Oral Answers to Questions

Martyn Day Excerpts

Tuesday 19th June 2018 Commons Chamber

The Secretary of State was asked—

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

1. What steps he has taken to tackle NHS workforce shortages.

[The Minister for Health (Stephen Barclay)]

NHS England, NHS Improvement and Health Education England are working with trusts on a range of recruitment, retention and return-to-practice programmes to ensure that the required workforce are in place to deliver safe and effective services.

[Martyn Day]

The nursing vacancy rate in England is more than double that in Scotland, with one in 10 positions unfilled. The Royal College of Nursing has welcomed the Scottish Government’s Health And Care (Staffing) (Scotland) Bill, which will enshrine safe staffing levels in law. Will the Minister now follow the Scottish Government’s example and bring such a provision into law for NHS England?

[Stephen Barclay]

I fear that the hon. Gentleman wrote his question before yesterday’s announcement. I thought that he might have started by welcoming the additional £2 billion of investment that Scotland’s NHS will be receiving. We are making historic investment in recruitment, which is why we are opening five new medical schools in England, training 1,500 new medical doctors, taking initiatives such as on apprenticeships and opening new pathways into clinical roles.

Mental Health Services: Children and Young People

Martyn Day Excerpts

Thursday 8th March 2018 Commons Chamber

[Steve Brine]

As ever, my hon. Friend makes a point about families. I said that we are already rolling out mental health first aid training to every secondary school, which is of course important, and we are also committed to rolling out mental health awareness training to all primary schools by 2022, but to coin a phrase, it takes a village. This is about the state—of course, schools are part of that—but also the third sector, which has an important role to play. It is also absolutely about the love, support and Christian embrace of families.

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

This is a very important issue, especially given that half of mental health problems are established by the age of 14. It is therefore particularly shocking that some children are receiving assistance only after attempting suicide. Claire Murdoch, the national mental health director of NHS England, has stated:

“Child and Adolescent Mental Health Services are now improving, but from a starting point of historic under-funding and legacy under-staffing”.

This report is surely an example of the latest reports in recent years demonstrating the impact of this Government’s austerity-driven agenda on public services. By comparison, in Scotland, which had the UK’s first ever dedicated mental health Minister, we have seen staffing for Scotland’s psychology and children and young people’s mental health care services at a record high, with a 79% increase since 2006. Surely as part of the Minister’s response to these findings he will wish to look at the actions being taken in Scotland and learn from them.

[Steve Brine]

We always look at the actions being taken in Scotland and in all the devolved Administrations. The hon. Gentleman is right to touch on prevention, which was the first point he made. The proposals in the Green Paper are focused on providing significant support for schools to develop the work they already do on prevention and early intervention. Today’s report talks about the many good things that are going on and, as I said, some of the things we have already taken forward with the Green Paper. While we are kicking this about, let us just remember in these exchanges that this is about the health of young people in England, whom we all represent.

Medicines and Medical Devices Safety Review

Martyn Day Excerpts

Wednesday 21st February 2018 Commons Chamber

[Mr Hunt]

I can absolutely give that assurance. We are considering how to strengthen oversight, because a tragedy is a tragedy wherever it happens, and we should be demanding the highest standards of care throughout our healthcare system. We are particularly considering the issue of data sharing, because often clinicians operate in both the NHS and the private sector, and we want to make sure that we do not have two datasets but that we share data in a way that makes patients safer.

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

I thank the Secretary of State for advance sight of his statement, although I am sure that some of the women affected by these medicines or medical devices will be sceptical and might wonder whether the Government have not just announced a review of reviews, especially given the outrage among patients and the wider public over the review process and its outcomes in the past.

