NHS Pay

Thank you to those who have taken the time to contact me regarding the Chancellor’s public sector pay increase announcement. Although most are in favour, many have queried why NHS staff have not been included. I believe that there may have been some confusion regarding the announcement so I hope this can help to clarify the situation.

Recent months have underlined that our public sector workers make a vital contribution to our country and are always there for us to rely on when we need them. This is why the Chancellor has announced that almost 900,000 public sector workers, including doctors, teachers and police officers, will see above-inflation pay rises – for the majority the third year in a row – reflecting their dedication, hard work and contribution to our country.

The government  and the rest of us are very proud of all our NHS staff, including nurses, and recognise their extraordinary commitment, working day and night putting our care and safety at the centre of everything they do.

More than one million NHS workers continue to benefit from the three-year Agenda for Change pay deal, which delivers a 3% award in 2020/21. Under this pay deal the starting pay for a newly qualified nurse has increased by over 12% since 2017/18. The Agenda for Change pay deal has also increased the lowest starting salary within the NHS by over 16%.

This deal was negotiated and agreed upon with the NHS trade unions separately from the deal announced today and represented one of the largest public sector pay increases in several years.

Pay for Agenda for Change staff, which includes nurses, will be revisited for 2021/22 once the benefits from the existing three-year pay deal have come into effect.

 

Campaign: Catchup with Cancer

I completely understand and share the concerns of those who have contacted me about this campaign– conditions like cancer have not disappeared because of Covid-19, and it is crucial that treatment can continue safely and in a timely manner. That sentiment is shared by ministers across Government, including the Prime Minister and Health Secretary, who have repeatedly made clear that the NHS remains open to care for patients beyond Covid-19.

The NHS is adapting how it runs its cancer services to ensure the safety of both patients and staff. Cancer specialists are discussing with their patients the potential risks to them, either through undergoing or to delay treatment at this time.

A letter has also been issued to NHS trusts, which sets out that local systems and cancer alliances must continue to identify ring-fenced diagnostic and surgical capacity for cancer, and providers must protect and deliver cancer surgery and cancer treatment by ensuring that cancer surgery ‘hubs’ are fully operational. NHS England has also published guidance and supported the development of these hubs for cancer surgery. Out of the 21 cancer alliance areas across England, hubs have already been developed for 18 and will soon be in place for all.

The NHS is working to bring cancer treatment back to pre-pandemic levels at the earliest possibility to minimise potential harm and to reduce the scale of the post-pandemic surge in demand. The NHS has responded brilliantly to Covid-19, and, thanks to social distancing, we have managed to protect it from becoming overwhelmed. It is now time to get the rest of the NHS going again, and that work is underway.

 

Campaign: No Recourse to Public Funds

The government has introduced a range of measures to provide financial protection for those affected by Covid-19, including those with no recourse to public funds (NRPF) including:

• Employers are able to apply for grants under the Coronavirus Job Retention Scheme for workers on the PAYE system.
• Statutory Sick Pay to be payable from Day 1 rather than Day 4.
• Contributory Employment and Support Allowance available from the first day of sickness rather than the eighth, subject to other eligibility criteria. 

Local authorities may also provide basic safety net support if it is established that there is a genuine care need that does not arise solely from destitution, for example, where there are community care needs, migrants with serious health problems or family cases. It is important to remember Covid-19 has been added to the list of communicable diseases so anyone experiencing symptoms regardless of their immigration status will be treated for free.

In addition, Individuals who have leave to remain on human rights grounds can already apply to have their no recourse to public funds condition lifted if they would otherwise be destitute. The Home Office are working to ensure that those who are eligible to have the condition lifted can have a decision taken as swiftly as possible.

The government and Local Authorities are continuing to coordinate efforts with charities and other agencies during this period. These organisations play a vital role and provide valuable feedback and insight that will help the government to support vulnerable families at this time. The government are continually reviewing the situation to consider what more can be done to help those in need.

 

Child protection: Covid-19

The government want to prioritise supporting those most in need at this very difficult time and ensuring that vulnerable children remain protected is a top priority for government. Schools have been asked to continue to provide care for vulnerable children including those who are supported by social work, those with safeguarding and welfare needs, including child in need plans, on child protection plans, ‘looked after’ children, young carers, disabled children, and those with education, health and care plans.

