Hospice Funding

Sally-Ann Hart Excerpts

Monday 22nd April 2024 Commons Chamber

[Sally-Ann Hart (Hastings and Rye) (Con)]

I beg to move,

That this House has considered the postcode lottery of funding for hospices; and calls on integrated care boards to urgently address the funding for hospice-provided palliative care in their areas.

As a member of all-party parliamentary group for hospice and end of life care, I am very happy to be co-leading this debate with my lovely friend, the hon. Member for Darlington (Peter Gibson), who applied for this debate today.

I have so much admiration for hospice and palliative care providers, and empathy for those experiencing dying, death and bereavement. Both my parents died of cancer, and I will always be grateful for the amazing care that they received. Hospice care is important to so many people and we are very lucky to have St Michael’s Hospice in beautiful Hastings and Rye, and Demelza House, which offers palliative care for children—largely through outreach work.

When my right hon. Friend the Member for Bromsgrove (Sir Sajid Javid) was Health and Social Care Secretary, he announced the legal right to palliative care for all ages. This was in an amendment to the Health and Care Act 2022, which declared, for the first time, a duty for integrated care boards in England to commission palliative and end of life care that meets the needs and demographic of the population it serves.

I could not believe that end of life care was not already a legal right. We should all want to see the best support available for those people who are nearing the end of their lives as well as their families, and excellent palliative care—support for people physically, mentally and spiritually—is vital.

[Barry Gardiner (Brent North) (Lab)]

I agree with everything that the hon. Member has just said. I wish to highlight the importance of palliative care for children and the amazing support that some children’s hospices are able to provide not just for the child, but for the entire family. It really is wraparound care, and so important for those parents going through that bereavement process.

[Sally-Ann Hart]

I thank the hon. Member for his intervention, and I could not agree more; he is absolutely right.

[Anna Firth (Southend West) (Con)]

My hon. Friend asks why this support is not funded. In Southend we have the absolutely brilliant Havens hospice, which includes the children’s hospice Little Havens. More than 80% of its funding comes from donations, so it is dependent on sky dives and cycle rides, which is fantastic, but given that we fund, on the NHS, the beginning of life with maternity care, does she not think that we should be funding the end of life?

[Sally-Ann Hart]

I do, and I will be coming to that a little later.

The future of end of life care is uncertain, as increasing costs and demands are putting huge pressures on hospices and care providers. When it comes to the debate on assisted suicide, it is important that people feel confident that their end of life care will protect them from pain and suffering.

Certainly, we need increased funding. More resources are needed for end of life care services, including hospices, home care and palliative care teams. St Michael’s Hospice, for example, costs around £7 million a year to run and it receives about £2 million a year from the integrated care board and the remaining £5 million comes from the community in various forms. Like all hospices, St Michael’s is heavily dependent on the generosity of local individuals, companies, groups and trusts. This funding model is uncertain and unsustainable and places hospices under considerable strain.

[Munira Wilson (Twickenham) (LD)]

I thank the hon. Lady for giving way and congratulate her on this important debate. On the point that the hon. Member for Brent North (Barry Gardiner) made about children’s hospices, I have the fantastic Shooting Star children’s hospice in Hampton in my constituency, which serves a wide catchment area. The hon. Lady mentioned the statutory duty, introduced by the Government, on ICBs to commission and fund palliative care, but the problem is that there is such huge variability. Surrey Heartlands, which is one of the ICBs that Shooting Star serves, spends only a paltry £39 per child, even though the average should be about £151, and other ICBs will not even disclose the amount. Does she agree that we need multi-year contracts with ICBs to serve these hospices?

[Sally-Ann Hart]

I agree, and will come to that later in my speech.

Demelza receives just 10% of its income from the children’s hospice grant, which ends in March 2025, and just 4% of its income from spot purchases, so 86% of its income must come from fundraising. I am concerned that neither the UK Government nor NHS England has set out whether the children’s hospice grant, which is worth £25 million, will continue beyond 2024-25. The grant is a vital source of funding for children’s hospices. Dependence on the generosity of members of the public to pay for vital healthcare would not be tolerated in other core areas of healthcare such as maternity services, cancer care or A&E. Hospices are the only statutory service that relies on fundraising to keep going, despite end of life care being an essential service that so many of us will need.

[Sir Desmond Swayne (New Forest West) (Con)]

What makes hospices so remarkable is their independence. My fear is that the more one demands that they be funded by the state, that independence will be curtailed and questioned. The hon. Member for Twickenham (Munira Wilson) put her finger on the difficulty: the problem is in the difference between the policies of different ICBs. Were they funded centrally by the grants available, as they were during the pandemic, I think it would be much better.

[Sally-Ann Hart]

I agree. It is important to point out that most hospices do not want 100% funding from the Government because they need the flexibility to do what they want. Fundraising is a really important part of the local community effort, bringing people together, but when the dependence on fundraising is so vast we might need to intervene to provide extra funding.

End of life care is an essential service that so many of us will need, but the situation is made worse by inflationary pressures and rising demand. We have an excellent ICB in Sussex—NHS Sussex, led by Adam Doyle—which has highlighted that hospices are recognised as having become increasingly fragile in recent years, due to a lack of resilience in their funding model, which is heavily reliant on gifted income alongside NHS grants.

[Bell Ribeiro-Addy (Streatham) (Lab)]

Royal Trinity Hospice in my constituency supports people across central and south-west London to live and die well. Next year it will cost it £19 million to deliver care for its around 2,500 patients and support for their nearly 1,000 loved ones—a 20% on-year increase. Meanwhile, the NHS funding that it receives will decrease in real terms to 24% of the costs of running its services. Does the hon. Member agree that the Government should commit to maintaining the funding levels that hospices such as Royal Trinity require to ensure that people receive the quality of end of life care and the dignified death that they deserve?

[Sally-Ann Hart]

This is the point of the debate: to work out what sort of funding models we need. ICBs also need to be given the freedom to assess the priorities in their local areas, but I take that on board.

We have eight hospices across Sussex, and in 2019 seven of them formed the Sussex hospice collaborative—partnership working to ensure that the hospices’ combined resources can be used to maximise the impact, reach and cost-effectiveness of their activities. NHS Sussex works closely with that collaborative arrangement, which has supported the ability to have collective conversations. In January, the APPG on hospice and end of life care published a report on Government funding for hospices. The inquiry found that despite the introduction of a legal requirement for integrated care boards to commission palliative and end of life care, ICB commissioning of hospice services is currently not fit for purpose, and the value that hospices provide to individuals in the wider health system is at risk.

Hospice funding has historically not risen in line with inflation, which has been brought starkly to light during the periods of high inflation in recent years. Costs to keep palliative services running have increased rapidly over the past few years, but that is not reflected in the Government funding that hospices receive to deliver the services, which has increased by only 1% each year on average.

[Tim Farron (Westmorland and Lonsdale) (LD)]

The hon. Member is being generous, and making an outstanding speech. I congratulate her on bringing this matter to the House. St Mary’s hospice, St John’s hospice and Eden Valley hospice, which serve the communities of Westmorland, struggle like others to find the funding that they need to keep going. One issue is increased pay settlements in the NHS, which are good, but to compete, and to get and retain staff, they need to raise their pay to keep pace. Does she agree that one model may well be that, rather than devolving this to ICBs, which are not elected and not directly accountable to anybody, the Government fund through the national health service pay rises at NHS pay rates directly to all our hospices, so they at least do not have to worry about that?

[Sally-Ann Hart]

The hon. Gentleman raises a valuable point, which I am sure the Minister will take onboard.

[Bob Seely (Isle of Wight) (Con)]

I am grateful to my hon. Friend for her excellent speech, and for securing this important debate. She comes to the crux of the matter. I am really interested to hear from the Minister, because our Mountbatten Isle of Wight hospice in Newport is much loved, and one of the core institutions on the Island. Its inflation costs in the last two years have been way above what it has been getting from the ICB.

