Health Infrastructure Plan

Helen Hayes Excerpts

Monday 30th September 2019 Commons Chamber

[Edward Argar]

I am pleased that two of the trio who have fought so hard for my hon. Friend’s local hospitals and services have had the opportunity to contribute. He is absolutely right to say that while the Labour party talks the talk, when we look at its track record in government, we see that all too often it absolutely failed to deliver by scrapping services or saddling trusts with debt.

[Helen Hayes (Dulwich and West Norwood) (Lab)]

The finances at King’s College Hospital were destabilised in 2011, when the Lib Dem-Tory coalition forced King’s to take on two additional hospitals following the failure of another hospital trust. King’s is now struggling with the greatest financial challenge of any hospital trust in the UK. It is desperately in need of capital investment to enable it to meet local needs. Will the Minister explain to this House and, more importantly, to the hard-working staff at King’s—whose life-saving and life-enhancing work every single day is so important in our area and across London, where their work was critical in responding to the Grenfell Tower tragedy and to the Westminster bridge and London bridge terror attacks—why there is not a single penny for King’s College Hospital in today’s announcement?

[Edward Argar]

While I recognise and pay tribute to the hon. Lady for her championing, as one would expect, of her constituents and local hospital, I am sure she will none the less welcome this Government’s massive investment in our NHS. I hear what she says about her own local hospital, and she is right to highlight the work done by the staff, who do amazing work day in, day out, particularly in the aftermath of some incredibly challenging disasters. I would be very happy to meet and talk to her in more detail about the finances of her hospital and trust since 2011, if she feels that would be useful.

Tessa Jowell Brain Cancer Mission

Helen Hayes Excerpts

Monday 13th May 2019 Commons Chamber

[Matt Hancock]

I know about my hon. Friend’s, sadly, personal experience with this horrible disease and pay tribute to her for speaking up because it is not easy. She is right to raise another frontier that we must cross, and I am fully open to research bids in this area to work not just on brain cancer but on brain cancer that is a secondary cancer, because that is a very important area to get right, too.

[Helen Hayes (Dulwich and West Norwood) (Lab)]

I welcome the announcement today and the progress made over the past year since Tessa so sadly passed away. I also welcome the announcement as someone who lost both my paternal grandparents to brain cancer. I want to pay tribute in particular to Tessa’s daughter, Jess Mills, who has worked with unswerving determination and energy to drive forward progress in Tessa’s name over the past year. May I say on behalf of my constituents in Dulwich and West Norwood, who Tessa represented for 23 years, how proud we are of her powerful legacy on brain cancer and the difference her work will make for thousands of people for generations to come? Throughout the whole of Tessa’s 23 years in Parliament, she was a tireless champion of King’s College hospital, which is currently in a very challenged financial position. May I encourage the Secretary of State in continuing his commitment to £33.9 billion of additional funding to look at how this national support may also be marshalled to secure Tessa’s legacy at local level?

[Matt Hancock]

Baroness Jowell’s successor in her parliamentary seat speaks very powerfully and the hon. Lady is right to highlight the role of King’s in this research. King’s has been developing this treatment for years, and as a result of its work, it can now be rolled out nationally. It is a hospital that, as the hon. Lady says, needs to address some of its local challenges, but we should not take away from some of the globally cutting-edge work that it does and the positive impact it has: potentially 2,000 people alive each year who would otherwise die. That is testament to the importance of this research.

Services for People with Autism

Helen Hayes Excerpts

Thursday 21st March 2019 Commons Chamber

[Helen Hayes (Dulwich and West Norwood) (Lab)]

It is a pleasure to follow the hon. Member for Dudley South (Mike Wood). I pay tribute to the right hon. Member for Chesham and Amersham (Dame Cheryl Gillan) for all her work over the past decade, and I send my best wishes to her and her family at this difficult time. I also congratulate the hon. Member for Bexhill and Battle (Huw Merriman) on starting this debate in her absence.

My interest in autism comes from the many constituents who have had cause to contact me. Some have autism or have a child or family member with autism and have faced a battle to secure the support and access to services they need. Too often, autistic people and their families face significant battles over a long period and across a range of public services, including education, health, housing and the welfare and benefits system. I have supported many families who have had to battle for assessment and diagnosis. Even when they succeed in getting a diagnosis, they often do not receive additional support. I have helped constituents with autism who are struggling to access the benefits they need, because DWP assessment processes are simply not fit for purpose for people with autism. Most heartbreakingly of all, I have supported constituents whose loved ones are in institutions, long-term hospital care or, as in one case, supported housing where their needs are not being met and where they have in fact suffered abuse and neglect.

Autism is not a learning disability and it is not an illness; it is a form of neurodiversity. I commend the work within my own party by Neurodivergent Labour, which is working to ensure policy commitments to create a society that works for everyone living with autism and other forms of neurodiversity. Autistic people often have very special gifts and talents, like the young man who spent time doing work experience in my office after his GCSEs last summer and who completed the most brilliant analysis of crime statistics in my constituency I have ever seen.

