Prostate Cancer

Lord Beamish Excerpts

Wednesday 3rd September 2025 Lords Chamber

[Lord Beamish (Lab)]

My Lords, I congratulate the noble Lord, Lord Mott, on securing this very important debate. I was diagnosed with prostate cancer last February. I had no symptoms. I was going as normal for my yearly health check at my local GP surgery when a nurse suggested that the PSA test might be appropriate because of my age. It came back positive and, as the noble Lord, Lord Dobbs, and my noble friend Lord Watson of Wyre Forest said, it is not a dignified process—although when you get the diagnosis, frankly you do not care.

Let us go through the reasons why this is not being offered. One, as the noble Lord, Lord Patel, said, is the PSA test. I accept that, but I am sure that the three of us who have just talked about our experiences would rather have had a chance of that test than nothing, which was the alternative. There are moves forward with PSA tests, saliva tests and other things, but we must have a screening programme that targets high-risk groups. Education is also going to be important. We need we need a national education programme on this.

Also, from the NHS’s point of view, there is the UK National Screening Committee. I campaigned with my noble friend Lord Watson in the other place around cardiac risk in the young, asking for screening of young people in active sports. The same excuses were used to resist that as are being used now for prostate cancer: false positives and raising anxiety. Yes, it is very stressful point when you get that diagnosis. Thankfully, my treatment is going well, which is down to the incredible people that we have in our NHS, who work very hard on our behalf. I am eternally grateful to them.

Let us look at the economics of this. If we are to reduce costs in the NHS, we must put more money and effort into prevention. This is about prevention. Put very crudely, early diagnosis and treatment is not only saving the NHS money but helping people have a positive and active life.

National Cancer Plan

Lord Beamish Excerpts

Monday 10th February 2025 Lords Chamber

[Baroness Merron (Lab)]

My condolences to the noble Lord; I am sorry to hear of the loss of his dear wife. I am afraid I cannot say when there will be a cure, but I can reassure him, as I have said previously, about the importance of research and research expenditure. We continue to make great strides, and we will continue on that trajectory.

[Lord Beamish (Lab)]

My Lords, I begin by declaring an interest as someone who is going through cancer treatment; I add my thanks to the doctors and our wonderful NHS workers. I agree with the noble Lord, Lord Scriven, who said that early detection is the main thing affecting whether someone survives cancer or not. I urge the Government to look at prostate cancer, particularly the PSA test, which we have to ask for now. Clearly, there is inequality throughout the country: in middle-class communities, where people ask for it, they get it; in poorer communities—certainly in Afro-Caribbean communities, which the right reverend Prelate referred to—detection is later and survival rates are poorer. If we cannot have a national screening plan straight away, can we not have a pilot to start with?

[Baroness Merron (Lab)]

I wish my noble friend well with his treatment. Screening for prostate cancer is not currently recommended in the UK because of the inaccuracy of the current best test available, which is the PSA. The advice we are given is that the PSA-based screening programme could harm men, as some could be diagnosed with a cancer that would not have caused them problems during their life; equally, some cancers may be missed. That is why we are investing £16 million towards the Prostate Cancer UK-led TRANSFORM programme, which is the name of the screening trial. On health inequalities, as I mentioned earlier, the trial is seeking to find better ways to detect prostate cancer, which is necessary, and to address the health inequalities.

Mental Health Bill [HL]

Lord Beamish Excerpts

Committee stage
Monday 20th January 2025 Lords Chamber

I remember a father showing me what happened to his adult son, who was a very able artist. He was misdiagnosed with schizophrenia, and I have seen the paintings that this man produced after somebody had tried to go through the list to find the right drug for him. It is a scandal; that is why I believe that this should be included in the Bill.

[Lord Beamish (Lab)]

My Lords, I will speak to Amendment 33 in the name of the noble Lord, Lord Scriven. If this Bill is a success, we shall, I hope, see fewer people with autism and learning difficulties detained under the Mental Health Act. However, the noble Lord’s amendment goes to the heart of the problem of resources. The current system is broken. It is a market system, which ends up with a lot of people finding themselves detained in facilities far from home, and getting out of that system can be very difficult.

The collection of data will be important: first, to find out how many people are being detained. Having spent 23 years in the other place and having been a passionate advocate for mental health, I always found that data is one thing that is never really kept. It is kept between the Department of Health and various other healthcare providers. Getting that visibility for the numbers we are talking about will be very important.

We need to be honest that, in the entire mental health debate, people with autism and learning disabilities have been overlooked. To get this right, having proper community-based facilities will be very important, but it will be expensive. The market model we have at the moment means that lots of private companies provide care at very high cost, and commissioners tend to have to commission only from certain providers. This leads to a shortage of supply and prices going up. The Minister needs to spell this out.

