Health and Wellbeing Services: Essex

Abena Oppong-Asare Excerpts

Tuesday 12th March 2024 Westminster Hall

[Abena Oppong-Asare (Erith and Thamesmead) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Henderson. I thank the right hon. Member for Witham (Priti Patel) for securing this important debate; I know this is something she is passionate about. She highlighted a number of important issues and concerns regarding health and wellbeing services in her constituency and across Essex, and I am pleased to respond on the Opposition’s behalf. I also thank other hon. Members for their contributions to the debate; I have found it very insightful.

I will start with GPs, as securing the future of general practice is integral to the future of the NHS as a whole. GPs are vital to their communities and contribute hugely to keeping the nation healthy. However, the Government have broken their promise to recruit more than 6,000 GPs in the last five years. Ultimately, the NHS has lost the equivalent of 1,830 full-time, fully qualified GPs since 2015. There is a GP shortage crisis, and Essex is unfortunately on its frontline.

When we break down the numbers of patients per GP in the UK, Mid and South Essex ICB is worse than anywhere else in the country—I do not dispute that. There is one GP for every 2,281 patients. Staff shortages are a vicious cycle that leads to worsening outcomes, and we must train thousands more GPs to finally end that cycle. If we do not, we risk allowing the health of our nation, and the health of the people of Essex, to just get worse.

It is also worrying that the Care Quality Commission warned Mid and South Essex NHS Foundation Trust last summer over failings in three Essex hospitals. It found that medical care had deteriorated, with waiting times not meeting national standards and patients not accessing services when they needed them. The people of Essex deserve better care. They deserve to be seen on time, and to have local hospitals providing quality care for them when they need it most.

In recent years, elective waiting lists have risen sharply in every region and area of England. However, there are large geographical differences, with the east of England being one of worst affected areas. When we compare the figures with January 2020, the waiting list at the end of last year was 113% higher in the east of England. At the start of last year, the Prime Minister made a promise to the country to get NHS waiting lists down. Last month, he admitted the obvious—that he had failed. However, the reality is that the Government have failed in achieving most of the waiting list and waiting time targets since 2010. Unfortunately, that is a result of 14 years of successive Conservative Governments running the NHS.

I will quickly reflect on the worrying state of maternal health services in Essex. We face a crisis in maternity services across the country, with the CQC rating two out of three maternity units dangerously substandard. For the people of Essex, all but one maternity hospital unit is failing. Following the release of the final Ockenden report nearly two years ago, I urge the Minister to respond on the Government’s progress on implementing the report’s immediate and essential actions in trusts across the country. Safe care for women, babies and their families must be the top priority for our Government. It is clear that more needs to be done to improve care and safety in maternity services in England.

The Essex mental health inquiry has been covered in this debate, and I praise the grieving families and hard-working campaigners for their efforts in securing a statutory inquiry. In particular, I want to honour Melanie Leahy, whose son Matthew died more than 10 years ago in a mental health unit in Essex. She has never given up hope of getting justice and fighting to improve mental health provision in Essex and across the country, and she is an inspiration to us all.

Labour welcomed the announcement at that time, and I hope to hear an update from the Government today about progress on the Lampard inquiry. The Secretary of State offered to meet families last year, but that has yet to happen. The Guardian reported today that bereaved families have accused the Minister of dragging their feet over the inquiry into the death of almost 2,000 patients across NHS mental health trusts in Essex. I hope to hear from him about when that meeting is scheduled to take place and when the inquiry’s terms of reference are scheduled to be published.

I urge the Government to do all they can to ensure that the inquiry finally provides answers for the bereaved families, who have been waiting for far too long. While we are most determined to find answers to the specific inquiry, we must be clear that poor mental health services and standards are worryingly prevalent across other parts of the country. We continue to hear of other tragedies in mental health services; those are unacceptable. The Government must treat those incidences as a wake-up call and act in the light of the soaring number of investigations to prevent any further suffering or loss of life.

