Jeremy Hunt letter shows weekday hospital care is under threat

Norman Lamb has accused the Government of putting the safety of weekday patient care at risk, after the Health Secretary failed to guarantee that more junior doctors will be hired to help deliver a seven-day NHS.

Throughout the year-long dispute over the junior doctors’ contract, Norman has expressed concern that Jeremy Hunt’s plan to make junior doctors work more at weekends will mean that hospitals have fewer medics on duty during the week, unless the NHS employs enough new junior doctors to fill the gap.

In the House of Commons on 5th September, the Health Secretary promised to write to Norman to confirm exactly how many additional doctors will be working in the NHS this year and every other year before the end of this parliament in 2020.  However, Hunt’s letter did not provide any detail on how many extra junior doctors would be trained and employed, despite having told Norman that he would give him a number.

In the letter, the Health Secretary said that it was up to each hospital trust to expand their junior doctor workforce, raising doubt that he would make good on his pledge to ensure that enough doctors are employed to protect weekday cover.  The letter simply restated the government’s longstanding pledge that there would be 11,500 more doctors by 2020 than there were in 2015.

The Health Secretary has previously acknowledged the potential for too few doctors being on duty between Monday and Friday as a result of the new junior doctors’ contract, which was imposed in October.  When Norman first raised the prospect of shortfalls in weekday medical rotas affecting care standards, in a Commons debate on the dispute on 19th May 2016, the Health Secretary told him: "The short answer is that we need to increase the NHS workforce."

Speaking to The Guardian, Norman Lamb said:

“This letter from Jeremy Hunt fails to reassure me.  There appears to be no clear plan as to when more junior doctors will be employed, and yet the changes to the contract are being imposed immediately.

“There seems to have been no assessment of the number of additional junior doctors needed to ensure that additional weekend hours won’t have a dangerous effect on weekday cover. Jeremy Hunt has failed to provide the evidence to back up his claim that the problem will be addressed by additional junior doctors.

“My fear is that unless you can guarantee that there will be more junior doctors employed, imposing a change which involves more hours being worked at weekends will inevitably reduce the numbers of hours worked during weekdays when the pressure is at its greatest. 

"This could result in real safety concerns. With many rotas already left unfilled around the country during the week, the Government risks making the situation worse by stretching NHS resources too far. The consequences for patient care could be disastrous." 


Serious mistakes in NHS patient care uncovered by Norman Lamb

Surgical, diagnostic and care errors are on the rise in NHS hospitals, according to official NHS England figures obtained by Norman Lamb MP.

The last three years have seen more ‘serious incidents’ involving delayed diagnosis, staff failure to act on patients’ test results, poor care of seriously ill patients, and mistakes in surgery.

The figures, which were obtained via a Freedom of Information request by Norman Lamb and reported in The Observer, have sparked concern that unprecedented strain on hospitals and staff is putting patients at risk, amid growing fears that the NHS will experience its worst winter crisis since 2011-12.

The figures show:

  • The number of serious incidents involving ‘sub-optimal care’ for a patient whose condition is deteriorating more than doubled from 260 in 2013/14 to 588 in 2015/16.
  • Diagnostic incidents including delayed diagnosis and a failure of healthcare professionals to act on test results have also jumped by more than 40%.  There were 923 incidents of this nature last year, while in 2013/14 there were just 654.
  • Hospitals recorded a sharp rise in surgical errors. In 2014/15, 362 serious incidents involved a surgical error or wrong-site surgery, in which surgeons operated on the wrong part of a patient’s body.  This figure more than doubled last year, when 740 serious surgical incidents were recorded.

Speaking to The Observer, Liberal Democrat Health Spokesperson Norman Lamb said:

“These figures confirm the stark and distressing reality that thousands of people are being failed in their hour of need because the NHS is under such intolerable pressure, with overstretched hospital staff unable to give patients the care and treatment they deserve.

“The Health Secretary has talked a lot about wanting to make the NHS the safest healthcare system in the world. But is that ambition realistic? These figures show worrying rises in the number of incidents which have a damaging and potentially fatal effect on patients.

“My worry is that the NHS is under such impossible pressure, with clinicians too often working under intense strain, that increases the risk of serious harm being caused to patients, which can have incalculable consequences for them and their families.”


