Infected Blood Inquiry

John Glen Excerpts

Tuesday 19th November 2024 Commons Chamber

[John Glen (Salisbury) (Con)]

May I first commend the hon. Member for Gedling (Michael Payne) for his maiden speech? I think we can all agree that it was very moving, and that he does great credit to his family and constituents. I apologise for not having been here for the first few minutes; I was running over from Portcullis House.

I had the privilege of being the Minister with responsibility for the infected blood compensation scheme. On 21 May, I brought the scheme to the Floor of the House, speaking from the Government Dispatch Box. In the six months prior, I had been determined—not knowing when the election would be called—to do everything I could to bring that compensation scheme to life after so much delay. That delay has been, as the hon. Member for Blyth and Ashington (Ian Lavery) rightly said, totally unacceptable for too long.

In my remarks to the House, I will pay tribute to the victims, explain some of my experiences as a Minister, and make some observations on what lessons and next steps may need to take place. First, I acknowledge the work of my successor as Paymaster General, the right hon. Member for Torfaen (Nick Thomas-Symonds). He has done virtually everything that I would have done, had the electorate overall given us a different outcome. Though I will always be available to members of the public to ask questions in this House, as is my responsibility as an Opposition Back-Bench MP, I believe that he is doing everything he can to move the scheme forward as quickly as possible, and I will come on to the mechanics of that in a moment.

During the month of May, I participated in 18 meetings. I met representatives of 40 groups in London, Leeds, Birmingham, Cardiff, Belfast and Edinburgh. Each meeting was a profoundly emotional and moving moment for me and the officials who accompanied me. I met people who had gone through unimaginable suffering and uncertainty for not just a matter of months, but, in some cases, a number of decades. Some had been infected through their marriage. Some had been born as haemophiliacs and had been treated in ways that had the consequences we have spoken about today. Some had transfusions when giving birth to their children. Some received blood transfusions from imports that proved to be defective. Some had hepatitis C or hepatitis B. Some had HIV. Many had a combination of different conditions. Some had been family members of those who had been infected. It was a humbling but tragic set of moments. In those conversations, I looked those individuals in the eye and said, “I am deeply sorry on behalf of the British state.” It was a great privilege to be asked to do that on behalf of His Majesty’s Government, but we must learn lessons collectively from the enduring failure to come to terms with what has happened over the course of so many Governments and so many decades.

Many of the individuals I met had campaigned relentlessly, and I pay tribute to them today. I will not draw on individual names, because there are just so many people, and it would be unfair to all those whom I met. It was right that we brought forward a second interim payment, and it was right that we recognised the affected communities as well as the infected communities. It was tragic to see that there were sometimes disputes and divisions among many of the communities, because so much time had passed and so much fear existed around who would be looked after first, and about whether there would therefore be constraints on the money available.

I will step back to last year. After the Remembrance weekend in 2023, I was asked to move from my long tenure in different roles in the Treasury to the Cabinet Office to become Paymaster General. The year before, I had had some exposure to the challenge of making provision for compensation, and my immediate predecessor, the former Member for Horsham, had done a lot to try to ascertain what had been done collectively in government. The truth is that there was a very wide envelope: it may have been between £2 billion and £20 billion, and it had moved around according to what analysis could be done. That was because the parameters were fundamentally going to be based on how much compensation we would pay the different groups who were infected and affected. My predecessor started that process, and I pay tribute to him for what he did.

I also pay tribute to the former Chancellor, my right hon. Friend the Member for Godalming and Ash (Jeremy Hunt), who said to me when I left the Treasury, “You have one duty in that job. That is a moral duty to resolve the compensation scheme.” I honestly believe that he was critical in ensuring that we got to where we did on 21 May. I pay tribute, too, to the right hon. Member for Kingston upon Hull North and Cottingham (Dame Diana Johnson), who did so much. At every question session, she sat just behind where I stand now, challenging me on what I was or was not doing. As the Paymaster General knows too well, there are always constraints; his officials will say, “I wouldn’t say that at this point.” We are always trying to say more, but I was acutely aware of how frustrated all the communities were, and that unless what I said was crystal clear, it would set off another storm of speculation on social media.