My experience is that autistic people are too often being let down across many public services, because schools are often not well enough equipped to meet their needs, because health services are not arranged to be accessible and because there is insufficient supported housing in small community settings, so far too many children and adults with autism are still in long-term hospital accommodation.

We must call out the impact of austerity on school provision for children with autism. Teaching assistants have a vital role in providing additional support in the classroom for children with autism, in helping to shape curriculum content to meet their needs and in helping to explain and mediate to manage their anxiety. Schools that are being forced under this Government to make teaching assistants redundant will run a greater risk of failing their students with autism.

Understanding that challenging behaviour in people with autism is often a symptom of anxiety not a sign of misbehaviour and that the route to addressing it lies in de-escalating and managing fear and anxiety rather than in greater discipline would be transformative in the classroom and prevent many exclusions. The Government have introduced new training in autism awareness for trainee teachers, but there is a huge knowledge gap in the existing workforce that needs to be addressed with properly resourced training for teachers and support staff.

Austerity is also contributing to increased difficulty with diagnosis and in accessing support post diagnosis. Many local authorities are being forced to raise the threshold for support because, across both child and adult social services, they are struggling to discharge even their basic statutory responsibilities. We need additional resources to be put into diagnosis and post-diagnosis support.

It has long been reported that there is a very significant under-diagnosis of autism in women and girls, and there is now emerging evidence that, for far too many women and girls, an autism diagnosis happens only after they have been admitted to hospital due to severe mental illness, whether an eating disorder, depression or an attempt to take their own life. This is simply unacceptable. What practical action is the Minister taking to address under-diagnosis in women and girls and to stop a lack of support on living well with autism resulting in an unnecessary deterioration in mental health?

It is astonishing that, eight years on from Winterbourne View and with “Transforming Care” due to end imminently, we are still living with the scandal of people with autism, a learning disability or both living in long-term hospital accommodation, where far too many of them are still subject to human rights abuses, including prone restraint and neglect.

This Government have failed to implement “Transforming Care”—there is no denying it and no escaping it. Private psychiatric hospitals, which are no place for any young person with autism to live, have been allowed to expand at huge cost to the public purse, while there has been paltry investment in delivering community-based supported housing in which we know people with autism can thrive. Will the Minister commit to renewed funding to deliver “Transforming Care” today?

Finally, my constituents Isabelle and Robin Garnett, whose son Matthew I have mentioned many times in this Chamber following his detention at St Andrew’s Hospital, Northampton under the Mental Health Act 1983, where he suffered appallingly, have launched a new campaign this week. #HumanToo is a campaign to give visibility to people living with autism in our community and against the abuse and neglect that far too many have suffered. Such a campaign should not be needed, but, shamefully, it is. I ask the Minister to support this campaign, not just with words but with meaningful action to ensure that every person living with autism has access to the support, services and understanding they need to live well and to fulfil their talents and potential in our communities.

Assessment and Treatment Units: Vulnerable People

Helen Hayes Excerpts

Tuesday 6th November 2018 Commons Chamber

[Caroline Dinenage]

Yes. I completely agree with my right hon. Friend. I think that the setting she describes that her constituent was in has now been shut, but the point is well made, and actually it is not just about keeping people safe; it is about treating them with dignity and respect, and providing care that is compassionate.

[Helen Hayes (Dulwich and West Norwood) (Lab)]

Several months ago, the Minister met my constituent Isabelle Garnett, whose son Matthew became seriously unwell as a consequence of the treatment he received at St Andrew’s Hospital in Northampton, where Bethany is also receiving such appalling treatment. Matthew’s parents were so worried about his health in St Andrew’s that they thought he would die there. He suffered a broken arm, bruises and other injuries and lost a catastrophic amount of weight.

Matthew is now, thankfully, thriving in a community setting, at significantly less cost than the £12,000 a week that the NHS was spending on completely inappropriate care at St Andrew’s. St Andrew’s is not a fit for purpose location for young people with autism and learning disability. Despite the testimony of Isabelle and many parents like her, why have hospitals like St Andrew’s been allowed to expand, while there has been no expansion of the type of entirely appropriate community provision that is needed?

[Caroline Dinenage]

The hon. Lady brought Matthew’s mum to meet me and I was very disturbed by the photographs she showed me of how poorly he looked when he was in the St Andrew’s setting, and how much happier and so much better he looks now that he is in the right kind of community provision. It speaks volumes about exactly what we are trying to achieve—to get people out of such settings into the right kind of community provision. That is what this is about, but people can only be moved out of settings like St Andrew’s—which is a place that does require improvement—about which the Care Quality Commission is concerned, when the right provision is available in the community. That is why we are putting the money through NHS England into local provision.

Oral Answers to Questions

Helen Hayes Excerpts

Tuesday 23rd October 2018 Commons Chamber

[Matt Hancock]

My hon. Friend knows my personal strength of feeling about tackling the scourge of fixed odds betting terminals. The links between gambling addiction and mental health issues—and indeed, directly to suicide—are clear in the evidence, and we must address them.

