Health, Social Care and Security — House of Commons, 2017-06-28
Topic: Health
Andrew William Murrison (Conservative, Centre-right): It is good to see you back in your place, Madam Deputy Speaker We have been treated to a range of excellent maiden speeches from my hon. Friends the Members for Gordon (Colin Clark) and for Hitchin and Harpenden (Bim Afolami), and the hon. Member for Stockton South (Dr Williams). They obviously have the measure of this place already, because not one of them is left in the Chamber, but in his absence, I reassure the hon. Member for Stockton South that we can never have too many doctors in the House I welcome the commitment in the Queen’s Speech to improving social care, and I welcome the plans for a consultation. All of us who have gone through the general election process—certainly on the Government Benches—will be aware of the importance of this issue. We may even recall the 2015 manifesto commitment, on which we stood, to implement something that looked a little bit like Dilnot. Most of us at the time thought that was a jolly good idea Our public services are all about pooled risk. That is what the NHS and our social services are all about—in everything, it seems, except for dementia and other chronic and long-term conditions that require ongoing care. For most of us, they will not actually be that expensive. Mercifully, for most of us dementia care will not be expensive. It is a condition that affects us right at the very end of our life and very few of us will require institutional care. For a few of us, however, it will be expensive. For those people and their families it will be a matter of huge importance, as many of us, particularly those of us on the Government Benches, found out a few weeks ago to our great cost. It seems reasonable that we should indeed have a Dilnot-style cap on our liability for these extraordinary costs that affect a few of us—a number of our families. It is surely right that we should do so, and I have no doubt that that will come out loud and clear in the consultation I very much welcome the commitment to mental health in the Queen’s Speech. I am particularly interested in mental health so far as it relates to the criminal justice system. It is welcome that we should be revising the Mental Health Act 1983. It has been a good piece of legislation and has served us well, but it is due for revision and updating. Some 10% of women and 30% of men in the criminal justice system have had some involvement with mental health services, or had to access acute mental health services prior to their incarceration. Ninety per cent. of people in the criminal justice system have some form of mental health problem. That is a huge indictment not, I would suggest, of the service, but of all of us. It is absolutely right that in our general attempt to reduce the rate of incarceration in this country, which is far too high, we focus particularly on the people in the prison system who have serious and significant mental health problems I very much welcome the focus on general practice articulated by my right hon. Friend the Secretary of State for Health and his Ministers. The service, it has to be said, is under pressure. It is certainly running hot, and my worry about the medical workforce—GPs, hospital doctors and nurses, and everybody who works in our NHS—is that we risk allowing the well of good will not just to get low but to run completely dry It is absolutely right that we should now look at removing the cap on pay for public sector workers, and that we should think in particular about those working in our health services. These people give far more back to the service than we give to them, in terms of the package, and those of us who go into medicine, healthcare or social care understand that. We do it because we want to give something back. We are altruists, but that only goes so far. When we have to support our families, pay the mortgage and deal with everything that bears down on people in their working lives, it is pretty rotten to see salaries increasing, rightly, in the general economy but not in the public service. It is absolutely understandable that the Government, as a big employer, should seek to contain cost. As an evangelist for reducing our deficit, I will support that, but there comes a point—I welcome the Government’s indication that it is rapidly approaching—when we have to look at pay settlement for those who work so well for us in the public sector I am absolutely obsessed by outcomes in healthcare; the Secretary of State will know that, because we have discussed it. Healthcare outcomes in this country languish behind those of countries with which we can reasonably be compared, and I do not mean the OECD average. I mean countries such as France, Germany and Holland. On Britain’s disappointing position in the league tables, we must do more to improve on things such as bowel cancer and cervical cancer, on which we are overtaking France and Germany respectively. We need to do that right across the board. I am left with the conclusion that because money, inputs and outcomes are causally related, we have to get the funding right I hope very much that the Government will consider again the proposal put forward by my hon. Friend the Member for Totnes (Dr Wollaston) and my right hon. Friend the Member for East Devon (Sir Hugo Swire) that we should achieve consensus through a cross-party commission on this issue, so that we can discuss, in the NHS’s 70th anniversary year, how to get sustainable funding for our NHS and make sure that this great national institution is fit for the next 70 years.