Medical Cannabis under Prescription

Mohammad Yasin Excerpts

Monday 20th May 2019 Commons Chamber

[Mohammad Yasin (Bedford) (Lab)]

It is a pleasure to follow my hon. Friend the Member for Middlesbrough (Andy McDonald). I pay tribute to the right hon. Member for Hemel Hempstead (Sir Mike Penning) for bringing this hugely important debate to Parliament.

The families of severely ill children and patients who had lived for years with conditions such as MS that meant a life of extreme pain believed that they had been offered a lifeline when the Home Secretary rescheduled medical cannabis so that it could be prescribed to patients who needed it. Six months on, hope has turned to despair as we are now in the unconscionable position whereby medicinal cannabis has been legalised but is almost impossible to access. It turns out that the policy change last year has so many ifs and buts and is steeped in so much bureaucracy that it is not yet worth the paper it was written on. The public are understandably bewildered and confused.

We have all heard the stories of parents who want only to protect their children from severe pain being denied life-saving drugs or having them confiscated by immigration officials. While the NHS and the medical professions are having arguments over what constitutes evidence on who is eligible for the drug, children and patients are suffering needlessly every day. It is a shameful situation and, as is so often the case, the Government’s defence is to say, “It’s nothing to do with us.” They have distanced themselves from the implementation of their own policy and outsourced the tricky bits to those on the frontline who have been given little support or guidance. In doing so, the Government have let so many people down. They have left seriously ill patients to fend for themselves—to be pushed from pillar to post, unable to find an NHS clinician willing to prescribe the only meds that control their seizures.

The campaign group End Our Pain, which is supporting more than 20 desperate families of children with intractable epilepsy, are having to help to fundraise around £2,000 a month to finance trips abroad to get access to the medical cannabis that the children need. This issue has nothing to do with illegal drugs and neither is it a Home Office issue; it is a public health issue. More than that, it is a humanitarian issue. The evidence is clear—certainly to the parents whose children are alive because of CBD—that the benefits outweigh any negative effects, so why are patients still cruelly suffering? Parents and patients are being criminalised, forced to go abroad or to order off the dark web to get hold of the life-saving medicines they were promised they would be able to access legally. I realise the importance of a proper regulatory development process to coincide with the new policy, but why is it taking so long?

[Gavin Robinson (Belfast East) (DUP)]

The hon. Gentleman is making a powerful point about the ineffectiveness of the new regulatory regime and how it is not working for families. I have a constituent called Jorja Emerson, and many campaigning Members from all parties will have met her father, who is in the Public Gallery. He was one of the first to receive a prescription under the new regulations. It has to come from a private clinic and it costs him exorbitant amounts of money, and even then he has to pay to fly to London to get it because he cannot cash the script in Northern Ireland. Even when it is operating, the system is not working for Mr Emerson or his daughter.

[Mohammad Yasin]

I absolutely agree with the hon. Gentleman, who makes a powerful point. That is why we are debating this issue today and urging the Government to take urgent steps and make these drugs available for children who are suffering. We can save lives by legalising them.

The evidence base and research surrounding the new policy must be called in and disseminated as soon as possible, and the barriers to clinically sound prescribing, including any training and support for prescribing doctors, must be addressed urgently. Yes, we have to get the policy implementation right and safe, but it is cruel and unjust to keep patients suffering while the Government hide behind a wall of red tape.

Appropriate ME Treatment

Mohammad Yasin Excerpts

Thursday 24th January 2019 Commons Chamber

[Mohammad Yasin (Bedford) (Lab)]

I am grateful to the hon. Member for Glasgow North West (Carol Monaghan) for securing this very important debate. I have received a number of requests from my constituents to attend this debate to highlight this devastating condition.

Sufferers of ME are often stigmatised and marginalised, as their conditions are not fully recognised by the Government or the medical profession. A number of my constituents suffer from ME. At least two have been bedridden for 30 years because of their condition, and their story is not uncommon. Some 250,000 people suffer from ME, with 25% of individuals house or bed-bound. Children as young as five can develop the condition, and it is the most common cause of long-term school sickness absences.

A Westminster Hall debate last February raised issues about the PACE trial, which has influenced the NHS treatment of ME. A report had recommended CBT and GET as effective treatments. More recent research has disproved that study, which shows that CBT is not effective, and that GET can worsen individual symptoms, as has been the case for some of my constituents. However, those are the only treatments available on the NHS, which means that individuals and their families must endure treatment that not only fails to improve them, but can worsen their condition.