[Helen Hayes (Dulwich and West Norwood) (Lab)]

My constituent David contacted me after his 18-year-old son became severely mentally unwell and needed emergency treatment. His son spent four days in A&E at the local hospital because no in-patient beds were available. This is not a one-off case: on a daily basis, mentally unwell people are being failed by our health service. When will the Secretary of State take meaningful action to fund mental health services properly and stop this scandal?

[Matt Hancock]

I am glad that, like me, the hon. Lady cares so much about getting this right. The long-term plan, which we are writing with the NHS, for how we will spend the £20 billion funding increase is where we can get these details right. Access to mental health services was not even measured before. The first step was to put the measurement in place, and now we can act on that measurement with the huge increase in funding coming to the NHS.

Transforming Care Programme

Helen Hayes Excerpts

Thursday 5th July 2018 Commons Chamber

[Helen Hayes (Dulwich and West Norwood) (Lab)]

I am grateful to the Backbench Business Committee for allocating time for the debate and to the right hon. Member for North Norfolk (Norman Lamb) for securing it. I am also grateful for his commitment to this issue over many years. It is a pleasure to follow the right hon. Member for Chesham and Amersham (Dame Cheryl Gillan). I am grateful, too, for her deep commitment to, and knowledge of, the subject of autism.

The treatment of residents at Winterbourne View was a national disgrace. That any human being should be subjected to such terrifying physical and emotional abuse in their own home setting is utterly abhorrent, and that those people should be among the most vulnerable and least able to speak out or defend themselves simply defies belief. The way in which we treat our most vulnerable residents is a mark of our civilisation, and Winterbourne View was a failure of the most basic measure of human decency. It was therefore absolutely right that the public outcry that followed Winterbourne View led to a firm commitment from the Government and to the transforming care programme.

However, the transforming care programme has failed to live up to its name. It has not substantially transformed the care and support that many people with autism and/or a learning disability are receiving. There are still far too many people living in hospitals such as Winterbourne View instead of homes. There are still far too many examples of families who have to fight each week to ensure their relatives’ safety and security, and even the basics of care, and too many people are still not receiving the support they need to live healthy, secure and fulfilled lives. We are now eight months away from the end of the transforming care programme and urgent action is needed to deliver a genuine transformation in the quality of care for thousands of people living with learning disability and autism in the UK.

In December 2012, 3,400 people were in NHS-funded learning disability in-patient beds, with around 1,200 in assessment and treatment units. The original Department of Health report following Winterbourne View found that the main reason for referral was the management of a crisis, suggesting that the failure in service provision had often started long before the person was admitted to hospital. The failure often involved a lack of support in other areas of health, social care and education provision, often leading to behaviour and mental health deteriorating over time and then reaching a crisis point. The report’s conclusion suggested six key changes, and I want to restate them because, in the experience of too many of my constituents, those changes have not yet been implemented or become a reality.

The first recommendation was that the information made available by councils, health bodies and care providers should be transparent and of good quality. The second was that community-based mental health services should offer assertive outreach, 24-hour crisis resolution and general support. The third recommendation was that small-scale residential care should be available to those in greatest need. The fourth was that employment or daytime activities should be offered. The fifth was that health and social care commissioners should start to plan from day one of admission to in-patient services for the move back to the community. The final recommendation was that the Care Quality Commission should monitor whether services are meeting essential standards, take enforcement action if a provider is not compliant, and monitor the operation of the Mental Health Act 1983.

Those recommendations bring me to the case of my constituent Matthew Garnett. Matthew’s mother Isabelle is in the Public Gallery today, and I am grateful to the Minister for taking the time to meet me and Isabelle recently. I have spoken of Matthew’s situation in the Chamber several times, but I make no apologies for raising it again today because his case illustrates exactly how little progress has been made in implementing the Department of Health’s original recommendations in response to Winterbourne View.

Matthew is approaching his 18th birthday. He is a tall young man whose absolute passion is football, particularly Liverpool FC. Matthew has autism. I first met Matthew’s mum at the start of 2016 when she came to my surgery following a deterioration in Matthew’s mental health and behaviour at home. Matthew had been admitted to a mental health unit under section. At that time, Matthew’s parents were concerned that the assessment unit that he was in had no specialism in autism and that he had been there for far too long without appropriate clinical support. They had been recommended a hospital in Northampton, St Andrew’s, as a place with the right expertise for Matthew to be able to get well and come home. I supported their battle to get access to a bed for Matthew at St Andrew’s, and we celebrated when he was allocated a bed.

After Matthew had been at St Andrew’s for just a few weeks, his parents came to see me again. They were concerned that Matthew seemed to be taking part in very few activities, that he was losing weight, that he had become more withdrawn and that they had noticed signs of anxiety in his behaviour. They were concerned that there was no discharge plan and that staff seemed reluctant even to talk about one. Matthew’s situation deteriorated rapidly at St Andrew’s. He suffered a broken wrist and bruising. His parents found excrement in his shoes. He lost a catastrophic amount of weight. His parents became gravely concerned that he would die, so we fought again. They found alternative community-based provision not far from the hospital. They contacted Alderwood, which the right hon. Member for North Norfolk has already mentioned, and discovered that it had a place for Matthew, so he moved in.