I understand what the noble Lord said in moving the amendment, but it is important to have visibility of not only the numbers but where the community facilities are going to be. New Clause 125FA(2)(b) in the amendment says the Secretary of State should ensure that community services are available to meet demand after 28 days. If you speak to any commissioner at the moment, they will tell you that that is completely unrealistic. I accept that it was put in the amendment for debate, but that is an aim we should be trying to get to in supporting people in the community. I have seen sad cases of people being stuck in the system. With the best will in the world, and I think there is cross-party support for this, we should not have people with learning disabilities and autism stuck in the system for as long as they are, with no way of getting out. I accept that the Bill aims to give a voice to those individuals, but without the resources to match, they will still go round the merry-go-round of different funders.

Another important issue that we need to highlight is the lack of support staff in the community for dealing with people with learning difficulties and autism. That is not seen as a priority at college. We need to put more emphasis on making it an attractive career and on the fact that it is vitally needed and will make a real difference to the individuals concerned. Training is important, but so is getting people into the service in the first place. I accept that the noble Lord is not going to press the amendment, but it goes to the heart of most of the matters in the Bill. We are deluding ourselves if we think the good and well-intentioned things in the Bill will be delivered without the resources to do so; they will not. The one without the other will lead to people still being detained when, in a modern society like ours, they really should not be.

[Baroness Murphy (CB)]

My Lords, I give my strong support to the noble Lord, Lord Scriven, asking for a road map, which I think is the political phrase we use now, to get to where we want to be. I remind him that, back when the then Government came in in 1987, we had a documented timetable for closing the learning disabilities hospitals but that never happened; it went too slowly. So, we have left people stranded in various independent sector and NHS facilities, partly, to be honest, because the Department of Health took its eye off the ball as to what was happening to people in long-stay care and just stopped looking. So I agree that we need some kind of timetable; otherwise, the Bill becomes simple aspirations, as we have already said.

Unfortunately, it is not just autism and learning disabilities that require special training. In a lot of areas of mental disorder, people get inadequate training in subspecialties when they are studying the general psychiatric stuff. Psychiatric nurses do not get enough, either. I agree that there are issues here that require a special target, but at the moment they do not get it, so I support that as well.

On the experience of the noble Baroness, Lady Browning, of course it is true that there are an awful lot of bad psychiatrists around. There are bad physicians and bad surgeons—not the noble Lord, Lord Kakkar, before he punches me on the chin. We should not say “bad”; I would say “not the best”. A friend of mine was visited by a community psychiatrist in old age psychiatry about a month ago. I asked his partner how it went, and he said, “Well, he was in and out in 15 minutes. He’d got 10 assessments he was going to do in people’s homes around south Norfolk in that time”. That was a totally inadequate amount of time to get a history from relatives, to get an understanding of what was going on in the home situation and to understand the problems this person was experiencing. I was shocked, but I was told not to be because it happens all the time that there is an inadequate length of time for people’s assessment.

It is hardly surprising that diagnoses are wrong and that people end up with the wrong prescriptions. It is deeply regrettable, but this will happen for as long as community services are underresourced. As we have heard from all around the Chamber, you can put as much in place as you like, but if it is underfunded, has the wrong facilities or is too far away from where people live, it just will not happen. We need a road map, and we need to know when these facilities will be made available, because the rest of it cannot happen until they are.

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[Lord Beamish (Lab)]

On that point, I welcome what my noble friend the Minister has announced, but the real problem is about housing, including specialist housing in different areas for individuals leaving secure units. That is not universal throughout this country, as people leaving mental health units are then having to travel long distances. Surely we need local plans, and that money going in locally to provide the housing needed.

[Baroness Merron (Lab)]

My noble friend makes a good point about housing; we discussed it on day 1 in Committee. We are working with our ministerial colleagues who deal with housing on the need for the right kind of housing to be available. The point was well made and is taken.

Health: Obesity

Lord Beamish Excerpts

Tuesday 7th January 2025 Lords Chamber

[Lord Beamish (Lab)]

My Lords, the Mental Health Foundation produced an excellent report on body image, which is about how not just younger people are affected by it but an increasing number of older people as well. It leads to people undertaking cosmetic surgery, some of whom go abroad because it is billed as being cheaper. What is the Minister doing to track this surgical tourism? What is the cost to the NHS?

[Baroness Merron (Lab)]

My noble friend is right that there is certainly an increased cost to the NHS. I do not have the exact figures available, but I would be pleased to look into it. We are very mindful of this and advise in particular that people should not go to areas where healthcare services are not properly regulated. They do so at their own risk, and it often comes back to the NHS to put that right. This is an increasing problem and one we are seeking to tackle.

