Closing tax loopholes to fund our NHS

On Tuesday night the House of Commons voted down the Prime Minister’s EU Withdrawal Agreement.  The Prime Minister showed great statesmanship in the immediate aftermath of the defeat. She made a statement inviting the Opposition parties to table a vote of “no confidence” in the Government.  Jeremy Corbyn MP had previously threatened this but not delivered but on this occasion did accept the challenge. 

I hope the Prime Minister wins and on Monday she will make a statement setting out a plan that will enable MPs from all parties to work together to find a solution to the current impasse.  

I have a section on my website dedicated to the EU referendum and regularly update it. I am easily contactable and always happy to listen to or read the opinions of my constituents. 

Despite Brexit grabbing the headlines, my daily work for you continues at pace. Many and varied issues are raised with me during my weekly constituency meetings. Sometimes these require changes to a particular “system” and working with local people to do this is a rewarding part of my role, especially when I am able to help to bring about positive change.   

A good example was a local business person who told me how overseas sellers were undercutting his business by selling their products online and not paying their fair share of taxes. Having raised this with Treasury Ministers, HMRC has taken action and in 2016 introduced new powers that has enabled the collection of £200m lost VAT. HMRC recently reported issuing over 4,600 ‘red flag’ notices to online marketplaces such as Amazon, ASOS, Etsy and Ebay since 2016. 

The number of overseas businesses making applications for VAT registration has grown to 58,000, in comparison to just 1,650 applications between 2015 and 2016. 

These new rules protect thousands of local entrepreneurs as well as enabling previously uncollected taxes to fund our vital public services. This is just one tax avoidance and evasion measure amongst more than 100 introduced since 2010 that has generated more than £200 billion revenue. 

As regular readers know, I work closely with our local NHS leaders, doctors and nurses. During meetings with local GPs the impact of the increasing costs of indemnity insurance on their ability to provide local GP services was discussed. I raised these concerns with the Department of Health and after a great deal of work with the medical profession, I am pleased that a solution has been found. 

April this year will see the launch of the long-awaited government backed GP indemnity scheme. This was announced in October 2017 and will cover all practice staff performing clinical roles under a General Medical Services (GMS), Personal Medical Services (PMS) or Alternative Provider Medical Services (APMS) contract. 

The scheme will be free at the point of use and will cover all practice work, as well as extended and out of hours services. This will enable more GPs and healthcare professionals to work flexibly and improve the accessibility of healthcare services that we all depend upon.

First published in the West Briton 17/01/19

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Investing in the future of our NHS

Ensuring the long term, sustainable funding of our NHS is one of the most pressing and potent political issues facing the country. Demand for NHS and care services only continues to rise as our population changes, as we live longer and new treatments and technologies are developed. 

The Government has worked closely with the NHS to agree a five-year plan of increased funding, with agreed additional investment of at least £8 billion in real terms throughout this Parliament. In addition, the Government has now announced that it will invest a further £20 billion by 2023/24 to transform health and social care so it can improve treatment and deliver better care for patients. 

More money than ever before is being spent on mental health services. I have worked alongside our local NHS to secure investment for a new specialist inpatient unit in Bodmin which is now under construction. This will mean that children and young people do not need to travel out of the county to receive vital care. 

Following the death of two students on the Penryn Campus who took their own lives after their battles with mental health issues, I have secured assurances from the Cornwall Partnership NHS Foundation Trust and local Clinical Commissioning Group that they will work with the University to provide more support to students who are experiencing mental illness. 

While investing more money into the NHS and securing Cornwall’s fair share is important, so too is ensuring it is spent wisely. So, I was pleased that the Government has recently set out plans to enable the NHS to make significant improvements in technology and purchasing. 

A new NHS app will be piloted in 5 areas in England from next month, ahead of a planned national roll-out in December. Patients will be able to download a test version of the app, allowing access to booking GP appointments, ordering repeat prescriptions, access to their medical record, 111 online access for urgent medical queries, data sharing preferences, organ donation preferences and end of life care preferences. 

