Coronavirus Act 2020 (Expiry of Mental Health Provisions) (England and Wales) Regulations 2020

Lord Walney Excerpts

Wednesday 25th November 2020 Grand Committee

[Lord Walney (Non-Afl)]

My Lords, I add my praise to the noble Lord, Lord Davies of Brixton, on making an accomplished maiden speech and I welcome him to the House. He notes that he is the first actuary ever to speak in the House of Lords. I guess that it is something of a coincidence that at least two former Ministers in the Department for Work and Pensions will have had a great deal of contact over the years with actuaries: the noble Lords, Lord Blunkett and Lord Hunt of Kings Heath. I served as a special adviser with the noble Lord, Lord Hunt, and we had a number of conversations with actuaries over the years. I hope that this does not damn him with faint praise, but the speech of the noble Lord, Lord Davies, was the most engaged and enlivening to be given by an actuary that I have yet had the privilege of listening to. I know that he will enlighten the House in many ways in the years ahead, and I welcome him.

Let me praise the Minister and his colleagues in the Department of Health and Social Care for taking this early step to remove these provisions. It is an unusual and commendable act to take swift action on a measure that was due to expire anyway, and it sends a welcome message about the Government’s attitude to mental health issues in that they have clearly heard and understood the grave concerns of many advocacy groups and individuals about the draconian level of these powers. It will help vulnerable individuals at an incredibly difficult time in their lives because of the trauma of lockdown restrictions to know that these provisions are no longer hanging over them. Let me give credit where it is due.

I will echo a number of previous speakers in raising concerns about the overall system. It is a symbol of the way that public services tend to act in that they have a bare level of functionality at the crisis end but remain desperately lacking at the preventive and therapeutic end of mental health provision, which remains a yawning gap. As many speakers have said, including the NHS Confederation, the peak has probably not yet come, and I hope that in the months ahead we will hear far more from the Government and the Minister about what action can be taken on that front.

Children and Mental Health Services

Lord Walney Excerpts

Tuesday 16th July 2019 Westminster Hall

[John Woodcock (Barrow and Furness) (Ind)]

Thank you for calling me early, Mr Pritchard; it is a pleasure to serve under you. I apologise to the hon. Member for Burton (Andrew Griffiths) for arriving late. I was in the main Chamber for the domestic abuse statement, which unfortunately ran over a little. I commend him and those who made interventions on what I heard them say. I am sure that throughout this debate we will be given shocking examples of how this is truly a nationwide crisis. Any Government of any hue must, as a first step, be honest about the scale of the problem and how much is being stored up for future generations, as was said eloquently by the hon. Gentleman.

I will give the Minister and the Chamber a couple of the many examples I have received from constituents who have got in touch. Drew is a nine-year-old boy whose mother contacted us in March last year in a desperate state. On a weekly basis, Drew talked about killing himself; he would regularly go so far as to put a rope around his neck. Obviously, they were seeking urgent medical help for Drew.

Fifteen months later, Drew had his first appointment with CAMHS. That was 15 months when that child was at risk and that family was going through something—it is really hard for parents to imagine their child in distress, desperately reaching out for help and just being put on an interminable waiting list. Drew’s mum is left wondering how best to house her family. Her benefits have been reduced because of the bedroom tax. The need for Drew to have a separate room is not acknowledged, despite the fact that he is aggressive and sometimes violent towards his sibling. His mum is now forced to confront the prospect of Drew sharing a bedroom with her. That is deeply inappropriate and a sign of a system that is broken locally.

Another example is a child who was deemed to be a clear suicide risk. A significant amount of resource was placed into multidisciplinary team meetings for the child, but in meeting after meeting, for whatever reason, CAMHS did not show. The process to provide appropriate help for that child could not go ahead and deeply scarce resources were being burned up. It was only after the intervention of our team that we managed to bring CAMHS to the table.

Professionals want to do things. No one goes into this field wanting to do the wrong thing; they go into it to help, but the resources are not there and often the system is inefficiently resourced. I briefly pay tribute to the work of the local commissioning group, which as of last week has put in some resource for mental health professionals to work across schools, but it does not come close to the level needed. I beg the Minister to listen and to do what she can to get the Government to act.

NHS Dentists: Cumbria

Lord Walney Excerpts

Wednesday 3rd July 2019 Westminster Hall

[Tim Farron]

The hon. Gentleman makes a good point; in a moment I will come to some answers to those problems. The challenge is especially acute in rural communities when it comes to attracting and retaining dentists to work in NHS practices in places that are relatively close to people’s homes.

[John Woodcock (Barrow and Furness) (Ind)]

I congratulate the hon. Gentleman on securing this debate on all our behalves. The problem affects not just rural areas but more remote urban areas such as Barrow. Does he share my huge concern that people in Barrow face a 90-mile trip to Whitehaven if they want access to a new NHS dentist? That is the longest trip in England, for a town where more a third of young people suffer tooth decay, compared with 5% in more affluent areas.

