing. The Minister will have heard that 43% of the estate is unsuitable for the delivery of modern healthcare yet, thanks to the hard work of staff, St Helier is one of the few hospitals that manages to keep on top of A&E waiting time targets. Would he like to be the bearer of good news and confirm that the Government will reinstate the £219 million that the Secretary of State cancelled to enable a new hospital to be built?
As the right hon. Gentleman knows, the south-west London sustainability and transformation plan area is in the process of turning its proposals into plans, with public consultation when appropriate. It has yet to make any recommendations. As he knows, it set up four local transformation boards to consider how best to transform services, including at both Epsom and St Helier hospitals, for the decade beyond 2020. It would therefore be wrong for me to prejudge those conclusions at this stage.
Rather than having empty political campaigns, does my hon. Friend have a sympathetic ear for an alternative, well thought-out plan for healthcare in Sutton which works clinically and financially and listens to all residents in Sutton?
My hon. Friend is right. We need to look to the proposals coming from the clinicians on the ground who are responsible for running acute services for the whole of south-west London. They have made it clear that they intend to consult the public once they have made their recommendations transparent. They intend to retain all five hospitals but to look at the configuration of services among them, and that needs to be led by clinicians.

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6. What steps are being taken to broaden routes into nursing. [900179]
Developing new routes into nursing is a priority for the Government. That is why we launched, as the Secretary of State set out, both the new nursing associate role and the nursing degree apprenticeship earlier this year. They will open new routes into the registered nursing profession for thousands of people from all backgrounds and allow employers to grow their own workforce from their local communities.
My constituents welcome the manifesto commitment to expand the number of clinical staff for mental health. What more can my hon. Friend say about plans for mental health nurse training and how they will benefit dementia services, in particular, in my constituency?
Health Education England’s “Workforce Plan for England” for 2016-17 indicated an increase of more than 3% in the number of mental health nurse training places. It stated:

“The current level of mental health nurse training is the highest of any nursing branch as a percentage of the workforce it serves”,

which should allow for an increase of some 22% to more than 8,000 full-time equivalent staff members in the mental health workforce by 2020.

The fact is that when the Government chose to charge students record levels of tuition fees and scrap their NHS bursary, the Secretary of State and his Ministers were warned that that would lead to a fall in the number of applications, and what has happened since then? The number of applications for nursing degrees has fallen by 23%. Given that the Secretary of State has already acknowledged that we cannot continue our over-reliance on EU staff following Brexit, when will Ministers understand that the biggest challenge facing nursing recruitment is not our policy on the EU, but the Government’s own health policies?
The hon. Gentleman is right to draw attention to the fact that we continue to have a surplus of applicants for nursing degree courses in this country. The level of that surplus has fallen somewhat as a result of the change in funding structures. We shall have to see where it ends up, because at present universities are not recruiting directly outside the UCAS system, but we are confident that there will be more applicants than places this year by a ratio of some 2:1.
Does the Minister agree that there are opportunities for more mature students to gain access to courses easily, and that more work must be done with adult learning institutions to provide courses that allow such direct access?
The hon. Gentleman is right to point out that the more mature workforce, particularly people resuming careers later in life—perhaps, in the case of women, after they have had children—is an important source of experienced professionals, and we need to do more than we have been doing to try to encourage such people to return to the workforce.

Dental Surgery: Children

11. What steps he is taking to reduce the number of children admitted to hospital for dental surgery. [900184]
Public Health England leads a wide-ranging programme to improve children’s oral health. Its oral health strategy, which was published last year, showed a marked improvement across the country in the proportion of children with no obvious tooth decay—it rose from 69% in 2008 to over 75% in 2015. NHS England is finalising plans for the “Starting Well” programme, which will operate in 13 high-needs areas to improve the oral health of under-fives.
Prevention and early intervention are crucial, but no NHS dentists are accepting new patients in Dewsbury, which has the second-worst provision in the country. Children in Dewsbury have five times the national average level of tooth decay. I have asked for help on this for two years, but absolutely nothing has been done. Can you tell me why the dental health of children in Dewsbury is so unimportant to this Government?
I cannot, but I hope that the Minister can—preferably rather briefly.
I will try, Mr Speaker.

NHS England recognises the significant challenges in dentistry in Yorkshire, which was why it ran a pilot scheme from January until the last week of June to improve access to primary care dentistry in the Bradford City, Bradford Districts and North Kirklees CCG areas. The pilot will inform the wider work that the NHS is considering across Yorkshire.

I declare an interest which is probably fairly well known.

The Minister will be aware that the answer is early-years prevention. A huge campaign, which is making progress, is being led by the chief dental officer, for whom I have considerable admiration. Is the Minister prepared to meet me and the chief dental officer to discuss that progress? In advance of that appointment, will he look at the possibility of providing additional funding from the annual dental clawback?

New Members probably will not know that the hon. Gentleman is a dentist.
I believe that my hon. Friend is the only dentist in the House, and he still practises occasionally. I would be delighted to meet my hon. and experienced Friend to discuss the issues about dentistry that he raises.

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NHS Improvement

15. What steps are being taken to ensure that NHS Improvement provides timely and effective support to health communities to deliver consistently high-quality care. [900189]
NHS Improvement offers tailored support to the organisations it oversees, particularly those that have gone into special measures as a result of a Care Quality Commission review. The Department, of course, has responsibility for holding NHS Improvement to account, and it does that through me.
Northern Lincolnshire and Goole NHS Foundation Trust is in special measures for both financial and quality reasons, but the support given to date by NHSI has been neither timely nor effective. What are the Government going to do about that?
We are clearly disappointed that Northern Lincolnshire and Goole NHS Foundation Trust has gone back into special measures. It is one of a very small number of trusts that have emerged from special measures and then reverted, so this is something in which we are taking a lot of interest. NHS Improvement has appointed an improvement director and is in the process of arranging for a nearby buddy trust to provide some support. I assure the hon. Gentleman that the Department is receiving weekly updates.

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Topical Questions

T4. Leicester and Leicestershire MPs, irrespective of party and led by the hon. Member for Leicester West (Liz Kendall), are united with local people, patients and medical professionals in opposition to NHS England’s badly thought out and, frankly, wrong proposals to close Glenfield hospital’s children’s heart unit. Can my right hon. Friend reassure me that he continues to appreciate the strength of feeling on this issue and that he will ensure that the eventual decision reflects the responses received to the consultation? [900202]
My hon. Friend and other Leicestershire MPs have made their views very clear to me. I hosted a number of them, from both sides of the House, to discuss this issue. He is aware that the public consultation on congenital heart disease services continues until 17 July. Obviously, we will take all the comments made into account when we come to the conclusions from that report.
T8. Last week I met doctors and nurses at the Friarage, an excellent small hospital serving a rural population spread over 1,000 square miles. Will my right hon. Friend urge South Tees Hospitals NHS Foundation Trust to do everything it can to ensure the continued provision of emergency care clinicians and anaesthetists at this vital local hospital? [900206]
I am aware that my hon. Friend has taken a strong interest in the number of consultants and anaesthetists available at the Friarage hospital. I will be happy to meet him to discuss his concerns in person.
Funding our national health service to meet the needs of UK residents is one proposition; funding an international health service open to the world is another proposition entirely. Are there any indications that advance charging for non-emergency treatment for overseas patients is putting more money into our NHS?
My hon. Friend is a doughty campaigner for ensuring that non-resident visitors to this country contribute for healthcare received here. We put in place a number of measures to enhance the appropriate charging structures and increased the funding received by the NHS from £89 million to £289 million in 2015-16. We expect similar action to result in a further increase.



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