‘Quick and thorough’ investigations needed for learning disability deaths

Norman Lamb, the Liberal Democrat Shadow Health Secretary, has welcomed the recommendations set out by the Care Quality Commission (CQC) to improve the processes for investigating and learning lessons from unexpected deaths in the NHS, but warned that progress must be made in ensuring that investigations are conducted in a timely manner. 

In April, the Health Secretary instructed the CQC to review how NHS trusts investigate and learn from patient deaths, following the tragic death of Connor Sparrowhawk, an 18-year-old with autism and learning disabilities who drowned in a bath while receiving care at Southern Health. 

A jury inquest found that neglect and other "serious failings" at the trust contributed to his death. After learning about the tragedy as a minister, Norman Lamb has campaigned closely with Connor's mother, Sara Ryan, who found that she was largely excluded from the investigation into her own son's death.  

This week, the CQC's national review found that the NHS is missing opportunities to learn from patient deaths, and that too many families are not being included or listened to when an investigation happens. It raised significant concerns about the quality of investigation processes led by NHS trusts, and the failure to prioritise learning from these deaths so that action can be taken to prevent similar deaths in future. 

The CQC has called for a new national framework, so that NHS trusts have clarity on the actions required when someone dies in their care.  All NHS trusts will be required to collect a range of information on potentially avoidable deaths, and to consider what lessons need to be learned, on a regular basis. Each trust will be asked to identify a board-level leader as patient safety director to take responsibility for this agenda and ensure that it is prioritised within the organisation. 

Responding to a statement by the Health Secretary Jeremy Hunt in the House of Commons, Mr. Lamb paid tribute to Sara Ryan and highlighted the importance of timely investigations when a patient dies in unexpected circumstances. He said:

"I also pay tribute to Sara Ryan, the mother of Connor Sparrowhawk, who has fought tirelessly for justice for those with learning disabilities. I warn the Secretary of State that I think she will take some convincing that things really will change, given all the resistance she has come up against. I hope he has managed to meet her; if not, would he be willing to meet her, with me, to discuss the plans going forward?

"One key issue not covered in the report or statement is the timeliness of investigations. A report nine months or a year after the incident is often no good at all: the organisation has moved on, and people have forgotten what has happened. I commend Mersey Care, which does a very quick, thorough investigation within 48 hours, when the information is really current and people are still shocked by what has happened. That is how Mersey Care seeks to implement the lessons from every tragedy."

In response, the Health Secretary praised Sara Ryan's campaign to achieve justice for people with learning disabilities, as well as Mr. Lamb's role in the Coalition Government. 

"I want to put on the record that the right hon. Gentleman was a big champion for people with learning disabilities when he was in my ministerial team, in particular over issues such as Winterbourne View, which he brought to my attention and did a huge amount of positive work on.

"I have met Sara Ryan. I spoke to her again yesterday. I repeat what I said in my statement, that without her campaigning we would not now be making the huge changes on a national level that we are. I wholeheartedly agree with the right hon. Gentleman’s other comments."

 


Tories must deliver on the Lib Dems' vision for child mental health

This article was first published by The Guardian on 7th December 2016

Norman Lamb, Liberal Democrat MP for North Norfolk and former Minister of State for Care & Support

If mental health is the Cinderella service of the NHS, then child and adolescent mental health services (CAMHS) is the Cinderella service of the Cinderella service. It’s a cliche that bears repeating, because the reality of children’s mental health services in this country still falls woefully short of the vision set by the Liberal Democrats and Conservatives during the coalition government.

One in 10 children suffers from depression, anxiety or another diagnosable mental health problem, and 75% of mental illness starts before the age of 18. Intervening early with effective, evidence-based support can not only stop a child’s condition deteriorating to crisis point, but also have a transformative effect on long-term recovery and life prospects in adulthood.

When mental ill health costs the economy an estimated £105bn every year, the economic as well as the moral case for prioritising children’s mental health is unanswerable. But when I became minister, I was horrified by what I witnessed.

For too many people, help is not available when they need it. Nearly a quarter of young people referred to specialist CAMHS services are turned away, often because they fail to meet outrageous eligibility thresholds. The anorexic teenager is denied treatment until she becomes dangerously thin. The boy with OCD is told there is no specialist support until he has experienced repeated suicidal thoughts. And those who do get treatment are often faced with excruciating waiting times, which can vary dramatically across the country.

As well as being morally indefensible, it is the antithesis of the important principle of early intervention. We have ended up with a grossly inefficient system designed to treat rather than prevent mental ill health in children. Fragmented, tiered services are complex and dysfunctional, while the perverse financial incentives in the system fail to encourage a focus on prevention and instead push children into specialist acute settings where NHS England picks up the bill, rather than local clinical commissioning groups.