Matthew is now flourishing. He volunteers at the local football club and in the village where his home is located. He takes part in a wide range of activities—from film nights to canoeing and trips to the seaside—and he is able to play and watch lots of football. Matthew is well and living life to the full. The care and support he is receiving costs considerably less than the £12,000 a week spent by the NHS on a private hospital bed in which his health was deteriorating and from which there was no plan to discharge him.

[Norman Lamb]

The hon. Lady is making a powerful case. Does she agree that the Care Quality Commission should do far more to challenge how these units often define themselves as specialist units? The care given to Matthew and Fouzia at St Andrew’s in Northampton was very far from specialist; it was inappropriate and it damaged them massively.

[Helen Hayes]

I thank the right hon. Gentleman for his intervention. I also visited St Andrew’s and, when I returned, I looked at how it was advertising its services and compared that with what I saw. I would go so far as to say that, in any consumer environment, a good case could be made that St Andrew’s was contravening the Trade Descriptions Act 1968 in how it was advertising itself, given the expertise the staff actually had in relation to autism. In my view, that is certainly a matter for the CQC.

Matthew’s case is important, because it demonstrates clearly that all the failures that led to Winterbourne View are still possible. Matthew’s family did not receive the support they needed for Matthew at any stage prior to his admission to hospital. It was that lack of support that led to his behaviour deteriorating in the first place. There was no assertive outreach or 24-hour crisis resolution support; there was just the local police force when things got too much. That was four years after the Department of Health report on Winterbourne View.

The small-scale residential setting in which Matthew is now living is brilliant, but there is far too little of that type of provision and none of it close to home. Matthew’s parents live in my south London constituency, and Matthew is currently living in Northamptonshire. I met the providers of his care at Alderwood, and they told me that what they provide is easily scalable. It is about training staff in effective communication techniques, paying staff properly and providing a good career structure so that providers can retain a stable team, and being able to access funding for the places they provide. It is not rocket science. It just needs a proper commitment to invest in settings that deliver the best possible care.

At St Andrew’s, Matthew was not participating in any meaningful activities on a day-to-day basis; the emphasis was on managing and containing his behaviour through medication rather than engaging him in recovery. In his new home at Alderwood, Matthew is on very low levels of medication. He takes part in meaningful activities that add value to his life and make a real contribution to his community on a daily basis.

There was no discharge planning while Matthew was at St Andrew’s. In fact, his parents were told they were being far too optimistic even to raise discharge with his clinicians. St Andrew’s is a private hospital that is largely funded by the NHS. The Government must look seriously and urgently at the perverse incentives at work in a system that is so reliant on the private sector because of the lack of NHS provision. Private hospitals currently have no incentive to discharge when they are being paid a rate of £12,000 a week by the NHS.

There was very little scrutiny of the effectiveness of the treatment Matthew was receiving in return for such large amounts of NHS funding, and no regard was given to the concerns of his family, who had to fight to get a second opinion, which was itself dismissed by staff at St Andrew’s.

Transforming care can never be fully implemented while such perverse incentives apply and while profit-making organisations are relied on to substitute for a lack of proper funding for NHS and social care provision. Private hospitals too often remain holding pens for patients, rather than the secure and supported homes that they need. No learning disabled or autistic person should be living in a hospital for the long term. We need homes not hospitals.

Too many of my constituents whose family members, including children, have a learning disability and/or autism still tell me that when they express concerns about the care their loved one is receiving, their views are not taken seriously and they have to battle to have their concerns addressed. Again, we cannot begin to see a system that delivers the care that vulnerable people need without proper processes for accountability through which family members can raise concerns.

I am concerned about the Government’s tracking of the progress of the implementation of transforming care. In response to a written question tabled by my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley), the Minister for Care highlighted, in her answer on 4 June, the plan to decommission 900 beds in mental health hospitals. Assuring transformation data provides figures on the number of people with learning disabilities and/or autism admitted and discharged. In the 2017-18 period, there were 330 more discharges than admissions, but it should be noted that that applies not to individual people, but to the individual instance of an admission or discharge, so there is no way to tell to what extent some people are caught in a revolving door. The dataset does not directly identify whether an admission is from the community or a transfer from another hospital setting. Similarly, the data does not directly identify whether the end of an episode of care is a discharge to the community or a transfer to another hospital setting. Thus, although 330 discharges might sound like progress, the Department of Health and Social Care has not so far provided figures for individual cases. In the light of the target of closing 900 beds, this cannot be seen in any way as a victory for either the Government or, more importantly, those vulnerable individuals whom transforming care is intended to safeguard.