[Tim Farron]

The hon. Gentleman makes an excellent point, which I will come to. He is absolutely right that the distance from the nearest available treatment affects urban as well as rural areas. It is a problem across the country that relates specifically to the NHS dental contract, which I will come to in a moment.

According to the most recent data available, taking a child living in Windermere to their nearest NHS dentist will involve a 60-mile round trip to Morecambe in Lancashire. That will mean a three to four-hour journey by public transport, with multiple changes. However, poor signposting by the NHS—it was not easy to decipher—means that that place is not obviously available. The nearest place advertising for new child NHS patients is in Appleby, which is an 87-mile round trip—two hours in the car or a five to six-hour round trip by public transport. It was only with the help of the British Dental Association that we managed to identify availability at the far-distant yet ever so slightly closer practice in Morecambe.

I am sure hon. Members will agree that this is beyond ridiculous. NHS dentistry is a public service. It should not take scouring the internet forensically with a fine-toothed comb and with the expert help of a national professional body to find a space for a child with an NHS dentist. That space has already been paid for through our taxes. Let us imagine for a moment the outrage if it were similarly impossible for people to get access to a GP.

For adults, the situation in Cumbria is even worse. I was appalled to discover that the nearest practice with available NHS provision for a new adult patient in Windermere involves a 98-mile round trip by car to Wigton—a six-hour round trip by public transport, involving three different trains and bus rides. The nearest practice that is adverting is even further away and involves a 104-mile trip, there and back, to Alston, taking over six hours by public transport. After that, the next option listed involved going 123 miles there and back to Blackpool.

Despite those obstacles, families in our communities are still trying to secure places at dental practices but are refused. In Sedbergh, Windermere, Grange, Ambleside and Kendal, dentists are working to their full capacity and even beyond, and are doing a brilliant job, but they simply do not have the numbers or the funding to meet demand. The Government have, cleverly or accidentally, dodged confronting the extent of the problem by doing away with official waiting lists. For the last six years, the NHS has held no waiting lists locally or nationally, and patients cannot depend on their clinical commissioning group or NHS England to support them in their quest to find a dentist who will treat them or their children. Will the Minister rectify that and ensure that reliable and up-to-date waiting lists are kept from now on?

We took the matter into our own hands locally. The Westmorland Gazette and I rang round our local dental surgeries to see whether there was availability, and found that in Kendal, not one of the 10 dental practices in our biggest town had a single space available for an NHS patient. Some 33% of new patients tried and failed to get a dentist appointment in the wider Morecambe bay CCG area last year. That is the equivalent of nearly 16,000 people. When we include those already on the books with a dentist, that figure rises to 18,000 people, and they are just the ones who have tried. That is a disgrace, and the situation is only getting worse.

The consequences should not be underestimated. Children across Cumbria have some of the worst dental health in England, with one in three suffering tooth decay by the age of five. In some areas, almost 20% of children under three have tooth decay, and a fifth have tooth decay when they are still toddlers. Often, that does long-term damage to their oral health before they even have the opportunity to make decisions for themselves. If children cannot see a dentist in a regular and timely way, preventable conditions become emergency conditions and the pressure is piled on NHS services, along with all their other responsibilities.

Nationally, tooth decay is the leading reason for hospital admissions among young children, despite being almost entirely preventable. In 2017-18, over 45,000 children were admitted to hospital to have multiple teeth extracted under general anaesthetic because of tooth decay. Children face completely unnecessary pain and distress, and the NHS faces a £36 million annual spend for that dental work. Dentistry in Cumbria is understaffed, underfunded and overstretched. Although this a local problem, it is a symptom of a systematic one, the effects of which are felt right across the country.

The primary cause of the increasing problems with dental access in Cumbria and across England is the way that this Government choose to commission dentistry. The NHS dental contract is completely perverse. Based on units of dental activity, it sets quotas on the number of patients an NHS dentist can see and the number of dental procedures they can perform in any given year. If a dentist delivers more than they have been commissioned to do, not only are they not remunerated for the extra work, but they have to bear the cost of any materials used, any necessary laboratory work or other overheads from their own pockets.

That is not the only issue. Last November, I managed to secure the agreement of health bosses to increase the contracts of local NHS dentists in Kendal, so that they could see and treat more patients. It was great news—I thought. However, when NHS England contacted our local dentists, it found that not one of them was able to take up its offer because, as it told me,

“the practices are already working to capacity within the staffing resources they have available, reporting they are having difficulties recruiting additional staff.”

Additional resources were made available, but there were not the dentists to provide the service for local people.

