Oral Answers to Questions

Vicky Foxcroft Excerpts

Tuesday 26th March 2019 Commons Chamber

[Stephen Hammond]

The Department of course takes such things seriously. My hon. Friend the Minister of State for Care met Baroness Harding last week to discuss how to ensure that there are nurses and carers to help people with learning disabilities. The money that has been promised to make that possible comes in the new financial year, which starts next week.

[Vicky Foxcroft (Lewisham, Deptford) (Lab)]

14. What progress his Department has made on the implementation of a public health approach to tackling violence.

[The Secretary of State for Health and Social Care (Matt Hancock)]

We are pursuing a multi-agency approach to prevent and tackle serious violence. Healthcare is of course one of the important and relevant agencies that need to work together right across government to reduce knife crime.

[Vicky Foxcroft]

The Government are committed to a public health approach, but we heard the Secretary of State dismiss it just a few weeks ago. What assurances can he give that he is now fully signed up to the approach? What evidence is his Department collating? How is the Department working with the Home Office to ensure that we have a long-term strategy for keeping our young people safe?

[Matt Hancock]

I am a huge fan of the public health approach to tackling knife crime. In fact, I was in Croydon yesterday to talk to charities and to students at Croydon College about the role the NHS can play in tackling the scourge of knife crime. I am a big fan of this agenda, and I look forward to working with the hon. Lady and colleagues from across the House.

NHS Outsourcing and Privatisation

Vicky Foxcroft Excerpts

Wednesday 23rd May 2018 Commons Chamber

[Jonathan Ashworth]

I greatly respect the hon. Lady, and I greatly enjoyed her Red Box blog on mental health provision last week. I know she thinks carefully about these matters, but this is not about ideology. It is about what works. Let us take the example of the East Kent contract for integrated NHS 111 and GP out-of-hours services, which began in January 2017. After only seven months of Primecare running it, the service was placed in special measures after it was rated inadequate. That is happening in her own backyard. This is not working, and that is the point we are making.

The history of PFI is that when we came into government, a third of hospitals were more than 50 years old. That is why we carried on with the John Major PFI scheme, which was the creation of that Government. Current Cabinet Ministers such as the shadow Health Secretary at the time, now the Secretary of State for International Trade, stood at the Dispatch Box and congratulated the Labour Government on taking up the private finance initiative developed under the previous Government. He said he would not object to the use of PFI

“exclusively to fund private capital projects”—[Official Report, 8 January 2003; Vol. 397, c. 181.]

In this House, the current Chancellor of the Duchy of Lancaster gave a “warm welcome” to a PFI in his own constituency. The Brexit Secretary said in this House:

“The PFI has many virtues—after all, it was a Conservative policy in the first instance.”—[Official Report, 10 March 1999; Vol. 327, c. 429.]

The Business Secretary said:

“PFI was initiated by the previous Conservative Government”—[Official Report, 12 February 2013; Vol. 558, c. 787.]

The Scottish Secretary has said that PFI is a “successful basis for funding”. The Welsh Secretary said:

“I am a fan of PFI in general.”—[Official Report, 4 November 2010; Vol. 517, c. 1124.]

We will take no lessons from the Tories when it comes to PFI.

We have not only seen facilities management contracts having to be brought back in-house in Leicestershire and Nottingham; we have also seen them deliver a poor quality of service across Lewisham and Greenwich. Those contracts at Lewisham Hospital should come back in-house. I know that the Labour candidate in Lewisham East will be campaigning to bring them back in-house, and I hope the Tory candidate will do the same.

[Vicky Foxcroft (Lewisham, Deptford) (Lab)]

Will my hon. Friend give way?

[Jonathan Ashworth]

I will give way to my hon. Friend from Lewisham, and then I will make progress.

[Vicky Foxcroft]

I thank my hon. Friend. He is right: the candidate in Lewisham East will absolutely be campaigning on that, because it is out of order and outrageous that many of the people working under that contract are not receiving pay for one week because Interserve is not paying them.

[Jonathan Ashworth]

Absolutely. I wish the Labour candidate in Lewisham East well and will be campaigning with them. We will be sending a firm message to the Tories that privatisation of the NHS will end. The NHS is not for sale.

