(3 years, 6 months ago)
Commons ChamberIt is a pleasure to be speaking in this debate on the Gracious Speech, and I absolutely welcome the agenda for national recovery that the Government have set, but in that recovery we must not forget the south-west. Clearly the north needs help, but levels of deprivation are as severe in the south-west as they are in many parts of the north, and that needs to be taken account of. The rural areas need support, especially support on infrastructure and broadband, which should be focused on those areas currently most exposed in the rural heartlands of the south-west.
Two key planks of the Gracious Speech have been education, and health and care and our NHS. The proposed suite of legislation to deliver that world-class health and care is extremely welcome, but I believe that a number of issues have been missed. First, mental health clearly must have parity of esteem with physical health, but nowhere on the face of the health and care Bill is that clear. There is no provision for representation on the new integrated care system boards for those providing mental health services. That is a must. There are no provisions for measuring outcomes for mental health measures.
Secondly, covid has demonstrated beyond doubt that medicines and devices are as much a key part of delivering good health and care as doctors, nurses and hospitals, and yet they too are absent from this legislation. If we are talking about integration, it cannot be just about integrating health and care; it must be about integrating health, care and the provision of medicines and devices. We know that access to medicine and devices has been one of the most challenging issues generally, not just during covid, and unless we look at the commissioning arrangements in the new legislation and ensure that they relate to all four parts of the system—health, care, medicines and devices—we will sub-optimise, and will not deliver the health and care that people need and deserve.
Thirdly, the inclusion of social care in the Gracious Speech is very welcome, but we need to remember that it is not just about money, but about the system itself; and again it is about parity of esteem. Social care has for too long been the Cinderella service. That must change. We must see proper recognition. We must see a proper career structure. We must see training for those entering social care, alongside those entering our health system. Nurses must be able to transfer across and between those two systems; and the pay of both must be equal, transparent and fair.
We also have a very sensible focus on public health. I am delighted by the focus on obesity, which is clearly a key issue of our time, but I would suggest that there is more than obesity. We need to recognise the increasing interest that individuals have in purchasing all sorts of substances across the counter and from beauticians, pharmacists and other professionals, which at the moment are not regulated to the same level as a medicine would be. There is a committee under the auspices of the Medicines and Healthcare Products Regulatory Agency—the Advisory Committee on Borderline Substances. Between that Committee and the Food Standards Agency these sorts of substances are evaluated for their efficacy and also their safety, and in light of the Cumberlege report I suggest that the Advisory Committee on Borderline Substances and the FSA be reviewed to establish whether the systems they have in place are adequate for the increasing demand for these new substances, nutritional and otherwise. This is important and urgently needed.
Finally, I turn to the legislation proposed for victims of abuse, and again in the health context. These victims need all the support we can give them. At the moment their first port of call is very often the police, but the reality is that they would deliver far more valuable information and would get far better support in the context of general practice within our NHS system, yet at the moment no training is provided for GPs and there is no expectation that they should deal with this as a front and centre concern coming through their doors on a day-to-day basis. I am delighted that Devon has the only clinical commissioning group pilot with a lead officer on domestic abuse and sexual violence, but that should be rolled out. Such offences are best detected and treated within our general practice and within our NHS. That needs to be looked at urgently if we are serious.
The issues I have raised are crucial if we are to deliver a best-in-class health and care system. These issues need to be covered not in secondary legislation, but on the face of the upcoming series of legislative provisions, because what is legislated for will be done.
(3 years, 10 months ago)
Commons ChamberI appreciate that the Secretary of State is giving thorough and detailed answers to a great many questions, but we have already taken up considerably more than an hour on this statement. There are still 13 people to participate and I would like to give everyone the chance to ask their question, but I must ask them not to make speeches or statements. Just ask a question, and if it is a short question the Secretary of State will be able to give quite a short answer.
Secretary of State, the future of the country is very much in your hands—the children are our future. I pay tribute to my local schools, who have risen to the challenge and continue to deliver an exemplary education. Closing schools is one thing; what is your plan to open them? What are your criteria? It cannot be to end lockdown having had a devastating effect on children’s mental health. What is your vision and what is your plan for optimising children’s life chances and giving a clear map of the future for children, parents, teachers, universities and employers? What, in your eyes, does good look like?
Order. I did tell the hon. Lady not to make a speech but to ask a question. She has asked several questions, which I am sure the Secretary of State will answer, but I must insist that while we have virtual proceedings in this Chamber, people who participate virtually adhere to the same rules that we adhere to in the Chamber. Nobody calls the Secretary of State “you”. “You” means the Chair; the Secretary of State is the right hon. Gentleman.