Westminster Hall

Thursday 10th October 2024 Westminster Hall

Thursday 10 October 2024

[Peter Dowd in the Chair]

Mental Health Support

Thursday 10th October 2024 Westminster Hall

13:30

[Sojan Joseph (Ashford) (Lab)]

I beg to move,

That this House has considered improving support for mental health.

It is a pleasure to see you in the Chair, Mr Dowd, and I am pleased to have secured this important debate. As today is World Mental Health Day, it is particularly appropriate that we have the opportunity to raise awareness of mental health issues and the mental health system in this country. It is important to reflect on how far we have come in this country in removing the stigma around mental health, and I hope this Parliament will play its part in continuing that progress. However, if we are to do so, we must be honest about the many challenges we still face. I also want to declare a personal interest: before being elected in July, I spent 22 years working in the NHS, primarily in mental health.

One of my main motivations in standing for Parliament was to play my part in building an NHS fit for the future. Improving support for mental health will be an integral part of that. With that in mind, I want to put on record my thanks to my former NHS colleagues working in the mental health system. They do an incredible job in incredibly difficult circumstances. It is important to say at the outset of this debate that any criticisms of the current system are not directed at the workforce. Without their hard work and dedication, the problems faced by those in need of mental health services would be far worse. I know from my own experience that in recent years, their work has often been made more difficult by policies imposed at a national level by the last Government. Even when it was clear that those policies were having a detrimental impact, Ministers were unwilling to make concessions.

Although the mental health workforce has expanded in recent years, it has only reached the same number of staff as it had when the last Labour Government were in office in 2010. More needs to be done regarding the recruitment and retention of staff, as underlined by the high number of vacancies. NHS data shows that in September last year, there were 28,600 vacancies, amounting to 19% of the total workforce and causing an increased reliance on agency staff. In the year to September 2023, there was a 19% turnover in the overall workforce. Those figures from the King’s Fund highlight the extent of the recruitment and retention crisis.

From my work as a manager in mental health services, I know that experienced staff play a vital role, and a vast amount of time has to be spent recruiting new experienced staff when they move on to different posts. That has meant that often the most challenging environments have been run by staff with the least experience. That obviously has a negative impact on patient care and can lead to an increased incidence of aggression and abuse of staff. It is therefore not a surprise to see staff shortages having a negative impact on staff morale. The King’s Fund has shown that in in-patient services, staff regularly work extra hours or additional shifts and often find themselves in environments and with patients they are unfamiliar with. Similarly, staff in community services say they are worn out and find their work frustrating and stressful.

For 14 years, we have had a string of Prime Ministers and Ministers speaking about achieving parity of esteem between physical and mental health in the NHS. While I do not doubt the intentions behind achieving that goal, after 14 years of Conservative Government we do not have that parity. Indeed, as Lord Darzi made clear in his excellent report:

“There is a fundamental problem in the distribution of resources between mental health and physical health. Mental health accounts for more than 20 per cent of the disease burden, but less than 10 per cent of NHS expenditure.”

Although there has been increased investment in mental health services at a higher rate than the overall NHS budget, there is still a large gap between resources and demand. It is little wonder that all the talk of parity has seemed little more than warm words. I genuinely hope that under this Government things will finally change. I should point out that when we talk about waiting lists, those waiting in the mental health system are never included. Will my hon. Friend the Minister say something about that and explain how the Government plan to put parity of esteem into practice? Can he also say whether the Government will continue to increase investment in mental health services at a higher rate than the overall NHS budget during this Parliament?

Lord Darzi’s recent report states that around 3.6 million people are in contact with mental health services, and in April this year around 1 million people were waiting for mental health services. As he makes clear, it has become all too normal to have to wait a long time to access mental health services. The NHS’s own data shows that in April this year, 10% of people who had been in contact with mental health services and were waiting for their second contact in adult community mental health services had been waiting for at least 116 weeks. All the evidence indicates that today we have a mental health system that is overstretched and under-resourced. In fact, there has never been so much demand for mental health support, with one in four people experiencing a diagnosable mental illness each year.

Figures from the British Medical Association indicate that last year there were a record 5 million referrals to mental health services in England. That is up by 33% on the number of referrals in 2019. The increase in the prevalence of depression over the last decade is a good example of how our mental health as a nation has got significantly worse. In 2012, the prevalence of depression was 5.8%. By 2022 that had more than doubled to 13.2%. In my own constituency of Ashford the figure was even higher, at 17%.

Given the increased prevalence of mental health issues, I was pleased that in the first King’s Speech of this Labour Government we saw mention of legislation to modernise the Mental Health Act 1983. The proposed legislation has been welcomed across the sector. It is an important opportunity to improve care and strengthen safeguards for people who are admitted to mental health hospitals. I hope the new Bill will address the fact that someone who is black or living in a deprived area is almost four times as likely to be sectioned under the Act.

Will my hon. Friend the Minister tell me when we can expect to see the Government’s legislation introduced in Parliament? As Lord Darzi identified in his report, the lack of capital investment in places where people are sectioned means that a lot of those places are unsuitable, outdated and unsafe. From my own experience, I know that nurses, managers and matrons spend a lot of time trying to get capital works done in an NHS trust.

People living with a long-term physical condition are 50% more likely to suffer from mental ill health, while those with Parkinson’s disease are twice as likely to be at risk of suicide. That underlines the importance of a wholesale change so that support can be accessed at an early stage. Too often, people can access support only after they have ended up in crisis. NHS figures show that in July there were just over 40,000 new urgent, very urgent or emergency referrals to crisis care teams. At that point, the treatment that patients receive is not only more intensive for them, but more costly for the NHS.

The difficulty of accessing mental health services explains why increased numbers of people who require support end up being admitted to accident and emergency departments. To illustrate that, I will use the example of my own integrated care board in Kent and Medway, which has recently launched several safe havens to provide support for anyone in a mental health crisis. They have helped to reduce the number of people who seek support by going to hospital emergency departments when they experience a mental health crisis. In my constituency, there is not yet a safe haven. That may explain why William Harvey hospital in Ashford has one of the highest rates of individuals presenting with primary mental health needs at an A&E. I welcome plans that are under way for a safe haven at the hospital in the near future.

When patients end up in hospital, there are significant difficulties in getting them a bed. This is a challenge in Kent and Medway, but the picture is not dissimilar across the rest of England. The Royal College of Psychiatrists recommends a maximum occupancy rate of 85% of beds for mental health patients. However, between April and June, the average occupancy rate of the 444 mental health beds in Kent and Medway was 91.7%. Across England, the average occupancy rate was 89.9%.

Then there is the issue of discharging patients. When they are clinically ready to leave hospital, there is often nowhere for them to go. That leaves them stuck in hospital, causing blockages in the system. In my own experience, nurses, doctors, managers, matrons and directors spend many working hours looking into moving people out of hospital, when they should be focusing on patient care. I believe that more appropriate housing must be built that is open for people leaving hospital. I urge the Department of Health and Social Care to work across Government to ensure that as the Government’s planning reforms are introduced, that point is taken into consideration.

We have seen an increase in adults being treated in hospitals for their mental health, and the situation is the same for children and young people. A recent report from the Education Policy Institute shows that the number of young people admitted to hospital increased by one fifth between 2017 and 2023. As the report indicates, that suggests that more young people are reaching a crisis point and are experiencing multiple admissions. The evidence also indicates that a large number of young people are not getting the necessary mental health support. A survey for Young Minds revealed that at least 60% of children considered to have a diagnosable mental health condition had not had contact with the NHS.

Research from the Maternal Mental Health Alliance published last week shows that more than 20% of women will face mental health challenges either during their pregnancy or in the perinatal period. It is clear from the research that many women struggle to access support, particularly those from racialised communities, young mothers and those experiencing domestic abuse or living in poverty.

We know that intervening early to ensure that people are kept in good health is not only better for the individual but tends to be far less costly. However, until now, efforts to prevent mental ill health have been severely underfunded and they have not been given the priority they deserve. I hope we will see a marked change in approach under this Government. With that in mind, I ask my hon. Friend the Minister whether greater priority will now be given to community-based support for mental health services. I hope he will agree that the easier it is for people to access mental health services locally, whether in a traditional health setting or through more informal drop-in services, the quicker they will be able to get the treatment they need.

Will my hon. Friend update us on the Government’s plans for Young Futures hubs for children and young people? These open-access drop-in hubs will be an important step in providing community-based mental health support for children and young people. Will he say something about the roll-out of those hubs?

Our manifesto commitment to introduce a specialist mental health professional in every school will be important in helping to identify mental health conditions early on so that they can be prevented from developing into more serious conditions in later life. Will that include access to counselling? Research from the British Association for Counselling and Psychotherapy indicates that children whose mental health difficulties are initially too complex for lower intensity interventions but not complex enough to be referred to higher intensity interventions, such as child and adolescent mental health services, can easily miss out on the mental health support they need. They could instead be helped by forms of provision such as counselling.

All the evidence shows that being active helps people’s mental health. Helping them back to work will also help to grow our economy. Lord Darzi’s report identified that, since the pandemic, the number of people who are economically inactive has increased by around 800,000, with people with mental health conditions accounting for most of the increase. I welcome the Government’s new initiative to work across Departments and create links between long-term unemployment and health. I also hope that they will look to reform the benefit system, ending the blame culture identified by the Secretary of State, so that we can treat people with mental health problems with dignity. I welcome the greater emphasis that Ministers have said will be put on prevention of illness, and I hope that my hon. Friend the Minister will be able to reassure me that the same emphasis will also apply to mental health.

As the Mental Health Foundation has said, there is clear evidence that place and the circumstances in which people are born, grow, study, live and work have a powerful influence on their mental health. Therefore, there must be a fundamental reform of the way in which we deal with mental health. We should be addressing the complexity of interactions and relationships, and how they affect individuals, families and communities. Rather than starting from the point of treating mental health, we should put the emphasis on creating a society that prevents mental ill health in the first place.

Beginning with central Government, I want to see a co-ordinated approach to developing effective policies to protect people’s mental health. With that in mind, the priority that this Government have already given to cutting pollution and building high-quality houses is welcome. I also welcome the proposed pre-watershed junk food ban and the steps that Ministers are taking to create a smokefree society. Going forward, I want to see greater cross-Government working to address the social determinants of our mental health.

In the coming months, the Government are set to publish their 10-year plan for the NHS. As my hon. Friend the Minister and his colleagues work on that, I hope that they will consult with campaigners and organisations working in mental health, as well as representatives of the workforce. By doing that, the Government will be able to grasp the opportunity to transform the way we approach the issue of mental health, ensure that there is true parity of esteem and provide real, meaningful change in the mental health system.

[Several hon. Members rose—]

[Peter Dowd (in the Chair)]

Order. This is clearly a popular subject. Lots of people had indicated previously that they wished to speak; there are obviously people who wish to speak who had not indicated beforehand, and others will want to intervene. The Minister and Opposition spokespersons have 10 minutes each. Having done the calculations, we will regrettably introduce a formal three-minute time limit on Back Benchers. You will be able to see the time on the screen, and regrettably I will have to cut you off in your prime if you go over three minutes. Just bear that in mind, please. I am sorry for the tutorial, but it is worth having, I suppose. Please bob if you do want to speak.

13:48

[Helen Maguire (Epsom and Ewell) (LD)]

It is an absolute pleasure to serve under your chairmanship, Mr Dowd, as I speak for the first time in Westminster Hall. I thank the hon. Member for Ashford (Sojan Joseph) for securing this important and timely debate on World Mental Health Day, and for speaking so well.

Mental health can affect any of us at any time, young or old. Unfortunately, too many people simply do not get the support they need and some go on to take their own life. Speaking personally, husbands of two friends of mine, a friend’s brother and a friend have taken their life, destroying families who are left behind figuring out how to cope.

Since becoming the MP for Epsom and Ewell, I have been shocked by the lack of mental health support, but also amazed at the ingenuity of local residents to provide it in its absence. I had the pleasure of meeting Charley Moore the other day—a Surrey female firefighter and founder of an all-female support group in Epsom and Ewell called Grow and Glow. She had a mental health crisis last year and found it very difficult to access support. She found many mental health groups for men, but she could not find any specifically for women, so she set one up.

I was also proud to meet two mental health charities the other day that were recognised at the BBC Surrey and Sussex Make a Difference Awards last week in my constituency. One was We Power On, which is a men’s mental health “walk and talk” support group set up by Chris Waller after he and his friend reconnected during lockdown and discovered that they were both struggling with their mental health. He won the bravery award. He takes people out at the weekend, walking on the lovely Epsom downs and sharing their experiences.

The other charity, Joe’s Buddy Line, was set up by Ivan Lyons, who won the community award and is one of my constituents. Ivan’s son was an award-winning radio producer on Capital Radio. Sadly, in 2020, Joe took his own life. Through Joe’s Buddy Line, Joe’s family advocate for mental health to be treated equally and with the same seriousness as physical health. The charity provides mental health support, advice and resources for schools. It is encouraging schools to put a mental health policy in place in every single school, giving teachers the support that they need to support the young people of today. The charity has highlighted to me that currently it is not a statutory requirement for a school to have a mental health policy. Such a policy would foster a whole-school approach, so today I am calling for a statutory requirement for all schools to have a specific mental health policy.

Too many people are simply suffering and too many lives are being lost, yet some of that is preventable. Early intervention and prevention are absolutely key. First, to ensure that our young people get the support they need before they reach crisis point, we need to equip them with the tools they need to build resilience to cope with modern life. We must ensure that no one feels alone in their mental health journey, and we need to normalise conversations about how we are feeling mentally. I am absolutely proud that in my constituency, individuals such as Ivan, Chris and Charley are taking the initiative to champion mental health support for everyone and fill in the gaps that they have identified in the services. Let us not forget—

[Peter Dowd (in the Chair)]

Order. Please sit down. May I reiterate that this is a very sensitive subject, and I do not want to have to stop people in mid-flow when they are talking? This is a very sensitive issue and it would sound rude, so I exhort hon. Members to keep to the three-minute limit. It is regrettable, as this is a very important subject, but please keep to the limit, because— I reiterate—this is such a sensitive subject, and I do not want to cut people off at a sensitive point.

13:52

[Tony Vaughan (Folkestone and Hythe) (Lab)]

It is a pleasure to serve under your chairship, Mr Dowd. I pay tribute to my hon. Friend the Member for Ashford (Sojan Joseph) not only for securing this debate but for his tireless, dedicated work as a mental health nurse in the NHS. I thank him for his service. His analysis of the problems and solutions was masterful, and Parliament is all the stronger for having his expertise and experience in this place.