Austerity: Life Expectancy

Vicky Foxcroft Excerpts

Wednesday 18th April 2018 Westminster Hall

[Robert Courts (Witney) (Con)]

It is a pleasure to serve under your chairmanship this afternoon, Mr Paisley. I shall keep my comments brief because many other Members wish to speak. I also take the opportunity to congratulate the hon. Member for Sheffield, Heeley (Louise Haigh) on securing a debate on this important matter.

When people think of the rolling hills of west Oxfordshire, I appreciate that poverty is not one of the things that immediately springs to mind, but that is to ignore some of the very real issues present in my constituency. There are real factors and pockets of deprivation, and rural poverty in particular is a real concern, so the issue is very live for those of us in the green shires, as well as for those in urban environments. I would like the House to bear that in mind.

The hon. Lady made some important points today, but I suggest that it is simplistic to look at a straightforward line between necessary control of public spending and an impact on life expectancy. As we have heard, a whole range of factors affect life expectancy and mortality—quality of life, mental health, obesity, housing, air quality—and simply to draw that straightforward causation line is to make things far too simple, when in fact we are dealing with a complex issue.

[Vicky Foxcroft (Lewisham, Deptford) (Lab)]

The hon. Gentleman talked about it being simplistic to talk about the cuts, austerity and so forth, but let us talk, for example, about the cost of a pupil going to a pupil referral unit being 10 times more expensive, or the cost of someone in prison being £35,000 per year. If we invested such money earlier in education, mental health support or support for our young people, we would save money. Indeed, he is the one coming out with the simplistic argument.

[Robert Courts]

The hon. Lady will not be surprised to hear that I do not agree with her. She made a number of points, but I am simply suggesting that the issue is complex. Saying simply that necessary control of public spending leads to an increase in mortality, as is being suggested, is too simplistic.

Let us look at the example of Scotland—this is a simple and important point—where free adult social care is offered and more is spent on healthcare per head than in England. However, life expectancy there is still lower than in England. That simply underlines my point, which I make in response to the hon. Member for Sheffield, Heeley, that it is too simplistic to say that that link between spending and outcomes is as straightforward as she would make out. That cannot be the case, or the situation in Scotland would not be as it is.

For that matter, let us look at the outcomes across Europe. The Public Health England figures are quite striking, particularly in graph form. They show that not only do we have a slight dip in life expectancy figures over the course of the past year or so, but so too do Italy, Spain and, strikingly, France—a dip almost identical to what we have seen in the UK, despite the fact that I understand the French spend the highest amount in Europe on healthcare. We are clearly dealing with a much more complicated situation, and lifestyle factors are crucial. Those are not restricted to the UK.

I am glad that the hon. Member for Sheffield, Heeley has accepted that life expectancy cannot be expected to increase forever. That is of course common sense and a point that she readily accepts, but the point bears repeating and remembering. For a number of reasons we have had extraordinary success in increasing healthcare over the past few years, but we are now faced with the results of that—an ageing and increasing population, therefore with increased complexity of morbidity factors.

I therefore applaud the approach being taken by the Government. We are not only investing as much as possible within the constraints of sensible Government spending, but ensuring that we address the lifestyle factors that can affect life expectancy in the round. However, as I continue to speak, I can see you looking at me with concern, Mr Paisley, so I will confine myself to those remarks.

NHS Staff Pay

Vicky Foxcroft Excerpts

Wednesday 21st March 2018 Commons Chamber

[Mr Hunt]

My hon. Friend is right. Just to reassure him, I do not think that any Health Secretary would ever say the NHS does not need additional funding. He makes an important point, and the truth is that at the 2010 election there was one party that wanted to cut funding for the NHS. It was the Labour party, and we stopped it.

[Vicky Foxcroft (Lewisham, Deptford) (Lab)]

When my sister broke her neck only weeks ago, I saw at first hand the pressures that NHS staff are under. They start shifts early and finish shifts late, and there are not the right staffing levels on wards. Those staff were amazing, however. The NHS is now short of 100,000 staff because of this Government’s neglect of the NHS workforce. Will the Government apologise to all NHS workers for undervaluing them for so long?

[Mr Hunt]

The hon. Lady needs to look at the facts before making those kinds of claims. Let us look at what has happened in the last five years—the period during which I have been Health Secretary. The numbers of qualified clinical staff have not gone down, but have gone up by 43,000. We are doing everything we can to increase the capacity of the NHS, and the hon. Lady should be welcoming that.