In recent years, one of the ways the Government could have acted would have been to deliver a reformed mental health Act. Reforms would have finally modernised legislation to strengthen people’s rights and choices within mental health settings. That was a manifesto pledge by the Government, and the Bill is ready to go—“oven-ready” as some on the Government Benches might have said previously. There is no excuse for the delay, but the Government have failed to get it done and deliver those much-needed changes. Labour has committed to introducing such a Bill in our first King’s Speech. Not only will it deliver real change to mental health services across the country, but it will deliver 8,500 new mental health specialists, mental health support in every school and open-access mental health hubs in every community. Those fully funded and game-changing policies will make a real difference to tackling the mental health crisis that we face.

As we have heard, health and wellbeing services in Essex and across the country are facing extreme challenges. If we are privileged to get into government, Labour is determined to make a real difference for the people of Essex and this country by delivering more GPs, midwives, health visitors and mental health support and cutting waiting lists and times. We will deliver a mission-driven Government and break out of the current doom loop. We will push decisions out to communities and finally end the short-term sticking-plaster politics of this Government.

Oral Answers to Questions

Abena Oppong-Asare Excerpts

Tuesday 5th March 2024 Commons Chamber

[Mr Speaker]

I call the shadow Minister.

[Abena Oppong-Asare (Erith and Thamesmead) (Lab)]

NHS figures from December show that the number of women waiting for gynaecological treatment reached another record high of nearly 600,000. That number has tripled since 2012. A Labour Government will cut NHS waiting lists in England by funding 2 million more appointments a year. What can the Minister say to the women waiting urgently for treatment?

[Andrew Stephenson]

I would say that we are sticking to our plan to back the NHS to cut waiting lists and make our NHS fairer, simpler and faster. When there is no strike action, that plan is working. We already eliminated the longest waits, and, in November, we saw the biggest fall in waiting lists outside of the pandemic in more than a decade, alongside record investment in things like women’s health hubs. We are prioritising women’s health.

Eating Disorders Awareness Week

Abena Oppong-Asare Excerpts

Thursday 29th February 2024 Westminster Hall

[Abena Oppong-Asare (Erith and Thamesmead) (Lab)]

It is a pleasure to serve with you in the Chair, Mr Hollobone. I want to start by praising the hon. Member for Bath (Wera Hobhouse) and my hon. Friend the Member for Sheffield, Hallam (Olivia Blake). They are true champions of those suffering from eating disorders or mental health issues, especially our children and young people. I congratulate them on securing the debate and on their excellent contributions, as well as their continued work through the APPG on eating disorders to help champion this issue. They have put this issue on the national radar and have worked effectively cross-party to try to eradicate the epidemic of eating disorders.

I also thank my right hon. Friend the Member for Hayes and Harlington (John McDonnell), who talked passionately about the impact that eating disorders have on individuals and highlighted the fact that we need to understand the impact they have on people’s lives, including at work. He also talked about the huge spike in hospitalisation figures.

I want to touch on some of the points mentioned by the hon. Member for Bath, who used powerful statistics to make the growing problem of eating disorders hit home. She highlighted the disparity between areas in how high up the agenda the issue is—it is not always high up the agenda—and talked about the importance of carers and parents knowing more about the condition so they can help to address it. That was echoed by my hon. Friend the Member for Sheffield, Hallam, who talked passionately about her constituent, who said she was “reduced to numbers” before receiving help. She also highlighted something that hit home with me when she spoke about how her constituent had said that no one should be “left to a medical emergency” before getting help, and that there should be standardised treatment for this particular matter.

I am pleased to speak on behalf of the Opposition to mark Eating Disorders Awareness Week. As many people in the room will be aware, eating disorders are serious mental illnesses that can have severe consequences. It is estimated that over 1 million people in the UK live with an eating disorder, and the reality is that for far too long, those suffering have been ignored. Eating disorders are responsible for more loss of life than any other mental health condition, as has been said. Unfortunately, as we have seen with the statistics raised in the debate, it is increasingly becoming quite common. The sooner someone receives treatment, the better their chances for making a full and sustained recovery, yet that is often not the case. It is a credit to the many campaigners and parliamentary colleagues in this room who have been working on this, along with vital charities, such as Beat, that we can say progress has been made in awareness and support. However, as we continue to face the severe consequences of the pandemic, we see a mental health crisis across our country. We all know that so much more urgently needs to be done.

The NHS figures suggest that the proportion of those aged 17 to 19 with an eating disorder stands at 12%, which is up from just 0.8% six years ago. Hospital admissions are double what they were a decade ago, and last year the awareness week focused on the specific challenges for men.

