Building an NHS Fit for the Future

Lord Beamish Excerpts

Monday 13th November 2023 Commons Chamber

[Helen Whately]

I understand what the hon. Gentleman is saying, and I know how strongly families and patients feel about this. It is not for me, as a Minister, to step on the independence of NICE, which has a remit to take those decisions. I am sure that the new Secretary of State for Health and Social Care, my hon. Friend the Member for Louth and Horncastle (Victoria Atkins), and other Ministers in the Department will continue to listen to the concerns of families about access to those treatments.

If we want to fully embrace preventive care, we must tackle the single biggest preventable cause of ill health, disability and death, which is smoking. Unlike drinking alcohol or eating fatty, salty or sugary foods, there is no safe level of smoking. It causes almost one hospital admission every minute, one in four cancer deaths and 64,000 deaths a year.

Four in five smokers start by the time they are 20, so the best thing we can do is to stop young people smoking in the first place. That is why this Government will automatically raise the smoking age by one year every year, so anyone who is 14 or younger today will never be able to buy tobacco legally. Increasing the smoking age works. When it rose to 18, smoking rates dropped by almost a third in that age group. Restricting choice is never easy, but this time it is the right thing to do. Existing smokers will not be affected, but the next generation will be smoke-free, saving thousands of lives, reducing pressure on the NHS and building a brighter future for our children.

[Mr Kevan Jones (North Durham) (Lab)]

I hear what the Minister says about the Government’s commitment to this policy, but can she explain why the Government are allowing a free vote rather than whipping Back Benchers to vote for Government policy?

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[Mr Kevan Jones (North Durham) (Lab)]

First, I congratulate the hon. Member for Uxbridge and South Ruislip (Steve Tuckwell) on making his maiden speech. Having mentioned his local boozer, he will no doubt be forever welcomed there with open arms. I welcome him to his place and thank him for his speech.

I note the historic event last week of the King making his first Gracious Address as sovereign. It is just a pity that the speech written for him by the Government was so thin, with little content and little vision. It was a clear demonstration that the Government not only are running out of steam, but have none left at all.

People know that I have campaigned on mental health for many years. It is 11 years since the hon. Member for Broxbourne (Sir Charles Walker) and I spoke, in a mental health debate, about our own mental health. I think attitudes have changed for the better over that period, and it has clearly moved up the political agenda. I was therefore, like a lot of campaigners and professionals, very disappointed that the reform of the Mental Health Act 1983 was dropped from the King’s Speech. The Act is outdated and archaic in parts, and its language is more fitting to the Victorian era. As my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) said, in some cases it is leading to people with learning difficulties and autism being locked in the system for many years, without any voice to raise their plight.

The Minister, in her address, seemed to dismiss that as though it was somehow not important, but depriving people of their liberty is a very serious thing. To deprive somebody of their liberty, you have to ensure that they not only have rights, but care. My concerns about the Mental Health Act relate to those with autism and learning disabilities, some of whom have been locked in the system for years without a strong advocate. There are people in the criminal justice system locked into a Kafkaesque system that we have created. The Minister more or less threw that aside. I am sorry, but if you are a black teenager in the criminal justice system or an adult with learning difficulties, the system needs reforming and it needs reforming now.

It is not as though the Government started with a blank sheet of paper. We had Sir Simon Wessely’s excellent review in 2018. The Government made a manifesto commitment in 2019 to bring forward legislation. There was a draft Bill last year and a Joint Committee to scrutinise it. One would have thought it was a clear priority for the Government to move the issue up the political agenda, but what we have had from the Department of Health and Social Care is not just no Bill, but inaction. The Joint Committee spent a great deal of time looking at the Bill and put forward 36 recommendations. Ten months later and they have not yet even been answered by the Government. This is not just the Government abandoning the Bill and a broken Conservative party manifesto promise; it is a dereliction of duties. Politics is about priorities and, for me, this is a priority. Some 50,000 people a year are sectioned under the Mental Health Act. For some, I accept, it is life changing. For others, however, it leads to a system that they get into and cannot get out of. It is right to reform the Act and it is absolutely shocking that that is not in the King’s Speech. It will certainly be a commitment for the next Labour Government. I and many on the Labour Benches will make sure it is a commitment.