Oral Answers to Questions

Vicky Foxcroft Excerpts

Tuesday 20th March 2018 Commons Chamber

[Anna Turley (Redcar) (Lab/Co-op)]

10. What estimate he has made of the number of young people who have not had access to child and adolescent mental health services after a referral in the last 12 months.

[Vicky Foxcroft (Lewisham, Deptford) (Lab)]

22. What estimate he has made of the number of young people who have not had access to child and adolescent mental health services after a referral in the last 12 months.

[The Parliamentary Under-Secretary of State for Health (Jackie Doyle-Price)]

We estimate that of the approximately 460,000 referrals made to children and young people’s NHS mental health services per year, 200,000 children receive treatment and many are appropriately signposted to other help. Treatment within the NHS is determined by clinical need and it is vital for all to remember that specialist services are not always appropriate for those referred. That said, we are committed to treating 70,000 more children and young people each year by 2020-21.

[Jackie Doyle-Price]

Having looked at the performance of the hon. Lady’s local trust, I can say that it is rising to the challenge extremely well, but that brings with it challenges. We are increasing the funding available for children and young people’s mental health services. We are relying on local clinical commissioning groups to purchase those services, but I can tell the hon. Lady that NHS England will be keeping this area under scrutiny, to ensure that we are delivering that help to the frontline.

[Vicky Foxcroft]

Does the Minister accept that cuts to mental health services mean that too many young people who have suffered trauma are not getting the support that they desperately need? Has she measured the impact of that on young people, and looked, in particular, at any links to the tragic incidents of youth violence that we are now seeing daily?

[Jackie Doyle-Price]

I do not accept the allegation that there have been cuts. We have increased expenditure by 20%. We recognise that we need to invest significantly more in improving children and young people’s mental health, and that is exactly what we will be doing.

 Orkambi and Cystic Fibrosis

Vicky Foxcroft Excerpts

Monday 19th March 2018 Westminster Hall

[Vicky Foxcroft (Lewisham, Deptford) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Roger.

Like many other right hon. and hon. Members, I was inspired to take part in the debate by two constituents. The first told me about his younger sister, who has cystic fibrosis. She has always been very healthy, but she is now in her 30s and reaching the point at which she will need to use additional medications. As he was emailing me, his sister was on her way to hospital to undergo an operation to put a port in her chest so that she could receive intravenous antibiotics. He ended his email by saying:

“I understand that the NHS is under pressure, but this illness is one of the beatable ones”.

The second message I received was from the parents of a 10-year-old girl named Ruby, whom I met soon after I was first elected as an MP when she came here to see me as part of the environmental change lobby. Ruby is a bright and optimistic girl who loves science and maths, swimming in the sea and making emojis to send to her friends. However, unlike her contemporaries, she has to take more than 30 tablets a day to help manage her condition. She also has to nebulise further drugs and have physiotherapy every morning and evening. Her condition brings with it regular visits to hospital for scans and tests.

Although Ruby copes brilliantly with her condition, her parents know that with each passing year, the likelihood of her health declining increases significantly. As well as the obvious effects cystic fibrosis will have on her lungs, it carries a vastly increased risk of diabetes, liver disease and chronic digestive problems. As children with cystic fibrosis grow older and begin to realise the condition’s potential impact on their future, it takes a major toll on their mental health. Ruby’s parents worry about that continually. Knowing that they might live only to their mid-30s is an incredibly heavy burden for a young person to carry. It is not difficult to see that being able to access Orkambi would have a profound effect on children such as Ruby by slowing the progression of that cruel disease, if not stopping it completely.

I will leave hon. Members with a few words Ruby’s father wrote to me that perfectly sum up the impact that access to Orkambi would have on families such as his:

“Whilst it is Ruby who carries by far the most weight of her cystic fibrosis, a drug like Orkambi has the potential to free all of us in her family – and the families of so many other children with cystic fibrosis – from the sometimes overwhelming worries about the future – knowing that next week, next month, next year, a new infection or new problem could arise and the downward spiral that has taken the lives of so many with cystic fibrosis could begin.

We know society has to balance the cost of treatments for all with the needs of individuals. We know society has difficult choices to make. But we believe there is a resolution that can do just that, by bringing together the brilliance of science and a health system that is, and always should be, free for all. Enabling access to treatments like Orkambi would literally change our daughter’s life for good.”