I also want to quickly echo the point made my hon. Friend the Member for Sheffield, Hallam, as well as other Members, on the importance of recognising that eating disorders do not discriminate. They affect any age, ethnicity, gender or socioeconomic background. It is important to highlight those facts when continuing to break down the stigmas and stereotypes that prevent so many people from reaching out and receiving much needed help.

This year, Beat has focused its attention on another important issue that has often been overlooked—avoidant/restrictive food intake disorder. It can affect anyone of any age, and Beat has estimated that the number of people with that disorder in the UK could be over 200,000. It can be very difficult to diagnose, and as Beat has highlighted, the information available to those seeking help can be very limited, which echoes what has been said by hon. Members today about parents and carers not having sufficient information on how to address these issues. For example, it has been highlighted that eight in 10 eating disorder service providers do not state on their website whether they offer ARFID care.

The data clearly shows that such cases, like all eating disorders, have surged in recent years across the UK. However, as cases have risen, services have struggled to match the demand, which means more waiting in anguish for longer. In 2015, the Government introduced new waiting times and access standards for community-based eating disorder services for children and young people. That included targets for one-week urgent treatment and four-week routine treatment, but those targets have never been met. I would be grateful if the Minister could tell us what will be done to address that failure. Meeting those targets is much needed. Instead of meeting those targets last year, one in five patients with non-urgent referrals were not seen within four weeks, and one in three patients with urgent referrals were not seen within a week. When children and young people with urgent cases of eating disorders wait more than 12 weeks to start treatment, the severity of the current crisis cannot be overlooked.

I also want to raise the important issue of providing adequate care to adults. As highlighted by the HSJ report last year, the deaths of 19 eating disorder patients, with at least 15 of those being deemed avoidable, demonstrated an urgent need to improve eating disorder provision. What more are the Government doing to address those concerns and ensure that all those patients receive the quality of care that they deserve?

I also want to touch on some of the points mentioned by my right hon. Friend the Member for Hayes and Harlington, my hon. Friend the Member for Sheffield, Hallam, and the hon. Member for Bath. They mentioned the lack of monitoring of the effectiveness of treatment being provided. Is the Minister aware that the Royal College of Psychiatrists has published guidance for healthcare professionals to support the development of specialist skills and knowledge to assess and treat people with eating disorders? What are the Government doing to ensure that that guidance is embedded in primary care and emergency departments? The Opposition recognise that, when it comes to eating disorders and all mental health issues, prevention is so important, and early prevention provides the best chance of recovery. Too many people, especially our children and young people, are stuck on mental health waiting lists for months or years instead of receiving the urgent care that they need.

We face a mental health crisis in this country, and we must have a Government that acknowledge that and will take urgent action. That is why Labour have committed to a child health action plan, with a bold ambition for this to be the healthiest generation of children ever. We will recruit thousands more mental health staff to cut waiting lists and ensure that more people can access treatment. We will focus on prevention, early diagnosis, early intervention and timely treatment near where people live.

To do that, we will put an open-access mental health hub for children and young people in every community, and a mental health specialist in every school. That will be paid for by abolishing tax loopholes for private equity fund managers and tax breaks for private schools. We cannot continue to lurch from crisis to crisis, which is what is currently happening. We must look at how we can build a new, solid, long-term foundation for a resilient health and care system, with an NHS that is truly fit for the future.

[The Minister for Health and Secondary Care (Andrew Stephenson)]

It is a pleasure to see you in the Chair, Mr Hollobone. I start by paying tribute to the hon. Member for Bath (Wera Hobhouse) for securing an important debate on an important topic. I know that both as an MP and as the chair of the all-party parliamentary group she has long been a champion for those living with eating disorders. She has worked with the hon. Member for Sheffield, Hallam (Olivia Blake) and others on the APPG to ensure that eating disorders are kept high on the political agenda.

I share the passion for this issue expressed by all the hon. and right hon. Members who have spoken in this debate. As the right hon. Member for Hayes and Harlington (John McDonnell) said, one thing that unites everybody in the Chamber today is that we have all tried to help a constituent, or the family of a constituent, who is suffering from an eating disorder. I have certainly done so in my 13 years as the MP for Pendle, and those cases that I have dealt with are some of the most difficult and emotional to have come across my desk in my surgery.