I therefore support suspending CBT and GET treatments in the NHS, as well as updated training for GPs and medical professionals, to alleviate the unnecessary hardship to which individuals with ME are currently subjected. ME has been overlooked for too long. We must fund and support research properly, and work to ensure that those who suffer from ME are listened to, diagnosed, and treated in the best possible way.

Oral Answers to Questions

Mohammad Yasin Excerpts

Tuesday 15th January 2019 Commons Chamber

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

Yes, of course we recognise the economic strain that obesity puts on the NHS, which is why we are taking the action we are, including with our renewed focus on prevention. The measures in the plan include doubling the capacity of the diabetes prevention programme and the further 1,000 children a year we hope to treat for severe complications relating to their obesity. That should help my hon. Friend’s CCG, as well as mine and those of all Members.

[Mohammad Yasin (Bedford) (Lab)]

T3. A senior Bedford GP was told by the East of England Ambulance Service that a patient who required urgent admission would have to wait 10 hours for an ambulance. I am deeply concerned about this response time. Will the Minister urgently investigate why patients are being deliberately downgraded when an ambulance is called from a GP surgery?

[Stephen Hammond]

A number of MPs, including the hon. Gentleman, have raised issues about the trust’s performance, and a range of actions have been put in place. He will be pleased to know that I met the performance director in December. I have been discussing several support mechanisms involving both the NHS and the Department, and I continue to receive reports. He will also be pleased to hear that the trust’s performance improved over December.

NHS Long-term Plan

Mohammad Yasin Excerpts

Monday 7th January 2019 Commons Chamber

[Matt Hancock]

My hon. Friend is absolutely right. Those standards are being trialled at the moment. Of course we want to get them right, but we will look at the results of those trials as soon as we can.

[Mohammad Yasin (Bedford) (Lab)]

The Bedfordshire mental health trust told me today that the need for in-patient beds for men has increased. Will the Secretary of State urgently reinstate the in-patient mental health facilities in Bedford, which his Government removed, so that my constituents no longer have to travel at least 20 miles to access care?

[Matt Hancock]

Of course the provision of services locally is a matter for local clinicians, and it must be led by local clinicians. I am always happy to look at individual cases and, as with the other example, I will ask the NHS to write back to the hon. Gentleman with an explanation.

Perinatal Mental Illness

Mohammad Yasin Excerpts

Thursday 19th July 2018 Westminster Hall

[Dr Williams]

I thank the hon. Gentleman for relating the experience of his constituent, which is, sadly, shared by too many other women. Of course, there are many dedicated health professionals who do identify mental health problems, but too many women say that they slipped through the net.

I will talk about why perinatal mental health problems are so important for a child. The first 1,001 days of a child’s life, from conception to the age of two, are absolutely crucial to their social, emotional and cognitive development. Put simply, those 1,001 days are when a brain is built and shaped. During that time, 1 million new neuronal connections are made every second in that child’s brain. When the environment the child experiences, whether inside or outside the womb, is happy, relaxed and stimulating, he or she learns and develops those connections in the brain. The baby grows and adapts in a positive environment.

However, many of the symptoms of mental health problems do not provide that ideal environment. Stress raises the level of cortisol, which can cross the placenta and affect a foetus. When someone is severely depressed, perhaps they do not smile, so a baby does not see the warmth, the love and the reciprocation that they need from their mother. When someone is anxious or has an obsessive compulsive disorder, a baby sees, learns and repeats actions from the environment they are experiencing from birth. They learn to behave like their mother.

A mum’s mental health problem can have such a significant effect on a baby that academics describe it as an adverse childhood experience. Adverse childhood experiences, or ACEs, are stressful events that occur in childhood.

[Mohammad Yasin (Bedford) (Lab)]

My hon. Friend is making a powerful speech. I was interested to hear the evidence put forward by the National Childbirth Trust to the all-party parliamentary group for the prevention of adverse childhood experiences that depression among 16-year-olds is usually linked to their mother’s pregnancy. I realise that the research is more complex, but given the worrying rise in the number of children and young people with mental health problems, is he as concerned as I am that one quarter of women are unable to access specialist perinatal services in the UK?

