Mental Health Treatment and Support

Toby Perkins Excerpts

Wednesday 7th June 2023 Commons Chamber

[Dr Rosena Allin-Khan (Tooting) (Lab)]

I beg to move,

That this House notes with concern the scale of the mental health crisis facing the country with patients suffering with mental health issues waiting more than 5.4 million hours in accident and emergency last year; further notes with concern the mental health crisis facing young people with nearly 400,000 children currently waiting for treatment; recognises the health inequalities within the use of the Mental Health Act 1983; and calls on the Government to adopt Labour’s plan to recruit thousands of mental health staff to expand access to treatment, to provide access to specialist mental health support in every school, to establish open access mental health hubs for children and young people and to bring in the first ever long-term, whole-Government plan to improve outcomes for people with mental health needs.

After 13 years in office, this Government have delivered the worst mental health crisis in our history. We are becoming a brittle, anxious, fractious society, the very bonds of which are frayed and torn. The causes of mental ill health are complex: poverty, homelessness, neglect, loneliness, debt, bereavement, domestic violence and child and adult trauma. Our understanding of mental health is developing all the time. We have moved on in the years since I trained as a doctor. We can now see how interlinked and enmeshed the range of factors is: warm and safe homes, fulfilling work, strong relationships, safe streets, opportunities to learn, fresh air and green spaces are policies for good mental health.

Nye Bevan talked about the serenity in knowing that medical care is free at the point of need. After 13 years of Conservatives, we are far from serene. For many of the families I meet, the future is filled with dark clouds, fear of displacement and debt, and a sense that society is going to hell in a handcart—a Britain where nothing works, where everything is broken and where everything costs more than six months ago. Zero-hours contracts, boarded up high streets, rapacious landlords, rising lawlessness and antisocial behaviour and the long-term effects of covid—no wonder we are in the grip of a mental health crisis.

[Mr Toby Perkins (Chesterfield) (Lab)]

I am very pleased with the way my hon. Friend has started her speech, because she is absolutely right. Alongside the additional healthcare staff needed and the many measures that my hon. Friend the Member for Ilford North (Wes Streeting) and I have been spelling out for the health service, the society that has been created over the past 13 years of austerity has had massive impact on the mental health crisis. I am glad that my hon. Friend has focused on that. It will be the job of the entire future Labour Government to support her and her colleagues to reduce the mental health crisis.

[Dr Allin-Khan]

I thank my hon. Friend for his intervention; he is right. I will talk about the need for mental health not to exist in a silo later in my remarks. Frankly, it is the problem of every single Government Department.

One in four people experiences a problem with their mental health each year in England. One in six people experiences a mental health condition, such as anxiety or depression, each week. Three in four people with mental ill health in England receive little or no treatment for their condition. And people with the most severe mental illnesses die up to 20 years sooner than the general population. I ask the House to reflect on that for a moment. Tragically, in 2021, over 5,000 suicides were registered, up by 300 on the previous year. The Government should wear these statistics like a badge of shame.

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[Neil O’Brien]

Those are not figures that I am familiar with or recognise, but I will certainly take this up with the London commissioners because it sounds like an important issue. I have talked about the dramatic increase we have already seen in the mental health workforce, and we are setting out further steps in our long-term workforce plan, but I will take that away and look at it closely with other Ministers.

[Mr Toby Perkins]

One of the issues here is that the demand for mental health services has gone through the roof, from 3.6 million in 2020-21 to 4.5 million in 2021-22. My hon. Friend the Member for Tooting (Dr Allin-Khan) was clear in her view, which I share, that the policies of this Government have been a factor in driving up the mental health demand. Does the Minister accept that? If not, what does he put it down to?

[Neil O’Brien]

I was just coming to that, but on the point about prevention and the social origins of these things, we are in agreement about tackling the origins of these things. In terms of financial security, that is why we are providing financial help worth £3,300 per household, one of the most dramatically generous packages anywhere in Europe. The question of good housing was raised earlier. We have the Social Housing (Regulation) Bill and we are taking action to extend the decent homes standard to the private rented sector.

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[Mr Toby Perkins (Chesterfield) (Lab)]

At 11.33 yesterday morning, this House finished Prayers and the first questions to the Health Secretary began. Disgracefully, two hours and five minutes later, the Government’s business was done and hon. Members were told that, if they had no further meetings, they could go home. This exhausted Government had literally nothing left to say or do.

It is therefore hugely welcome that my hon. Friends the Members for Tooting (Dr Allin-Khan) and for Ilford North (Wes Streeting) have stepped forward on behalf of the Government-in-waiting to ensure that today there is a debate on a matter of considerable importance. Every week in my constituency surgeries I meet parents exasperated that the treatment and support that they know their children need is not available. That can lead to the unchecked exacerbation of problems and children missing school—not the odd day, but months at a time. Whole years of their schooling are lost and family routines decimated as the entire family steps in to provide the support that an earlier intervention could have prevented.