Determined to address this appalling situation, I set up a task force. The result was Future in mind: a blueprint for the modernisation of child and adolescent mental health services, backed by extra funding of £250m each year until 2020.

At its heart is a significant shift towards the prevention of ill health, working with schools to strengthen resilience and improve support before health deteriorates. Attracting support from across the political spectrum, it was subsequently endorsed by NHS England’s own five-year plan for mental health.

The Conservative government, however, has shown little drive to deliver on this golden opportunity. In the first year of the promised investment, only £143m was released instead of the £250m expected. Mental health providers have reported that the money failed to reach frontline services, with many still seeing cuts to their budgets.

Worse still, the government chose not to make up this £107m shortfall in the second year of the programme. Nor was the money that was allocated to clinical commissioning groups ringfenced, so there is a real risk that it will leak out to other local priorities such as A&E waiting times.

It’s hardly surprising that we’ve not seen the progress many had hoped for. The Education Policy Institute’s commission on children’s mental health, which I chair, recently published its final report, highlighting that excessive waiting times and treatment thresholds are still commonplace. There also remains a dreadful cliff edge at the age of 18 when young people make the transition from CAMHS to adult services.

The health secretary, Jeremy Hunt, recently pledged his commitment to CAMHS, which he rightly identified as the “biggest single area of weakness” in the NHS. But rhetoric is not enough. It’s now time for a bold statement of intent, otherwise all momentum will be lost.

We need to see a bold programme of reform – implementing the principles of Future in mind – with an ambitious focus on schools and prevention, early intervention, and improving access to high-quality services. The EPI commission called for the government to use the additional £250m a year as a lever to drive continued change, making receipt of the money conditional on areas demonstrating that all the money is being spent on children and that there is an ambitious programme to shift resources to prevention. Each area should also be expected to demonstrate that they have delivered on their plans.

The chronic underfunding of children’s mental health services must be consigned to history. Despite receiving a paltry 0.7% of the total NHS budget, CAMHS is too often at the front of the queue when there are cuts or “efficiencies” to be made. The health secretary should make it his priority to reverse this scandalous disinvestment, pushing and cajoling the NHS to ensure that every last penny of the extra money secured by the Liberal Democrats is spent as intended.

Children and young people have been let down for too long. We know what an effective and modern children’s mental health service looks like, and we have a roadmap for how to get there. Responsibility now lies with the government to deliver on it so that all young people receive the support they need to flourish and achieve their full potential.


Fostering system in need of reform - Lamb

Norman Lamb, the Liberal Democrat MP for North Norfolk, has written to the Chair of the Education Select Committee in support of the Norfolk Foster Care Association’s proposals for reforming the fostering system.

In October, the Committee launched a new inquiry into fostering in England, looking at a range of issues including the adequacy of current recognition and support given to foster carers, challenges in recruitment and retention, and the stability of foster care placements for looked-after children.

In its submission to the inquiry, the Norfolk Foster Care Association (NFCA) has highlighted a range of serious concerns about the fostering system.  These include, but are not limited to:

  • inadequate support for foster carers from local authorities;
  • frequent and unnecessary removal of children from their established foster placements;
  • a lack of legal protections for foster carers who blow the whistle on bad practice; and
  • a failure to ensure that allegations or complaints about foster carers are investigated fairly.

The NFCA also questioned the fairness and legality of Norfolk County Council’s implementation of the ‘Staying Put’ initiative.  The scheme supports young people to remain with their foster families beyond their 18th birthday, but a cap on funding in Norfolk currently discriminates against young people wishing to remain with ‘Level 5’ foster carers, who receive the highest pay rates because of their specialist knowledge and experience. 

The NFCA has put forward a set of recommendations to improve the fostering system so that it better supports foster carers and the vulnerable young people who depend on them.  Key recommendations include:

  • better support for foster care associations from local councils;
  • statutory whistleblowing protections for foster carers;
  • new standards to ensure that investigations into foster carers are conducted fairly;
  • more robust processes for removing children from their foster placements; and
  • a Central Register to overcome recruitment challenges and allow foster carers to relocate more easily to other parts of the country. 