The problem is at least in part the result of the contract, which pays a set amount for particular types of treatment, in some cases regardless of the number of teeth the dentist is treating. In practice, that means that a dentist gets paid an average of £75 for an entire course of treatment, including six fillings, three extractions and a root canal, but that is not enough to cover their overheads. They get paid exactly the same amount of money for a single filling. That acts as a serious disincentive for dentistry, full stop, but especially in more deprived areas, where evidence shows that more significant treatment is often required.

Perhaps the most significant issue with the current dental contract is that it totally fails to provide any serious recognition or budget for preventive work. The work of educating adults, parents and children to maintain good dental health receives no funding, despite the fact that that would significantly ease the burden on dentists and the NHS as a whole further down the line. Indeed, check-ups are the smallest and least-remunerated part of the unit of dental activity worksheet. As a consequence, there is no massive incentive to up the number that a dentist does.

None of that is helped by the Government’s decision to cut £500,000 in the last few months from Cumbria’s public health budget this year, undermining vital preventive work, especially in our schools. Nor does it help that we are currently in limbo when it comes to the future of emergency dental services under the soon to be defunct Cumbria Partnership NHS Foundation Trust. Will the Minister tell me which trust will be responsible for emergency dentistry in south Cumbria after October?

Morale among dentists practising in the NHS is at an all-time low. The latest British Dental Association membership survey shows that nearly three in five dental practitioners in England are planning to scale down or leave NHS work entirely in the next five years. Those with the highest NHS commitments are the most likely to want to leave. In recent months, I have received countless letters at an increasing rate from residents, many of them very elderly, asking where they can go for dental treatment, as their current dentist has gone private and they have effectively been kicked off the list. A lot of parents have contacted me saying that they have been asked to pay now that they have been kicked off their local dentist’s NHS list. If they pay, the dentist might provide NHS provision for their children. It strikes me that that is a form of bribery. Many parents cannot afford to pay for themselves just so their children can get free care. That is not right.

The current system also fails to use the skills of all dental staff to their full potential. The NHS dentist contract restricts the initiation of a course of treatment to dentists alone. I met the British Association of Dental Therapists, which explained that dentists often refer the patient to a therapist to carry out the treatment if it is within the remit of their qualification. The fact that that can be begun only by a dentist creates a bottleneck that prevents patients from receiving the treatment that they need when they need it. The dental therapists made the case to me—and, I believe, to the Government—for reforming the system to allow them to initiate a course of treatment, ease some of the burden on dentists, and enable patients to be seen more quickly. I ask the Minister to action that request, or at least to look into it as a matter of urgency.

I welcome the Government’s steps to reform the system by beginning to carry out a few pilots and trials in different forms of commissioning, but the pilots have not gone far enough, there are not many of them, and the proposed systems do not provide a complete break from the old “unit of dental activity” system. Rather, they blend it with new systems. In the face of the crisis that we have on our hands, I am afraid that a piecemeal change is simply not enough for the people of Cumbria. We need total system reform. The Government need to sit up, take notice and change the contract so that people get the dental treatment they need. The current system is unjust, not fair to dentists and patients, and not fit for purpose. It is not good enough for Cumbria.

Urgent action is needed to roll out a system that fairly rewards dentists for the work they do, includes incentives for preventive work and allows all dental practitioners to use their skills to their full capacity. If we want our NHS dentists to feel that their vital work is valued and not to feel encouraged to move into working privately or give up the profession altogether, we need to take swift, far-reaching action. We need a funding system that does not feel like a treadmill, that rewards preventive care and that is not riddled with unfairness, idiosyncrasies and perverse incentives.

Those of us living in Cumbria are seeing the colossal impact of the current system on the health of children and adults alike, and we are further affected by the huge distances that we have to travel to get care, if we are lucky enough to stumble across an NHS dentists with available space. My question to the Minister is this: what action will she take to provide my constituents with the NHS dental healthcare that they desperately need and that their taxes have already paid for?

--- Later in debate ---

[Seema Kennedy]

The hon. Gentleman anticipates my speech: I will talk about contract reform later. He knows much better than me that the problem with the previous contract was that it was introduced with perhaps a bit too much haste, and we are now living with the consequences. We are mindful that we need a contract that works well and is sustainable for the future.

Nationally, we are introducing so-called flexible commissioning, which allows local NHS commissioners to commission a wider range of services from dental practices. That is expected to make NHS dentistry more attractive to new performers. Another key recruitment and retention challenge—of course, this is not confined to dentists; it applies to a whole range of healthcare and other professionals—is the growing demand among younger dentists for more varied portfolio careers. NHSE is working closely with Health Education England and a wide range of stakeholders to make portfolio careers a reality for dental professionals, allowing dentists to move between specialities such as prevention, restorative work, oral health and special care dentistry.