The issue of mental health support is a policy challenge that goes beyond party political lines. Any civilised society is judged on how it treats its most vulnerable. The state of people’s mental health in our nations is incredibly concerning. As a former trustee of South Kent Mind in my constituency of Folkestone and Hythe, I have seen a downward trajectory in people’s mental health outcomes, particularly in deprived areas, and how mental health services are increasingly under strain. I also pay tribute to the incredible work done by South Kent Mind, which provides invaluable advice and well-run and well-attended classes, such as cookery and exercise classes, which provide local people with a sense of community, togetherness and support. Statistics from Mind have laid bare the reality. Each year, one in four people in England will experience a mental health problem of some kind, and one in six people report experiencing a common mental health problem, such as anxiety and depression. The number of people reporting self-harm went up by 62% between 2000 and 2014, and the number of people reporting suicidal thoughts in the past year went up by 30% between 2000 and 2014.

The mental health of people in this country is undoubtedly deteriorating, and we know that some groups are more likely than others to be impacted by mental health problems, such as the LGBTQIA+ community, black British people and women aged 16 to 24. There are several reasons behind the steep increase in suffering, such as the giant evils of inequality and austerity that have ripped the heart out of our communities. Unemployment and poor housing still plague people’s mental health, just as they did in the age of the Victorian workhouse. There are in addition recent phenomena, such as the rise of social media, creating unprecedented pressures on young people to look a certain way, and the decline in physical health in our communities, especially in de-industrialised areas.

As a society we say that one suicide is too many, and that we want to remove the stigma around mental health. But as we know, the stigma festers in too many houses, homes, offices and sports clubs, particularly with men and boys, for whom talking about feelings or being seen to be vulnerable can be perceived as weak or embarrassing. I sense that I am out of time, so I will sit down.

13:55

[Dr Luke Evans (Hinckley and Bosworth) (Con)]

Thank you, Mr Dowd, for allowing me to take off my neck brace to speak. I congratulate the hon. Member for Ashford (Sojan Joseph) on speaking so powerfully on this topic. I was a doctor before I came to this House, so for me the topic is important. There is a clear distinction when we debate this topic between mental wellbeing and mental health. Lockdown proved that everyone’s mental wellbeing gets punished, but not everyone has a mental health issue. That is important when we are trying to segregate services: how do we supply the correct services to the people who need them the most?

I have spent the last five years in Parliament campaigning around body image and for a men’s health Minister, particularly with regard to suicide. But I turn my attention to something close to my heart that is really important: the issue of adolescent mental health, because I am deeply concerned by the increase in children who are suffering. It is not just things such as eating disorders; we are seeing attention deficit hyperactivity disorder, we are seeing anxiety and we are seeing autism.

I plead with the new Minister to think radically, in a positive way, when it comes to the NHS. In my area of Leicestershire, 40% of child and adolescent mental health services is taken up by dealing with ADHD and autism. That takes a lot of attention away from the kids who are self-harming, or have eating disorders or significant serious depression or psychosis. There is a radical solution: pull out education and health and pool those services as specialisms. That would build on the work that the last Conservative Government did on placing representatives and mental health workers in school, and would allow GPs and CAMHS the freedom to concentrate on what they need to deal with.

[John Glen (Salisbury) (Con)]

On that point, may I draw my hon. Friend’s attention to the role of care co-ordinators with adolescents, and the problems and challenges of the transition to adult care? That moment can be critical in securing a pathway to an effective outcome. Often, the confusion over where responsibilities are delineated and begin has been a difficulty for my constituents.

[Dr Evans]

My hon. Friend is absolutely spot on. The cliff edges that exist in the NHS—and education and social services—cause a real problem, particularly for families, because at 18 someone does not just lose their diagnosis.

It is important to pool those areas because it allows us to stratify the way that we use our limited resources, and we know that health costs will continue to go up and spiral. I urge the Minister to have a think about potentially creating almost a national special educational needs and disabilities service, which would pool education and health experts together, releasing schools and relieving GPs’ primary care and secondary care with specialists. Now we have the set-up of ICBs, there is scope to do that regionally across the 42 areas.

It is well worth thinking about pooling those resources together, because it would be possible to give specialist help; and as the hon. Member for Ashford said, identifying people early means that they will not end up in a crisis. That brings us back to preventive care, to identify those who are having problems with wellbeing or who have mental health issues. For me, that is the crux of what we need to do: how do we pool the resources in a way that is sustainable for the taxpayer and, most importantly, service users and providers—the children and adolescents, and the staff who have to cope with some of the most difficult problems? I leave the Minister with that thought.

13:59

[Jack Abbott (Ipswich) (Lab/Co-op)]

It is a privilege to serve under your chairmanship, Mr Dowd. I thank my hon. Friend the Member for Ashford (Sojan Joseph) for securing this important debate on World Mental Health Day. Sitting in the Chamber are Members from every corner of the country and from all sides of the House—evidence that the mental health crisis is undeniably a national one.

My constituents in Ipswich, under the Norfolk and Suffolk mental health trust, suffer a particularly desperate service in an already broken system. Since its creation in 2012, the Norfolk and Suffolk foundation trust has been—it arguably still is—the worst-performing mental health trust in the whole country. It was the first mental health trust to be put into special measures, in 2015, and it was then put into the NHS recovery support programme when the body was set up in 2021.

We are almost entirely accustomed to the slew of reports that find that the trust “requires improvement” or is “inadequate”, but time does not allow me to give a detailed overview of the litany of failures that have brought us to this point. However, there are two key tenets to the scandal. First, there is the scandal of the perhaps euphemistically named unexpected or avoidable deaths. The 2022 Care Quality Commission report found that there were 155 such deaths in the two years preceding the report, and the NSFT’s own “Learning from Deaths” report admitted to 418 unexpected unnatural deaths in a four-year period. Many of those deaths were entirely avoidable suicides, some while directly in the NSFT’s care. Those numbers, even taken at face value, which is unfortunately hard to do given the trust’s record, are emblematic of what my hon. Friend the Member for Norwich South (Clive Lewis) aptly called the “slow-motion disaster” of mental health care.

Secondly, there is the cruel detail of unrecorded or unaccounted deaths, which led to thousands of people falling through the gaps, left off official statistics and totted up retrospectively as if they were a mere glitch in the system—the dead dehumanised, lost and buried in spreadsheets. It is not right that, after facing allegations as serious as the NSFT has faced, it should be allowed to mark its on homework on the matter.

But with a new Government comes an opportunity for a new approach. I therefore ask the Minister to meet me to discuss a pathway to justice and to change Suffolk’s mental health services. This is the crux of the debate. The families who have suffered so much deserve justice, and all my constituents deserve change. Those two things are inseparable—we simply cannot have one without the other—and there is no time to waste in delivering them.

14:01

[Mark Ferguson (Gateshead Central and Whickham) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Dowd, in my first Westminster Hall contribution. I declare an interest: I was a former national officer for Unison, representing mental health workers and others. I thank my hon. Friend the Member for Ashford (Sojan Joseph) for securing this important debate, timely as it is on World Mental Health Day.

Improving support for mental health is one of the key recommendations of Lord Darzi’s report that the House discussed on Monday—a damning read, yet completely unsurprising to any patient who has engaged with the NHS in recent years. The surge in demand in respect of mental health needs in children and young people is not being met by community-based services, and Lord Darzi’s report found that after years of cuts the number of mental health nurses has only just returned to 2010 levels.

Indeed, the Department of Health and Social Care’s own dataset shows that in the year 2023-24 in my community of Gateshead, 1,745 children and young people aged between nought and 17 years of age were left waiting for first contact with child and adolescent mental health services, having waited at least six months since referral—every single one an individual suffering and part of a family in my community being let down. At the same time, only 60 children and young people in Gateshead received that first contact within six months. Those figures reflect the trend across the country, with 109,000 children and young people under 18 waiting a year or more for first contact. That is why we need more support for children in their communities and schools, but without continuing to overstretch teachers. I welcome the Government’s commitment to roll out mental health councillors in every school and mental health hubs in the community, to cut through the backlog and ensure accessible support.

Lord Darzi’s report identifies a worrying normalisation of long waiting lists. I am in no doubt about the brilliant NHS staff in Gateshead, and elsewhere across our country, who work tirelessly day in, day out—something I know from personal experience. It is not the fault of mental health workers, nurses or GPs but, unfortunately, that of a decade of austerity and the top-down reorganisation of our NHS. To quote Laura Bunt, chief executive of the charity YoungMinds:

“Lord Darzi’s review confirms what we know already–that young people and their mental health have been severely let down by the system there to support them.”

It is our opportunity and responsibility to put that right.

14:04

[Dr Lauren Sullivan (Gravesham) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Dowd. I thank my hon. Friend the Member for Ashford (Sojan Joseph) for securing this afternoon’s important debate.

As we know, one in four of us will deal with a mental health issue at some point in our lives. As is the case across the country, following the decade of under-investment that has just been referred to, my constituents in Gravesham are concerned about the difficulty of accessing the right support in good time, without waiting on waiting lists for years. We can all agree that mental health is just as important as physical health, and that the strain on the NHS at this moment in time is enormous. The system is very close to breaking point.

If the system is close to breaking, so are our young people. The lack of open access to universal provision was, I think, touched upon by the hon. Member for Hinckley and Bosworth (Dr Evans). It is about having a safe place to discuss mental wellbeing so that we prevent those people then needing further additional help.

In Gravesham, we are fortunate to have the Elliott Holmes Memorial Fund, a community interest company that aims to give direct access for counselling to young people in Gravesham. At the moment, there are no people on the waiting list, because they are being seen by dedicated counsellors. Based on national statistics, 1,200 young people in Gravesham between the ages of 13 and 19 are struggling with their mental health, but the fund has helped 271 young people since 2022.

I would like to place on the record my thanks to the fund for providing a space for young people’s issues to be heard. The fund was set up in memory of Elliott Holmes, who tragically took his own life in 2020 after suffering from mental illness for a number of years. After his passing, his family set up the fund to try to keep other young people from that path. I would like to thank them for that.

I know that this Government are committed to addressing the mental health crisis that we are facing, and I am pleased to see that the King’s Speech included specific mention of legislation, in the form of a mental health Bill. In particular, I would be pleased to hear what further things we can do to prevent this deepening, worsening crisis.

14:07

[Shockat Adam (Leicester South) (Ind)]

It is a privilege to speak under your chairmanship, Mr Dowd.

I concur with everybody in thanking the hon. Member for Ashford (Sojan Joseph) for securing this vital debate. I want to touch on something he said about ethnic minorities. According to all the information we have, people from all ethnic minorities are detained under the Mental Health Act 1983 at much higher rates than any other people. Furthermore, they have the worst experiences and the worst outcomes. Would the Minister please look into the issue and see to it that our fantastic healthcare workers, whether they are in the education sector or in the health service, look into this vital issue, and are culturally sensitive when dealing with people from ethnic minorities?

14:08

[Rachael Maskell (York Central) (Lab/Co-op)]

It is a pleasure to see you in the Chair, Mr Dowd. I think we all agree that, in introducing this debate, my hon. Friend the Member for Ashford (Sojan Joseph) gave an incredible speech, as all contributors have.

I want to talk a little bit about the transitional approach that we are taking in York, following the Trieste model. It is seeing a real transition, in the way the Health Secretary has described, from secondary care, which we know is just not able to cope with the capacity and demand that is placed on it, into a more primary-care and socialised setting. It is really transformative for the people in my city.

We are setting up community mental health hubs in my city. We have one, and we are going to have two more to follow, with one working 24/7. The model is co-produced and multi-agency, and is moving to provide open-access support to help people to manage their own mental health challenges, with interventions from health professionals, social prescribing and peer support, and to look at issues around welfare, debt and employment support.

Particularly in respect of community outreach, the hub is taking people who feel so neglected, because there just is not the capacity, into a space where they can get support and then progress on with their lives. It is centred around a café where people are encouraged to engage and talk. The café is run by service users, so it is a wholly-owned model, and it is incredibly successful.

The Trieste model is considered one of the best models of service provision in the world because of its emphasis on integration with the whole community and with the self, with professional support at hand if needed. In Trieste, very few depend on secondary care or acute psychiatric care, and residential placements are few and far between. We need to look at that, particularly in respect of the transitions and the Government’s ambition. Following a social model means we do not pathologise mental health but deal with it and help people to build on their strengths and to build resilience into the future.

Our programme is linked with the local university, York St John University, which runs the Converge programme that enables people to use education not only as a way to deal with their mental health issues but to learn new skills and feel included in our community. It contrasts so much with the traditional model, which we know just is not functioning given the demand on services. I therefore urge the Minister to have a look at what is happening in Trieste and to come and have a look at what is happening in York. Let us put this into a model in which people live with mental health as opposed to struggling with it.

14:11

[Helena Dollimore (Hastings and Rye) (Lab/Co-op)]

It is a pleasure to serve under your chairmanship, Mr Dowd. I thank my hon. Friend the Member for Ashford (Sojan Joseph) for securing this important debate on such an important issue. I speak for many when I say that we are lucky to have his experience in the House; he has such expertise in mental health. We are all here because for too long mental health has not been given the same focus as physical health. It has not been given the same funding or the right focus, and there has been far too much stigma in talking about it.

In my Hastings and Rye constituency, too many children and young people are waiting far too long for mental health support. That is why I am really pleased to see this Labour Government’s focus on children’s mental health and cutting NHS waiting lists, putting more mental health specialists into schools in particular, and hiring 8,500 mental health specialists into our NHS to cut waiting lists.

I recently attended a memorial for Phoebe, who sadly took her own life in Hastings this July. Phoebe was aged just 14. She had been on a child and adolescent mental health services waiting list since January, and she never got the support she needed. She never got that appointment with CAMHS. Her mum Tamzin and her whole family are now showing amazing courage and amazing strength in channelling this tragedy and their grief into campaigning to make sure that this never happens to any child again, and that we get more focus on children and young people’s mental health.

I thank all the charities that are working on this issue in all our constituencies, and I thank all the mental health workers who work so hard to provide the support that is needed. In my Hastings and Rye constituency, Eggtooth is a local mental health charity that provides vital support and early intervention for around 250 children in Hastings and Rother a year. I have been contacted by many parents and healthcare professionals who are extremely concerned to hear that the funding for Eggtooth is now under threat from the local NHS integrated care board.

[Mark Ferguson]

Does my hon. Friend agree that charities in her constituency, in mine and in so many others provide the valuable resource that helps us to deal with the crisis in CAMHS?

[Helena Dollimore]

Absolutely. I thank my hon. Friend for that important point recognising the important contribution that so many charities and staff make.

I am extremely concerned to hear that Eggtooth’s funding is now at risk and I wish to share with Members some of the views of local healthcare professionals about the importance of the service. A local doctor says:

“The withdrawal of Eggtooth from children’s mental health services in Sussex would leave a profound gap in support for vulnerable young people.”

A local paediatric nurse says:

“I have stories to tell which I cannot share where children and young people have been helped…I worked in acute emergency settings and safeguarding previously and often saw the outcomes of no intervention.”