In a letter to the Education Committee chair Neil Carmichael MP, Norman Lamb, a long-time campaigner for better rights for foster carers, endorsed the NCFA’s proposals for strengthening the system. He has also called for representatives from the NCFA to be invited to give spoken evidence to the inquiry at future meetings.

Commenting, Norman Lamb said:

“Foster carers play a hugely valuable role in caring for society’s most vulnerable children, and it’s a great scandal that they are so often denied the support, rights and protections they deserve. This ultimately has a damaging effect on the wellbeing of looked-after children who, above all else, are in need of safety and stability.

“This inquiry is a timely opportunity to shine a light on some of the most egregious failings in the system and provide a catalyst for change. I am very pleased to support the NFCA’s involvement in the process, and hope that the Education Committee will take its important recommendations on board.” 


Chancellor must pledge funding for rural roads - Lamb

Norman Lamb, the Liberal Democrat MP for North Norfolk, has called on the Chancellor to ensure that rural areas get a fair slice of new funding for improving Britain’s roads.

In his first Autumn Statement tomorrow (Wednesday 23rd November), Chancellor Philip Hammond is set to announce an extra £1.3bn for improving Britain’s roads, to ease congestion in towns and cities and upgrade transport networks.

Mr. Lamb has now urged the Chancellor to make sure that rural areas share the benefit of this investment as well as towns and cities, particularly country roads prone to flooding.

Commenting on the eve of the Autumn Statement, he said:

“Roads and transport links are a crucial part of Britain’s infrastructure, so the announcement of additional investment is welcome.

“However, Mr. Hammond must make sure that a fair share of this money is spent on maintaining rural roads. Roads in Norfolk have not been well enough maintained in recent years with cutbacks to funding. They are often hit by flooding problems because of inadequate drainage, causing great inconvenience to local residents and damage to the local economy. The sad truth is that the Government doesn't seem to realise that they will pay the price for this neglect in years to come. 

"Better maintenance and better drainage in rural areas must be a priority, and my challenge to the Chancellor is to provide a cast-iron guarantee that communities like Norfolk will not miss out on this much-needed investment.”


Social care boost urgently needed - Lamb

More vulnerable people will suffer from failures of care unless the Government addresses the chronic underfunding of the social care system in next week’s Autumn Statement, Norman Lamb has warned. 

This week, the North Norfolk MP challenged the Health Secretary to confront the growing crisis in social care, and repeated his call for the Government to work together with other political parties to develop a sustainable long-term funding settlement. Speaking in a House of Commons debate, he said:

“Does the Secretary of State ever feel that he is confronted by a pretty fundamental choice? He can either preside over a system that deteriorates with an increasing number of failures of care, which I know he cares passionately about, or he can be the politician in Government who confronts that, who works with other parties and who comes up with a sustainable long-term solution. It is one or the other. I urge him to take the latter course.”

The care sector is teetering on the brink of collapse. Despite an ageing population and rapidly rising demand for care services, spending on social care in the UK is set to fall to less than 1% of GDP by the end of the decade. Cuts to the budgets of local authorities have meant that increasing numbers of elderly and disabled social care users are not receiving adequate support to live independently, and are left to fend for themselves unless they can afford to pay for care.

Avoidable hospital admissions caused by a lack of community care have also exacerbated pressure on hospital departments which are already over-stretched. In September, a total of 196,246 hospital bed days were lost due to delays in discharging patients who were medically well enough to leave hospital – the highest number since records began. The main reason for these delays was a lack of follow-up care in the community.

The Liberal Democrats have long called for the creation of a cross-party commission to find an efficient and effective solution to the existential threat to the future of the NHS and social care, and have set up an expert group to look at the case for a dedicated Health and Care Tax. In this week’s debate, Norman Lamb repeated his plea to the government and opposition parties to be pragmatic and open-minded on the possibility of a tax to sustain these cherished services for future generations:

“All of us on both sides of the House must confront the chronic underfunding of the health and care system, and we need to find ways to raise significantly more resources to ensure we have a modern and efficient health and care system.”

The social care precept, which was announced in last year’s Spending Review, allows local authorities to increase council tax by an extra 2% per annum to raise extra funds for social care. The Government is reported to be considering lifting the 2% cap, in order to allow local areas to raise yet more money for social care at no extra cost to the Treasury. But in a letter to the Health Secretary, Mr. Lamb has warned that the Government must not treat the social care precept as an excuse to starve local authorities of the central funding required to provide care users with the support they need. He wrote:

“Last year, I welcomed the social care precept as a means of providing additional flexibility to local authorities – but only on the condition that this serves to supplement, rather than replace, a fair allocation of resources to local authorities from central government.

