Interim NHS People Plan

Ben Bradshaw Excerpts

Wednesday 5th June 2019 Commons Chamber

[Stephen Hammond]

My hon. Friend will know, because I have been in debates with him before, that I recognise the exceptional work that those two all-party groups do. He will know from the long-term plan that we have set out new commitments on diagnosis for all cancers and for cardiac. He will know that the reason why we have set out an interim people plan and will then set out a final people plan is that a long-term plan cannot work unless we have the people to back it up and are training the right number of people. This plan sets out how to recruit more people, how to train more people, how to give people the skills to deal with what will face the clinicians and the physicians of the 21st century, and that is key to delivering what he has asked for.

[Mr Ben Bradshaw (Exeter) (Lab)]

Baroness Harding, who is a Conservative peer, and Sir David Behan, the head of Health Education England, told the Health Committee yesterday in absolutely clear terms that both the abolition of nursing bursaries and Brexit are seriously exacerbating the staffing crisis in the NHS. Are they wrong?

[Stephen Hammond]

I am sure they will also have said that one of the things Health Education England has explicitly set out is that one of the biggest barriers to more nurses was that there was not the placement capacity. I am sure Sir David Behan will also have set out that he therefore welcomes entirely the 5,000 extra clinical placements that are being made available, which is a 25% increase on last year.

The right hon. Gentleman will also know, as I have set out, that there are more EU nationals working in the NHS now than there were at the time of the referendum. However, one of the reasons why we are having an interim people plan is that we are not complacent. There are huge challenges, as I set out not only in my written ministerial statement, but in my opening remarks. That is why this plan is addressing the shortages in nursing, and it is right that we do so.

Oral Answers to Questions

Ben Bradshaw Excerpts

Tuesday 7th May 2019 Commons Chamber

[Stephen Hammond]

As my hon. Friend has heard, the Secretary of State commissioned Baroness Harding to bring forward the interim workforce plan. One of the workstreams was looking at retention and the staff we currently have. More than 52,000 nurses are in undergraduate training, and it is essential that they stay in the NHS after training. What Baroness Harding outlined today will ensure that that happens.

[Mr Ben Bradshaw (Exeter) (Lab)]

Can the Minister confirm today’s Daily Mail report that the NHS plans to recruit thousands of overseas nurses over the next five years? How much of that shortage has been caused by the exodus of EU nationals from the NHS, and how much of it by the Government’s disastrous decision to abolish nursing bursaries?

Access to Medical Cannabis

Ben Bradshaw Excerpts

Monday 8th April 2019 Commons Chamber

[Matt Hancock]

If I may, Mr Speaker, I would like to add to my previous answer by congratulating my hon. Friend the Member for Watford, the former Business Minister, on all that he did to support business, enterprise and the case for capitalism while he was in his former job. I regret his departing from the Government, because he was a brilliant Minister.

On the question ahead of me, so to speak, the Chair of the Select Committee, the hon. Member for Totnes (Dr Wollaston), is right to say that it is vital to bring forward these clinical trials, and that the pharmaceutical companies that provide the oils have not pushed forward the trials in the way that would normally happen. We have therefore stepped in to try to make them happen, but we do need the calls to be answered.

[Mr Ben Bradshaw (Exeter) (Lab)]

The Secretary of State talks about removing barriers, but it is clear to me that the main barrier is the British Paediatric Neurology Association itself. When its president came to give evidence to the Health and Social Care Committee a couple of weeks ago, he was arrogant, he was dismissive of the families’ experience, and he misled our Committee by denying that Members of this House had sought a dialogue with him, which he had refused. What is the Secretary of State going to do to remove the obstacle of the BPNA?

[Matt Hancock]

I am sure that the BPNA will have heard that testimony from the right hon. Gentleman. Of course, the BPNA is independent of Government, and we have to follow the clinical judgments made by the relevant organisations, whether a royal college or, as in this case, an association. What I have done is ensure that a second opinion is available, because the BPNA guidance is merely guidance; it is not absolute. A clinician on the specialist register can make a decision according to what they think is best for the patient in front of them.

