Dental Training College: East Anglia

Baroness Laing of Elderslie Excerpts

Tuesday 11th October 2022 Commons Chamber

[Peter Aldous]

rose—

[Madam Deputy Speaker (Dame Eleanor Laing)]

I cannot quite tell whether the hon. Gentleman wishes to contribute.

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[Jerome Mayhew]

I am grateful—

[Madam Deputy Speaker]

Order. Perhaps I am confused, but I thought that the hon. Member for Broadland (Jerome Mayhew) had finished. [Interruption.] Ah, so now he is intervening on the hon. Member for Waveney (Peter Aldous). That is absolutely fine.

Women’s Health Strategy for England

Baroness Laing of Elderslie Excerpts

Wednesday 20th July 2022 Commons Chamber

[Wes Streeting (Ilford North) (Lab)]

Let me begin by thanking the Secretary of State for advance sight of his statement and adding my thanks to the Minister of State, to his predecessor as Secretary of State, the right hon. Member for Bromsgrove (Sajid Javid), who is sat opposite, and to officials in the Department for the work they have done. I am genuinely glad that this work is out of the door when so much else has been in hiatus because of the wider political change afoot in the Government. I join the Secretary of State in recognising the campaigning efforts of his constituent Kath Sansom, as well as the efforts of my hon. Friend the Member for Swansea East (Carolyn Harris), who has campaigned tirelessly to raise awareness of the menopause and has been a driving force for change on behalf of women everywhere.

For too long, women's health has been an afterthought, and the voices of women have been at best ignored and at worst silenced. Four out of five women who responded to the Government’s survey could remember a time where they did not feel listened to by a healthcare professional, and that has simply got to change. In recent years, we have seen a string of healthcare scandals primarily affecting women: nearly 2,000 reported cases of avoidable harm and death in maternity services at Shrewsbury and Telford; more than 1,000 women operated on unnecessarily by the rogue breast surgeon Ian Paterson; thousands given faulty PIP— Poly Implant Prothèse—breast implants; and many left with traumatic complications after vaginal mesh surgery. Meanwhile, every woman who needs to use the NHS today faces record high waiting times. The NHS is losing midwives faster than it can recruit them. Gynaecology waiting lists have grown faster than those for any other medical specialty. The number of women having cervical screening is falling. And black women are 40% more likely to experience a miscarriage than white women. That is the cost for women of 12 years of Conservatives mismanagement, so I want to address each part of the strategy in turn.

The strategy promises new research, which is of course important. Studies suggest that gender biases in clinical trials are contributing to worse health outcomes for women. There is evidence that the impact of women-specific health conditions such as heavy menstrual bleeding, endometriosis, pregnancy-related issues and the menopause is overlooked. So of course what the Secretary of State has said today about improving data is so important, but will he also set out how exactly the Government intend to make use of this new data to improve outcomes for women?

Improving the education and training of health professionals is essential, because when we do not do that, there are consequences. Almost one in 10 women has to see their GP 10 times before they get proper help and advice about the menopause, and half of medical schools do not teach doctors about the menopause, even though it affects every woman. I challenge the Secretary of State to go further than the proposal he outlined to train incoming medical students and incoming doctors. What plans do the Government have for clinicians who are already practising? We need to upskill the existing workforce, not just the incoming workforce. However, let us be clear: informing clinicians is no good if we do not also improve access to hormone replacement therapy, so where is the action in the strategy to end the postcode lottery for treatment?

Breast cancer is the most common cancer in the UK, and the NHS offers regular breast cancer screening to women aged between 50 and 70. That can prevent avoidable deaths by identifying cancer early, when it is more treatable and survival is more likely. Yet, fewer women in the most deprived areas than in the most affluent areas receive regular breast screening. Even before the pandemic too many women with suspected breast cancer were waiting more than the recommended two weeks to see a specialist. How will the programme announced today make a difference to outcomes for patients if, once diagnosed, they just end up on a waiting list that is far too long and they cannot access the treatment they need?

I welcome what the Secretary of State said about removing barriers to in vitro fertilisation for women in same-sex couples. For far too long they have faced unnecessary obstacles to accessing IVF, for no other reason than that they love another woman. It is high time that we put that right.

I also want to mention endometriosis. Tens of thousands of women provided testimony to the Government about the issues they face with diagnosis and treatment. Will the Secretary of State give the House an assurance that every woman who is treated for this disease will have equal access to specialist services from day one? Will he make sure that they do not have to fight to get the diagnosis in the first place?

On polycystic ovary syndrome, what will the Secretary of State do to make sure that we equalise access to a range of treatments, not least for women for whom the pill is simply inappropriate? We must make sure we end the division between those who receive a prescription on the NHS and those who go private, receiving better treatment.