More than £200 million will also be invested to make a group of NHS trusts into internationally recognised centres for technological and digital innovation. The funding will support new Global Digital Exemplars in acute, mental health, community and ambulance trusts in England to set a gold standard of innovation for other services to follow. 

A new HealthTech Advisory Board, chaired by Dr Ben Goldacre, will highlight where change needs to happen, where best practice isn’t being followed, and will be an ideas hub for how to improve patient outcomes and experience and make the lives of NHS staff easier. 

Our hospitals operate dozens of systems each that don’t talk to each other. GPs, social care, pharmacies and community care are on different systems. Systems crashing is a regular occurrence. The social care system is not at all integrated, when its integration is vital. 

The generic technology available outside the NHS is a million times better. Now is the moment to put the failures of the past behind us, and set our sights on the NHS being the most cutting-edge system in the world for the use of technology to improve our health, make our lives easier, and make money go further. 

A modern health service shouldn’t involve 234 separate trusts spending time and money negotiating different contracts and prices for the same thing. An example of this price variation includes the lowest priced 12-pack of rubber gloves costing 35p, while the highest priced cost £16.47. That’s why the Government’s work to centralise how the NHS buys goods and services is crucial. 

By streamlining the process and freeing trusts up from having to do this, we will save staff valuable time, save huge amounts of money and be able to reinvest the savings into patient care and frontline services 

The Department of Health and Social Care anticipates the new supply chain will generate savings of £2.4 billion over a 5-year period, all to be ploughed back into frontline services. 

 First published in the Falmouth Wave October edition

Rising Living Standards and Wellbeing

How does a country measure its success? The most reported measure of success is economic with gross domestic product (GDP) probably most often quoted. Of course ensuring people have the opportunity to reach their potential in their chosen occupation is important and this week’s good news of record levels of people from all backgrounds and ages in employment and growing wages is welcome. More of our children and young people are receiving a good education compared to 2010 and average life expectancy continues to rise. All these measure progress.

There is a growing recognition that how we are doing as a nation is at least as much about people’s well-being as it is about the country’s economic health.

In November 2010, David Cameron established the Measuring National Well-being (MNW) programme. The aim was to monitor and report “how the UK is doing” by producing accepted and trusted measures of the well-being of the nation. Twice a year the independent Office for National Statistics report progress against a set of headline indicators covering areas of our lives including our health, natural environment, personal finances and crime.

The measures include both objective data (unemployment rate) and subjective data (satisfaction with job) to provide a more complete view of the nation’s progress than economic measures can do alone.

The latest update of the Measuring of National Well-being programme published in April provides a broadly positive picture of life in the UK, with most indicators either improving or staying the same over the short-term (one year) and long-term (five years). It shows the strengths and challenges of different age groups in society. These insights can help target services where they are most needed and can have the best impact.

This programme has led to significant positive changes in the development of policy, particularly the promotion of good mental health and a very welcome focus on understanding and treating mental ill health. We changed the law so that mental health is taken as seriously as physical health.

The fastest growing NHS spending is on mental health £11.86 billion last year, with further growth committed.  Spending by local GP NHS Commissioners on children and young people’s mental health services grew by £103 million between 2015/16 and 2016/17, up to £619 million. This is a 20 per cent increase year on year. I am pleased that our new residential children and young people’s mental health service in Bodmin is underway.

Last week, I visited Roseland Community College, an outstanding local school, and listened to children and staff who are participating in HeadStart Kernow. It’s a partnership between Cornwall Council, our local NHS, schools, voluntary sector organisations and the National Lottery. It aims to build resilience and mental wellbeing for children and young people and from what I heard is doing a good job. This vital prevention work matters to children now and in the future as the causes of mental ill health in adults often starts in childhood.

First published in the West Briton 17/05/18

Integration of Health and Social Care

Thank you to everyone who played their part in helping keep Cornwall warm, well and on the move during the recent very cold weather and storms.