Medicines safety and licensing are reserved matters, and although we welcome the fact that the Government are not just doing nothing, it is disappointing that the review will not really consider the scientific evidence on Primodos, valproate and surgical mesh. Given the recent shambles over the Primodos expert working group, everyone needs confidence that this will not turn into a Government whitewash. How can patients be assured of the chair’s independence? Who will take a final decision on who advises the chair? Will those affected and those who took part in the initial reviews be able to participate? I am sure the Secretary of State is aware that Professor Alison Britton is already leading an independent review in Scotland of vaginal mesh. Will he and his officials seek to take advice and soundings from her findings and expertise in this process? Finally, having as much information and background as possible on women’s experiences is extremely important in getting justice and improving patient safety, so does the Secretary of State think that setting up a mechanism within his Department to collate extensive qualitative research for patients would be useful?

[Mr Hunt]

With respect to the hon. Gentleman, he is being a little uncharitable in describing this as a “review of reviews”. We have announced immediate action in each of these three cases—it will happen right away and will be of huge significance in the use of valproate, help for families who think they have suffered as a result of Primodos and the use of mesh. A lot of things are happening right away. These are complex issues, however, and if we are to step back and look at the systemic failures we think have happened, it is important that we ask what changes are needed. That is why we need someone of Baroness Cumberlege’s experience: she has a huge track record of campaigning on women’s issues; she was a Minister at the Department of Health for five years; and she did the “Better Births” review for NHS England in 2015. She is hugely experienced and passionate about patient safety and making sure that the patient voice is heard.

Oral Answers to Questions

Martyn Day Excerpts

Tuesday 6th February 2018 Commons Chamber

[Mr Hunt]

My hon. Friend speaks very wisely—we do need to be better at retaining our existing workforce. I think that is why the Treasury has given me extra latitude in negotiations on the pay rise—those discussions are currently happening—but we also need to be much better at flexible working and at recognising the challenges people have in their ordinary working lives.

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

Unlike in Scotland, where student nurses receive free tuition and a nursing bursary of over £6,500 a year, nurses in England now face debts of £50,000 on graduation. Owing to that, training applications in England have dropped by a third since 2015, and the new nursing apprenticeship attracted only 30 trainees against a target of 1,000. Will the Secretary of State not accept that he got it wrong, and reinstate the nursing bursary?

[Mr Hunt]

I am interested to hear the hon. Gentleman say that, because we have published a draft of a workforce strategy in this country, but I notice that Audit Scotland says that in Scotland there is a lack of a long-term strategic plan for the workforce. I gently say to him that there are workforce pressures across the United Kingdom. We have a plan to dramatically increase the number of nurses that we employ in the NHS, and I am sure many people in Scotland would like to see the same there.

[Martyn Day]

The Secretary of State has claimed that the removal of the bursary would fund 10,000 extra training places, but the first 5,000 will start only this autumn and the nurses will qualify only in 2021. With more than 36,000 nursing vacancies in England, more nurses leaving than joining and a 90% drop in EU nurses coming to the UK because of Brexit, exactly who does he expect to care for patients in the meantime?

[Mr Hunt]

As we discussed earlier, we are broadening the routes into nursing from just traditional higher education courses, including nurse apprenticeships and people being able to train on the job over four years in a hospital. We hope that a whole group of healthcare assistants who currently find it difficult to get into nursing can become nurses. I think that would be very welcome in Scotland as well.

Oral Answers to Questions

Martyn Day Excerpts

Tuesday 19th December 2017 Commons Chamber

[Mr Hunt]

My hon. Friend is absolutely right. Of course, both things matter, and hospitals do need the right level of funding, but one of the highlights of the year for me was visiting my hon. Friend’s local trust in Carlisle and seeing the total transformation in leadership there. It was one of the most troubled trusts in the NHS but, thanks to the incredible dedication of the doctors, nurses and everyone working in the trust, it has really turned things around.

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

The Scottish Government already pay nurses and care assistants the highest rate in the UK, have maintained the nursing bursary, and have now committed to a 3% pay rise for those earning £30,000 or less. Does the Secretary of State recognise that his failure similarly to value NHS staff in England is one reason why England’s nursing vacancy rate is more than double that of Scotland?