I also want to raise some points about what has not been mentioned today. In addition to the appalling figures on black maternity deaths, a quarter of black women surveyed by Five X More felt that they received a poor or very poor standard of care during pregnancy, labour and post-natal care. Women who live in deprived areas are more likely to suffer a stillbirth than their richer counterparts. My hon. Friend the Member for Oxford East (Anneliese Dodds), the shadow Secretary of State for Women and Equalities, has pledged a new race equality Act to tackle the structural inequalities in our society, including in healthcare. However, the Government are more interested in stoking culture wars than in acknowledging that these inequalities even exist. Surely that has to change when there is a new leadership of the Conservative party.

In conclusion, the reality that faces women in this country is this: breast cancer waiting times are through the floor, half a million women are waiting for gynaecology treatment, black women are four times more likely to die in pregnancy and childbirth, and too many women still cannot get HRT when they need it. This strategy simply will not solve the depth of the crisis in women’s healthcare after 12 years of Conservative mismanagement. Every day this Conservative Government remain in office is another day when women will have to wait far too long for the care they desperately need.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I call Sajid Javid.

[Steve Barclay]

rose—

[Madam Deputy Speaker]

Oh, I beg your pardon! It is probably a good idea if I allow the Secretary of State to answer the shadow Secretary of State. I am too many steps ahead.

[Steve Barclay]

I do not want those on the Opposition Front Bench thinking that their points have not been addressed.

I think there is much common ground on both sides of the House on the importance of this strategy and the need for a culture and system change in the NHS to address many of the concerns raised in past debates in the House on issues such as mesh, Paterson and Ockenden. I also think there are a lot of areas where colleagues on both sides of the House will work together to encourage commissioners in our constituencies to reshape services in a way that better reflects the needs set out in this strategy.

The hon. Member for Ilford North (Wes Streeting) is right to highlight the fact that many respondents felt they had not been heard in the past. That is why we have taken the first step of appointing a women’s health ambassador—Professor Dame Lesley Regan, who is an extremely respected figure in women’s health—to better champion women. It is also why I signalled in my statement the importance of data and of breaking it down by sex by default to better target our research on conditions that impact women differently from men or that affect only women and that are often not as well researched as they should be. Again, I think there is common ground on both sides of the House on the issue of research.

I agree with the hon. Gentleman about the need to improve training for existing clinicians as well as for those new to the profession. That is why I signalled in my statement our desire to work with the royal colleges and others to make sure that that continuing professional development is there.

The hon. Gentleman raised the issue of access to HRT. He will be aware that we have put prepayment certificates in place from April next year so that someone will pay only the equivalent of two prescription charges for their HRT supply. Officials in the Department have done considerable work on supply chain issues to tackle some of the difficulties that were there in the past.

On the hon. Gentleman’s point about how we address outcomes for patients, I saw a good illustration this morning at Homerton. Redesigning services avoids the need for invasive and more expensive theatre treatment, and the use of new equipment allows a better service to the patient. In the strategy, Professor Dame Lesley Regan makes the point that the irony is that we could deliver services that are far better for the patient but also cheaper for the taxpayer if we embraced a women’s hub model of the sort we see in Homerton. I very much look forward to taking the data we have forward in conversations with other commissioners around the country.

I am pleased that the hon. Gentleman recognised and welcomed the removal of barriers to IVF, as will Members on both sides of the House who have seen the challenges that that issue presents in constituency cases.

On speed of service, community diagnostic centres have an important role to play. The hon. Gentleman also raised the issue of ethnic minorities. We have put in place a maternity disparities taskforce, and ministerial colleagues have already met three times as part of that taskforce, so the characterisation that Ministers are not engaging on the issue is, I am afraid, wide of the mark.

The hon. Gentleman mentioned breast cancer. He will have noted from my statement that an additional £10 million has been targeted specifically at that issue, with a further 25 mobile units. Again, that is about addressing the disparity in women’s health data in different parts of the country.

Overall this is an important strategy. We have listened to the very large number of responses to the consultation, and that is reflected in the strategy. I think this is an area on which there is much common ground on both sides of the House.

[Madam Deputy Speaker (Dame Eleanor Laing)]

And now I call Sajid Javid.

[Sajid Javid (Bromsgrove) (Con)]

There was a time when I would follow right after the shadow Secretary of State, but not any more. However, I am very pleased to follow my right hon. Friend the Secretary of State, and I welcome him to his new role. He has the privilege of running a fantastic Department that is so important to the British people. He has excelled in every role he has held in Government so far, and I know he will do so again.

I strongly welcome the women’s health strategy—as we heard, it is the first published by any Government. I congratulate everyone involved, including all the officials and especially the excellent Minister of State, Department for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield), who is sitting on the Treasury Bench, and the previous Minister of State, my right hon. Friend the Member for Mid Bedfordshire (Ms Dorries).

Does the Secretary of State agree that, when it comes to women’s health, early diagnosis is essential? I absolutely welcome the commitment in the strategy on mandatory training in women’s health issues for new doctors, but will my right hon. Friend say a little more about what can be done on training for existing doctors and clinicians?

