Oral Answers to Questions

Debate between Baroness Laing of Elderslie and Gillian Keegan

Monday 11th March 2024 Commons Chamber

[Gillian Keegan]

The hon. Gentleman puts his finger on a very important point. We work with employers in farming and fishing, and we have a number of apprenticeship standards across those industries. We are always happy to work with any industry that sees an opportunity for more apprentices to be trained in their industry.

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. Before I call the second question, Mr Speaker would like me to convey to the House his apologies for his unavoidable absence from questions this afternoon as he has to attend the Commonwealth service in Westminster Abbey, which is about to start at any minute now.

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[Gillian Keegan]

This Conservative Government are backing this country’s brilliant childcare providers as we roll out our historic childcare offer. As my hon. Friend has pointed out, that is on top of the roll-out of universal services in family hubs. To give certainty to the early years sector, we have confirmed that average funding rates will increase over the next two financial years—as he stated, the details are in the Red Book—giving them the confidence to invest and expand. Only the Conservatives have a plan for hard-working parents.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I call the SNP spokesman.

Safety of School Buildings

Debate between Baroness Laing of Elderslie and Gillian Keegan

Wednesday 6th September 2023 Commons Chamber

[Gillian Keegan]

I will look at Leeds specifically, but we have awarded millions to Leeds. The biggest difference between our programme and any programme that was ever done by your Government when they were in power—

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. I think the Secretary of State means “his Government”.

[Gillian Keegan]

I am sorry. Unlike the hon. Gentleman’s Government when they were in power, we actually did a conditions survey. We have done two conditions surveys and we have done a full RAAC survey, which we are now finishing with the responses that are coming in. We know the conditions; previously, the Labour Government did not know anything about the conditions and no decisions were made based on the condition of schools.

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[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. I appreciate that the Secretary of State has been very generous in giving way to Members, but she will not be as aware as I am that there are 22 people who wish to speak this afternoon. The Secretary of State is very politely giving way to Members who are not going to take part in the debate, and if we have long interventions from those Members, people who are waiting to speak will not have the chance to do so when we come to the end of the debate. I am trying to get some fairness into this, but I do appreciate that the Secretary of State is being polite and I will allow her to respond to the intervention.

[Gillian Keegan]

Thank you for that, Madam Deputy Speaker, and for giving me the reminder, because I do not want to take time away from people who have put in to speak. What my right hon. Friend the Schools Minister said is absolutely right: any time there is an immediate risk, action is immediately taken. However, what we were doing was more preventive than that: finding out where everything was, so that we could act. When the three new cases happened over the summer, that is when I made a decision to be very cautious, because I did not want to take any risk whatsoever. I knew exactly where to go, because I knew exactly which schools were judged as non-critical. I knew exactly what we needed to do.

Reinforced Autoclaved Aerated Concrete in Education Settings

Debate between Baroness Laing of Elderslie and Gillian Keegan

Monday 4th September 2023 Commons Chamber

[Gillian Keegan]

I thank the hon. Lady, and of course that is me, but what matters is what you do. When I was given new information and had to consider the impact that this would have on our schools and children, I took action even though it was politically difficult. Yesterday, when the hon. Lady was asked about Wales and RAAC, she waved away concerns and said that there was no problem. Why? Because it involved a Labour Government with Labour policies. Today, two schools closed in Wales just as they start their surveying programme. We started our surveying programme in March 2022. One of these involves taking decisions and being honest with the public; one is trying to score political points. I answered her question: the information will be provided this week—[Interruption.]

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. That is enough.

[Gillian Keegan]

Thank you, Madam Deputy Speaker. I think I answered the hon. Lady’s question. The information will be published this week. Everything will be fully funded: the mitigation, any revenue that is required on a case-by-case basis, and also the rebuilding of the schools.

When it comes to doing a good job, I make no apologies for praising the work of the Department for Education. Not my work, no, but the work of colleagues, of schools and of professionals who have helped to ensure that we are not sending children back to school without the guarantee that they will be safe. I have had teams working for weeks and all weekend to get portacabins, to find alternative sites and to help put in place urgent mitigations. Those people are doing a brilliant job and I want to thank each and every one of them.