On the advice of my officials, I appointed Sir Jonathan Montgomery, who in the early months of 2024 assembled a small group of technical experts to advise on how to translate the compensation study of Sir Robert Francis into a full compensation scheme. We asked how, across the five heads of loss—injury impact, social impact, autonomy, the care award and the financial loss award—we could put a number on the relative suffering across all the different conditions. How could we put a number on the loss of a normal life, the loss of the ability to work, the loss of a sense of respect from the community in which people lived, and the stigma that other Members have referred to?

It was suggested to me at the time that I had done it the wrong way round—that I should have engaged with the community. I took the view that we were not going to get this resolved if we had done it that way round, but I knew it was critically important for all the communities to be engaged with, and I always had that expectation and intention. That is why, when I announced the scheme to the House on 21 May, I established a series of engagements where Sir Robert Francis met representatives of the infected and affected communities to go through the scheme and establish where changes needed to be made. Those engagements happened in June. I pay tribute to my successor, the Paymaster General, who engaged with the output of that work and—as per the timetable that had been agreed—made virtually all of the changes that were requested.

Today, understandably, I hear speed being urged across the House—that this should happen quicker to get the payments made. I totally understand that, and to some extent, I agree with it. However, I want to reassure the House that David Foley, who is now setting up and, I think, heading up the Infected Blood Compensation Authority as an arm’s length body of Government, is a superbly experienced civil servant. Neither I nor the Minister could have written the cheques ourselves to set up the processes and systems for evaluating entitlement and getting money out as quickly as possible. For those infected individuals who are alive—around 4,000—speed is obviously an imperative. The reason I took the decision on the £210,000 second interim payment, alongside the £100,000 from October 2022, was that I received advice, and I pressed and challenged my officials to get to a number that was the maximum that everyone would receive.

However, it is of course wholly necessary not just to get a first tranche fully paid out, but to get everyone else paid out. I acknowledge that there are questions about how to verify the date of infection, but despite all the bad things that have happened, obviously we must reconcile speed and effective decision making with ensuring that we pay the people who are entitled to the payments.

In Sir Brian Langstaff’s seven-volume report, of which I went to see the publication on Monday 20 May, he made a number of recommendations, and the Minister has indicated the Government’s willingness to honour those—the national memorial, and biannual meetings with those who have suffered in order to get to grips with the duty of candour. I want us as a House to be clear and honest about what we are really asking for, because the report spanned decades and different generations of Ministers, civil servants and orthodoxies in the medical profession. We need to encourage curiosity among individuals who see things going wrong but are held back from being truly candid because there tends to be group-think which prevents a thorough interrogation of what should be done.

Distortions happen, recollections have varied and medical professionals would make different judgments now from those they would have made at different points in the past. We need to be wise about what the duty of candour will look like, but we need to grasp the core argument that Brian Langstaff makes: we have to change the culture across Government and public service and in politics. I hope the Minister does not move on, but if he does, I hope he moves up. If he stays in his position, however, he can have an impact over time. When Ministers move, they have a received wisdom from their officials of a previous iteration, and we sometimes need to encourage the infusion of new Ministers to ask challenging questions and allow progress to be made.

I have profound concerns about public inquiries. A lot has been said in recent months about the multiple public inquiries that have occurred—how we can make them more systematic and aligned; the secretariats and the processes they run can obviously be streamlined. They are presented as the only cathartic method for the British state to come to terms with something that has gone wrong, and they are often not constrained in any way. They are typically led by retired High Court judges, and I have nothing against them, but we sometimes need to broaden the expertise such as by having economists and other people involved in looking at these things.

I pay tribute to Brian Langstaff, because the inquiry was a massive undertaking, but seven years is an enormous amount of time. I am not an expert on this, but let us think about the read-across to the covid inquiry. Many people have expectations of what that will deliver, but in other countries such analyses have brought forward recommendations and changes much more quickly. We have to get the balance right—not to cover up anything, but because we end up putting things into the long grass for so long. We as a Parliament need to come to terms with that.

I have probably spoken for too long, but I hope I can be forgiven for doing so given the role I had. I want to pay tribute to the work that has been done by those responsible for bringing us to this point. I pay tribute to all the victims and campaigners who have been so determined despite numerous knock-backs from Governments over the years. My own Government absolutely have to take their full share of the blame. Interim arrangements were made and ad hoc compensation schemes were set up, but responsibility was not taken by the British state, and it is absolutely right that we have done so now.