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[Steve Barclay]

Part of the reason this is a 10-year strategy is that we do need a change of culture as well as a change of systems, and that is what the strategy maps out. A key component of that is how we empower patients through areas such as the NHS website, working with trusted partners who provide health information. The hon. Lady is also right about training, not just for new entrants into the medical profession but for existing clinicians. We will be working with the royal colleges and others to drive that forward.

[Madam Deputy Speaker (Dame Eleanor Laing)]

And finally, Jim Shannon.

[Jim Shannon (Strangford) (DUP)]

Thank you, Madam Deputy Speaker. I have the strongest legs in the Chamber.

I very much welcome the Secretary of State’s announcement of additional moneys for women’s health training. He referred to one-stop clinics. I coincidentally spoke to a medical student who graduated in Cardiff today, who feels that more is needed for the specialty of women’s health, and specifically the menopause, which the hon. Member for Swansea East (Carolyn Harris) mentioned. What training will be extended to GPs, in the context of one-stop clinics, to ensure that each surgery has a trained GP available to advise and to help?

[Steve Barclay]

One of the key issues highlighted in the response to the call for evidence was how areas such as the menopause were being dealt with by the NHS. That is why we have a menopause taskforce looking at specific recommendations, one of which concerns the training of clinicians.

[Madam Deputy Speaker]

I thank the Secretary of State and everyone who took part in the statement.

Access to GP Services and NHS Dentistry

Baroness Laing of Elderslie Excerpts

Tuesday 21st June 2022 Commons Chamber

[Hon. Members]

Give way!

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. If the Minister is not giving way, she is not giving way.

[Hon. Members]

Frit!

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[Maria Caulfield]

The hon. Gentleman may say, “Here we go,” but Opposition Members acknowledged this afternoon that the Labour contract was causing the problems. We are getting on with dealing with that.

My hon. Friend the Member for Waveney (Peter Aldous) asked what progress is being made. We put the negotiations to the BDA on 24 March and made a final offer—[Interruption.] They don’t want to listen, Madam Deputy Speaker; they don’t care. We put the final offer to the BDA on 20 May, and we are waiting to hear back. We are reforming the dental contract, which perversely disincentivises dentists to take on NHS work.

To correct the hon. Member for Portsmouth South (Stephen Morgan), he did not host that dental summit; it was my right hon. Friend the Member for Portsmouth North (Penny Mordaunt), who invited me. The summit came up with a solution, and I am meeting her team so that we can work on that and take it forward.

In addition to the dental contract, we are reforming how we take on dentists from overseas. We consulted the GDC, which recently ran a consultation, and we will be laying legislation to give it powers to allow dentists to come here more easily—[Interruption.]

[Madam Deputy Speaker]

Order. I can hear what Members are saying, and it is just not right. It is simply rude when we are supposed to be listening to the Minister.

[Lloyd Russell-Moyle (Brighton, Kemptown) (Lab/Co-op)]

And I think she could do better.

[Madam Deputy Speaker]

Order. You are not saying anything while you are sitting down—nothing! I call the Minister.

[Maria Caulfield]

Thank you, Madam Deputy Speaker. Labour Members do not want to hear about the work that the Government have been doing. They are just too busy criticising.

My hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson) also mentioned the work that we are doing on centres for dental development. We are already working in places such as Cornwall to start training more dentists in those areas. In Norfolk and Norwich, we have met representatives from the university. The meeting was led by local MPs who brought people together to set up centres. We have also been working in Lincolnshire as well.

We are empowering the dental workforce by changing and upskilling dental technicians, dental nurses, and dental assistants to be able to take on more work. We are also tackling the issue of clawback.

You would think, Madam Deputy Speaker, that this is just an issue in England. If we look at Labour-run Wales, we find that the Community Health Councils have acknowledged that Wales is also facing a crisis of access to GPs, and that patients are waiting more than an hour to get through on the phone only to find that there are no appointments left.

The number of dental practices in Wales has fallen—from 1,500 in 2019 to 1,389 last year. In the past year alone in Wales, there was a 71% drop in courses of dental treatment. Why is that happening under a Labour Government? [Interruption.] I have given the answer. Opposition Members are too busy talking, Madam Deputy Speaker. They do not want to hear the answers.

Opposition parties need to be honest with the public. Whether we are talking about Scotland, Wales or Northern Ireland, we are all facing the same challenges. [Interruption.] No! There is a Labour-run Government in Wales and an SNP Government in Scotland. [Interruption.] The Opposition continue to play politics, but we are getting on with the business of reforming and making those changes. They have no solutions, no answers and no ideas. It is this Government who are delivering the changes. We are being honest with the British public that we will face challenges, but we are making the changes to improve access to both dental and primary care services.

Question put and agreed to.

Resolved,

That this House notes that primary care is in crisis, with people across the country struggling to access GP services and dental treatment; believes that everyone should be able to get an appointment to see a doctor when they need to and has the right to receive dental treatment when they need it; is concerned by the Government’s failure to remain on track to deliver 6,000 additional GPs by 2024-25; and therefore calls on the Secretary of State for Health and Social Care to urgently bring forward a plan to fix the crisis in primary care, meet the Government’s GP target and ensure everyone who needs an NHS dentist can access one.