We want UK-trained dentists in the NHS, and we want them to stay in those careers, but dentists from overseas also play an important part in delivering NHS care. I am pleased that the NHS and the Government have taken steps through the launch of the EU settlement scheme to maintain that essential supply of dedicated and skilled workers, including European economic area-trained dentists, when we leave the EU. Last summer, doctors and nurses were removed from the tier 2 cap, leaving more places for other highly skilled professionals, including dentists.

The interim NHS people plan, which was published early last month, commits to creating a capable and motivated multidisciplinary dental workforce of a sufficient size to meet population health needs. The full people plan will be published later this year.

We are working closely with NHSE to reform the current dental contract. Feedback from dentists who are testing the prototype contract suggests it is a more satisfying way of delivering care. It supports a better skills mix, allowing dental care to be supported by a wider range of staff, such as therapists and hygienists. At a meeting a couple of weeks ago with a wide range of dental stakeholders, I announced that a further 28 dental practices had joined the programme, bringing to 102 the number of practices that are testing the new prevention-focused way of delivering care. NHSE is considering carefully when that approach can be rolled out more widely across the NHS. It is important that we get the new contract right, but I am hopeful that the roll-out will happen as soon as possible.

I want to touch briefly on three questions hon. Members asked. The first and most important was about children’s oral health. I heartily agree with the hon. Member for Westmorland and Lonsdale about the importance of children’s oral health and all the preventive measures the Department can take to protect children’s teeth. He rightly pointed out something that not all hon. Members are aware of: the biggest cause of emergency admission for children is poor oral health. Of course, that is entirely preventable. The Government are committed to that, particularly among deprived children. We have made the Starting Well approach available to other NHS England commissioners, and that is promoting increased access and early preventive care for very young children.

[John Woodcock]

That more than a third of children under five in Barrow have tooth decay is truly appalling. The Government need to make faster progress. I assume the Minister would vigorously oppose any attempt to weaken the sugar tax, which is designed to move people away from that harmful substance towards a healthier lifestyle.

[Seema Kennedy]

The hon. Gentleman makes a very timely intervention. We can see how successful the soft drinks industry levy has been in how it has helped to reformulate sugary drinks, the amount of money it has raised that has been recycled into school sports, and the fact that it is changing people’s tastes and behaviour. The prevention Green Paper is in train; let us hope that he is pleased with what is announced in it.

The hon. Member for Westmorland and Lonsdale mentioned emergency dentistry and I will have to write to him with specifics about the commissioning of services.

On the public health budget, I know from conversations with Members across the House that there are pressures on local government budgets. The ring-fenced public health budget will be a matter for the forthcoming spending review, when it will be assessed using all available evidence. The hon. Gentleman can be assured that I will take away all the evidence I gather from meetings with Members across the House and in my ministerial position to feed into the spending review process.

Acquired Brain Injury

Lord Walney Excerpts

Tuesday 2nd July 2019 Westminster Hall

[The Parliamentary Under-Secretary of State for Health and Social Care (Seema Kennedy)]

It is a pleasure to serve under your chairmanship, Mr Rosindell. I thank the hon. Member for Rhondda (Chris Bryant) for introducing the debate, and for challenging the Government on this important issue. He is an indefatigable champion for those living with acquired brain injury, about which he has taught me a lot in the few months for which I have been in my position.

I also thank all right hon. and hon. Members who have spoken, and those who have been present but have not spoken. People have shared personal experiences—things that are painful to them, and that they have lived with for a long time. I particularly welcome the hon. Member for Newport West (Ruth Jones) to her place. I think that this is the first time that I have responded to a debate in which she has spoken.

As with many long-term conditions, ABI affects not only a person’s health but aspects of their family life, work and relationships. I responded to the debate on 9 May. I am still chasing ministerial colleagues in other Departments for their comments, but because time is quite short I will focus today on the many points that have been raised about the health aspects. However, I will go back to ministerial colleagues, chase them and impress on them that this important issue affects many Government Departments.

I met representatives of Headway after the debate on 9 May, and I thank those who work with Headway and organisations such as the UK Brain Injury Forum. Such organisations are really valuable to people living with ABI. They raise awareness and provide help to support those with the condition, as well as families and carers. The hon. Member for Darlington (Jenny Chapman) mentioned how important that is. I take on board the report of the all-party group, to which the Government responded, and I pay tribute to the hon. Member for Rhondda and my right hon. Friend the Member for South Holland and The Deepings (Sir John Hayes).

In 2014, two years after the introduction of major trauma centres, there was an independent audit of the regional trauma networks, commissioned by NHS England. That audit showed that patients had a 30% improved chance of surviving severe injuries, and that the networks had saved 600 lives. That does not mean that they are perfect, but some progress has been made since their inception. Although the majority of rehabilitation care is locally provided, NHS England commissions specialised services for those patients with the most complex levels of need. For people who have ABI, timely and appropriate neuro-rehabilitation is an important part of their care.