“With councils coming under ever greater financial strain, reliance on the social care precept to fund care services will inevitably entrench and widen regional health inequalities, as poorer parts of the country with the greatest health needs are less able to raise the resources needed. Having read reports that the Government intends to lift the 2% cap on the social care precept, I would appreciate your thoughts on this.”

Commenting ahead of the Autumn Statement, Norman Lamb said:

“Emergency funding is desperately needed to halt the rapid deterioration of the care sector. The system is now at breaking point, which will have devastating consequences for elderly and disabled people who are told that there is no care available. The Government knows this, so it would be unthinkable for the Prime Minister and the Chancellor not to act in next week’s Autumn Statement.”


Prime Minister and Chancellor must deliver Equality for Mental Health

The cross-party ‘Equality 4 Mental Health’ campaign, co-founded by North Norfolk MP Norman Lamb, has won the backing of nine former Health Secretaries in calling on the Prime Minister and the Chancellor to address the continuing injustice suffered by people with mental ill health in next week’s Autumn Statement.

The health secretaries, who served under both Labour and the Conservatives, have been joined by seven former health ministers, the former Chief Executive of NHS England, a former Permanent Secretary at the Department of Health, the current chair of the Health Select Committee, and leading mental health charities Mind and Rethink Mental Illness.

The 'Equality 4 Mental Health' campaign was launched ahead of last year's spending review by Lib Dem MP Norman Lamb, Tory MP Andrew Mitchell and Time to Change Ambassador Alastair Campbell. 250 leaders from across society joined the demand for an end to the historic injustice of discrimination against the mentally ill within the NHS, and the then Chancellor George Osborne recognised the work of the campaign in announcing an extra £600m for mental health services.

However, many of the examples of injustice and discrimination that were identified a year ago are still all-too-evident evident today.

Many mental health trusts continue to experience cuts to their budgets despite the rhetoric of ‘parity of esteem’ from Government and NHS England. Suicide remains the biggest killer of men under the age of 45 in the UK. Mental health research receives a disproportionately small amount of public funding, and flagship new treatment standards for people suffering from a first episode of psychosis have not been backed by the necessary resources.

In her first speech as Prime Minister, Theresa May promised to fight “burning injustice” in British society, highlighting that there is too often “not enough help to hand” for those who suffer from mental health conditions. She is right, and now has the opportunity to address this.

Norman Lamb, the Liberal Democrat spokesperson and former Minister of State for Care and Support, said:

“It is a stain on our country that people with mental ill health are so often treated as second class citizens. Last year’s joint statement sent a powerful message that this cannot be tolerated, but still we are reminded on a weekly basis how people with mental illness are left without the treatment and support they desperately need. 

“Promised investment hasn’t made the difference many expected – especially in services for children and young people, where the majority of mental health problems begin. At a time when the prevalence of mental illness seems to be rising, it would be negligent for the Government not to act.

Alastair Campbell, former Director of Communications to Tony Blair and co-founder of Equality 4 Mental Health, said:

“We welcome the fact that stigma around mental illness is decreasing but are concerned that the services are not there to match the need. The Prime Minister’s expressed commitment to tackling the growing mental health crisis is welcome, and the Autumn Statement is a golden opportunity for her to deliver on this rhetoric.”

Andrew Mitchell, Conservative MP for Sutton Coldfield and former International Development Secretary and Government Chief Whip, said:

“We are concerned at the new evidence emerging of inequalities in the mental health system based on age, gender, ethnicity and social class.  Promised funding for children and young people’s mental health is not getting through to where it is needed in many parts of the country. NHS Digital has also exposed a dramatic increase in mental illness and self-harm among young women in recent years, while people from Black British communities and lower-income households are less likely to receive treatment for common mental disorders.

“People of all political stripes, who share a belief in the fundamental principle of equality for mental health, must work together to make this ambition a reality.”

 

The full statement is as follows:

EQUALITY4MENTALHEALTH

A year ago, 250 leaders from across society came together to make a plea to Government – to deliver EQUALITY4MENTALHEALTH. The campaign highlighted the current gross disadvantage suffered by those with mental ill health within our publicly funded NHS and urged action from the Government to end this historic injustice.