[Dr Williams]

I thank my hon. Friend for making several points, including that a child whose mum experiences mental health problems is more likely to develop mental health problems themselves. Despite significant Government investment in specialist perinatal mental health services, significant inequalities remain throughout the country and there are still areas where, as he said, one quarter of women with significant mental health problems are not able to access specialist facilities. I hope we will get the chance to talk more later about access to specialist services.

Other adverse childhood experiences include domestic violence; parental separation or divorce; being a victim of physical, sexual or emotional abuse; physical or emotional neglect; or growing up in a household where there are adults experiencing alcohol and drug problems. Mental health problems in a mother can have as significant an impact on a child as some of those other problems. The term ACEs was originally developed in the US, but other studies have reported similar findings in England and Wales. Those ACEs have, as my hon. Friend has said, been found to have lifelong impacts on health and behaviour. They are relevant to all sectors and involve all of society.

An ACE survey of adults in Wales found that, compared with people who had experienced no ACEs, those with four or more were more likely to have been in prison; develop heart disease; frequently visit their GP; develop type 2 diabetes; have committed violence in the last 12 months; and have health-harming behaviours, such as high-risk drinking, smoking or drug use

Children’s exposure to adverse and stressful experiences can have a long-lasting impact on their ability to think and to interact with others, and on their learning. Health and societal inequalities that develop during early years stick with children for life. That is why I chair the APPG for the prevention of adverse childhood experiences. It is also why the identification and treatment of maternal mental health problems is not only important for the individual mother but crucial for all of us in society.

National Childbirth Trust research shows that as many as half of new mothers’ mental health problems are not picked up by a health professional. That is not to say that health professionals are not asking—they often are. There are many fantastic nurses, GPs, midwives, health visitors and others who provide care during pregnancy and during the post-natal period. However, those services, as my hon. Friend the Member for West Ham (Lyn Brown) has said, are overstretched. We all know how hard-pressed GP services are. The Government have acknowledged the problem and have promised to recruit an extra 5,000 GPs by 2020. However, they are failing miserably and are struggling to even maintain GP numbers. NHS Digital reports a decrease in full-time equivalent GPs from March 2017 to March 2018.

Perhaps a little less well known is the dramatic fall in the number of health visitors. Since 2015, there has been a loss of more than 2,000—almost a 20% drop—so each health visitor has to work harder. I commend health visitors for the work they do but, overall, women are experiencing a drop in services.

Staff numbers are part of the problem, but there are many other reasons why the problems of almost half of women with perinatal mental health problems are not identified. Stigma, and the societal pressure to be seen to be coping, makes it hard for some women to disclose that they have a mental health problem. Also, as the hon. Member for Thirsk and Malton (Kevin Hollinrake) has said, health services do not always ask women about their mental health in the most sensitive way. That is sometimes because they are pushed for time and sometimes because they have not been trained to sensitively and gently probe behind the “I’m okay” response that people are primed to give.

As a result, the hidden half of new mums with mental health problems struggle on alone, often afraid to reach out for help. The overwhelming majority of women who experienced a mental health problem said that it had an impact on their ability to cope or look after their children, and also on their family relationships. The mother of a woman suffering from post-natal depression told me:

“As a parent, watching a child go through that and feeling unable to make it better is a horrible experience. Health professionals need to make sure that husbands, partners and the family know about the likelihood of such depression…and know where to get support and help.”

Perinatal mental illness has an immediate effect not only on mothers; it can have lasting consequences for relationships in the wider family. With the added pressure to be a perfect mother, and the expectations from many that come along with that, it is no wonder that so many women feel unable to cope. One constituent described this to me:

“I remember comparing myself to the younger mums who would turn up to the mother and baby groups looking fresh and without a care in the world, making motherhood look like a walk in the park. Although my son was thriving, I felt like I was failing, because I wasn’t like the young mums or the ones in those perfect baby ads. I didn’t want to share my feelings because I felt I’d been a failure in comparison to them. I believe the pressures of our professions and the guilt of parenthood traps us into a dark place.”

It is often the most vulnerable who receive the least support, with evidence suggesting that those in areas of higher deprivation are less likely to be asked about their mental health. In dealing with this issue, the Minister has the chance to fulfil two parts of her ministerial brief, because investing in perinatal mental health will help to improve mental health and reduce health inequalities.

I have described the problem, but what are the solutions? Identification is key. Regardless of what services may or may not be out there—from specialist mother and baby units, to secondary care perinatal mental health teams, to cognitive behavioural therapy and the prescription of medication—half of women with the problem are not even identified. That is where I believe we need to start.