Improving eating disorder services is a key priority for the Government and a vital part of our work to improve mental health services. As we have heard, this week is national Eating Disorders Awareness Week, and raising awareness is essential to making progress on this important issue. I am grateful for the work of Beat and other charities across the whole sector; they have shone a light on eating disorders and they support people who are struggling.

We know that having an eating disorder can so often be utterly devastating for those with the condition, as well as for those around them. As I think has been said by pretty much every hon. Member who spoke today, we know that eating disorders can affect people of any age, gender, ethnicity or background. However, we do know that recovery is possible, and that access to the right treatment and support can be life changing. Early intervention is vital, and we want to ensure that children and young people with eating disorders get swift access to support.

Since 2016, investment in children and young people’s eating disorder community services has risen every year; £53 million was invested per year in 2021-22, and that figure rose to £54 million in 2023-24. As part of the £500 million covid-19 mental health recovery action plan, we invested an extra £79 million to significantly expand young people’s mental health services—enabling 2,000 more children and young people to access eating disorder services. We have also introduced a waiting time standard for children and young people with eating disorders. Our aim is for 95% of children to receive treatment within one week for urgent cases, and within four weeks for routine cases.

[Abena Oppong-Asare]

On the Minister’s point about getting waiting time targets down to one week, those targets were implemented in 2015, and they are yet to be met. Could the Minister explain what work is being done to address that, because he just mentioned those same targets again?

[Andrew Stephenson]

I completely recognise the shadow Minister’s challenge on that point and the concern that she has—I will set out what we are doing to address it. She also mentioned the Royal College of Psychiatrists, which published a report on this today. It is worth putting on record that we very much welcome that and that we look forward to working with it and other stakeholders. Waits are not as short as we would like, and the Government are determined to meet our waiting-time standards for children and young people with eating disorders. Extra investment is going into the services to meet increased demands and reduce waits, so hopefully we will start to see progress made towards meeting those targets. However, we acknowledge that, while there has been record investment and progress in improving access to eating disorder services and improving quality, there has also been a significant increase in demand for those services over the past few years. That was especially true during the pandemic, with increased demand outstripping the planned growth in capacity.

Children and young people’s eating disorder services are treating 47% more children and young people than before the pandemic, with almost 12,000 children and young people starting routine or urgent treatment in 2022-23, compared with just over 8,000 in 2019-20. That surge in demand has made meeting our waiting-time targets more challenging, and waits are not as short as we would like them to be. However, I am proud that our services and clinicians, backed by new funding, are supporting more children and young people than ever before. Those services are changing and saving lives.

We also know that even earlier intervention is critical to prevent eating disorders from developing. Community-based early mental health and wellbeing support hubs for children and young people aged 11 to 25 can play a key role in providing that support. In October 2023, we announced that £4.92 million from the Treasury’s shared outcomes fund would be available to support hubs, and an evaluation to build the evidence base underpinning those services.

[Andrew Stephenson]

We do need more information on that, and I will come to that point. The next point that I wanted to make was on an announcement that I know the hon. Lady will already be aware of, but other hon. Members may not be. Following the evaluation of some excellent commercial tenders from hubs across the country, the Government announced just this week that we are now providing an additional £3 million, which means that total of 24 hubs will receive a share of almost £8 million in 2024-25. That is more than double our original target of funding 10 hubs, and organisations across England—from Gateshead to Truro—will now benefit.

I appreciate that there is still a bit of a postcode lottery around the country, but we are looking to strengthen services, working with different partners across England, to ensure that we are improving services—enhancing existing services—or developing new services where they have not been provided in the past.

[Abena Oppong-Asare]

I just want to add to the point made by the hon. Member for Bath (Wera Hobhouse) about hubs. What work will be done to ensure that the data is captured to see how the growing problem of eating disorders can be addressed and what effective treatments could slow the increase?

[Andrew Stephenson]

We are working very closely with NHS England and partners to ensure that that data is captured. We are also working with the charities involved in this sector and with others.

I know that the Minister with responsibility for mental health, my hon. Friend the Member for Lewes (Maria Caulfield), has been doing a lot of work on this and has met with various stakeholders. I perhaps should have said at the start of the debate that the reason my hon. Friend is not here and hon. Members have me instead is, of course, that the International Women’s Day debate in the Chamber was still going when this debate started —so, unfortunately, there was an unavoidable clash.