[Mr Hunt]

What I recognise is that life expectancy continues to rise in England but has ground to a halt in Scotland. One reason why is that the Scottish National party has consistently not taken the extra resources it could take and put them into the NHS, but has instead chosen other priorities.

[Martyn Day]

At the previous Health questions, the Secretary of State said that funding from the Chancellor to remove the pay cap would be based on productivity improvements. Will he elaborate on what productivity improvements are expected and when NHS England staff will get the pay rise that they deserve?

[Mr Hunt]

We are having fruitful and productive discussions about productivity with the “Agenda for Change” unions, including the Royal College of Nursing. We are looking at all sorts of things, including how the increments system works. I am hopeful that we will have a win-win: a modern contract that is fit for the future for “Agenda for Change” staff and that also allows us to go beyond the 1% cap, as the Chancellor has authorised me to do.

King’s College Hospital Foundation Trust

Martyn Day Excerpts

Tuesday 12th December 2017 Commons Chamber

[Mr Dunne]

My hon. Friend is quite right. There has to be a sense of responsibility and accountability for delivering on budget deficits—if they are deficits—that have been agreed between the regulator and the trust. That is happening up and down the country, and it would be unfair on other trusts and other areas of the country if one trust was allowed to get away with its performance unchecked.

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

The key to this question has to be ensuring sustainable delivery of the NHS. The Minister may wish to look at the model in Scotland, where we have boosted investment and listened to the needs of our healthcare workers. By stark contrast, the UK Government seem intent on burning their bridges with NHS staff with their cost cutting and special financial measures. When will the UK Government wake up and realise that their ideologically driven austerity threatens the very future of our NHS?

[Mr Dunne]

I am afraid that the hon. Gentleman was not referring to the urgent question. We are talking about what has happened at King’s over the past few days, rather than what is happening in Scotland.

Deafness and Hearing Loss

Martyn Day Excerpts

Thursday 30th November 2017 Westminster Hall

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

It is a pleasure to serve under your chairmanship, Ms Buck, and to take part in this important debate secured by the hon. Member for Poplar and Limehouse (Jim Fitzpatrick). It has been a consensual debate across the Chamber, which is extremely welcome.

This will be the first time that my words have ever been signed, as well as it being the first time in a parliamentary debate; I certainly hope it becomes a regular feature in Parliament. It would be nice if the signing was on the live feed, not only on the re-broadcast. I do not know whose remit that is in—perhaps the parliamentary authorities or the Administration Committee could discuss it further with the broadcasters to see how best we can implement that. Again, I thank the hon. Gentleman for securing the debate; it is a tremendous first. I echo the calls from the hon. Member for Milton Keynes South (Iain Stewart) that providing sign language interpretation should become a regular feature.

Various Members have discussed the multiplicity of Departments responsible for this sphere. If that is not simplified, there certainly seems to be a need for there to be, at the very least, a clear, identified lead Department. That may be an easier route. We have heard of the many day-to-day difficulties experienced by those who are hard of hearing—one person in six is affected, and they are less likely to be in employment. On the one hand, it is welcome news that technology is making it easier for people suffering from deafness to work, while, on the other, it is worrying that the cap on Access to Work support has disproportionately impacted on those with hearing loss. That point has been well made and I do not need to emphasise it further; the cost-benefit ratio of £1 spent to £1.48 received says it all, in financial terms.

Various Members have given their personal stories and accounts, such as the hon. Member for Rochester and Strood (Kelly Tolhurst). I am also grateful to the right hon. Member for Wolverhampton South East (Mr McFadden) for the case he identified, which put a very human dimension on to the issue. I cannot imagine what it would be like to not hear family or listen to music; I have no comprehension of how awful that would be. However, there are ways that we can help people, and we should do everything we can to ensure a better quality of life for everyone. Indeed, that is effectively the challenge of today: to ensure that deaf people can be fully involved in daily and public life as active, healthy citizens who can make informed choices about every aspect of their own lives.

