Health and Social Care

Chris Skidmore Excerpts

Thursday 5th September 2019 Ministerial Corrections

The following is an extract from the Adjournment debate on Department of Health and Social Care: Treasury Funding on 4 September 2019.

[Chris Skidmore]

Earlier today, the Chancellor reaffirmed the Government’s commitment to a £33.9 billion cash-terms increase in the NHS budget by 2023-24. This includes a £6.2 billion increase in NHS funding next year. This historic NHS settlement provides the largest cash increase in public services since the second world war. There is not time to go into the specific details of how this will be spent, but I would urge everyone, as part of their bedtime reading, to turn to page 9 of the Blue Book of spending round 2019 to see how some of that money is being spent. I am delighted that it will also include a £250 million funding boost for Health Education England next year, which is equivalent to 3.4% real-terms growth.

[Official Report, 4 September 2019, Vol. 664, c. 326-327.]

Letter of correction from the Minister for Health:

An error has been identified in my response to the debate on Department of Health and Social Care: Treasury Funding.

The correct response should have been:

[Chris Skidmore]

Earlier today, the Chancellor reaffirmed the Government’s commitment to a £33.9 billion cash-terms increase in the NHS budget by 2023-24. This includes a £6.2 billion increase in NHS funding next year. This historic NHS settlement provides the largest cash increase in public services since the second world war. There is not time to go into the specific details of how this will be spent, but I would urge everyone, as part of their bedtime reading, to turn to page 9 of the Blue Book of spending round 2019 to see how some of that money is being spent. I am delighted that it will also include a £210 million funding boost for Health Education England next year, which is equivalent to 3.4% real-terms growth.

Department of Health and Social Care: Treasury Funding

Chris Skidmore Excerpts

Wednesday 4th September 2019 Commons Chamber

[The Minister for Health (Chris Skidmore)]

I congratulate my right hon. Friend the Member for Harlow (Robert Halfon) on securing this important debate. It is the first debate to which I have been able to respond in my new role. I know that my right hon. Friend campaigns tirelessly on matters of healthcare in Essex and, in particular, on the issue of funding for the Princess Alexandra Hospital NHS Trust. I also know that he met my predecessor to discuss issues, including the hospital’s workforce and the services provided by the trust. This is the fifth debate that he has initiated on this issue, which may be a record in the House of Commons. We in the Department, and my officials who are sitting in the Box tonight, are fully aware of the concerns that he has raised. Let me explain why we continue to take them seriously and want to continue to work with him.

Both my right hon. Friend the Secretary of State for Health and Social Care and my predecessor, my hon. Friend the Member for Wimbledon (Stephen Hammond), have visited the trust over the past few months and seen at first hand the excellent work that is being done by NHS staff despite the challenges faced by the estate, which my right hon. Friend has described. I should be delighted if he welcomed a visit from me so I could see the estate and thank the staff for the excellent work that they have done in improving the hospital. My right hon. Friend described in his eloquent speech the commitment that the staff have given to the hospital, across the board, and I should be delighted to see that at first hand.

As my right hon. Friend knows, the Government have already made significant funding available for health capital investment, recognising that the NHS faces the challenges posed by poor infrastructure and ageing estates. Between 2016-17 and 2018-19, we increased capital funding by £1.3 billion, an increase of about 30%. As my right hon. Friend said, we have also announced a £1 billion funding boost for the NHS, along with 20 new hospital upgrades to help staff to deliver the best possible health services in their buildings. I have had the pleasure of touring some of these potential new upgrades, including in Luton and Dunstable, which is relatively near my right hon. Friend’s patch, with a £99 million project, and Heartlands hospital in Birmingham, Barking, Stoke, Staffordshire and Croydon, to recognise that we do need to see upgrades—not just these 20 upgrades, but future additional upgrades.

My right hon. Friend the Secretary of State for Health and Social Care is committed to ensuring we make future investments in capital for the NHS. He recently set out that we will establish a new health infrastructure plan. This will be brought forward to deliver strategic major hospital rebuilding programmes, providing the necessary health infrastructure across the country. The shape of this will be confirmed in due course. I am not able to give specific details, but it will be similar to the road investment strategy process at the Department for Transport, with further long-term capital funding that we are discussing with our Treasury colleagues.

Delivering capital investment is a complex process and it takes time. I fully understand that my right hon. Friend has been very patient about the Princess Alexandra hospital, but this does need to be done thoroughly and professionally, alongside delivering the everyday healthcare services. There is a necessary process of assurance to ensure that services are transformed for the benefit of patients. This process is led by the trust, and includes a number of business case checkpoints and involves procurement, design, delivery and capability. Funding is provided when the full business case has been approved.