Our ICB is in special measures. We had two meetings with the ICB last week, and it was very unclear about some of its long-term plans and how it is using its funding. Does she agree that we need to ensure that our ICBs are properly managed and run? I am delighted that she has a great ICB. For us, it is a little more complicated. We need to ensure that funding goes through to hospices, so that when there is a state element of funding—one can debate the important nature of fundraising—the NHS money gets through. Right now, it does not seem to be doing so.

[Sally-Ann Hart]

It is unfortunate that your ICB is not very good at all—

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. It is the hon. Gentleman’s ICB, not mine.

[Sally-Ann Hart]

Yes—my hon. Friend’s ICB is not very good. Obviously, leadership structure and a clear list of priorities is essential to deliver what the public need.

The significant funding challenges are particularly concerning in the context of increasing need. Sue Ryder, a palliative and bereavement support charity, projects that the demand for specialist palliative care services in England may rise by 55% over the current decade. That rise in demand is due to several factors, including increased mortality rates and a growing desire by patients to die at home rather than in hospital. We clearly need a commitment from Government to fund a much higher percentage of total palliative care costs than at present to ensure the sustainability of the hospice sector and the vital services that hospices provide in the medium term. ICBs cannot commission specialist services without the funding to do so.

The APPG’s report made a number of recommendations to Government, the NHS and local authorities. On funding, the APPG recommended that the Government produce a national plan to ensure the right funding flows to hospices, and conduct or commission a piece of work to understand the costs of providing different models of palliative and end of life care. It also called for Government funding to address immediate pressures of paying increased staffing costs for hospices, and said that ICBs must ensure uplifts to hospice contracts that are equitable with uplifts received by NHS-run services.

[Jim Shannon (Strangford) (DUP)]

We have a Marie Curie hospice in Belfast that gives excellent care to those who have cancer. Does the hon. Lady agree that, while it is important to have the financial part in place—without it, hospices cannot go on—the faith aspect is important as well? Many people need hospice care on their last journey, ever mindful that their last journey is not in this world; the next world is the one that matters. When it comes to ensuring that moneys are available, does she agree that faith is important as well, and that the faith care that the Marie Curie hospice gives in Belfast is an example of what we all need? Whatever our faith may be—Christianity or another religion—it is important to have something that looks after the hereafter.

[Sally-Ann Hart]

Faith is important for so many people. Even for those without a faith, there is a spiritual aspect that needs to be looked after.

My hon. Friend the Member for Darlington will cover the report in more detail. Hospices need to be able to plan and invest in their services and develop and train specialist staff, so they need to know in advance how much funding they are getting. Hospices already face issues of training and recruitment, and whether they will be able even to provide an adequate service because of funding restraints should not be another worry. My goddaughter is a young doctor who wants to specialise in palliative care, which is remarkable for a young person. We need more young people—more medics, nurses, occupational therapists and so on—in this growing area. A three-year funding cycle at least is required, as it would allow hospices and palliative care providers to plan accordingly.

I conclude my remarks with a worrying Hospice UK statistic: it estimates that the end of life care sector is on track for a £77 million collective deficit for the financial year 2023-24. That would present the worst end of year figures for the sector in around 20 years of tracking. Those losses are not sustainable, and our right to end of life care is at risk unless immediate action is taken. Our hospices, palliative care and end of life services need to be properly funded. Will the Minister outline what steps she is taking to ensure that that happens?

--- Later in debate ---

[Sally-Ann Hart]

I thank the members of the Backbench Business Committee for granting this important debate in this House, as well as all the Members who have spoken today and Hospice UK for their dedicated work and support. I especially thank St Michael’s Hospice and Demelza, their staff and all the volunteers, as well as local people for their donations and fundraising, especially during challenging economic times. I also thank my hon. Friend the Member for Darlington (Peter Gibson) for all his long-standing hard work and advocacy on behalf of hospices and end of life care.

Members from across the House have spoken collectively on this important issue, with a passion and consensus that shows that the funding of hospices and palliative and end of life care is not a political issue. The Government do financially support hospices through ICBs, but funding models also require closer consideration, ensuring parity with the NHS while maintaining hospices’ independence and flexibility. The Minister has heard many similar themes, mainly surrounding certainty of funding, on a sustainable basis, and better collaboration between ICBs, the NHS and hospices. I thank her for her work, her consideration and listening to the debate. Extra Government funding via ICBs can improve a localised approach. We all call for more funding to be included in the spending review.

Question put and agreed to.

Resolved,

That this House has considered the postcode lottery of funding for hospices; and calls on integrated care boards to urgently address the funding for hospice-provided palliative care in their areas.

Business of the House (Today) (No. 2)

Ordered,

That, at this day’s sitting, the Speaker shall not adjourn the House until any Messages from the Lords relating to the Safety of Rwanda (Asylum and Immigration) Bill shall have been received.—(Aaron Bell.)

Parents and Carers of Infants: Support

Sally-Ann Hart Excerpts

Tuesday 12th March 2024 Westminster Hall

[Sally-Ann Hart (Hastings and Rye) (Con)]

I beg to move,

That this House has considered information on support available for parents and carers of infants.

It is a pleasure to serve under your chairmanship, Mr Henderson. As vice chair of the all-party parliamentary group for conception to age two—the first 1,001 days—and mother to three adult children, I know how important the early days are. There is a wealth of evidence that the critical 1,001 days from conception to the age of two have a significant impact on the health, wellbeing and opportunities of babies and children throughout the rest of their lives.

The arrival of a new baby can bring huge joy to families, but it can also be a time of stress and anxiety as parents and carers adjust to the new responsibility, which can be overwhelming. There is no rulebook in parenting, and all families need some help to give their babies the best start in life. Parents are always learning and adapting to the different needs of growing children. We are all fallible. Help comes from family, friends, healthcare professionals or volunteers. There is often a huge variety of support and services available, but as my right hon. Friend the Minister found when she led the early years healthy development review, it is not always easy for families to access information about what support is available. That can make it hard for families who are juggling the demands of caring for a baby to find the support they need when they need it most. That is why I introduced the Support for Infants and Parents etc (Information) Bill on 6 February.

Before I continue, I thank the Chamber Engagement Team for their work in engaging the public on the Bill, and the Department of Health and Social Care for its advice. Interestingly, in feedback to the Chamber Engagement Team, many responders said that they were given very little information, especially on breastfeeding, and that lots of parents were paying for information from private providers, or mainly got information from online communities. Others had more mixed experiences, often saying they were given better information ante, rather than post, natal. Only a minority had much better experiences. Most people centred their responses on improving the dissemination of more consistent information. Increasing the numbers of health visitors and midwives was also a popular theme, and many said that they had heard of the family hub network, and the Start for Life programme.

My Bill is intended to support a baby’s cognitive, emotional and physical development during the 1,001 critical days from pregnancy up to the age of two by making information on the support available easier to access.

[Mark Logan (Bolton North East) (Con)]

I congratulate my hon. Friend on securing this debate. In my constituency, there is an organisation called Family and Babies Bolton. Elaine put together the organisation over a number of years. It deals with breastfeeding and breastfeeding support and information for new mothers. Does my hon. Friend agree that this debate is a great opportunity to recognise the work of those organisations, not only in Bolton but across the country, which ensure a better future for our babies and infants?

--- Later in debate ---

[Sally-Ann Hart]

I agree with my hon. Friend. The wonderful thing is that we have so many voluntary organisations that do amazing work helping young mothers and parents with breast and infant feeding. Our family hubs focus on that, as does the Start for Life programme. It is not just one organisation; there are lots of services out there that can support parents doing this.

The Bill will achieve its aims by ensuring that local authorities publish a Start for Life offer on their websites and via other means they consider appropriate—for example, by providing physical as well as digital copies of their offer. A Start for Life offer is information on services that a local authority is aware are available in its area for infants, parents or carers of infants, or prospective parents and carers, that are provided by or on behalf of public authorities.