The disinvestment in health visiting is significant; there can be no solution to the problem while health visiting is not properly resourced. Will the Minister say what she intends to do within her Department to ensure that local authorities are adequately funded and supported so that there is investment in crucial services for children aged 0 to 19, rather than the cuts that we have seen in the past three years?

However, there is another, relatively low-cost opportunity to identify the hidden half. About six weeks after giving birth, new mothers see their GP for a six-week baby check, with many practices also offering a maternal health check. Official National Institute for Health and Care Excellence guidance encourages doctors to do that and inquire about a mother’s emotional wellbeing, providing an opportunity for them to spot the development of any mental health problems. That check could be the last time a mother sees a health professional for a routine appointment in which there is the opportunity to focus on the mother, rather than her baby.

While some women get an excellent six-week check, showing its potential, other women miss out. A fifth of women questioned in a recent NCT survey said that they were not asked about their emotional or mental wellbeing at that appointment. Some women’s checks are all about their baby. Why do all women not get the check that they need? Despite the six-week baby check being part of the GP contract, for which they receive funding, doctors do not receive any funding for the check on the mum. It is a credit to many practices that they offer the checks without funding, but making the time for a full appointment can be challenging, meaning that there is little opportunity to encourage a mother to talk about how she feels, which takes time. A rushed appointment can make many, like the constituent of the hon. Member for Thirsk and Malton, feeling dismissed, or like it was a tick-box exercise.

One woman I heard from recently said her appointment made her

“feel like she was a burden”.

Another of my constituents spoke movingly of her experience:

“I knew there was something very wrong almost as soon as my son was born. Nothing I was ‘supposed’ to be feeling was happening. All I wanted to do was cry. I was feeding him and taking good care of him, but I felt empty inside, and so sad. I can’t remember anyone asking me how I was. I only saw my health visitor once, and that wasn’t in private so there was no opportunity to confide in her.

I told my GP I had postnatal depression and that I needed some help. He told me ‘you have a good family, you should be grateful—you need to pull yourself together.’ I don’t think I have the words to explain how damaging that was. I felt too ashamed to see him again so I changed to another medical centre. My first appointment was with a GP who listened to me. I found the courage to confide in her and she offered me support straight away. I remember very little of my child’s first year of life and I’m sure that is because of the trauma and deep depression I experienced.”

That could have been prevented if my constituent had been seen early on in the post-natal period, and if that first GP had delivered open, supportive questioning that reassured her, rather than made her feel ashamed.

Another constituent told me:

“I sat down with my GP, who had a check-list printed out and placed on his desk. He ran through the questions at a rapid rate, didn’t listen to my answers at all and placed ticks in the boxes after he asked the questions—not based on my reply. Hopefully a separate check for mothers can be achieved, as mothers just want someone to talk to who will not judge them for their feelings.”

About 30% of women diagnosed with post-natal depression still have depression beyond the first year of childbirth. If problems are not identified and treated early, they can worsen and develop into a much more severe mental illness. That underlines the need for an early check. If depression was recognised and treated appropriately within the perinatal period, it could prevent some effects that are much harder to treat in the long run.

BAME Blood, Stem Cell and Organ Donation

Mohammad Yasin Excerpts

Wednesday 27th June 2018 Westminster Hall

[Mohammad Yasin (Bedford) (Lab)]

I beg to move,

That this House has considered BAME blood, stem cell and organ donation.

It is a pleasure to serve under your chairmanship, Sir Henry. I first became aware of the issue of blood, stem cell and organ donation within black, Asian, mixed race and minority ethnic communities when I met Poonam Shah, who works in my constituency. Poonam’s husband, Rakesh, died from a blood disorder at the age of just 35. Due to Rakesh’s Indian heritage, he struggled to find a donor with the 10 matching genes that would have helped ensure that his blood would accept the donor’s cells. Eventually, an anonymous donor with eight out of 10 matches was found from South Africa for Rakesh, who had a stem cell transplant in October 2014.

[Mark Tami (Alyn and Deeside) (Lab)]

I am very pleased that my hon. Friend has secured this important debate. I should declare that I am chair of the all-party parliamentary group on stem cell transplantation. My hon. Friend makes a point that is particularly relevant for the BAME community—often the donor will come from outside the UK. There have been a number of cases where there have been difficulties with visas. Time is vital in this area and we need a fast-track process to make sure that those people can get here as quickly as possible.

