Oral Answers to Questions

Rushanara Ali Excerpts

Tuesday 29th October 2019 Commons Chamber

[Ms Dorries]

I thank my hon. Friend for that question. Just over 40% of all booked appointments take place on the same day with GPs. However, it is important to recognise that many patients will be appropriately booking ahead as part of the ongoing plan for long-term conditions. The new GP contract will see billions of pounds in extra investment for improved access to GPs, expanded services at local practices and longer appointments for patients who need them. NHS England is working with stakeholders and is undertaking a national review of access to general practice services.

[Rushanara Ali (Bethnal Green and Bow) (Lab)]

With more than 5 million people across England unable to book an appointment with a GP outside working hours, many of our constituents have had to wait two or three weeks to get an appointment. With the loss of 1,600 full-time GPs since 2015 and billions of pounds in cuts since 2010, does the Minister realise that the NHS is certainly not safe with the Conservative party, and that is what the British people think?

[Ms Dorries]

I simply do not recognise the scenario that the hon. Lady has just articulated. There is access to GP practices throughout England outside of working hours.

Health

Rushanara Ali Excerpts

Tuesday 14th May 2019 Commons Chamber

[Matt Hancock]

We have made those resources available. The resources from the NHS to make PrEP available have been put forward. I find it deeply frustrating that in many areas that has not yet been delivered by local councils. We are working with local councils and urging them to take up the offer that is already available from the NHS. I totally understand and share the hon. Gentleman’s frustration. We are working to push local authorities to do this, but responsibility for public and sexual health services was transferred to local councils, as a result of a decision taken by this House. I am doing my part. I would love to work with him to ensure that it can actually be delivered on the ground because he is absolutely right that it is the right thing to do and the right direction to go in.

[Rushanara Ali (Bethnal Green and Bow) (Lab)]

The objective fact is that the public health grant has gone down by £700 million between 2014-15 and 2019-20. If a person gets on the tube at Westminster station and travels to Whitechapel station in my constituency, average life expectancy drops by six months at every stop. That is the reality in constituencies such as mine. My appeal to the Secretary of State, if he is serious about tackling health inequalities, is to back local authorities with the resources they need.

[Matt Hancock]

The public health grant is of course an important part of this, but it is only one part. The overall funding of the NHS is rising by £33.9 billion, the first £6.2 billion of which came on stream last month. I understand the hon. Lady’s point. That is on the money. On the health inequalities, I entirely agree with her that they should be tackled. Doing so is at the heart of the NHS long-term plan. It is a vital task that we do not shirk. Indeed, we embrace it and are addressing it.

Let me turn to the details of the motion. While I care deeply about making sure that we have the best possible health in this nation and the strongest possible NHS—and we are prepared to put the resources in to see that happen—I also care about good governance of the nation. The way that we are run is one of the reasons this country has been strong over generations, and I believe that using the Humble Address to undermine the ability of experts, clinicians, and civil servants to give me the benefit of their frank and wise advice not only undermines me as Secretary of State, but makes it harder to make good decisions. I know the shadow Secretary of State sits on the Front Bench with revolutionaries, but I thought he was a grown-up. I do not know what his mentor, Lord Mandelson, would make of his posturing today. Of course, we will object to the motion and, if he searched the depths of his heart, he would too.

The hon. Gentleman has obviously had a missive from the Leader of the Opposition’s office—LOTO, as it is called—telling him to present the Humble Address, but it is not his style. I hope that we can get back to debating these issues on a proper motion in the future. I respect and like the hon. Gentleman: he is a really nice guy. If he had asked for the information directly—perhaps he could have sent me a message on the app—

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[Rushanara Ali (Bethnal Green and Bow) (Lab)]

The health of the population should be the Government’s and Parliament’s highest priority. From the times of the ancient civilisations, enlightened authorities have sought to prevent disease, provide clean water and sanitation, and enable citizens to live long, healthy lives. In the UK, we have a long history of interventions to improve the health of the nation, from the great sanitation projects in the Victorian era, to the Clean Air Acts, slum clearances and inoculation programmes in the 20th century, and the public smoking ban in the 21st century. Of course, all of that was accelerated with the establishment of the national health service, yet in these first decades of our new century it is clear that something is going seriously wrong.

With all our medical and scientific advances, surely we should have ended preventable disease, enabled many more years of healthy life, and witnessed ever-lengthening life expectancies. But we know that the opposite is true, as many right hon. and hon. Members have pointed out. We face an explosion of obesity and obesity-related diseases, such as type 2 diabetes and coronary heart disease. We are in the depths of a mental health crisis, with ever-growing demand for ever-diminishing mental health services. Society faces the health risks from smoking, alcohol and drug misuse, and sexually transmitted diseases.

The thing that should make us really angry is the stark difference in health and life expectancy between rich and poor. These inequalities in health are a terrible scar on our society, no matter which side of the House we are on. How can we fail to be ashamed when a person’s life expectancy depends largely on their postcode and income, and what their parents did for a living? There are many incredibly positive things in my constituency, including some of the most improved schools, which have not only improved opportunity and life chances but played a role in tackling health inequality and improving wellbeing. I pay tribute to all the health professionals and community workers in the clinical commissioning group, including its chair Sam Everington and others, who have led the way on tackling the public health challenge, but the reality is that despite all their work my constituents face massive health inequalities.