We called on ministers to deliver on their public commitment to parity between physical and mental health, to ensure for those who suffer from mental ill health equal, timely access to treatment as others enjoy, the same right to the best evidence-based treatment and an equitable share of health research funding.

We were encouraged by the supportive response of the then Prime Minister David Cameron and above all by the announcement of extra funds for mental health by then Chancellor George Osborne. We also welcome the ambitious plans set out in NHS England's Five Year Forward View for Mental Health, and the continued investment in the Improving Access to Psychological Therapies programme. We particularly welcome, on the day she took office, the new Prime Minister's stated intention to focus on mental health.

However, despite the warm words, one year on, we see the same enduring injustice, the massive economic cost of neglect of mental ill health - estimated to be £105bn a year - and the distress suffered by countless families across the country because of failures of the system adequately to support people in need.

In particular we highlight:

1. Despite the promised increases in funding, mental health trusts in England are still suffering cuts to their budgets. Two in every five trusts saw their budgets cut in 2015-16, according to analysis by the King’s Fund. [1]

2. Suicide remains the biggest killer of men under the age of 45 in the UK and the rate has been increasing in recent years. The male suicide rate was three times higher than the female rate in 2014. [2] [3]

3. People experiencing a mental health crisis are still routinely shunted across the country in search of a hospital bed.  Last year, nearly 5,500 mental health patients in England had to travel out of area to receive treatment – an increase of 13% from the previous year. [4]

4. Services for children and young people are going backwards in many areas, with up to 75% getting no support or treatment at all for mental health conditions. Children and young people's mental health services receive just 0.7% of the total NHS budget. In the first year of promised additional investment, only £143m was allocated instead of the £250m expected.

5. Children and young people with eating disorders and mental illness are still too often turned away unless they reach high thresholds for treatment, such as a low BMI and repeated suicidal thoughts. [5]

6. There is evidence of a growing mental health crisis among young women.  More than a quarter (28%) of women aged 16-24 have a mental health disorder, according to a major report by NHS Digital, while reports of self-harm trebled in this group to 19.7% between 2007 and 2014. There needs to be greater understanding of the reasons for this trend, though childhood trauma, sexual abuse, low self-esteem and social media pressures have been cited as possible contributing factors. [6]

7. People experiencing a first episode of psychosis are being denied the timely package of specialist treatment they should be entitled to under flagship new treatment standards in the NHS.  Early Intervention in Psychosis (EIP) is being restricted to patients under the age of 35 across a quarter of the country, while most CCGs are unable to say how much they had spent on the service or whether their care package is delivered in line with official requirements. [7]

8. There are inequalities in access to treatment for mental health disorders related to socio-economic class and ethnic background.  White British adults are more than twice as likely to receive treatment as black adults for common mental disorders, while people living in lower income households are more likely to have requested but not received a particular mental health treatment. [8]

9. Significant concerns that the potential value of Sustainability and Transformation Plans to bring all parts of the health and care system together will be undermined if mental health is peripheral to plans under development across the country.

10. Research into mental ill health continues to lose out with just 5.5% of research funding going to mental health compared to a share of the total disease burden of about 23%. [9]

We are alarmed and dismayed that so many of these points echo those made a year ago when promises of real change were made by the previous Prime Minister and Chancellor. We call on their successors, Mrs May and Mr Hammond, to address this disadvantage in the Autumn Statement and to make good the promise to achieve genuine equality or parity of esteem for those suffering mental ill health.

Norman Lamb, Alastair Campbell, Andrew Mitchell (Co-founders, Equality4Mental Health)

Andy Burnham, Ken Clarke, Frank Dobson, Stephen Dorrell, Patricia Hewitt, Alan Johnson, Andrew Lansley, Alan Milburn, John Reid (Former Secretaries of State for Health)

Paul Burstow, Caroline Flint, Tessa Jowell, Norman Lamb, Ivan Lewis, Dan Poulter (Former Ministers of State and Parliamentary Under-Secretaries of State for Health)

Sarah Wollaston (Chair, Health Select Committee)

David Nicholson (Former Chief Executive, NHS England)

Lord Crisp (Former Permanent Secretary, Department of Health)

 


NHS Maternity Care in Crisis - Lamb

The Government must take urgent action reverse the growing crisis in NHS maternity care, Norman Lamb MP has warned, after ministers confirmed that the number of student midwives fell by more than 300 last year.