In particular, the Bill focuses on services that support the physical and mental health and development of infants, and that support parents and carers, or prospective parents and carers, in providing support to their infants. The services named in the Bill that local authorities will be under a duty to publish information about are maternity services, health visiting services for current or prospective parents or carers of infants, services promoting positive relationships between infants and their parents or carers, mental health services, and breastfeeding and other infant-feeding services. Local authorities will be able to provide additional information on other services that they consider it appropriate to include information about.

The Bill also includes a regulation-making power so that the Secretary of State may ensure that information on other services provided by or on behalf of a public authority that are likely to support infants, parents or carers of infants, or prospective parents or carers, are included in a Start for Life offer in the future. The Bill introduces a further duty on the Secretary of State to publish guidance to local authorities relating to those duties. It is important that parents receive evidence-based support and are provided with information that is backed by research and proven by parents, such as that of the Start for Life programme.

While I understand that guidance on Start for Life offers already exists, I know there will be a huge amount of learning from the Government’s family hubs and Start for Life programme that could be considered and taken on board as part of new statutory guidance. A duty to consult on the statutory guidance will ensure that local authorities and bodies the Secretary of State consults will have the chance to have their say on what will most help them to fulfil that duty and support families locally.

Finally, the Bill requires the Government to publish an annual report that sets out information about support that is being provided in England for infants, their parents and carers, and prospective parents and carers. The report will also include information that the Secretary of State considers appropriate to include, such as information about the impact of support on outcomes. That is very important as it will create further transparency for prospective parents, and for parents and carers of infants, so that they can understand the support available as they navigate the joys and the challenges of raising a new baby.

I will say a few words on the family hubs and Start for Life programme. Family hubs offer early support to families and young children to help them overcome difficulties and build strong relationships. East Sussex County Council was one of the trailblazers benefiting from the £300 million investment up to 2025. It is leading the way and supporting other local authorities to improve services that are offered to families so that they can be rolled out more widely across the country.

We have three family hubs in Hastings, offering support including maternity and health-visiting services, breast and infant feeding, parenting programmes, budgeting, employability and many other things. I pay tribute to East Sussex County Council’s director of children’s services, Alison Jeffrey, who is soon to retire, for all her dedication, determination and service to all families across East Sussex—especially to ensure that children’s life circumstances are not life sentences.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady. When it comes to the issue of childcare or support available for parents and carers of infants, what she is saying is really important. Just to give a quick point of view from Northern Ireland, there has been an increase of some 14% in the price of childcare—which is part of this topic—in Northern Ireland as of 2021. My party has long pushed for an increase in the tax-free childcare allowance beyond 20%.

The pressure on working-class families cannot continue. More needs to be done to support them financially with childcare, so that they can go out and work and, as a result, make ends meet at the end of the month. The hon. Lady is right to raise this matter. I would press the case of working-class families who are under extreme financial pressure.

[Sally-Ann Hart]

I thank the hon. Gentleman for his comments. The Bill is not specifically to do with childcare; it is also to do with the information given to parents and carers and prospective parents and carers of babies and infants. However, I do take on board his point about childcare. I think the hon. Gentleman will be aware that people who are in receipt of universal credit get free childcare, to some extent. That is worth noting, is it not? I thank him for his intervention.

Strong families are at the heart of communities. It is so important in Hastings and Rye to have high ambitions for and expectations of our families, because supportive families make for more stable communities, better outcomes for children and happier individuals. Investing in families and making sure they get the support they need from birth through to adulthood helps with children’s educational attainment, wellbeing and life chances, while improving wider outcomes such as poor mental health and unemployment. That is why funding allocated to family hubs must continue beyond 2025, and further funding should be allocated to extend the scheme to all local authorities in England beyond the 75 pilot authorities.

My Bill is scheduled to have its Second Reading on 15 March—this coming Friday. I hope it will be successful and that we can work together to ensure that every baby has the best start in life.

[Tim Loughton (East Worthing and Shoreham) (Con)]

I came along this afternoon just to listen, not to speak. However, I have been so inspired by my Sussex colleague, my hon. Friend the Member for Hastings and Rye (Sally-Ann Hart), and equally so shocked by the revelation that the hon. Member for Strangford (Jim Shannon) does not intend to make a speech in this debate—above and beyond the mini contribution he has already made—that I will use the time available to make a few comments. I want to speak particularly in support of my hon. Friend’s Bill, which I wish well this Friday, but also in the greater context of the Best Start for Life programme that has been championed over so many years by the Minister.

It is worth reminding ourselves why the whole issue of getting the best start in life and encouraging, nurturing and supporting parents at the very early stages is so important. I speak as the chair of the APPG on conception to age two—first 1,001 days. We have a display of officers from that eminent group here today, which was set up by the Minister herself some years ago. Those first 1,001 days are critical because it is a period of uniquely rapid growth in toddlers’ brains. More than a million new connections are formed every second in a baby’s brain, and babies’ growing brains are shaped by their experiences, particularly the interactions they have with their parents and other caregivers. What happens during this crucial time lays the foundations for future development, not just during childhood but into adulthood. They are effectively lifelong.

There is a lot of research showing that the way in which parents interact with their baby predicts the child’s later development. In order to thrive, children absolutely must have a loving and secure relationship with at least one sensitive, nurturing caregiver who can respond to his or her needs. That is why it is so important to support parents and parent-infant relationships to give children the best start in life. A range of stress factors during pregnancy and early years can be communicated to and can impact on a baby or growing toddler.

The cost of not getting it right is considerable. Some years ago, when the Maternal Mental Health Alliance issued its flagship report, it costed maternal perinatal mental health problems at some £8.1 billion. That is what it is costing for not giving mums and dads the best support to ensure that they can bond with their children. One in six new mothers will suffer some form of perinatal mental illness, and covid certainly worsened that situation, with all the pressures on first-time parents in particular of babies born during covid, as they did not have access to some of the support networks that we took for granted until then. In addition, child neglect has been costed at something like £15 billion each year, so we are spending £23 billion-plus on the consequences of not getting it right by intervening at a stage when it could have the maximum impact for the parent and, mostly importantly, the developing and growing child.

Healthy social and emotional development in the first 1,001 days means that individuals are more likely to have improved mental and physical health outcomes from cradle to grave. It means that children can start school with the language, social and emotional skills they need to play, explore and learn, and that children and young people are better able to understand and manage their emotions and behaviours, leading to less risky and antisocial behaviour later on. It also means that children can have the skills they need to form trusting, healthy relationships.

It has been calculated that some 28% of mothers with mental health problems report having difficulties bonding with their children. Research suggests that the initial dysfunctioning of mother-baby relationships affects children’s development by impairing their psychomotor and socio-emotional development. As well as the direct impact on the child, it can have longer-term adverse effects on the parents and wider family. The onset of a maternal mental health condition can precipitate relapse or recurrence of previous mental illness. It has the potential to herald the onset of long-term mental health problems and is associated with an increased risk of maternal suicide, and we know how alarming the figures are for women who commit suicide soon after giving birth. It is important to say that this is not limited to mothers; there is also an impact on fathers. Post-natal depression has been linked with depression in fathers and high rates of family breakdown, so this is all about families and the children. That is why it is important not only that we have a range of services available in a joined-up way, but that those parents know how to access those services and whom to speak to.

I will give an example from all those many centuries ago when I was the Children’s Minister. One of the first things I did in the first summer recess was to spend a week being a social worker in Stockport. I went out with real-life social workers, without cameras, just doing their daily job. One of the first places I was taken to, with a really impressive social worker—I think they chose one of the most challenging cases they could—was a house in one of the most deprived parts of Stockport, where a young mum with three young boys from three different fathers, none of whom was on the scene, were living in absolute squalor. There were no carpets on the floor, and they were literally eating off the floor. There was nothing in the fridge, some furniture dumped at the bottom of the garden and dirty mattresses that the kids were sleeping on.

One of the children had a bad toothache—I remember it distinctly as if it were yesterday—so the social worker said to the mother, “Why haven’t you taken the child to the dentist?” because it had been going on for some time. The mother herself had had a tooth problem the day before. She had gone to the emergency dentist and had it sorted out, but she had not had the presence of mind to take the son with her. Before long, if things went on like that, those children would have ended up in care. The mother would have been absolutely beside herself—she doted on and relied on those children greatly, and the kids relied on her. For all her problems and challenges in being a decent mother, that was all she knew; she had had poor parenting herself.