With every tube stop between Westminster station and Whitechapel station, people’s life expectancy goes down by six months. That is a scandal. Tower Hamlets has the shortest life expectancy of all London boroughs, with men living on average five years less than men in Kensington and Chelsea. We have the 12th highest prevalence of diagnosed diabetes, major challenges with obesity among children, and high levels of smoking, HIV, sexually transmitted infections and drug addiction. Even though many of my constituents abstain from alcohol, Tower Hamlets unfortunately has the seventh highest number of people with alcohol dependency.

In 2017, Sir Michael Marmot warned that the historic rises in life expectancy—the result of centuries of improvements—had ground to a halt. It is almost beyond belief that centuries of progress should end on our watch. The Institute for Fiscal Studies has warned of some of the challenges, including around suicide, drug overdose and alcohol-related liver diseases, which are affecting middle-aged men throughout England. Given the scale of the challenge and the dangers of going backwards, what are Ministers doing about this? We would think they would be investing in the kinds of programmes that help to tackle the public health emergency, but instead we see significant funding cuts, as many Members have said. In my borough, we have lost £3 million since 2015-16—in one of the areas with the highest levels of deprivation and child poverty in the country.

We need Government investment to tackle the public health challenge. Otherwise, all the Government’s investment in the national health service will be undermined, as many have pointed out, and the Government will be missing a trick. We should in this debate be unified on the need to tackle the public health challenge in all our constituencies. Ministers talk about cross-party working, so my appeal to them is that they put that to the test and put in the investment to support local agencies, local authorities and health professionals. Let us deal with this appalling challenge by working together, because it is desperately needed.

Acquired Brain Injury

Rushanara Ali Excerpts

Thursday 9th May 2019 Commons Chamber

[Rushanara Ali (Bethnal Green and Bow) (Lab)]

A great friend of mine suffered a brain aneurysm, and she may not have survived were it not for the Royal London Hospital and its support. My hon. Friend makes a good point about the need for that wider specialism in other hospitals and for transition support to provide much-needed rehabilitation.

[Chris Bryant]

My hon. Friend is absolutely right. If there is one thing that I have learnt from my experience of melanoma this year—incidentally, the thing on the back of my head is not a brain injury; I am still getting over the melanoma being cut out—it is that I, as the patient, wanted to go to the real expert, and I would travel as far as I needed to do that. Sometimes in politics it is easy to join the bandwagon when people say, “No, everything’s got to be intensely local,” but the decision on major trauma centres was a brave one taken by this Government. The Conservatives are not a party that I support, but it was the right decision for saving people’s lives. We can now save people’s quality of life as well.

The APPG also called for proper return-to-school plans for every child with acquired brain injury, training for teachers, prison officers and benefits assessors, and proper protocols shared across all sports for concussion in sport.

The effects of a brain injury can be profound. Some sufferers have severely impaired physical mobility, and there can be major behavioural challenges. I have heard of patients losing all sense of inhibition, suddenly becoming tactless, using crude and abusive language, divulging private information and becoming impulsive, irritable and aggressive; or, on the opposite side, completely passive, unresponsive and lacking initiative. Others become obsessive, repeatedly checking their possessions or becoming profoundly self-centred.

Social Media and Health

Rushanara Ali Excerpts

Tuesday 30th April 2019 Commons Chamber

[Matt Hancock]

I pay tribute to the work that the Digital, Culture, Media and Sport Committee has done in this area, both when I was Culture Secretary and since. Its work and the approach it has taken are groundbreaking, and that has played a part in the change in attitudes that we have seen from the social companies, which at least now accept that it is their responsibility, as well as the principle that they have a duty of care to people on their sites.

As my hon. Friend says, there is clearly an awful lot to do to get to where we need to be. If we step back from this whole question, the technology that has brought about social media companies is still relatively new; it is only 15 or 20 years old. Around the world, the way in which society has responded to it has not yet matured. The good social media companies now get the fact that they have such an impact on society that a regulatory framework is necessary, and in fact have welcomed the White Paper that we introduced as an approach that could be replicated around the world. My hon. Friend is quite right that, once one country or jurisdiction gets this right, it will be taken as a model elsewhere, so that, ultimately, the power of this amazing new way in which we communicate—by God, Mr Speaker, in this House we all use it—can be for the good, and we can mitigate all the downsides that come with it.

[Rushanara Ali (Bethnal Green and Bow) (Lab)]

I, too, welcome the Secretary of State’s statement, but for too long internet companies have been too slow to protect children from the risks of suicide and other harms such as online hate and the threat of far-right and religious extremists and terrorists. He will be aware that, internationally, companies such as Facebook have fallen very short and were accused by the United Nations of playing a “determining role” in the genocide in Burma. This is a massive problem, and it is right that Britain should lead the way. Is he speaking to his counterparts in other Departments? Will he make sure that the legislation actually ensures that companies are responsible for content, as well as ensuring that there are strong, large fines if they continue to fail?

[Matt Hancock]

We have proposed fines as called for by the hon. Lady, and of course this is a cross-Government effort. My responsibilities are the health impacts, but technology has an impact right across the board, including on the quality of debate in our democracy, which is a Cabinet Office issue, and with regard to terrorism content, which is a Home Office issue. The Department for Digital, Culture, Media and Sport leads across the board and the Prime Minister herself has led global debates on this. The hon. Lady is quite right to point out that there is a broad range of impacts, and we work together to tackle them.