Health and Care Bill

Baroness Laing of Elderslie Excerpts

Consideration of Lords amendments
Wednesday 30th March 2022 Commons Chamber

Consideration of Lords amendments

[Madam Deputy Speaker (Dame Eleanor Laing)]

I must draw the House’s attention to the fact that financial privilege is engaged by Lords amendments 34 to 37, 52 to 54, 80, 81, 84, 86 to 88, 91, 93, 94, 96, 97 and 129. If they are agreed to, I will cause the customary entry waiving Commons financial privilege to be entered in the Journal.

After Clause 148

Mandatory training on learning disability and autism

[The Minister for Health (Edward Argar)]

I beg to move Government amendment (a) to Lords amendment 91.

[Madam Deputy Speaker]

With this it will be convenient to discuss the following:

Lords amendment 91.

Lords amendment 85, and Government motion to disagree.

Lords amendment 86, and Government motion to disagree.

Lords amendment 87, and Government motion to disagree.

Lords amendment 88, and Government motion to disagree.

Lords amendment 92, Government motion to disagree, and Government amendment (a) in lieu.

Lords amendment 95, Government motion to disagree, and Government amendment (a) in lieu.

Lords amendments 52 to 54, 66 to 79, 82, 84, 93, 94, 96 to 101 and 109 to 122.

Lords amendment 123, and amendment (a) thereto.

Lords amendment 124, and amendment (a) thereto.

Lords amendment 125, and amendment (a) thereto.

Lords amendment 126, and amendment (a) thereto.

Lords amendment 127, and amendment (a) thereto.

Lords amendments 128 and 129.

[Edward Argar]

It is a pleasure to debate their lordships’ amendments and to serve opposite the hon. Member for Tooting (Dr Allin-Khan) for our consideration of this group of amendments—I do not usually do so as our portfolios do not always overlap. The amendments in the group all relate to questions of patient safety, patient engagement, public health and building a learning culture in the NHS.

First, may I put on record how proud I am that the Government are protecting the safety of women and girls through the hymenoplasty amendment, which I know has cross-party agreement? I will run through the amendments and concessions that the Government have made on a number of aspects of the Bill before turning to the perhaps more contentious areas in the group. We have tabled amendments to ban the carrying out, offering and aiding and abetting of hymenoplasty in the United Kingdom. We have accepted all the recommendations of the expert panel on hymenoplasty and agree that the procedure is inextricably linked to virginity testing and violence and that it has no place in our society. I offer my gratitude to all the members of that expert panel, to those who have campaigned so long and so hard on the issue and to my hon. Friend the Member for North West Durham (Mr Holden) for his continued hard work to protect vulnerable women and girls.

I urge the House to support amendments 84, 96 and 129, which create a licensing regime for non-surgical cosmetic procedures.

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[Edward Argar]

I beg to move, that this House disagrees with Lords amendment 29.

[Madam Deputy Speaker (Dame Eleanor Laing)]

With this it will be convenient to discuss the following:

Lords amendment 30, and Government motion to disagree.

Lords amendment 48, Government motion to disagree, Government amendment (a) in lieu, and amendment (b) in lieu.

Lords amendment 57, and Government motion to disagree.

Lords amendment 89, Government motion to disagree, and Government amendment (a) in lieu.

Lords amendment 108, and Government motion to disagree.

Lords amendments 42 to 47, 55, 56 and 58 to 64.

[Edward Argar]

It is a pleasure in discussing this set of amendments to be facing the shadow Secretary of State, the hon. Member for Ilford North (Wes Streeting), although I might not say that after he has made his contribution or challenged me. I am grateful for the opportunity to speak to this important set of amendments, and I again put on record my gratitude to their lordships for the work they have done in scrutinising this Bill. This group is about accountability and makes it clearer that the Government are committed to ensuring that the NHS is transparent, accountable and effective.

Lords amendments 42 to 47 ensure that the procurement regulations will have to include provision for procurement processes and objectives; for steps to be taken when competitively tendering; and for transparency, fairness, the verification of compliance and the management of conflicts of interest. They also require NHS England to issue guidance on the regulations. It behoves me to pay tribute to the shadow Minister, the hon. Member for Bristol South (Karin Smyth), who served on the Bill Committee throughout. Although we did not always agree, she brought her expertise and forensic skills with issues such as this to that Committee. Even if she did not always agree with the conclusions, she made sure we were well informed in the conclusions we reached.

We recognise those key aspects as vital. While it was always our intention to include them in the new provider selection regime, the amendments add clarity and clearly signal our intentions. Furthermore, Lords amendment 47 makes the regulations subject to the affirmative procedure. We are grateful for the input of the Delegated Powers and Regulatory Reform Committee in advising that, and we have listened.

