No deal Brexit: National Audit Office warns of risk to medical supplies

On the 5th September this year, I asked the Brexit Secretary, Stephen Barclay what level of mortality he would consider acceptable in the event of a No-Deal Brexit. He dismissed my question, answering that the medicines industry had gone above and beyond to ensure sufficient supplies. I am sure that both suppliers and our NHS have been working flat out to plan for No-Deal, but it’s not enough.

Now we’re just days before we are due to leave and we’re nowhere near ready. This report from the National Audit Office today on NHS readiness and the potential disruption to medicine supplies makes extremely worrying reading, but it’s not a surprise.

The report acknowledges that there is no way of knowing what may happen at the UK/EU border when the UK leaves the EU, with ministers asking government departments to be prepared for a ‘reasonable worst case scenario’.

This is based on assumptions that the flow of goods across the channel could be reduced to 40-60% of current levels on day one, not returning to close to current levels until 12 months after leaving the EU. Over half (7,000) of all medicines are estimated to come to the UK from or via the EU, with a further 450,000-500,000 different types of medical supplies that are used by the NHS and distributed to hospitals, care homes, dental practices, pharmacies and individuals at home.

The Treasury will be allocating £150million to the Department for Transport to secure freight capacity from October, to prioritise medical supplies amongst other critical goods, however the procurement process to employ the necessary companies to operate this service is still ongoing. I’m greatly concerned that the report warns that there is limited time available to complete the procurement process: it has started later than anticipated, and now depends on the process ‘running smoothly’. Beyond that, there is further uncertainty and risk whether the successful operators will be able to mobilise quickly enough, and it is acknowledged that only some of the service will be ready to operate in time, with much of it only ready a month after leaving.

So much uncertainty; with departments having to work on the basis of untested assumptions determined by ministers, it’s clear that leaving without a deal presents a level of risk that no competent or moral leader should ever remotely consider. A no deal Brexit could spell disaster for the most vulnerable people in Britain.

August Bedford Independent Column – Local Healthcare

August Bedford Independent Column – Local Healthcare

Stalled discussions over the merger between Bedford Hospital and the Luton & Dunstable were revived at the start of August by a promise of investment.

It’s not hard to see why Prime Minister Boris Johnson would make such an announcement at this point  – the threat of a vote of no confidence when MP’s return after the summer break looms, and giving money to hospitals might seem like a way to secure support from MPs.

But this is not a new pledge.

The money for this merger was bid for and promised a long time ago – it’s just that the treasury wouldn’t release it.

For Bedford Hospital, the announcement ends years of uncertainty, and will be good for staff morale and retention.

I am pleased that services will be retained at Bedford after what has been a long and hard-fought campaign, and I will hold NHS bosses to their promises to keep A&E, Maternity and Paediatrics at Bedford.

But these merger plans don’t offer much in the way of enhanced facilities for Bedford, with most of the capital earmarked for upgrades to the Luton site.

I now want to see real investment in our healthcare facilities locally; for a return of inpatient mental health beds, for better access to primary care and better facilities for our GPs, and for enough money to keep essential services like our hydrotherapy pool running.

It’s not just acute NHS services that will need extra cash if we are to tackle the burgeoninghealthcare crisis either.

If more money isn’t provided for social care, hospitals will continue to pick up the slack. Bedford Borough Council are particularly good at ensuring seamless transfers of care, but the system is undoubtedly struggling.

The workforce shortages we see throughout the health and social care system will significantly worsen if strict post-Brexit immigration rules force lower income workers to leave the UK.

If Boris Johnson is serious about our nation’s health, he’ll provide some genuinely new money for the whole system.

He’ll scrap his dangerous no-deal Brexit plans that further threaten the stability of our health and social care workforce and would likely disrupt medical supply lines.

And he’ll reverse short-sighted Public Health cuts so that people can be helped to live healthier lives. Prevention is not only better than cure, it’s cheaper. But perhaps he doesn’t think he’ll be PM for long enough to see the benefits.

Read the article here at Bedford Independent

Protect The Protectors

Several constituents have contacted me regarding the Assaults on Emergency Workers (Offences) Bill 2017-19, and I was pleased to support the Bill, which today passed its third reading in the House of Commons. My full speech is printed below.

The Bill would, for the first time, make it an aggravated offence to attack an emergency worker. With 169 police officers assaulted in Bedfordshire last year, and 37 NHS workers assaulted in Bedford Hospital in 2016 (the last year official statistics are available), this law aims to help deter people from assaulting the workers who protect our public on a daily basis, and to ensure those that do face tough sanctions.