That nurse makes a vital point about the importance of early intervention, as have many Members. We know that to intervene early is better for the young person, and we know it will cost the taxpayer less. To give an example, the support that Eggtooth provides costs around £520 per child. By contrast, a CAMHS referral costs almost £2,500, and an A&E intervention, should that be needed, costs even more. I urge the integrated care board to reconsider the decision.

I strongly welcome the Labour Government’s commitment to cut NHS waiting lists, cut mental health waiting lists and focus on early intervention, particularly in schools, where we need it the most. It is on all of us in this House to keep alive the memory of Phoebe and that of all those who have lost their lives to suicide.

14:15

[Tristan Osborne (Chatham and Aylesford) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Dowd. I thank the many Members from across the Chamber for their contributions, and I particularly thank my hon. Friend the Member for Hastings and Rye (Helena Dollimore), who spoke about one of her constituents, Phoebe. This year’s World Mental Health Day theme is about the link between safe and healthy workplaces and safeguarding mental wellbeing, while unhealthy environments marked by stigma and harassment can harm it. Poor mental health not only affects individuals and their families but leads to reduced performance, absenteeism and high turnover rates. I therefore welcome the global campaign to challenge absenteeism and the impact of mental health. Across the world, 12 billion days are lost annually to these issues, costing the global economy $1 trillion.

In my area, NHS Digital data and the House of Commons Library show that mental health provision is not sufficient. We see an increasing reliance on primary care services and an inability of secondary care services to deal with the increased pressures. Across the three key areas linked to diagnosis of depression, 17.3% of residents above the age of 60 in my constituency in Kent now have a diagnosis. Dementia is a rising challenge, with 24,000 people in Kent and Medway and nearly 1 million people in the UK experiencing it. As my colleagues have said, there are also concerns around mental health provision for young people, with 13,000 children and 14,000 adults waiting for neurodivergent condition tests, and ADHD and autism CAMHS referrals rising by some 600%.

I welcome the Government’s commitment to mental health, both in the Darzi report and in updating the Mental Health Act 1983. Within that, will the Minister review how we invest in mental health care and infrastructure alongside the Darzi report, with the mental health investment standard for capital spending, and will he urgently reflect on how we effectively give hospitals extra support with other standards? Will he also consider how we can improve patient flow in hospital services, with support for initiatives such as Right Care, Right Person, which has been adopted by Kent police; specific and targeted mental health-related discharge packages with support and home care; and an expansion of psychological therapies for those with severe mental illness?

Lastly, I welcome the intervention in schools with an increased provision of specialist mental health support. Can we also look at utilising other approaches to reduce waiting times for CAMHS, as my hon. Friend the Member for Hastings and Rye mentioned, and to reduce the stress on parents of navigating a special educational needs system that is not fit for purpose? The Government have made the necessary and correct interventions to improve our health services, but a long journey remains ahead.

14:18

[Dr Simon Opher (Stroud) (Lab)]

On World Mental Health Day, I am wearing this slightly ghastly yellow tie. May I also do a little promotion? In room M in Portcullis House at 3 o’clock, at the end of the debate, we have some young people, through YoungMinds, telling us what they think of the service. It is really important, particularly with young people, to make sure that we develop services that they want and that we do not dictate.

I am still a practising GP in Stroud. More than 90% of mental health consultations take place in primary care and more than 40% of GP consultations concern mental health. I am sure the hon. Member for Hinckley and Bosworth (Dr Evans) will concur with me on that front. I would like to divide mental health into two sections. There is serious mental illness, which is serious and enduring, affecting about 130,000 people in this country. I will make a little plug: they tend to die 10 to 20 years earlier than other people and we must promote their physical health.

The other area is anxiety and depression. We have 8 million people in this country on antidepressants—selective serotonin reuptake inhibitors—and at least 2 million of them are trying to get off. We need to ensure we do not over-medicalise mental health. I was pleased to hear what my hon. Friend the Member for Ashford said about mental wellbeing and mental health. We all get a bit pissed off sometimes—that is normal for humans—and it is extremely important that we do not conflate that with mental ill health.

[John Glen]

May I just say how much I agree with that remark? We may disagree about resourcing and what has happened over the past 14 years, but we need the confidence to talk about building resilience and prevention so that people do not get to the point where they need medical intervention. We have the responsibility to talk about that in this place and in our communities so that we get to the root causes, which are not always to do with socioeconomic matters.

[Dr Opher]

Absolutely; I fully agree with that.

I want to make a couple of comments about the state of mental health services, for which there are extraordinary waits: a patient of mine had to wait six months following a suicide attempt. That is simply not good enough. In Stroud, we have to wait four years for neurodiversity assessments because we do not have enough resource. In my opinion, we need to move the resource into the community.

I also support what my hon. Friend the Member for Ashford said about health and education. We need mental health support teams in our schools, and we must spread SEND provision evenly.

The Under-Secretary of State for Public Health and Prevention is with us, so I want to talk about the prevention of mental health issues. There is quite a lot of evidence about promoting maternal and infant mental health, and also about parenting and bullying at school. Using arts and culture is an incredibly strong way of improving mental health.

I was impressed with what my hon. Friend the Member for York Central (Rachael Maskell) said about the community basis of mental health treatment. For many lower-level conditions, there is no need for consultant-led care. Support that takes place in the community costs much less and can be really effective.

The CAMHS waiting list is appalling, and we have a crisis with SEND and delays with education, health and care plans. We do not have enough educational psychologists either. I want to stress what my hon. Friend the Member for Ashford said about care co-ordinators. Young people’s social prescribers are very effective and tend to de-medicalise things that can be supported in the community.

I am really impressed that we are going to get 8,500 more mental health workers. I am also impressed by what they will be doing in schools. We need to improve the physical health of people with serious mental illness, reduce the number of SSRI antidepressant medications, and promote social prescribing, the arts and community care in our mental health services.

[Peter Dowd (in the Chair)]

Can I just remind Members about modes of expression? I will be diplomatic about it.

14:23

[Lola McEvoy (Darlington) (Lab)]

I rise to speak about this issue on World Mental Health Day. I have championed it many times across my career and I will continue to do so in my time in this place.

My constituents—and, I am sure, those of all hon. Members—want something that we used to take for granted: a happy, decent life, with a better future for their children. For too many in Darlington, that is not the reality, and I believe that the current mental health crisis is a product of our times. I will focus my brief contribution not on those with severe mental illness, who are often in crisis, but on those who are struggling with day-to-day poor mental health.

I agree with the hon. Member for Hinckley and Bosworth (Dr Evans), who advocated a cross-departmental approach. Poor mental health is pushing people out of work, and that is a huge issue for the Treasury and the Department for Work and Pensions. A lack of child mental health support and a failure to tackle the online safety crisis for children is leading to school refusals, which is an issue not only for the Department for Education but for the economy and for future generations. Loneliness is impacting the physical health of our older people, which is an issue for the NHS. The lack of opportunity, quality work, maternal mental health services, veteran support and childcare support is driving people in my constituency to despair.

I have mentioned this before, but I will mention it again on this day: within my own network, I have lost seven men to suicide. Only one of them had a severe mental illness. In my region, we have the highest rate of male suicide and the lowest wages. I ask that we, as a Government who are committed to equality of opportunity for our regions, consider my constituency and my region for a cross-departmental pilot to tackle poor mental health before we lose any more people to avoidable deaths.

[Peter Dowd (in the Chair)]

I now come to the Opposition spokespersons.

14:25

[Dr Danny Chambers (Winchester) (LD)]

Thank you, Mr Dowd, for calling me to speak.

As a veterinary surgeon, I come from a profession that has a suicide rate four times the national average. Like many people in this Chamber, I have experienced the pain of losing friends and colleagues to suicide. That led me to become a trustee of a mental health charity for several years, and I am honoured to be the spokesperson on mental health for the Liberal Democrats.

Although we have undoubtedly focused on NHS clinical services in this debate, we often underestimate the profound impact that non-medical issues, such as living in poverty, financial worries, debt and insecure housing, can have on mental health and how they can hinder people’s recovery from a mental health crisis.

I am incredibly proud of a project that I visited just last week in my constituency of Winchester that is run by Melbury Lodge mental health hospital and the citizens advice bureau in Westminster. This project provides one-to-one advice and support to in-patients on matters relating to living in the community, from relationship and financial advice to management of debt and benefits and housing problems. Someone who ends up being admitted to a mental health unit will find that their post—correspondence relating to their benefits, mortgages and other bills—all goes to their home address, and if nobody else lives there, they will not receive any of it. When they are discharged, they may get out and find that there is a problem with their benefits, or that they have received a huge bill that they were not expecting.

Amazingly, the Melbury Lodge and Citizens Advice team have demonstrated that for every £1 spent on this project, the NHS system avoids spending on average £14.06, which is a huge return on investment. As we extrapolate out, the research shows that having the Citizens Advice service on site means that Melbury Lodge has avoided spending nearly a quarter of a million pounds. This cost avoidance is achieved through shorter in-patient stays, fewer readmissions, reduced medication and better engagement with community services. That is a staggering amount of money that can now be spent directly on clinical care. I urge the Government to look at the results of this initiative with a view to rolling it out in other parts of the country, because it is good for patients, good for NHS staff and good for the taxpayer. I am really excited that this project has been shortlisted for an NHS parliamentary award next week, and I look forward to supporting the team in person.

We need to acknowledge the impact that the lack of mental healthcare has on other public services. When I go out with the police in Winchester, they tell me that they spend between 40% and 50% of their time dealing with mental health issues in some capacity.

The hon. Member for Hastings and Rye (Helena Dollimore) mentioned the cost when people in a mental health crisis, who are often already on a mental health waiting list, arrive at accident and emergency departments. One of the biggest issues raised with me by parents in Winchester is the huge delay for children who are waiting for diagnoses of ADHD and autism.

The hon. Member for Ashford (Sojan Joseph) has already mentioned that the Darzi report acknowledged that 20% of the NHS disease burden is due to mental health issues.

[Lola McEvoy]

Does the hon. Member agree that too often people confuse neurodiversity, which we should celebrate; severe mental illness, which we need to support people with and help them manage; and poor mental health, which is a day-to-day thing that can often be caused by circumstances?

[Dr Chambers]

That is a good and important point. We also need to acknowledge that people with certain issues—neurodiversity, undiagnosed ADHD or autism—who do not get the support they need are more likely to develop mental health issues as a result. It is a bit of a chicken-and egg-situation.

Finally, as I was saying, only 10% of the NHS budget is for mental health, but it is 20% of the disease burden. The obvious question people ask is: how do we afford that? When I look at the pressure on the police, A&E and the education system, the question I would ask is: how can we afford not to treat mental health properly?

14:30

[Dr Ben Spencer (Runnymede and Weybridge) (Con)]

It is a pleasure to serve under your chairmanship, Mr Dowd. I start by declaring that I am a former consultant psychiatrist and that a family member is a consultant psychiatrist.

Listening to this debate has been a mixed experience. It has been great to hear the wealth of talent and expertise that we have in the House, but at times it has been harrowing to hear people speak about their personal experiences or those of their constituents. That is a reminder to us all of just how substantial the impact of mental illness can be on people—our families and friends. The tone in which this very sensitive debate has been conducted is fantastic.

I thank the hon. Member for Ashford (Sojan Joseph) for bringing forward this debate, for the wealth of experience—22 years—that he brings to this place, and for a very balanced speech in which he acknowledged the catchment investments under the previous Government and raised the importance of waiting lists. When I was first elected, I brought up targets for mental health in a private Member’s Bill, which did not end up going anywhere, on waiting times for getting an in-patient bed when one is requested for somebody with a mental disorder. Of course, we all want improvements in mental health care and treatment, and there need to be improvements in mental health care and treatment. I am sure there will be no disagreement across the House about that.

The hon. Member for Ashford was absolutely spot on to mention housing, work and benefits. It is a testament to his experiences in psychiatric nursing that he went on to mention the surrounding holistic care. One of the challenges of debates on improving mental health services is that we must acknowledge that that involves many other areas of public policy, public provision and cultural factors, and try to broaden that as much as possible.

[Dr Evans]

The former Member for Doncaster, who is now sadly not in this House, was a significant champion for men’s and boys’ health—suicide in particular, which has been mentioned here, is such a problem. My hon. Friend stated the case for mental health being a pan-Government policy area—does he believe that strengthens the argument for having a Minister for men and boys to go across Government and think about all these issues, especially as suicide is the leading cause of death for young men under the age of 45?

[Dr Spencer]

My hon. Friend is absolutely right to point out that, sadly, suicide is the No.1 cause of death among young men. My understanding, although the stats change all the time, is that below the age of 45, suicide is the No.1 cause of death among both men and women. It is absolutely right that we look at sex-specific approaches to intervention. Factors affecting health in men will be different from factors affecting health in women.

I want to go back to the social elements of mental health care, which the hon. Member for Ashford mentioned, and a smoke-free society and banning tobacco. Certainly when I was practising, 50% of tobacco was consumed by people with a severe mental illness. That raises a whole host of concerns and issues about what is happening with tobacco consumption and people with a mental disorder.

My hon. Friend the Member for Hinckley and Bosworth (Dr Evans) was absolutely right, given his experience, about something he has mentioned many times in the House: the importance of delineating mental wellbeing and mental illness. I tend to think about it in this way: we all have mental health, but we need to separate mental wellbeing from mental illness. The two are different and need different approaches, as was echoed by my right hon. Friend the Member for Salisbury (John Glen) and the new hon. Member for Stroud (Dr Opher), who gave rise to a very fertile discussion on his views on the area. The hon. Member for Leicester South (Shockat Adam), who is no longer in his place, rightly pointed out inequalities in detention and outcomes for those from minority ethnic backgrounds. That is a very important issue.

That brings me on to our record in Government over the past 14 years; there are a few things I want to pick out. One is that we set parity of esteem in law through the Health and Social Care Act 2012, which was a big step forward. We still need parity of esteem in outcomes, but nevertheless that was a very important step. We expanded access to psychological therapies and I am particularly pleased by the expansion of individual placement and support, which has been shown to help people get into work, particularly those with a chronic and enduring mental illness. We have seen more people take up maternity care, and we also invested in the mental health estate.

In fact, in my own constituency, we have a new mental health hospital. The Abraham Cowley Unit is being rebuilt, which will provide world-class care for people living in my patch. Perhaps most important of all, given the conversation that we have had today, is the decrease in in-patient and out-patient suicide that we have seen over the years. Of course, I recognise that there are a variety of factors driving that but we should be pleased that things are moving in the right direction on suicides, although there is more to be done.