The Minister, in her Gatling gun approach to her speech, was more or less saying that it does not matter because everything else is okay in mental health. I am sorry, but it is not. In April 2022 we had, with much fanfare, the 10-year mental health and wellbeing plan. Over 5,200 individuals and mental health charities responded to a consultation, only to find out in January this year that it had been completely scrapped. The Minister talks about mental health being a priority, but the facts do not support that. Unless we have a proper joined-up approach to mental health, we will not get on top of the issue of individuals who need help, or have a system fit for a modern country such as the UK.

[Jim Shannon (Strangford) (DUP)]

I congratulate the right hon. Gentleman on raising this matter. Throughout my time in the House he has spoken up significantly for those with mental health issues, and he understands the subject very well. One group who seem to fall below the radar are veterans. In Northern Ireland, a large number of people who have served in the forces suffer from post-traumatic stress disorder. Does the right hon. Gentleman agree that those veterans who are suffering greatly must be a priority in addressing mental health?

[Mr Jones]

I agree with the hon. Gentleman. As a former veterans Minister, I did a lot about veterans mental health. We now have a disjointed system with a veterans Minister who, in Trumpian style, says that everything is perfect and everything is working, when it is clearly not. We need to ensure that veterans receive the best mental health care in their local areas, and that means adopting a joint approach.

If we are to get on top of the nation’s mental health, that must be done through a public health approach. It must be done at local level, and it must ensure that public health takes a lead. Less than 2% of the mental health budget is spent on preventive work, which needs to be done not just in schools but in communities generally. Fortunately for my constituency, a new initiative has been launched in Chester-le-Street where GPs and local community groups divert people from mental health services by securing them the help they need, and I congratulate those who are involved.

Tobacco affects mental health, with 50% higher smoking rates among those with a mental illness and two-thirds higher death rates, so I support the movement for a smoke-free generation, although I note that the Government will not ask their Back Benchers to support the policy because they know they will not receive it. Action also needs to be taken on illegal sales of counterfeit tobacco, but that cannot be done in the present circumstances, because the number of local trading standards officers has been cut by 52% since 2009. We need to ensure that more money is put into trading standards and policing. The Government keep saying how wonderful it is that we have extra policing, but in fact County Durham has 140 fewer police officers than it had in 2010. It is important for us to have the enforcement side, because without that some people will be driven into the illegal tobacco market, but we cannot see it as a silver bullet that will justify cuts in public health budgets. We need continued, dedicated local smoking cessation programmes, because without them we will not make the strides that we want to make.

I shall say something on two other issues. First, on leasehold reform, let us look at the facts, as opposed to what the Government are saying. The Government have given the impression that this reform will affect every leaseholder, but it will not; it will apply only to new buildings. There is no roll-out of the commonhold for new flats, which constitute the majority of leasehold properties. This outdated feudal system needs to change. There will be a great many disappointed people who, having assumed they would suddenly be given more rights, then find otherwise. Let us be honest: this has been fuelled by the Government’s right to buy scheme, which is being used by Persimmon and other big house builders as a way of making extra cash, mainly at the expense of the taxpayer and those poor individuals.

Secondly, on transport, I have heard the references to the Network North plan. I will not dwell on it too much, because I do not believe anything in it. We know that 85% of it has already been announced, but some of those announcements have been withdrawn very quickly. In the north-east, for example, the Government argued that the Leamside line, which would help my constituency of North Durham, would be reopened, only for that announcement to be withdrawn within 24 hours. I doubt that many of these projects will see fruition.

With my role on the Intelligence and Security Committee, I welcome the investigatory powers reforms, which will be important in ensuring that the right safeguards are in place for the way our security services collect bulk data, and in bringing some of the oversight up to date. It is also important that the Government work closely with the ISC—something they did not do on the National Security Bill that went through in the last Parliament. We are still waiting for a response to some of our arguments around how the ISC is run. This legislation will be important to ensure that we give our security services the necessary powers to protect us all, and to ensure that we get the proper oversight.