The new law has support from the Royal College of Nursing, Unison, the Fire Bridges Union, the Police Federation, The British Transport Police and the GMB union.

I am backing the Bill to #ProtectTheProtectors because I believe it’s unacceptable that the hardworking men and women in Bedford’s NHS, Fire and Police services face serious assault and abuse simply for doing their jobs. Any assault on emergency workers is unacceptable, and it’s time the law reflected the seriousness of attacks on people working for the public good. Assaults on emergency workers should not be viewed as an occupational hazard.

Society owes a debt of thanks to our emergency workers. Parliament now needs to give them the support and protection they need, and that’s why I supported the Bill today.

“In March I received a letter from Kathryn Holloway, the Police and Crime Commissioner for Bedfordshire explaining why this Bill was so important to protect our emergency workers.
In Bedfordshire, a police officer who has been assaulted is contacted by a member of the Senior Team within 72 hours or less of the assault.

Sadly, such calls are a weekly event.

24,000 police officers were assaulted in the year 2016/17 and over 70,000 NHS staff in England alone.

Assaults on emergency workers should not be viewed as an occupational hazard. While some judges will add an additional penalty if an assault on an officer is proven in court – it is not automatic.

And CPS judges have historically viewed that an assault in the course of arrest is to some extent just part of the job.

We must not tolerate this any longer.

We must put legislation in place guaranteeing a tough line on anyone who assaults an emergency worker – and this must extend to spitting – a disgusting and aggressive attack – and sexual assault.

The Regional Crown Prosecutor for Bedfordshire advises officers and staff to give the same amount of attention to their own witness statements as to those of other victims, and to provide Personal Impact Statements to the court.

The Chief Constable of Bedfordshire police has agreed to supply a supplementary Personal Statement in the event of any serious assault, detailing its impact on the Force and colleagues, to add weight to the argument for the maximum penalty.

But this kind of good practice is weakened without the legislation to back it up. That’s why this Bill is so important.”

NHS Waiting Times Abandoned

A number of constituents have contacted me to express concern about the Government’s mandate to NHS England for 2018-19, which confirmed that flagship waiting times targets for planned and emergency care have been abandoned for another year.

I share these concerns about the Government’s sustained underfunding and mismanagement of our NHS. NHS England recorded the worst ever A&E performance this winter, with over 1,000 patients being stuck on trolleys for over 12 hours and a 515% increase in patients waiting over four hours, compared with 2011.

The Government’s mandate has not set objectives for either the 18-week referral to treatment target nor the four-hour A&E target to be met within the year. I believe this is a clear admission by Ministers that they are failing to properly fund and resource our NHS.

Despite the very best efforts of our brilliant NHS staff, patients and their families will understandably be concerned by the downturn in standards. It is completely unacceptable for anyone needing urgent treatment to be turned away – patient safety must be an absolute priority – yet ambulance diverts have reached record highs as A&E departments nationwide are under relentless pressure.

The Royal College of Emergency Medicine (RCEM) has said patient care will continue to suffer unless funding for healthcare is increased on an urgent basis. In its report, Vision 2020, the RCEM calls for an additional 2,200 A&E consultants, 100 extra training places annually for four years, and more hospital beds.

Labour’s 2017 General Election manifesto pledged an additional £45 billion in the NHS and social care system to give patients the well-resourced services they need. The manifesto also outlined a long-term workforce plan to ensure safe staffing levels and to give staff the support they need. I believe this would have ensured the standards of service to which patients are legally entitled under the NHS constitution, prevented the routine breach of safe levels of bed occupancy, and guaranteed the four-hour A&E target.

I will urge the Government at every opportunity to give the NHS the funding it needs to ensure our health service remains a world class service all year round.

Alfie Dingley: Medical Cannabis Use Plea

A petition was handed in to Government on 20th March calling for six-year-old Alfie Dingley to be granted a special licence to use medical cannabis. I sympathise profoundly with the situation he and his family are facing, and with others who are in search of the most effective treatment or pain relief for medical conditions.

Alfie’s life is blighted by up to 30 violent epileptic seizures a day. He and his family travelled to the Netherlands where Alfie took a cannabis-based medication, which his family claim significantly reduced the number of seizures he experienced. It is understandable that his family want him to have whatever medication they feel will help him. I believe Ministers must ensure that all evidence relating to Alfie’s case has been examined and that all avenues of treatment are being considered to ensure that Alfie has the best possible quality of life.