Today is World Mental Health day and it is a very broad topic, but in my time I would like to focus specifically on one area that, as it certainly was in my former career, is often neglected—psychosis. It particularly affects people suffering from schizophrenia or bipolar affective disorder. It can be a very disabling illness and has been responsible for quite a degree of disability and health concern in the UK. Often debates such as these, and debates in the media, do not focus on psychosis and I think a big part of that comes from the stigma attached to it. People who work in the sector, and those with expertise here, will know that it is an area of great need both in terms of community mental health teams and in-patient settings. The hon. Member for Stroud was absolutely right and I am glad he pointed this out: the 10 to 15 years of life lost following a diagnosis of psychosis is something that we have to fix.

I believe that we also need to improve access to treatments such as clozapine, which is an excellent treatment for schizophrenia. I am pleased to have previously worked with Clozapine Support Group UK in its campaign to try to get more access to clozapine for people for whom it is indicated. We have also seen the reform of the Mental Health Act 1983, which the former Prime Minister Theresa May kicked off with the Wessely review. I was part of the working groups on the Wessely review, particularly looking at helping with the tribunal system, and I was on the pre-legislative scrutiny committee as well. How we look after people detained for treatment in the absence of consent is very important, and I am pleased that this Government have committed to take forward the work on reviewing that Act.

I thank everyone who works in the care and treatment of people with mental illness. As we have heard today, that is a very broad sector; it is not only people who work in the NHS but those who work in the third sector in a variety of organisations and institutions. That is very important work.

[Lee Pitcher (Doncaster East and the Isle of Axholme) (Lab)]

Will the hon. Member give way?

[Dr Spencer]

Very briefly—I have only a couple of minutes left.

[Lee Pitcher]

My cousin died from suicide two years ago. We have talked about a lot of facts and figures today, and we have talked a bit about heart, but I can absolutely tell the hon. Member that a family never recovers from that. My auntie and uncle will never recover from the fact that they lost their child before they themselves went.

All a person can do in that situation is put their energy into something positive, and that is about how to help people going forwards. One of the big things is absolutely those charities that support people, such as the Jackson Hope Foundation. I have gone along and spoken there myself even this last Friday, and I talked about some of my experiences in Parliament really openly and freely. It is a safe place. There are 16 men there talking unbelievably openly about how they feel, and it makes such a difference. I want to ensure that going forwards, whatever we do, learning from those groups feeds into our plans and strategies because it makes all the difference to people.

[Dr Spencer]

I thank the hon. Gentleman for sharing something so personal in his intervention, and for sharing his experience of the impact of suicide. Many Members have shared personal experience in this debate. That is very important.

I am mindful that there will be people in the Gallery or watching at home who may be affected by the topics we are discussing, and I take a moment to point out that there are a variety of services to help people in their recovery, if one can call it that, after a loved one has tragically died from suicide, or to help people who are in crisis, such as local crisis services, the Samaritans or Mind. There is a variety of third sector and charity helplines that can help. Men’s Sheds is one organisation I know of that is very helpful. I am really pleased that the hon. Gentleman raised this issue.

I will finish with a few questions for the Minister. The Government do not have a mental health care and treatment strategy or a psychosis strategy and, following an answer to a written parliamentary question I tabled, I understand that there are no plans for a mental ill health strategy to be brought in. Given today’s debate, I wonder whether the Minister will reconsider that position. What are the Government’s plans on taking forward our suicide prevention strategy, or a specific psychosis or mental ill health strategy—however he wants to cut the cloth?

Secondly, when does he expect the Mental Health Bill to have its First Reading in this place? All Members are going to want to extensively debate and scrutinise that Bill. When does he expect it to come forward? What is his appraisal of the challenges that the Bill needs to answer when it comes to the interaction between the Mental Health Act 1983 and the Mental Capacity Act 2005 and the deprivation of liberty safeguards? What about the MM case on deprivation of liberty in the context of a restricted patient in the community, and the interaction with the Children’s Act 1989 on when children can choose a nominated representative? I realise he may not have the answers to that immediately, but I would be grateful if he could write to me. Community mental health teams are the core of psychiatric teams in the community and our psychiatric care and treatment service. What is his plan to support them?

Finally, what is his appraisal of integrated care systems and their commissioning of mental health services? The hon. Member for Hastings and Rye (Helena Dollimore) mentioned the challenges with her ICS. What is the Minister’s appraisal of that commissioning and how integrated care systems can be held to account to make sure that is being delivered?

[Peter Dowd (in the Chair)]

I want to give the sponsor an opportunity to wind up at the end. I call the Minister.

14:43

[The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)]

It is a pleasure to serve under your chairmanship, Mr Dowd, and it is also a pleasure to respond to this debate on World Mental Health Day. I am grateful to my hon. Friend the Member for Ashford (Sojan Joseph) for securing the debate and for drawing on his long-standing experience of working in mental health care to raise so many important points in the debate. As several others have, including the shadow Minister, I thank everybody who works in the field of mental health, whether as a mental health practitioner or as one of the very many volunteers who give up their time freely to help people who are facing particular difficulties in their lives.

I am responding to this debate on behalf of Baroness Merron, the Minister with responsibility for mental health, so apologies if I do not answer everybody’s questions. I have taken copious notes and am sure that the powers that be sitting behind me have taken even more. If I do not answer all the points raised, Members can expect to receive something from the relevant Minister in due course.

It has been a great debate. I thank my hon. Friend the Member for Folkestone and Hythe (Tony Vaughan) and the hon. Members for Epsom and Ewell (Helen Maguire) and for Hinckley and Bosworth (Dr Evans). The latter made a really important point about the interrelationship between education and health in the whole sphere of special educational needs, autism and so on. I reassure him and others who made that point that the beauty of being part of a mission-led Government that has five missions—one is the health mission and another is the opportunities mission—is that it allows Ministers the opportunity to look at things in the round and break out of departmental silos. I assure him that on these issues I am having bilateral meetings with counterparts in the Department for Education about how we drive forward key elements of the health mission, and also about the role that the Department of Health and Social Care can play in achieving the Government’s opportunities mission. That work is taking place at departmental level.

I thank my hon. Friend the Member for Gateshead Central and Whickham (Mark Ferguson) for his contribution, and the hon. Member for Leicester South (Shockat Adam), who is not in his place but made some really important points, particularly about the impact of the Mental Health Act on black and minority ethnic groups. I, and the Government, think it is shameful that under the existing Mental Health Act black people are three and a half times more likely to be detained than white people and eight times more likely to be placed on a community treatment order. Our mental health Bill will give patients greater choice and autonomy and enhanced rights and support, and we will ensure that it is designed to be respectful in terms of treatment with the aim of eradicating inequalities. I put that on the record because the hon. Member for Leicester South made an important point.

I thank my hon. Friends the Members for Gravesham (Dr Sullivan) and for York Central (Rachael Maskell). My hon. Friend the Member for Hastings and Rye (Helena Dollimore) made a powerful contribution about Phoebe and about her ICB—I hope the ICB has listened. My hon. Friend the Member for Chatham and Aylesford (Tristan Osborne) made a contribution, as did my hon. Friend the Member for Stroud (Dr Opher). I reiterate to him that of course the arts have a powerful role to play in the health and wellbeing of the individual. I was fortunate last Friday to see the Manchester Camerata, one of the great orchestras in my home city, at the Gorton Monastery in my constituency, which is now a health and wellbeing hub. As well as understanding the work that it does, I also learned a lot more about social prescribing and about its powerful listening service.

[Sonia Kumar (Dudley) (Lab)]

As an NHS physiotherapist working in Dudley, I know very well that mental health is multifaceted. It affects not just one part of a person’s life, but everything: sleep deprivation, diet, overeating, undereating and building relationships. Does the Minister agree that we need more care in the community, including first contact practitioners, social prescribers and councillors in the community as the first line of treatment?

[Andrew Gwynne]

My hon. Friend is absolutely right. At the heart of the health mission that the Labour Government want to see is the shift from hospital to community, from analogue to digital and from sickness to prevention. What we do in the community really matters. Our ambition for the future of mental health services is wrapped up in those shifts, particularly the shift from hospital to community.

[John Glen]

Could I share my experience as a Minister? When we looked at social prescribing when I was in the Treasury, it was always difficult to establish an evidence base to justify the allocation of resources. I urge the Minister to continue that battle to make the case, because I am sure that the instinct of all Members throughout the House is that there is something in that ambition, and we must find a way of unlocking it so that we can get social prescription out into the community where a variety of provision is available.

[Andrew Gwynne]

The right hon. Gentleman is absolutely right. That will be one of the big challenges with the prevention agenda more generally, because often the investment we have to make today does not pay dividends immediately and there is a bit of a punt. Having been a Treasury Minister, he will know the challenges that that can present to the Treasury orthodoxy, but we have to push on this agenda.

I always say that being an MP and a GP is only one letter apart. We are often dealing with the same people who present with the same problems but from a different angle. We go away as Members of Parliament trying to fix the issue as they have presented it to us, and the GP will write a prescription and send them off having sorted out the issue as it was presented to them. However, the beauty of social prescribing is that there is an opportunity to deal with the whole issue in the round. The argument has been won with almost everybody, and any tips from the right hon. Member for Salisbury (John Glen) so we can get this over the line with the Treasury will be welcome.

I should mention my hon. Friend the Member for Darlington (Lola McEvoy), and welcome the hon. Members for Winchester (Dr Chambers) and for Runnymede and Weybridge (Dr Spencer) to their Front-Bench positions.

In the minutes I have left, I want to say to the House that many of the issues raised by Members during the debate are symptomatic of a struggling NHS. If we look at the figures, the challenges facing the NHS are sobering. In 2023, one in five children and young people aged eight to 25 had a mental health problem, which is a rise from one in eight in 2017. The covid-19 pandemic has exacerbated need, with analysis showing that 1.5 million children and young people under the age of 18 could need new or increased mental health support following the pandemic.

[Dr Luke Evans]

I want to raise an issue as the Minister is the Minister responsible for prevention. One of the biggest and most shocking things we saw during the pandemic was the increase in eating disorders, which is a very difficult topic for any Government around the world to try to break down. We know that the impact of eating disorders lives with people for the rest of their life and can cause them to lose their life, so will the Minister ensure that they are looked at as a priority? There was previously a roundtable; will he look into doing something similar again to bring experts together?

[Andrew Gwynne]

I am reluctant to commit Ministers to roundtables when I am covering another portfolio, because then they will do the same when they cover me in Westminster Hall debates, but I will say that we take this agenda incredibly seriously. When we were in opposition we gave support to the then Government, and I assure the hon. Gentleman that we will do everything we can to support people who have eating disorders and to get the right provision and support at the right time to the people who need it.

As I was saying, the covid-19 pandemic has exacerbated the need for mental health support. Around 345,000 children and young people were on a mental health waiting list at the end of July this year, with more than 10% of them having waited for more than two years. Some groups of children and young people are disproportionately impacted by mental health problems largely driven by a complex interplay of social and environmental determinants of poor mental health, as we heard in the debate.

We are committed to reforming the NHS to ensure that we give mental health the same attention and focus as physical health. It is unacceptable that too many children, young people and adults do not receive the mental health- care that they need, and we know that waits for mental health services are far too long. We are determined to change that, which is why we will recruit 8,500 additional mental health workers across child and adolescent mental health services. We will also introduce a specialist mental health professional in every school and roll out Young Futures hubs. We are working with our colleagues at NHS England and in the Department for Education as we plan the delivery of those commitments.

Early intervention on mental health issues is vital if we want to prevent young people from reaching crisis point. Schools and colleges play an important role in early support, which is why we have committed to providing a mental health professional in every school. However, it is not enough to provide access to a mental health professional when young people are struggling; we want the education system to set young people up to thrive, and we know that schools and colleges can have a profound impact on the promotion of good mental health and wellbeing. Doing this will require a holistic approach, drawing in many aspects of the school or college’s provision. I know there are many schools that already do this work, and my Department is working alongside the DFE to understand how we can support best practice across the sector.

As I have said, our manifesto commits us to rolling out Young Futures hubs. This national network will bring local services together and deliver support for teenagers who are at risk of being drawn into crime or who face mental health challenges. The hubs will provide open-access mental health support for children and young people in every community.

On other aspects of our plans, the mental health Bill announced in the King’s Speech will deliver the Government’s manifesto commitment to modernise the Mental Health Act 1983. It will give patients greater choice, autonomy, enhanced rights and support, and it will ensure that everyone is treated with dignity and respect throughout their medical treatment. It is important that we get the balance right to ensure that people receive the support and treatment they need when necessary for their own protection and that of others. The Bill will make the Mental Health Act 1983 fit for the 21st century, redressing the balance of power from the system to the patient and ensuring that people with the most severe mental health conditions get better and more personalised care. It will also limit the scope to detain people with a learning disability and autistic people under the 1983 Act.

Finally, Lord Darzi’s report identified circumstances in which mental health patients are being accommodated in Victorian-era cells that are infested with vermin, with 17 men sharing two showers. We will ensure that everyone is treated with dignity and respect throughout their treatment in a mental health hospital, and we will fix the broken system to ensure that we give mental health the same attention as physical health.

If I have not answered Members’ questions, those Members will be written to by the relevant Minister. I again congratulate my hon. Friend the Member for Ashford on securing the debate.

[Peter Dowd (in the Chair)]

I call Sojan Joseph to wind up very briefly.

14:58

[Sojan Joseph]

I thank the Minister for his brief answer, and I thank the shadow Minister and the Liberal Democrat spokesperson for their responses to the debate. I also thank the other Members who took time out of their busy schedule to be here.

I thank all the organisations that contacted me in advance of the debate. There are too many to mention them all, but they include the Education Policy Institute, the Royal College of Paediatrics and Child Health, the Royal College of Psychiatrists, the Royal College of Nurses, the Children and Young People’s Mental Health Coalition, the British Association for Counselling and Psychotherapy, the Maternal Mental Health Alliance, YoungMinds, the King’s Fund and, finally, Flourish, which is based in my Ashford constituency. I hope that the Department of Health and Social Care will actively engage with these organisations from across the sector to draw on their knowledge and experience.

Question put and agreed to.

Resolved,

That this House has considered improving support for mental health.

Gaza and Humanitarian Aid

Thursday 10th October 2024 Westminster Hall

15:01

[Ayoub Khan (Birmingham Perry Barr) (Ind)]

I beg to move,

That this House has considered humanitarian aid and Gaza.

I thank everybody for attending this very important debate. I begin by paying tribute to the humanitarian aid workers in Gaza, who continue their lifesaving efforts and face impossible odds. Despite having every reason to lose hope, they remain steadfast in their mission to provide aid, and are the only source of survival and hope for the people of Gaza. Sadly, at least 289 of those brave individuals have been killed. I trust that Members present will join me in honouring each and every one of them.

The horrors facing the people of Gaza are overwhelming, reflecting Israel’s efforts to strip away their humanity. Since the attack on 7 October, the collective punishment inflicted on Gaza has been shocking. Ninety per cent. of the population has been displaced, being moved from pillar to post, and 96% face acute food insecurity. There have been over 42,000 deaths in the past year, although that number does not include the thousands of bodies still buried under the rubble of destroyed buildings: loved ones who will never be recovered.