The 20 hospital upgrades announced in August were for hospitals that had just missed out on the sustainable transformation programme bid in December 2018, so were able to be progressed having followed the process.

I take the point raised on population growth. That is important in assessing future bids; they must be based on future patient demand, just as clinical commissioning group allocations are currently adjusted to population to take account of growth and movement. I take the point that the areas outside London in the home counties have increased population and population movement, and we are therefore constantly in a state of catch-up in local healthcare services.

I know that my right hon. Friend has also raised proposals to build a new hospital in Harlow with the Chancellor of the Exchequer; I know that because I saw a picture on his Twitter feed, and I am sure he will have listened closely to proposals to fund a new health campus in Harlow.

On 5 August the Government announced a £1.8 billion increase to NHS capital spending, on top of the additional £3.9 billion announced in the 2017 spring and autumn budgets. Some £1 billion of this increase will ensure existing upgrade programmes can proceed by tackling the most urgent projects, and £850 million of the funding will allow 20 new hospital upgrades. I am sure my right hon. Friend will welcome that Luton and Dunstable near his constituency will benefit from this. However, I know he will be understandably disappointed that the new health campus in Harlow scheme was not included on that list. However, the scheme has the support of the Secretary of State for Health and other Ministers, and I understand that the scheme is well developed. NHS Improvement and NHS England will continue to work with the trust to develop its options to tackle the challenges it faces and secure the best outcomes for patients.

In the wider Essex area, there have been several successful bids in the sustainability and transformation partnership tranche 4, which includes £4.2 million awarded to Luton and Dunstable renal dialysis unit relocation, £7.1 million awarded to the Hertfordshire and west Essex vascular surgery network, £11 million to the West Hertfordshire Hospitals NHS Trust emergency care transformation and in Suffolk and north-east Essex £18 million awarded to the East of England Ambulance Service NHS Trust for infrastructure and capacity transformation.

I am sure that my right hon. Friend will agree that this affirms the Government’s commitment to ensuring the region receives its share of NHS funding. We expect there to be further opportunities to access capital in future years, with the decision on what this looks like to be decided in due course. I am sure the Chancellor of the Exchequer and the Chief Secretary to the Treasury will continue to listen to my right hon. Friend’s appeals on this issue, and I will be happy to make representations on his behalf.

Earlier today, the Chancellor reaffirmed the Government’s commitment to a £33.9 billion cash-terms increase in the NHS budget by 2023-24. This includes a £6.2 billion increase in NHS funding next year. This historic NHS settlement provides the largest cash increase in public services since the second world war. There is not time to go into the specific details of how this will be spent, but I would urge everyone, as part of their bedtime reading, to turn to page 9 of the Blue Book of spending round 2019 to see how some of that money is being spent. I am delighted that it will also include a £250 million funding boost for Health Education England next year, which is equivalent to 3.4% real-terms growth.[Official Report, 5 September 2019, Vol. 664, c. 3MC.] This will allow staff at the Princess Alexandra Hospital, particularly nurses, midwives and allied health professionals, to access a personal training budget of £1,000 for every member of staff of those professions. Staff at the hospital will be able to benefit from some of the announcements that have been made today.

As a former Universities Minister, I pay tribute to my right hon. Friend’s work as Chairman of the Education Committee and to his statement about the importance of research in relation to the campus and the health hub. We recognise that, when it comes to training, there needs to be an holistic approach to funding. Yes, capital is important, but we must ensure that the individuals working in those new buildings feel that they have a place within their local NHS and that they want to stay there and continue to work there. That is why some of the announcements today on education and training are absolutely vital, and I am sure my right hon. Friend shares that commitment. Looking at some of the money that has been announced today, we also see that £250 million is to be invested in ground-breaking new AI technologies to help to solve some of healthcare’s toughest challenges.

When we look at the Princess Alexandra Hospital NHS Trust, we must also look at the Harlow science hub campus programme, which is incredibly exciting. I remember it being announced in the 2016 Budget, when I was the former Chancellor’s Parliamentary Private Secretary. There was enormous excitement, and I would like to commend my right hon. Friend for his tireless campaigning relating to the public health campus, which would not have happened if it was not for him making the case in the first place and going to the former Chancellor and securing the funding. It will be the largest centre of its kind in Europe, providing a new national centre for applied and public health science, as well as the headquarters of Public Health England. I know that this is still on schedule with the demolition work already under way, as is the preparation for the construction work, which starts early next year.