I do not think that social media is very helpful in trying to come to terms with the trauma of all this, or in giving clarity to those who need it. I wish David Foley and the IBCA well. I think there will be a series of letters about how to interpret individual recommendations, but he is setting up an efficient mechanism which, once it starts delivering, will deliver more and more rapidly—I am convinced of that. For some it cannot come soon enough, but I hope that very soon we can draw the right enduring lessons from this national scandal, and I hope it will never happen again.

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[Pete Wishart (Perth and Kinross-shire) (SNP)]

It is always difficult to follow somebody who has said almost exactly what I had intended to say in my speech. What I will try to do for you, Madam Deputy Speaker, is rephrase it in a way that will hopefully be helpful and useful to the House. I am grateful to follow the hon. Member for Eltham and Chislehurst (Clive Efford), who raised a number of really important issues about which those on the Government Front Bench should listen carefully.

I noticed the Paymaster General’s reaction to the hon. Member for Eltham and Chislehurst; he has got to relax a little. We are trying to help and to be the voice of the community, who are telling us these things. They want to be engaged and properly consulted with. They want to be part of the process. That is what they are telling the all-party parliamentary group on haemophilia and contaminated blood, and that is what we are hearing from all the representative groups right across the United Kingdom. Perhaps the Paymaster General should just take on board some of the things that we are trying to put forward about the feelings and opinions of a lot of the community and what they are saying to us directly as a consequence of what is happening.

I congratulate the Government on honouring their commitment to have a debate. It is a pity that we did not get the full day, but one thing I have noticed is that it is getting a bit quieter in the Chamber when we have these debates and statements. I hope that there will not be fatigue when it comes to discussing important issues relating to the infected blood scandal, as we as a House will need a detailed approach to the ongoing compensation schemes.

I really hope that we will not get to a stage where the Government see this as “job done” and another box to be ticked, thinking, “There we go: infected blood is dealt with and we can now move on.” It is incumbent on all of us who were involved in the campaign to ensure that we continue to press the Government, ensuring that we talk up on behalf of our constituents and those impacted and affected.

I really hope that we start to see some newer Labour Members, in particular, taking a bigger interest—we used to have really involved, detailed debates where people turned up and played their part—as I am sure that many of them represent people who are impacted and affected. It would be good to see a few of them turn up.

[John Glen]

I think it is it is a good sign that there are fewer Members of Parliament in the Chamber, because it shows that there has been meaningful progress. I do not see tetchiness from the Minister; what I see is somebody who has listened carefully to the representations of the community and acted on them. I accept and acknowledge that there are outstanding matters, but actually, when infrastructure has been set up—in some cases for 20 years—to campaign, it can be quite difficult to adjust to delivery mode.

[Pete Wishart]

There is no one in the House more experienced than the right hon. Gentleman. I pay tribute to what he did in government and how he brought this issue forward. He is right; we must be a bit careful, but all of us involved are just trying to take the debate forward. He is possibly right that there may be satisfaction that things have moved on and we are at a different stage in the campaign, but it is still important that we continue to ask questions of Government. That is what we are all trying to do in this debate.

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[Andrew Gwynne]

I agree with the hon. Gentleman, which is why IBCA is operationally independent—that is the crucial thing here. It does not have the fingerprints of Ministers all over it, because that is where the distrust comes from. It operates independently, but as a public body it is accountable to this House for how it spends that money and how it operates as an organisation. While IBCA is operationally independent to ensure a separation between Executive Ministers and the functioning of that body, it is accountable to this House. I think that is absolutely the right balance.

[John Glen]

I endorse what the Minister has said about the way in which IBCA has been set up. It seems to me an entirely sensible arrangement that respects the need to have some distance from Government, but clearly there cannot be a bespoke arrangement for every single entity that is set up. This was the point I was trying to make, respectfully, about Sir Brian Langstaff earlier: he did a brilliant job, but some aspects of this issue will need a slightly different judgment made by Ministers. I welcome the decision that the Minister and his colleagues have made.

[Andrew Gwynne]

I thank the right hon. Gentleman for that intervention. I hope that Members across the House can see why we have set IBCA up in the way we have. It is for precisely that reason: we have to have that operational separation from Ministers and the Executive, but there also has to be political oversight from all quarters of this Chamber, because this is a public body spending public money—and a great deal of public money at that.