The Department for Education will work with schools and local authorities to help identify the children who most need support at this time.

Social workers will continue to work with vulnerable children in this difficult period and support these children to access provision in schools, and any other support they require.

The latest guidance on vulnerable children and young people can be found here: https://www.gov.uk/government/collections/coronavirus-covid-19-guidance-for-schools-and-other-educational-settings.

 

Adult Social care: Covid-19

The Department of Health and Social Care are working closely across Government with local authorities and providers to make sure the social care sector is prepared and able to respond to COVID-19.

Local authorities, clinical commissioning groups and providers should have appropriate arrangements in place to manage their workforce. The Department of Health and Social Care expect them to work together to make sure that the valued social care staff, including frontier workers, can continue working wherever possible.

The government are aware that social care will be at the frontline of our response to COVID-19, with social care providers looking after many of the most vulnerable in society which is why they have made a £5 billion contingency fund available to support the National Health Service and local authorities to meet the additional costs they will face. This will ensure they can maintain social care provision, given the additional pressures on the sector caused by COVID-19.

Social care guidance is being worked on urgently and updated regularly. The latest advice which the government keeps under review is available at the following link:

https://www.gov.uk/government/publications/guidance-for-social-or-community-care-and-residential-settings-on-covid-19

 

Abortion clinic protests

The Home Office are aware of a number of recent protests outside abortion clinics and are taking the matter seriously. This country has a proud history of allowing free speech but the right to peaceful protest does not extend to harassment or threatening behaviour. The law currently provides protection against such acts.

The Government recognises the adverse impact that anti-abortion protests can have on patients and staff and are keeping this important matter under review. Government officials regularly liaise with national policing leads to assess if there have been any developments on protest activities outside abortion clinics.

 

Diabetes UK: A Missing part of Diabetes care

It is important that we provide emotional and psychological support to those with long term health conditions to ensure that sufferers are able to live fuller and healthier lives.

On 21 March 2018, NHS England and NHS Improvement along with the National Collaborating Centre for Mental Health published 'The Improving Access to Psychological Therapies Pathway for People with Long-term Physical Health Conditions and Medically Unexplained Symptoms' which is available at the following link: www.england.nhs.uk/wp-content/uploads/2018/03/improving-access-to-psychological-therapies-long-term-conditions-pathway.pdf

The guidance outlines the Improving Access to Psychological Therapies (IAPT) pathway to support the national expansion of IAPT services. The expansion of these service will help adults with depression and anxiety disorders who also have long term conditions including diabetes. 

 

Refusal of assistant animals on public and private transport

My office recently met with the Guide Dog association in Westminster to discuss the issues that those with assistant dogs face. It is important that we take this issue seriously as busses, taxis and private hire vehicles (PHVs) provide vital services for disabled people. It is unacceptable for drivers of these vehicles to refuse the carriage of passengers with assistance dogs without reason.

In February, the Government published its response to the report of the Chair of the Task and Finish Group on Taxis and PHV licensing. This indicated its intention to introduce mandatory disability awareness training as part of National Minimum Standards, although no timeframe was given, they have stated that this will be introduced when parliamentary time allows. In the meantime, the government will urge licensing authorities to use their existing powers to ensure that all taxi and PHV drivers have the knowledge and skills necessary to provide every passenger with the assistance they require.

The government have also worked with disabled people and the bus industry to develop best practice guidance to support the implementation of disability awareness training. As a result, the government are developing a monitoring and enforcement framework to ensure that drivers better able to respond to passenger needs. Additionally, the government will also ask operators about their plans in the upcoming Annual Bus Statistics survey, and plan to publish the results, subject to quality considerations.

I am a huge supporter of the Guide Dog Association and I will continue support their work in parliament.

 

Brexit and the NHS

The NHS is a source of great pride for our country and plays a vital part in our society. The government will ensure that when we leave the EU at the end of October our frontline services are fully prepared, which is why the government are bolstering our already extremely resilient contingency plans. 

The Health Minister is strengthening our preparations for Brexit with an express freight service to deliver medicines and medical products into the country within 24-72 hours. The new freight service will support existing plans such as building buffer stocks of medicines and medical products, procuring additional warehouse capacity and supporting companies to get ready to meet new customs and border requirements.