I thank the APPG for all the work it has done on rehabilitation prescriptions, which reflect the assessment of the physical, functional, vocational, educational, cognitive, psychological and social rehabilitation needs of a patient, and are an important element of rehab care. Of course, the APPG report stated that all patients with ABI should benefit from an RP.

I will touch on lots of the points that Members have mentioned. In particular, I thank the hon. Member for Rhondda for drawing the House’s attention to the third and final report of the audit, which was published in April 2019, only a few days before we last discussed this matter. It is encouraging that 94% of patients accessing specialist rehab have evidence of functional improvement, but the report suggests that there is more work to be done to ensure that all patients who could benefit from specialist rehabilitation can access it.

[John Woodcock (Barrow and Furness) (Ind)]

Does the Minister share my concern that there is no universal information for when people present at A&E or the doctor’s with a head injury? After I fell off a ladder in 2012, I was surprised that I was not given so much as a leaflet to say that there might be long-lasting effects. Some people are clearly good at picking it up, but it should be absolutely obvious that everyone who strikes their head should be given extra attention by the NHS in case they develop symptoms.

[Seema Kennedy]

I thank the hon. Gentleman for raising that point. I was talking to another colleague who had a brain injury just last year, and she said exactly the same thing. That was not in A&E; it was at a GP practice. There are of course training modules for GPs to access, but debates such as this one and my conversations with NHS England can only help in raising awareness. I thank the hon. Gentleman for bringing that point to my attention.

To return to the audit, its authors estimate that current provision caters for 40% of those who need the services, so there is a lot more to do. On capacity, the audit made some recommendations, including that trauma centres should review their processes and ensure that standards for rehabilitation provision and availability are met, and that commissioners should consider opportunities for development of specialist rehab capacity, both for in-patient and community-based services—a point that hon. Members have raised. These are important points. Although we only had this debate two months ago, I am glad that the hon. Member for Rhondda has raised the subject again. I will discuss with NHS England what it is thinking, what it is doing on the audit and what the next steps are. We need to impress on it the importance of bed provision.

The majority of rehab care is commissioned and managed locally and there are guidelines produced by NHS England, such as the principles and expectations for good adult rehabilitation, which describe what good rehabilitation care looks like. There is additional guidance that covers both adults and children.

Many hon. Members mentioned neuro-rehabilitation for children, and I know that NHS England is aware that there is variability in the provision for children. Best practice guidance was published in 2016, but there is always more to be done. I will take the points away and speak to NHS England. We are looking at how we can educate people on foetal alcohol syndrome, and I am happy to report back to the House on that.

The hon. Member for Newport West raised a specific issue about speech and language therapists and physiotherapists. I very much agree that we need a joined-up approach to care and I am concerned to hear that there is a gap. Members can make representations to NHS England on that. I know the situation is different in Wales, but I would be very happy if the hon. Lady would keep me informed.

The hon. Member for Rhondda raised the injury cost recovery scheme. Again, that is a matter for the DWP and I will be pressing ministerial colleagues to respond on that point. That scheme allows for the recovery of costs for providing treatment to an injured person where that person has made a successful personal injury claim against a third party. It recovers funds from insurance companies and pays into the NHS or hospital ambulance services. The current cap is around £53,000, renewed annually in line with inflation. I will follow up with more detail—the hon. Gentleman looks slightly sceptical.

Services for People with Autism

Lord Walney Excerpts

Thursday 21st March 2019 Commons Chamber

[Trudy Harrison (Copeland) (Con)]

It is a pleasure to follow my hon. Friend the Member for Torbay (Kevin Foster), who made many powerful points. I commend my right hon. Friend the Member for Chesham and Amersham (Dame Cheryl Gillan) for securing this important debate ahead of World Autism Week and thank my hon. Friend the Member for Bexhill and Battle (Huw Merriman) for his outstanding representation of her in the Chamber today. I also commend the all-party group report, “Autism and Education 2017”, which was written in partnership with the National Autistic Society.

I am a member of the Education Committee, which is also looking into the needs of children and young people with special educational needs and disabilities. The autism APPG’s report contained some shocking statistics. The one that really upset me was that fewer than half of the children and young people on the autism spectrum going to school say that they are happy. It says that a lack of understanding from their peers and their teachers is the main reason for such unhappiness. The thought of any child or young person not looking forward to their day at school is, to me, so incredibly sad and utterly avoidable. We need better understanding and a co-ordinated resourced approach.

[John Woodcock (Barrow and Furness) (Ind)]

I do not wish to take up much of the House’s time, but has the hon. Lady had a chance to meet my constituent, Deborah Brownson, who has created extraordinary facilities through the online autism plan to help parents and children who are facing difficulties? If she has not met her, she should and join the campaign to get Government support for what Deborah is doing.