As I have said, we are aiming for the second set of regulations to be in place by 31 March 2025. That will support our intention that payments to the affected begin next year. There are important details, especially in relation to Sir Robert Francis’s recommendations, the majority of which the Government have accepted, that must be worked through ahead of the second set of regulations. This includes details such as the eligibility criteria for people who are affected, and how the Government should define the parameters of the definition of unethical testing.

Turning to payments, the selection of those who have been contacted for first payments was a decision for the Infected Blood Compensation Authority. The first group of people who are receiving invites to claim are: first, those who are known to be already eligible for compensation; secondly, those registered with support schemes, which means we are likely to have much of the necessary information for these people already; thirdly, those from areas across the UK; and fourthly, those who represent a range of infection types and of severity within those infections.

Let me turn to some of the questions raised about this area. The hon. Member for Eastleigh mentioned people dying before compensation is awarded. I hope I can reassure her that when a person with an eligible infection has, tragically, died before receiving compensation, we will ensure that their personal representatives can claim compensation on behalf of the deceased’s estate. I hope that clarifies the point for her.

My hon. Friend the Member for Swindon North talked about the exclusion of victims with hepatitis B from the compensation scheme. People with chronic hepatitis B and those who die in the acute period are eligible for compensation, as are their loved ones as affected. I suggest that my hon. Friend writes to the Minister for the Cabinet Office with his constituent’s details, so that we can look more closely at his case. My hon. Friend the Member for Eltham and Chislehurst asked whether there will be payments by the end of the year. The answer is yes, and as I have said, there will be payments to the affected from next year, when we have the new regulations in place.

The right hon. Member for East Hampshire asked about the steps taken to provide accessible information on compensation. I want to spell out to him that Sir Robert recommended that there should be a higher award of £15,000 for children subject to unethical research at the school in his constituency. That is why there is a difference, which I hope clarifies that point for him. As I have said, at the start of November the Infected Blood Compensation Authority invited the first cohort of people to make compensation claims.

Candour in the civil service and in Government was raised by my hon. Friend the Member for Eltham and Chislehurst and the hon. Member for Perth and Kinross-shire in their contributions. The King’s Speech set out the commitment to bring forward legislation to introduce a duty of candour for public authorities and public servants. This legislation will be the catalyst for a changed culture in the public sector. The Prime Minister confirmed at the Labour party conference that legislation on the duty of candour would be delivered by this Government. He confirmed that the duty will apply to public authorities and public servants, and it will include criminal sanctions. The Bill will be introduced to Parliament before the next anniversary of the Hillsborough disaster in April 2025.

In closing, today I hope the House has heard how we are starting to deliver compensation and how we are starting to respond to the inquiry recommendations. Admittedly, they are still small steps, but they are steps in the right direction. This work is far from over. We owe it to the victims and their families to see it through, and we will of course regularly update the House as this progresses. I reiterate on behalf of the Government and the Department of Health and Social Care, and as a mere ordinary Member of Parliament for Gorton and Denton, representing some of the infected and affected, that we are truly sorry. We let you down. We will learn from these lessons, and we must never ever let anything like this happen again.

Question put and agreed to.

Resolved,

That this House has considered the Infected Blood Inquiry.

National Insurance Contributions: Healthcare

John Glen Excerpts

Thursday 14th November 2024 Commons Chamber

[Karin Smyth]

I am so pleased to see my hon. Friend in her place. As I said to the hon. Member for Aberdeenshire North and Moray East (Seamus Logan), the SNP has been in charge of Scotland for a very long time. We have certainly missed having a Scottish Labour voice in this place. She makes an excellent point and shines some sunlight in this place on the actions that have been taken up in Holyrood.

[John Glen (Salisbury) (Con)]

Julia’s House hospice does amazing work across Wiltshire and Dorset, but its chief executive Martin Edwards came to Parliament on Tuesday to tell me that the additional national insurance contributions will cost the hospice £250,000 a year. For that hospice, and Naomi House, which does similar good work, the changes are a significant concern. I know that the people of Wiltshire and Dorset will do as much as they can to raise additional funds, but will the Minister reflect on that unexpected gap and offer some reassurance?