However, I know that this is a topic very close to my hon. Friend’s heart, and getting the data right is really important for us to ensure that the gaps that currently exist in services are being addressed. I will certainly ensure that the shadow Minister’s issue is raised with my hon. Friend; if I may, I will ask her to write to the hon. Lady on that.

We know that eating disorders can have devastating effects on adults too. Under the NHS long term plan, by 2023-24 we are investing almost £1 billion extra in community mental health care for adults with severe mental illness, including eating disorders. That extra funding will help to enhance the capacity of new or improved community eating disorder teams covering the whole of the country. As part of funding provided in 2021-22 in response to pressures created by the pandemic, we also provided £58 million to support the expansion of community mental health services for adults, including those relating to eating disorders.

Many hon. Members in their contributions raised avoidant/restrictive food intake disorder, or ARFID. I share their ambition to improve support for people living with this under-recognised condition. In 2019-20, NHS England funded seven community eating disorder teams for children and young people, one in each region of England, in a pilot programme to improve access, assessment and treatment for children presenting with ARFID. The pilots ran from September 2019 to March 2020 and included training to support the adaption of each service’s existing care pathways, assessments and treatment interventions for children and young people with ARFID. The training from those pilots is now available for local areas to commission for their community children and young people’s eating disorders services. In 2021, NHS England also commissioned ARFID training for staff delivering treatment in inpatient children and young people’s mental health services.

We recognise that more needs to be done. We know that the earlier treatment is provided, the greater the chance of recovery. NHS England continues to work with eating disorders services and local commissioners to improve access to treatment for all children and young people with a suspected eating disorder, including those presenting with ARFID.

Several hon. and right hon. Members raised the issue of BMI and the Dump the Scales campaign. NHS England continues to emphasise to systems and services that BMI should not be used as a single measure to determine access to treatment within either adult or children and young people’s eating disorders services. That is in line with NICE recommendations and is included in the national published guidance, as well as in the recent community mental health framework. NHS England is also in the process of updating the children and young person’s guidance, which will also state that BMI should not be used as a single measure.

The hon. Member for Bath asked whether we would consider appointing an eating disorder champion who could help to galvanise action and support for people living with those conditions. As she may know, the Government do not currently have plans to appoint a specific champion role, but I can assure her that the Department of Health and Social Care and NHS England already work closely with stakeholders advocating for better care, such as Beat. We are also very grateful for the work of Dr Alex George in his role as the Government’s ambassador for children and young people’s mental health, which includes championing the needs of those with eating disorders.

The right hon. Member for Hayes and Harlington raised the issue of palliative care pathways. I want to assure him and other hon. Members that people with eating disorders should not be routinely placed on palliative care pathways, including those with severe, complex or enduring eating disorders. The NHS is clear that all those with severe, complex or enduring eating disorders should have access to evidence-based treatments focused on helping people recover, including hospital-based care if appropriate. Staff involved in the care of people with complex and severe eating disorders must adhere to the legal frameworks that safeguard their best interests, and NHS England will work with patient groups and stakeholders to develop further guidance on that.

The hon. Members for Bath and for North Ayrshire and Arran (Patricia Gibson) raised the issue of suicide. It is critical that we all do all we can for those affected by eating disorders before they reach that point. That is why the Government published a suicide prevention strategy in September of last year, which aims to reduce suicide over the next five years. I want to reassure right hon. and hon. Members that people in contact with mental health services, including those with eating disorders, are a priority group for the strategy.

In closing, I extend my thanks once again to the hon. Member for Bath for securing the debate, and to all the hon. and right hon. Members here today for their thoughtful contributions and questions.

Oral Answers to Questions

Abena Oppong-Asare Excerpts

Tuesday 23rd January 2024 Commons Chamber

[Mr Speaker]

I call the shadow Minister.

[Abena Oppong-Asare (Erith and Thamesmead) (Lab)]

Recruiting and retraining more NHS staff is crucial if women are to get gynaecology, obstetric and maternity care. I would like to share the story of Sandy Simmons. She was told 11 months ago that she needed surgery for a uterine prolapse; today, after nearly a year of pain, she is still waiting. Labour candidates such as Keir Cozens in Great Yarmouth are speaking up for women like Sandy and the 905 women waiting more than a year for treatment in Norfolk and Norwich University Hospital. Will the Secretary of State apologise to these women—or, like the Prime Minister, will she just walk away?