[Mohammad Yasin]

My hon. Friend makes a very good point. I recognise the work that he has done as the chair of the APPG on stem cells. This is a very important issue, and that is why we are having this debate today.

[Afzal Khan (Manchester, Gorton) (Lab)]

I congratulate my hon. Friend on securing this debate. Those from the BAME community make up 5% of blood donors, yet they make up 14% of the population. The Imam Hussain Blood Donation Campaign was set up in my own city of Manchester; it has had a tremendous success rate of 3,408 donations. To be successful, it is important to ensure that cultural initiatives such as that are taken, so that we can carry on with improvements. If not, we will carry on experiencing difficulties.

[Mohammad Yasin]

My hon. Friend makes an important point and I will refer to similar points later in my speech.

Sadly, despite receiving a transplant, Rakesh’s condition, MDS, was so advanced that he died in December 2014, leaving Poonam and their two young children. After Rakesh’s death, Poonam decided to raise funds for Anthony Nolan and raise awareness among people from south Asia and other ethnic minority backgrounds about stem cell donations.

[Mr Tanmanjeet Singh Dhesi (Slough) (Lab)]

I thank my hon. Friend for securing this debate. Does he agree that Health Ministers should work more closely with grassroots and community organisations? Currently, donors from Asian or other minority ethnic backgrounds make up just 15% of the stem cell register, but campaigns such as Cure Kaiya, which held an event in my constituency, and Match4Rajie are encouraging more people from BAME backgrounds to become registered donors.

[Mohammad Yasin]

My hon. Friend makes a very important point.

In November, Poonam’s fundraising efforts were recognised when she was awarded individual fundraiser of the year. I was so inspired by her story that I wanted to help raise awareness of the issue in BAME communities, because none of us know whether we or one of our loved ones might be a name on that list in need of a match, desperately waiting for a lifesaving opportunity. The reality is that many patients will not receive the stem cell transplant they need, because either there is no donor available or a donor cannot be found quickly enough. Only 20% of BAME patients receive the best possible match, compared with 69% of white, northern European patients.

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Gentleman for bringing this matter forward. I have always supported the issue of organ transplants, including for BAME people. With only six out of every 100 people who have signed up to the NHS organ donor register having told us that they are from black, Asian or minority ethnic communities, does the hon. Gentleman feel as I feel that when it comes to organ donation, every race is needed and we should urge the Minister to respond with a focused campaign for BAME donation? That is the best way forward and I think the Minister needs to do that.

[Mohammad Yasin]

I agree with the hon. Gentleman’s point. The disparity urgently needs to be addressed and I therefore welcome the very timely review by my hon. Friend the Member for Wolverhampton South West (Eleanor Smith) on BAME stem cell and organ donation.

The problem of insufficient blood, stem cell and organ donation is fundamentally one of supply and demand. According to the review, fewer than 5% of donors who gave blood in the past year were from BAME communities, although the BAME group makes up around 14% of the total UK population. Currently, only 1% of people who give blood in England are black. BAME people are unequally affected by that, as they are subject to a higher demand and shorter supply than other groups. The most common blood diseases that affect BAME communities are thalassaemia and sickle cell disease.

[Mrs Helen Grant (Maidstone and The Weald) (Con)]

I congratulate the hon. Gentleman on securing this important debate. While we know that there are problems and that there is much still to do, will he join me in congratulating Kanya King and the MOBO Awards on all the great campaigning work that they do to increase BAME blood and organ donation? They do an excellent job. Will he also join me in encouraging other organisations and companies with existing BAME reach to campaign in a similar manner?

[Mohammad Yasin]

I agree with the hon. Lady. BAME donors make up 15% of the stem cell register; black donors make up just 1.2% of potential donors on the British Bone Marrow Registry. I hope the Minister shares my concerns about those statistics and that she will commit today to agreeing in full to the recommendations of the review by my hon. Friend the Member for Wolverhampton South West.

[Eleanor Smith (Wolverhampton South West) (Lab)]

I thank my hon. Friend for securing this timely debate. My review, “Ending the Silent Crisis”, is about the lack of stem cell and organ donation in black and minority ethnic groups. I hope that the Minister will look at the review’s recommendations, take them on board and come back to us on them.

[Mohammad Yasin]

I thank my hon. Friend for her hard work on the review and I look forward to working together on the issue.

