Speeches by George.

“You want a regulatory environment that gives you greater flexibility, and there certainly seems to be an environment in which you are either exonerated or publicly hanged and flogged. There seems to be no in-between way of resolving issues so that you are supporting doctors. How would you see that being delivered?”

“I have one final question on this. In your risk register, the risk of delay and omission is given the red rank. What types of omissions are you concerned may be made, and how has the Department responded to your concerns?”

“There are budgetary pressures to find intermediate people on lower salaries to undertake the functions that a higher-paid person was undertaking before. You mentioned anxiety and controversy. To what extent do you think the GMC has a role in quelling or resolving the controversies and anxieties within the profession? D…”

“What can you say to reassure us that you are having those conversations, and that you are not just saying there are conversations behind closed doors where we are supposed to imagine what they are?”

“Moving on to the legislation under which you operate, you have described it as antiquated, and you are certainly running two parallel frameworks at the moment. The Government have acknowledged—certainly the previous Government did, but I believe the present one also have—that it is unacceptable that the GMC can appeal …”

“As my hon. Friend knows, I strongly support his proposed legislation; indeed, I am a sponsor of it. Does he agree that, in order to advance new regulations, the Government need to review whether there is sufficient bridleway capacity across the countryside to avoid the necessity of using roads? It is clear that there a…”

“I thank the Minister for his reply. He has described the impact that the storm has had on our communities. As he rightly says, west Cornwall and the Isles of Scilly took the brunt of the storm, but it nevertheless had a devastating effect throughout Cornwall, south-west England and beyond. Nursing home patients were ev…”

“(Urgent Question): To ask the Chancellor of the Duchy of Lancaster if he will make a statement following Storm Goretti.”

“We all agree that it is better to shift from hospital to community. People want to be treated closer to home, not further from home. But the expert panel found that it would be completely inappropriate to shift the burden of palliative care into the community unless sufficient planning and resources were in place. You …”

“As well as the patient, there is also the family around them in the home. The expert panel identified that the value of unpaid carers is effectively about £29 billion, in terms of supporting those in need of end-of-life and palliative care. Is that going to be part of your MSF? Is your MSF going to be integrated with o…”

“Right.”

“That seems to be contrary to—”

“You mean there is a gradual diminution of numbers and proportions that are admitted.”

“More so than a residential home? There would be admissions to hospital from there.”

“Looking more widely, I think the patient and family point of view is, yes, shift out to the community, but to a certain extent there is a fear of out of sight, out of mind, and they would feel safer in the hospital. There is not the 24/7 access to medication, advice and specialist palliative care when needed. Therefore…”

“On the question of geographical coverage, and given the Minister’s comment that he has not received representations about further areas for inclusion, I urge the Government to review the scheme and to take an objective measure themselves of where else it might extend to, rather than inviting us to form an orderly queue…”

“Okay. The question was about the integration, rather than the funding.”

“Yes, it is. But Cornwall Hospice Care—St Julia’s, as was—has been hit by the national insurance increase, which cost it a quarter of a million a year on its turnover. There seems to be a balancing message at the moment, but certainly one that puts it under a lot of pressure.”

“But you are sending them two messages: on the one hand, they must work within their budgets; on the other hand, they must not engage in recruitment freezes. The two things do not add up at the moment, do they? You have left them in an impossible position.”

“Will the Minister give way one more time?”