In response to a written parliamentary question from Mr. Lamb, the Liberal Democrat spokesperson for Health, the Minister of State for Health Philip Dunne revealed that there were just 6,350 student midwives training at the end of 2015/16.  This compares to 6,662 in the previous year, amounting to fall in the number of student midwives of almost 5%.

The figures were revealed on the same day that new maternity ratings were published, showing that maternity services in 74 per cent of CCGs are in need of improvement.

A recent report by the Royal College of Midwives also found that some maternity units are ‘dangerous’ as a result of overstretched staff and poor working conditions, warning that the NHS is facing an exodus of demoralised and overworked midwives.

The Government has published an action plan for ‘Safer maternity care’ to drive up the quality and safety of maternity services in the NHS, but Mr. Lamb has warned that ministers must provide evidence that the situation is improving quickly. He said:

“The alarming decline in the number of student midwives could have dangerous consequences when maternity services are already buckling under pressure.  It is even more concerning given the risk that fewer staff will come from other parts of Europe following the Brexit vote.

“The blunt truth is that the NHS will not be able to properly care for mothers and their babies unless we are training enough midwives. New mothers are not being given the care and attention they deserve because staff are exhausted and rushed off their feet, and this must be addressed as a number one priority.

“The recent measures announced by the Government are welcome, but there will need to be immediate evidence that progress is being made. We cannot afford to let this crisis turn into a catastrophe.

“The Secretary of State must provide cast-iron assurances that more midwives will be trained next year.  After the removal of student bursaries, it is vital that new incentives are put in place to ensure that midwifery remains a viable, attractive and rewarding career path for people from all backgrounds.”


Lamb condemns local pharmacy budget cuts

Norman Lamb, the Liberal Democrat MP for North Norfolk, has condemned the Government's announcement that funding for community pharmacy will be slashed by more than 7% over the next two years. 

Pharmacies are the lifeblood of local communities, providing advice, support and treatment to 1.6 million people every day.  In September, the Department of Health paused its plans to reduce funding for these services, after pharmacists and local residents warned that reduced access to pharmacies for those who rely on them will put more pressure on overstretched GP surgeries and hospitals. 

The Government re-opened negotiations with the Pharmaceutical Services Negotiating Committee (PSNC) and other stakeholders in light of these protests - but today confirmed, in a statement to Parliament, that pharmacies will lose 4% of their funding in 2016/17 and a further 3.4% in 2017/18. 

The Health Minister also announced changes to the funding system, so that payments to pharmacies will be more closely linked to the services they provide.  However, he confirmed that the annual pharmacy budget will be reduced from £2.8bn to less than £2.6bn over the next two years, and critics have suggested that these cuts could lead to 3,000 pharmacies being closed across the country as a result. 

Challenging the Government's cost-cutting agenda in the House of Commons, Norman Lamb said:

"There is no escaping the fact that this amounts to a significant cut in prevention services, which is what always happens when the finances of the NHS are under pressure. I absolutely accept the need for reform of the financial incentives involved, to ensure that we get the best outcomes from the money being spent, but surely we should be investing more in prevention in order to ensure that the NHS is sustainable." 

In response, Health Minister David Mowat offered a vague suggestion of additional funding for prevention services - despite the heavy cuts to public health budgets previously announced by the Government. He said: 

"The quality system that I have mentioned is about potentially investing more in prevention and linking the best pharmacies—the high quality pharmacies—more closely to local authorities, public health schemes and all that goes with that. I make the point again that there is a requirement for efficiency savings, but we do not believe that they will affect access overall. We do not believe that this will affect the public’s ability to use pharmacies as they do now. This will be part of modernising and digitising the service and providing resources for other parts of the NHS that need them very much.

 

Commenting afterwards, Norman Lamb rejected the idea that reducing pharmacy budgets would save money or make the health service more efficient.

“The Government’s belief that cutting funding for community pharmacies will improve efficiency in the NHS is a complete false economy", he said.

“These myopic plans will further increase pressure on GP surgeries and hospitals that are already buckling under the strain of limited resources and unprecedented demand for services.  More people will be forced to take unnecessary trips to their GP and even A&E, which is completely counter to NHS England’s vision in the Five Year Forward View.

“If the government wants to ensure that health service is more efficient and focused on preventing ill health, then surely we should be investing more – not less – in pharmacies and other preventive services.

“This was the latest in a chain of fig-leaf consultations from the Conservative Government, which is more concerned about cutting costs in a desperate attempt to make ends meet than creating an NHS that meets the needs of patients.”