Speeches by Beales.

“That is very helpful. Finally—I am running over time—the letter also mentions the development of a new urgent and emergency care strategy. Sarah-Jane, this might be a question for you. Why is that strategy needed? How will it be different from, or add something to, the existing strategies or, for instance, the A&E mode…”

“How long do you envisage the support package for those 30 areas being in place for, in the evolution from trust to system?”

“So you see this as the first stage?”

“Do the 30 areas need system-wide plans for their area, based on all the partners rather than just the trust?”

“Sorry to interject, but in answer to previous questions you have spoken about the plans being very much focused on and owned by the trust. You are now talking about the identification, the broader systemic issues, the relationships with primary care and mental health, which we heard about from the previous panel, and h…”

“The RCN talked about accountability and leadership being key, and you have touched on that as well. This issue is vital, but can I take you back to whether it is a wider systemic issue with trusts, management and leadership performance? On leadership and accountability, it should not take a strategy or the GIRFT progra…”

“What will the support for the 30 trusts look like in practice? Professor Briggs, you may want to elaborate on this. Is it purely about giving advice and sharing knowledge? If the identification of resourcing-based issues, capital investment issues or wider systemic interrelationships with parts of the system come up, w…”

“This Wednesday marked Holi, a festival celebrated by millions around the world and here in the UK. Last year, I had the privilege of celebrating Holi with Hindu cultural groups in West Drayton and Uxbridge. We threw colourful paint and played traditional games, and children described what the first Holi festival that t…”

“It is a pleasure to serve under your chairmanship, Dr Murrison. I thank my hon. Friend the Member for Rugby (John Slinger) for securing this important and timely debate. Social cohesion can feel like quite an abstract, nebulous term, but we all know, and have heard today, that the practice of social cohesion and how it…”

“Should the NHS take the same approach to pharmaceutical interventions as well? Obviously the NHS is contracting Lilly and others around injectables. Rather than a simple price-based approach, should there be an outcomes-focused approach? I think Susan talked about the requirement that the private sector develop wraparo…”

“So you are actively finding the most in need.”

“I am not necessarily mandating either one. I am just asking whether you believe a referral-based payment system is the right approach. Whether it is a primary care-based incentive, a provider incentive or an incentive for the ICB, do you think that a more outcomes-focused incentive approach is a better way of using the…”

“I guess that QOF does different things, though. For example, in the diabetes world, you can refer someone to book a diabetes education course, and there is a QOF for that. I guess that QOF was changed to attendance at a course to encourage a good referral and actively ensure that the GP service played a role in making …”

“Does anyone else on the panel want to talk? Susan, you wanted to come in.”

“We touched before on GP-based payments. Following on from that point, Claudia, do you think the payment system needs to have a more graduated focus that heavily incentivises the most in need, rather than a blanket payment approach for referrals? Do we need a smarter payment system that looks at outcomes as well as refe…”

“Is that via primary care, secondary care or local authority public health?”

“How do you deal with the capacity issues that you touched on earlier as being the priority, as opposed to incentivising referrals. We know that there are capacity issues to get people into services. If you are proactively going out and finding people, and we are already struggling as a system to deal with the people wh…”

“Where you do believe that would sit in the system best, in terms of outreach and proactive engagement?”

“That is helpful.”

“But you would potentially get no wraparound support? If I went to Pharmacy4U or something and ordered an injectable, I would not necessarily get any contact from my GP, a health professional or a health hub. But if I went on an app, felt I needed something and referred myself to a programme, or share my interest in it,…”