What struck me was that a number of professionals had been going in and out of that house over a period of time, and virtually every time they went, she had to start her whole story again about the various problems. There was no real joined-up action where that mum and her kids were almost literally taken by the scruff of the neck to children’s support services at the local children centre, taken to the dentist, or given information and classes on nutrition and feeding and things like that. What was needed was somebody to take control of that family’s life, get them back on the straight and narrow, and join up all the services and all that information, and that just was not happening. A lot of money, time and resources were being spent on that family, and things were not getting any better. That is why the Start for Life programme, and the Bill that my hon. Friend the Member for Hastings and Rye is putting together, are all about making sure that somebody takes control of the information around a family’s requirements and needs, points them in the right direction, and takes them physically to where they need to go if necessary, so that it does not constantly start again every time the family comes into contact with yet another agency or professional service. That is why the work on the red book—digitising it, for example—is important to make sure that information is readily available to everyone having contact with families that need that sort of help.

None of this is rocket science or, frankly, new; we have been talking about it for many years. Earlier, I dug out one of the reports from the conception to age two: first 1001 days all-party parliamentary group. “Building Great Britons”, which we produced back in 2015, is now almost 10 years old. I reread the foreword, which I wrote, and we made some recommendations. I will go through those quickly to see how many have become reality and how many can still become reality with the assistance of my hon. Friend’s Bill. We also came up with two conclusions. The first was:

“We want to create children who at the end of their first 1001 days have the social and emotional resources that form a strong foundation for good citizenship.”

Tick—that is absolutely still our goal. The second conclusion was:

“Without intervention, there will be in the future, as in the past, high intergenerational transmission of disadvantage, inequality, dysfunction and child maltreatment. These self-perpetuating cycles create untold and recurring costs for society. The economic value of breaking these cycles will be enormous.”

Tick—that absolutely applies today, as it did then. A case in point is the one I cited in Stockport, which is a textbook example of how failing to intervene properly is costing an awful lot of money.

The first recommendation was:

“Achieving the very best experience for children in their first 1001 days should be a mainstream undertaking by all political parties and a key priority for NHS England.”

I hope that the Start for Life programme, which the Minister proposed, was done with the sign-up of all the other main political parties. That is really important, because it is a long-term scheme. When there are changes of Government, it is important that one does not change everything for the sake of changing it—I was going to say, “Throw the baby out with the bathwater.” One might want a bit of rebranding or tweaking here and there, but this needs at least a decade to really take effect. I hope that the good work the Minister has done will carry over if there is a change of personnel and Government in the future.

The second recommendation was:

“Require local authorities, CCGs and Health & Wellbeing Boards to prioritise all factors leading to the development of socially and emotionally capable children at age 2, by: adopting …a ‘1001-days’ strategy”.

That is part of what the Bill proposed by my hon. Friend the Member for Hastings and Rye will impress on local authorities. Much of this is delivered through local authorities and local health professionals. It is all very well for the Government to say, “This is what needs to happen,” but it does not happen unless there is the buy-in, the infrastructure and the commitment to deliver it at the sharp end at local level.

The third recommendation was:

“National government should establish a ‘1001-days’ strategy fund to support local authorities and CCGs to make a decisive switch over the next 5 years, to a primary preventive approach”.

I think we are only part of the way on that one. The Minister may want to pick that up and explain how we can achieve that.

The fourth recommendation was:

“Hold Health & Wellbeing Boards responsible for ensuring that local authorities and CCGs demonstrate delivery of a sound primary prevention approach”,

as outlined in part 2 of our report. Again, that is what my hon. Friend’s Bill is trying to get at. We need to see commitment at a local level for local people to judge. They can do it in different ways. What might apply well in my constituency might not apply so well in my hon. Friend’s constituency, in large northern metropolitan boroughs, or in rural constituencies. It is up to local interpretation how it is best delivered, with a framework set out nationally, but with local authorities and local agencies having to describe and set out how they are going to achieve the goals and aims.

The fifth recommendation was:

“Build on the ‘Early Help’ recommendations of the Munro Review”,

which I commissioned in 2010,

“by requiring and supporting all relevant agencies in prevention to work together to prevent child maltreatment and promote secure attachment.”

As I found in office, joined-up government is an illusion. I hope that the appointment of my right hon. Friend the Minister, with a remit in several different Departments as well as Best Start for Life, achieves more of a joined-up approach in that regard.

The sixth recommendation was:

“Appoint a Minister for families and Best Start in Life with cross-departmental responsibility”,

which I hope the Minister is achieving. I hope it will survive and continue under whoever fills her shoes at some hopefully distant stage in the future.

The seventh recommendation was:

“Make joint inter-agency training on the importance of the early years for social and emotional development, for all professionals working with children and families in the early years, a priority in the ‘1001-days’ strategy.”

That is important, as I found in safeguarding. We need professionals from different bodies singing from the same song sheet. The most effective way to do that is with joint inter-agency training so that they learn about the requirements of the job sitting next to the police officer, the health visitor, the teacher, the GP, or whichever professional is involved. We do not do inter-agency joint training nearly effectively enough.

[Sally-Ann Hart]

My hon. Friend makes a valid point. Family hubs involve partnership working. I know that East Sussex family hubs partner with police, health and education, so they really do provide whole-family support.

[Tim Loughton]

That is absolutely right. We had children’s centres to an extent; we must have family hubs to a much larger extent. We need a sort of Piccadilly Circus of different professionals coming together, sharing information and nominating who will act for a particular family to make sure that the job is done and that a family in need does not fall foul of memos circulating between different professionals that never actually hit the spot. Somebody must pick it up and act on it. So many safeguarding cases end badly because somebody does not take responsibility, pick up the ball and act on it in whatever way. That is why family hubs are important.

We have all the relevant people in the same place, although hopefully going out of the family hub because most of the good things happen outside a family hub. It is not all about bricks and mortar, but where the services are targeted. The problem with children’s centres in the past, great idea though they were, was that the 15% most deprived families who would benefit most from the services offered by children’s centres tended to be those who did not access those centres. Family hubs are all about getting across thresholds where people live and go, work and shop and whatever it may be.

That was effectively the eighth recommendation. Children’s centres and youth hubs should be set up to be a melting pot of different services available.

The final recommendation was:

“Research evidence and good local area data are necessary to ensure effective changes are implemented to services. Where data and evidence are not available, these should be prioritised and supported with appropriate funding.”

I hope that as family hubs are rolled out and the Best Start for Life project becomes a reality they will start to produce the evidence we need to show that the impacts we are having on babies and their parents is life changing and dramatic. It is certainly a good investment socially and financially because hopefully we can prevent all the problems by getting in at the most appropriate time, at the earliest time.

Communication, information and all the things that my hon. Friend the Member for Hastings and Rye is endeavouring to achieve with her Bill—I wish her well with that on Friday—are all about continuing the jigsaw of the Best Start for Life, which my right hon. Friend the Minister started and which I hope will come to full fruition, because we desperately need it for so many of our children, families and babies in this country.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)]

It is a real pleasure to serve under your chairmanship, Mr Henderson. What a lovely debate! I thank all colleagues from across the House for their contributions; it has been genuinely interesting. I would like to begin by thanking my hon. Friend the Member for Hastings and Rye (Sally-Ann Hart) for introducing her Bill on such an important topic and for securing time to debate it today. As Members will know, I have been championing the needs of babies for getting on for 27 years—gosh, that makes me very old. Now, having the huge honour of being the Minister with responsibility for Start for Life, I remain as committed and as passionate as ever in my mission to make sure that every baby gets the best start for life.

It began with my mum, a qualified midwife, asking me to help her to write a business plan for the Oxford Parent-Infant Project, a charity that to this day helps families who are struggling emotionally to cope with the journey to parenthood. Having experienced post-natal depression myself with my first son, who is now 28 and very big, I know only too well how crucial the earliest years are.