--- Later in debate ---

[Tonia Antoniazzi (Gower) (Lab)]

I congratulate the right hon. Member for Hemel Hempstead (Sir Mike Penning), my co-chair of the APPG on medical cannabis under prescription. The situation is, frankly, intolerable. I have spoken with all of the families requesting medicinal cannabis with THC—let us not forget the THC. I am sure that Teagan will get a second opinion and that she is another child who will get access to medical cannabis, but what about all the others? They cannot wait. My right hon. Friend the Member for Exeter (Mr Bradshaw) spoke truthfully about the inquiry and the evidence it has taken. The BPNA has not spoken as it should have and it has not done enough to support the families.

[Mr Bradshaw]

It lied.

[Tonia Antoniazzi]

I will not use that word, but I totally agree with my right hon. Friend. I say to the Secretary of State that this has got to stop. We cannot wait for clinical trials. There is medicine out there—get it to the children who need it.

Oral Answers to Questions

Ben Bradshaw Excerpts

Tuesday 26th March 2019 Commons Chamber

[Matt Hancock]

I met the parents of some of the children whose needs are best met through the use of medicinal cannabis. My heart goes out to those who are fighting for this cause. We changed the law in the autumn to try to make it easier, and I am looking very closely at what we can do to make sure that the intention of that decision is met.

[Mr Ben Bradshaw (Exeter) (Lab)]

The Health Committee heard last week that patients are dying unnecessarily and up to a million families are being driven to criminality by getting medical cannabis illegally, and the situation has got worse since the Government changed the law in November. When are these families going to get access to medical cannabis for their children and other sufferers that they would have access to if they lived in Germany, the Netherlands, Canada or the United States?

[Matt Hancock]

As the right hon. Gentleman knows, I supported and indeed participated in the decision to ensure that access was made legal in the autumn, and I am working right now on trying to make sure that some of the challenges in the system are unblocked. Ultimately, these things have to be clinician led, but my sympathy is with those who are campaigning, whom I have met, because I know of the anguish that this problem is causing.

Health and Social Care Committee

Ben Bradshaw Excerpts

Thursday 28th February 2019 Westminster Hall

[Dr Paul Williams (Stockton South) (Lab)]

Thank you, Mr Sharma, for inviting me to address this Chamber, so that I can present the Health and Social Care Committee’s report into the first 1,000 days of life.

I have been studying and working in health for the past 27 years and I have concluded that if our society wants the most effective interventions to improve health, we must act in the period from conception to the age of two. That is because the seeds of health inequalities are sown during that time. Good social, emotional, physical and language development during that time is crucial to building healthy brains and children, and having a healthy society.

This week our report set out an ambition challenge to the Government and all our colleagues in the House. We want to kick-start the second revolution in early years services, as recommended by the Marmot review in 2010, so that our country can become the best place in the world for a child to be born. Building that kind of society drives me, not only as an MP, but as a father and doctor.

I thank the hon. Member for Totnes (Dr Wollaston) for letting me take the Chair of the Committee for this inquiry. It is typical of her generosity of spirit that she seeks to give opportunities to others. I hope that I have done justice to the chance she gave me. I thank my Committee colleagues—of all parties and of none—for their support and guidance during our inquiry. I thank our Health and Social Care Committee staff team, particularly Lewis Pickett, Dr Joe Freer and Huw Yardley, who played a crucial role in helping us to make this report a reality.

Almost all research into this subject demonstrates that our path in life is set during the crucial first 1,000 days from conception to the age of two. Healthy social and emotional development during that time lays the foundations for lifelong good physical and mental health. Yet, our current political system invests a fortune in reacting to problems much later in life, leaving a gaping void where we should be warriors for a fairer and healthier society.

During the first 1,000 days of life, more than 1 million new brain connections are made every single second, and babies’ brains are shaped by the way in which they interact with others. However, more than 8,000 babies under the age of one in England currently live in households where domestic violence, alcohol or drug dependency and severe mental illness are all present. Over 200,000 children under the age of one live with an adult who has experienced domestic violence or abuse. Two million children under the age of five live with an adult with a mental health problem.

We know that many children who experience such adversity become happy and healthy adults, but adversity in childhood is strongly linked to almost all health problems and many social problems. Children exposed to adverse childhood experiences are much more likely to get heart disease, cancer and mental health problems than those who are not. Children exposed to four or more ACEs are 30 times more likely to attempt suicide at some point in their life, 11 times more likely to end up in prison and three times more likely to smoke as adults than those exposed to no ACEs. Our politics is currently failing some of these babies and other children who are born into families where poverty strongly affects their chance of achieving good health.