Additionally, arrangements are in place to ensure that the prices paid by the NHS for medicines provide value for money. The prices and the profits made on the sales of branded medicines to the NHS are controlled by the voluntary Pharmaceutical Price Regulation Scheme. This is a UK arrangement and I have not seen any speculation that leaving the EU without a deal would prevent this continuing to operate. 

 

The Vagrancy Act and rough sleeping

This Government is clear that no one should be criminalised for having nowhere to live and for sleeping rough. Before being elected to Parliament, I worked to raise funds to provide a hostel and day centre for homeless women in London and saw for myself how difficult life is for homeless people.

The Vagrancy Act 1824 provides the police with the power to arrest those begging or persistently begging in a public place. It is an operational matter for the police to determine when it is appropriate to make use of this power in line with their duties to keep the peace and to protect communities. 

The cross-Government Rough Sleeping Strategy, which was published in August, committed to reviewing homelessness and rough sleeping legislation, including the Vagrancy Act 1824. The Government believes that review of the 1824 Act, rather than immediate wholesale repeal, is the right course of action to ensure the consequences of repeal are fully understood. MHCLG will report no later than March 2020.

In its first year, the Rough Sleeping Initiative (RSI) provided over 1,750 new bed spaces and 500 staff. This year the government have expanded the RSI with investment of £46 million for 246 areas – providing funding for an estimated 2,600 bed spaces and 750 staff. The government  have also backed the Rough Sleeping Strategy with £100 million of funding.

 

Euthanasia and assisted dying 

I recognise the strong feelings on this issue and have seen the terrible suffering which some people go through as they approach the end of their lives. However, I am opposed to any change in the law regarding euthanasia, doctor-assisted dying or any subject linked. I believe that the balance of what doctors can and cannot do is about right as it is, and I don't believe that heavy-handed legislation would help matters. In September 2015, the House of Commons rejected, by a large majority, allowing doctors to assist people to take their own lives and I haven't seen any evidence that opinions have changed.

 

Pension Credit 

Pension Credit is an important benefit specifically intended to help the poorest pensioners. There are over 1.6m pensioners already claiming Pension Credit worth over £5billion a year. Age UK estimated that 37% of single pensioners and 50% of couples entitled to pension credit are not claiming. This means each year £3 billion goes unclaimed, a saving that the government does not wish to make. It is important that more people to come forward and claim the pension credits they deserve. 

The Department for Work and Pensions (DWP) welcome and encourage initiatives to promote take up of Pension Credit by national and local organisations who may often be best placed to understand the local circumstances and needs in the community. For this reason, DWP have developed the Pension Credit toolkit, as an on-line tool for agencies and welfare rights organisations to use in order to encourage Pension Credit take-up. It can be found at: www.gov.uk/government/publications/pension-credit-toolkit

In addition, the DWP targets activity on engaging with people who may be eligible to benefits at pivotal stages, such as when they claim State Pension or report a change in their circumstances. The DWP uses a wide range of channels to communicate information about benefits to potential customers; including information on https://gov.uk/, but also in leaflets and by telephone. DWP staff in Pension Centres and Jobcentres including visiting officers are able to provide help and advice about entitlement to benefits, as are staff in Local Authorities who administer Housing Benefit.

 

Radiotherapy

The NHS Long Term Plan reaffirmed the commitment to modernise radiotherapy, as well as making specific commitments to commission the National Health Service new state-of-the-art Proton Beam facilities in London and Manchester. The plan also committed to reforming the specialised commissioning payments for radiotherapy hypofractionation to support further equipment upgrades.

The Long Term Plan also set out NHS England’s commitment to review the National Tariff, in particular to ensure that appropriate incentives are in place to encourage providers to deliver modern techniques, including hypofractionation, and to upgrade and replace equipment. Over the last two years, £130 million has been invested in modernising radiotherapy equipment, with over 80 machines funded for replacement or upgrade across the country since October 2016. This gives cancer patients access to the latest technology, regardless of where they live.

With a quarter of NHS cancer patients are treated with radiotherapy, it is important that we to invest in the service. I will continue to support improvements in cancer treatment to ensure that every person has the best chance at a full recovery.