Mental health is not a minority issue. Every year, one in four people will experience a common mental health problem. This Government are guilty of both underfunding mental health services and, through their actions, causing the number of people with mental health problems to rise. We all know that the Government have allowed our country’s economy to end up in a terrible mess and that money is short, but it is welcome and right that the Labour party and my hon. Friend the Member for Ilford North have been able to secure a commitment for additional funding from shadow Treasury colleagues—all of us who sit in Front Bench positions will know that is very difficult—to pursue the plans that are so desperately needed.

I want to talk about access to services locally. Stephen Jones in my constituency had a child with a mental health crisis that required in-patient treatment. The child was moved to Stoke-on-Trent, 70 miles away, because there are no child in-patient beds available in the whole of Derbyshire. The isolation that Stephen’s child experienced exacerbated their problems and made it harder for the family to support them. I stress to my Front-Bench colleagues that, while we realise that specialist staff will not be based in every single village and town, we need to give real consideration to providing those specialist services close enough that families can easily play their part in supporting patients, particularly children, in their treatment and recovery.

I am pleased that my hon. Friend the Member for Tooting focused on some of the causes of the mental health crisis. The Government are quick to talk about the increased amounts they are spending, but they are forced to spend more because there are more and more patients coming forward. If we had a huge expansion in the number of people with cancer, we would have to increase the number of cancer doctors, and yet we have far more people with mental health crises. The Government need to stop for a minute and think about the role they have played in causing that increase.

From the start in 2010, the Government’s pursuit of people on benefits, their targeting of the unemployed and the mentally ill, their approach to work capability assessments and the reduction in housing benefit, leading to record levels of poverty and homelessness, have all played a part in increasing the pressures on people and have in themselves added to the mental health crisis. No one is suggesting that those are the only causes—of course, very successful people can have mental health crises, too—but the Government should take that expansion in the numbers seriously.

The pressures on children in that period have exacerbated the problems. Between 2017 and 2022 alone, the number of children aged between seven and 16 with a probable mental health disorder rose from 12% to 18%. Shockingly, among those aged between 17 and 19, the figure more than doubled, from 10% to 25.7%.

Finally, let me turn to the Government’s disappointing, inadequate and defensive amendment to the motion. It says everything about their complacency and lack of ideas that they should try to convince the House that they have already acted to reduce A&E stays. Last year in Chesterfield alone, people suffering a mental health crisis spent 5,254 hours in A&E. It is clear from the debate that our nation’s mental health patients are being let down and the Government have neither the wit nor the will to fix it. I am pleased that Labour will prioritise this crucial area of health and I endorse the motion.

Oral Answers to Questions

Toby Perkins Excerpts

Tuesday 24th January 2023 Commons Chamber

[Will Quince]

As I said, we are creating 7,000 additional general and acute beds. We are investing £500 million in adult social care specifically for discharge, and that goes up to £600 million next year and £1 billion the year after. There is also an extra £250 million. The hon. Lady asks specifically about adult social care. That is exactly why the Chancellor announced £7.5 billion in the autumn statement—the largest investment in social care ever.

[Mr Toby Perkins (Chesterfield) (Lab)]

11. If he will make an assessment of the adequacy of GP appointment availability in (a) Chesterfield constituency, (b) Derbyshire and (c) England.

[The Parliamentary Under-Secretary of State for Health and Social Care (Neil O’Brien)]

In November, there were 13.9% more appointments in general practice across England as a whole than in the same month before the pandemic. In Derby and Derbyshire, there were 16.6% more appointments. Our GPs are doing more than ever, and, compared with 2015-16, we are investing a fifth more in real terms. But we know that demand is unprecedented, and we are working to further support our hard-working GPs.

[Mr Perkins]

I thank the Minister for that answer. We know that there are GP appointment difficulties everywhere, but we also know that it is much more difficult in more deprived communities. Social Market Foundation research shows that GPs in more deprived communities have twice as many patients on their books than those in more affluent areas. This means that, in addition to the greater health inequalities in those communities, people are finding it very difficult to get appointments, including at the Royal Primary Care practice in Staveley. Why should patients in more deprived communities be expected to tolerate far greater difficulties in getting GP appointments than those in more affluent areas?