Lords amendment 55, supported by the Scottish Government, makes it clear that any powers or duties conferred on Scottish Ministers in relation to their role in collecting information for medicine information systems can be treated in the same way as other NHS powers or duties in Scotland and be delegated to health boards in Scotland.

Lords amendments 56 and 58 to 64 relate to the power to transfer the functions of arm’s length bodies. Following constructive engagement with the devolved Governments, these amendments enable us to proceed on a UK-wide basis. Lords amendment 56 clarifies that the powers in part 3 of the Bill in respect of special health authorities apply in relation only to England and cross-border special health authorities, and not Wales-only special health authorities. Lords amendments 58 and 59 remove devolved Ministers and Welsh NHS trusts from the list of appropriate persons to whom property, rights and liabilities can be transferred through a transfer scheme following a transfer of functions.

Lords amendment 60 creates a requirement for the Government to obtain the consent of the devolved Governments for any transfer of functions within the competence of their legislatures or which modify functions exercised by the Welsh Ministers, Scottish Ministers or a Northern Ireland Department. Finally, Lords amendments 61 to 64 are consequential upon the changes made by Lords amendment 60.

I am also asking the House to disagree with several amendments made in the other place. First, Lords amendment 29 relates to the workforce, and I reassure the House that the Government are committed to improving workforce planning. We recognise the importance of having a properly trained workforce in sufficient numbers and in the right places. We are already taking the steps we need to ensure we have record numbers of staff working in the NHS. While we recognise the strength of feeling behind the amendment, we simply do not think it is necessary in its current form, and we urge the House to reject it.

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[Wes Streeting]

I wholeheartedly agree with my hon. Friend. To be honest, I do not know whether No. 10 or No. 11 is running the show. We hear that the Chancellor also blocks the Prime Minister from time to time. I can think of a few occasions during lockdown where that would have been good, if the Chancellor had bolted the door to the back garden, but we will not dwell on that now, Madam Deputy Speaker, because you will tick me off—

[Madam Deputy Speaker (Dame Eleanor Laing)]

No, we will not.

[Wes Streeting]

As you already are, Madam Deputy Speaker, but I could not resist.

The problem is that unless we face up to the scale of the workforce challenge, the Government simply will not deliver the shorter waiting times that patients need until they break out of their straitjacket. They should start today; otherwise, patients will be left wondering why they are paying more in taxes but waiting longer for care.

Government Members may argue that we do not need Lords amendment 29, because there is a planned update to “Framework 15”, Health Education England’s 15-year strategic framework for workforce planning—[Interruption.] My hon. Friend the Member for Bristol South (Karin Smyth) cannot wait; she is watching her inbox daily, waiting for it to arrive. The truth is that this is inadequate. Previous iterations of the framework have not quantified the staffing numbers needed. The Secretary of State was recently unable to confirm when he appeared before the Health and Social Care Committee that the revised framework will set out the required numbers of staff. The truth is that the recent past is littered with promises of workforce strategies and frameworks that have either not materialised or failed to deliver the action needed.

Let me turn to the Minister’s claim that we have record numbers of doctors and nurses—it is today’s equivalent of, “You’ve never had it so good.” We all know—he knows this very well—that the population is growing and ageing, and as it does so, we need the numbers of nurses, doctors and carers to keep up. This is a question not just of recruitment, but of retention. When I ask frontline staff, “What would make the single biggest difference to your morale? What would be the thing that keeps you going even though you are exhausted, stressed and burned out?”, their answer is very simple: they just want to know that the cavalry is coming and that significant numbers of staff will be recruited to help provide the support they need. Their greatest fear is that the people who have slogged their guts out to get us through the pandemic will be left alone as they try to help the NHS to recover from the pandemic and from the problems that existed before it. If we are not careful, we will risk losing those staff, creating even greater pressures—a greater cost to patient care, a greater cost to patient safety and a greater cost in recruiting and training new doctors and nurses. With the best will in the world, and with the best training available at our brilliant medical schools, doctors and nurses take years to develop the skills and experience to make them outstanding clinicians. Those are the people we risk losing at this very moment.





While I have the opportunity, may I say to the Minister that I cannot understand why there are 791 medical school graduates who still do not have a junior doctor post? These people are qualified, they are ready and there is a shortage—get them to work!

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[Several hon. Members rose—]

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. It has only just become obvious to me that so many people wish to speak on this group of amendments. I will have to set an immediate time limit of four minutes, which might be reduced to three minutes. People who intervened on the Front Benchers will be considered to have already made their contribution.

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[Justin Madders (Ellesmere Port and Neston) (Lab)]

I wish to speak to Lords amendment 29 on the workforce. The most important thing I learned during my five years as a shadow Health Minister is that everything comes back to the workforce. We can have the grandest plans, strategy documents, reorganisations, integrations and configurations—all of which are probably in this Bill, in various forms—but it will all count for very little if the fundamental cog in the machine, the workforce, is not a central part of those plans. The consistent failure to invest in, and provide a plan for, the workforce, so that it can meet demand over a sustained period is at the root of the challenges that the NHS and social care face today. We now have a chance to correct that.