 

Asthma Prescription Charges

Baroness Blackwood recently met with Asthma UK and discussed their report 'Paying to breathe'. Departmental officials continue to engage with Asthma UK on the issues raised in the meeting however,  the Department of Health and Social Care have no plans to review the current system of medical exemptions from prescription charges. Extensive arrangements are already in place to help people access National Health Service prescriptions which include a broad range of NHS prescription charge exemptions. 

To support those with the greatest need who do not qualify for an exemption, the cost of prescription pre-payment certificates has been frozen for another year. A holder of a 12-month certificate can get all the prescriptions they need for just £2 per week. 

I have raised this issue with the government previously and hope to see the Department of Health and Social Care rethink their stance on this issue.  

 

Campaign: The Children’s Society- Local Welfare Assistance Scheme

The reforms to the Social Fund in 2013 have allowed local authorities in England and the devolved administrations in Scotland and Wales to deliver their own local provision for people who are in need of urgent help. The Government believe that councils are best placed to decide how to target flexible help to support local welfare needs. 

The Local Government Finance Settlement for 2015-16 identifies a notional amount relating to local welfare provision totalling £129.6 million for England. The notional allocation for local welfare provision remains at £129.6 million in England in the Local Government Financial Settlement until 2019/20. There are currently no plans to ringfence this notional allocation for local welfare assistance schemes.

I believe that all children should be given access to the tools that they need to thrive in life and will continue to do what I can to support the needs of young people in parliament.

 

Child Victims Of Modern Slavery

I believe that we should do all that we can to protect those most at risk of trafficking in our society. Child victims of modern slavery and human trafficking are among the most vulnerable people in the UK, with separated and unaccompanied children in migration most at risk.

Statutory provision for Independent Child Trafficking Advocates (ICTAs) was made in section 48 of the Modern Slavery Act 2015. ICTAs advocate on behalf of child victims and ensure their voices are taken into account for all decisions made for them. Three early-adopter sites (Greater Manchester, Hampshire and the Isle of Wight, and the whole of Wales) have been successfully running this service, delivered by the charity Barnardo’s, since January 2017. A recently published Independent Review of the Modern Slavery Act, described ICTAs as “A service that is a companion for a trafficked child, helping them to navigate towards a safer future” recommending that the service continues.

The Home office are carefully considered the recommendations of the independent review and published their formal response on the government website. To read the response in full click here. The Government remains committed to rolling out the ICTA service nationally as soon as possible to ensure the safety of the most vulnerable children in our society.

 

Dementia Care

I recently attended the Alzheimer’s Society’s photo exhibition, to show my support for the great work that they do. I was shocked to hear that there are over 850,000 people with dementia in the UK, a number predicted to rise to 2 million by 2051. As of April 2019, there are 7,341 care homes in England that provide dementia care. Of those that have a Care Quality Commission (CQC) rating, 76% are rated Good or Outstanding. This is a great achievement however, more needs to be done to support those in need.

The government are committed to ensuring that everybody, including those who live with dementia, has access to the care and support that they need. The NHS Long Term Plan, published in January 2019, commits the National Health Service to continuing to improve the care provided to people with dementia and their carers. The Government’s Dementia 2020 Challenge aims to make England the best country in the world for dementia care, support, awareness and research. In 2019 the Department of Health and Social Care have given local authorities access to up to £3.9 billion more funding for adult social care. The government will set out plans to reform the social care system to ensure it is sustainable for the future.

I will continue to support improvements in care for sufferers.

 

Medicinal Cannabis

I have always opposed the legalisation of so-called recreational Cannabis and continue to do so. However, medicinal Cannabis is a different matter and I support its use when the medical profession approve of it, after thoroughly investigating its benefits as against potential problems which might be caused by its application. Strains of the plant have been used for years and the range was extended in November 2018. Since then, around 110 patients have received Cannabis-based medicine, but there do appear to be barriers to its use, and the government is investigating why this should be so, as well as carrying out cost-benefit analysis. The recent debate, which I attended for a while, was useful in highlighting the issue.

Campaign: End Our Pain "Patients need help: act now to support those denied medical cannabis"

The Government is working hard to get the right approach. The law was changed on 1 November last year to ensure that it is now legal for doctors on the specialist register of the General Medical Council to prescribe cannabis-based products for medicinal use in the UK. Whether to prescribe must remain a clinical decision to be made with the patients and their families, taking into account the best available international clinical evidence and the circumstances of each individual patient.