Oral Answers to Questions

Lord Walney Excerpts

Tuesday 27th November 2018 Commons Chamber

[Matt Hancock]

My heart goes out to the parents of this child, my hon. Friend’s constituents, as I am sure it does from everybody in this House. Of course I will happily take up this individual case. But she raises the broader point, too. I am meeting the Justice Secretary on this topic to discuss what further we can do. It is technically a matter for the Ministry of Justice, but I understand entirely why we need to work together to make progress.

[John Woodcock (Barrow and Furness) (Ind)]

Is not the Secretary of State alarmed that fake psychiatrist Zholia Alemi was revalidated in 2013 under the supposedly strengthened revalidation process? Why did the Government not act on the findings of the Sir Keith Pearson report in January last year, which pointed out this exact weakness in the system?

[Stephen Hammond]

The hon. Gentleman raised that matter with me last week. He knows that the Government take it very seriously and that we are asking the General Medical Council for an immediate review of that case, but I am happy to meet him to discuss it further.

Acquired Brain Injury

Lord Walney Excerpts

Monday 18th June 2018 Commons Chamber

[John Woodcock (Barrow and Furness) (Ind)]

It is a privilege to speak in this debate today. I often think how lucky I am to be able to continue speaking in this House at all. I was incredibly lucky because, when I fell off a ladder onto a wooden block in my attic in a classic case of what not to do around the home—I was 8 feet off the ground and my head 14 feet off the ground—I did not suffer a brain bleed. I was profoundly lucky to be in a job with a support system around me and with wonderful staff who were able to take the load from me for a full two years. At first, I was not able to work much at all except in very small bursts. I slowly built that up, but I had to resign from the Front Bench. I often think how the history of these past few years might have been different had I remained a shadow roads Minister under the then Leader of the Opposition.

In listening to these moving accounts from across the Chamber, I have found so many of them to ring true. My personality changed—largely for the better in many ways—but I became much less risk averse in a way that was not healthy. I suffered from depression. As I was recovering, I was not able to spend time with my small children. My marriage broke down, and I could work only for very small amounts of time. I feel so lucky, because there are so many people whose employment circumstances would not allow that at all and who would not have the system around them. I was lucky because I was able to understand the system and to ask for the best care. I eventually was referred to the best care in the NHS and I got it and I have pretty much been able to make a full recovery. My family will tell me what a nightmare I am whenever I try to find something because my short-term recall, which was never good in the first place, will never come back to even the mediocre place that it was in before.

I want to finish by saying that, yes, we should be so proud of the positive role that the NHS can play, but it is not the case that everyone receives good care when they acquire a brain injury. I am not saying this to complain, but it is important to state what happened. I was given great care by paramedics who thought that my back could be broken when I fell off the ladder. All the tests were done. I was very, very sore. When I was released the next day, I was not even given a leaflet to say, “Look out, here are the symptoms of a head injury.”

I thought that concussion was something that lasted for 24 to 48 hours. After a couple of weeks, I found that I still could not really work, except for very short 30 to 90 second bursts, I went back to my GP who said, “You have a stressful job and a young child. I think you are suffering from stress.” I said, “No, I’ve worked for Gordon Brown; I know what stress is. This is not stress.” It was only because I was able to push and because he had a personal relationship with the lead neurologist for the area that he picked up the phone and I was seen. So many people do not have that. I congratulate both my hon. Friend the Member for Rhondda (Chris Bryant) and the right hon. Member for South Holland and The Deepings (Mr Hayes) on securing this debate and Headway on the recovery that it has given and on spreading awareness of this condition, which we have to keep on raising to ensure that people get the care that they need.

Maternity Safety Strategy

Lord Walney Excerpts

Tuesday 28th November 2017 Commons Chamber

[John Woodcock (Barrow and Furness) (Lab/Co-op)]

The brand new maternity unit at Furness General Hospital will open shortly, thanks to the campaigning of the whole community, but it will be safer thanks to the Secretary of State’s personal commitment, thanks to the staff and thanks to the parents of Elleanor Bennett, Alex Brady, Chester Hendrickson, Joshua Titcombe and others who have campaigned tirelessly for local and national change. Will he join my calls for their struggle to be permanently commemorated within the new unit?

[Mr Hunt]

I am happy to do that. I think I have met most of those parents. The hon. Gentleman has been incredibly supportive to them locally—they have told me that. When Carl Hendrickson came to see me, he brought his 11-year-old son, and I offered for the son to wait outside, but he said no—he wanted his son to be with him. I think it was because he wanted his son to know that he had been to the top to try to understand why his child and his wife died because of mistakes in that maternity unit. The hospital has done an incredible turnaround job—we are all really proud of what it has done—and we are confident that it would not happen again, but that is not to say that there is not a huge amount more we all need to do.