I know that Public Health England and the chief executive of the Princess Alexandra Hospital NHS Trust have been in discussions over the last 12 months about what opportunities can arise as a result of the move to Harlow, and I hope to hear more about this soon. Indeed, I will be delighted to come up to Harlow as part of the visit to the hospital trust and to look at how we can explore developing the wider benefits that the scheme may have.

[Robert Halfon]

I thank my hon. Friend very much for what he has said and for his commitment to visit the Princess Alexandra Hospital. Just to be clear, will he confirm that there will be a capital fund from the Treasury for significant capital funding programmes for significant hospital upgrades and that the Princess Alexandra Hospital is very much on that list?

[Chris Skidmore]

This was announced today as part of the spending round document. Paragraph 2.4 states:

The Department for Health and Social Care will receive a new multi-year capital settlement at the next capital review. This will look to deliver a smarter, more strategic long-term approach to the country’s health infrastructure, with investment focused on local areas where the need is greatest. The plan will include capital to build new hospitals”.

I want to reassure my right hon. Friend that when it comes to the Princess Alexandra Hospital, it is under serious consideration in relation to ensuring that that refurbishment will be able to take place for the future.

Question put and agreed to.

Kettering General Hospital Urgent Care Hub

Chris Skidmore Excerpts

Tuesday 3rd September 2019 Westminster Hall

[The Minister for Health (Chris Skidmore)]

It is an honour to serve under your chairmanship, Mr Bone, in my first debate as the new Minister of State for health.

I congratulate my hon. Friend the Member for Kettering (Mr Hollobone) on securing this debate on the proposed urgent care hub at Kettering General Hospital. This is an important issue for not only my hon. Friend but his constituents in the wider Kettering community, and it is one on which he campaigns tirelessly. I congratulate him on his diligence and determination to continue that, bringing it before the House today.

Kettering General Hospital, as my hon. Friend mentioned, has stood on the same site for nearly 122 years. It plays a vital role in the community, and he set out eloquently the importance of the hospital to that community. In January this year, my predecessor, my hon. Friend the Member for Wimbledon (Stephen Hammond), discussed the urgent care hub proposal with my hon. Friend the Member for Kettering and visited the hospital, following the foundation trust’s unsuccessful £45.7 million sustainability and transformation partnership bid in July 2018. My hon. Friend set out clearly the need to cope with rising demand, with which the urgent care hub could assist.

Given the unsuccessful bid, I am sure that my hon. Friend is aware that the sustainability and transformation partnership programme has been the main funding route for strategic capital development projects. Under that programme, capital has been allocated to more than 170 STP schemes since July 2017, which now amounts to about £3.3 billion. STP investments will modernise and transform NHS buildings and services across the country, including new urgent care centres, integrated care hubs that bring together primary and community services, and investment in new mental health facilities.

On 5 August this year, the Government announced a £1.8 billion increase in NHS capital spending, on top of the additional £3.9 billion announced in the 2017 spring and autumn budgets. Of the increase in NHS capital spending, £1 billion will allow existing upgrade programmes to proceed, to tackle the most urgent infrastructure projects. Some £850 million will allow 20 new hospital upgrades to start as soon as possible. Those hospitals were chosen because they applied for funding in tranche 4 of the sustainability and transformation partnerships, but narrowly missed out. I will set out the short process that we go through to designate the waves, whereby the 20 hospitals that narrowly missed out on upgrades previously will receive funding this time.

[Mr Hollobone]

Kettering General Hospital narrowly missed out on previous funding allocations. Northamptonshire is the only one of the 44 STPs in the country never to have received any capital funding in the four waves that have taken place. I find that staggering, given the overwhelming support from the local NHS for the urgent care hub proposals.

[Chris Skidmore]

NHS Improvement and NHS England follow an independent assessment process. Previous waves, and the allocation of the 20 hospital upgrades that were announced last month, were assessed on the following six criteria: deliverability; patient benefit and demand management; service need and transformation; financial sustainability that delivers savings to both the organisation and the sustainability and transformation partnership; value for money, including return on investment; and estates.

