Select Committee
Parliament

Anne Marie Morris moves on to ask Chris Wormald about the bigger financial picture and how all the relevant aspects of the health service can be measured.

Mr Wormald says the Better Care Fund "creates a framework for looking at these issues".

"I do think we've made a lot of progress at making all these things work together," he says.

Simon Stevens says there are models of cooperation across England.

Lib Dem John Pugh takes up the point, describing a case that he says demonstrates a lack of "systems management" in co-ordinating all the services.

Simon Stevens agrees that each piece of the system might be doing the right thing, but that the "combined result" is poor care for the patient.

He says improvements in overall systems management will be the "real litmus test" for how well all the NHS's improvement plans are working.

Chris Wormald says "structural changes are rarely the answer", he says it comes down to good relationships between the individuals running the services on the ground.

Mr Pugh says some systems management has been "stripped out" by recent NHS reforms, but Mr Stevens they are not talking about something that once existed and has been taken away, integration of services is a new development.

House of Commons
Parliament

Labour's Owen Smith acknowledges that the debate is about NHS England but says he has been "goaded" into speaking about NHS Wales.

He accuses the government of demoralising NHS staff and undermining faith in its services. 

He says Wales has better ambulance response times and shorter cancer treatment times. 

He acknowledges that some parts of the Welsh health service falls behind England but he puts this down to a poorer, older, rural post-industrial population.

He concludes that the differences in health services is negligible. 

House of Lords
Parliament

While votes at committee stage are rare, they do occur on the most contentious matters. On Monday, peers defeated the government to add a clause to the bill specifying the autonomy of universities.

Labour spokesman Lord Stevenson claims that ministers are not taking peers' concerns about the bill on board and appeals for greater "engagement".

He addresses government spokesman Viscount Younger: "I do appeal to him to think hard about what happened on Monday."

If the Conservative front bench does not do so, Lord Stevenson warns: "I sense trouble."

House of Lords
Parliament

Liberal Democrat peer Baroness Garden of Frognal still thinks that part-time courses should be represented "on the face of the bill".

Otherwise, she argues, such courses and students "will be overlooked in the massive move to promote the traditional full time courses".

She withdraws her amendment to require the Office for Students to have regard to part-time and distance learning, but adds that she is likely to introduce a similar proposal when the bill reaches its next stage.

This is in keeping with House of Lords convention at committee stage, in which votes on amendments are rare. However, votes are common when a bill returns to the House for report stage.

House of Commons
Parliament

Labour's Mark Hendrick tells MPs that only four hospitals in the country are currently meeting the target of seeing 95% patients within four hours.

He says this is "testimony to the cuts being forced" on the NHS and local government social services.

He urges the government to increase funding on the NHS "as a matter of urgency".

Select Committee
Parliament

Anne Marie Morris asks how NHS Improvement will "mark the homework" of the various shared development plans.

Jim Mackey says NHS Improvement will "challenge them on their assumptions" and negotiate on the funding required to implement the plans.

Mr Mackey says NHS Improvement will be looking at the basis for the contracts agreed in the SDPs, and looking at how realistic their assumptions on rates of demand are.

If individual plans are "miles off what is deliverable" they will work with other providers who have been able to draw up more workable plans.

Ms Morris says she doesn't believe the people drawing up the SDPs are well enough informed about the new models of care being developed.

Mr Mackey agrees some SDPs are more advanced than others, but that it is up to all providers to exchange information.

House of Lords
Parliament

Higher education spokesman Viscount Younger of Leckie says "the government wholeheartedly agrees" about the important contribution of part-time and mature students.

He insists that the new regulator, the Office for Students, "will promote student choice" and the bill gives it "a general duty" to consider all students.

He disagrees with proposed amendments which would give it an explicit duty to have regard to part-time and distance learning, arguing that this could lead to the organisation being overburdened.

Select Committee
Parliament

The SNP's Philip Boswell asks how the cutting of both acute hospital beds and social care funding can be justified.

Simon Stevens says he is campaigning against cuts to social care, but says the reduction in acute care beds is due to the modernisation of treatments and health care generally.

Chris Wormald says the government has taken "immediate steps" to release extra funds for social care.

House of Commons
Parliament

Conservative Andrea Jenkyns begins by attacking the Red Cross' comments that the situation in hospitals is in a "humanitarian crisis".

She attacks the claim as "ill-thought, sloppy and irresponsible".

She notes that registered charities are "legally obliged" to be neutral.

She suggests that if the chief executive, Mike Adamson, cannot be neutral "he should examine his position".

House of Lords
Parliament

Crossbencher Baroness Wolf of Dulwich, a professor at King's College London, says a commitment by the Office of Students to part-time learning should be "central to their concerns" rather than "something you add on at the end".

Labour education spokesman Lord Stevenson of Balmacara agrees that the interests of part-time and mature students should be "central" and the bill should be amended to reflect this.

Select Committee
Parliament

Responding to a question from Comptroller General Amyas Morse about why other comparable countries spend more on healthcare, Simon Stevens cites a Daily Mail article as being an "accurate reflection" of NHS spending on doctors, beds and scanners.

He says that the NHS is however more efficient than the health services offered in other developed countries, and that accounts for much of the lower spending in the UK.

Select Committee
Parliament

Simon Stevens says NHS England will be publishing its update on the five year forward view in March, covering the next two years.

Mr Stevens says 2018 is predicted to be the "toughest" year for the NHS in terms of funding.

He says the March plan will set out what the NHS is able to deliver against targets, with particular focus on GP, cancer and mental health services.

Ms Smyth asks him if the March document will address the "decline in social care services".

"It'll have to," he says.  He says no-one disagrees with the fact that the lack of social care is causing delayed discharge from hospital.

House of Commons
Parliament

Labour's Catherine West notes that she is following two former chief whips (Rosie Winterton and Mark Harper).

She ponders what the collective noun for a group of chief whips is.

"A crop?" someone offers. 

House of Lords
Parliament

Among the peers speaking in support of "life-long learning" is former education secretary Lord Blunkett.

The Labour peer says that offering part-time courses can help universities to "reach out and become essential parts of their own community, as well as reaching out internationally".

House of Commons
Parliament

Conservative Mark Harper argues that savings had to be made, to ease the budget defecit.

However, he says that local authorities had a choice over what to cut. He tells MPs that in his area of Gloucester the council chose to prioritise adult social care.

Select Committee
Parliament

Labour's Karin Smyth asks about government attempts to reduce demand on the NHS.

Chris Wormald says more people need to be treated in primary care settings, and in the long term for people's overall health to be better so that they use the services less.

Mr Wormald says there is "a lot of progress" on smoking and teenage pregnancies. He says more progress is needed on mental health and obesity.

Ms Smyth asks Jim Mackey why the NHS is still busier in the past two years despite government efforts to reduce demand.

Mr Mackey says there has been a particular spike in respiratory diseases in older people this winter, and that better health care is actually leading to more hospital admissions of people who "five years ago would have been no longer with us".

House of Commons
Parliament

Labour's Louise Ellman notes that there has been much comment about hospitals.

However, she urges MPs to also focus on services provided outside of hospitals such as community pharmacies and social care.

If they are working effectively, she says, people can leave hospital faster.

She expresses "extreme concern" about government cuts to community pharmacies. She asks ministers to think again.