[Neil O’Brien]

In Derby and Derbyshire, for example, there are 495 more doctors and other patient-facing staff than in 2019. Step 1 is to have more clinicians, which we are doing through that investment. The hon. Member raises a point about Carr-Hill and the funding formula underlying general practice. There is actually heavy weighting for deprivation, and the point he raises is partly driven by the fact that older people tend not to live in the most deprived areas, and younger people tend to live in high IMD—index of multiple deprivation—areas. That is the reason for the statistic he used. Funding is rightly driven by health need, which is also heavily driven by age. We are looking at this issue, but the interpretation he is putting on it—that there is not a large weighting for deprivation—is not quite right.

NHS: Long-term Strategy

Toby Perkins Excerpts

Wednesday 11th January 2023 Commons Chamber

[Wes Streeting]

The hon. Gentleman has got some brass neck. I have already given him figures showing that per capita funding increased by 5% under the last Labour Government—[Interruption.] And as for GDP, perhaps he should look at growth figures and ask why the economy is so much smaller than it would have been if we had had a Labour Government managing the economy well. That is the truth; it is a simple fact. If not, perhaps he wants to explain how his Government will put more money into the NHS, but I did not hear that commitment.

[Mr Toby Perkins (Chesterfield) (Lab)]

I thank my hon. Friend for his excellent speech. I do not quite know why I have intervened, because I am very much enjoying watching him flay the bowling to the boundary when he gets questions from Conservative Members. He is absolutely on to something in relation to the money that has been wasted in our NHS by the failure to plan for NHS staffing. Is not the reality that far too much money is being spent on agency workers because there is no long-term strategic plan for NHS staffing?

[Wes Streeting]

My hon. Friend is absolutely right. We are spending £3 billion on agency costs that would surely be better spent on ensuring that we have a serious workforce plan, and on hospital departments that are staffed by regulars who get to know their shift, get to know their colleagues, and get to know their patients and communities.

Let me turn to what the Secretary of State for Department for Business, Energy and Industrial Strategy said about ambulance staff, because I think he irresponsibly suggested that ambulance staff have not committed to minimum service levels for category 2 calls today, which is just not true. I think he ought to apologise to ambulance workers.

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[Mr Toby Perkins (Chesterfield) (Lab)]

I rise to support the motion on behalf of not only the Labour party but every person in Chesterfield who has contacted me in recent times in despair about the state of our national health service.

I first came to this place in 2010. Over the first year or two that I was a Member of Parliament, I had virtually no casework about the health service. Very occasionally someone might have got in touch with me, but now in every single surgery, someone comes to see me about being unable to access a doctor’s appointment, or about how long they have been waiting for a hospital appointment or an operation. Tragically, far too often I meet the families of people who are deceased but would be alive today if they had got the treatment that they should have had. It is for them that we are having this debate. It is for them that we need a long-term plan.

One of my first duties in the new year was my regular monthly catch-up with Hal Spencer, the chief executive of the Chesterfield Royal Hospital. I was expecting it to be a difficult meeting, and my goodness it was. The strain put on the senior management in our national health service, due to the failures under this Government, was etched all over his face. Chesterfield Royal Hospital had a critical incident over the Christmas period. It is a very good hospital, staffed by wonderful people who are professional, committed and passionate about the service that they provide. But imagine being a caring, dedicated, passionate, committed person and meeting patients who have been waiting 24 hours on a trolley before you get to see them. Imagine being an A&E registrar and knowing that people are arriving in agony, but that all you can give them is paracetamol to get them through the next 12 or 18 hours before they are seen. Imagine being a professional and seeing people with cancer who have been waiting, knowing that their cancer has got worse because you have not been able to see them soon enough.

The constant sticking-plaster approach of this Government is letting those people down. It is, as the motion says, costing hundreds of lives every week due to the collapse of emergency care. As my hon. Friend the Member for Ilford North (Wes Streeting) said, we need that long-term plan to address the staffing crisis in our national health service, which has 160,000 vacancies. We need it to address the failure in general practice where the poorer you are, the more likely it is that your GP service will be unable to see you. We need it to address the failure in care that means 100 people in Chesterfield Royal Hospital over Christmas were fit to leave but did not have a care package to support them.

If we can get that long-term plan to address the failure in general practice and social care, we will save money. One of the maddest things about the failure in our NHS is that we are spending far, far more treating people in hospital beds than if we were able to treat them at home with a social care package, or in a general practice if they were able to get in there. I support the motion and I thank my hon. Friend for introducing it. The people of Chesterfield will demand that we deliver when we get a Labour Government.

NHS Winter Pressures

Toby Perkins Excerpts

Monday 9th January 2023 Commons Chamber

[Steve Barclay]

One of the things that my hon. Friend agrees with is that more decisions should be devolved rather than every decision being made in Westminster. Part of the reason for integrated care boards is so that they can look at where best to allocate their funds locally. He raises an extremely important point. He is right that around a quarter of delayed discharges are on the social care side—a fifth actually, in the NHS; there are a number of factors within that, which we will need to disaggregate.