As well as the top-scoring schemes, a number of schemes of critical service importance have been included, such as mental health and learning disability schemes, drawing on the advice from sustainability and transformation partnerships and national and regional NHS leadership. Together, the schemes demonstrate that they will deliver clear improvements to services. That may not be the answer that my hon. Friend wants to hear, but let me reassure him that I am happy for NHS England and NHS Improvement to discuss how the process and the scoring of requirements operate in greater detail with the chief executive, Simon Welden, who is sitting in the Public Gallery. If the trust would like to have that meeting, I will happily help to arrange that feedback for the hospital and my hon. Friend.

On future capital funding, an extra £1.8 billion was announced in August. That money, to enable investments in critical infrastructure, was not previously available, and gives new spending power to the NHS to fund new projects. The £1.8 billion is a brand-new capital injection on top of money announced in previous Budgets and spending reviews. The Department’s capital spending limit has increased accordingly: following the announcement on 5 August, the capital spend on health for 2019-20 has gone up from £5.92 billion to £7.02 billion. It is important to make that clear, given some wish to look for bad news in any good news announcement. It is important to recognise that the £1 billion boost, and the £100 million of the £850 million allocated this year, will be spent on that capital allocation.

[Mr Hollobone]

I join the Minister in welcoming the £1.8 billion of extra capital funding for the NHS and the £1 billion wave of funding at the end of 2018. That is all very good news, but given there is almost £3 billion of extra capital injection, we simply cannot understand why £49 million of that could not find its way to Kettering, particularly as there is already a worked-up business case, to get the project up and running quickly.

[Chris Skidmore]

As a new Health Minister, I have found that the wave approach to the sustainability and transformation partnerships programme has highlighted a wider issue with NHS capital. My hon. Friend’s point about geographical distribution applies not just to bricks and mortar but to diagnostic equipment. We must make sure that our national health service is truly national, by giving every trust equal opportunities to apply for and receive funding. That is why the Secretary of State recently set out that, as a Government, we will establish a new health infrastructure plan. The plan will mean that we take a strategic approach when looking at hospitals that need upgrades, and how that will fit into a wider strategy that will be organised in the Department, taking into account local needs and NHS clinical requirements.

We will put in place a long-term strategy to upgrade and improve our NHS. That will deliver a major strategic hospital rebuilding programme that will provide the necessary health infrastructure across the country. I cannot go into any further detail, apart from to say that the shape of that will be confirmed in due course. To offer a comparison, the road investment strategy—RIS 1 and RIS 2—has a longer term process by which we can move away from a succession of waves. We have waves 1, 2, 3 and 4 of funding as part of the STP processes: some of those projects are further along and more developed than others; some have more advanced business cases than others, as my hon. Friend mentioned. It is important to take a strategic approach for the future.

I understand that my hon. Friend was disappointed that Kettering General Hospital was not selected for funding this time. However, as he mentioned, the trust secured £6 million in emergency capital funding this year, to deal with safety-related estates work. In addition, between 2017-18 and 2018-19, the trust received more than £14 million in capital to fund improvements to the hospital, including £12 million to tackle the urgent capital backlog and other essential capital expenditure. It received £2.4 million for winter pressures and £820,000 for electronic prescribing. That does not make up for what my hon. Friend recognises as an important development and improvement to the estate, but in Kettering the trust has improved enormously and has made great strides in recent years.

I note that while the Care Quality Commission rated the hospital as “needs improvement” after its inspection earlier this year, the trust has been taken out of special measures for quality following the CQC report published in May 2019. I am pleased that, despite the rising demand my hon. Friend mentioned, it is still providing patients with safe and good quality care and is focused on embedding a culture of continuous quality improvement. I am delighted that Kettering General Hospital is participating in a national urgent and emergency care standards pilot, and I await information and learnings on that this year.

[Mr Hollobone]

I am glad that the Minister highlights the huge improvements made at the hospital and the superb leadership we now have in place. Will he accept an invitation to visit the hospital and see the A&E department at first hand?

[Chris Skidmore]

I thank my hon. Friend for that invitation; I would be delighted to visit the hospital. I pay tribute to the staff at Kettering General Hospital, who continue to work hard and who contributed to the hospital’s receiving a good rating for care. I hope we will continue discussions during my visit.

I hope that, if my hon. Friend and the trust are willing, I can arrange the meeting to go through the criteria for STP wave 4 in finer detail. I hope that he understands that we are looking at setting up a new process by which capital infrastructure projects will be delivered. The Government have made significant investments in the NHS as part of their long-term plan. We recognise that we need to mirror that investment in NHS capital. I thank my hon. Friend for raising this important issue, and I look forward to working with him.

Question put and agreed to.