Let us look at some of the challenges. There are 93,000 NHS staff vacancies; £6 billion-plus has been spent on temporary staff to fill gaps; and more than half of staff are working unpaid extra hours each week, with 44% saying that they have felt ill with work-related issues—little wonder, given that retention remains a huge issue. We need a plan, and we need to give staff some semblance of hope that we are listening—that the claps on a Thursday were not just an empty gesture; that the tributes that we rightly pay here to their dedication are not meaningless platitudes; and that there is a determination to do something about the persistent rota gaps that mean that staff are both exhausted and demoralised.

The Health and Social Care Committee report on staff burnout says:

“It is clear that workforce planning has been led by the funding envelope available to health and social care rather than by demand and the capacity required to service that demand.”

That is rather the nub of it. Health and social care are both demand-led systems, yet the funding and therefore the workforce capacity are not linked to demand. Until that central issue is addressed, we will keep coming back to the many varied and unfortunate consequences of an overstretched and under-resourced workforce.

I suspect that the Minister—who I have a lot of time for, even though he is often wrong on these things—might privately think that a long-term workforce plan might be a good idea, not just to ensure that the NHS can plan properly and to move forward on a sustainable footing, but because that might help his Department when it goes into negotiations on the spending round with the Treasury, as it will be able to point to an independently verified assessment of workforce need. If the amendment has a weakness, it is that it does not ensure that any plan is actually feasible, because there is no requirement in it that any plan be fully funded. However, a plan that shows, for all the world to see, a clear funding gap would be helpful to the Minister, because it would allow him to go to the Treasury with a clear and objective demand. As he knows, I like to be helpful to him, so I hope that on this occasion he can support the amendment.

This debate is timely because it comes on a day when two surveys have been released that lay bare the crisis that we face. One survey shows that public satisfaction ratings with the NHS are reported to be at a 25-year low—a quarter of a century of surveys there—and another shows that the number of NHS staff who would recommend their trust as a place to work has plummeted. Those two facts are intertwined and symptomatic of the workforce crisis that the amendment is trying to address.

The question we must ask ourselves, if we choose not to support the Lords amendment, is whether the Government’s existing plans create sufficient accountability and rigour to deliver the transformative approach that the amendment would. In my view, it introduces a level of robustness to workforce planning that is currently missing. For the reasons I have set out, we owe it to the workforce, to patients and to those in receipt of social care to put workforce planning on the strong footing that the amendment would deliver.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I am surprised that the hon. Member for Strangford (Jim Shannon) does not wish to speak. [Interruption.] Oh, he does. I hope he will be brief, so that the Minister will have time to answer the debate.

[Jim Shannon]

I certainly will make my points quickly. My first is on the organ transplant amendment, to which the Minister referred. I fully support the measure and have been asking for it for a number of years in the House, so I am pleased to see it moved tonight. Secondly, I am not sure whether the right hon. Member for Chingford and Woodford Green (Sir Iain Duncan Smith) is going to push his amendment to a vote—[Interruption.] He is not, but if he did, he would have my support and probably that of my party, too.

Thirdly, I am pleased to lend my support to Lords amendment 29. It would create a national independent view of how many health, social care and public health staff are needed to keep pace with projected patient demand over the next five, 10 and 20 years. I wholeheartedly agree with Macmillan Cancer Support that the Bill will fail to address the biggest challenge facing the NHS and social care right now: staffing shortages and pressures. The Government need to take Lords amendment 29 seriously. The hon. Member for Ellesmere Port and Neston (Justin Madders) referred to it, too. We recognise that we need to address staff shortages as soon as possible. I have referred to Macmillan and their request for an additional 3,371 cancer nurse specialists to help address that issue.

I will conclude with this point. I understand that the Government may come back with all the justifications as to why this is not the right amendment—the Minister is a real good man; we all know that, and he responds well to all our requests—but I am content that it would begin to address the issue that our NHS workforce is disintegrating. One of my constituents is in a prestigious medical school here on the mainland. She went to do her rotation with a GP as part of the work she does. He told her, “Do any job but this.” I thought that was disappointing. He said, “It will consume your life. You will work long hospital shifts and you will not have a personal life.” This is a seasoned GP who simply cannot cope, so we must do something, and this amendment is a way forward. I therefore will support it whenever it comes to a vote.

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[Edward Argar]

I think that was exactly five seconds, and I am grateful to my right hon. Friend. I suspect that colleagues across Government will have heard what he said and will pay very careful attention to it, as I know Ministers across Government do to all that my right hon. Friend says in this House.

With that in mind, I ask the House to accept the motions in my name on the amendment paper.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I congratulate the Minister on his perfect timing. That is very rarely done with such precision.

Question put, That this House disagrees with Lords amendment 29.