It is clear that increasing the number of BAME stem cell donors requires a many-sided approach, but one of the most important things that can be done is to integrate information about donation into the formal curriculum, which the review recommends. We already know that education works. For example, Anthony Nolan and other blood disorder charities have had great success working with schools, universities and colleges across the UK. Just last month, I wrote a letter to all schools with a sixth form in or near my constituency to ask whether they would consider using an assembly or personal, social, health and economic lessons to teach students about the importance of donating stem cells, blood and organs. I am delighted that one of the schools has already agreed to do so.

Since the Hero Project started in 2009, more than 32,000 people have signed up to the Anthony Nolan stem cell donor register, and approximately 16% of them are from a BAME background. The Hero Project recognises that the different religious views about organ donation are one of the barriers preventing people from signing up to the organ donation register. Anthony Nolan and other blood disorder charities recognise and respect those diverse views and tailor their message to suit different interpretations of faith. They focus on what people can do to help, not on what they cannot do.

The review found that the three main barriers that prevent people from signing up are a lack of knowledge or awareness, religious permissibility and a lack of trust in medical institutions. The opt-out system for organ and tissue donation, with additional safeguards, is welcome, but there must be an awareness campaign that is mindful of the cultural sensitivities relating to organ donation and addresses the significant pressure on NHS Blood and Transplant’s capacity to accommodate any rise in organ donations.

It is vital that we get more young people from BAME backgrounds, such as students, to sign up to the stem cell donor register, because the research shows that the younger the donor, the more likely the patient is to survive. What steps will the Minister take to ensure that all students aged 16 and above have the opportunity to learn about the importance of donating stem cells, blood and organs? There is a real desire in the BAME community —especially among the younger generation—to turn this issue around.

I was touched by the action of the Bandhan Bedford Group, a group of Asian professional women in my constituency who helped to add 300 new names to the stem cell register. They organised a stem cell drive this month in Bedford, with support from the blood cancer charity DKMS, to help Kaiya Patel, a five-year-old girl who I understand is still waiting for a lifesaving match for her rare and aggressive form of leukaemia. I know that similar drives are taking place around the country, but this is a race against time. It has been reported that, to have a chance, Kaiya needs a transplant within the next two months.

There is a strong will out there to increase the life chances of people from a BAME background. I hope that this timely review, which highlights the scale of this silent crisis, is enough to spur the Government into assisting communities with a more co-ordinated approach. This blatant inequality must end.

NHS Outsourcing and Privatisation

Mohammad Yasin Excerpts

Wednesday 23rd May 2018 Commons Chamber

[Mohammad Yasin (Bedford) (Lab)]

I remember when I first heard the term STP; I was portfolio holder for adult services at the time, and while I supported the need for a better integrated health and social care system, there were no details of what this might mean in the future. Within a few months, NHS bosses started talking about accountable care systems and accountable care organisations. Bedford, Luton and Milton Keynes would become a “first wave” accountable care system and this was good, they told us. The decision to become a “first wave ACS” had to be taken within 24 to 48 hours to secure additional funding, so there was no time for consultation with other councillors, let alone the public.

The same approach was taken with the STPs: no or little consultation with a take-it-or-leave-it funding deal, with no time given to us to analyse or debate the pros and cons. Recently we learned that the three CCGs in our STP area have agreed to merge their executive functions, which was “nothing to do with MPs and councillors,” they said, and nothing to do with the public. But they cannot tell us who will be accountable under this new structure, and it is likely that it will not be the people making decisions about our health and social care system.

The term ACO emerged in the US in 2006. ACOs were designed to improve patient experience and control federal expenditure within the US healthcare system, which is dominated by private health and insurance companies. But so far the evidence of the effect of ACOs on quality is not convincing and in fact spending has increased.

There is an inherent risk that if we invite tenders from providers to run health and social care systems across the country, and we do so without proper consultation with patients and service users, we will end up with the sort of mess that we saw at Hinchingbrooke Hospital and hospitals suing the NHS, as Virgin Care did, but on a much larger scale.

The Government’s healthcare reforms of 2012 have created chaos in our health service. We now have a system that allows private providers to escape necessary scrutiny when they get things wrong and to walk away from unprofitable contracts without reproach. Billions of pounds have been wasted that could and should have been invested in frontline care.

Social Care

Mohammad Yasin Excerpts

Wednesday 25th April 2018 Commons Chamber

[Mohammad Yasin (Bedford) (Lab)]

Thank you for keeping the best until last, Mr Speaker. It is a great honour to speak in this very important debate.