On my hon. Friend’s point about local capacity, the Government are allocating the funding to his local ICB. I am sure he will have a conversation with his ICB on where the spare capacity can be best identified and rolled out at pace.

[Mr Toby Perkins (Chesterfield) (Lab)]

Last week, I met Hal Spencer, the chief executive of Chesterfield Royal Hospital; the pressures that he and his staff had faced as the hospital went into a critical incident over Christmas were etched all over his face. He spoke about the pressures on A&E registrars, ambulance drivers and nurses and about coming face to face with people who had been waiting 24 hours in a corridor on a trolley or who had been waiting many hours for an ambulance to turn up.

Is not the reality that this is a system-wide failure 13 years in the making? Did the right hon. Member for Gainsborough (Sir Edward Leigh) not hit the nail on the head in saying that Labour has a long-term plan for our NHS and this Government do not?

[Steve Barclay]

On the hon. Gentleman’s first point, this is absolutely a system-wide challenge. That is why the use of innovations such as virtual wards in demand management upstream, in the care home or on the home, is important, just as discharge—getting patients to leave hospital who are fit to do so—is important. The focus has often been on ambulances being delayed at A&E or on the significant and real pressures in emergency departments themselves, but the challenge is much wider. That is what the funding in the autumn statement recognised.

In response to his second point about this being a longer-term issue in England specifically, I would just point him to the examples in Wales and the pressures in Scotland. This surge in flu combined with covid and the pandemic legacy that we have seen in England have created so much pressure over the festive period, and it is something with which many other health systems around the globe have also been grappling.

Government PPE Contracts

Toby Perkins Excerpts

Tuesday 6th December 2022 Commons Chamber

[Angela Rayner (Ashton-under-Lyne) (Lab)]

I beg to move,

That this House –

(a) notes that the Department for Health and Social Care purchased more than £12 billion of Personal Protective Equipment (PPE) in 2020-21;

(b) regrets that the Government has now written £8.7 billion off the value of this £12 billion, including £4 billion that was spent on PPE which did not meet NHS standards and was unusable;

(c) is extremely concerned that the Government’s high priority lane for procurement during the pandemic appears to have resulted in contracts being awarded without due diligence and wasted taxpayer money;

(d) considers there should be examination of the process by which contracts were awarded through the high priority lane; and

(e) accordingly resolves that an Humble Address be presented to His Majesty, that he will be graciously pleased to give direction that all papers, advice and correspondence involving Ministers and Special Advisers, including submissions and electronic communications, relating to the Government contracts for garments for biological or chemical protection, awarded to PPE Medpro by the Department for Health and Social Care, references CF-0029900D0O000000rwimUAA1 and 547578, be provided to the Committee of Public Accounts.

The motion before the House is simple: this is a plea for answers, clarity and the truth. The choice that the House makes today is also simple. Our demand is clear: end the cover-up and begin the clean-up. We already know that the so-called VIP lane for personal protective equipment enabled the shameful waste of taxpayers’ money and inexcusable profiteering by unfit and unqualified providers. We know the Government have already written off £10 billion of public funds spent on personal protective equipment that was either unusable, overpriced or undelivered. Ministers have admitted that they are still paying £770,000 a day of taxpayers’ cash to store gloves, goggles and gowns. That is enough to pay for 75,000 spaces in after-school clubs, or 19,000 places in full-time nursery care. Every day, £106,000 of that money is sent to China to pay for storage costs alone.

We already know that £4 billion-worth of unusable PPE was burned to generate power after 70 million PPE items were sold off for just £400,000. What we do not yet know is what was said in correspondence between the key participants on the Government Benches and their unqualified cronies on the make and on the take. We do not even know exactly where our money ended up, but we do know that, if Ministers get their way, the system could be used again and the scandal repeated, enriching fraudsters at the expense of the taxpayer and creating a new mountain of waste.

[Mr Toby Perkins (Chesterfield) (Lab)]

My right hon. Friend is absolutely right that this is a scandalous waste of public money. Equally important is that our care sector and health sector were desperate for PPE during the pandemic. Specialised Canvas in my constituency changed all its manufacturing to be able to make PPE and got a large number of contracts from individual trusts, but it was completely unable to get any contracts out of the Department of Health and Social Care. So alongside the public money wastage, we also had nurses and carers unable to access PPE at the height of the pandemic when they desperately needed it.

[Angela Rayner]

My hon. Friend is absolutely right. He made two points, which I will come to in greater detail in my speech, but one was the lack of PPE for those on the frontline, as well as the total disrespect in the way that contracts were handed out through the VIP lane, at the expense of businesses up and down the UK that had experience and could have helped during the pandemic, but which were not party to WhatsApps or whatever else got them to Ministers and access to the VIP lane.