[Karin Smyth]

I agree with the right hon. Gentleman that his hospice, and the hospices in many of our constituencies, do great work. We are aware of the precarious situation that they have been in for a number of years, and we want to ensure that they are fully part of end of life care. He will know from his time in the Treasury that there are complicated processes, both in the Treasury and in the Department of Health and Social Care. When I talk about the normal processes for allocating money, I think he understands that well. We are mindful of hospices’ concerns, and we will continue to talk with them.

Mental Health Support

John Glen Excerpts

Thursday 10th October 2024 Westminster Hall

[Dr Luke Evans (Hinckley and Bosworth) (Con)]

Thank you, Mr Dowd, for allowing me to take off my neck brace to speak. I congratulate the hon. Member for Ashford (Sojan Joseph) on speaking so powerfully on this topic. I was a doctor before I came to this House, so for me the topic is important. There is a clear distinction when we debate this topic between mental wellbeing and mental health. Lockdown proved that everyone’s mental wellbeing gets punished, but not everyone has a mental health issue. That is important when we are trying to segregate services: how do we supply the correct services to the people who need them the most?

I have spent the last five years in Parliament campaigning around body image and for a men’s health Minister, particularly with regard to suicide. But I turn my attention to something close to my heart that is really important: the issue of adolescent mental health, because I am deeply concerned by the increase in children who are suffering. It is not just things such as eating disorders; we are seeing attention deficit hyperactivity disorder, we are seeing anxiety and we are seeing autism.

I plead with the new Minister to think radically, in a positive way, when it comes to the NHS. In my area of Leicestershire, 40% of child and adolescent mental health services is taken up by dealing with ADHD and autism. That takes a lot of attention away from the kids who are self-harming, or have eating disorders or significant serious depression or psychosis. There is a radical solution: pull out education and health and pool those services as specialisms. That would build on the work that the last Conservative Government did on placing representatives and mental health workers in school, and would allow GPs and CAMHS the freedom to concentrate on what they need to deal with.

[John Glen (Salisbury) (Con)]

On that point, may I draw my hon. Friend’s attention to the role of care co-ordinators with adolescents, and the problems and challenges of the transition to adult care? That moment can be critical in securing a pathway to an effective outcome. Often, the confusion over where responsibilities are delineated and begin has been a difficulty for my constituents.

[Dr Evans]

My hon. Friend is absolutely spot on. The cliff edges that exist in the NHS—and education and social services—cause a real problem, particularly for families, because at 18 someone does not just lose their diagnosis.

It is important to pool those areas because it allows us to stratify the way that we use our limited resources, and we know that health costs will continue to go up and spiral. I urge the Minister to have a think about potentially creating almost a national special educational needs and disabilities service, which would pool education and health experts together, releasing schools and relieving GPs’ primary care and secondary care with specialists. Now we have the set-up of ICBs, there is scope to do that regionally across the 42 areas.

It is well worth thinking about pooling those resources together, because it would be possible to give specialist help; and as the hon. Member for Ashford said, identifying people early means that they will not end up in a crisis. That brings us back to preventive care, to identify those who are having problems with wellbeing or who have mental health issues. For me, that is the crux of what we need to do: how do we pool the resources in a way that is sustainable for the taxpayer and, most importantly, service users and providers—the children and adolescents, and the staff who have to cope with some of the most difficult problems? I leave the Minister with that thought.

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[Dr Simon Opher (Stroud) (Lab)]

On World Mental Health Day, I am wearing this slightly ghastly yellow tie. May I also do a little promotion? In room M in Portcullis House at 3 o’clock, at the end of the debate, we have some young people, through YoungMinds, telling us what they think of the service. It is really important, particularly with young people, to make sure that we develop services that they want and that we do not dictate.

I am still a practising GP in Stroud. More than 90% of mental health consultations take place in primary care and more than 40% of GP consultations concern mental health. I am sure the hon. Member for Hinckley and Bosworth (Dr Evans) will concur with me on that front. I would like to divide mental health into two sections. There is serious mental illness, which is serious and enduring, affecting about 130,000 people in this country. I will make a little plug: they tend to die 10 to 20 years earlier than other people and we must promote their physical health.