As part of this inquiry, our Committee read 90 submissions of written evidence and held three focus groups with stakeholders. I thank those who made superb contributions to our three oral evidence sessions. I particularly thank David Munday from Unison, Sally Hogg from Parent Infant Partnership and Viv Bennett from Public Health England for their guidance to me.

Our Committee was keen to reach outside Westminster for evidence. We hosted an online forum on Mumsnet, where we heard 80 stories from parents telling us about their experiences of pregnancy and early childhood, as well as their views on services. We visited the Blackpool Better Start project, run by the National Society for the Prevention of Cruelty to Children and funded by the Big Lottery Fund. We held focus groups with representatives from councils, clinical commissioning groups and charities from across the country.

We all know how austerity has affected our councils and the NHS over the last nine years, but we saw how a relatively small Big Lottery Fund investment had helped local authorities to redesign their services. Staff were able to take time to reflect. The extra money brought added capacity and outside expertise. We saw joined-up, effective collaboration between the council, NHS commissioners and providers, the voluntary sector and the police.

We also saw the importance of investing in long-term goals and service transformation, rather than just using money to firefight short-term challenges. We heard how having a one-stop shop for families helped to provide better support, and helped professionals to have better relationships with each other and to share information. We visited community spaces across Blackpool, including a library and a local park, which had been transformed by members of the local community, to make them more suitable for families with young children. We heard about the importance of a father in a young child’s life. Some fathers say that they lack parenting skills and other fathers felt that the system excluded them.

I firmly believe that we need to devote much more attention and protection to resources for this crucial period of life. There are many people across the political divide who share that belief. This is an area where politicians should be working together. It was very encouraging to hear that the Early Years Family Support Ministerial Group, led by the Leader of the House, was announced shortly after the start of our inquiry. That has the potential to take forward some of our Committee’s recommendations. I will soon be meeting with the Leader of the House to hear about the group’s progress.

Our inquiry has identified the need for a long-term, cross-Government strategy for the first 1,000 days of life, setting demanding goals to reduce ACEs, improve school readiness, and reduce infant mortality and child poverty. Our report recommends that the Minister for the Cabinet Office should be given specific Cabinet-level responsibility for the oversight of this national strategy.

We want communities, the NHS and voluntary groups to be led by local authorities, to develop their plans to bring this Government strategy to life, inspiring improved support for children, parents and families in their area. We think that a Government transformation fund should be established to encourage these different groups to come together, to pool their resources and deliver shared, agreed actions. We also think that a single nominated individual in each area should be accountable to the Government for progress.

Our report also calls for the existing, and actually very good, healthy child programme to be improved and be given greater impetus. It should be expanded to focus more on the whole family rather than just the child, begin before conception, deliver more continuity of care for families—something we found families really valued—and extend health visitor engagement beyond the age of two and a half, to ensure that all children become school-ready.

We heard from Scotland, Wales, Northern Ireland and parts of the United Kingdom that had enhanced the healthy child programme. However, we also heard from too many areas where some of the contact with health visitors was just a letter, and we were told that 65% of families do not even see a health visitor at all after the six to eight-week check. That clearly is not good enough. Our report recommends that information sharing needs to be significantly improved. Information needs to be better shared between organisations so care can be better co-ordinated and the long-term impact of an intervention can be tracked and assessed.

Alongside that, we need a workforce strategy to address the reduction in health visitors. That does not seem to have been a deliberate strategy, but happened because local authorities were given the funds for the healthy child programme at the same time as they had their budgets cut. We also want the strategy to make sure that knowledge and skills are improved, especially knowledge of ACEs and the importance of using motivational interviewing techniques.

If we get this crucial 1,000 days of life right, it will have huge benefits for everyone in our society. As politicians, we should try to get it right not just because it makes financial sense, but because every single one of us in Parliament has a moral responsibility to our country’s children. Every child deserves the best start in life.

[Mr Ben Bradshaw (Exeter) (Lab)]

I congratulate my hon. Friend on his excellent chairing of the inquiry, his drafting of the report and his speech. Children in their first 1,000 years do not have as much of a political voice as other lobby groups, but does he agree that when Governments face difficult decisions about spending priorities, spending money on those children makes more sense than spending money on older young people in higher education, many of whom are well-off and talented and will do perfectly well in the rest of their lives? The best investment is in those first 1,000 years.