Take the mystery of a PPE company with links to a Tory politician. While it is for the authorities to decide whether any law is broken, and I will not comment on the ongoing investigations, we do know that PPE Medpro was referred to the VIP lane by a sitting member of the Cabinet after lobbying from another Tory politician five days before it was even legally registered as a company. The House may recall that that particular company was subsequently awarded two contracts worth £203 million to supply PPE, with £81 million to supply 210 million face masks awarded in May 2020 and a £122 million contract to supply 25 million surgical gowns awarded in June 2020. The face masks were bought by the Government from PPE Medpro for more than twice the price of identical items from other suppliers, and the surgical gowns were rejected for use in the NHS after a technical inspection. All of them were never even used. It points to a total failure of due diligence and the rotten stench of cronyism.

Urgent and Emergency Care

Toby Perkins Excerpts

Monday 5th September 2022 Commons Chamber

[Steve Barclay]

I know my hon. Friend is a strong champion for this issue; when I was Chief Secretary to the Treasury, I remember him lobbying me about how a bridge from one bit of the hospital estate to another could provide additional capacity to meet the pressures his trust has faced. That is partly why we have been working intensively with the trusts that have the most severe cases of ambulance delays, looking through the work of the taskforce at best practice and what works best in those settings, and ensuring that the trust chief execs have the right level of support. It is important to recognise that the problem does not always manifest where it is caused. Quite often, challenges on the social care side, or further upstream in the conveyancing rate, put pressure on an emergency department and on the trust.

[Mr Toby Perkins (Chesterfield) (Lab)]

The Secretary of State is absolutely right about the abject failure in care that his Government have overseen over the past 12 years, but his statement did not refer so much to the pressures in A&E. It seems entirely wrong to me that if someone walks into an A&E department they are its responsibility, but if they turn up in an ambulance they are expected to sit in it for hours on end until the A&E is willing to take responsibility. Will the Secretary of State say more about dealing with the issue so that A&E departments realise that however someone arrives—whether they walk through the door or arrive in an ambulance—they should be the responsibility of the A&E, and the ambulance should be out fetching other people in the area?

[Steve Barclay]

The hon. Member makes a very fair point. Within the question he raises is the unmet need where an ambulance does not reach a patient in the community, as opposed to the known risk once the patient is within the hospital trust’s purview. On capacity in A&E, as I touched on in my statement, we put in £450 million at the 2020 spending review to upgrade A&E facilities at 120 trusts.

With respect to the hon. Member’s specific point, he may be aware of the letter that the NHS medical director Professor Stephen Powis and the chief nurse Ruth May sent at the time of the heatwave about where risk sits within hospitals. The taskforce has been doing further work on pre-cohorting, post-cohorting and observation bays so that we can better free up that ambulance capacity and get it back on the road.

Oral Answers to Questions

Toby Perkins Excerpts

Tuesday 19th April 2022 Commons Chamber

[Maggie Throup]

My hon. Friend raises an important issue specific to her area, and other areas that attract people who go there for their holidays and are perhaps not there on a permanent basis. We are determined through our White Papers to address every health inequality, whether caused by a moving population or a static population, in the sorts of areas that the hon. Member for Wansbeck (Ian Lavery) talked about.

[Mr Toby Perkins (Chesterfield) (Lab)]

8. What recent assessment he has made of the scale of the backlog in cancer treatments in (a) Derbyshire and (b) England.

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

Cancer treatment and diagnosis remained a top priority throughout the pandemic, with 4.4 million urgent referrals during the period and over 1 million people receiving cancer treatment. Thanks to the brilliant work of our NHS staff, first treatments for cancer have been maintained at above 94% of usual levels over the course of the pandemic. However, we know that fewer people came forward, so we are now seeing record numbers of people coming through the system, with November last year having the highest number of 11,000 cancer referrals per working day.

[Mr Perkins]

I asked specifically about Derbyshire, but I did not get an answer. Derbyshire clinical commissioning group has failed to reach any of the cancer referral targets for the most recent 12 months. Although this is a national failure, the shortages are particularly acute in Derbyshire. These failures have tragic consequences. My constituent Paul Bryan is just 58. He has been attending his surgery for two years; he kept getting dismissed and was not tested, and now the prostate cancer that was undiagnosed for all that time has spread to his ribs, spine and bones, and his diagnosis is terminal. His family are urging the Government to show more urgency to improve outcomes, so that other families do not have to experience such needless heartbreak. Will the Minister explain to the Bryans why the Government rejected the workforce planning amendment to the Health and Care Bill that could have helped our NHS get the cancer specialists it needs and prevented heartbreak like the Bryans in other families?