The other area is anxiety and depression. We have 8 million people in this country on antidepressants—selective serotonin reuptake inhibitors—and at least 2 million of them are trying to get off. We need to ensure we do not over-medicalise mental health. I was pleased to hear what my hon. Friend the Member for Ashford said about mental wellbeing and mental health. We all get a bit pissed off sometimes—that is normal for humans—and it is extremely important that we do not conflate that with mental ill health.

[John Glen]

May I just say how much I agree with that remark? We may disagree about resourcing and what has happened over the past 14 years, but we need the confidence to talk about building resilience and prevention so that people do not get to the point where they need medical intervention. We have the responsibility to talk about that in this place and in our communities so that we get to the root causes, which are not always to do with socioeconomic matters.

[Dr Opher]

Absolutely; I fully agree with that.

I want to make a couple of comments about the state of mental health services, for which there are extraordinary waits: a patient of mine had to wait six months following a suicide attempt. That is simply not good enough. In Stroud, we have to wait four years for neurodiversity assessments because we do not have enough resource. In my opinion, we need to move the resource into the community.

I also support what my hon. Friend the Member for Ashford said about health and education. We need mental health support teams in our schools, and we must spread SEND provision evenly.

The Under-Secretary of State for Public Health and Prevention is with us, so I want to talk about the prevention of mental health issues. There is quite a lot of evidence about promoting maternal and infant mental health, and also about parenting and bullying at school. Using arts and culture is an incredibly strong way of improving mental health.

I was impressed with what my hon. Friend the Member for York Central (Rachael Maskell) said about the community basis of mental health treatment. For many lower-level conditions, there is no need for consultant-led care. Support that takes place in the community costs much less and can be really effective.

The CAMHS waiting list is appalling, and we have a crisis with SEND and delays with education, health and care plans. We do not have enough educational psychologists either. I want to stress what my hon. Friend the Member for Ashford said about care co-ordinators. Young people’s social prescribers are very effective and tend to de-medicalise things that can be supported in the community.

I am really impressed that we are going to get 8,500 more mental health workers. I am also impressed by what they will be doing in schools. We need to improve the physical health of people with serious mental illness, reduce the number of SSRI antidepressant medications, and promote social prescribing, the arts and community care in our mental health services.

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[Andrew Gwynne]

My hon. Friend is absolutely right. At the heart of the health mission that the Labour Government want to see is the shift from hospital to community, from analogue to digital and from sickness to prevention. What we do in the community really matters. Our ambition for the future of mental health services is wrapped up in those shifts, particularly the shift from hospital to community.

[John Glen]

Could I share my experience as a Minister? When we looked at social prescribing when I was in the Treasury, it was always difficult to establish an evidence base to justify the allocation of resources. I urge the Minister to continue that battle to make the case, because I am sure that the instinct of all Members throughout the House is that there is something in that ambition, and we must find a way of unlocking it so that we can get social prescription out into the community where a variety of provision is available.

[Andrew Gwynne]

The right hon. Gentleman is absolutely right. That will be one of the big challenges with the prevention agenda more generally, because often the investment we have to make today does not pay dividends immediately and there is a bit of a punt. Having been a Treasury Minister, he will know the challenges that that can present to the Treasury orthodoxy, but we have to push on this agenda.

I always say that being an MP and a GP is only one letter apart. We are often dealing with the same people who present with the same problems but from a different angle. We go away as Members of Parliament trying to fix the issue as they have presented it to us, and the GP will write a prescription and send them off having sorted out the issue as it was presented to them. However, the beauty of social prescribing is that there is an opportunity to deal with the whole issue in the round. The argument has been won with almost everybody, and any tips from the right hon. Member for Salisbury (John Glen) so we can get this over the line with the Treasury will be welcome.

I should mention my hon. Friend the Member for Darlington (Lola McEvoy), and welcome the hon. Members for Winchester (Dr Chambers) and for Runnymede and Weybridge (Dr Spencer) to their Front-Bench positions.

In the minutes I have left, I want to say to the House that many of the issues raised by Members during the debate are symptomatic of a struggling NHS. If we look at the figures, the challenges facing the NHS are sobering. In 2023, one in five children and young people aged eight to 25 had a mental health problem, which is a rise from one in eight in 2017. The covid-19 pandemic has exacerbated need, with analysis showing that 1.5 million children and young people under the age of 18 could need new or increased mental health support following the pandemic.