I have spent much of the last 27 years helping to establish parent-infant partnerships and various different charities providing therapeutic support for families, and then, in Parliament, working on the cross-party manifesto for the 1,001 critical days, and championing babies in Government and in Parliament.

I have worked with many colleagues. I am grateful to the hon. Member for Denton and Reddish (Andrew Gwynne) for noting that this is a cross-party agenda. I totally agree with him. I had so many conversations with Dame Tessa Jowell about the fact that Sure Start went so far, but that family hubs would be the 21st-century version. That is not to denigrate in any way the fantastic work of Sure Start, but family hubs are a one-stop shop, building on that excellent work and using the potential for digital to create a digital red book. The shadow Secretary of State, the hon. Member for Ilford North (Wes Streeting), has been sending me parliamentary questions about that. I encourage him to continue doing so, because it might speed things up.

There are many different measures to create the one-stop shop for parents, in a way that did not exist with Sure Start. Crucially, we want to make sure that those services are completely universal. What every parent and carer has said is, “No.1: tell me where I can get services and what they might consist of. No. 2: don’t stigmatise me. Don’t make me feel that if I go to this place, you might start proceedings against me and my children.”

The programme is designed to improve on, build on and grow that crucial support for the early years, and I am delighted to hear that it has the support of the hon. Member for Denton and Reddish.

As well as the support from Dame Tessa Jowell, Lord Field, Lord Blunkett, Lord Cameron, my right hon. Friend the Member for Maidenhead (Mrs May), Boris Johnson and our present Prime Minister, who all support this crucial early days agenda, I pay particular tribute to the support from my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton), who has worked with me for so many years. We met when I was 18 and he was 19 at university. Before we were in Parliament together, we had this same interest in early years. As a former Children’s Minister, he has done so much to promote this agenda. I have mostly enjoyed working with him; sometimes I wish he would pipe down, but it is really excellent that he carries on banging the drum for early years. We have worked on it for so long together; he feels like an old pair of boots. Is that parliamentary language, Mr Henderson? I am sure it is.

As my hon. Friend the Member for East Worthing and Shoreham discussed, there is strong evidence that the 1,001 days from conception to the age of two set the foundations for our cognitive, emotional and physical development. Nurtured babies will go on to develop strong relationships and, as they grow up, will be better equipped to tackle the challenges that life throws at them. Investing in that critical period represents a real opportunity to improve outcomes and tackle health disparities by ensuring that millions of babies and their families have access to a one-stop shop style of family hub where all support services can be found in one welcoming universal hub.

Shockingly, up to 40% of babies are not securely attached by the time they reach the age of five to a loving adult carer. Worse still, around 10% have disorganised attachment, which is closely linked with the worst outcomes in our society.

I was delighted, back in July 2020, when the then Prime Minister asked me to chair the early years healthy development review. The goal was to create a vision for brilliance during the 1,001 critical days from conception to a child’s second birthday.

During that review, I met with families, academics, frontline professionals, charities and volunteers to understand what was going well and where change was needed. I saw excellent examples of people helping families when they needed it most, but I also heard how hard it can be for parents and carers to find timely support. I heard about the many services available to families, which are delivered by a workforce of highly skilled professionals, as well as many dedicated volunteers, but I also heard that information on those services is often patchy and difficult to find, with parents finding it almost impossible to navigate the system and understand what support is available to them.

In March 2021, the Government published “The best start for life: a vision for the 1001 critical days”. The vision set out six action areas for improving support for families during those critical days to ensure that every baby in England is given the best possible start in life, regardless of their background. It is the first action area in that vision that describes how every local authority in England, working with the NHS and other partners, will be encouraged to provide a clear and joined-up Start for Life offer to every new family.

Each local authority’s Start for Life offer would describe the essential support that every new family might need, as well as providing information on the additional support that some families require. A clear and accessible Start for Life offer will help to signpost families to the support and services available where they live, and those Start for Life offers should explain clearly to parents and carers what exactly is available and where to find it. The recommendations included in the vision are relevant to every local authority in England.

In my role as the Under-Secretary of State for Public Health, Start for Life and Primary Care, I now have the ongoing pleasure of visiting local authorities up and down the country, and I see directly some great work happening to give every baby the best start in life. Just last week I visited Uxbridge family hub, where I saw some fantastic work by Hillingdon Council and its partners to provide vital services to families with babies. That included providing a welcoming space for parents and carers to make new friends, and offering many different specialist support services, including antenatal, midwifery and health visiting, as well as infant-feeding and parent-infant-relationship support.

To support the implementation of the Best Start for Life vision, the Government are investing around £300 million to improve support for families through the family hubs and Start for Life programme. The programme is implementing many elements of the vision and is delivering a step change in outcomes for babies, children, parents and carers in 75 upper-tier local authorities in England, including most of those with high levels of deprivation.

The programme provides funding for local authorities to publish Start for Life offers and to establish parent and carer panels so that they can receive direct feedback from those using the services. There are many examples of good progress in publishing and publicising Start for Life offers right across the country. For example, Northumberland County Council has equipped every health visitor, midwife and family-hub practitioner with a QR-code keyring that, when scanned, takes users to a bespoke website setting out the local Start for Life offer. That ensures that parents and carers can be encouraged to access the offer at every opportunity.

Many local authorities that have not yet received additional funding through the family hub and Start for Life offer have also chosen to publish their Start for Life offers anyway, and to implement other elements of the vision, because they can see the huge benefits to future outcomes for families and their children. Early prevention is not just kinder but much cheaper than later interventions.

In the Government, and across parties, we all remain committed to ensuring that every baby gets the best start in life. Central to that is ensuring that parents are able to easily find the support that they need, when they need it most. The Support for Infants and Parents etc (Information) Bill, introduced by my hon. Friend the Member for Hastings and Rye, has the potential to help ensure that that is the case, so I want to conclude by reiterating my thanks to my hon. Friend for her introduction of that private Member’s Bill, and for securing today’s debate on such an important issue.

The debate has highlighted just how important the 1,001 critical days are, as well as the huge opportunity that the Bill provides to ensure that families have access to vital information about the support available to them at such a critical stage in both their lives and the life of their baby. I look forward to the Bill’s Second Reading on Friday.

5.20 pm

[Sally-Ann Hart]

I thank everyone who has attended this debate and made a contribution, showing support on this very important issue. I especially thank my right hon. Friend the Minister for her comments and her interest in this private Member’s Bill.

I thank my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton) for his valuable comments as chair of the APPG on conception to age two—first 1001 days. As a former Children’s Minister, his knowledge, passion and focus on children and families is exemplary. He highlighted the long-term aims that were in the “Building Great Britons” report—it was extremely helpful for him to draw attention to them—and how failing to intervene is not just a social and human issue, but an economic one, too, if we are going to put the pound signs in front of our eyes.

My right hon. Friend the Minister and my hon. Friend the Member for East Worthing and Shoreham are the dream team for early years. I have to say that—it is absolutely right. I also thank the shadow Minister, the hon. Member for Denton and Reddish (Andrew Gwynne), for his kind words and support, for his clear passion for children and families, and for his clear acknowledgment that children and families are not political. They really are not political.

In conclusion, I believe that the support for my private Member’s Bill, the Support for Infants and Parents etc (Information) Bill, will play an important role in helping to achieve the Government’s aim of giving every baby the best start in life. I hope that the Government will support the Bill when it has its Second Reading on Friday.

Question put and agreed to.

Resolved,

That this House has considered information on support available for parents and carers of infants.

5.22 pm

Sitting adjourned.

Illegal Vapes

Sally-Ann Hart Excerpts

Tuesday 16th January 2024 Westminster Hall

[Sally-Ann Hart (Hastings and Rye) (Con)]

It is a pleasure to speak under your chairmanship, Sir Mark. I congratulate my hon. Friend the Member for Darlington (Peter Gibson) on securing today’s debate on a very important issue.