This case is the latest in a long line of examples that have led to more calls for legislation to permit the medical use of cannabis, and while I do not agree with legalising cannabis for general use, I believe the Government should look carefully at the case for the use of cannabis or cannabis products as a medicine.

Currently, cannabis and cannabinoids are classified as a Class B controlled drug (depending on individual circumstances, Class B drugs carry up to 5 years in prison and an unlimited fine for possession, and up to 14 years and an unlimited fine for supply and production), and the Misuse of Drugs Regulations 2001 list cannabis as “a drug with no recognised medicinal uses outside research”. I believe that where there is evidence, the Government should consider the case for trials and the potential rescheduling of cannabis. This could enable its availability for use in healthcare in the UK.

The Government has said it is exploring every option within the current regulatory framework, including options of issuing a license to the family of Alfie Dingley. I will follow the Government’s progress closely.

Putnoe Walk in Centre

I have received many letters expressing concerns about the potential closure of Putnoe Walk in Centre.

The original proposal was for the creation of an Urgent Treatment Centre at Bedford Hospital to be completed in March , with the aim that this would be an enhanced walk in service in a more central location. They had intended to close the walk in element of the Putnoe Medical Centre as part of these plans.

Bedfordshire CCG tell me that they are required to provide this facility on the hospital site – it is ‘nationally mandated’  and has to be located next to hospital facilities– But providing an urgent treatment centre on the hospital site raises a number of questions to which I do not yet have an answer, including whether encouraging people to visit an already-crowded hospital site, with the Accident and Emergency facilities in the same area, would actual reduce the pressure on the existing A&E, and whether sufficient parking can be provided on the hospital site.

It would appear that the proposal to close the Walk in Centre, has, at least temporarily, been paused. The CCG are looking at how they can provide extended hour services for patients across the area and tell me that they have taken on board the overwhelming opposition to removing walk in facilities. Together with Labour Councillors, I am pressing for this facility to remain in Putnoe, and for other walk in facilities to be provided throughout the constituency. They are a vital service .

Along with Labour colleagues in Parliament, I will continue to make the case to Government that they need to tackle the crisis in NHS Funding and give our health service the money it needs to provide world class care, to stop privatisation and reinstate bursaries for trainee nurses, and to allow plans for the creation of Accountable Care Organisations proper democratic scrutiny at all levels.

Accountable Care Organisations

Accountable Care Organisations (ACOs) and Accountable Care Systems (ACSs) are being established by NHS England as a new phase in the development of Sustainability and Transformation Plans (STPs). NHS England aim to bring together local NHS organisations, in partnership with social care services, to join up the health and social care system. The Bedford, Luton and Milton Keynes STP is one of the ‘first wave’ of ACOs, and as such this is of particular interest to many of my constituents.

In September, the Department of Health launched a consultation seeking views on changes to regulations required to develop ACO contracts. The Government proposes to make these changes to the NHS without a vote in Parliament, and they will have legal effect from February 2018. These regulations will have far reaching implications for commissioning in the NHS and I agree with you that large scale organisational changes should be subject to proper scrutiny.

As it stands, there are unanswered questions about how ACOs will be accountable to the public, what the levels of private sector involvement will be, and what the implications will be for NHS staff. STPs have been controversial and concerns have been raised that they are a way for the Government to cut NHS services. The Government has not said how it will deliver the funding which would be needed to make ACOs work. Indeed, following the Budget, NHS England said that the Government’s financial settlement will mean the NHS will “not be able to do everything being expected of it” and that difficult decisions will need to be made about which services and treatments it can deliver.

I believe the sustained underfunding of the NHS is stretching the finances of our healthcare services beyond their limits, and there are reasonable concerns that ACOs could be used as a vehicle for greater rationing of treatment locally. In this context, I believe it is essential that the decision on whether to introduce ACOs into the NHS is taken in public, with a full debate and vote in Parliament. This is why the Opposition front bench has tabled an Early Day Motion (EDM 660), as part of a campaign to force the Government to hold a debate on these changes.

I have signed EDM 660 and I agree that the Government should provide Parliamentary time for MPs to debate and vote on whether to introduce ACOs into the NHS. The secrecy in which ACOs have been conceived and are being pushed forward is, I believe, unhelpful and contrary to the Government’s duty to be open, transparent and accountable in NHS decision-making.