NHS: Treatment of Children from Other Countries

Lord Beamish Excerpts

Thursday 21st November 2024 Lords Chamber

[Baroness Merron (Lab)]

The agreements that the UK has in place which contain referral arrangements whereby the funding is discussed and agreed as part of the process of the referral are with the member states of the EU, Switzerland, the EFTA-EEA bloc of countries, the British Crown dependencies and some overseas territories. As the noble Lord rightly acknowledges, it is only fair that those using the NHS are those contributing to it, and we therefore have to ensure that we stick to those agreements. If trusts seek to undertake work outside of that area, that will be a matter for individual trusts, which will have to make decisions about their funding and their requirements to serve the NHS.

[Lord Beamish (Lab)]

Will my noble friend the Minister join me in congratulating the heart transplant unit at the Freeman Hospital in Newcastle, particularly the unit which conducts children’s heart transplants, providing a great service not just for this country but for children from across the world? One of the issues, though, is trying to encourage donors to come forward. What more can be done to encourage donors, specifically children, to come forward?

[Baroness Merron (Lab)]

I am very happy to add my congratulations to the hospital, which my noble friend knows very well. There are several approaches that we take on donors. One is the increased use of technology to ensure that organs donated can be used when and where needed. We tend to lose a lot of organs because that is not possible to do, depending on the technology. Another approach is to ensure that organ donation is a route that people are assured they can take, feel confident in, and are willing to participate in, including where somebody has died and we must deal very delicately, of course, with their loved ones.

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.

Dental Care: Durham

Lord Beamish Excerpts

Wednesday 24th May 2023 Commons Chamber

[Mary Kelly Foy]

I could not agree more with my hon. Friend. The dentists that I have spoken to recently all want to help NHS patients, but the way the contracts are designed, it is not worth their while, and of course they have to make a living.

I mentioned that I made a point of order yesterday regarding the Prime Minister, who has repeatedly claimed that there are “500 more dentists” in the NHS. However, following a freedom of information request, we now know that the number of dentists in the NHS fell by nearly 700 last year. The number of dentists has also fallen since the pandemic and is at its lowest level in a decade.

Diagnosing the causes of the problem is not complicated. As I mentioned at the beginning, Britain has poorer oral health than any other developed economy. The system is also dysfunctional, and practices have handed back a record £400 million-worth of funding back to the Government because they do not have the capacity to meet the required targets.

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

Does my hon. Friend and neighbour agree that we have to see what the need is in each area? I contrast the current approach with when Labour were in power in Durham: we brought in new capacity where we knew that areas did not have access to NHS dentistry.

[Mary Kelly Foy]

I thank my right hon. Friend for the intervention. We all know that there is huge demand and such a lack of NHS dentists out there that it is, I guess, a question of political will whether this problem is solved or not.

The absence of oral healthcare from our national debate about the future of the NHS is alarming. Dentistry is integral to our national health and therefore must be key to the NHS. Without proper investment in preventive healthcare such as dental check-ups, we cannot quickly treat oral cancers, nor can we stem the flow of people with dental problems into our already overcrowded accident and emergency departments.

I would be grateful if the Minister responded to the following questions. First, will he ensure that dentistry is properly represented in the governance structures of the NHS? Dentistry must be at the centre of the policy-making process, not an afterthought. Secondly, will the Government publish a comprehensive national dental strategy, one that is focused on prevention and tackling health inequalities? Thirdly, will he undertake meaningful reform of the NHS dental contract, which would stem the flow of dentists out of the system? Fourthly, will he work with the BDA on the previous points?

Finally, as I have said, I raised a point of order yesterday on the Prime Minister’s claim that there are 500 extra dentists in the NHS. There are in fact 700 fewer dentists, not more. Unless I have missed something today, the Prime Minister has not corrected the record, as he is obliged to. Will the Minister finally correct the record on behalf of the Prime Minister?

I could have spoken for hours this evening, reading out the correspondence I have received from constituents. Each constituent’s experience reflects a serious failure by this Government, so I implore the Minister not to insult the intelligence of the people of Durham, but to take this opportunity to accept that there is a crisis in NHS dentistry and to commit finally to meaningful reform.

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[Neil O’Brien]

I have already read out the statistics. I will not read them out again, and I do not think there is a need to correct the record. The statistics that the hon. Lady is drawing on are incomplete, because there is effectively a two-month lag between activity and the need to report that activity. Drawing on such incomplete information does not give the full picture, so I caution her against doing so.

First, I encourage the hon. Lady to wait for the official data in the usual way. Secondly, we are looking to improve that official data by, indeed, working with and responding to concerns raised by the BDA. I do not think that headcount is a sensible measure with the workforce. There are more people doing NHS work than there were in 2010. What we are really interested in is the total amount of activity, which is best measured by the total number of UDAs being delivered. As I have said, that total amount of activity is going up. In the last month for which we have data, it had gone up from 85% in March 2022 to about 101% in March 2023, but it is still not high enough. Although the trend is positive and dentists are doing more NHS work, the point of agreement here is that that needs to improve further.