Tobacco Control Plan

Vicky Foxcroft Excerpts

Thursday 19th October 2017 Commons Chamber

[Vicky Foxcroft (Lewisham, Deptford) (Lab)]

Perhaps I should start by declaring an interest as an electronic cigarette smoker myself. I have seen at first hand the health benefits of moving from smoking to electronic cigarettes, including being able to run much further and feeling much healthier. A smoker who gives up for, say, six months will start to feel the same benefits. I encourage the hon. Gentleman to seek a lot more research in this area.

[Will Quince]

I thank my hon. Friend—I use that description intentionally—for that intervention, and I think she is absolutely right. Without wanting in any way to sound patronising, I applaud her for making the move from smoking cigarettes to using e-cigarettes. The evidence is out there to suggest that it is a great way to transition off smoking and off nicotine entirely. Far more research needs to be done in this area, and I hope that the Chancellor is looking at how we could, in the Budget, encourage tobacco manufacturers to provide these products for free to women who are struggling to give up smoking during pregnancy, in particular.

I would also like to touch on the important issue of carbon monoxide monitoring. Challenges remain for staff in implementing the NICE guidance, particularly in relation to carbon monoxide screening. NICE has recommended since 2010 that pregnant women be screened for exposure to carbon monoxide. The current tobacco control plan reiterates the importance of that and further commits to recording women’s carbon monoxide levels in the maternity services dataset. However, front-line staff do not universally have access to carbon monoxide monitors.

We know already that babies who are exposed to carbon monoxide are more likely to suffer birth defects, to be born prematurely and to have a low birth weight, so it is incredibly important that we look at this area. Carbon monoxide screening is one of the key elements in supporting women who smoke to access quit services. Properly embedded into services, screening can transform outcomes. The evidence from the north-east shows that following a comprehensive programme to train midwives, provide them with monitors and set up referral routes to local quit smoking services, smoking in pregnancy rates fell by nearly a third. We know that this absolutely works.

I stress to the Minister that carbon monoxide monitors are not an optional extra; they are an essential tool for midwives. We would never ask midwives to do their jobs without, for example, blood pressure monitors. In the same way, all midwives should have access to CO monitors. Part of the problem is that there is no consistent national approach to the provision of these vital pieces of equipment. Local decisions determine whether midwives and health visitors have access to them, so there is local variation.

I would also like to touch on training for health professionals. The smoking in pregnancy challenge group, a coalition of health and baby charities, produced a report in July examining the training needs of midwives and obstetricians in England. That report was launched at a joint event of the all-party group on baby loss and the all-party group on smoking and health. I co-chaired the event, and the Minister kindly attended and addressed the meeting. I do not need to remind the Minister of this, but the report found that although health professionals have generally received training about the harms of smoking in pregnancy, a majority have had no training in how to communicate those harms to women and support them effectively to access the treatment that is available. Health professionals say that, in the absence of training, they lack the confidence to engage in such conversations.

The report recommends that such training form a regular part of mandatory midwifery training and be embedded into obstetricians’ continuing professional development. Can the Minister outline the steps that are being taken to review and implement the findings of this report? Will consideration be given to extending the analysis undertaken by the smoking in pregnancy challenge group to look at training needs, involving key stakeholders such as other health professionals?

To conclude, I very much welcome the new tobacco control plan and the commitments that the Minister and the Government have made in this area. Is there more that we can do? Yes, of course, there is much more that we can do. I know that the Minister, the Secretary of State and the Minister of State, my hon. Friend the Member for Ludlow (Mr Dunne) are as passionate as I am about reducing our miscarriage, stillbirth and neonatal death rates.

I repeat, because it is really important, that this debate is not about demonising or criticising women who smoke during pregnancy. I fully appreciate how addictive smoking is; it is really hard to stop. Like my hon. Friends the Members for Chippenham and for Harrow East, I have seen my parents struggle. They have both been smoke-free for many years, and I am very proud of them, but it is incredibly difficult.

When it comes to pregnancy, we know that all parents want to give their baby the best possible start in life, so I thank the Minister for all the work that he and the Department have done so far. I ask him to keep a watchful eye on this issue and to be pragmatic in ensuring that the Government give anyone who is struggling to quit smoking the tools and the support that they need to help them to achieve that goal.