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[Gillian Keegan]

I am glad that my hon. Friend used the word “reasonable”, because the reason we have asked for the revenue to come on an individual basis is that they will all differ. Obviously, we need to ensure that it is reasonable, and that it is put in place. We will certainly support any school with additional funding as is required. Due to the fact that, as he mentioned, almost half the cases are in Essex, it probably warrants setting up a working group with the Essex MPs, so that we can work through them in great detail.

[Madam Deputy Speaker (Dame Eleanor Laing)]

Excellent. I call Jess Phillips.

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[Gillian Keegan]

I know my hon. Friend has raised that particular school before and has had a couple of meetings on it. The school rebuilding programme is focused on condition and we will specifically work with him to understand what options there are for that school and what PFI is doing to stop its eligibility for rebuilding.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I call Sarah Dyke for her maiden question.

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[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. Before the Secretary of State answers, we are not doing very well on the short short questions, are we? Of course, it is up to colleagues. If the House decides that it wants to vote at midnight tonight, that is fine by me, but I think that it is probably not the consensus, so please let us take some action now: everybody look at what they have written down and cut it in half.

[Gillian Keegan]

I can confirm that surveyors registered with the Royal Institution of Chartered Surveyors are acceptable.

Mental Health Act 1983: Detention of People with Autism and other Lifelong Conditions

Debate between Baroness Laing of Elderslie and Gillian Keegan

Thursday 20th January 2022 Commons Chamber

[The Minister for Care and Mental Health (Gillian Keegan)]

I take this opportunity to genuinely thank my right hon. and learned Friend the Member for South Swindon (Sir Robert Buckland) for securing a debate on this vitally important topic. Improving the care and treatment of autistic people is something he has championed, particularly through his commitment to reform of the Mental Health Act. I thank him for his continued work on this matter, no matter where he is sat. I give him my commitment that I share his determination for change, and I will continue to work with him. There is absolutely no place for poor-quality care for autistic people or anybody with a learning disability in our society. The system needs change.

I recently visited Norfolk to meet the families of those affected by the tragedy that occurred at Cawston Park Hospital, which was the subject of a previous Adjournment debate. I met the parents of the young people who suffered and sadly died and heard at first hand about the experience of people with autism and people with Down’s syndrome in health and care settings, and it was shocking. Such experience has too often fallen unacceptably short of the standard of care that individuals and families—those people who are the most vulnerable and often voiceless—should rightly expect. It is truly awful to hear about such appalling experiences.

We are taking action for children, young people and adults, for people who have been in-patients for longer than they should, and to prevent people from being admitted, even for a short time, when they do not need to be. I welcome this opportunity to set out the immediate and longer-term actions we are taking. They include our planned Mental Health Act reforms, which will provide the opportunity to change the legal framework and to reinforce and underpin the changes we are making now. I cannot commit today to a timetable for that, but the planning is well under way and I will keep my right hon. and learned Friend informed.

To keep people safe now, all autistic people and people with a learning disability must receive high-quality, safe care. That is our first priority. We know that some people may require support in a mental health hospital; when that is necessary, it should have a clear therapeutic benefit, be the least restrictive support possible, be close to home and be for the shortest possible time. We will not tolerate instances of abuse or poor-quality care.

To ensure that people are safe, all autistic people and people with a learning disability in an in-patient setting now receive a safe and wellbeing review. These reviews, which are led by NHS England, are a priority and the majority will be completed by the end of January. We also fully support the more robust approach that the CQC is taking in increasing the amount of shorter, unannounced inspections and closing hospitals that do not provide a high-quality standard of care.

My right hon. and learned Friend mentioned people who are in long-term segregation. There are about 100 of them and a couple of cases were mentioned in the debate. Every single one of them will receive independently chaired reviews of their care and treatment. The reviews will consider how to move towards a less restrictive or, ideally, community-based setting.

As part of a wider £31 million package to support discharge and develop community support, we have provided funding for a senior intervenors pilot. These independent experts will work to resolve blockages in the path to discharge, where there can be multidiscipline teams who basically do not agree or manage to find a solution among themselves. The senior intervenors will help to unblock things for those people in a long-term situation, and move them towards a less restrictive setting and back into the community, which is where we want people wherever possible.