[Mr Kevan Jones]

I am sorry, but the Minister cannot have it both ways. First, the population of this country has increased since 2010 and we need to measure the number of dentists against the size of the population. The other thing is that he can talk about UDAs, but if people are in an NHS dentist desert, as is the case in Durham, it does not matter if the number has gone up elsewhere. If people do not have access to a dentist, they do not have access to a dentist and therefore cannot be treated.

[Neil O’Brien]

That point is clearly correct, but that is not to disagree with anything that I have just said.

Rather than getting into the weeds—I have already read out the official statistics—let me try to end on a note of agreement. We absolutely want to take further steps to ensure that we increase access to NHS dentistry where it is lowest and, as well as improving the service for patients right across the country and improving preventive activity, we want to see particularly rapid improvement in those areas, perhaps including that of the hon. Member for City of Durham, that have not had the level of access that we would want over recent times.

Question put and agreed to.

Health and Care Bill

Lord Beamish Excerpts

Report stage
Tuesday 23rd November 2021 Commons Chamber

[Richard Graham (Gloucester) (Con)]

I rise to speak on amendment 10. I want to start by relaying a conversation that I had soon after being elected 11 years ago in Gloucester. I talked to the chief executive of a hospital trust—he has subsequently moved on—and asked him how many nurses a year we needed to replace those who have retired and resigned, and to cope with increasing demand, not just in the hospital trust but including district nurses and nurses to cover the whole panoply of our needs in the county of Gloucestershire. He explained that we needed roughly 400 a year at that time. I asked him how many we were training. He said that the University of the West of England trains around 120 graduates a year from its nursing outlet in Gloucester. How do we meet the gap, I asked, and he said, “Well, we advertise. We try to encourage people from London to look for a change in their lifestyle and we recruit from abroad.” I asked him where that got us to. He said, “Well, it increases the numbers, but it never gets us enough. We struggle with a permanent shortfall of recruitment.”

Over the next few years, I worked on three things. The first was to support the Government push to create nursing associates. The second was to encourage the University of Gloucestershire to become a nursing teaching university and to submit an application to get pilot project status for the nursing associates’ training. Both of those came to pass. They were a credit to the Government, a credit to the university and a credit to the Nursing and Midwifery Council that supported them. None the less, we were, and are, still short; that gap has not been closed.

One other thing that I have done recently is to support the close engagement with the Government of the Philippines, who have kindly allowed us to carry on recruiting nurses from the Philippines to the United Kingdom during the pandemic. I ask everyone here to join me in paying tribute to the roughly 35,000 nurses from the Philippines who have made such a difference to our NHS. All those things have helped, but anyone who has played the role that all of us in this House have over the past two years will know that the people problem is the greatest problem that we have.

I chaired, first every week and now every two or three weeks, a meeting between all the MPs in Gloucestershire, the heads of the NHS trusts, public health and the county council. Time and again, the same issue comes up in a slightly different way: it is about people. Yes, we could build extra wards. Yes, we could convert offices into wards. Yes, we could build bed capacity, but we do not have more people to look after the patients in them. Yes, we have plenty of spaces in care homes, but we need to be able to send people back to their home from hospital, because that is how they recover best, and we do not have enough domiciliary care workers.

We have gone round and round for the past 10 or 11 years on this issue of staff—doctors in primary care surgeries, nurses everywhere and domiciliary care workers. I do not believe that we can resolve this problem until we start planning for the needs in different parts of the country and then working out how we can provide the training, the skills and the recruitment of individuals to make that happen. Of course it will not be perfect. Of course disasters such as the pandemic will make a bad situation much worse. We recognise that, but until we start that process, I do not believe that things will change. For as long as I am MP for Gloucester, I am absolutely certain that I will be having the same conversations about human resources—the people who deliver the care and health that all the people in my constituency and across the county and country need and deserve. It is not the best use of MPs’ time to constantly have to sit down with our health professionals in local NHS trusts to work out how we are going to mind the gap. That whole process has to be started from higher up, in the Department of Health and Social Care.

Today, we have an amendment that has enormous support not just from the Select Committee that my right hon. Friend the Member for South West Surrey (Jeremy Hunt) chairs, but from outside this House from the royal colleges, the NHS trusts and many others beside. I am frustrated that the Government have so far not indicated whether they will accept the amendment. In their hearts, the Minister and his colleagues, all good people trying to do their best, recognise that this problem will have to be tackled. Perhaps part of the solution will be in the White Paper that we are all so eagerly waiting for and that we wish that we had been able to have a few days ago, before the votes last night, on which I supported the Government on the basis of trust. None the less, there comes a time when we have to say and vote for what we believe in. I do believe that we need this change and that the Government can and should do it, and I will vote for it.