On the face of it, nicotine vaping is substantially less harmful than smoking. It is also one of the most effective tools for quitting smoking. However, I believe that before I speak about illicit vapes it is worth noting that although vaping has helped adults to quit smoking, we do not know for sure its long-term health effects and have only an early understanding of the kinds of health problems that vaping poses. The Royal College of Physicians noted that some cancer-causing substances present in tobacco smoke have also been detected in e-cigarette vapour, which raises the possibility that long-term use of vapes may increase the risk of smoking-related diseases. However, the risks are obviously much lower than those posed by smoking.

Vaping is becoming more and more popular with young people. According to Action on Smoking and Health, over 20% of children between the ages of 11 and 17 tried vaping in 2023—up from 15.8% in 2022. There is potential for the major health disaster of a new generation of young people getting hooked on nicotine. Although nicotine itself is not the problem per se, the different substances found in e-liquids cause concern. To analyse the real contents of popular vapes, the Inter Scientific laboratory, which offers regulatory and testing services, looked at a selection of vapes confiscated from school pupils in the UK. It examined them to ensure that the UK tobacco and related products regulations were met, but it found high levels of metals in the e-liquid that far exceeded safe exposure levels. Results from the 18 vapes analysed showed 2.4 times the safe level of lead, 9.6 times the safe level of nickel and 6.6 times the safe level of chromium. Obviously there was a low dataset, but it shows that the regulations on vapes are not being met in this country.

Then we come to illegal vapes. Trading standards seized over 2 million illicit vapes across England between 2022 and 2023. In East Sussex, over 3,000 illegal vapes were seized in 2020. I believe that this is only the tip of the iceberg. Illicit vapes are particularly popular with under-age consumers, because they are cheap and can be bought in shops that are less likely to check ID. Research from the Chartered Trading Standards Institute suggests that a third of products sold in UK shops are likely to be illegal. Given the levels of metals found in legal vapes, I dread to think what the levels might be in the illegal ones. The situation is staggering, and young people are often unaware of what they are actually buying.

How do we tackle this problem? The solution lies in the method that we used to reduce smoking rates in children between 2000 and 2021. By reducing vaping rates in children, we can also help to address the scourge of illicit vapes. ASH’s response to the Government’s recent call for evidence on youth vaping is fantastic. I do not have time to go into the detail of its suggestions for tackling youth vaping, but it emphasises four key policy levers at the Government’s disposal, and I am sure the Minister is considering its recommendations.

I am glad that the Government have set out plans to introduce a tobacco and vapes Bill in this parliamentary Session, and I hope it will address many of the issues highlighted in today’s debate, because that will help to protect the health of children and adults in Hastings and Rye, now and in the future.

Oral Answers to Questions

Sally-Ann Hart Excerpts

Tuesday 5th December 2023 Commons Chamber

[Maria Caulfield]

That is the difference between the SNP and the Conservatives: we have aspiration for people, and we absolutely want to support people with mental health problems and illness to get into work. They should have the same opportunities to get into work, and not just to get a job, but to get a good job and get a career. If we look at its website, Mind supports people getting into work, saying that it is not just a source of income, but provides a “sense of identity” and “structure” as well as support, confidence and ambition.

[Sally-Ann Hart (Hastings and Rye) (Con)]

A recent study by Magic Breakfast and the British Nutrition Foundation found that eating a healthy breakfast can improve the nutritional intake of the most vulnerable children, improving their physical and cognitive development and their mental health. Will my hon. Friend work with colleagues in the Department for Education to consider expanding school breakfast provision in order to reduce the health impact of child food insecurity?

[Maria Caulfield]

We want a more cross-Government approach to mental health provision, and that is why in our suicide prevention strategy we are working with multiple Departments. My hon. Friend asks about support for nutrition in schools, and I will certainly raise that with colleagues in the Department for Education to see what more can be done.

Draft Mental Health Bill

Sally-Ann Hart Excerpts

Monday 27th June 2022 Commons Chamber

[Sajid Javid]

The hon. Gentleman will know that the investment already going into the workforce is at record levels. As the NHS sets out its 15-year workforce strategy, it will look into acquired brain injury, and rightly so. I thank him for the work he is doing with the Minister for Care and Mental Health, my hon. Friend the Member for Chichester (Gillian Keegan), on the ABI strategy. I understand that the call for evidence has just closed. That process will also help to bring about the change that he seeks.

[Sally-Ann Hart (Hastings and Rye) (Con)]

I met some amazing young people from my constituency last week during the “It’s our Care” lobby of Parliament, and one issue they raised was mental health among looked-after children. What steps is my right hon. Friend taking to ensure that the mental health needs of looked-after children are taken into account, so that they, too, can thrive?

[Sajid Javid]

My hon. Friend raises an important issue. We have increased to a record level resources for mental health services for children, including looked-after children, but we need to ensure that the strategy is fit for the future. This will be a key part of our 10-year mental health strategy.

Multi-hospital NHS Trusts: Transportation

Sally-Ann Hart Excerpts

Wednesday 9th March 2022 Westminster Hall

[The Minister for Health (Edward Argar)]

It is a pleasure to serve under your chairmanship, Ms Nokes. I congratulate my hon. Friend the Member for Eastbourne (Caroline Ansell) on securing this important debate. As she alluded to, she has been a regular and persistent—albeit always courteous—campaigner for the NHS in her constituency, for her local hospital and, most importantly, for her constituents and their ability to access the services they need. I am aware of her long-standing interest in the issue. It is fair to say that her constituents are incredibly lucky to be represented by someone with such a passion for Eastbourne.

I join her in paying tribute to her hospital trust and everyone who works there, across the three sites, for what they have done, not just over the past two years in extraordinary circumstances, but what they do every day, year in, year out. I also join her in paying tribute to the Eastbourne Herald, of which I am maybe not as assiduous a reader as I should be. The latest story I read was about disco public lavatories. I have followed the important work undertaken by India Wentworth, since she joined the Herald in 2020, in campaigning on the issue and drawing to public attention the challenges faced by my hon. Friend’s constituents and others in Sussex.

It is rightly the responsibility of clinical commissioning groups—CCGs—or what will soon become integrated care boards and trusts, to plan for reconfigurations of NHS services. It is important that any such plan commands local legitimacy and confidence. I will respond to my hon. Friend’s questions. One was about consultation around reconfigurations, and how public transport and accessibility featured in that. All reconfigurations are subject to four Government tests. The first is strong public and patient engagement. To her point about the 2019 survey, I encourage her trust to continue engaging with that patient voice, including specifically around access. I will come on to access in a moment in the reconfiguration criteria.

Other tests are consistency with current and prospective need for patient choice: a clear clinical evidence base; and support for proposals from clinical commissioners. It is important to hear from as many local people as possible about the practical impacts and concerns. None of the decisions on reconfigurations is easy or straightforward. They are about balancing different needs and benefits. Rightly, in the different reconfigurations my hon. Friend alluded to—ophthalmology and cardiology —as we would expect in any reconfiguration, clinical needs and safety in achieving the best clinical outcome for patients are obviously paramount.

Achieving that sometimes comes with challenging changes to where people may access services, compared with where they previously did so. We would expect, among that consideration of benefits and challenges, patient transport, inequalities and equality of access to feature heavily. I expect my hon. Friend’s trust, in reaching decisions, will have given due weight to such considerations.

I am well aware of the geography of her constituency and that of her near neighbour, my hon. Friend the Member for Hastings and Rye (Sally-Ann Hart), having grown up on Romney Marsh and having late grandparents who lived in the Icklesham/Winchelsea area of my hon. Friend’s constituency. I know the area well, going across to Hastings and further to Bexhill and Eastbourne. I also know the horror which is the A259, on most days. I was going to say at rush hour, but it is not just at rush hour these days. My hon. Friend’s comments about congestion going up from 36% to 60%, certainly on that road, chime with me; and that is going back 20 to 25 years to when I was last regularly in that part of the world.

The challenges of getting between the three sites are considerable. My hon. Friend alluded to the bus routes. There are bus routes but she is right that, certainly in one case, a change must be made to make the connecting journey. A patient going into hospital wants to minimise the stresses and challenges faced in getting there and back.