I am also concerned that the Government's focus for the final few months of transforming care is far too much on hospital bed closures. Bed closures should be a consequence of the provision of properly funded, high-quality community settings, and the by-product of achieving better outcomes for people currently in long-term hospital provision. Instead, the Government continually refer to bed closures as the headline target and measure for transforming care. Without high-quality, properly resourced alternative provision, bed closures, in themselves, will simply result in further pressures on the NHS, as people who are discharged without sufficient support will end up readmitted, via A&E, to a situation where fewer in-patient beds are available. It is almost impossible to find any meaningful data on the funding and level of community provision for people with autism and learning disabilities, and I urge the Government to switch their focus from bed closures to community provision for the final eight months of transforming care in its current form.

I also want to highlight the regulatory gap that still exists. A constituent contacted me recently on behalf of her brother, who is an adult with autism living in a supported housing provision, paid for through his personal budget. He needs a high level of support and his personal budget is considerable, but his sister has raised concerns about his treatment in the community provision over a period of months. The provision involves a high level of care, but is technically supported housing, which means that it is not regulated by the CQC. The recent report by the Housing, Communities and Local Government Committee and the Work and Pensions Committee on supported housing highlighted this gap in regulation and called on the Government to take action to address it, and I want to do so again today. There is great urgency that we make progress on transforming care, but discharging vulnerable people from hospital into settings that are not regulated creates a risk that they will be failed yet again.

Finally, I wish to highlight the wider gap in awareness and support, particularly in the area of autism. In schools and in the NHS, the experience of far too many of my constituents is that the support needed so that autistic people, particularly children, are able to thrive is simply not there. This continued failure to properly equip teachers and healthcare professionals to understand autism and the support that their students and patients need has long-term consequences through an increased level of care that people need later in life and an increased likelihood of crisis. I urge the Minister to work with her colleagues, particularly those in the Department for Education, to accelerate and bring forward training in autism for teachers, and not just new teachers coming through the education system now but existing teachers who are working day in, day out, without the knowledge that they need to serve autistic students well.

There is no way around the fact that the transforming care programme has failed significantly to date. We need a renewed focus on care and support for people with learning disabilities and autism. In every community throughout the country they should be living well, close to family and friends and properly supported, not locked away receiving over-medicalised care, with no one monitoring how effective that care is or what the public purse receives by way of high-quality provision in return for the expenditure. We need homes not hospitals, and we need everybody living with autism and a learning disability in this country to be able to live life to the full, with dignity, in community settings that are close to home.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I call Ronnie Cowan.

--- Later in debate ---

[Caroline Dinenage]

I am very glad the right hon. Gentleman said that because as part of the Department of Health and Social Care legacy scheme we are providing £70,000 in this year for that sort of intermediate and reablement provision which Share Lives would come under. We should definitely be investing more in that.

I take very seriously the right hon. Gentleman’s point on conflicts of interest. We have to look at that very carefully, because it might imply that any clinician would be conflicted in making a clinical decision because they are employed by a trust. Providers are monitored by the CQC and doctors are of course subject to extremely rigorous professional registration, but I take what he says very seriously and I will look more closely at his concerns. I am very happy to meet him to discuss this issue further if he would like me to do so.

The right hon. Gentleman spoke about pooling resources. There are now formal mechanisms for that to take place, such as section 75 and the ways in which CCGs and local authorities can work together. That is the point of having transforming care partnerships’ commissioners working together.

The right hon. Gentleman spoke about the exclusion of families from decisions. That really upsets me and it really should not happen. There are legal duties, under the Mental Capacity Act 2005 and the Mental Health Act 2007, to have independent mental health advocates. I would be very keen to speak to him further about what more we can do to make sure that the legislation is having the desired effect.

My right hon. Friend the Member for Chesham and Amersham knows I am a massive fan of hers. She has probably done more to further the cause of individuals with autism and their families than anybody else in the history of this building. She spoke with great knowledge about autism and was absolutely right to point out that transforming care is not only about learning disabilities but people with autism. In Think Autism, the adult autism strategy, we set a programme of action across Government to support autistic people to lead fulfilling and independent lives where possible. We have recently refreshed the governance arrangements that will achieve greater traction and delivery of the required outcomes, better supporting autistic people to live healthy independent lives and participate in their local communities.

My right hon. Friend spoke about autism care pathways. NHS England is developing a framework of adult community mental health services which will include care for adults with comorbid neurodevelopmental disorders and/or learning disabilities, rather than the pathways planned and set out in the “Five Year Forward View” implementation plan. NHS England’s care pathway programme has evolved to take account of the current operational context and expert service user advice. The pathway is linear about discrete episodes of care, so is more appropriate for specific interventions undertaken by specialist teams.

My right hon. Friend spoke about the barriers that autistic people face in accessing mental health services. Trusts should already be ensuring that services are accessible to people with autism and that they have made reasonable adjustments to care pathways to ensure that people with learning disabilities and autism can access the highly personalised care and achieve the equality of outcome that we all want.

The hon. Member for Dulwich and West Norwood spoke about her constituent, Matthew Garnett. It was a great pleasure to meet the hon. Lady and Matthew’s mum, Isabelle, recently. I was very shocked to hear of Matthew’s experience and deeply upset to see the pictures of him at his lowest ebb, when he was suffering from the neglect that she spoke of. It was very distressing. I am pleased that the NHS is learning from this. The Marsh review into Matthew’s care has helped to shape a much more focused approach to the needs of children and young people who are at risk of slipping into the sort of crisis that she mentioned. The operational delivery group allows stakeholders, including young people, to shape policy.