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

I rise to support new clause 1, which stands in the name of the right hon. Member for Romsey and Southampton North (Caroline Nokes), myself and 18 other right hon. and hon. Members from across the House. I first took an interest in this subject through a constituent, Dawn Knight, from Tanfield in my constituency. Dawn raised issues around the cosmetic surgery industry having been a victim of a particular hospital group. She has been a tireless campaigner in ensuring not only that victims get a voice, but that we press for more regulation.

I join others in paying tribute to the all-party group on beauty, aesthetics and wellbeing for its recent report and to my hon. Friends the Members for Swansea East (Carolyn Harris) and for Bradford South (Judith Cummins) for their work on that report, which highlights what my hon. Friend the Member for Ellesmere Port and Neston (Justin Madders) called the “wild west”. That is exactly what it is: it is a wild west without any regulation. It is a multibillion-pound industry, which is not only putting people at risk, but costing the NHS money.

In April 2013, the Health Secretary at the time—Andrew Lansley, now Lord Lansley—commissioned Sir Bruce Keogh to carry out a review of the regulation of cosmetic surgery. The review came out not only when we were having problems in the sector itself, but when interest was heightened around Poly Implant Prothèse breast implants, which people will well remember. When the review concluded, it explicitly advised the Government to increase regulation of the cosmetic surgery industry to prevent unlicensed treatments and increase patient safety. The review stated that a person having a non-surgical procedure

“has no more protection and redress than someone buying a ballpoint pen or a toothbrush”,

and

“dermal fillers are a crisis waiting to happen.”

As the right hon. Member for Romsey and Southampton North said, that crisis has actually happened already.

I have been campaigning on this issue for a number of years, during which time I have gone through a succession of Health Ministers, all of whom have come back with two points. The first is, “We are going to implement the Keogh recommendations”. But because Ministers were too terrified previously to make any health legislation, they were reluctant to bring those recommendations forward in that way.

The only good news in the area has been private Member’s Bill of the hon. Member for Sevenoaks (Laura Trott), the Botulinum Toxin and Cosmetic Fillers (Children) Act 2021. That legislation was tightly focused—as all private Member’s Bill have to be—and banned botox injections for under-18s. I congratulate the hon. Member on that work. However, any other regulations have been left unfinished. I have sheaves of letters from former Health Ministers saying, “The Keogh recommendations will be implemented”, but they have not been to date. If we do not do that in this Bill, when will it be done? I doubt that the Department will come forward with a Bill just to implement those recommendations; that is wishful thinking.

There is clearly no regulatory framework in the UK at present for those performing aesthetic non-surgical cosmetic treatments. The area is completely unregulated and lacks any national standards. There is no consumer protection, education, training or qualifications for those administering such treatments. As my hon. Friend the Member for Brent Central (Dawn Butler) said, some people call themselves nurses with no qualifications whatever. There is a huge discrepancy between the standards and qualifications of the training of these people. The other side of the issue, to which I will turn in a minute, is the regulated system, which, frankly, is failing as well.

The right hon. Member for Romsey and Southampton North raised the issue of training. If hon. Members visit any website tonight, they will see huge adverts saying, “Become a dermal filler specialist: training and qualification online within half an hour”—even less time in some cases. The people offering such services have no qualifications whatever, because the qualifications are not worth the paper that they are written on, but these people start carrying out invasive procedures without anybody stopping them. They can do it in a kitchen, or in any area that has not been clinically cleaned and is not of a standard that we would expect for medical procedures. It is a multimillion-pound racket that includes both the people offering the training and those carrying out procedures. It is an increasing issue, which needs to be addressed.

We also need to address the issue of advertising. As I have said before in the House, the Advertising Standards Authority is frankly a complete waste of time. If hon. Members go on any website tonight, or even open the national newspapers, they will see people advertising these services—potentially dangerous procedures—without any qualifications. We might ask, “Why would people have these procedures?” Well, I suggest that everyone reads the Mental Health Foundation’s 2019 report on body image, which shows the increasing pressure on young people.

The right hon. Member for Romsey and Southampton North is correct that this issue mainly affects young women, but it is increasingly an issue for some young men. The pressure of factors such as advertising and photo enhancements lead people to think that there is the perfect individual, but—apart from you, Mr Deputy Speaker—I am not sure that there is. The foundation’s reports highlights the pressure that is put on young people, but particularly young women. If they look at prices for procedures, they end up going to people who are completely unqualified. It is a scandal that there is no legislation to prevent this.