Autism and Learning Disability Training: Healthcare Professionals

Chris Skidmore Excerpts

Monday 22nd October 2018 Westminster Hall

[Chris Skidmore (Kingswood) (Con)]

Thank you for calling me to speak, Dame Cheryl. I recognise your expertise and knowledge in this area. As one of the leading Members of the House, you have worked tirelessly to represent the rights of those with autism, and you took the Autism Act through Parliament. My comments will pale in comparison. Your position today prevents you from speaking, but I want those watching the debate to know how indebted Members on both sides of the House are to you for your efforts.

I speak in my capacity as the Member of Parliament for Kingswood, near Bristol. My constituent, Paula McGowan, has worked tirelessly and courageously to highlight the tragic death of her son, Oliver McGowan, on 11 November 2016. Paula’s work to establish Oliver’s campaign and call for mandatory autism and learning disability training for NHS professionals led to the creation of a petition, which had been signed by 51,310 people as of around 3 pm. I am extremely grateful to the Petitions Committee for scheduling this debate on that petition.

I speak as Paula’s local representative, but what she has achieved in the face of such extreme grief and anguish is so remarkable that, in all honesty, she should be telling Oliver’s story in this debate. That story is awful and harrowing, but it needs to be told. I am grateful to the hon. Member for Cambridge (Daniel Zeichner) for putting Paula’s testimony on the record. She sent me some additional personal words. It is important that I place those words on the record, too, not only for the benefit of Members present but so that they stand as a testament to Oliver and so that his death is remembered eternally in the House’s official record, Hansard.

Paula states:

“From the moment Oliver was born, we knew that he was special and our love for him was overwhelming. Oliver was born premature and developed meningitis at three weeks of age. He was very ill and we were told they did not expect him to survive. However, Oliver began to recover. Everybody who came into contact with Oliver warmed to him and could not resist spending time with this baby.

Sadly, Oliver developed a second episode of meningitis and was incredibly ill. Amazingly, against all odds and many months of hospital treatment, Oliver’s strength and determination shone through and he survived once again, and as always with that beautiful heart warming smile that everybody was drawn to. Oliver—as a result of an infarction caused by the meningitis—was left with mild cerebral palsy, focal epilepsy and later on a diagnosis of high functioning autism.

Oliver’s disabilities did not hold him back. He had a can do attitude and amazed everybody with his achievements. He played for the South and North West Centres of Excellence England development football squads. He was a registered athlete with the Power of 10 and was ranked 3rd best in the country for athletics. Oliver was a member of Team Bath and was being trained to become a Paralympian.

Oliver was a natural leader and became a prefect and chair of the school council, later college. He attained several GCSE and BTEC examinations. He went on to attend National Star College in Cheltenham. Their opinions of Oliver were very complimentary, writing how he was often mistaken to be a member of staff; how friendly and kind he was, supporting students who were less able than himself; his wicked sense of humour; and the aspirations they had for him to start a sports course at a local ski centre.

Oliver brought so much happiness and fun to our lives; he always saw the best in everything and taught all of us how to look at things differently. Oliver never failed to light up a room with the sound of his laughter. He wanted to make everybody happy and did his best to achieve that. Despite his limitations, he never complained or asked, ‘Why me?’ He accepted everything and always with a smile. His courage and enthusiasm was inspirational. We were told by his neurologist that Oliver had a full life expectancy and it was expected he would live an independent life with a little support.

On 15 October 2015, Oliver was admitted to a children’s hospital, having what we—his parents—and college staff recognised to be simple partial seizures. These caused Oliver to be anxious, agitated and confused. After several weeks of tests Oliver was discharged home and given sertraline—an antidepressant medication—to treat his anxiety. We were surprised as Oliver was not depressed. Once this medication was increased, it caused a change to Oliver’s mood and increased his seizures greatly.

He was admitted back to the same hospital on 15 December 2015, but this time was given antipsychotic medications. The doctors were misunderstanding Oliver’s autistic behaviours to be an ictal psychosis, and his normal autistic obsessions to be delusional behaviours. The effect on Oliver was catastrophic. Oliver’s seizures threshold and anxiety deteriorated and he was eventually held against his will under the Mental Health Act, section 2. We challenged this on numerous occasions, stating we felt it was the drugs that were causing the changes to Oliver’s mood and seizures.

A psychiatric bed could not be found and doctors decided to remove the antipsychotic medications. Within days Oliver’s mood and seizure activity improved and he was discharged back home into our care. A community psychiatrist wrote Oliver was sensitive to antipsychotic and benzodiazepine medications.