The care home market, both for residential and nursing care, is dominated by the private sector, which holds 86% of all places. It is divided between lucrative self-pay homes and those with local government-funded residents, which are really struggling to cover the growing costs of caring for a population that is living longer, with more complex health needs. Many councils are struggling just to meet their statutory duties on a reduced budget. The Government’s decision to push a crisis of their own making on to local government is helping nobody. Central Government funding is totally inadequate. That is why, despite the new funding that has been made available for adult social care, there will still be a funding gap of £2.2 billion by 2020. I hope that this is addressed in the delayed Green Paper.

The Government must accept that their over-reliance on the private sector is not solving the problems in the social care sector and all too often is making them worse. In the last few days, Allied Healthcare has issued warnings and is now searching for a rescue plan. The company cited a rise in the cost of nurses and doctors as a result of tighter immigration rules and a shortage of trainees—problems that were created wholly by Government policy. Across the sector, providers and councils are reporting difficulties in recruiting from overseas because of the hostile environment created by our Prime Minister.

One of the nine priorities in the Government’s “Shared delivery plan: 2015 to 2020” is to

“make sure the health and care system workforce has the right skills and the right number of staff in the most appropriate settings to provide consistently safe and high-quality care.”

A report by the National Audit Office published in February shows the extent to which the Government have failed on this. The high turnover rates and difficulty recruiting that the NAO reports can be traced back to central Government underfunding. A cash-starved state is forced to tender contracts for services that private companies can deliver only by paying low wages, cutting corners or exploiting their workforce with zero- hours contracts and unpaid travel time. The Green Paper is an opportunity for the Government to go back to the drawing board on social care funding. Councils need a sustainable settlement, and we need to see adult social care given parity with the health service. Surely this joined-up thinking was why the Department of Health was renamed the Department of Health and Social Care.

Autism

Mohammad Yasin Excerpts

Thursday 29th March 2018 Commons Chamber

[Mohammad Yasin (Bedford) (Lab)]

It is an honour to speak in this important debate. My constituent, 14-year-old Zachary Saunders-Love, has a severe intellectual disability, autistic spectrum disorder and sensory and communication issues. Zachary is a wonderful young boy, physically strong but often unco-ordinated and unco-operative. The week before Christmas, he made a clumsy grab at one of his teaching assistants at his special school, and accidentally fractured her collarbone. It was an awful thing to happen, for Zachary, his family and the teaching staff. As a result, Zachary was permanently excluded from his special school. Since then, he has been stuck at home, being cared for by his father, Mark, who is losing hope of finding a suitable alternative facility nearby able to handle children of his size and with his complex needs. Mark told me:

“My son and many like him have a life limiting condition that will last for their entire time on Earth. Many won’t improve. None of them will get better. They will never be numerate or literate and they will never give back to society in real terms. Because of this they are not welcome in schools who are ultimately in competition with each other for results, and resources.”

A recent Ofsted report showed that Bedford Borough Council had significant challenges with special educational needs and disability provision. I know that it is working hard to make the necessary improvements, and I will be meeting with local authority leaders as soon as possible to discuss this important issue. I was pleased to hear the Secretary of State addressing the all-party group on autism recently about the need for a review of the shockingly high exclusion rates among SEND children. Will the Minister update us on when this review will take place, and will she agree to meet with Mark Love, who only wants to give his son the education he deserves and has some fantastic ideas for easing the burden on the SEND service?

NHS Winter Crisis

Mohammad Yasin Excerpts

Wednesday 10th January 2018 Commons Chamber

[Mohammad Yasin (Bedford) (Lab)]

I will concentrate on my main point in the 90 seconds being given to me.

NHS staff have said that this winter crisis was predictable and preventable. Bedford Hospital NHS Trust was one of the 24 trusts that issued a warning saying they were at full capacity. Patients, including many elderly and frail people, are routinely stuck in the back of ambulances in logjams waiting to get into A&E. The NHS is coping with an increase in demand, while being severely underfunded. We have also learned that Bedford walk-in medical centre in Putnoe is now under threat. Some 40% of our walk-in centres nationwide have closed under the Tories since 2010. Commissioners take decisions in response to budgetary constraints and cut services that are on the face of it costly to provide, but the human costs of such cuts are catastrophic, especially in places such as Bedford, whose hospital is already struggling to cope.

I finish by thanking all the staff who worked hard over Christmas and gave their time, when they could have spent it enjoying time with their families.