--- Later in debate ---

[Sarah Olney (Richmond Park) (LD)]

I rise to speak in support of amendment 10, tabled by the right hon. Member for South West Surrey (Jeremy Hunt), the Chair of the Health and Social Care Committee, because the amendment reflects the key issue facing the NHS and all our health and care services at this time: the workforce. Access to healthcare services is the No. 1 issue raised with me by constituents at the moment, and I know that concern is being echoed in other constituencies across the country.

People are experiencing the issue in many different ways. Some are struggling to get a GP appointment. I regularly speak to parents in great distress because of the lack of available help for their children’s mental health needs. The accident and emergency department at Kingston Hospital in my constituency has regularly had to ask patients to consider whether there are more appropriate sources of help for their needs. Patients waiting in the backlog of elective procedures are regularly having appointments rescheduled or cancelled. Ambulances do not always arrive when called.

The impacts are many and various, but when I speak to health service leaders in my local area, the answer is pretty much the same: there is a lack of available staff. Even in cases where lack of funds is not in itself a limiting factor, the lack of people with the relevant skills makes it impossible to fill all the vacancies they are able to pay for.

Many of these problems are covid-related. The current NHS waiting list is estimated to be over 6 million, and it is clear that much of that is because so many elective treatments were delayed during lockdown. Demand for mental health services has accelerated because of the impact of the lockdown, particularly on young people. Covid is still with us, of course, and workforces in every part of the economy are being impacted by the need for individuals to isolate when they have symptoms or test positive. Healthcare staff need to be more vigilant than the rest of us.

Many of these problems are also Brexit related. A lot of young Europeans decided to return to their home countries at the start of lockdown and have not since returned. Brexit has stymied our ability to recruit from the EU, shutting off an extremely important supply for all parts of the labour market, but the effect is being felt most markedly in health and social care, since it is having to manage the extraordinary demand of a global pandemic at the same time.

Many of these problems are also the result of a long-term failure to correctly predict or prepare for workforce demand. One of the huge advantages of a national health service is that it is possible to get clear data from right across the sector and to make appropriate plans and decisions. For some reason, that has not been done, and it is absolutely right that the Government should adopt amendment 10 to start to put that right.

I want to amplify a Backbench Business debate that I was able to bring to this Chamber a few weeks ago, in partnership with the right hon. Member for South Northamptonshire (Dame Andrea Leadsom) and the hon. Member for Newcastle upon Tyne North (Catherine McKinnell). It was on the subject of giving every baby the best start in life, and it was the firm view of all who attended that debate that the health visiting workforce needs to be substantially boosted to enable all new parents to receive a home visit from a trained healthcare professional. During the course of that debate, we heard of the many ways in which a health visiting workforce can support new families and the critical role they play in supporting babies and their families. One estimate is that the cost of poor parental mental health in the first year of life is more than £8 billion. It is clear that the cost of boosting our health visiting workforce would more than pay for itself in a very short time.

I also want to reflect briefly on a conversation I had with a constituent in the street in Richmond town centre on Saturday. Despite having two degrees, she was working in the care sector, and she was talking to me about her terms and conditions of work. She is employed by an agency and is not allowed to engage with any other agency. She is on a zero-hours contract, so she has to sit at home and wait to hear how many hours she might be required to work the following week. For various reasons that suits her, but I feel that it underpins the recruitment crisis we are experiencing in our social care sector, because that is no way to retain skilled and committed staff.

[Mr Kevan Jones]

Does the hon. Lady agree that it is not just about levels of pay and uncertainty for those individuals, but ensuring that we nationally accredit the qualifications of those individuals and address the career paths that do not exist in those sectors at the moment?

[Sarah Olney]

The right hon. Gentleman is absolutely right, and that is the point I want to make: we need to boost the status of our care home staff and improve their terms and conditions. We need to improve their pay. This lady who I spoke to on Saturday was telling me that she gets paid for the hours she spends in people’s homes, but not the time spent travelling in between. It is clear to me that the crisis of staffing we are experiencing in our care sector—I think every one of us as MPs is hearing about it regularly from our constituents, who are at the sharp end of that—is as much about workforce planning and improving terms and conditions. The Government needs to give that the most urgent attention, and amendment 10 would go some way to resolving that, although it will not resolve it entirely.

I know that Ministers will push back against the cost of boosting the workforce in all areas of the NHS, but they must surely realise the cost of failing to do so. The right hon. Member for South West Surrey. along with the hon. Member for Central Ayrshire (Dr Whitford), spoke about the cost of locum resource in the NHS. It is not just about the direct cost of locums or of worsening health outcomes as people wait longer for treatment; it is also about the lost productivity of days off sick, the cost of poor mental health as lives are put on hold and, as has been mentioned many times, the cost of exhausted and demoralised staff who are overwhelmed by the demands on the NHS. We cannot afford to continue to fail to effectively plan our healthcare workforce.