[Dr Williams]

I agree with my right hon. Friend’s proposition that investment at the beginning of life is likely to pay the greatest dividends, particularly in reducing inequalities. As politicians, we should represent all members of our communities, not just those who are old enough to vote or who choose to vote. There is an opportunity in the comprehensive spending review to make the case for long-term investment in that group of children.

Oral Answers to Questions

Ben Bradshaw Excerpts

Tuesday 27th November 2018 Commons Chamber

[Jackie Doyle-Price]

My hon. Friend will be aware that we have brought forward proposals to have a mental health lead in all schools. We are also introducing a brand new workforce to support schools and improve mental health provision. The first wave of staff are being recruited for training now, and we have 210 applicants for the first wave of places.

[Mr Ben Bradshaw (Exeter) (Lab)]

T8. To mark the 30th World AIDS Day on Saturday, will the Government commit to a more ambitious, but completely achievable, target of ending all new HIV infections by 2030?

[Matt Hancock]

I join the right hon. Gentleman in celebrating World Aids Day and ensuring that we redouble our commitment to making sure that we do everything we can. I will certainly look into the precise commitment that he asks for to make sure not only that it is deliverable but that we work not just here but around the world to end this scourge.

Health and Social Care Committee

Ben Bradshaw Excerpts

Thursday 1st November 2018 Westminster Hall

[Dr Sarah Wollaston (Totnes) (Con)]

I would like to present a report on “Prison health” by the Select Committee on Health and Social Care. I start by thanking my fellow Committee members and the Committee staff, particularly Huw Yardley and Lewis Pickett. I also particularly thank all those who gave evidence to our inquiry, both in person and in writing. We visited HMP Isis, HMP Belmarsh and HMP Thameside, and I thank the staff, healthcare staff and all the people in prison who spoke to us about their experiences.

A prison sentence is a deprivation of liberty, not a sentence to poorer health or healthcare, yet sadly that was the picture that we found in our inquiry. Too many prisoners are still in overcrowded, unsanitary prisons with overstretched workforces. Those poor conditions contribute to even worse outcomes and health for those who arrive in prison, who are often from very deprived backgrounds and suffering from serious health inequalities. Violence and self-harm are at record highs, and most prisons exceed their certified normal accommodation level, with a quarter of prisoners living in overcrowded cells over the last two years. Staffing shortages have led to restricted regimes that severely limit prisoner activity, as well as their access to health and care services, both in and outside our prisons.

Too many prisoners still die in custody or shortly after their release. Although deaths in custody have fallen slightly since peaking in 2016 as a result of increased suicides, so-called natural-cause deaths are the highest cause of mortality in prisons and, I am afraid, reflect serious lapses in care. Every suicide should be regarded as preventable. It is simply unacceptable that those known to be at risk face unacceptable delays while awaiting transfer to more appropriate settings. We see that happen time and again, without appropriate action being taken.

Our report refers to the impact of the increasingly widespread use of novel psychoactive substances, not just on prisoners but on prison staff; dealing with violent incidents takes time away from the work that we would otherwise expect prison staff to do. We heard time and again from people in prison who we met of not being able to attend appointments, either within or outside the prison, because there simply were not the staff there, because they had been diverted to other cases.

We have made recommendations for the National Prison Healthcare Board. We would like it to agree a definition of equivalent care, and to tackle the health inequalities that we know prisoners face. It also needs to take a more comprehensive and robust approach to identifying and dealing with the healthcare needs of people in prison. However, many of our recommendations will not be met until sufficient prison officers are in post. That is an overriding issue, because the cut in prison officer numbers—I know the Government are starting to address that—lies at the root of so many problems in our jails.

Health, wellbeing, care and recovery need to be a core part of the Government’s plans for prison reform. It is in all our interests to care about the health and wellbeing of prisoners, because they will later be back in our communities. If more of them become dependent on drugs during their time in prison, and these problems worsen, they will come back into our communities with even worse health issues, health inequalities and mental health problems. I know it is difficult, because it sometimes seems that the public do not care about our prisoners, but it is absolutely in everybody’s interest to care about the health and wellbeing of our prison population.

I am afraid that our report highlights a system in which, time and again, reports from Her Majesty’s inspectorate of prisons are not acted on. We need those reports to have real teeth, and for people to be able to take action, or to be held accountable for not taking action. We heard time and again of governors not having the levers—even if they had the financial powers—to take the necessary action.