[Maria Caulfield]

I am sorry to hear about the case of the Bryan family, but I reassure the hon. Gentleman that, in Derby and Derbyshire, 92% of treatments start within 30 days, despite record numbers of patients coming forward. To tackle the issue of getting people diagnosed earlier, which is key to getting more successful treatment, we are rolling out rapid diagnostic centres across the country so that people can access screening and testing much more quickly and easily. We have 159 of those live right now, with more to follow.

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[Sajid Javid]

My right hon. Friend is right to raise this, and many of us will have seen the recent reports, especially from the families affected. It is right that we reconsider this and make sure that sodium valproate, and any other medicine, is given only in the clinically appropriate setting.

[Mr Toby Perkins (Chesterfield) (Lab)]

T7. The Secretary of State is right that we all want to get to the bottom of many important health matters, and we do not want what he described as personal affairs to get in the way of that. In order to ensure that the House concentrates entirely on those matters, will he welcome HMRC investigating whether he was claiming non-dom status on a solely—

[Mr Speaker]

Order. Let us move on. What a waste of a question. Dehenna Davison.

Civil Proceedings

Toby Perkins Excerpts

Tuesday 29th March 2022 Commons Chamber

[Maggie Throup]

I shall come shortly to the specific parts of the extension that are relevant to Northern Ireland. I am sure that the hon. Gentleman will appreciate that we have had ongoing conversations with the devolved Administrations throughout the whole two years.

The Coronavirus Act 2020 also helped to ease the burden on frontline staff in our critical public services. For example, provisions in the Act have helped the courts and tribunal system to keep functioning throughout the pandemic by allowing thousands of hearings to take place remotely.

[Mr Toby Perkins (Chesterfield) (Lab)]

The Minister has now turned to the subject I wanted to ask her about. She talks about our courts, but the reality is that they are in a terrible position. We are up to a record 708 days for the average time it takes to prosecute suspected criminals. The longer those delays go on, the more victims wait. No party can seriously claim to be tough on crime while allowing victims to be left waiting and allowing criminals to spend 708 days before they are prosecuted. Will the Minister apologise to those people who are waiting and tell us that the Government have some kind of strategy to address that appalling record backlog?

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[Andrew Gwynne (Denton and Reddish) (Lab)]

I start by echoing the Minister’s thanks to healthcare and frontline public service workers and, indeed, the public for all they have done to get us to this point after two years of the pandemic. I am grateful for the opportunity to respond to the two motions before the House today on behalf of Her Majesty’s loyal Opposition.

Clearly, as the shadow public health Minister, I will be focusing primarily on elements of the motions that relate to public health, but I will also touch on the extension of the justice provisions relating to coroners’ inquests and remote hearings. I know my colleagues on the Bill Committees for the Judicial Review and Courts Bill and the Police, Crime, Sentencing and Courts Bill have already engaged constructively with the Government on those provisions and supported their being moved on to statute.

However, we have called for the Government to provide further evidence on the impact that those measures, particularly remote hearings, may have on people with disabilities and those who are digitally excluded. I would be grateful if the Minister reiterated those concerns to her colleagues in the Ministry of Justice—I notice the Under-Secretary of State for Justice, the hon. Member for South Suffolk (James Cartlidge) sitting alongside her—and urge them to put the appropriate safeguards in place. With a Crown court backlog already at 60,000—caused, I may add, by the Government’s short-sightedness and incompetence—we must ensure that inequality is not further entrenched in our justice system.

Moving on to public health, the Coronavirus Act 2020 was an unprecedented Act for unprecedented times. It enabled the Government to take rapid and wide-ranging steps to limit the spread of covid-19, and in turn to protect lives, livelihoods and our national health service. Correctly, it was never intended to last forever. Vaccination, as the Minister has said, has proved an invaluable tool in our fight against coronavirus, and it is thanks to our incredible scientists, our NHS staff and the British public that we are able to be here today to debate the end of many of the Act’s provisions.

It is important to note, however, that covid has not gone anywhere—it is still very much here. It has certainly not gone anywhere for the 1.5 million people who are living with the symptoms of long covid, or the 800,000 clinically vulnerable and immunosuppressed people who continue to call on the Government for better clarity and access to antiviral and retroviral treatment. I would be grateful if, in her closing remarks, the Minister outlined what steps the Government will be taking to better support those communities, and when full guidance will be given on free testing provision. In three days’ time, the general public will be unable to access free lateral flow tests, yet there is still no guidance on which groups will remain eligible for free testing.