The National Institute for Health and Care Excellence (NICE), has also been commissioned to develop guidelines on the prescribing of cannabis-based medicinal products by October 2019. The guidance will focus on four indications: chronic pain, intractable nausea and vomiting, treatment-resistant epilepsy and spasticity. It will be based on the best available international evidence and produced using NICE’s world-renowned process for delivering such guidelines. This guidance will update and replace the interim guidance.

 

Campaign: HCPC Fees

The Health and Care Professions Council (HCPC) performs an important role in the health and care sectors across the UK, ensuring safety and quality from our healthcare professionals. The main source of funding for HCPC is through registration fees paid by healthcare professionals registering to practice in the UK.

The regulators are responsible for determining the level of their annual registration fees. Following public consultation, the HCPC have decided to raise its annual fees from £90 to £106 a year from October 2019. Despite most respondents not being in favour of a price increase, many wanted the HCPC to invest more in improving the quality and timeliness of their services. The HCPC have been clear that the principal reason for the increase in fees is to allow it to deliver the improvements identified by registrants in the consultation. Following the increase, HCPC registration fees will remain the lowest of any UK health and care regulators. Since the registration fees are tax-deductible, the annual increase will amount to just over £1 a month extra for most of the registrants.

The HCPC is independent of the Government and is funded by registrants’ fees on a cost-recovery basis. The Professional Standards Authority (PSA) is responsible for providing oversight to HCPC. It is not the Government’s role to advise HCPC what their fees should be.

However, in response to the Westminster Hall debate on this subject, the Minister for Health has written to the HCPC to ask they look at the disparity between the fees that are payable by part-time and full-time staff. I will continue to speak with any constituents effected and help in any way that I can.

 

Campaign: NHS Long Term Plan 

The NHS Long Term Plan is a new plan for the NHS to improve the quality of patient care and health outcomes. It sets out how the £20.5 billion budget settlement for the NHS, announced by the Prime Minister in summer 2018, will be spent over the next 5 years.

The plan has been developed in partnership with frontline health and care staff, patients and their families. It will improve outcomes for major diseases, including cancer, heart disease, stroke, respiratory disease and dementia.

The plan also includes measures to:

• improve out-of-hospital care, supporting primary medical and community health services
• ensure all children get the best start in life by continuing to improve maternity safety including halving the number of stillbirths, maternal and neonatal deaths and serious brain injury by 2025
• support older people through more personalised care and stronger community and primary care services
• make digital health services a mainstream part of the NHS, so that in 5 years, patients in England will be able to access a digital GP offer

I continue to meet with local health chiefs in the constituency to listen to their concerns, and progress, and raise these issues with the Health Secretary. 

 

Campaign: Fostering: Staying Put 

I recognise the excellent contribution foster carers make to our society and the role they play in shaping, often vulnerable, young people's lives. Since the introduction of Staying Put in 2014, young people in England have had the legal right to stay living with their former foster carers after they turn 18. I have received campaign emails from constituents asking the government to introduce a national minimum allowance for Staying Put to cover the cost of looking after a young person.

The Minister has outlined the following: 

The government keeps the Staying Put policy under constant review, including through monitoring data from local authorities on take-up by young people, engagement with the sector, and reviewing information from Ofsted inspections of local authorities. Staying Put was also considered as part of the independent fostering review undertaken by Sir Martin Narey and Mark Owers, published in February 2018. Staying Put has helped thousands of care leavers to transition more smoothly from care to independence, and provides continuity of relationships and care arrangements. Latest data shows that in the year ending March 2018, 55% of 18 year olds chose to Stay Put – an increase of 4% on 2017.

The government does not believe that introducing a national minimum allowance for Staying Put carers is the right way forward. Unlike children in foster care, young people in Staying Put arrangements are adults and may be in work, or claiming benefits. These can be used to contribute to the cost of providing the Staying Put arrangement, in a similar way that young people who are still living at home with their parents may contribute to the cost of running the household. The current arrangements allow local authorities to consider all factors in relation to each local Staying Put arrangement, and to negotiate the amount that the carer receives on a case-by-case basis.