My hon. Friend the Member for Broxtowe (Darren Henry) mentioned the need to build and make sure we have the right support in the community. The Government want to make sure that, wherever possible, autistic people and people with a learning disability are able to lead full lives in the community, close to their families, with the right support in place to prevent crisis.

In the NHS long-term plan we committed to reduce the number of autistic people and people with a learning disability who are in-patients in mental health hospitals by 50% by the end of March 2024. Since 2015, we have achieved a 29% reduction, which is equivalent to a reduction of around 800 in-patient beds—800 people—and means we need to close around 600 more to meet the target. I am firmly committed to achieving that.

The building the right support programme is our national policy to ensure that autistic people and people with a learning disability are supported in the community, and more than £90 million of additional funding for community services and support for discharges has been provided for 2021-22 to help to achieve that. Joint action across organisations and systems is essential to drive progress, so we are developing an action plan to outline the steps that we and all our partners will take to deliver that action with urgency, and we will publish it as soon as possible. We also know that early diagnosis is key, as the hon. Member for Strangford (Jim Shannon) mentioned, and that prevention and intervention at an early stage are vital, so we are investing £2.5 million to test and implement the most effective ways to reduce autism diagnosis waiting times for children and young people in England. Additionally, we are investing £600,000 in significantly expanding an autism early identification pilot to at least 100 schools over the next three years. Those actions and others set out in our all-age autism strategy, which was published in July, should make a big difference.

I want to touch on the subject of “do not attempt CPR” decisions, which hon. Members have mentioned. My right hon. and learned Friend the Member for South Swindon mentioned the culture; we are working to ensure that there is a culture of compassionate care for autistic people and people with a learning disability that is also of the highest quality. The Department has remained crystal clear that it is unacceptable for DNACPR decisions to be applied in a blanket fashion to any group of people.

We have also developed and trialled the Oliver McGowan mandatory training in learning disability and autism for all health and social care staff, working with Health Education England and Skills for Care. The programme is backed by a £1.4 million investment, and I think it will go a long way towards changing the culture.

We want to end inappropriate detentions for autistic people and people with a learning disability, and we are introducing once-in-a-generation reforms to the Mental Health Act that will be critical to achieving that. Under our proposed reforms, we will limit the scope to detain autistic people or people with a learning disability under section 3 of the Act. We want to prevent the detention under section 3 of people who do not have a co-occurring mental health condition; they simply have a learning disability.

We want to ensure that the right services are in place, allowing individuals to receive the best possible care in the community. Our proposed reforms will create new duties for commissioners to ensure an adequate supply of community services and ensure that every local area understands and monitors the risk of crisis at an individual level. This will transform our capability to provide those services in the community and to keep people safe in their community.

I thank all hon. Members for their contributions and thank my right hon. and learned Friend again for securing this vital debate. It is important that we continue to listen to people with lived experience and to their families, most importantly, in shaping and delivering high-quality care, both in in-patient settings, where they still exist, and in the community. Having heard some truly shocking experiences as Minister for Care and Mental Health, I am grateful that the debate has given us an opportunity to set out my personal commitment and to give a voice to those people who, for too long, have not had one.

In addition to the work that the Government are undertaking now and in the longer term, we must make sure that all autistic individuals and people with other lifelong conditions are treated with dignity and respect and are able to lead fulfilling lives in their community. I am absolutely determined to see that happen, and I look forward to working with my right hon. and learned Friend; I know that he is determined, too. There should never be an instance of people with a learning disability and autistic people being treated as anything less than equal in our society. He has my commitment that I will work with him to achieve that.

[Madam Deputy Speaker (Dame Eleanor Laing)]

Before I put the Question, I am sure that the whole House will wish to join me in congratulating the right hon. and learned Member for South Swindon (Sir Robert Buckland) on his knighthood. [Hon. Members: “Hear, hear.”] Congratulations, Sir Robert—I see that we have quite a lot of Sir Roberts around.