[Mr Perkins]

On behalf of the numerous immuno-suppressed people in Chesterfield and their families who have contacted me, I thank my hon. Friend for what he has just said. He is absolutely right that many of them still feel prisoners in their own home and feel utterly ignored, and the Government’s failure on sick pay has only added to their sense of being forgotten. Will he reinforce the message to the Government that those people are not being properly catered for?

[Andrew Gwynne]

I thank my hon. Friend for his kind remarks. I have met numerous groups representing the clinically vulnerable, the clinically extremely vulnerable and the immunosuppressed communities, and the level of anxiety and worry in those communities is clear. While we have all, to some extent, been able to get back to as near a normal life as possible, those communities still feel isolated, under pressure and incredibly concerned about what mixing and social interaction would mean for them, were they to get coronavirus.

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[Andrew Gwynne]

My right hon. Friend is absolutely right. Of course, for too many people in this country, that is the reality of their day-to-day to living—and we know that it is going to get worse. I should remind the Government that we are in the middle of a cost of living crisis, although I appreciate that they may not have realised that given the Chancellor’s spring statement last week and his inexplicable decision to clobber working people with the highest tax burden in 70 years. Inflation is at a 30-year high, energy prices are sky-rocketing, and we are facing the biggest drop in living standards since the 1950s. I really do fear that, as my right hon. Friend said, more and more people will be drawn into levels of poverty that we have not seen in this country for a very long time.

This is completely the wrong time for the Government to remove provisions that give people the financial support to self-isolate while also ending free tests. Surely the Minister cannot continue to defend this patently self-defeating policy. If people cannot afford to test and they cannot afford to self-isolate, what does the Minister think will happen? Do the Government think that covid will magically vanish? Of course it will not. Living with covid does not mean ignoring the fact that it exists. It does not mean turning back the clock to 2019 and forgetting that the pandemic ever happened. The pandemic happened, covid is here, and for too many people covid will still be an issue going forward.

In terms of living with covid, only Labour has set out a proper plan that would prepare us for new variants while securing our lives, livelihoods, and liberties. We would prioritise testing and make it fit for the future, fix sick pay, and learn the lessons of the pandemic. The Conservatives’ plan is to repeat the phrase “personal responsibility” over and over again, and hope that no one notices that there actually is no plan. We cannot simply turn back the clock and pretend that covid never happened.

[Mr Perkins]

I entirely agree with my hon. Friend. Does he, like me, feel that the term “personal responsibility” would be slightly less nauseating if it did not come from a Prime Minister in Downing Street where 20 people are today receiving fines from the police for their failure to display any kind of personal responsibility while demanding it from some of the poorest people in the country?

--- Later in debate ---

[Mr Toby Perkins (Chesterfield) (Lab)]

I want to speak briefly about the courts provisions. Like my hon. Friend the Member for Denton and Reddish (Andrew Gwynne), I do not have any particular issues—in fact, I welcome the recognition of the need to speed up the processes in court. However, we cannot discuss this issue without stopping for a moment to recognise the hugely damaging impact of the current court delays on victims of crime and the extent to which they continue to be doubly punished: punished initially because of the offence against them and punished again when they are forced to wait months or even years for justice.

I have never heard such a self-congratulatory response from the Government than that given by the Minister, especially when we consider that their record, on both the death rate in the country and the economic consequences, pales in comparison with the performance of many European nations. However, Ministers stand there and talk about how wonderfully we did. When it comes to the courts, the reality, as victims in my constituency and those across the country know, is that although things got much worse during the pandemic, they were disastrous before that. They were disastrous because of the scale of court closures between 2010 and 2019, and because legal aid cuts meant that many people ended up representing themselves, which causes court cases to take much longer because those people do not have access to proper judicial advice. The court delays are leaving victims in our constituencies simply waiting and waiting to a totally unreasonable degree. We hear from the police that when victims are left waiting, the stress of that, and of being unable to put an end to their ordeal, often leads them to withdraw permission to go ahead with the case, and criminals get away with what they have done. Not only are victims waiting 708 days—the average time it takes to go from offence to completion of a case—in torment, but criminals are out on the street when they should be banged up, because of the failure of this Government. I welcome these temporary provisions, but there needs to be real acceptance of what is actually happening to victims.

I support what my hon. Friend the Member for Denton and Reddish and the hon. Member for St Albans (Daisy Cooper) said about Evusheld—a drug for those who are immunosuppressed. The hon. Lady is absolutely right that for many of them the last years have been a prison sentence. Somebody who I know and have been to football with over many years has not been to a game for two and a half years. I never thought he would miss a game, but he has not been along since the start of the pandemic. He feels trapped, and absolutely unable to do the things that he would like to. There needs to be progress on that.