Civil Proceedings

Baroness Laing of Elderslie Excerpts

Tuesday 29th March 2022 Commons Chamber

[Madam Deputy Speaker (Dame Eleanor Laing)]

Motions 3 and 4 will be debated together. Under the terms of the Business of the House (Today) order, the Questions on the motions will be put separately, no later than 90 minutes after the start of this debate.

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

I beg to move,

That the Coronavirus Act 2020 (Delay in Expiry: Inquests, Courts and Tribunals, and Statutory Sick Pay) (England and Wales and Northern Ireland) Regulations 2022 (SI, 2022, No. 362), dated 23 March 2022, a copy of which was laid before this House on 23 March, be approved.

[Madam Deputy Speaker]

With this it will be convenient to discuss the following motion on the Coronavirus Act 2020 (Review of Temporary Provisions) (No.4):

That the temporary provisions of the Coronavirus Act 2020 should not yet expire.

[Maggie Throup]

Throughout the pandemic, the Government have done everything in our power to protect the lives and livelihoods of people across the country .The Coronavirus Act has been a vital tool, allowing us to do that. Last week marks two years since the Act gained Royal Assent and the automatic expiry date for its temporary provisions. This is an opportunity to reflect on the progress we have made in our fight against covid-19 and on how the Act has supported us in that fight, as well as in encouraging important innovations in some of our public services, which we want to take forward.

First, I come to the support the Act has given us. It was an extraordinary piece of legislation for an extraordinary time in this country’s history, giving us the powers we needed to keep the country safe, and the economy and public services open at the time of need. It helped us to bolster the health and social care workforce by suspending rules in the NHS pension schemes for England and Wales, and allowing the creation of temporary registers enabling recently retired NHS and social care staff to return to the workforce and play their part. Almost 15,000 nurses, midwives and, in England, nursing associates joined these temporary registers to help deal with the impact of the pandemic, as well as more than 10,000 paramedics, operating department practitioners and other professionals, and about 6,500 social workers.

The Act also helped the Government to offer unprecedented economic support and to help people and businesses at a time when so many businesses faced disruption. That includes the coronavirus job retention scheme, also known as furlough, which has supported 11.7 million jobs.

Dementia Research in the UK

Baroness Laing of Elderslie Excerpts

Thursday 10th February 2022 Commons Chamber

[John Nicolson (Ochil and South Perthshire) (SNP)]

My mum died of dementia at the start of the covid outbreak. She formed a great attachment to Madam Deputy Speaker, of whom she was very fond, and Madam Deputy Speaker was very fond of her. Her name was Marion. She went from being a sparkling presence to somebody who, at the start of the pandemic, was locked in for her own protection and I was not able to go and see her. I had never before understood the whole idea of somebody turning their face to the wall, but she just stopped eating and drinking, and within a week, she was dead. I hope that when the story of the pandemic is written, we will remember all those people who died because of it and who will never be recorded as having died of covid. They died through loneliness, which is so important for us all to remember.

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. May I interrupt to say to the hon. Gentleman and to the House that his mother was a sparkling presence and a lovely lady? I was very fond of her and it is tragic that he has lost her. We all feel it very deeply with him.

Children’s Mental Health

Baroness Laing of Elderslie Excerpts

Tuesday 8th February 2022 Commons Chamber

[Several hon. Members rose—]

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. It will be obvious that a great many people wish to speak this afternoon and limited time is available, so there will be an immediate time limit on Back-Bench speeches of five minutes. I give that warning now so that people can tear up several of their bits of paper and adjust accordingly. I call the Minister.

--- Later in debate ---

[Several hon. Members rose—]

[Madam Deputy Speaker (Dame Eleanor Laing)]

I am afraid I have to now reduce the time limit to four minutes.

Down Syndrome Bill

Baroness Laing of Elderslie Excerpts

3rd reading
Friday 4th February 2022 Commons Chamber

[Dr Fox]

With the leave of the House, may I say what an absolute joy it has been to find this bolthole of consensus in the psychodrama that seems to be British contemporary politics? I thank colleagues for their very kind words today; to get to this level of flattery in the House of Commons, one normally needs to be dead. [Laughter.]

I remind colleagues of the point made by my hon. Friend the Member for North Devon (Selaine Saxby) that this Bill is not about a medical condition, Down syndrome, but about people with Down syndrome, who have a right to dignity and individuality and to make the choices for their own lives that we all take for granted.

I want to thank the many people who have made today possible. I thank the National Down Syndrome Policy Group, and all the other voices in the Down syndrome community, including the carers and families whose input has been invaluable. I thank the officials at the Department of Health and Social Care, who have done outstanding work behind the scenes to bring us to the point that we have reached today. I especially thank the Minister. We have been so lucky to have a Minister in the shape of my hon. Friend the Member for Chichester (Gillian Keegan). Not only is she an outstanding Minister in her own right, but her family background and understanding of the issue have been crucial in helping to provide the necessary momentum within Government. Indeed, I thank the Government as a whole, and in particular the Secretaries of State who signed off the two very important amendments. I am sure that they entirely understood the precedents they were setting, and it was therefore—as they would say in “Yes, Minister”—all the braver of them to do so.