My hon. Friend alluded to two specific reconfigurations. With regard to the ophthalmology reconfiguration, the travel analysis summary, included as part of the consultation documents, set out that proposals would affect outpatients and people who come to the Conquest Hospital, in the constituency of my hon. Friend the Member for Hastings and Rye, for procedures but do not stay overnight. That is around 27% of all ophthalmology patients who attend East Sussex Healthcare NHS Trust hospitals for treatment and care. The analysis indicates there will be an increase in travel time for around 21% of patients who would use public transport and for 8% of patients who might travel by car—their own car, taxi or similar.

Were the proposals to go ahead, some people would have a shorter journey and others a longer journey to their appointment. The longer journeys would cost more, but, as the trust pointed out to me, people would, hopefully, have fewer appointments overall, would therefore not have to go to the hospital as often, and would not incur cumulatively the cost for the extra appointments that were no longer required, so they should not pay too much more.

My hon. Friend set out the impact on people on low incomes—the 25% who have no car and for whom a taxi or private hire vehicle might be prohibitively expensive—and she gave a moving example in her remarks about the choices that some people might have to face. I expect the trust to consider that extremely carefully.

My hon. Friend touched on the shuttle bus service and gave an example of where it has worked well in providing a service that works for patients, and it has environmental benefits as well. I encourage her trust to continue looking at such options. If it is helpful to my hon. Friend, I will speak to NHS England’s south-east region to see whether it can convene a meeting to discuss that further with her and her trust to see what options might help fill the gap, even if what was initially put forward might be deemed impractical by the trust.

My hon. Friend focused on patients and the impact on them, but she talked about staff as well, and it is important that in considering services and transport services for people to get to, from and between hospital buildings in the same trust, we do not forget the impact on staff. Although I know that sunny Eastbourne, Hastings and Bexhill are wonderful places to live, work in and visit, I will not tempt my hon. Friend to talk about the challenges of the rail links between her constituency and London. Because of the location of the hospitals and trusts, there is still a degree of temptation or ability for highly qualified professionals to perhaps say, “I will have a longer commute and work in London”, or, “I will go and work in a big London teaching hospital”, so we need to do everything we can to make it attractive and easy for people to make the conscious choice to work in the local hospitals to make sure we have the workforce that we need.

My hon. Friend raised other issues. As well as thanking the team and her local paper, she has talked in the past about getting me down to Eastbourne to visit her local hospital—something I have agreed to—and I will see whether that might be possible during the Easter recess. I hope sunny Eastbourne will be sunny by the time we get to April.

[Sally-Ann Hart (Hastings and Rye) (Con)]

I am sure the Minister will join me in congratulating my hon. Friend the Member for Eastbourne (Caroline Ansell) on her well-presented and organised argument. Will the Minister also consider the community volunteering work that went on during the pandemic at HEART, for example, in Hastings? Perhaps a helping hand could be given there. It took patients to hospital and helped in that way, but sometimes these organisations need a bit more resourcing. Will he look at how we could maximise the potential of the community volunteer groups that have really grown throughout the pandemic to see how best we can utilise them in taking people to hospital for appointments?

[Edward Argar]

Before my hon. Friend’s intervention and although my private secretaries will wince at the logistics, I was about to offer to try to come down to Eastbourne, via Bexhill, and then go to see my hon. Friend in Hastings and visit the Conquest. I may then re-live the experiences of travelling along the A259 and possibly regret doing so. None the less, I will be happy to visit her at the same time. She mentioned, rightly, the hugely important role played throughout the pandemic—and in more normal times—by organisations of volunteers, charities and third-sector organisations to help with patient transport.

My hon. Friend mentioned HEART—I entirely endorse what she says about the value of such organisations. I encourage local authorities and NHS trusts to recognise that value and seek to work collaboratively with such organisations to enable them to continue doing that vital work. In same spirit, I am also an occasional reader of the Hastings and St Leonards Observer. I enjoy my local papers. I tend to find the news I get in local newspapers rather more interesting and accurate than some of what I read in national newspapers. Perhaps when we go down to visit her, we might talk to both local papers if that would be helpful.

My hon. Friend the Member for Eastbourne raised a number of points about the bus improvement strategy and the broader approach to improving public transport links in this country. My right hon. Friend the Member for North East Somerset (Mr Rees-Mogg) set out recently in the House that the Government are investing more than £5 billion in buses and cycling during the course of this Parliament. Local authorities have published bus improvement plans, which provide an assessment of existing services in the area, including details of current provision for rural and coastal communities. It is right that those plans are driven by local authorities, who know their areas best and have that local engagement. I encourage them to think broadly, about not just links between a town centre and other areas but the broader transport links that might exist in an area and how public transport can help enhance them, reflecting the patterns of travel that individuals have for particular purposes, be it work, going to a hospital appointment or otherwise.

We recognise that for those unable to travel independently, NHS-funded patient transport services are essential. Those services are commissioned locally for eligible patients with a specific need for transport assistance to and from their care provider for planned appointments and treatment. Although most people can travel to treatment independently or with support from family and friends, as my hon. Friend set out, those services play a hugely important role for those whose medical condition, severe mobility constraint or financial circumstances make that challenging. They deliver around 11 million to 12 million patient journeys each year, covering around half a million miles each weekday.

In August 2021, NHS England and NHS Improvement published the outcome of a review into patient transport services. The review’s final report sets out a new national framework for the services, with the aim of ensuring that they are consistently responsive, fair and sustainable. The first component of the new national framework is a commitment to update the national guidance on eligibility. That commitment responds to the concerns raised by patient groups and others during the review process that access to patient transport services is inconsistent between areas.

Health Incentives Scheme

Sally-Ann Hart Excerpts

Friday 22nd October 2021 Commons Chamber

[Sally-Ann Hart (Hastings and Rye) (Con)]

I welcome the news that the scheme will be developed in partnership with businesses and the third sector—the private sector and charities—with that dream team of public, private and volunteers. Will the Minister confirm that her Department will look at outcomes and measuring them and will take robust anti-fraud measures to verify that users of the scheme who gain access to the rewards will have genuinely improved their behaviour?

[Maggie Throup]

I reassure my hon. Friend that many checks and balances will be put into the app and the scheme to make sure that they are used appropriately and effectively and that we get some good outcomes from them.

Covid-19 Vaccine Damage Bill

Sally-Ann Hart Excerpts

Friday 10th September 2021 Commons Chamber

[Sir Christopher Chope (Christchurch) (Con)]

I beg to move, That the Bill be now read a Second time.

This Bill addresses a very hot topic and I am not sure that we will be able to do it justice in 23 minutes. I start with the proposition that those of us who have been double jabbed with a vaccine against covid-19 must count our blessings if we have not suffered any adverse consequences, and I am happy to include myself in that category. This Bill is about all those who have suffered injury or even death as a result of enlisting in the war against covid by being vaccinated. The numbers affected are relatively low, which is all the more reason why the Government should not be playing hard to get in relation to the compensation scheme for those who suffer adverse consequences as a result of having done the right thing.

The Government have produced quite a lot of information about the extent of vaccine damage. Some of that is set out in the documents that the Government produce on those who have applied for compensation or have notified under the yellow card scheme. Essentially, what the yellow card scheme shows—from the most recent report, which came out on 9 September and covers the period from 9 December to 1 December—is that there have been 435 reports of major blood clots and low platelet counts, including 74 deaths. It shows that there have been 767 cases of inflammation of the heart, a condition that is almost unheard of in medicine on a normal day-to-day basis. It shows that there have been some 35,000 reports of menstrual disorder, and there are all sorts of other effects set out in the comprehensive report. Very worryingly, it says that there are 1,632 reports of deaths having taken place shortly after vaccination.

If we are trying to build vaccine confidence, we need to ensure that we are open with the public about the facts. That is why I was very disappointed when I asked the Secretary of State on 7 July

“what information his Department holds on the number of deaths that have been reported of people who have died within (a) one month, (b) two months and (c) three months of having received a covid-19 vaccination since 1 January”.