Less noticeable but just as chilling as the recent weather is the further take over of our local Labour Party by the hard left. The resignation of the group leader on Cornwall Council follows others from across the country who describe bullying, intimidation, threats and anti-Semitism against themselves and colleagues who do not agree with the hard left Momentum, Corbyn’s support group within the Labour Party.

As Cornwall Council is led by Liberal Democrats, you may not think this matters too much to us locally. But it does. It is having a chilling effect on the decisions that the leadership of Cornwall Council need to take to improve our vitally important local public services.

Clear evidence of this is the press release snuck out by Cornwall Council last week while the Duchy was dealing with the impact of the severe weather.

The press release announced the decision of the Cabinet not to take significant action to improve our health and care system in Cornwall. They have chosen not to take the common sense step of joining up and integrating our health and care services. They will not support the development of a local Accountable Care System, despite the support of the leaders of our local NHS and care services and despite the success of this type of approach in other parts of the country such as Manchester.

Our whole health and care system in Cornwall is currently in “special measures” receiving additional help from NHS England to make the vital improvements we need to see. The past mistakes of Cornwall Council are well documented, poor social care commissioning, poor relationships with our local NHS and lack of integration of health and care services – all contributing to the current problems.

The Cabinet made one of the most important decisions that will effect every one of us – alone. Why did they not allow all our Councillors a say? Why no debate in public for us all to see? The Scrutiny Panel of the Council has been leading an Inquiry into a proposed Accountable Care System. The Councillors worked really hard with a wide range of health care professionals to inform their recommendations. Why is there work being ignored?

Why? Because the Corbyn led, Momentum controlled Labour Party is running a nation wide scare campaign against the creation of local Accountable Care Systems. They falsely claim this will lead to the privatisation and Americanisation of our NHS. The Inquiry into the Cornwall ACS investigated these claims and found that they were not true. However, our Lib Dem Council is running scared of making the changes that will improve services for local people because they are bowing to this pressure.

The leaders of Cornwall Council have put politics before people. Along with my Conservative Cornwall Councillors I urge them to rethink and enable the whole Council a say.

First published in the West Briton 08/03/18

Supporting high quality local journalism

Last year, as part of the BBC charter renewal process, I campaigned for greater investment in high quality local journalism. BBC Radio Cornwall and Spotlight do a great job but I think we need additional news reporting. As more decisions, including about public expenditure is devolved across the UK, including Cornwall, it’s more important than ever that the media hold to account local politicians and public services.

I am pleased that the BBC set aside £8m a year to pay for 150 reporters, who will work for local news organisations rather than the BBC. The three Devon and Cornwall journalists cover council meetings and public services and share their stories with the BBC.

Getting to the heart of an issue should be straight forward. After all, we live in an age when it has never been easier to communicate and more data is published by independent and trustworthy sources like the Office for National Statistics than ever before. The Parliamentary website is a mine of free, impartial, expert and topical briefings.

Robust high quality journalism is important for public scrutiny and underpins democratic debate – but as print circulations decline and more readers move online, the press faces an uncertain future.

So I am pleased that the government has recently launched a review that will look at the sustainability of the national, regional and local press, how content creators are appropriately rewarded for their online creations, and ensure that the UK has a vibrant, independent and plural free press as one of the cornerstones of our public debate.

Transparency about MPs work in Parliament has helped improve public scrutiny. Given that there isn’t an equivalent to the Hansard Report of everything said and voted on in Parliament, we rely on journalists attending and reporting on local council meetings to shine a light on proceedings. Cornwall Council has large budgets and increasing influence about the future of local NHS services, house building and economic development, yet while some meetings are webcast and some papers published, it lacks transparency.

While the three additional BBC funded local journalists are a step in the right direction, I think more should be done and hope that the review will enable more high quality local journalism.

Finally, in response to a letter published in this newspaper last week, I thought you would appreciate this update on the facts. I had secured the commitment from NHS England to review the formula used to allocate funding not only to local NHS commissioning groups but also for treatments in hospital.

I have requested data from the leadership of the RCHT to make the case for how the formula needs to change for the benefit of patients in Cornwall.