[Helen Hayes]

The right hon. Member for North Norfolk (Norman Lamb) raised the issue of St Andrew’s in Northampton having been able to expand so significantly with the benefit of NHS funding—I cannot remember the exact percentage, but the percentage of funding that comes from the NHS for St Andrew’s is up in the eighties and nineties. Does she agree that this is not the right model and will she commit to looking at limiting the further expansion of private in-patient beds, when they are not what is needed for treating young people with autism and learning disability?

[Caroline Dinenage]

We can certainly look at what the hon. Lady suggests. I am pleased that the operational delivery group, which I just mentioned, allows stakeholders to shape policy and it is really good news that Isabelle Garnett, Matthew’s mum, is a major contributor to this and liaises with NHS England directly on its programme around children either in hospital or at risk of being admitted.

The right hon. Member for North Norfolk asked why the evaluation was cancelled. As he knows, an evaluation sponsored by NHS England is already under way, and the Department, having invited bids for its evaluation, was not satisfied that the proposals received were what was needed. That does not mean that we are not absolutely determined to critically review progress, particularly working with stakeholders and users.

The right hon. Gentleman spoke about the “No voice unheard, no right ignored” Green Paper. Although I am always ready to bow to his incredible knowledge in this field, it is not entirely true to say that the Green Paper went unheeded. Some of the recommendations were overtaken by changes in Government policy, and indeed, in Governments, but we have taken forward work such as the named social worker pilot and a review of the Mental Health Act. We have asked Professor Sir Simon Wessely, the chair of the independent review, to listen to people with direct experience of the Mental Health Act and this, of course, includes autistic people and their carers. He published his interim report to update the Government on his progress, which sets out specific issues that we must explore to look at how we can improve the scope of the Act.

The hon. Member for Dulwich and West Norwood also spoke about training for teachers in autism. The Department for Education has funded training and support for teachers through the Autism Education Trust. That is in early years, schools and further education, and so far, 175,000 staff have been trained.

Department of Health and Social Care and Ministry of Housing, Communities and Local Government

Helen Hayes Excerpts

Monday 2nd July 2018 Commons Chamber

[Helen Hayes (Dulwich and West Norwood) (Lab)]

It is a pleasure to follow the hon. Member for Mid Worcestershire (Nigel Huddleston) and to speak in the estimates day debate to mark the 70th anniversary of our NHS—the most remarkable achievement of a Labour Government to provide free healthcare for all, free at the point of delivery.

I want to speak about King’s College Hospital—a major teaching hospital, tertiary referral hospital, and local district and general hospital in my constituency. There is a strong bond between local residents and King’s. I am proud that my mum worked at King’s as an occupational therapist for 10 years. Like so many local residents, I owe a personal debt of gratitude to the tremendously hard-working staff at the hospital. I was a surgical in-patient at King’s in my 20s, gave birth to both of my daughters there in my 30s, and have subsequently been an out-patient. My family rely on the A&E to be there when we need it. As we celebrate the 70th anniversary of the NHS, I pay tribute to the staff at King’s for their skill and professionalism, commitment and dedication, care and compassion.

King’s went through very challenging times during the 1980s and ’90s, but was completely transformed by Labour’s investment and NHS reforms. By 2010, the hospital had achieved a balanced budget every year and was meeting all its major targets. Since 2010, however, King’s has faced very significant and substantial challenges, driven principally by chronic underfunding and an enforced decision in 2013 to take on the management of Princess Royal University Hospital and Orpington Hospital when South London Healthcare NHS Trust failed. King’s now finds itself in special financial measures, with an annual deficit of £140 million.

While there are some areas where the trust can make improvements—and I know that staff are working as hard as they can to do so—many of the problems that it faces are outside its control. The Government’s funding model rewards elective surgery and penalises emergency work. King’s has a regional trauma centre and a stroke centre. It is one of a small number of London hospitals with a helipad. It has a busy accident and emergency unit and will soon open a new critical care unit. These specialisms save lives daily, but the funding model does not recognise this work. As a result, the hospital is grossly underfunded, even though London needs centres of emergency excellence such as King’s—no more so than during the Westminster and London Bridge terror attacks and the Grenfell Tower fire last year, when the team at King’s were at the forefront of the emergency life-saving response.

Last year the Government refused to allocate sustainability and transformation funding to King’s, in contrast to many other hospitals, resulting in the hospital’s already challenged financial situation becoming significantly worse. In the context of a spiralling financial decline, the Government then decided to fine King’s for not achieving its already impossible financial control targets—even though it was the Government’s failure to provide adequate funding that led to the inability to meet these targets in the first place. Since King’s has been in special financial measures, the trust has been charged penal rates of interest on the money it has had to borrow to tackle the deficit it faces.