[Sally-Ann Hart (Hastings and Rye) (Con)]

Will my hon. Friend give way?

[Sir Christopher Chope]

Yes, but perhaps it would be more convenient if I actually read out the answer that we received from the Minister. He said:

“Data on the number of deaths reported of people who have died within one, two and three months of having received a COVID-19 vaccination since 1 January 2021 is not available in the format requested.

Public Health England (PHE) monitors the number of people who have been admitted to hospital and died from COVID-19 who have received one or two doses of the vaccine and will publish this data in due course.”

That data has not yet been published. It is very important that we are able to put this issue into context. There is a lot more damage being done to our citizens as a result of covid-19 vaccinations than in any other vaccination programme in history. That does not mean to say that it is not worth while, and I am certainly not an anti-vaxxer or anything like that, but what is important is that, if people do the right thing, they should not be denied access to compensation.

--- Later in debate ---

[Sir Christopher Chope]

I am most grateful for that. There is some doubt as to who the relevant Minister is. When I put down questions on this subject, I am told that it is the responsibility of the Department for Work and Pensions to deal with the vaccine damage Act. From that Department I have received information about the number of applications that have been made up until the middle of July. Up until 23 June, there had been 154 applications—obviously, there are many, many more now—but there are only four people in that Department dealing with all vaccine damage applications, so no decisions have been made and there is no indication as to when any decisions will be forthcoming.

[Sally-Ann Hart]

I am just looking at the Government website. The Government published a press release on 3 December last year, saying that covid-19 would be added to the vaccine damage payment scheme. Are you saying that it has not been yet, or that it has?

[Sir Christopher Chope]

I do not think that Madam Deputy Speaker is saying anything. I am saying that it was added to the scheme, but, to all intents and purposes, it was just a gesture. In the substance of it, people have now started applying under the Act for compensation and none of those cases has been dealt with. No decisions have been made in any of those cases. No decisions have been made in any of those cases. There is now a worrying Government response to a petition that reflects what is in my Bill, calling for reform to the Vaccine Damage Payments Act 1979

“to improve support for those harmed by covid-19 vaccines”.

You may remember, Madam Deputy Speaker, that the Pearson commission found that those injured as a result of vaccination should have access to financial support and that that was the background to the 1979 Act. However, the Act makes provision of a maximum payment of £120,000 together with a threshold of 60% disablement. As a result, fewer than 2% of applications are successful. My Bill calls for the Government to set up a judge-led inquiry into the issues raised.

The petition says:

“Reforming the VDPA will maintain vaccine confidence and provide urgent support for those injured/bereaved through covid-19 vaccination.”

What did the Department say in response to the petition? As you know, Madam Deputy Speaker, when a petition has gathered more than 10,000, signatures, that triggers a Government response—we do not get a debate in the House until there are 100,000 signatures. The response, dated 5 August, says:

“The Government has a robust system to monitor potential side effects of the COVID-19 vaccine and has added the vaccine to the VDPS. We will consider further action as more evidence becomes available.”

It goes on to tell us what we already know about the 1979 Act. It then says:

“Whilst understanding the desire and need to move forward rapidly with processing these claims, it is important to have an established evidence base around causational links between the vaccine and potential side effects. Not doing so risks claims being declined in error based on a lack of evidence, disadvantaging applicants.”

However, we already have a lot of evidence that people have suffered damage, if not death, as a result of these vaccinations. A recent coroner’s report on somebody—I think in the north of England—came to the verdict was that they had died as a direct result of receiving the covid-19 vaccine. The response continues:

“More widely, the Government is currently looking at how it can improve the operational aspects of the VDPS to better meet the additional demand created by the inclusion of the COVID-19 vaccine and improve the customer experience. Once more is known about the possible links between the vaccine and potential side effects, it will be considered whether a wider review of the VDPS is needed.”

My Bill answers that question by saying that we need such a review now.

Oral Answers to Questions

Sally-Ann Hart Excerpts

Tuesday 13th July 2021 Commons Chamber

[Helen Whately]

The Secretary of State has already said that we are working on our plans for social care reform, and we will be bringing them forward later this year. Of course, as part of those plans we are considering unpaid carers.

[Sally-Ann Hart (Hastings and Rye) (Con)]

  If he will make a statement on his departmental responsibilities.

[The Secretary of State for Health and Social Care (Sajid Javid)]

It is an honour to be here for my first oral questions as the Secretary of State for Health and Social Care, and I thank the Prime Minister for bringing me back from furlough. I accepted this role because I love my country and the NHS. I know that I join this Department at a pivotal time, and I have three pressing priorities for these critical few months. The first is getting us on the path out of this pandemic. The second is busting the backlog of non-covid services. The third is putting social care on a sustainable footing for the future. I want to draw on what I have learnt during this time of adversity and what we have all learnt together. I want to make this great nation a healthier and fairer place, and I am looking forward to working with all hon. Members in this House.

[Mr Speaker]

You missed the fourth: a 24-hour accident and emergency unit for Chorley.

[Sally-Ann Hart]

East Sussex Healthcare NHS Trust has the potential to get hundreds of millions in investment as part of the Government’s NHS estate infrastructure improvement plan. Will funding be allocated on a two to three-year basis, so that the NHS can better plan its funding and estates plans? Where funding has been indicated for a longer term, what plans are there to ensure that providers have sufficient resource in the shorter term to address immediate issues, or to support covid or recovery?

[Sajid Javid]

We have put more and more capital into the NHS. There are always representations from hon. Members, including you, Mr Speaker, for even more capital. My hon. Friend is right to raise the issue of the importance of local healthcare systems, which will need more capital funding as we progress. She will know that we set out our capital plans for this financial year, 2021-22, but she is right to say that multi-year funding will mean that trusts can plan better, and that is a priority; we want the spending review to have more sight and better planning for capital.

Covid-19

Sally-Ann Hart Excerpts

Tuesday 12th January 2021 Commons Chamber

[Sally-Ann Hart (Hastings and Rye) (Con) [V]]

For 11 months now, we have been gripped in the jaws of the covid-19 health pandemic. It has brought hardship on businesses and livelihoods, upended our very freedoms and liberties, and unfortunately, for too many families, brought heartbreak and sorrow at the loss of a loved one.

The area I want to focus on is the impact that covid-19, and with it, the necessary measures for lockdown that the Government have introduced to suppress the virus, has had on education—specifically, the toll it has taken on university students. Many in this House will have experienced the excitement, anticipation and nerves of those first few days at university, meeting new people, settling into student digs, attending the first lecture—and yes, out of the gaze of mum and dad, enjoying a drink or two more than perhaps one should. But for thousands of students this year and last, that experience has been denied them; they are experiencing a university education and lifestyle through a screen back at the family home as the covid-19 virus continues to swirl around us.

University staff and lecturers have gone above and beyond to support students and ensure that they can still receive the education they signed up for. However, this is not comparable to the experience students should be getting. It is not offering students access to the resources and facilities that cohorts before them could utilise. We therefore have to ask: is this year really worth over £9,000 for the educational experience students are getting? Meanwhile, is it right that when we have asked students to do the right thing and stay at home away from university, they are still being charged for rent at their university halls of residence?

This next generation are going to be the pioneers in industries and endeavours that none of us can even imagine right now. In the post-covid-19 world, we are going to need new talent to drive our green industrial revolution, to chart our course around the world as global Britain, to end up educating and training the generation that comes after them—and yes, to be the scientists of the future who will discover new vaccines for diseases and viruses that we do not know of yet.

So far these students have had a raw deal through no fault of their own, and we should do something now to help them out. We can start by reducing their university fees for the covid-19 period and not asking them to pay rent on university accommodation that they are being asked not to stay in. Those might seem like small gestures, but they matter. We need to be doing all we can to support our young people through this challenging time. They face an uncertain jobs market and an economy battered by recent events, so let us reduce some of the burden now. University staff are playing their part, with the provision of education; now, as a Government, we can do our bit and relieve the financial pressures that our students are facing.