This debate is not about the Israelis’ military onslaught of Palestinian civilians in Gaza; it is about those being killed not by weapons, but by the lack of basic humanitarian assistance. Israel has weaponised the denial of aid, pushing the remaining Palestinians to the brink of death. The health crisis in Gaza is devastating. Since 7 October, at least 10 children per day have limbs amputated, many without anaesthesia. Over half a million of the population suffer from diseases such as jaundice, caused by malnutrition and the unsanitary conditions they are forced to live in. That is the size of almost half of Birmingham’s population.

Hospitals—the very places that could help—are in ruin; 31 of Gaza’s 36 hospitals, and most United Nations healthcare stations, have been damaged or completely destroyed by Israeli airstrikes and ground operations. The Lancet estimates that the real death toll could be closer to 186,000, and with flood season approaching, the situation is set to get even worse.

It is not a case of shortage of aid, as we all know—we have all seen the thousands of trucks lined up on the border. This is a deliberate act. Israeli authorities are intentionally limiting the supply of vital aid. They have destroyed civilian infrastructure, such as schools, water stations, mosques and churches, and claimed military necessity. But the humanitarian workers on the ground tell a very different story. These are not military targets, yet the bombs keep falling and critical aid facilities are being obliterated.

Before 7 October, Gaza was receiving 508 aid trucks a day—just enough to keep the population afloat. Now the numbers stand at a mere 52 trucks, according to Oxfam aid workers.

[Iqbal Mohamed (Dewsbury and Batley) (Ind)]

Throughout the past 12 months, the UK Government have failed to highlight or prevent the Israeli Government’s denial of international assistance into Gaza and their clear breaches of international humanitarian law. The UK has also failed to highlight the Israeli Government’s not complying with International Court of Justice orders, which require them to facilitate the unimpeded access to Gaza of United Nations and other officials engaged in the provision of humanitarian aid. The UK is failing to stand up for international law as Israeli forces are forcibly transferring civilians as we speak—

[Valerie Vaz (in the Chair)]

Order. This should be an intervention, not a speech, because many people are waiting to speak.

[Iqbal Mohamed]

Does my hon. Friend agree that the UK must act urgently to enforce UK Security Council resolutions?

[Ayoub Khan]

I thank the hon. Member for his intervention. I think we are all singing off the same hymn sheet when it comes to what the UK should be doing.

Experts say that 2,000 trucks are required to address the current crisis, but only 52 are coming in at the moment. Aid convoys are being blocked not only at the checkpoints by Israeli soldiers; we have all witnessed some of the Israeli civilians blocking aid at crossings like Kerem Shalom and Nitzana. While the Israeli Army are competent to disperse thousands of protesters in Tel Aviv within minutes, they choose not to disperse the fewer than 100 protesters blocking life-saving aid. Even once they get through that blockade, they are shot at by IDF forces, either by snipers, drones or other military means.

We all know about the killings of the seven aid workers from the World Central Kitchen charity, which included three British aid workers. That was despite the Israeli Army being given co-ordinates and information about locations.

[Dr Rupa Huq (Ealing Central and Acton) (Lab)]

The hon. Gentleman mentioned aid workers. Does he not agree that it is not just aid workers but those in the media, teachers, doctors and medical staff where we are seeing a discrediting and delegitimisation of the UN? He mentioned buildings, even the oldest church in Christendom. It feels like even within the rules of war, something has gone wrong here.

[Ayoub Khan]

Of course. The biggest problem we have is that journalists are not allowed in. One has to think about the reason why journalists are not being afforded the opportunity to report impartially—it is not happening. If the Israeli Government have nothing to hide, we would expect them to be welcoming journalists into the war zone. The risks are down to the journalists. However, we have seen this on an enormous scale. Journalists believe that they are being targeted specifically, so there is no reporting from within.

This is collective punishment on an enormous scale. There are no red lines for Netanyahu’s Government. The actions of the IDF over the past 369 days are not those of a moral army as Israel claims, but actions that have crossed every moral and legal boundary. Netanyahu’s pursuit of Gaza’s destruction is relentless and will not stop unless forced to do so. I welcome the reinstatement of the United Nations Relief and Works Agency for Palestine Refugees funding by this Government, but we must do more.

[Mr Adnan Hussain (Blackburn) (Ind)]

I agree that calls for additional aid and safe routes for the delivery of aid into Gaza are vital and encouraged. However, does the hon. Member agree that questions must be raised as to the absurdity of a situation in which we as a country provide both the aid and the weapons to bomb the besieged people of Gaza?

[Ayoub Khan]

I agree, and I am sure there will be many similar contributions throughout this debate.

I welcome the Government’s reinstatement of UNRWA funding, but we must do more. We must address the root cause of the suffering, and an immediate, permanent ceasefire is absolutely essential. Diplomatic calls from Governments of various nations have fallen on deaf ears. The only option available now is to enforce a ceasefire through the prohibition of all arms sales to Israel. If the UK did that, it would send a clear message to others, who would inevitably follow suit, but innocent lives are being lost and the Government have done little to change the course of Israeli aggression. I ask the rhetorical question: how can we send aid with one hand while providing the weapons of destruction with the other? How can we claim to stand for morality and justice when we are complicit in this collective punishment?

Time is of the essence. Every 10 minutes, another child in Gaza dies. This regime of mass murder and destruction is fuelled by the west’s unconditional support and its granting of full impunity for breaches of international humanitarian law. The time for change is now, not later. Will the Minister admit that Israel is actively blocking efforts to distribute humanitarian aid and reach a ceasefire agreement? What will the Government do to encourage Israel to open border crossings for humanitarian aid?

[Several hon. Members rose—]

[Valerie Vaz (in the Chair)]

Order. A number of Members wish to speak, so I will impose an informal three-minute time limit. Please be kind to each other so you can all get in.

15:11

[Jeremy Corbyn (Islington North) (Ind)]

I thank my hon. Friend the Member for Birmingham Perry Barr (Ayoub Khan) for securing this absolutely crucial and essential debate.

Last night, my hon. Friends the Members for Blackburn (Mr Hussain) and for Birmingham Perry Barr and I attended a film showing by Al Jazeera at a cinema near here. The film showed very raw footage of the behaviour of Israeli soldiers in Gaza. It was about the destruction of life and of the appalling death toll of children, in particular, across Gaza. It showed soldiers cheering when they destroyed an entire Palestinian village. It showed pictures—devastatingly realistic in the horror they showed—of the torture of Palestinian prisoners held in Israeli prisons.

Afterwards, we had a question and answer session with a number of lawyers, medical people and so on. A doctor said that when she tried to enter Gaza to act as a doctor, she was restricted to one suitcase and told that she had to bring in three days’ water supply, have her own personal security and have a car and a driver with her at all times just to undertake her work. She said that there are very few hospitals working in Gaza, and the conditions are appalling and abominable. Many doctors are now not working in Gaza any more because they simply cannot get in; Israel controls all access and exit. The small number of very brave and wonderful doctors who were working there are now being forced to go elsewhere. The film showed the way in which Israel’s occupation has been entirely directed towards the destruction of Palestinian life—Palestinian buildings, schools, roads, hospitals and everything else.

I have never forgotten going to Beech primary school in Jabalia refugee camp many years ago—a wonderful school in a wonderful place with wonderful children. With joy, the children sat down and read, through translation, the poetry they had written about their lives, their hopes and what they wanted to achieve. We then went on to the roof of the school, and we could see the fence on one side and, not that far away, the sea on the other. To the north, we could see Ashkelon. We could hear the sadness in their voices when they said, “We are never going to be able to go anywhere. We are never going to be able to travel anywhere. We are forever prisoners in this school and our homes,” but at least at that time they had homes and a school. I have seen the footage and seen the films; the school is totally destroyed. Many of those children who I met, who were so happy in those days, are now deceased. Famine is there in Gaza. It is recognised as a famine around the world. Polluted water, inadequate food, inadequate medical supplies—it is an absolutely appalling situation.

Yes, obviously we have to demand all the aid that we can to go into Gaza—we would do that for any people anywhere in the world—but when there are more than 40,000 recorded deaths, and possibly 100,000 more bodies waiting to be discovered under the rubble, the answer has to be a political one. Why are we still supplying arms to Israel, knowing full well that those arms, in contravention of ICJ rulings, are actually being used to bomb civilian targets in Gaza?

War crimes are being committed before our very eyes on our televisions every night. It is up to our Government to show that they believe in international law. If they did, they would halt the supply of weapons to Israel, because they know full well that those weapons are being used to destroy human life, in breach of all aspects of international humanitarian law.

[Valerie Vaz (in the Chair)]

I expect to take winding-up speeches from the Front Benches at about 4.5 pm.

15:16

[Florence Eshalomi (Vauxhall and Camberwell Green) (Lab/Co-op)]

It is a pleasure to serve under your chairmanship this afternoon, Ms Vaz. I also want to pay tribute to the hon. Member for Birmingham Perry Barr (Ayoub Khan) for securing this important and timely debate.

A year on from the tragic terrorist attack by Hamas, with an estimated 101 people still being held hostage, we are seeing the devastating impact on innocent civilians caught up in this war. As we have heard, it is estimated that more than 41,000 Palestinians have been killed, more than 90,000 injured and up to 1.9 million internally displaced. Thousands of families are trapped, unable to leave their homes to find vital food and water, and many now face starvation.

Shortly after this conflict started I met with Islamic Relief UK, which is based in my constituency of Vauxhall and Camberwell Green. Staff spoke to me about the devastation and the impact on the ground in Gaza, including the bombing of their offices, and the fact that they lost contact with their aid workers for two days. Over the past year, Islamic Relief UK has distributed more than £26 million of aid to the people in Palestine. I pay tribute to Islamic Relief UK and the many other aid organisations and charities working on the ground, with their aid workers risking their own lives to help innocent civilians.

Along with many others, I welcomed the Foreign Secretary’s announcement, in his first statement to the House, that the UK would lift the pause on funding to UNRWA, and that an additional £21 million would be made available to support that work; but sadly, that money will be too late for the many people who have already died.

I had the opportunity to meet a senior representative from UNRWA last week, and he outlined three main challenges to me. The first was logistical: the vital aid continues to be blocked. There are an estimated 70 trucks going in, compared with the 400 pre this conflict. Moving aid around Gaza is nigh on impossible, with an estimated 30% of that aid being looted because people are just so desperate. Aid workers are being attacked.

The second was political: we all have to acknowledge the concerted attempt to discredit and undermine the work of UNRWA. As the Foreign Secretary stated:

“UNRWA is absolutely central to those efforts; no other agency can deliver aid on the scale needed.”—[Official Report, 19 July 2024; Vol. 752, c. 300.]

However, there are three Bills currently in the Knesset aimed at discrediting UNRWA’s operation in East Jerusalem, stripping its status as an aid agency and declaring it a terrorist organisation.

The third challenge was financial; there are still serious difficulties, and the largest donor—the US—has still not reinstated its funding. Is the Minister aware of today’s letter, co-signed by 15 leading aid agencies including Islamic Relief UK, Medical Aid for Palestinians and Oxfam, calling on the UK to continue to take a stand on upholding international law, to oppose the annexation in northern Gaza, to support the independence of the ICJ, and to review the sale of arms? As we enter the second year of this conflict, we restate our calls for an immediate ceasefire and lasting peace in the region.

15:19

[Andy Slaughter (Hammersmith and Chiswick) (Lab)]

It is a pleasure to be under your chairmanship, Ms Vaz. I congratulate the hon. Member for Birmingham Perry Barr (Ayoub Khan) on securing this debate.

Earlier this week, six Arab ambassadors came to speak to Members in this House, from not only Palestine and Lebanon, the two main protagonists, but Egypt, Saudi, Jordan and Bahrain, and they said that they spoke on behalf of the whole Arab community. The message they wanted to get across to Members was that long-term peace and security is attainable in the region; it has been for nearly 20 years now under the Arab peace initiative. Looking forward, that is still the prospect they want, which includes not just Arab states but the 58 Muslim states around the world not just recognising but co-operating fully with Israel.

However, what we have seen over the past year is the opposite; there has been the ratcheting up of violence. Now that has happened on both sides and nobody present holds a brief for Hamas or Hezbollah, but because of the asymmetric nature of this war, almost all the deaths post the terrible atrocity of 7 October last year have been predominantly among Palestinians—41,000 in Gaza and almost 1,000 in the west bank—as well as now over 2,000 Lebanese civilians. The question today is: what will the British Government’s response be? Yes, the Government have consistently called for a ceasefire. The Minister, who does his job excellently, has been very consistent in saying that, but there is no response; on the contrary—the atrocities get worse.

What is happening? We saw today another school attacked and nearly 30 people killed there, and there are attacks on UN positions by Israeli forces. Yes, the Government are right to emphasise aid—which is the subject of this debate—and the practicalities of getting aid in, but also those attacks on civilians are happening daily. There is the forcible transfer of the population. There are beaches of international law happening all the time. There is the collective punishment of the Palestinians, particularly in Gaza. There is famine and disease throughout the territory.

I say to the Minister gently that we need more from the Government now. We need to know what they will do to ensure a ceasefire. What practical steps can they take with allies? We also need—this was emphasised very much by the ambassadors this week—an early and clear recognition of the Palestinian state. Until that exists, it is almost impossible to frame the terms of a ceasefire and a lasting peace in the region, and that is what we need.

15:22

[John McDonnell (Hayes and Harlington) (Ind)]

I want to raise again the issue of the evacuation of seriously injured children from Gaza. When the Ukraine war started, we very rapidly put in place a mechanism for the evacuation of injured children from Ukraine to hospitals here, to ensure that they had the appropriate treatment. It was a system that seemed to have worked effectively. Soon after the attack on Gaza, my friend Kate Hollern, who was the hon. Member for Blackburn, raised in this House the issue of trying to instigate a similar scheme for Palestinian children. I think she did that around November or December, but we heard nothing back. I raised the issue again on the Floor of the House with the then deputy Foreign Secretary—the right hon. Member for Sutton Coldfield (Mr Mitchell)—and we were given an assurance. I had met with the voluntary organisation Save Gaza’s Children, which is based in France, and there is also Save A Child, which was doing work at that point to evacuate children to Italy and to other countries surrounding Palestine.

I raised the issue again in May because we had no response. Then the general election happened so I wrote to the Prime Minister, because I felt this needed a prime ministerial push to get it through. I raised it with the Foreign Secretary because we needed to ensure that our diplomatic efforts were involved, and I wrote to the Home Secretary as well because we needed the visa arrangements put in place. I never received a response.

I wrote again in August to the Minister for Development, my right hon. Friend the Member for Oxford East (Anneliese Dodds), and I did receive a response. However, it was not about the evacuation but the assistance being provided to organisations hopefully working as best they could within Gaza. So I wrote again, and I have not received a second response. I am not sure what is happening in Government on this. I understand that a new Government have come in and it is difficult settling down and sorting out arrangements, but this is a matter of urgency.