[Victoria Atkins]

I was genuinely delighted to welcome the hon. Lady to the Government’s women’s health summit last week to announce the consolidation, and indeed the improvement, of the women’s health strategy that this Government have launched. We saw significant success last year with hormone replacement therapy improvements and she knows, because she attended the summit, that I have just announced a £50 million research fund looking at maternity disparities and also research into female-specific conditions. Any concern she has about operation times she should take up with the local trust and it will perhaps tell her what impact industrial action has had, sadly, on elective surgery.

Oral Answers to Questions

Abena Oppong-Asare Excerpts

Tuesday 5th December 2023 Commons Chamber

[Madam Deputy Speaker (Dame Eleanor Laing)]

I call the shadow Minister.

[Abena Oppong-Asare (Erith and Thamesmead) (Lab)]

I begin by welcoming the Secretary of State and her Ministers to their posts.

Last year, the Prime Minister pledged to restore NHS dentistry, including a specific promise to protect its budget, yet last month we learned that he will break that promise and allow ICBs to raid dentistry budgets to fill the gaps. Labour has a plan for 700,000 extra appointments, supervised toothbrushing in schools and a targeted dentistry recruitment scheme in left-behind areas. It is all fully funded by abolishing non-dom tax status. We have a plan, but the Government’s plan is four months overdue. Where is it?

[Victoria Atkins]

I thank the hon. Lady for her warm welcome. I look forward to discussing these matters with her over the Dispatch Box.

Over the weekend, I was rather pleased to see the Leader of the Opposition’s damascene conversion to the Conservative cause. As the shadow Secretary of State is on his world tour investigating what other health systems are doing, the Labour party may wish to bear in mind the words of wisdom from the great lady herself: “The problem with socialism is that at some point you run out of other people’s money.”

--- Later in debate ---

[Madam Deputy Speaker (Dame Eleanor Laing)]

I call the shadow Minister.

[Abena Oppong-Asare (Erith and Thamesmead) (Lab)]

Thanks to their own internal chaos, the Conservatives have utterly failed in their promise at the last general election to fix the crisis in social care once and for all. We now have over 150,000 care vacancies and 390,000 care staff leaving their jobs each year, meaning that 60% of patients in England who are fit for discharge are being kept in hospital each day. Will the Minister therefore back Labour’s plan to deliver a fair pay agreement, with better terms, conditions, training and pay, to ensure that we have the staff required to care for all those who need it?

[Helen Whately]

Labour really have not got a leg to stand on when it comes to social care reform. They did not do anything the last time they were in government, and they still do not have a plan for social care. In government, we are reforming social care careers—[Interruption.] If the hon. Lady will take a look at what we are doing, we are introducing a new career structure for people working in social care, introducing new qualifications and investing in training for social care. We are doing what needs to be done to ensure that social care as a career works for UK workers. [Interruption.]

--- Later in debate ---

[Madam Deputy Speaker (Dame Eleanor Laing)]

I call the shadow Minister.

[Abena Oppong-Asare (Erith and Thamesmead) (Lab)]

Under the last Labour Government, there was no winter crisis. Under the Tories, we have gone from no winter crisis, to an annual crisis, to a crisis all year around. Rather than tackling the crisis at source, this Government have only sticking-plaster solutions for a few months at a time. How will patients know that a winter crisis has been avoided if problems persist into the spring?

[Helen Whately]

I am really sorry, but the hon. Member’s memory appears to be very short. I was working in healthcare when there was a Labour Government and I remember very well problems for the NHS during winter. She does not even need to look back into the past; she can look at the Labour-run NHS in Wales, where they are having so much difficulty with A&E performance that they even fudged the figures and hid a whole load of patients so people would not notice what was going on.

--- Later in debate ---

[Madam Deputy Speaker (Dame Eleanor Laing)]

I call the shadow Minister.