I also support what my hon. Friend the Member for Bradford East (Imran Hussain) said about the need to investigate putting on a longer-term basis the welcome provisions that speed up the issuing of death certificates.

Oral Answers to Questions

Toby Perkins Excerpts

Tuesday 1st March 2022 Commons Chamber

[Maggie Throup]

The temporary approval was put in place during the pandemic to address a specific and acute medical need to reduce the risk of transmission of covid-19. It was recognised that without it, significant numbers of women would not have been able to safely access abortion services. Thanks to the success and impact of the national vaccination programme, the situation is now very different. In making this decision, the Secretary of State has considered all the risks and benefits regarding the temporary approval.

[Mr Toby Perkins (Chesterfield) (Lab)]

17. What assessment he has made of the adequacy of child mental health in-patient provision in Derbyshire.

[The Minister for Care and Mental Health (Gillian Keegan)]

We want to ensure that more children and young people can access appropriate support in their community, and that those who require in-patient cases are treated as close to home as possible. The East Midlands Provider Collaborative is responsible for commissioning tasks for tier 4 in-patient children and adolescent mental health services, including for Derbyshire. It has implemented strategies to ensure the most efficient use of in-patient beds, including a review of the types of beds required by east midlands patients.

[Mr Perkins]

My constituent Stephen Jones wants what the Minister wants, but when his daughter required in-patient child mental health facilities she was forced to go to Stoke to receive them. He had a 70-mile journey every time he wanted to see her, which was obviously very expensive and also just impossible to do. It meant that his daughter’s mental health got worse, because she felt that she had been abandoned by her own family, putting the whole family under pressure. In addition, if people do not receive universal credit, they get no support with the financial impact. Will the Minister tell us more about how we can ensure that children’s mental health is not exacerbated by the inability to access services locally?

[Gillian Keegan]

The hon. Gentleman raises a very important point. Clearly, these are distressing enough times without having that commute and those travel arrangements on top of that, but sometimes the services are highly specialised. We are trying to get the right blend between access to highly specialised in-patient services and making sure that we increase community efforts. We have been working very hard to ensure that there are more community efforts, but we have also invested £10 million more in capital for more beds to make sure people can get treatment closer to home.

--- Later in debate ---

[Sajid Javid]

First, I pay tribute to my hon. Friend and to my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes) for all the work they have done on this most important of issues. Over the past few months, we have all heard in this House some horrific examples of botched, non-cosmetic procedures scarring people for life. No longer will that be allowed. We will be introducing a licensing regime for such procedures. The details of the regime will be set out in regulations, meaning that it will be flexible, agile and change in response to changes in the cosmetics industry.

[Mr Toby Perkins (Chesterfield) (Lab)]

T4. The response from the hon. Member for Lewes (Maria Caulfield) to the question from my right hon. Friend the Member for Kingston upon Hull North (Dame Diana Johnson) on health inequalities gives me no confidence that the Government have a plan to address these inequalities at all. She says that we have had a pandemic—of course we have, but the point is that it has happened everywhere. What does it say about this Government’s priorities that waiting times are escalating to a far greater extent in more deprived communities than they are in the more affluent communities that the Tories are so happy to represent?

[Maria Caulfield]

I can only reiterate that we have a laser focus on this issue, and that is why we will be bringing forward the health disparities White Paper. I also point the hon. Gentleman to the NHS’s approach of the Core20PLUS5, where it is targeting the most deprived 20% of the population in five clinical priority areas: maternity, severe mental illness, chronic respiratory disease, early cancer diagnosis and hypertension. We will deliver on resolving disparities issues.

Elective Care Recovery in England

Toby Perkins Excerpts

Monday 7th February 2022 Commons Chamber

[Edward Argar]

It is always hard to prove a counterfactual, as my right hon. Friend will know, but we do know that the necessary measures we took during the pandemic to help to tackle this dangerous virus inevitably had a significant impact on waiting lists. Due to infection prevention and control measures and a range of other things, normal levels of surgery and planned surgery were not able to go ahead. He may be able to extrapolate from that, but, as I say, it is slightly difficult to come up with a detailed counterfactual.

[Mr Toby Perkins (Chesterfield) (Lab)]

My mother died prematurely of lung cancer in her early sixties, so I know, as many others in this House do, that when it comes to cancer, waiting times do not just inconvenience; they literally mean the difference between life and death. I agree with the Minister that this is about not just investment but outcomes, and it is purely on outcomes that this Government are failing. Does he agree that the briefings from his Department suggesting the political games at the top of the Conservative party—“Who’s up, who’s down, who’s going to be the next leader?”—are influencing and impacting on the Government’s ability to get this plan out, and that that will not be forgiven by those people who are waiting for cancer treatment right now?