We have had further reports this morning of another hospital being attacked, and we have also heard reports of the doctors being threatened that if they did not evacuate they would be arrested. We have even had ambulance workers arrested this morning as well. They are being forced to choose between evacuating children from intensive care, which is risky, or leaving them behind, and as a result some doctors are risking their lives.

We could do exactly as we have done with Ukraine, by simply establishing a system to ensure that those seriously injured children are evacuated. Clinicians are willing to assist here; in fact, I have had clinicians contact me to say, “What can we do?” and “How can we assist?” I ask the Under-Secretary of State for Foreign, Commonwealth and Development Affairs, my hon. Friend the Member for Lincoln (Hamish Falconer), to take this and come back as a matter of urgency. Children are dying as a result and we cannot stand to one side.

15:25

[Mary Kelly Foy (City of Durham) (Lab)]

I thank the hon. Member for Birmingham Perry Barr (Ayoub Khan) for securing this afternoon’s debate. In the short time I have, I want to focus on the plight of Christians in Palestine. In April, I was honoured to meet Father Gabriel Romanelli, the parish priest at the Holy Family church in Gaza, who informed a group of MPs of the tragedies that had befallen his flock, none more so than the killing of Nahida Anton and her daughter Samar. They were two parishioners at the church who were killed inside the parish compound by a sniper; several others were wounded.

It was the week before Christmas, a Christmas that for Palestinians would be observed under rubble, in ruins and in perpetual fear. Rev. Munther Isaac put that into words when he said:

“If Jesus was born today, he’d be born under the rubble of Gaza.”

We all know that places of worship should be protected under the Geneva conventions. I say “should be” because in this and many other instances, they are not. It is heartbreaking, then, to consider that both Nahida and Samar must have thought they were safe in church when, in fact, a sniper was targeting them. I cannot imagine what the family was going through.

What happened at the Holy Family church is a microcosm of the war itself: a war where human rights are ignored, where long-standing conventions are breached and where innocent people like Nahida and Samar are killed. Earlier this year, I asked the former deputy Foreign Secretary, the right hon. Member for Sutton Coldfield (Mr Mitchell), whether the Foreign, Commonwealth and Development Office condemned the attack. He answered:

“We are not clear about the full facts of what happened.”—[Official Report, 8 January 2024; Vol. 743, c. 46.]

In contrast, Cardinal Vincent, the Archbishop of Westminster, was unambiguous. He said:

“They were shot in cold blood inside the premises of the parish, where there are no belligerents.”

He also said:

“The people in Gaza…are not given to tell lies.”

I implore the Minister from the bottom of my heart to listen to the Palestinians in Gaza, and reflect on the bitter injustices of Nahida and Samar’s deaths and all those who have suffered similar fates. The last time I spoke about Palestine in Westminster Hall, the death toll was 25,000. It is now, as we have heard, well over 41,000. I urge the Minister to use the full weight of the FCDO to bring this war to an end, and to commit to the Palestinian people that we will assist them in rebuilding their lives. We need diplomacy, not an all-out war. The people of Gaza cannot have another Christmas under the rubble.

15:28

[Shockat Adam (Leicester South) (Ind)]

It is an honour to speak under your chairship, Ms Vaz, and I thank my hon. Friend the Member for Birmingham Perry Barr (Ayoub Khan) for bringing this vital discussion. I want to reiterate and confirm what my right hon. Friend the Member for Hayes and Harlington (John McDonnell) said in discussing the children. The suffering of all victims of war is devastating, but when it comes to innocent children belonging to all faiths and no faith, it really does affect our humanity and our future.

This is my question to the Minister. As we speak, there are fewer than 16 hospitals standing in Gaza and there is nowhere for children to be treated. More than 50,000 children require treatment who are not even victims of the war; they are suffering from malnutrition and other ailments. Can we, like some of our European partners, look at avenues and mechanisms to bring those children here or treat them somewhere neutral to give them that much-needed support?

15:25

[Rachael Maskell (York Central) (Lab/Co-op)]

It is a pleasure to see you in the Chair, Ms Vaz. I thank the hon. Member for Birmingham Perry Barr (Ayoub Khan) for organising today’s debate.

The tragedy of Gaza just leaves us speechless. The devastation that we are witnessing on our screens is horrific, but to be in Gaza is unimaginable at this time. We stand by all those on both sides who are experiencing the trauma of loss, through hostage taking and lives lost.

We know that this can be prevented. It is immoral and it is man-made. We have to act more strongly. Of course, we have to end the sale of all arms, and end those export licences. We have to increase our funding to UNRWA, as the ambassador has called for, and we need to apply greater leverage, including sanctions, to ensure that we can get a political outcome.

I have to question what happened on 18 September at the UN General Assembly. We could have used our influence in that forum in a different way—124 countries, including our allies, France, Spain, Norway and New Zealand, had the courage to call for a ceasefire and to put that on record. It is one thing to call for something, but when we have a vote, that is decisive and it makes a difference. I just cannot comprehend why we did not use our leverage at that critical point to try and stand by the people who are suffering in Gaza right now.

We know that things are getting even worse, with the suffering getting even greater. We think about the seasonal change that is coming and the risks that come from that; we see the data from the Famine Early Warning Systems Network, highlighting the scale of malnutrition, hunger and the spread of disease; we know that people are dying every day before our eyes and we could do more.

When the Minister and his colleagues are at those platforms, I ask that he does everything possible within his power to use that leverage to call this to an end. We cannot just cross by on the other side. We must not let perfection be the enemy of good. Even if resolutions are not perfect, we know that they can save lives, they can end the carnage and they can build the hope of having food, clean water and aid to heal wounds and bring pain relief. I say to the Minister that every opportunity must be utilised to ensure that we have the humanitarian response to end this nightmare.

15:32

[Apsana Begum (Poplar and Limehouse) (Ind)]

In February this year, I secured and led a debate on the humanitarian catastrophe in Gaza. During the debate, I quoted Save the Children International’s chief executive officer’s harrowing plea:

“We are running out of words to describe the horror unfolding for Gaza’s children.”

Eight months later, it is absolutely and utterly devastating to be here again today, and that things have gone from bad to worse. As such, I urge the Government today to refrain from the insult of the usual euphemistic phrasing of speaking of too many civilians being killed or broad references to the humanitarian situation without condemning the actions that are so clearly responsible.

This is not about some random natural disaster. It is just beyond disturbing that so many cannot express a simple condemnation of the type of war being conducted by the Israeli military—the unprecedented death toll, the violence against women and children, the deliberate targeting of civilian infrastructure, the blocking of aid and the weaponisation of starvation.

It is just not enough to repeat the lines that Israel must uphold international human rights standards in theory, when it is so clear that they have not and are not doing so, and have effectively been given the go-ahead to continue to not do so. Quite frankly, the UK’s continued support and facilitation of this is absolutely shocking to my constituents, and indeed to the majority of people in the UK.

No matter the brutality of the censorship at home, the silencing or the spin, the inescapable truth is that civilians in Gaza, including large numbers of children, are facing healthcare shortages and diseases. This is what happens when hospitals are targeted and health and sanitation and other infrastructure is wilfully destroyed. My constituents have opposed this, but this is what the UK continues to facilitate. Civilians in Gaza, including large numbers of children, are not only starving, but being starved. This is what happens when food is being prevented from getting to those who need it. Civilians in Gaza, including large numbers of children, are not simply dying; they are being killed.

The lifting of the pause on funding the UNRWA is a welcome step forward, but as we speak, new mass displacement orders will worsen the entire, already dire, situation. I speculate that the Minister will likely assert something along the lines that aid must get to where it is needed in theory, yet everyone is clear that aid is being blocked and hindered by Israel, the UK’s close and staunch ally. The best way we know to ensure that aid is delivered is to secure a ceasefire. It is important that there is an arms embargo, including of F-35 fighter jets, which are being traded to be used against civilians. It has implications for global human rights benchmarks.

The horrors that continue to unfold before our eyes mean that we are being changed forever, but it has been made very clear that UK and US foreign policy interests are being pursued with an utter disregard for Palestinian life. It is chilling, and the complicity will never, ever be forgotten.

15:35

[Barry Gardiner (Brent West) (Lab)]

As politicians, we talk of the international rules-based system, by which we mean the World Trade Organisation and the United Nations, but often we do so only when it suits our position. When it does not, we ignore it. That is why it is crucial that we grasp the legal implications of the decision promulgated on 19 July this year by the International Court of Justice. It settled the law in its advisory opinion on the legality of Israel’s continued presence in the occupied Palestinian territory. The opinion came from a request by the United Nations General Assembly in December 2022, and I believe it carries immense weight. It is the interpretation of our world’s highest court of law as it relates to the occupation of Palestine.

The court ruled that the occupied Palestinian territory is to be considered a single territorial unit, which means that the failure to recognise Palestine as a state is now out of step with international law. On 10 September, Palestine took its seat at the 79th session of the General Assembly of the United Nations. It is not yet a full member, because it has been blocked by the United States, but it has the right to submit proposals and amendments. The Government of the UK still does not recognise the Palestinian state, and I believe that that is now incompatible with international law.

The court ruled that settlements and outposts in the west bank and East Jerusalem were unlawful. It does not matter that Israeli law considers settlements to be lawful; they are not, and they should be evacuated. The court ruled that Israel’s exploitation of natural resources in settled land was also unlawful. The court ruled that Israel occupied Gaza. It ruled that it occupied the west bank and East Jerusalem. It ruled that that occupation was unlawful. It ruled that the occupation must be brought to an end.

That also means that, in its actions, Israel must behave not as a warring nation state against another warring state, but as an occupying force, with all the obligations that entails about its conduct, including ensuring that aid can get through to all who need it. Israel ought to cease its unlawful activities, halt all new settlement activity and provide full reparation for the damage caused by its wrongful acts, which includes returning land, property and assets seized since the occupation began in 1967 and allowing displaced Palestinians to return to their original places of residence.

The court made it clear that other states also have obligations. It emphasised that all states are required not to recognise the illegal situation created by Israel’s actions in the occupied territories. That means that they should not engage in trade, investment or diplomatic relations that would entrench Israel’s unlawful presence. The advisory opinion is a landmark in the legal and political struggle over the fate of the Palestinian people and the integrity of international law. It highlights the obligations of all states, including the United Kingdom, to ensure that the rule of law prevails. We are all duty bound not only to act in the interests of justice and human rights, but to uphold the very principles of international law. That is the law. It is clear. It has been authoritatively stated by the court. What is not clear is whether Governments will abide by it. The law can state, the court can rule, but none of it brings about anything unless the power of enforcement lies behind it.

In the UK we are very fond of saying that we respect the international court and the international rules-based order. My challenge to the Minister is this: show it.

15:40

[Mr Adnan Hussain (Blackburn) (Ind)]

I repeat again the absurdity of the situation whereby we give aid with one hand to the besieged population of Gaza and provide weapons with the other, which has created the catastrophic circumstances that have taken the lives of over 40,000. Although the Prime Minister has made his position on the refusal to stop all the arms sales to Israel abundantly clear in Parliament just this week, I will none the less press the matter. Will the Minister assure us, especially in the light of further news today of a school housing displaced civilians in Gaza being bombed? Just weeks ago, a humanitarian safe zone, al-Mawasi, a camp identified by Israel itself, was bombed, with families dissipated in seconds. I therefore ask the Minister once again whether the Government’s position on arms sales to Israel will be revisited. Can he also answer whether, given the abundance of evidence already available, arms sales to a country plausibly accused of committing genocide can be morally or legally justified?

15:42

[Andy McDonald (Middlesbrough and Thornaby East) (Lab)]

It is a pleasure to see you in the Chair this afternoon, Ms Vaz. I congratulate the hon. Member for Birmingham Perry Barr (Ayoub Khan) on securing this debate. Before the recent recess, I tabled a written question to the Government. The answer is overdue, so I will briefly provide the background and put it to the Minister.

On 2 September, the Government revoked licences for all items used in the current conflict in Gaza that go to the Israel Defence Forces. It did so because there exists a clear risk that they might be used to commit or facilitate a serious violation of international humanitarian law. This is evidenced by events such as the IDF-confirmed use of 2,000 lb bombs, bunker-busting bombs, in a declared safe zone in al-Mawasi in July when they killed at least 90 Palestinians and injured over 30.

The revocation includes licences for F-35 fighter jet components where they go directly to Israel. They are revoked, but those in the supply chain in the global pool are not. Clearly, the components can still be used to facilitate a serious violation of international humanitarian law and to frustrate humanitarian aid. So I ask my Government to make it their policy to seek to negotiate an end-use agreement with F-35 programme supply chain and electronic stockpile management system counterparts, to end the re-export of F-35s to Israel.

The Dutch Government have suspended direct sales but continue to supply the global pool, but surely a discussion must be had with partner nations on managing the programme so that the global pool of spare parts is not used to repair Israeli F-35 jets. Unless the issue is raised and resolved with partner nations, I submit that the Government are at risk of breaching our own commitments to upholding international humanitarian law. I pray in aid the UN inquiry, which said today that it found that Israel carried out a “concerted policy” of destroying Gaza’s healthcare systems in the Gaza war—actions amounting to both

“war crimes and the crime against humanity of extermination”,

so I urge my Government to utilise all the levers at their disposal, and accept that the recognition of the state of Palestine is a prerequisite of peace—and that the optimal time to do so is now.

15:45

[Melanie Ward (Cowdenbeath and Kirkcaldy) (Lab)]

It is a pleasure to serve under your chairship, Ms Vaz. I thank the hon. Member for Birmingham Perry Barr (Ayoub Khan) for securing this important debate.

It is impossible to do justice to the horrors in Gaza—famine conditions and polio among them—in the short time we have today. I was in Gaza in April this year, six months into the horrific humanitarian catastrophe that continues now. What I witnessed then was haunting, and it is so much worse in Gaza today.

I wish to raise two main issues. First, there are alarming reports in the Israeli media that Israeli Prime Minister Netanyahu is considering a proposal from Smotrich and Ben Gvir, the far-right members of his Cabinet, which would effectively prevent aid agencies, including the UN, from operating or distributing aid in Gaza. Instead, it would hand all such responsibility to the Israeli military, reportedly including the running of field hospitals. There are many reasons why that would be unacceptable.

In January this year, the International Court of Justice ordered “immediate and effective” measures to protect Palestinians in Gaza from the risk of genocide by ensuring sufficient humanitarian assistance and enabling access to basic services. Despite that, the number of aid trucks that entered Gaza last month was the lowest we have seen since the start of the year. This is not an accident; the aid is deliberately obstructed by the Israeli Government. In April, I saw the queues of hundreds of trucks filled with aid stuck at crossings into Gaza. The aid is there—it is simply not allowed to enter Gaza in the quantities needed, nor are aid workers allowed to safely distribute it. The fact that more than 300 aid workers and almost 1,000 healthcare workers have been killed in the last year is testament to that.