King’s does not have access to the capital funding it needs to undertake routine buildings maintenance and to invest in the infrastructure it needs to be able to be as efficient as possible. The Government love to recommend efficiency improvements. At King’s, efficiencies can be delivered if the buildings and outdated equipment are fit for purpose for the needs of patients in the 21st century. Both King’s and Maudsley Hospital across the road urgently need more funding to meet mental health needs in our communities. Too many local residents are ending up in mental health crisis because early intervention is not there, and too many of those patients spend far too long—often days at a time—waiting in accident and emergency at King’s for the mental health support that they need.

I raise these issues today because while any additional funding for the NHS is welcome, the problems at King’s cannot and will not be solved by 3.5% a year for five years. King’s needs new funding now to overcome its current challenges. It needs an end to the perverse policies of financial penalties for failing to meet impossible targets. It needs urgent capital funding to enable the Denmark Hill site in my constituency to be fit for purpose to meet patient needs. It needs revenue funding to enable it to recruit and retain the staff that it needs to run the hospital.

It is an appalling and unacceptable fact that as we mark the 70th anniversary of the NHS this week, one of the biggest teaching and research hospitals in the country, with such world-class life-saving and enhancing expertise, is in such a perilous financial state. This must be stopped. We owe it to the staff; we owe it to the patients. There is no way around the need for additional funding now. I call on the Government to acknowledge this challenge—to acknowledge the impossibility of the current situation at King’s with the current financial settlement and to step in to provide the funding it so desperately needs.

Adult Social Care: Long-term Funding

Helen Hayes Excerpts

Thursday 28th June 2018 Commons Chamber

[Mr Betts]

It is about getting a well-paid, well-trained workforce. NHS staff who do a similar job get paid about 29% more. I am not saying they are well paid, but clearly social care staff are not well paid. That funding gap has to be addressed and people have to be properly paid. The Committees signed up to the Unison charter for the workforce in social care.

[Helen Hayes (Dulwich and West Norwood) (Lab)]

I congratulate my hon. Friend and the hon. Member for Totnes (Dr Wollaston) on their leadership on this issue. The inquiry’s report provides incontrovertible evidence of the crisis facing social care funding. I particularly welcome the recommendation that social care should be provided to those who need it free at the point of delivery, and the very practical recommendations for raising the additional funding we so urgently need. I come to the House from a meeting of supported housing providers, which provide housing for older people in my constituency and elsewhere in Southwark. All highlighted to me the increasing numbers of referrals they receive from older people who are being made homeless and suffering problems in the private rented sector. This problem is growing. The report highlights the importance of housing for the delivery of a sustainable social care system and I wonder whether my hon. Friend might just say a little bit about that now.

[Mr Betts]

Absolutely. Most people receive care in their own home. The Committee’s report on housing for older people looked at the nature of the home. It showed the importance of the warmth of the home and the ability to get around the home—trip hazards and so on. Means-testing for the disability facilities grant relates to means-testing for care provision and other benefits, so they need to be properly integrated. Another recommendation in the report was that where means tests exist, they need to be joined up together.

Mental Health Units (Use of Force) Bill (Third sitting)

Helen Hayes Excerpts

Wednesday 25th April 2018 Public Bill Committees

[Jackie Doyle-Price]

The hon. Lady makes some excellent points, and in the run-up to the Bill, we discussed some of those wider issues. It is incredibly sad that undercover reporting has, on occasion, shown such bad abuse. The fact that there is a camera will affect people’s behaviour in a positive way, although perhaps it is sad that we need to rely on that. We must, however, balance that with the need for privacy, and we can have further discussion on that. However, I see no reason why we would not have cameras in communal areas, for example. We will discuss the provisions in the Bill with organisations such as the College of Policing, and that will enable a discussion to take place with providers about where it is appropriate to have cameras. I am sure we will return to that issue.

[Helen Hayes (Dulwich and West Norwood) (Lab)]

I rise briefly to support my hon. Friend the Member for Liverpool, Wavertree and the potential exploration of the use of cameras in secure mental health settings. I have worked on behalf of a constituent with autism who was detained at St Andrew’s, which is a private mental health facility in Northampton, and I have got to know other families who had children in that facility who did not have an extensive capacity to communicate for themselves. Those families had grave concerns about the use of force and their children’s treatment more widely, which manifested itself in aspects of their behaviour—they became withdrawn and fearful, and there were some physical signs as well. The families were unable to say, however, that detention had taken place, and there is a case to be made for the kind of transparency that the use of cameras would bring, perhaps in rooms where detention and the use of force are more likely to take place—

[The Chair]

Order. Interventions really should be brief.

Cancer Treatment

Helen Hayes Excerpts

Thursday 19th April 2018 Commons Chamber

[Helen Hayes (Dulwich and West Norwood) (Lab)]

I congratulate my hon. Friend the Member for Croydon Central (Sarah Jones) on securing this important debate, and I am grateful to the Backbench Business Committee for allowing it time. It is a pleasure to follow the right hon. Member for Old Bexley and Sidcup (James Brokenshire), who so powerfully shared his own experience of cancer and cancer treatment.