My hon. Friend the Member for Edinburgh East (Tommy Sheppard) covered much of what happens in Scotland, but I will mention a few of the points again. The Scottish Government have a British Sign Language national plan, which, as has been said, aims to make Scotland the best place in the world for BSL users to live, work and visit. It seems to be a regular feature in debates that I am always telling people to visit my constituency, so I might as well emphasise this again: it is a great place, and if hon. Members have not been, they should come.

The British Sign Language (Scotland) Act 2015 requires public bodies in Scotland to publish plans for how they will promote and support BSL every six years. The first national plan covers the Scottish Government, and other public bodies, including councils, NHS boards, colleges and universities, will publish plans next year. The national plan, which runs from 2017-23, is the first of its kind in the UK and sets out 10 long-term goals for BSL in Scotland, covering early years and education, training and work, health, mental health and wellbeing, transport, culture and the arts, justice and democracy. It describes 70 actions Scottish Ministers will take by 2020, whereafter a progress report shall be published and a further set of actions for delivery by 2023 will be identified. My hon. Friend the Member for Edinburgh East mentioned several of those key actions, so I will not repeat them.

However, I can think of a 71st action that might feed into the next round for the Scottish Government and might be one we should take forward in this Parliament, and that is what we as individual elected Members do to facilitate that. In preparing for the debate, I thought about what we do on home visits and for people visiting our constituency offices. There are a number of issues, and we may need parliamentary guidance on how best to service all our constituents with their inquiries.

In Scotland, a lot of it is about attitude, but our plan is also backed up by money: £1.3 million has been put in to support it. That is not a grand amount, but it is enough to do a fair amount of work. Dr Terry Riley, chair of the British Deaf Association, said that the Scottish Government’s national plan is

“a brilliant example for the rest of the United Kingdom to follow.”

I hope that Ministers will have a look at what we are doing in Scotland. I have a copy of the plan here, if anyone wants it. I am not hard of hearing, but I am poor of vision, and I am pleased to say that the plan is in quite large print, so it suits the likes of myself to a tee.

It is not just through the BSL national plan that the Scottish Government are taking action to help. The disability delivery plan is another way that we can help by removing barriers and promoting independent living, with a key target being a reduction in the employment gap between disabled people and the rest of the population. It has been highlighted today that deaf people are not in as great an employment position as other members of society.

The Scotland Act 2016 devolved a number of powers to set up employment schemes to assist those at risk of becoming long-term unemployed and to help disabled people into work, including schemes that seek to help employers to find suitable employees. As a result, Fair Start Scotland will operate from 2018 for three years, with the aim of helping a minimum of 38,000 people into work. I hope that a number of those will be deaf people and those who are hard of hearing.

At a UK level, more needs to be done to address the gender, race and disability pay gap and tackle pay inequality and occupational segregation. To that end, I support extension of pay gap reporting to cover gender, race and disability. I am keen to hear the Minister’s thoughts on that. Better and more statistics could help us greatly in this cause.

I would also like to hear from the Minister on EU law, which has played a huge role in upholding the rights of disabled people. Those rights must be protected post-Brexit. There are many examples, but of particular importance to the deaf community are the employment equality directive of 2000 and the public sector websites and mobile applications directive of 2016, which requires public sector bodies to ensure that their websites and mobile apps comply with accessibility standards so that they can be used by disabled people.

As well as protecting existing EU measures, it is important to ensure that the UK is not left behind. For example, the European Accessibility Act is being negotiated at an EU level. The Equality and Human Rights Commission has said that the Act will benefit disabled people by providing common rules on accessibility in relation to computers and operating systems, ATMs, ticketing and check-in machines, smartphones, TV equipment related to digital television services, telephony services and related equipment. It would be great to know what the UK proposals are for those areas in the future. It would be tremendous if the Minister looked into that.

There is much we can learn from different countries. My hon. Friend the Member for Edinburgh East and I have mentioned what is happening in Scotland, and the hon. Member for Milton Keynes South mentioned some of the things happening in Australia. There is a lot we can learn, and I look forward to hearing the other winding-up speeches and seeing this go further forward.