I am also very happy to support the amendments tabled by the hon. Member for North West Durham (Mr Holden) on virginity testing and hymenoplasty. I am delighted that the Government are adopting the provisions on virginity testing. We still have much to do to make this country a safe place for women and girls, but all progress is to be welcomed, and I am very glad that this opportunity to bring to an end the degrading practice of virginity testing has not been lost. I congratulate the hon. Member for North West Durham on all the work he has done and, although they may have left the Chamber, the representatives of the other charities referred to earlier. I hope in due course we will see the provisions for hymenoplasty as well, when the review has concluded.

Giving Every Baby the Best Start in Life

Lord Beamish Excerpts

Tuesday 9th November 2021 Commons Chamber

[David Simmonds (Ruislip, Northwood and Pinner) (Con)]

All of us in this House who are parents or have young children among our family and friends will know that there is an abundance of advice available on the topic of today’s debate and many of us take that advice: we talk to our babies in the womb; we play games with them before they are born; we study baby-led weaning; and we invest in stain-proof covers that never seem to extend quite far enough. But wherever on the nurturing scale we sit as mums and dads, babies thrive when they are surrounded by adults taking an active interest.

The focus of my contribution is the babies and young children who need extra help to thrive—those whose interests are at the heart of the decision by the Government to invest in family hubs in the recent Budget, as championed by my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom). As many Members have said, it is welcome that this agenda is taking a higher profile in the context of levelling up, because we all recognise the need to build on sound foundations.

Twenty years’ experience in children’s services has taught me a lot about the strengths and weaknesses of the child support system in our country. Like our NHS, we are very good at emergency services, and studies by academics at the University of Bristol and the University of Warwick show that the UK has a world-leading child protection system. But today’s debate goes beyond protection from harm, and into how we help children to thrive and flourish—something that is a matter not just of social responsibility but, as my right hon. Friend the Member for South Northamptonshire highlighted, of long-term economic benefit to our country.

Thriving children live lives that cost the taxpayer less and contribute more to everyone’s benefit. To that end, I am going to offer three points, which are focused on how we turn the widely-shared aspiration that we hear in the Chamber—I grew up in the village of the hon. Member for Pontypridd (Alex Davies-Jones) and am glad to hear of the progress it is making—into a change that children and their families can see and feel in their lives.

First, we need to follow the flow of money. The funding for early years, which is a key statutory responsibility for all local authorities, remains mired in bureaucratic processes that are dominated by those whose focus, for good reasons, is elsewhere. Schools forums, which determine the distribution of the dedicated schools grant, in which much of this funding sits, are dominated by the interests of our secondary schools. A fragmented early years sector of small private, voluntary, charitable providers often struggles to be heard. There is a structure around the money that inhibits innovation and flexibility, and stands in the way of creating the joined-up local offer that my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton) highlighted. Although I can see that there is a perceived political benefit to lumping that early years funding in with schools, in reality the needs of the sectors are different.

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

I have listened carefully to what the hon. Gentleman says about ringfencing and I do not disagree, but that is why Sure Start funding was directed through local authorities and ringfenced at a local level for local authorities to draw up their local strategies. He talks about levelling up, but this process did not start in 2019. We have seen the devastation of Sure Start centres, certainly in County Durham, as a result of cuts to that funding by his Government—although I know that he perhaps was not in the House then.

[David Simmonds]

It is good to hear the right hon. Member’s contribution. I was in a local authority throughout Sure Start’s implementation period, and although it was welcome to see a Government giving a high degree of priority to children in the earliest years of their lives, there were a number of failings with that programme. One was that the pace at which Government sought to deliver it—for understandable reasons, it was a political priority—meant that poor decisions were often made about the location of services and exactly what was delivered. At a time when many activities outside Sure Start were a high priority for local areas, Sure Start was generously funded to meet the Government’s aspiration while other activities, such as child protection, were starved of cash. Although all Governments want to deliver their priorities, we need to achieve a longer-term consensus about what is in the interests of children in the earliest years of their lives.

I call on Ministers to consider how we free the early years sector from the shackles imposed by the dedicated schools grant and bring it together with other local authority and NHS budgets, so that investment can be aligned with the needs of local families and built on the strengths of the early years sector. We must not forget that the sector is not just about nurseries; it provides an opportunity to join up with a range of local statutory and non-statutory services, which include health visiting, child minding, family hubs, child protection, public health, vaccination services, libraries, play and informal learning. When I was a new parent, the services provided by the libraries of the London borough of Hillingdon, including story time for young children, were an outstanding example of that early support. They were a chance to meet other parents whose children were at the same stage, to get informal advice and tips. That may sit outside what Government mandate, but it is exactly the sort of thing that parents of young children treasure.