I pay tribute to my friend and predecessor as MP for Dulwich and West Norwood, Baroness Tessa Jowell of Brixton, who has inspired this debate. When I was selected as the Labour party candidate for the 2015 election after Tessa had announced that she was stepping down, four words seemed to come instantly to everyone’s lips as I went around the constituency speaking to people: “big shoes to fill”. They certainly were.

As a constituency MP, Tessa helped and supported countless individuals and families facing the most difficult of circumstances with compassion and tenacity. My strong memory of my first experiences of doorstep campaigning in the constituency is of how many people offered, unprompted, their gratitude that Tessa had helped them, often going above and beyond the call of duty. More than that, Tessa worked to deliver lasting change for our communities in Dulwich and West Norwood, by campaigning to secure investment to deliver not one, not two, but five brilliant new schools in the constituency. As a Labour Minister, she established the Sure Start programme, which was the fruit of her lifelong passion for supporting parents and babies to address disadvantage early and to enable every child to thrive. Sure Start centres made a difference across the country, including in Dulwich and West Norwood, where they are still highly valued by parents and carers. Through sheer inspirational determination, Tessa also delivered the greatest celebration of London and Londoners that we have ever known—the 2012 Olympics.

Across everything she did as our MP, Tessa established a clear and principled way of doing politics, based on listening to, engaging with and responding to the concerns of local residents; identifying and working on the issues that matter to all of us and that bring people together; using the currency of personal stories, compassion and kindness rather than trading in statistics and cheap political shots; and, most of all, seeking to empower people and to tackle disadvantage and adversity head-on. It is therefore no surprise to Tessa’s many friends in Parliament, in Dulwich and West Norwood, across London and beyond that she is now using the very difficult personal circumstances of her brain tumour diagnosis to work to make a difference for other people in the same circumstances. It is no surprise, but it is remarkable in a situation where many of us would be focused only on our immediate loved ones, and it is extremely brave.

My own family knows the pain of brain tumour diagnosis. In 1983, at the age of 66, just a year after he had retired from his career as a bus driver and spent his life savings on a small house with an indoor toilet and a garden where he could grow his beloved dahlias, my grandfather George Hayes died from a brain tumour. Seven years later, in a situation so statistically rare that doctors had to be persuaded to take her symptoms seriously, my grandmother, George’s wife Olive, also passed away from a brain tumour, at the age of 71. We know as a family the fear and anxiety that such a serious diagnosis brings, the hopelessness of finding that there is very little that can be done, and the pain of watching loved ones deteriorate and lose capacity at the hands of such a cruel disease.

My first thought when I learned the horrible news of Tessa’s diagnosis was of grandparents George and Olive, and my second thought was that the treatment and prognosis for brain tumours must be much better now than it was then. I looked up the statistics, and was shocked to find that, although brain tumour survival rates have doubled since the 1970s, it is only from 6% to 14% compared with a 10-year survival rate of 50% across all types of cancer in the UK. Brain tumours kill more children and adults under the age of 40 than any other cancer, yet just 1% of the national spend on cancer research has been allocated to brain tumour research. As a consequence of this lack of funding, there is a shortage of drugs, and patient participation in clinical trials for brain tumour patients is extremely low—just 6.4% of adults compared with 61.4% for leukaemia. The survival rates for brain tumour patients after one year are less than 40%; after five years, less than 20%; and after 10 years, just 14%. Time is short for patients and their families.

Tessa has rightly called for more funding for research into treating brain tumours, but she has importantly also called for a more flexible approach to participation in adaptive trials. Such trials allow patients who have a diagnosis that without a breakthrough treatment will certainly be terminal to add new drugs to their treatment plan, or to switch between new medications in a trial rather than having to wait sequentially for each trial to conclude. They are really important. It is also important that better ways are found to share the data from brain tumour patients in order that it can be used for research. This is what most brain tumour patients want, and it is what most members of the public would want, faced with an illness that cannot be cured. Our experience and our data should be used to try to improve the prognosis for others in future.

Tessa has also called for improvements in the way that treatment is provided to brain tumour patients and the wider environment of care. There is still too much variation across the country in diagnosis, referral-to-treatment times, access to specialists and clinical trials, and palliative care for those who need it. We have in this country exemplary services in all of these areas, but they are not available to every patient. That must change. Everyone with brain tumour symptoms should be diagnosed as early as possible; be referred to a specialist centre with access to the most up-to-date surgical techniques and drug therapies; and have access to the very best support services, including counselling as well as physio and occupational therapy. If and when the time sadly comes, everyone should have access to the gold standard of palliative care, which exists in some parts of the country but which is currently not available everywhere.

I welcome the Secretary of State’s engagement with Tessa’s campaign for better research, access to clinical trials, treatment and care, along with the work of the brain tumour Task And Finish Group, Brain Tumour Research and others, but we must make change happen. It is our commitment, Tessa, and my promise on behalf of all those who love you in Dulwich and West Norwood that, collectively, we will take on your campaign, and that your vision of people living better lives for longer with cancer, and with brain tumours in particular, will become a reality.

[Hon. Members]

Hear, hear!