Health

Martyn Day Excerpts

Tuesday 21st November 2017 Ministerial Corrections

[Chris Stephens (Glasgow South West) (SNP)]

7. What recent assessment his Department has made of the effect of the UK leaving the EU on the health and social care sector.

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

20. What recent assessment his Department has made of the effect of the UK leaving the EU on the health and social care sector.

[The Minister of State, Department of Health (Mr Philip Dunne)]

We are fully engaged with the highest level of Government work on Brexit. My right hon. Friend the Secretary of State is a member of the Cabinet Committee on Brexit, and he is engaged on all areas where Brexit may impact the health and social care sector.

[Official Report, 14 November 2017, Vol. 631, c. 139.]



Letter of correction from Mr Dunne.



An error has been identified in the answer I gave to the hon. Members for Glasgow South West (Chris Stephens) and for Linlithgow and East Falkirk (Martyn Day).



The correct answer should have been:

Oral Answers to Questions

Martyn Day Excerpts

Tuesday 14th November 2017 Commons Chamber

[Chris Stephens (Glasgow South West) (SNP)]

7. What recent assessment his Department has made of the effect of the UK leaving the EU on the health and social care sector.

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

20. What recent assessment his Department has made of the effect of the UK leaving the EU on the health and social care sector.

[The Minister of State, Department of Health (Mr Philip Dunne)]

We are fully engaged with the highest level of Government work on Brexit. My right hon. Friend the Secretary of State is a member of the Cabinet Committee on Brexit, and he is engaged on all areas where Brexit may impact the health and social care sector. We are actively considering the Brexit implications for the UK on workforce, medicine and equipment regulation, reciprocal healthcare, life sciences, public health, research, trade and data.[Official Report, 21 November 2017, Vol. 631, c. 5MC .]

[Mr Dunne]

It is the case that we have been reliant for much of the increase in clinicians in this country on doctors and nurses coming from the EU, so a reduction in that increase is something we are watching carefully. I gently say to the hon. Gentleman that the last figures we have show that, as of the end of June, there were 3,193 more clinicians working in the NHS in England than there were in June 2016.[Official Report, 21 November 2017, Vol. 631, c. 6MC.]

[Martyn Day]

Brexit may well result in a loss of both rights and funding for people with disabilities, so when will this Government release their full impact assessment of the medical and social care sector?

[Mr Dunne]

The hon. Gentleman is looking for answers about social care. The Under-Secretary of State for Health, my hon. Friend the Member for Thurrock (Jackie Doyle-Price), who has responsibility for social care, has made it clear that a paper will be published in due course. I am afraid that the hon. Gentleman will just have to be a bit more patient.

Vaping

Martyn Day Excerpts

Wednesday 1st November 2017 Westminster Hall

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

It is a pleasure to serve under your chairmanship, Mr Howarth. I thank the hon. Member for Dartford (Gareth Johnson) for securing this debate on nicotine vapour products. I fully agree with him about their potential to save thousands of lives. We should always bear that in mind. I am grateful that he clarified the point about the public perception of the safety of vaping versus traditional cigarettes. We need to get that important message out there, especially given that some of the briefings we have seen show that people think it is as dangerous. Clearly, it is not.

I also agree that we need a fact-based approach, and that a lot more research needs to be done. I am grateful to the hon. Member for Ipswich (Sandy Martin) for mentioning some of the studies, and I look forward to seeing their results. The hon. Member for Dartford mentioned one of the most interesting dilemmas, which relates to the rules on advertising and the anomalies. How do we accurately advertise the benefits of this product to the people who would benefit from it—the 7 million smokers who are not vaping—without making it attractive and sexy to people who do not smoke at all? Finding that balance will be challenging, and I do not envy anyone who has to come up with the regulations that deal with that problem.