We call on the Government to regard the health of our prison population as a serious public health crisis requiring a whole-systems approach that takes root in sentencing and release, making sure that people are only in prison if absolutely necessary, that those with serious mental health problems are transferred in a timely manner and that sees time in prison as an opportunity to act and to address serious health inequalities. That is not only in their interest but in all our interests.

[Mr Ben Bradshaw (Exeter) (Lab)]

Given the picture the hon. Lady just described, she will be aware of the serious problems in Exeter Prison, which the staff there are doing their utmost to try to address. Does she agree that, as we face voting on the Budget later this afternoon, it might have been better, rather than giving tax cuts to the richest 10%, for the Chancellor to spend that money on helping our prisons to deliver the kind of services that she would like to see?

[Dr Wollaston]

I thank the right hon. Gentleman for his contribution towards the report. He identifies that this is an area that is often deprioritised in favour of other issues. However, we absolutely have to prioritise the health of our prison population. I agree that we should address staffing levels. We should also look at the health and wellbeing of our prison staff. Too many leave because of the pressures and the violence that they face in prison.

Oral Answers to Questions

Ben Bradshaw Excerpts

Tuesday 23rd October 2018 Commons Chamber

[Steve Brine]

Yes.

[Mr Ben Bradshaw (Exeter) (Lab)]

Is it true that the Secretary of State is now so worried about the supply of vital medicines in the event of a no deal or a hard Brexit that he has asked the pharmaceutical industry to extend the period of stockpiling from six weeks to 20 weeks?

[Matt Hancock]

No, that is not true. We are working very closely with the pharmaceutical industry to make sure that, in the event of a no-deal Brexit, which I regard as unlikely, we mitigate as much as possible the impact on the supply of medicines and that the supply of medicines can be unhindered.

Adult Social Care: Long-term Funding

Ben Bradshaw Excerpts

Thursday 28th June 2018 Commons Chamber

[Mr Betts]

It is a difficult decision. Germany does not exempt people under 40, but there are other tweaks to the system. For example, people without children pay extra and people who are not working pay extra in retirement because they do not have an employer contribution. We have not just mirrored the German system absolutely. We have taken elements from it, which I think is quite right. Japan’s system is not dissimilar and it does restrict payments to those over 40. We have looked at different systems. It is a challenge, but in the end we felt that there were considerable pressures on younger people at this point in time: family pressures, housing pressures, job pressures. We therefore felt that to start at 40 was a reasonable benchmark, bearing in mind that for the vast majority of people it will mean that they will pay into the care system at some point in their lives.

[Mr Ben Bradshaw (Exeter) (Lab)]

Is it not remarkable, given the failure of successive Governments to grasp this nettle, that two cross-party Committees with Members holding widely different views and ideologies managed to agree a unanimous report? Does that not make it even more incumbent on the Government, given the acuteness of the crisis, to take this report very seriously and to implement its recommendations as quickly as possible?

[Mr Betts]

I completely agree with my right hon. Friend. The fundamental question is: if we can do it, why can’t they? We have done the difficult part. We have set out a framework. Those on the Government Front Bench may not want to accept every detailed element of it, but it is there to work from. It should mean that we ought to be able to get to a consensus and an agreement about what should be done in a much shorter period of time than the years the Government were perhaps initially contemplating.

Oral Answers to Questions

Ben Bradshaw Excerpts

Tuesday 19th June 2018 Commons Chamber

[Mr Ben Bradshaw (Exeter) (Lab)]

But the Royal College of Nursing and the Nursing and Midwifery Council are both now so worried about Brexit’s impact on the staffing crisis that they have called for a people’s vote on a deal. Given their on-the-ground experience and the demolition of the myth of a Brexit dividend for the NHS, is it not becoming ever more clear that the dogmatic hard Brexit being pursued by the Government is already doing untold damage to our NHS?

[Stephen Barclay]

The right hon. Gentleman, as a former Minister of State, will not want to choose selectively from the data on European economic area recruitment into the NHS. He will know full well that there are 3,200 more NHS staff from the EU since the referendum, which shows that people are still coming. If he has an issue with the Brexit dividend, perhaps, as my right hon. Friend the Secretary of State pointed out yesterday, he will raise that with his party leader, who sees that there is a Brexit dividend.