Medicines Regulation

Lord Walney Excerpts

Tuesday 21st November 2017 Westminster Hall

[John Woodcock (Barrow and Furness) (Lab/Co-op)]

It is a pleasure to serve under your chairmanship, Mr Davies. It is unfortunate that I am following two superb contributions. I congratulate my hon. Friend the Member for Bishop Auckland (Helen Goodman) on securing this important and timely debate. She and my hon. Friend the Member for Lewisham East (Heidi Alexander) spoke powerfully and persuasively about the risks that the UK pharmaceutical industry in its entirety faces. I am not going to attempt to add to what they said and the questions they asked. Rather, I am going to focus on the cephalosporins business, which is carried out on three sites, two of which are in the UK—in the constituency of my hon. Friend the Member for Bishop Auckland and in Ulverston in my constituency, where there is a genuinely world-class sterile facility where the drugs are created. They are then placed in a powder form in Barnard Castle and in vials in Verona.

As the Minister is surely aware, there was great celebration in Ulverston, and it was heralded by the then Prime Minister and Chancellor, David Cameron and George Osborne, when David Cameron visited the day after the 2012 Budget and made a Budget roll-out announcement that GSK was going to be investing at least £350 million in a new biopharm pharmaceutical facility, largely as a result of the patent-box tax legislation, which the Conservative Government continued from Labour’s innovative tax policy, introduced by Prime Minister Gordon Brown. In July, GSK announced—out of the blue, for all intents and purposes—that it is going to pull that investment and scrap the entire project, leaving our community devastated. Not only that, but it is launching a strategic review of the existing cephalosporins business, which has been running for decades across both sites and is growing in profitability and potential.

Although cephalosporins are not a new product, they are well established. British manufacturing of such products in Ulverston and Barnard Castle, and across into the EU in Verona, has enabled them to penetrate new markets and benefit many more critically ill patients in hospitals. They are the very strongest antibiotics, and are typically used in hospitals for people with very serious vulnerabilities and infections. That business had and has a great future, but GSK has clearly signalled at a corporate level that it wishes to divest. Officially, that is a review of the business, but the company at the highest level is clear that it wants to find a new buyer.

When the company dropped its bombshell in July, it was clear and categoric that the decision was not as a result of Brexit. The company took care to say that, and we have to take it at its word. We can detect the thinking of the new chief executive officer, Emma Walmsley—a Barrovian, by the way, which has made the decision all the more stinging—that GSK wants to focus on fewer products, completely cutting some and potentially divesting itself of others. Although Brexit may not have triggered that deeply worrying blow to pharmaceutical manufacturing in the north of England, however, it is certainly a significant factor in whether we will be successful in finding a new buyer for the plant who is prepared to invest and to take the business to new heights, sustaining the employment of people in my constituency and in Barnard Castle, as well as creating more jobs in the decades ahead.

Every business, in no matter what sector, operates on the basis of wanting certainty and stability and of not liking uncertainty or the potential risk in what is at the moment the complete lack of clarity that the Government can give on the future of the regulatory environment for medicines in this country. I therefore really hope that the Minister is listening to what we are saying.

In another sector that is enormously important to our regional economy, civil nuclear, we do get a sense that, at the ministerial level at least, the Government are working hard to overcome this—I absolutely agree with my hon. Friends—absolutely nonsensical decision to rule out anything based on ECJ jurisdiction, thereby creating all the problems. We need to hear from the Minister that he is prepared to do whatever it takes to ensure that the transition is seamless. He should not only produce something a year down the line but give a level of certainty now, ready for GSK in Ulverston to attract new buyers to the site.

The Minister might be aware that I have formed the GSK Ulverston taskforce—which brings together community stakeholders and the site directors, with input from the Department for Business, Energy and Industrial Strategy and the local authorities—to ensure that we all maximise the chances of attracting a new investor. The decision will principally be a commercial decision, of course, but the Government can help in many ways. I would say that they have a duty and a responsibility to help, given the level to which they heralded the new jobs that have now been cancelled.

Other important areas include infrastructure, but I do not expect the Minister to go into those today. He can, however, acknowledge the difficulty that uncertainty causes to attracting new investors. I hope he will give more certainty today, and he should certainly undertake to go away and come back in short order to inform Parliament of what the relationship will be, so that the Government and we as a taskforce can better communicate that to the stakeholders.

My final request is that the Minister or his counterpart in the other place, Lord Howe—

[The Parliamentary Under-Secretary of State for Health (Steve Brine)]

Lord O’Shaughnessy.

[John Woodcock]

Lord O’Shaughnessy—apologies, the previous Minister in the Lords has moved on. I thank the Minister here for the correction. I hope that he or Lord O’Shaughnessy will meet with me, my hon. Friend the Member for Bishop Auckland and other members of the taskforce. Lord Prior was really helpful when he spoke to me on the day of the announcement but there has been significant progress since then and many more challenges need to be met. If the Minister undertakes to make that happen, it will be very helpful.