The positive case in favour of vaping has been well made today. Most of the harm caused by cigarettes and other smoked tobacco products comes not from the nicotine but from the smoke, which contains a huge number of carcinogens. I am very grateful to the Royal College of Physicians for its work in estimating that the hazard from long-term vapour inhalation is about 5% that of the harm of smoking. We need to get the message out to smokers that vaping is much safer. More than one quarter of all cancer deaths can be attributed directly to smoking. Smoking is associated with 10,000 deaths and about 128,000 hospital admissions each year in Scotland alone. It costs the Scottish NHS more than £300 million to treat smoking-related illnesses. It does not take a genius to work out that it is in the interest of our public purse to encourage people on to smoking cessation products.

A statistic that I have seen—I have forgotten which briefing it was in; it may have been by the Independent British Vape Trade Association, but I apologise if I have misattributed it—states that for each person we can persuade to stop smoking, we will save about £74,000 in public health benefits. That would have a huge impact, so we need to take it very seriously.

Smoking is, without any doubt, the primary preventable cause of ill health and premature death, which is why the Scottish Government are taking radical action to attempt to stub it out. We aim to create a tobacco-free generation by 2034. Smoking rates, especially among young people, are at record lows across Scotland.

We also share the view of the Royal College of Physicians and ASH that e-cigarettes should be regulated to encourage their use as a means of stopping smoking but to discourage their use by non-smokers. That is very much the dilemma that we have with advertising.

In Scotland, we know that e-cigarettes are almost certainly safer than cigarettes and have a role to play in helping people to quit smoking, but I certainly do not believe that children or young people should have access to them. A public consultation paper, “A Consultation on Electronic Cigarettes and Strengthening Tobacco Control in Scotland”, was launched in October 2014, following which the Scottish Government introduced the Health (Tobacco, Nicotine etc. and Care) (Scotland) Act 2016. The Act had cross-party support, although a number of concerns were raised during debates in the Scottish Parliament. Among other measures, it banned the sale of NVPs to under-18s, made it illegal to buy NVPs for under-18s and required all shops to have an age verification policy. That is key to preventing a new generation of people from using nicotine-based products.

In Scotland, there has been record investment in NHS smoking cessation services. We know they have a cost benefit for every pound we spend. My area is served by two NHS trusts: Forth Valley and Lothian. This issue falls under devolved competences, so it is worth pointing out that neither trust outwardly endorses e-cigarettes, unlike some stop-smoking services elsewhere.

Although I have been unable to ascertain accurate local figures, ASH states that there are 3 million vapers across the UK, half of whom have given up smoking, and that about 97% of all vapers are either current smokers or ex-smokers. The information available suggests that vaping is not currently a gateway to tobacco products and that it helps people to stop smoking, so it is genuinely a positive measure.

Vaping also helps to reduce second-hand smoke, as the hon. Member for Gordon (Colin Clark) has said. In Scotland, the number of children affected by second-hand smoke in the home has reduced from 11% to 6%. I do not know what proportion of that reduction was caused by NVP products and what proportion was caused by the “Take it right outside” campaign, but both have clearly contributed to it.

There is clearly a role for vaping to play in helping people to stop smoking. Despite my thick throat—I have managed not to cough today—I have never smoked in my life, but I have many friends who have done so. Looking back over the years since the smoking ban was introduced in Scotland in 2006—I thought it was a birthday present for me, as it was introduced on my birthday, 26 March—I can see that it has certainly improved the lives of many people. I have friends who gave up largely due to that event. Some managed to stop through sheer willpower—a minority, I have to say—while others struggled and used different cessation products. Vaping is probably the most popular method in my social circle. It certainly makes a real difference.

Vaping is significantly less harmful than continuing to smoke. Harm reduction is not as good as cessation, but it is way better than smoking. Realistically, given how addictive nicotine products are, that may be the best we can expect for many people. I believe that vaping can lead to a serious reduction in smoking. I welcome this debate, and I thank the hon. Member for Dartford for securing it.