[Abena Oppong-Asare (Erith and Thamesmead) (Lab)]

The Care Quality Commission now says that almost two thirds of England’s maternity services are rated inadequate or requiring improvement in safety, up from 55% last year. The Government have been told time and time again to recruit more midwives, and to value midwives so that they do not want to leave the profession in the first place. As a result of ministerial failure, mothers—especially those from black and ethnic minority groups—do not get the safe, good-quality maternity care that they deserve. What is the Minister’s plan to properly improve maternity care?

[Maria Caulfield]

The hon. Lady may not have listened to my first answer. We have increased the number of midwives—it is up 14% since 2010—and increased the number of midwifery training places by 3,650. We have also introduced a maternity support programme that is providing intensive support for the 32 trusts that are going through it. The hon. Lady may want to speak to her ministerial colleagues in Wales, where Labour runs the health service, because Healthcare Inspectorate Wales recently issued an immediate improvement notice to Cardiff and Vale University Health Board for its maternity services.

Oral Answers to Questions

Abena Oppong-Asare Excerpts

Tuesday 17th October 2023 Commons Chamber

[Mr Speaker]

I call the shadow Minister.

[Abena Oppong-Asare (Erith and Thamesmead) (Lab)]

The House of Commons Library says there has been no statistically significant change in the rate of suicides in England since 2015. Suicide remains the biggest killer of men under 50 in the UK. Why has it taken so long for the Government to bring forward a strategy, and why do they continue to drag their feet over reform to the Mental Health Act? Can the Minister give the House a firm timetable today?

[Maria Caulfield]

The hon. Lady is not quite right in her statistics. Just before covid we had seen a 20% reduction compared with two decades ago in suicide levels in England. She might be interested to know that in Labour-run Wales suicide rates are higher than in England, and its suicide prevention strategy expired last year. Mental health has been demoted on the shadow Front Bench, too, as we saw from the resignation of the hon. Member for Tooting (Dr Allin-Khan) when the role of shadow mental health Minister was removed from the Opposition Front Bench.

Defibrillators: Public Access

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Tuesday 4th July 2023 Westminster Hall

[Abena Oppong-Asare (Erith and Thamesmead) (Lab)]

I beg to move,

That this House has considered public access to defibrillators.

It is a pleasure to serve under your chairship, Sir Charles. I am bringing this motion before the House this afternoon to maintain the steady pressure from campaigners and parliamentarians in relation to increasing awareness of and knowledge about defibrillators in two key regards: one, where they are; and two, how to use them. This continues the fine work conducted by Members from across this House, including the members of the all-party parliamentary group on defibrillators, its chair—the hon. Member for Stoke-on-Trent North (Jonathan Gullis) —and the hon. Member for Strangford (Jim Shannon), as well as Members of the other place.

This issue was brought home to me by the experience of my constituent, Bonnie McGhee, who works in the cardiology unit at Queen Elizabeth Hospital. Sadly, Bonnie lost her father to a cardiac arrest, but has since successfully raised funds for a defibrillator in his memory. Access to a defibrillator may have saved his life. The defibrillator that Bonnie funded is in the Clockhouse Community Centre in memory of her father, Jeffrey Anthony Mee. I think of Bonnie and her late father often, and today, they are especially in my thoughts.

In the UK, one person dies every three minutes from a heart or circulatory disease and, every year, 60,000 out-of-hospital cardiac arrests occur. Research by the National Institute for Health and Care Research found that only 8% of people suffering a heart attack outside of hospital will survive. However, the same research found that the odds of survival increase to 32% if a member of the public has access to an automated external defibrillator. If someone has access to a public defibrillator and can administer a life-saving electric shock to the heart to restore its normal rhythm, that will improve the likelihood of survival for anyone who has had a cardiac arrest.

Defibrillators represent an incredible technical advance. They are lightweight, easy to use and designed only to help and not harm the patient. The issue is not about their design but their distribution and public awareness of what they are and how to use them.

[Virginia Crosbie (Ynys Môn) (Con)]

I thank the hon. Member for securing this important debate and for her excellent speech. Does she agree that community defibrillator training sessions are vital, and will she join me in thanking people such as Ryan Cawsey of St John Ambulance Cymru and Stephanie Roberts of the Gwalchmai Hotel, who make possible free defibrillator training sessions for Ynys Môn constituents?

[Abena Oppong-Asare]

I thank the hon. Member for her intervention, and I will come to that really important point about community training. I also thank her and agree with her comments about the charities and organisations that are already doing the groundwork to provide help and ensure that people are adequately trained.