When I left Gaza, I also visited warehouses full of aid items rejected by the Israeli authorities. I checked the list this morning, preparing for this debate. It included: wooden and metal crutches, wheelchairs, green sleeping bags, commodes, solar lamps, first-aid kits, an anaesthesia machine, generators, a bag of UNICEF footballs, bleach, and pots and pans. I could go on. The idea that a Government and military who do this should be allowed to take operational control of a humanitarian aid effort is unconscionable. I ask the Minister to be clear today that our Government oppose this, and to raise the subject with the Israelis. There is no excuse for the Israeli Government’s denial of Palestinian’s access to humanitarian aid. It is a violation of international law.

Secondly, the situation for civilians across Gaza is a living nightmare. Worst of all is the situation for civilians in the north, who have been trapped for over a year now. Months ago, civilians there were eating grass and animal feed to try to survive, and it is so much worse now. I want to raise alarm at the Israeli military’s most recent forced displacement orders for civilians in the north of Gaza being told to move south. This includes orders to evacuate critically ill patients and healthcare workers from the Al-Awda, Indonesian and Kamal Adwan hospitals. This morning I saw footage of intubated children and babies in incubators in the paediatric intensive care unit at Kamal Adwan hospital; they cannot evacuate, and even if they could, there is nowhere safe to go. Does the Minister agree that this military action is intolerable, unacceptable and must end?

Our new Government have taken important first steps on UNRWA, arms and the ICC. There is much more to do. It is true that the Palestinians of Gaza need a ceasefire and access to aid, and aid workers need to be able to work safely, but Palestinians do not just need aid. They have the same rights to safety, freedom and dignity as everyone else, and we in this House would do well to remember that.

15:49

[Tony Vaughan (Folkestone and Hythe) (Lab)]

It is always a pleasure to serve under your chairmanship, Ms Vaz, and I thank the hon. Member for Birmingham Perry Barr (Ayoub Khan) for securing the debate.

The situation in Gaza is horrific and tragic. The British Red Cross has stated that more than 41,000 people have been killed in Gaza, and many more have been injured and displaced. Hostages are still being held and survivors are traumatised.

The meetings that I have attended with ambassadors from the region have searingly impressed upon me how desperate and urgent the situation now is in Gaza and the west bank. Making sure that enough aid enters and is properly distributed to the people in Gaza is a moral imperative. It is also a legal imperative. In January, the International Court of Justice ordered Israel to take measures to prevent genocide, in order to ensure that humanitarian aid reaches Palestinians, but that order is not yet being complied with. As hon. Friends have said, aid is still being blocked. It is of particular concern that the Israeli military are forcing hospitals—which are full of displaced civilians, medical staff and sick patients, all of whom are protected under international law—to shut down. The health system in Gaza must not be allowed to collapse.

I thank the Minister for all his work on this issue. Will he confirm that the UK is taking urgent action to stop Israel forcibly displacing Palestinians from the north; to ensure that adequate aid reaches those who need it; to ensure that civilians, including those in hospitals and in their homes, are protected at all times; and, ultimately, to secure an urgent ceasefire? Respect for the international rule of law requires this.

15:51

[Steve Witherden (Montgomeryshire and Glyndŵr) (Lab)]

It is a pleasure to speak under your chairpersonship, Ms Vaz. I congratulate the hon. Member for Birmingham Perry Barr (Ayoub Khan) on securing this crucial debate, which coincides with today’s nationwide workplace day of action for Palestine.

This past year has been marked by indiscriminate loss, with lives tragically taken on 7 October last year and in the ongoing horrors that we have witnessed unfolding since then. Over 41,000 people have been reported killed in Gaza, alongside 695 in the west bank, with many more unaccounted for beneath the rubble.

The impact on women and children has been particularly severe, with Oxfam reporting last week that more women and children have been killed in Gaza by the Israeli military in the past year than have been killed in any other conflict in the last two decades. In addition to the ongoing daily bombardment, the malnutrition, disease and unmet medical needs pose an even greater threat to Palestinian lives.

Yesterday marked a year since Israel’s Minister of Defence declared a “complete siege” on Gaza, stating that there would be:

“No electricity, no food, no water, no gas—it’s all closed.”

The humanitarian crisis that has followed has been beyond comprehension. Approximately 83% of required food aid is blocked from entering Gaza, while the risk of famine becomes more imminent. Over 70% of civilian infrastructure, including hospitals, has been destroyed, with more than 500 recorded attacks on medical facilities and hundreds of healthcare workers having been killed. Last month, the United Nations reported that the number of aid workers killed in Gaza in the past year is the highest ever recorded in a single crisis.

With food aid and healthcare are under attack, and aid workers paying the ultimate price for their efforts to provide relief, we must urgently address this humanitarian disaster and ensure that unimpeded aid reaches all those who so desperately need it. I welcome the actions taken by the Labour Government in our first months in office to facilitate the entry of humanitarian aid into Gaza. We have restored funding to UNRWA and engaged with the United Nations Security Council to ensure that there is a global focus on protecting civilians in Gaza. However, given the scale of the crisis, our Government should be doing everything in their power to secure an immediate and permanent ceasefire. Without one, the humanitarian crisis in Gaza will worsen, essential aid will be obstructed and suffering will be prolonged.

The decision in September to suspend about 30 UK arms export licences to Israel from a total of approximately 350 marked a crucial step towards achieving a ceasefire for all Palestinians and Israelis. However, by excluding export licences for F-35 fighter jet parts from that announcement, the UK risks complicity in Israel’s potential violations of international law. F-35s, described as the most lethal fighter jets in the world, are partly manufactured in Britain and are currently deployed in Gaza, causing significant civilian casualties and hindering the distribution of aid while destroying vital healthcare infrastructure. Can the Minister clarify how the decision to continue allowing licences for F-35 components exported via third-party countries aligns with the UK’s international legal obligations? How does this approach ensure that critical aid can be delivered securely to alleviate the suffering in Gaza, especially given the risks to medical workers and the destruction of healthcare facilities?

We must urgently end these atrocities and stand for humanity. Allowing the horrifying decline of this conflict to continue will lead to even greater consequences. Diolch yn fawr.

15:56

[Tahir Ali (Birmingham Hall Green and Moseley) (Lab)]

It is a pleasure to serve under your chairmanship, Ms Vaz.

The people of Gaza are being let down by the international community. We have reached a point where the human suffering and cultural devastation in the area is undeniable, yet we continue to fail to provide a sustainable amount of life-saving aid. The Palestinian people should not be subjected to a lack of food, water and medical supplies.

I have received hundreds of emails from the constituents of Birmingham Hall Green and Moseley, who are extremely worried about the restrictions on food and humanitarian aid due to the new customs rule on aid trucks enforced by the Israeli Government. The United Nations reports that in September, more than 90% of efforts to get trucks into Gaza were either denied or delayed by the Israeli Government.

Palestinian children are suffering the most from the catastrophic restrictions imposed on them. Over 2 million people—more than 90% of the population of Gaza—are living in tents after being forced from their homes by the Israeli Government’s actions. This will prove to be a deadly winter, with the danger of hypothermia. Israel’s ongoing attack is punishing the Palestinian people by denying them the human right to adequate housing.

Now is the time for action. We have heard words in this House for more than 12 months, but it is about time they were translated into action. Israel must be held accountable for the war crimes it is committing, and this Government must now stop all arms sales to Israel. The international community needs to work together and look for viable ways to get vital aid into Gaza.

Finally, we need to push for a full, permanent ceasefire to stop this humanitarian disaster, and give international organisations proper access to Gaza. I thank the hon. Member for Birmingham Perry Barr (Ayoub Khan) for securing this debate.

15:59

[Chris Murray (Edinburgh East and Musselburgh) (Lab)]

It does not need saying, because everyone with eyes can see it, but we cannot say it often enough: too many civilians have died over the last year in the middle east. It is so important that as few as possible follow them.

Before being elected, I worked at Save the Children, and I have worked on migration policy for the past 15 years. I am profoundly worried by the high levels of displacement we are seeing in the middle east. One million people have been displaced in Lebanon. Within Gaza, it is estimated that nine in 10 people have been displaced at some point. This is awful for those personally affected, but it is also profoundly politically destabilising to an already febrile situation, and it adds to the potential for escalation and therefore miscalculation.

We should be terrified of escalation and miscalculation. That is the biggest threat to the humanitarian situation, because we have already seen things escalate appallingly quickly. We must be clear: “escalate to de-escalate” is a falsehood, it is misguided and it will strategically misfire for all. Will the Government strain every sinew to avoid further escalation in the middle east? The reason is not just political or diplomatic; it is humanitarian. Too many have died already, and the only way to stop more joining them is by stopping escalation.

I know that the Minister will be constrained in what he can say today. I welcome the decisions on UNRWA, arms and the ICC, and the commitment to the rule of law, but can he reassure us that the Government’s aim in this situation is de-escalation for humanitarian purposes?

[Valerie Vaz (in the Chair)]

We will try to get everyone in. We have three people and I want to start wind-ups at 4.5 pm, so please keep it short.

16:00

[Laurence Turner (Birmingham Northfield) (Lab)]

It is a pleasure to serve under your chairship, Ms Vaz. I thank the hon. Member for Birmingham Perry Barr (Ayoub Khan) for securing this important and timely debate.

Earlier this week, the House marked the one-year anniversary of the 7 October atrocities. On that day and the days that followed, Hamas and other groups intended to ignite a wider war, and the death and destruction that would follow in its wake. Today, when over 2 million people have been displaced, over 40,000 Palestinians are dead and the threat of wider war looms all too closely, we must redouble our efforts in pursuit of an immediate ceasefire, the return of hostages and real progress—after these long years—towards a two-state solution that upholds the dignity of the Palestinian people and the security and territorial integrity of both nations.

Six months ago, the Israeli Defence Minister said:

“We plan to flood Gaza with aid and we are expecting to reach 500 trucks per day.”

However, since then the World Health Organisation has warned that lifesaving hospital aid has been cut off, and the UN has warned that starvation has spread throughout Gaza. There were just 52 aid trucks each day in September —a bare tenth of the pre-October rates and far short of the total needed to relieve the extreme distress.

Noting the UK Government’s existing assessment that Israel is not ensuring that lifesaving food and medical supplies are reaching civilians in Gaza, I ask the Minister to update us today on what representations and protests the UK Government have made to the Israeli Government on the entry of food and aid into Gaza. Secondly, what steps are the Government taking to work with aid agencies and civil society to offer protection to aid workers, including British aid workers, who face unacceptable risk? Finally, will he give us a broader update on the UK Government’s efforts to progress ceasefire talks and bring forward a credible reconstruction programme in Gaza?

I know that hon. Members welcome the decision to reinstate UNRWA funding, but that cannot be the end of the process. I also know that the Minister takes this important matter seriously, and I hope he will ensure that there is further debate and scrutiny in this House.

[Valerie Vaz (in the Chair)]

Two minutes left.

16:03

[Blair McDougall (East Renfrewshire) (Lab)]

I began this week by speaking to commemorate the hostages who were taken on 7 October. I see no contradiction in ending it by recognising the horror of the humanitarian situation within Gaza. It is important to put it on the record that people in Gaza do not choose to be ruled by Hamas. A poll published last month showed that two thirds of people in Gaza support a two-state solution, not the destruction of Israel, and only 6% support Hamas.

In the short time I have, I want to ask the Minister to reflect on three particular things. First, in a deeply uncertain environment, we know one thing: winter is coming. It is about to get colder and wetter, and the lower immunity that people have due to malnutrition—particularly children—means an increased risk of respiratory diseases, diarrhoea and other common diseases. Along with others, I ask the Minister what more he can do to ensure that more shelter and more hygiene kits are allowed through to reach those who need it.

Secondly, looking beyond the ceasefire that we all want, I want to talk about the long tail of insecurity within Gaza. Dozens of bakeries have been destroyed and about two thirds of agricultural land has been damaged in some way. Fields, greenhouses, polytunnels and irritation systems have been damaged. The plan for the day after has to start now. What plans do the Government have to ensure that horticulture, livestock farming and fishing are restored and the bakeries and markets rebuilt? Otherwise, this will be not a short-term emergency but a long-term problem.

Finally, after the 2014 Gaza war generous pledges were made by international donors for reconstruction. In some cases, the funds pledged simply did not come through. In many cases, attempts to reconstruct were blocked by the Israeli Government. There were other cases. For example, Fatah accused Hamas of stealing hundreds of millions of dollars of reconstruction aid. In 2014, about 150,000 properties were damaged in some way. This war has far outstripped that. What can the Minister do, working with international partners, to ensure that the failures after the last 2014 war in Gaza are not repeated?

16:06

[Brian Mathew (Melksham and Devizes) (LD)]

I speak as someone who knew Gaza in the happy times when, as a young university researcher, I went with my Israeli friends from Kibbutz Re’im to meet their Arab friends in Gaza City to drink coffee and trade. We have heard in the debate about the horror and the passion. We have also heard of solutions, a recognition of the state of Palestine and, indeed, the inclusion of the evacuation of wounded children.

War is a horrible thing, and it makes people behave badly, especially when they feel—and, indeed, have been—hurt as the Israelis have been by the events of 7 October last year. There are things that can be done, which we have heard today, including the release of the hostages and the end of the war, but there are also things that must be done in the future to see Palestine’s future assured, such as the closure of the illegal settlements in the west bank and the rebuilding of Gaza itself. For that to happen, trust needs to be built, and for that to be built, our Government need to be talking to not just the leadership but the opposition in Israel. Jaw-jaw is indeed better than war-war.

16:07

[Monica Harding (Esher and Walton) (LD)]

It is a pleasure to serve under your chairmanship, Ms Vaz. I congratulate the hon. Member for Birmingham Perry Barr (Ayoub Khan) on securing the debate on this most critical issue. This is my first contribution in my capacity as Liberal Democrat spokesperson for international development, and this is a hugely pressing issue.

Hon. Members have spoken of the many aid agencies working in incredibly difficult situations and risking their lives. I want to add my voice to the tributes paid to them. Liberal Democrats share the calls we have heard today for an immediate recognition of a Palestinian state and urge the Government to use every lever they have to de-escalate the conflict. Conflict is escalating in the middle east. We are on the brink of a regional war, which would be of devastating consequence to innocent civilians, be they Palestinian, Lebanese, Israeli or Iranian.

We now face a second humanitarian crisis in the region in Lebanon, where hundreds of thousands are already displaced in addition to the many Syrian refugees already living in Lebanon. We cannot afford for Lebanon to become a failed state. We welcome the increase in aid to Lebanon of £10 million but, frankly, that is a drop in the ocean. As recently as 2019-20, the UK ODA allocation to Lebanon was over £200 million. This year we are looking at less than £20 million.