Along with my Cornish MP colleagues we did secure a change in the formula that allocates funding to our local NHS Commissioners that sees Cornwall receiving more than the England average per person. I am determined to secure the further change necessary so the RCHT receives its fair share of funding.

First published in the West Briton 22/02/18

Welcoming record funding for Cornwall’s NHS

Like most local families, I depend on our local NHS and will continue to work hard to ensure we have high quality local NHS services.

NHS staff provide invaluable support to us all in our time of greatest need and deserve our deepest gratitude for their tireless efforts, particularly during this challenging winter period with so many people suffering from flu.

In 2010, the Conservative-led coalition government faced perilous public finances. Many public services had to make significant savings to help reduce Labour’s deficit, which stood at record levels in 2009/10. The Department of Health’s budget has been consistently protected since 2010 and continues to rise.

It is absolutely false for Labour to claim that the Health budget was cut since 2010. The 2010 Spending Review included real terms increases in overall NHS funding; an additional £1 billion per year for social care; a new cancer drugs fund, expanding access to psychological therapies, and continued increases in staffing.

From 2015, the Conservative Government continued to increase investment in the NHS: from £101 billion in 2015 to £120 billion by 2020.

Far from lagging behind similar nations, new research from the Nuffield Trust shows that the UK spends above the EU and OECD averages on healthcare, as a percentage of GDP. It found that Britain spent 9.8 per cent of its GDP on healthcare, compared to the average for the EU-15 of 9.7 per cent.

This investment will ensure that everyone has access to NHS hospitals and GP services 7 days a week. There are now over 11,000 more doctors and 11,000 more nurses working in the NHS than in May 2010. The number of patients being treated is at record levels and public satisfaction amongst hospital inpatients is at its highest levels in more than two decades.

This Government has a proud record of investing in the NHS: in 2017, £435 million was provided to the NHS to prepare A&E departments for the winter and to support the NHS throughout the most challenging months of the year. An additional £2 billion is being invested in Adult Social Care, which will relieve pressure on the NHS, and the NHS is offering free flu jabs to 21 million to protect them this winter, the highest number ever.

Since being elected in 2010, I have worked hard to ensure that our local NHS is fairly funded. The totally impartial House of Commons Library has produced a briefing providing information about NHS funding in Cornwall. It shows we receive more per head than the England average. A copy is on my website or please call my office 01872 274760 and they will send you a copy in the post.

Please be assured that during this time of unprecedented demands on our NHS, I will continue to ensure that funding for health and care in Cornwall continues to increase. But it’s not just about more funding, it’s also about joining up health and care services for patients and families in Cornwall.

First published in the West Briton 01/02/18

Special Measures

Like my constituents, my family and I depend on our local NHS and care services. We all want Treliske to deliver good quality and safe healthcare with people not having to wait too long for treatment. I know that the staff at Treliske work hard to deliver high quality healthcare, often in challenging circumstances. The government is committed to enabling the staff at Treliske to deliver high quality and safe services at Treliske.

In the last few years, the regulators of our NHS and care services have been given more resources to undertake rigorous, independent reviews. The Care Quality Commission recently recommended “special measures” for Treliske. This means that NHS England will provide additional support to help Treliske make improvements. Other hospitals have undergone the same process and have come out stronger. It’s not an easy process but it can work.

As is well documented, one of the main problems at Treliske is the fact that people who should be treated at home or in a more appropriate care setting are not. The Care Quality Commission highlighted the issue of delayed transfers of care and the need for Cornwall Council to work more effectively with our local NHS. Cornwall Council has been given additional funding for social care and needs to spend this money on social care now.

There will be those that say it’s all about more funding. Of course our NHS needs to be well funded. Every year Cornwall’s NHS does receive more funding. Cornwall currently receives more than the English average funding per person. As important as the amount of money is how that money is spent. With support from NHS England, our health and care system leaders now have the opportunity to deliver improvements. I will continue to do everything that I can to support them.

First published in the West Briton