This will be the last King’s Speech before the general election. It was half-hearted and full of gimmicks that were designed to be eye-catching, but it has no long-term plan for the future of our country. That is the disappointing thing, and that will only change when we get a change of Government at the next general election.

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[The Secretary of State for Work and Pensions (Mel Stride)]

May I begin by welcoming the new Secretary of State for Health and Social Care, my hon. Friend the Member for Louth and Horncastle (Victoria Atkins), to her place? This has been a good and full debate. It has, in large part, been fairly well-informed, although I thought the quality of the offerings from behind me was a little ahead of that from in front. None the less, it has been a good and passionate debate.

No effort today was in any way better than that of my hon. Friend the Member for Uxbridge and South Ruislip (Steve Tuckwell), who gave us a virtuoso example of a maiden speech. He referred to the fact that it was in his constituency that Winston Churchill first uttered the immortal words,

“Never in the field of human conflict was so much owed by so many to so few.”

Of course, Churchill then repeated that in this Chamber, but not with the same eloquence as my hon. Friend, and he certainly did not manage to squeeze in a tribute to the Middlesex Arms, my hon. Friend’s local pub, where I am sure a free beer awaits him—that is probably where he is at this very moment. Now that I too, in addition to him, have mentioned his local pub, I hope that a second pint awaits him.

There are certain things that the shadow Secretary of State, the hon. Member for Leicester West (Liz Kendall), and I can agree on, and smoking is one of them. I was interested to learn that she is a former smoker. They always say that former smokers have a passionate desire to stop other people smoking, and she certainly demonstrated that. We know that one in four cancers is caused by smoking. As a father of three young daughters, vaping is of great concern to me personally, and I was pleased to see the reference in the King’s Speech to getting on top of those kinds of products and the way in which they are retailed.

The hon. Lady also mentioned mental health, as did many of this afternoon’s speakers. We have said that we will come forward with a mental health Bill if parliamentary time allows, and of course that does not mean we have not already done a very great deal in exactly that space, or will not do a great deal further. Some £2 billion of extra funding is already going into mental healthcare compared with four years ago, with a 20% increase in staffing since 2010. It does not stop there: we will also be bringing forward mental health hospitals and 100 specialist ambulances.

[Mr Kevan Jones]

We have now been waiting six years for a change to the Mental Health Act 1983. The Minister says that the Government are committed to mental health, but earlier this year we saw the 10-year mental health and wellbeing plan scrapped. I am sorry, but I have to say to the Minister that words are pretty hollow; when it comes to action, the Government are doing very little.

[Mel Stride]

I have just set out for the right hon. Gentleman two very significant actions that this Government have taken: £2 billion of additional funding compared with just four years ago, and a staff increase of some 20% since 2010.

I have to pick up on the non-doms point, because we hear it so often from the Opposition. Those poor old non-doms are going to be paying for the entire British economy over and over again. They pay UK taxes on their UK income, and it is just not realistic to expect to be gaining more tax in the longer term as a result of taxing them.

We have heard much about waits for NHS services. We have been working very hard on that issue, and it has to be recognised that we have had a pandemic, as well as a considerable amount of industrial action. Frankly, if the Opposition had done more with their trade union paymasters to encourage them to go back to work, we would have had smaller backlogs than we do at the moment. We have already largely eradicated the 18-month waits; the two-year waits have already been abolished; and we are rolling out all sorts of approaches to make sure we have more provision going forward, including 140 new surgical hubs. When Labour tells us about their plans, we need only to look at Wales, where we can see the results of Labour’s stewardship of the health service: on average, waiting times in Wales are five weeks longer than in England.

The hon. Member for Leicester West spent some time discussing employment, an area in which we have a first-class record. Economic inactivity, which she raised, is almost 300,000 lower than it was at its peak during the pandemic: it is below the average level of the OECD and the average level across the European Union. Unemployment is at a near-historic low, the number of those in payroll employment is at a near-historic high, and youth unemployment is down 44% on 2010. What happened under the Labour party? As Opposition Members know, it went up by almost exactly the same amount—another 44%. Labour is the party of unemployment; it has never left office with unemployment anything other than higher than when it came in. Under Labour’s stewardship, 1.4 million people were languishing on long-term benefits for over a decade, and that is a disgrace.