Matt Hancock on the challenges facing the NHS in England

The new Secretary of State for Health and Social Care, Matt Hancock, has appeared before a session of the Health and Social Care Select Committee where he has discussed the current state of provision and his future priorities. The highlights of the two-and-a-half-hour session are summarised below.

While the Committee welcomed the Government’s commitment to more NHS funding in England, they noted that the 3.4% real-terms increase translates to only 2.3% once adjusted for age and population. The Committee’s Chair, Dr Sarah Wollaston MP, noted that despite the Secretary of State setting out three priorities — workforce, technology, and prevention — this budgetary increase would not apply to Health Education England (responsible for training new NHS workforce), nor to public health and social care because these are funded via local government. The Committee also challenged the Secretary of State to clarify where he was willing to scale back ambitions in order to focus on these priorities.

The Government’s upcoming Green Paper on social care was also discussed, with the Committee cautioning that it needed to cover all forms of adult social care, rather than simply focusing on elderly care. The Committee asked for the Secretary of State’s opinions on integration between health and social care, and how he intended to improve this. Notably, in his response Hancock was adamant that he wanted to resist the instinct to conduct another top-down reorganisation, instead favouring an “evolution” of existing arrangements towards greater integration.

This sentiment was echoed when the Committee asked about the current state of STPs, with the Secretary of state renewing support for such partnerships, saying that these bodies should be allowed to find new and better ways of integrating care in line with an ethos of “collaboration, not competition”. Dr Paul Williams MP from the Committee picked up on this phrase, asking how this outlook was compatible with a situation where CCGs feel they have to put services out to market even where they believe integrating them internally is in the interests of patients.

The Committee also discussed mental health spending, and the funding and staff that would be required to bring outcomes up to parity with physical health. Luciana Berger MP from the Committee raised an Institute of Fiscal Studies estimate that £27bn would be required to go from 30% of those needing treatment getting it, up to 70% provision. Dr Williams also raised the issue of the number of doctors leaving the profession, and concerns over workload and below inflation pay increases. The Secretary of State’s response talked about shifting responsibility to non-GPs, with nurse practitioners seeing cases that do not require a GP.

Data-sharing, data-protection, and the need to strike a balance between the two was discussed. Notably, when the Secretary of State was questioned about the concept of putting control of medical records in the hands of individuals, he described the proposal as an “incredibly positive step”.

The Committee raised issues around balancing access to urgent care with asylum rules and eligibility for NHS services. The Committee also discussed at length the issues arising from the UK’s impending exit from the EU, particularly contingency plans on provision of medicines in the event of a no-deal Brexit. Luciana Berger highlighted the challenges posed by logistics surrounding medical radio-isotopes, which are used in the treatment of 800,000 people a year, and which the UK does not produce and cannot stockpile. The Committee also raised the issue of the 150,000 EU nationals in the UK’s health and care systems, and the effects on staffing should a significant proportion of these people choose to leave the UK in the coming years.

The full transcript is available here.

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Published 24. July 2018 in News UK