--- Later in debate ---

[Steve Brine]

We should always try to be courteous to one another in this House, if we can manage that. To refer to the previous point, DEFRA is responsible for animal medicines policy; EMA covers both human and animal medicines. The Department of Health and DEFRA work incredibly closely together; therefore, DEFRA Ministers answer on applications for animals. I can assist with that at any time.

We are working with Sir John Bell and others in the life sciences sector to consider the industrial strategy in more detail, and specifically what action can be taken by Government and industry in partnership through an ambitious sector deal. At the launch of “Life Sciences: Industrial Strategy”, the Secretary of State for Business, Energy and Industrial Strategy, who has been much spoken of already in this debate, reiterated the Government’s commitment to the sector by announcing the first phase of their investment—£146 million for leading-edge healthcare, which is expected to leverage more than £250 million of private funding from the industry.

Leaving the EU, with all its challenges, allows us to make fresh choices about how we shape our economy and presents an opportunity to deliver a bold industrial strategy that prepares us for the years ahead. Our approach to the EU exit negotiations for medicines regulation is focused on building on the strengths of the MHRA and the UK life sciences sector that I have just set out. As the UK leaves the EU, both parties will have the shared aim to protect the health of patients across Europe and to ensure the safe and timely access to medicines and medical devices that I know concerns hon. Members as it concerns me. It is in the interests of patients and the life sciences industry for us to find a way to continue UK-EU co-operation and to ensure continued sharing of data, even if our precise relationship with the EU will, by necessity, change.

Earlier this year, the Secretary of State for Health and the Secretary of State for Business, Energy and Industrial Strategy published an open letter in the Financial Times setting out Government’s aim to retain a close working partnership in respect of medicines regulation after the UK leaves the EU. Our approach is underpinned by three key principles, which are worth stating. First, patients should not be disadvantaged; secondly, innovators should be able to get their products into the UK market as quickly and simply as possible; and thirdly, the UK should continue to play a leading role in promoting public health.

Yesterday, obviously, the new location of the EMA was announced; in 2019 it will move to Amsterdam. Both the UK and the EU have a collective responsibility to make sure that the process is as seamless as possible, in order to minimise disruption to existing regulatory procedures and public health protection. There are no benefits to UK or EU patients in tearing up the sort of close working relationships that get crucial drugs on the market as fast as possible, share early alerts about problems with medicines or allow patients to benefit from new scientific discoveries earlier. As the Prime Minister has said, there is also no need to impose tariffs where we have none now, which is the case for medicines and medical technologies.

Continued collaboration is in the interests of public health and safety across the continent of Europe, and in the UK for our constituents, because we all know that health is different. Medicines and med tech are different from other consumer products. Patients who need an innovative treatment cannot simply pay more or consume less but otherwise carry on as they were, marginally worse off. We recognise that it could be the difference, as has been said, between life and death. We look forward to discussing these issues as early as possible with our EU counterparts as part of the negotiations.

[John Woodcock]

Presumably the Minister recognises the need for cross-border manufacture with European nations to remain absolutely seamless. The issue of cephalosporins in GSK affects not only in Barnard Castle and Ulverston but Verona, which obviously is in Italy.

[Steve Brine]

Yes, of course. I want to come on to the many different questions asked. The hon. Member for Central Ayrshire (Dr Whitford) said that Scotland would have bid for the EMA if it had voted yes a couple of years ago. I do not think that it would have done, because it would not have been a European Union member state.

[Steve Brine]

rose—

[John Woodcock]

On a point of order, Mr Davies. If the Minister is struggling and feeling unwell, is there a way in which we could bring the debate to an earlier close and he could write to us in response to our questions? I am concerned by how he seems.

[Geraint Davies (in the Chair)]

The Minister is the last speaker. He can stop the debate at any time, at which point I will ask Helen Goodman to make her closing remarks for two minutes. Feel free to end whenever you feel is appropriate, Minister.

NHS and Social Care Funding

Lord Walney Excerpts

Wednesday 11th January 2017 Commons Chamber

[Mr Hunt]

I will give way a couple more times, and then I am going to conclude my comments.

[John Woodcock (Barrow and Furness) (Lab/Co-op)]

As the Government often point out, they want to hand decisions to local groups, but could the Secretary of State explain to worried patients in the south and west of Cumbria why local health services are suggesting the changes to A&E in the west and potentially the south? I know he has spent a lot of time looking at this area.

[Mr Hunt]

First, I would like to use this moment to congratulate the hon. Gentleman’s local trust on coming out of special measures last year and on the progress it is making. In a way, that is the answer to his point. His local trust was in special measures, and North Cumbria is still in special measures. We had some profound worries about patient care in both trusts, and we still do in the North Cumbria trust. That is why the status quo is not an option, but we understand the concerns of his constituents and many others about some of the proposals being made.