Question put and agreed to.

Adult Social Care

Debate between Baroness Laing of Elderslie and Gillian Keegan

Wednesday 1st December 2021 Commons Chamber

[Gillian Keegan]

My right hon. Friend is right that this is a start. It is a 10-year vision, and obviously we had a three-year spending review and the spending that we set out was a three-year spending settlement, so of course it is just a start.

On the steps to ensure that local authorities move to a fair rate and a fair cost of care, we are exploring a number of options, and we will set out further detail at the local government finance settlement later this year. Local authorities moving towards a fair rate of care is key to building a solid foundation for the future adult social care system, so we will be working closely with them to shape the best possible approach to implementation across different local markets. We will shortly be engaging with local authorities and providers, and we will publish further guidance in due course.

My right hon. Friend is absolutely right about the workforce. I have never worked in a business where the workforce was not key to anything that needed to be delivered, but in the care sector in particular, it is impossible to deliver anything without the workforce. It is also difficult to look at the workforce structure. As I say, it is the largest workforce in the country, with 1.54 million people working in it, but with 40% churn and very high amounts of zero-hours contracts and of retraining. I have never seen something that has that—[Interruption.] This has been the case for decades, and nobody has done anything to address it. [Interruption.] Nobody has done anything to address it. We do need to address it, and that is what we are here to do today, but—[Interruption.]

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. Please do not shout at the Minister.

[Gillian Keegan]

Thank you, Madam Deputy Speaker. As was clear from their 13 years in Government, Labour Members are not interested in finding the answer, and they are certainly not interested in listening to my version of giving the answer.

Having 40% churn and such a high degree of insecurity in the workforce is not sustainable, so we need to fix that. We need to put the knowledge and skills frameworks in place. We need to invest in training and learning. We need to ensure it is captured and transferable. We need to have career routes that mean people can progress in the workforce. In my short time in the job, that has been immediately identifiable. The hon. Member for Sheffield, Heeley (Louise Haigh) and I worked on professionalising the social care workforce about four-and-a-half years ago, when we set up the all-party parliamentary group on social care. The issue has been recognised. It is not easy to fix. It is a large private sector. There is very large and increasing demand, but we are going to take the steps to fix it and the White Paper starts that process.

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[Madam Deputy Speaker]

I thank the hon. Gentleman very much for that. I can say “Minister”; it is the hon. Gentleman who cannot. Minister!

[Gillian Keegan]

Thank you, Madam Deputy Speaker.

The hon. Gentleman has asked a good question. Dealing with covid is very challenging for many workforces, which is one of the reasons for our taking the difficult step of making vaccination a condition of deployment in this sector, and also offering the third dose—the booster—which many of those people have now had. It reduces the likelihood of transmitting or contracting covid, although it does not eliminate it altogether. The hon. Gentleman is right about the pressures on the workforce, which are increased by the need to manage covid in the case of residents and also people who are in their own homes. We have invested £162.5 million to help with those pressures in the short term.

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[Gillian Keegan]

Yes of course. There are regional differences in care. There are lots of regional differences. There are differences in how much the care cap of £86,000 is worth, which is what I think my hon. Friend is concerned about. There are regional differences in how much people pay for care: it is much cheaper in various areas compared with the more expensive areas. I am asked why we will have a fixed sum of £86,000, and that is a good question. If we are looking at it as a percentage of assets, £86,000 will be different for different people, of course. The question was: why should we not base this on a percentage of assets? When I looked at the system we would have to build, I saw that it would be absolutely unworkable. It will be difficult to implement the cap anyway, because we will need a metering system that every council will have to operate for everyone who is paying for social care at different rates and different times. The system that we will have to build is very complex. Having a cap that will also enable us to talk to other players such as insurers, to see what other insurance products come forth, was considered the only implementable way.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I gently suggest to the Minister that the rule about facing the Chair when addressing the House is not just about courtesy and politeness—I know that she is the most courteous and polite person on the planet. It is also because if she is looking at someone who has asked a question, the microphone does not pick up her voice. I say this to everyone. That is why it is important to face this way; if she does so, she can be properly heard.