On 15 April 2016, Oliver was readmitted back to the same hospital having simple partial seizures and was anxious. Sadly, Oliver was again given antipsychotic medications, one or more of which caused a serious side effect called oculogyric crisis. He was left like this for several hours as the doctor at first believed it was behavioural. After four hours he was given procyclidine medication. Again, Oliver’s mood changed significantly. He was hallucinating, having up to 30 seizures a day—something we had never seen happen—and had problems urinating, extreme high blood pressure readings and sweating, all of which were linked to medications.

We strongly believed the drugs were the cause of the decline in Oliver’s mood difficulties. It was obvious that doctors and nurses had little to no understanding of autism and how autistic behaviours could present in a person with ongoing seizures. When in seizure, Oliver was always fully conscious, and because he had no control of the seizures they caused him to be frustrated and scared.

At my request, Oliver was transferred to a specialist adult hospital, which I thought would have understood Oliver’s epilepsy better. Oliver had been provided with a letter stating his reactions to previous medications. Sadly, the use of physical restraint was increased with up to eight staff being involved. Oliver was suddenly not allowed any privacy with his personal care. He had three staff sat around his bed and he was kept in a darkened room. Oliver was very frightened and he told me just how scared the staff were making him feel.

Oliver was again given different antipsychotic medications and consequently detained against his will and transferred to a specialist mental health ward. The different approach from skilled staff allowed Oliver to improve within days. The words from staff including doctors from the unit were that Oliver was not psychotic or mentally ill, and that his placement there was a total misuse of the Mental Health Act. They reduced all antipsychotic medications and Oliver was discharged after a few days into the care of a specialist learning disability team, again with a letter saying that he was sensitive to antipsychotics and benzodiazepines.

The team was very supportive and specialised in people with autism and learning difficulties. A consultant psychiatrist in learning disability wrote that Oliver was not psychotic or mentally ill. He believed Oliver’s behaviours were a result of autism and mild learning difficulties and an environment that was not adapted to meet his needs.

Sadly, on 16 October 2016, Oliver had a cluster of seizures and was admitted to an adult general hospital. Oliver told ambulance staff and also doctors in A&E not to give him antipsychotic medications as they messed with his brain and made his eyes go up. He was reassured by doctors they had no intention of using those medications. We gave doctors a folder of supporting letters stating Oliver’s reaction to antipsychotic medications, and it was subsequently written in bold red ink on Oliver’s medical care sheets he was intolerant to all antipsychotics.

Oliver was intubated. The safeguarding officer was consulted on how to manage Oliver’s anxiety when sedation was reduced. His advice to the doctors was a non-pharmaceutical approach and to use soft handcuffs. We were told we should be present as we would be able to reassure and comfort him. We were told that most people would become highly anxious when woken from being sedated. This advice was not listened to and sedation was reduced without our presence. According to staff, Oliver became anxious. He would have felt scared waking to find tubes in his throat and in unfamiliar surroundings without familiar faces. Full sedation was increased.

We were consulted by a neuropsychiatrist who had met Oliver for two 10 minute appointments in the community. She asked us about giving Oliver an antipsychotic. We made it very clear about Oliver’s previous reactions to this type of medication and that she did NOT have Oliver’s or our permission to administer any antipsychotic medications. Despite this, Oliver was given the antipsychotic medication olanzapine at a low dose that evening without our knowledge. The next day, we again made it clear to all doctors and nurses that they did not have Oliver’s permission to administer this.

Oliver, over the next few days, developed a temperature of 42^°. Because doctors said his liver function was elevated he was not given any medication to control the temperature other than a light blow up mattress filled with cold air. This was not effective. Doctors could not understand the decline in Oliver’s condition and they sent him for a scan of his liver and lungs. Unfortunately, it was several more days before they scanned his brain. It was so badly swollen it was bulging out the base of his skull. We were told Oliver had neuroleptic malignant syndrome, a rare but serious side effect of antipsychotic medications.

A week later, the decision was made to turn Oliver’s life support machines off. Oliver passed away several days later on 11 November 2016: Armistice Day—poignant given we are a military family.”

Paula continues:

“Oliver’s was a life wasted due to doctors not communicating effectively with family and practitioners who knew him well and who were in daily contact with the hospital. We believe the doctors were arrogant and ignorant and believed they knew Oliver better than his parents. They did not consult wider, when there was ample opportunity to do so.