Having touched on the funding challenge, we need to ensure that every area has the scope to develop a strategy for thriving that suits local circumstances. Many of our councils—the 152 top-tier authorities—are in partnership arrangements of one kind or another. Some are council to council, and others reflect outsourced services. That all reflects issues of local need and capacity. Along with the statutory lead member for children’s services and the director of children’s services, the health and wellbeing board has the most scope to join up the offer to get babies the best start in life. Those boards—statutory committees of the local authority—still struggle to assert their role, especially with the NHS, which in my experience is strategically disengaged, despite their role as key partners.

The rearguard action fought by the NHS against making public health a local and accountable service has also inhibited innovation and tied up resources in rolled-over NHS contracts rather than stimulating the reshaping of local services around children. I have seen some outstanding examples of such reshaping, however. I pay tribute to my constituent Dr Jide Menakaya, a leading paediatrician who has led work across the sector in his field of neonatal care in the London borough of Hillingdon to join up children’s services and Sure Start so mums and dads have a seamless experience. However, the system still tends to stand in the way of creativity rather than promoting it.

My suggestion to the Front-Bench team is that, in line with previous asks of our health and wellbeing boards—for example, to produce joint strategies on child mental health—we look at setting a clear expectation for them on a strategy for helping children to thrive in line with the first 1,001 days ambitions. Much of this already exists in different forms at a local level, but for a new parent or an expectant family, it can feel hard to access and fragmented, because it is driven by the disparate duties and funding regimes imposed by Government. In line with the local offer for children with special educational needs and disabilities, a strategic approach to the local offer for the earliest years will deliver greater value for money and, vitally, greater coherence for parents who access it.

The final area that I would like to put forward for consideration is accountability. Successive Governments have adjusted the regulatory environment for the early years, but broadly speaking the two priorities today are school readiness—seen in the regulation of settings such as child minding and nurseries—and the avoidance of harm to children, which is seen in the regulation of child protection and the NHS. We are in a context where resources are extremely stretched—not just money, but, as we have heard from a number of Members, the workforce too—which tends to drive a risk-averse approach in the early years, prioritising the absence of failure, rather than the promotion of innovation. We need to consider how we line up the accountability that we have all talked about with what we are seeking to achieve for our children. My suggestion to Ministers is that we need to look beyond the current inspection regimes and datasets used for performance management, many strengths though they have, and think about how we measure the things involved in a child thriving—the positive health and social outcomes that we want for babies in our country and how we incentivise the behaviour that will deliver them. Time is tight, so I will simply say that we have so many statutory duties in place that will help us deliver that, but so often the holders of those duties lack the autonomy needed to fulfil the aspirations we have. We need a permissive approach from Government.

In conclusion, we need to recognise that much of what we do is world class and of the highest quality, as many parents of young children, including me, can attest, but the regulatory regime still too often expects low standards. Rather than contributing to success, we have a complex funding system that stands in the way of local communities and their leaders delivering value for money and good outcomes for every child. We all want to give our babies the very best start in life. By enabling local leadership, setting high standards and setting people free to innovate, we give ourselves the best chance of levelling up life chances for all our children.

Covid-19 Vaccinations: 12 to 15-year-olds

Lord Beamish Excerpts

Monday 13th September 2021 Commons Chamber

[Nadhim Zahawi]

The important thing to remember is that the JCVI’s advice was very much predicated on what it was clinically qualified to look at. It was its recommendation to the chief medical officers to then take a further look. My hon. Friend will recall that JCVI’s advice was that, on balance, it is beneficial for children to have the vaccine rather than not have the vaccine, but not enough to recommend a universal programme, hence its advice to CMOs to go further on that. The work the CMOs have done in recommending a single dose is very much predicated on the data they have seen. JCVI, by the way, were in the room during the deliberations from America and elsewhere on the myocarditis on the second dose.

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

I welcome the statement from the Minister tonight. I agree with my right hon. Friend the Member for Leicester South (Jonathan Ashworth) when he says that clear information will be key. I would just suggest that social media might be more effective with young people rather than leaflets. May I raise an issue around children with special educational needs? Some may already have been vaccinated because of vulnerabilities. Will the Minister outline what arrangements have been put in place for schools and cohorts of individual children with special educational needs? It will need a lot more effort and time to ensure we get them vaccinated.

[Nadhim Zahawi]

The right hon. Gentleman is quite right. A number of children with special educational needs would have been vaccinated already, because they would have come under the earlier JCVI recommendation. The school-age vaccination programme does pay particular and careful consideration to those schools, working with school leaders and making sure that parents are able to get all the information. I mentioned leaflets earlier, but of course there will be a digital information programme as well.