This week, news has been dominated by the Government’s introduction of the European Union (Notification of Withdrawal) Bill to the House of Commons, which will be used to confer power on the Prime Minister to invoke Article 50 to leave the EU. The Bill has been allocated two days for its Second Reading debate on Tuesday 31st January and Wednesday 1st February, before being considered and concluded in Committee between Monday 6th February and Wednesday 8th February. The current suggestion is that the Second Reading in the House of Lords will take place on Monday 20th February, before completion of the Bill’s passage by mid-March.
The introduction of the Bill followed the Supreme Court’s decision that Parliament should give its approval before official negotiations on leaving the EU begin, dismissing the Government’s argument that this isn’t needed. The Labour leader Jeremy Corbyn will impose a three-line whip on the passage of the Bill so as “not to block Article 50”, but a number of MPs have said they will vote against it, including the former leadership contender Owen Smith. The Government will also publish a White Paper on its ambitions for negotiations, but there is not currently a commitment to publish this before the passage of the legislation.
The Health Secretary Jeremy Hunt has appeared before the Health Select Committee to give evidence on the impact of Brexit on healthcare. Health Committee Chair Dr Sarah Wollaston wrote to Hunt in December warning that leaving the EU will have major consequences for a wide range of health and social care issues, including public health, but Hunt told the Committee that his department is well prepared.
In other news, the Scottish Government has published a consultation seeking views on draft guidance on Healthcare in Schools; Labour MP Catherine West received an answer to her written question on diagnosis of chronic urinary tract infections; a survey of head teachers has shown that school budgets are in serious difficulties; and the Royal College of Paediatrics and Child has launched a report calling for Government to reverse cuts to public health.
Hunt gives evidence on impact of Brexit on healthcare
Health Secretary Jeremy Hunt appeared before the Health Select Committee this week to give evidence on the impact of Brexit on healthcare, taking questions on how the Department of Health and NHS planned to deal with this.
Responding to a question on the DH’s capacity to handle leaving the EU, Hunt said that the department has a director who is full-time on Brexit and a Brexit programme, and that the department has “done a review of every area of departmental policy to see which ones are going to be affected”. He said an estimated two-thirds of DH officials will have some involvement with Brexit policy at some levels, stating that “we are confident we have enough resources to deal with Brexit.”
Hunt also acknowledged that leaving the EU will have implications for the NHS. He said the UK will need staff from Europe in the short term but that he wants the country to become “self-sufficient” in its number of doctors. He also suggested that the benefits of increasing medical training places will not be felt until the middle of next parliament.
However, figures showing that the number of EU nurses coming to the UK has fallen 90% since the Brexit vote might cause some to question whether this increase will happen soon enough. Released after Hunt’s appearance in front of the Health Committee, the statistics from the Nursing and Midwifery Council show that the number of nurses and midwives from other European nations joining the register to work here dropped from 1,304 in July to 101 last month.
Commenting on these figures, Janet Davies, chief executive of the Royal College of Nursing, said: “With 24,000 nursing vacancies across the UK, the NHS could not cope without the contribution from EU nurses. Without a guarantee that EU nationals working in the NHS can remain, it will be much harder to retain and recruit staff from the EU, and patient care will suffer as a result.”
Answer received to written question on diagnosis of chronic urinary tract infections
Catherine West MP (Labour, Hornsey and Wood Green) has received an answer to a written question on diagnosis of chronic urinary tract infections. Ms West’s question asked how many patients have been diagnosed with chronic urinary tract infections over the last 12 months. In response, Health Minister David Mowat said that there were 196,692 finished hospital admission episodes with a primary diagnosis of urinary tract infections in England in 2015/16.
Scottish Government seeks views on Healthcare in Schools guidance
The Scottish Government has published a consultation on draft guidance on Healthcare in Schools, the purpose of which is to inform local policy development between NHS boards, education authorities, schools and other partners in supporting children and young people with healthcare needs in schools.
Chapter two of the guidance is most relevant for the PCF, as this sets out the rights and responsibilities of all concerned with healthcare in schools, including the school health team. This states that the role of the school health team is “to provide support to children, young people and their families in school and provide advice, guidance and sometimes support on supporting healthcare needs in school.” These functions will be provided by a team of staff employed by the NHS board working collaboratively with the education authority within schools and communities, and (among others) may include healthcare support workers, community children’s nurses, and other registered nurses working within schools.
Chapter 5 of the guidance is also states that “staff in schools and the wider school health team must make reasonable adjustments to ensure that children and young people with healthcare needs are enabled to participate in the opportunities that learning provides.” This includes school trips, sporting activities and work placements.
School budgets near “breaking point”, survey warns
A survey of more than 1,000 schools by the National Association of Head Teachers (NAHT) shows that two-thirds of schools are making ‘significant’ cuts or dipping into reserves to stave off deficits, with four in five school leaders stating that budget cuts would have a negative impact on standards. The Government said it had protected the core schools budget in real terms, but the NAHT’s Breaking Point survey for 2016-17 shows that the number of schools in deficit has risen to 18% – up from 8% in 2015. The findings show that 71% of head teachers balance budgets by making cuts or using reserves; 72% fear budgets will be unsustainable by 2019; and 85% save money by spending less on new equipment.
Heads indicated that the main cost pressures are policy changes, including the decline in local authority services and the abolition of a central government grant which allows councils to support schools supporting greater numbers of pupils with mental health issues. NAHT general secretary Russel Hobby said the funding schools receive is not keeping up with the expenditure they face. Citing a 2015 Institute for Fiscal Studies report, he said the Government’s funding commitment equates to the first real terms cut in education spending since the 1990s. The Shadow Education Secretary Angela Rayner argued that it was wrong to impose a choice on schools between whether to cut school staff or invest in new equipment on head teachers.
Dr Geraldine Walters gives interview on new NMC standards
Dr Geraldine Walters, the Nursing and Midwifery Council’s (NMC) director of nursing and midwifery education, standards and policy, has given an interview to the Nursing Times on the NMC’s revised pre-registration nurse training standards. The standards are currently being developed to better reflect requirements placed on nurses, having last been updated in 2010, in a review led by Professor Dame Jill Macleod-Clark which will consult nurses in the spring. Dr Walters said that the updated standards need to provide clarity on the “exact set of clinical skills and tasks newly qualified nurses should be able to do”.
Dr Walters also highlighted that due to changes to the skill mix of healthcare professionals – which will soon grow to include nursing associates – students need to be better prepared to deliver more care in the community. She said that the NMC is considering incorporating some of the components of the specialist community public health nursing training, given to health visitors and school nurses, into pre-registration education. Beyond this, the updated standards are expected to focus on mentoring requirements and the potential for defining a standard set of clinical tasks necessary for all students to do by the end of their training.
RCPCH: cuts to public health budgets disproportionately affect children’s services
The Royal College of Paediatrics and Child Health (RCPCH) has published a report warning that cuts to public health budgets in England are disproportionately affecting children’s services and putting early intervention at risk.
The College’s annual “State of Child Health” report stated that there have been improvements in child health in recent decades, but indicated that the UK still lags behind much of Europe in areas such as infant mortality, smoking during pregnancy and breastfeeding rates. The report called on the UK Government should develop a child health and wellbeing strategy, adopt a ‘child health in all policies’ approach, and reverse public health cuts to address this.
The report attached particular importance to school nurses, stating that “school nurses play a vital role in early identification and intervention, preventing more serious problems later in life” – and that “these services must be preserved”.