We have since been told by the doctor who administered the antipsychotic drug that she would have given it regardless of our wishes, as she believed it was in Oliver’s best interests, and she would do the same thing again given the same situation knowing that Oliver has lost his life. We understand that many people receive the medications that Oliver was given, often for managing a mental health condition, and do so without suffering the effects that Oliver had. In Oliver’s case, we had clear understanding that he was sensitive to these medications and we believe they should not have been prescribed.

We believe that Oliver’s death was very preventable. We believe that Oliver was given excessive drugs due to medical staff not understanding autism impacted by seizure activity. They did not ever try to adapt the environment to meet his needs, but used excessive restraint methods. They failed to make any communication with community-based professionals who were working with Oliver on a daily basis and knew him well.”

A later inquest into Oliver’s death concluded that the care Oliver received in the lead-up to his death was “appropriate”. It stated that despite warnings from Oliver and his parents, the development of complications from medication could not have been predicted. As a local Member of Parliament, I was in contact with Paula after Oliver passed away to support her when she approached the local police and coroner’s office to ask for an investigation into the death of her son. I will continue to offer all the support that I can.

In spite of that inquest’s conclusions, the Government’s learning disabilities mortality review programme, which investigated Oliver’s case, highlighted the challenges that vulnerable people such as Oliver still face in gaining access to appropriate care. There remain serious disparities in the quality of health support and care received by people with autism and learning disabilities. The evidence shows, as has already been mentioned, that people with learning disabilities die at a far greater rate than others. Often, that can be prevented with the right care and support and better awareness and training.

Recent reports from Mencap, which has been recognised for its ongoing efforts and campaigns, found that one in four doctors and nurses has never had any type of training on learning disability. Clearly, that is unacceptable. Every person should receive the same high quality of care, whether or not they have a learning disability. Although we have made progress in our collective understanding of autism and learning disabilities, much more needs to be done to ensure that vulnerable people receive the right support from our healthcare system when they need it most. I am encouraged that the Government have accepted all the recommendations from the learning disabilities mortality review, including recommendation 6, which proposes the introduction of mandatory training for all health and care staff. I am also pleased that they have committed to delivering that training in partnership with people with experience, including families and parents like Paula.

I welcome the Government’s proposals for a consultation on options for delivering that essential training to staff, which is due to be completed by the end of March 2019. With that in mind, I would welcome it being arranged for Paula to meet the Minister to discuss Oliver’s campaign and its consequences, and for this work to continue. I would also welcome the Minister and the Department continuing their close working with Mencap, the National Autistic Society, other charities and relevant organisations, and indeed Members of Parliament such as the Solicitor General, my hon. and learned Friend the Member for South Swindon (Robert Buckland)—he is in his place but his ministerial role affords that he cannot speak in the debate—who have personal experience of autism. It is right to draw on that.

[Lyn Brown]

I have listened to the hon. Gentleman and have been really affected by his speech; I am sure he has been affected as the local MP. I pay tribute to him for how he is putting his case, but does he not agree that the review is unnecessary and that what we actually need is some action now?

[Chris Skidmore]

I agree that we need clarity, not only extra guidance. The review is one step in a journey that has yet to be completed. I own up to this, having been a Minister previously: there is a commitment to looking at guidance and training, but I am concerned with the implementation. Going forward, we could produce all the training, guidance and material we want, but how will we monitor the outcomes? What are we seeking to achieve?

A couple of months into my job as a Minister in the Cabinet Office, having previously been secretary of the all-party parliamentary group for disability as a Back Bencher, I wanted to look at how we could increase and encourage electoral registration among those with learning disabilities. The answer I got was, “Well, there is guidance out there already, Minister. The Electoral Commission has produced documentation.” However, it was patently clear to me that it was not being implemented in polling stations across the country. I would like to see a commitment from the Minister not just for consultation and guidance to be produced but to ensure that we have accountability. The Care Quality Commission must be involved, and people must be judged on the standards introduced; this must be followed through.

In conclusion—this may chime with what the hon. Member for West Ham (Lyn Brown) said—I return to the words of Paula McGowan:

“If the guidelines and principles from NHS England’s STOMP—stopping the over-medication of people who have learning disabilities—project had been followed with healthcare professionals being able to listen to family and specialist colleagues, then we firmly believe that Oliver would still be here today. We believe that Oliver’s premature death should be in the public’s interest, and I challenge the Government to: ask people with a learning disability, autism or both, their families and carers for their opinion and concerns about treatment; listen to all involved and show respect to those opinions and concerns; and do something about it and work in partnership with us. Specifically, NHS professionals who provide specialist care in learning disability and autism should: put people at the heart of all decision making; respect our point of view; not make decisions without us; and enable us to understand complex decisions in a way that is relevant to all and provide information and explanation.