I thank my own staff in the House of Commons, and I thank my constituency assistant Annabel Tall, who began much of this process when she brought her son Freddie to see me at my constituency surgery, shedding light—many colleagues will have had this experience—on the difficulties that parents can have in fighting fire on so many fronts on behalf of those whom they love. I hope that means that in some sense we have gone full circle today.

I thank all colleagues for their support, for their contributions, for the encouragement that they have given, and for their advocacy of this whole process in the House of Commons, in the constituency and in the media. It has been a real example of what we can achieve together—and that includes the all-party parliamentary group on Down syndrome, which provided so much support.

None of us are passengers in our own lives or in the society in which we live, and change is always within our grasp if we choose to seize it, especially those of us who are in the uniquely privileged position of being able to make the laws in our own country. I thank all those who have chosen that path today. The real heroes of this debate, however, are not those in the Chamber or those who make the laws pertaining to Down syndrome, but all those who have fought, struggled, and overcome the challenges that they have faced without our help for far too long.

Question put and agreed to.

Bill accordingly read the Third time and passed.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I am delighted to say that the Ayes have it.

Covid-19: Purchasing Effort

Baroness Laing of Elderslie Excerpts

Thursday 3rd February 2022 Commons Chamber

[Edward Argar]

The NHS and the Department get their annual budgets and spend them on what is necessary to meet the health and care needs of the nation. On the hon. Gentleman’s specific point, he might characterise the £33.9 billion increase by 2023-24, which we have enshrined in law, as part of the Brexit dividend.

[Madam Deputy Speaker (Dame Eleanor Laing)]

And finally, I call Jim Shannon.

[Jim Shannon (Strangford) (DUP)]

It is always a pleasure to ask a question in this House, at whatever time, Madam Deputy Speaker. May I thank the Minister and the Government for their endeavours during the pandemic? I do not think that anybody in this House does not recognise that, without the Government’s initiatives, these things would not have happened.

I understand the pressure that the Department of Health and Social Care was under at the outset of the pandemic to ensure that staff were not taking their lives in their own hands when they entered hospital. But Minister, reports of £8.7 billion losses are astounding. Will there be a full investigation into the scale of loss and the reasons for the loss? I understand the problems at that time—I really do—but think of the good that that money could have done to address waiting lists and new cancer drugs. Minister, what has happened grieves me in my heart, and I suspect it grieves you in your heart—

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. Please will the hon. Gentleman not call the Minister “you”? It is my ambition that he will one day get this right—please, please.

[Jim Shannon]

It grieves me in my heart, and I suspect that it grieves the Minister in his heart as well.

NHS Hysteroscopy Treatment

Baroness Laing of Elderslie Excerpts

Monday 31st January 2022 Commons Chamber

[Maria Caulfield]

I completely agree with the hon. Lady. She made a point about having the data to see how many hysteroscopies fail and whether that money could be better spent on offering an anaesthetic up front to many women. I do not have an answer to that, but it would be interesting to look at that information.

Alongside clinical guidelines and access to high-quality patient information, I stress the importance of the voices of patients, which are critical at every stage of the treatment pathway. Decisions should always be discussed and shared between clinician and patient. The Government are committed to ensuring that the voices of women in particular are more central in the healthcare system.

The women’s health strategy has been touched on several times. We have also taken key learnings from reports such as the Cumberlege review, where women were talking for a long time about the issues that they faced before anyone truly listened. We need to improve that so we are not learning from such incidents after nine years of raising them on the Floor of the House. The women’s health strategy will include gynae issues such as endometriosis and polycystic ovary disease, which are conditions that do need a hysteroscopy, so I am pretty confident that we will cover that in the strategy. We will also have a women’s health ambassador—they will be appointed in the coming weeks; applications are almost closed—with whom I will meet. I want them to lead on these issues, where they can be a real voice for patients, do a deep dive into what is happening at the coalface and speak up for women if it is not working. We have guidelines, but we do not know whether they are being used in clinical practice. From what the hon. Lady says, it sounds like there are clearly issues that need to be addressed.

I reassure the hon. Lady that I am happy to work with her on this issue. Improving the tariffs is one thing, but there are still women who are not getting the information that they need to make informed decisions about pain relief and anaesthetic that could be available. I welcome the new information from the Royal College of Obstetricians and Gynaecologists on pain relief specifically for this procedure, which will be out next month, and I will feed back to it on updating the guidelines to ensure that patients are involved in the process.

I thank the hon. Lady for raising this important matter. I hope that we have raised its profile and that women are more aware of their options. When they go to that clinic appointment, they can ask for pain relief, they can have it as an in-patient, and they do not need to have it right there, right then. I look forward to continuing to work with her and all Members across the House to ensure that women are offered a hysteroscopy and can access the information they need and the care they deserve.

[Madam Deputy Speaker (Dame Eleanor Laing)]

Genuinely, thank you.

Question put and agreed to.