Amidst the tensions in the region, we cannot and must not forget Gaza. The Liberal Democrats continue to call for an immediate bilateral ceasefire in Gaza to resolve the humanitarian devastation there, get the hostages out and open the door to a two-state solution.

There is clearly a dire humanitarian need in the strip. Amidst an escalation of the conflict in the region, the flow of essential goods into Gaza has been critically restricted, causing a drop in aid supplies and a critical shortage of commercial goods. Aid entering Gaza has plummeted to its lowest level in months. If the flow of assistance does not resume, more than 1 million vulnerable people will lose the assistance they rely on in October. Three quarters of Gaza’s population rely on food aid to survive. People have run out of ways to cope, food systems have collapsed and the risk of famine persists. The World Health Organisation is now looking to carry out the second phase of a polio inoculation campaign after the first case of polio in Gaza in 25 years was found over the summer.

First, we call on the UK Government to increase humanitarian support to Gaza. The Liberal Democrats have long urged the Government to restore the 0.7% of national income target for international development spending—indeed, when in government, we enshrined that target in law. Now that the aid budget has been so depleted, we face humanitarian crises such as these with one hand tied behind our back. We continue to urge the Government to look again at returning to 0.7%. There are also specific problems with getting aid into Gaza. Not enough humanitarian aid is getting into the strip, and the Rafah crossing is shut. I hope that the Minister will provide an update on what exchanges he and his counterparts have had with all relevant agencies, in particular with the Israeli Government, to ensure that aid is stepped up.

Secondly, we know that there are particular problems with the distribution of aid in Gaza, with no deconfliction system in place. We have heard about how aid entering into one part of the strip does not get to its intended destination, because human need is so great along the way. Will the Minister update us on what work the FCDO is doing to try to make it easier and safer for aid to be distributed in a manner that protects the safety of aid workers?

Thirdly, we are now moving into the winter months, and as the temperatures drop they pose particular challenges to the humanitarian situation in the strip. It is vital that we act now and quickly with our allies to do all we can to ensure that we can support Gazans through these winter months and beyond. Will the Minister update us on what steps he and his ministerial colleagues are taking to that end?

Fourthly, the Liberal Democrats welcome the Government’s decision to once again provide UK ODA to UNRWA. Will the Minister update us on what conversations he has had with counterparts in UNRWA, including on the implementation of the Colonna report? It is vital that these recommendations are implemented as soon as possible, thereby ensuring that all work to support Palestinians in Gaza is of the highest possible standards and integrity.

Finally, looking across from Gaza into the west bank, will the Minister update us on the level of UK ODA being provided to support the Palestinian Authority? Supporting the Palestinian Authority and improving wider conditions for Palestinians is absolutely vital at this difficult moment.

16:13

[Dame Harriett Baldwin (West Worcestershire) (Con)]

It is a pleasure to serve under your chairmanship, Ms Vaz. This afternoon has been an opportunity to hear voices from across the United Kingdom. I congratulate the hon. Member for Birmingham Perry Barr (Ayoub Khan) on securing the debate. We have heard voices not only from Birmingham, but from London and across the English home counties. We have heard strong Scottish voices, and we have heard from Durham and York. In the interests of time, I will not list every constituency from which we heard passionately and expressively that the Palestinians face a devastating humanitarian crisis, but the UK should continue to play a leading role in alleviating that suffering.

This week of all weeks, however, we must remind ourselves that on 7 October Israel suffered an appalling attack—a modern-day pogrom. It was the worst loss of Jewish life since the second world war, a horrific display of antisemitism and a brutal reminder of the existential threats that Israel must contend with. We must always state that Israel has the right to defend itself in accordance with international humanitarian law.

As we have heard, so many innocent civilians are suffering not only in Israel, but in Gaza and now Lebanon. This conflict must come to a sustainable end as quickly as possible, starting with the immediate and unconditional release of the remaining hostages captive in Gaza, including the British citizen Emily Damari. Can I ask the Minister—a former hostage negotiator himself—for an update on the Government’s efforts to secure her release and the release of the other hostages who are in such awful jeopardy?

The previous UK Government trebled our aid commitment in the last financial year and facilitated aid flows into Gaza by land, sea and air. In the interests of time, I will not list them all; I will focus on the 11 airdrops delivered directly to Gaza through a temporary marine corridor that was supported by the Royal Fleet Auxiliary and the funding of field hospitals to treat thousands of patients. Can the Minister confirm that these efforts continue under the new Government?

During the previous Government, Israel committed to increasing the amount of aid getting into Gaza, including by allowing the delivery of humanitarian aid through Ashdod and Erez, extending the opening hours of Kerem Shalom, increasing the total number of aid trucks to at least 500 a day, and allowing more types of aid, including fuel for bakeries and hospitals. We welcome the recent pause for polio vaccinations and wish to put on record our gratitude to the World Health Organisation, the British Red Cross, the World Food Programme and UNICEF staff, who are doing vital humanitarian work and should be commended.

As we have heard today, aid workers are not a target. Protecting humanitarian actors must be a priority, and guaranteed deconfliction for aid convoys and other humanitarian work is essential. We should also take this opportunity to pay tribute to all of the brave aid workers in Gaza and our fellow citizens James Kirby, John Chapman and James Henderson who were killed delivering aid in Gaza earlier this year.

Can we have an update from the Minister on the work that the Government are doing to advance on these key areas? What steps have they taken to help to increase the amount of aid getting over the border into Gaza? What additional aid, supplies and humanitarian support has the UK sent? What action have the Government taken to make the case for the protection of the humanitarian personnel on the ground distributing that aid?

In the interests of time, I will skip over the situation with UNRWA, but I want to hear an update from the Minister on the implementation of the Colonna recommendations and the UK Government’s scrutiny of it. As we heard earlier this week from the Leader of the Opposition, the situation in the middle east is grave. There is no equivalence between Iran’s terrorist proxies and Israel. Israel has a right to defend itself, and we support it in those goals, but too many innocent civilian lives have been lost and irreparably changed by this conflict. The UK should continue to carefully support them through our humanitarian aid commitments, and I look forward to the Minister reporting to us on the progress made.

16:18

[The Parliamentary Under-Secretary of State for Foreign, Commonwealth and Development Affairs (Hamish Falconer)]

I am grateful to the hon. Member for Birmingham Perry Barr (Ayoub Khan) for securing this important debate, and I thank you, Ms Vaz, for your expert management of today’s proceedings. This is my first debate in this place, so I am sure that I will be considerably less expert, and I beg your indulgence at the outset. I will try to be brief so that I can give the hon. Member an opportunity to respond.

As many have said, this week marked one year since Hamas’s brutal attack against Israel. It was the worst attack in its history and without doubt the darkest day in Jewish history since the Holocaust. As many have said in this Chamber, my thoughts are with Jewish people around the world and the Jewish community here in the United Kingdom. More than 1,000 people were massacred, hundreds were taken hostage and many are still cruelly detained today, including Emily Damari. I reiterate our commitment to bringing those hostages home; we will not give up until they are, and work is ongoing on that.

However, as has been the subject of most of the interventions, we also look back on a year of devastating conflict and suffering. I will say a little about the Government’s assessment of the situation in Gaza, then, in the time available, I will focus particularly on the humanitarian situation. I recognise that it is my fault that there are some late parliamentary questions on these issues, particularly relating to the detail on F-35s, and I will be pleased to respond in writing.

A year on, close to 42,000 people have now been killed in Gaza, with over half of all bodies identified being women and children. We believe that more than 90% of the population has been displaced, many of them repeatedly. There is now simply no safe place to go. The humanitarian zone covers less than 15% of the Gaza strip, and as has been mentioned, not even that is always safe. It is chronically overcrowded and the lack of clean water and sanitation means that the risk of disease is rife.

Reference has also been made to the severe lack of food which, according to the IPC, means that the whole population is at risk of starvation, and we expect a further update on that in due course. Sixty-six per cent of buildings, including hospitals—as many have mentioned—are damaged or destroyed. Parents cannot feed their children. Children cannot go to school. Families cannot support each other. I have been asked many questions by contributors about humanitarian access, and I want to be clear on the Government’s position: it remains wholly inadequate. There have been repeated attacks on convoys, evacuation orders have undermined operations and the level is far below Israel’s commitment to flood Gaza with aid.

[Andy McDonald]

I raised earlier the question of the Israeli military action to which the Minister has just referred. In the past hour or so, the UN has stated on its website:

“Israel Defense Forces (IDF) fired on UN peacekeepers in Lebanon early Thursday morning.”

Two peacekeepers were injured, which is yet further evidence that Israel behaves with complete contempt and disregard for international law and norms. Will he join me in condemning such action?

[Hamish Falconer]

They have only just come in, but we are very concerned about reports of attacks on staff of the United Nations Interim Force in Lebanon. The work of UN peacekeepers is incredibly important and a vital contribution to global peace and security. We will be able to say more as reports become clearer.

The situation in Gaza is a catastrophe on all counts. A few contributors have mentioned winterisation. We are deeply concerned that winter is coming in and the shortage of aid into Gaza means that most of the civilian population is unprepared for the drop in temperature. I will be visiting the region next week in part to look into some of those matters further. We intend to work together with our allies. Since entering office in July, we have made a series of key decisions. Along with our allies, we have been pushing for an immediate ceasefire since day 1, and I was confused by the reference to our position on 18 September. We have been calling for an immediate ceasefire since 4 July, and we will continue to call for an immediate ceasefire. The fact that is has not yet been abided by does not in any way undermine the urgency of what we are doing.

[Rachael Maskell]

I was referring to the UN General Assembly resolution where we did not vote with 124 countries.

[Hamish Falconer]

I think that is an issue in relation to the advisory opinion of the ICJ rather than the ceasefire; that is how I understood my hon. Friend’s remarks. I will stick to the ceasefire now, and I can come to the advisory opinion later. We are clear that we need a ceasefire; we need a ceasefire in Gaza and we need a ceasefire in Lebanon. It is clearly a statement of fact that neither of those things is happening, and we continue to work behind the scenes with our partners to try to achieve that. That point has been made by both the Prime Minister and Foreign Secretary, as well as the whole ministerial team in the Foreign Office.

We are repeatedly urging our Israeli counterparts— I think it is on this issue that I have received the most questions over the afternoon. We are asking them to take three key steps. The first is to take all necessary precautions to avoid civilian casualties, and we have heard many lurid examples of where that has not been the case. The second is to ensure that aid can flow freely into Gaza through all land routes, and many contributors have described how that is not currently the case. The third is to allow the UN and its humanitarian partners to operate safely and effectively. I recognise some of the concerns raised this afternoon about the functioning of UNRWA, so I will say a little bit about that.

[Barry Gardiner]

I congratulate the Minister on making his maiden address. Can he reflect on the verb that he used? He said that we have been “asking” Israel to do those three things. He then went on to elaborate that none of those three had actually been fulfilled. Is it not time to stop “asking” and to do something a little stronger?

[Hamish Falconer]

My colleague will understand that there is a difference between what we can say in public and what we can say in private. However, I reassure him that those points are being made to partners with force, with emphasis and with consistency. As he will have seen through a number of forums over the last few weeks, the UK has made its position absolutely clear. It is, of course, a frustration to me that at this stage, and since we came into power in July, we are still having some of those discussions, so I recognise the frustration in his voice.

On my first day as a Minister, we lifted the funding pause on UNRWA. We provided £21 million to support its humanitarian appeal in Gaza. No other agency can deliver aid to Gaza on the scale that is needed. We must support UNRWA to do its job effectively. Of course, in delivering, we expect it to meet the highest standards of neutrality, as laid out in Catherine Colonna’s independent review, and the Minister for Development has met her to discuss such matters. Of our funding to UNRWA this year, £1 million has gone to support the implementation of its agreed action plan. However, I take note of the reference to some of the discussions in the Israeli Knesset. I want to emphasise the importance that the UK places on UNRWA, on its continued function and its unique role in the area, as well as our full support for the UN Secretary-General.

[John McDonnell]

I am sorry to interrupt the Minister’s flow, but before he sits down, can he give me some assurance that he will take back to his colleagues the issue about the evacuation of children? I raised it again on Monday with the Prime Minister and still got no response.

[Hamish Falconer]

I was coming to that issue, but I will take it now.

I am very familiar with these issues; in fact, as an official in 2014, I was working with the mass atrocity prevention hub, where I know my colleagues have also served, to try to identify children at that time and in that stage of the war. It is incredibly depressing to be in this Chamber 10 years on talking about injured children in Gaza again. At that time, I was tasked with trying to find children who could benefit from UK medical assistance, and I was honestly not able to find children who would not be better served in the region. Having discussed the matter with officials—I understand the Minister for Development has looked at this as well—we primarily share the view expressed in WHO guidance that children should be treated in the region as much as possible. That will mean in most cases that being treated in Egypt or somewhere nearby is going to be more appropriate than being treated in the UK. However, I will go back to the Department and secure a fuller answer.

I want to return briefly to the mandate of the UN. We are clear that Israel must respect the mandate of the UN and must enable humanitarian workers to travel easily into and throughout Gaza.

[Apsana Begum]

It is absolutely clear that aid and aid workers are being hindered and blocked by Israel. At the same time, the UK considers Israel to be one of its closest allies. How does that make sense in terms of how the UK represents itself at the UN and on the world platform? The Minister seems to be suggesting that efforts are being made to secure a ceasefire to provide aid, when it is obvious that there is a block and that the UK is facilitating that, as opposed to opposing it.

[Hamish Falconer]

I do not accept that we are facilitating rather than opposing. I could not be clearer in everything I have said this afternoon about the position of the British Government. I have been clear with my colleagues about our frustration that we have not been able to make more progress on the things that we have been calling for. I want to reassure colleagues across the House that the whole ministerial team is working hard day and night on these issues. We recognise the acute nature of the situation before us, and we treat it with the full gravity that it deserves.

[Mr Hussain]

Will the Minister give way?

[Hamish Falconer]

I will try to make a tiny bit more progress, and then I will hand back.

[Valerie Vaz (in the Chair)]

You have a minute left, Minister.

[Hamish Falconer]

Then I will probably get to the end, in order to allow people to respond.

From the Prime Minister down, we will continue to call on all parties to act in accordance with international humanitarian law. Earlier in July, when he was visiting the region, the Foreign Secretary announced £5.5 million in new medical aid to field hospitals in Gaza; I think that was the subject of a question that was asked today. We are working to try to bolster medical capacity for patients. We think that is best done in the region, and we are frustrated by the impediments that still exist, particularly around children being able to access medical care and other aid.

[Valerie Vaz (in the Chair)]

Order. I want to put the Question.

Question put and agreed to.

Resolved,

That this House has considered humanitarian aid and Gaza.

16:30

Sitting adjourned.