In particular, check if your patient has a hospital passport. Respect your patient by getting down to the same level as them—don’t stand if your patient is sitting. Give them personal space. Modify your language so that it is clear and precise, and don’t use medical jargon. Check your patient has understood what you are saying. Effectively listen to your patient. Give your patient time. Make them feel valued and included in their treatment plan. Mostly”—

above all—

“offer reassurance. In addition, liaise with healthcare colleagues in general hospitals to raise awareness and understanding of learning disability, autism and the principles of STOMP. And, above all, do everything in your power to prevent a story like Oliver’s from having to be told again.”

From my own point of view, I hope that we can all work together to ensure that we do not have to stand here again, making the case for change. Let us support Oliver’s campaign and ensure that his death marks a watershed moment and a turning point in how we treat those with autism and learning disabilities in the NHS.

Oral Answers to Questions

Chris Skidmore Excerpts

Tuesday 8th May 2018 Commons Chamber

[Mr Speaker]

Splendid. I call Chris Skidmore.

[Chris Skidmore (Kingswood) (Con)]

Several of my constituents have contacted me to welcome the Government’s recent announcement of additional investment for prostate cancer funding. Will the Minister update the House on what the money is and what it will be spent on?

[Steve Brine]

Gladly. Prostate cancer survival rates are at a record high, but we want to do even better, so last month the Prime Minister announced £75 million to support new research into the early diagnosis and treatment of prostate cancer. The National Institute for Health Research will recruit 40,000 more patients, which is a lot, for more than 60 studies into prostate cancer over the next five years.

Learning Disabilities Mortality Review

Chris Skidmore Excerpts

Tuesday 8th May 2018 Commons Chamber

[Caroline Dinenage]

The hon. Lady is right to raise the inequalities of diagnosis of conditions and illnesses for which catching them early can mean the difference between life and death. That is why we have introduced annual health checks for people with learning disabilities. They mark a huge step forward and will help to reduce recognised health inequalities and ensure that reasonably adjusted care needs are much better communicated to other NHS partners.

[Chris Skidmore (Kingswood) (Con)]

As a Bristol-area MP, I thank the University of Bristol for its rigorous review, which marks a milestone in increased transparency and in setting out appalling healthcare inequalities. I note with interest that the review recommends efforts to improve awareness of the signs of sepsis and pneumonia in patients with learning disabilities in the NHS. Will the Minister reassure the House that the NHS will take up that recommendation urgently?

Breast Cancer Screening

Chris Skidmore Excerpts

Wednesday 2nd May 2018 Commons Chamber

[Mr Hunt]

Yes, I am happy to give that assurance. The number of people affected is only an estimate at the moment, but there will obviously be great interest in the House and in the country in what the actual number ends up being.

[Chris Skidmore (Kingswood) (Con)]

An additional 200,000 to 300,000 women could be seeking breast cancer screening within the next six months, which works out roughly at an additional 2,000 women a day. What reassurances can the Secretary of State give to the women who were due a screening anyway that their treatment will not be delayed as a result of the additional need?

[Mr Hunt]

That is an important question. One of our top priorities has been to construct a resolution to the problem that will not have an impact on the regular screening programme for women between the ages of 50 and 70, which is so important. All I can say is that a huge amount of trouble has been taken to try to ensure that we are putting additional capacity into the system to deal with the extra work.

Oral Answers to Questions

Chris Skidmore Excerpts

Tuesday 6th February 2018 Commons Chamber

[Stephen Barclay]

My hon. Friend is right to point out the need to give support to this trust. That is why a wider package of £1.6 billion of funding has been given to the NHS to improve accident and emergency and elective care performance. Alongside that, we have specific work through NHS Improvement to address some of the particular issues that he alluded to in his trust.

[Chris Skidmore (Kingswood) (Con)]

rose—

[Fiona Bruce (Congleton) (Con)]

rose—

--- Later in debate ---

[Chris Skidmore (Kingswood) (Con)]

Will the Secretary of State update the House on progress made in reducing the cost of agency nurses so that the money can be reinvested in full-time nursing?

[Mr Hunt]

I am happy to do that. It is one of the great successes of NHS Improvement, which should be celebrated, that it has brought down the amount spent on agency nursing by £1 billion in the last couple of years. That is a huge achievement. Every penny of that goes back into frontline care.