Research from Resuscitation Council UK shows that access to AEDs is not fairly distributed across the income and ethnic distribution of England. In other words, if someone is poor and/or black, they are less likely to have access to a defibrillator, but if someone is affluent and white, they are more likely to have access. The research shows unequal access across England, with fewer in the north-east and more in London. This is a classic example of what Dr Tudor Hart called “inverse care law”, whereby people with the most needs get the least provision, and vice versa. I hope that the Minister can address that point and tell us what the Government are doing to tackle these stark examples of health inequality.

[Angus Brendan MacNeil (Na h-Eileanan an Iar) (SNP)]

I am grateful to the hon. Member for securing this important debate. I want to mention Lucky2BHere, a charity based on the Isle of Skye that works across Na h-Eileanan an Iar and the highlands. There are now more than 150 defibrillators across the Western Isles—my constituency—which is about the length of Wales. There is one outside my constituency office in Stornoway, which I will come back to in a second. They are outside schools, and can be accessed at all times.

The work is having to be done be volunteers, who see the great need for it. Michelle Macleod, who works in my office, collapsed in 2019 after having run a relay part of a half marathon, and it was with the help of defibrillators that her life was saved. That underscores, on a personal and an office basis, exactly how important those defibrillators are in my constituency. I congratulate the hon. Member on raising this subject, so that there is greater awareness among the public and the Government about what needs to be done.

[Abena Oppong-Asare]

I thank the hon. Member for making such an important contribution and Lucky2BHere for the work it is doing. I acknowledge his constituent, whose life was saved by this work. Volunteers are doing a lot of work to raise money for defibrillators. I have seen it happen in my constituency recently, where the Friends of Lesnes Abbey and Woods have raised money for defibrillators.

I welcome the Minister’s announcement that £1 million will be available for community defibrillators. I am sure that he will set out how that money will be used and what impact it will have. Otherwise, the money risks being more of a PR exercise than an exercise in serious public health policy.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady for securing the debate. She was very kind to mention me earlier—I brought the Automated External Defibrillators (Public Access) Bill to the House in 2020, as most Members will know. The Government accepted the need to have defibrillators in schools, which was really good.

The person who made that happen was Mark King, whose son Oliver died in March 2011 from a cardiac arrest—he was an outstanding young man who would have gone very far in the world. There have been 4,500 AEDs placed in schools, 70,000 staff have been trained in AED awareness and 47 lives have been saved. Two of the lives saved were in my constituency, because the defibrillators were in place at the right time. I congratulate the hon. Lady on securing the debate, and I look forward to doing even more. Perhaps the Minister can give an indication what the next steps will be.

[Abena Oppong-Asare]

This is not to blow his trumpet, but I thank the hon. Member for the work he has done on the issue and for the important points that he just highlighted.

Let me go back to my point about the Minister’s announcement of the £1 million that will be available for community defibrillators. I have questions about the timing of the announcement, just a few days ahead of this debate. What will the method of distribution be for the roll-out? I am concerned that Ministers will pitch community groups against one another in a cruel competition to see who wins. The danger is that the winners are either the best organised or have the loudest voices, or else are favoured in the eyes of Ministers. This does happen with schemes of this nature. Resuscitation Council UK warns about

“defibrillators being disproportionately stored in communities that have resources, amplifying the UK’s mismatch between Automated External Defibrillator…density and Out of Hospital Cardiac Arrest incidence. By instead targeting public-access devices in areas of poor health and high OHCA incidence, this initiative could increase the chance of survival in the most high-risk communities.”

There is also the issue of public awareness and knowledge. Each year, there are 60,000 out-of-hospital cardiac arrests in the UK, with less than one in 10 surviving. While immediate CPR and defibrillation can more than double the chances of survival, public access defibrillators are used in less than one in 10 cases. Defibrillators must be located in well-signposted, unlocked and easily accessible places that members of the community can access immediately in an emergency. They must be maintained and ready for use. By the way, the criminal justice system should throw the book at anyone convicted of vandalising public access defibrillators. Few crimes are more mindless than selfishly disabling a defibrillator that might save a stranger’s life. Does the Minister believe that the current range of punishments available to the courts for vandalising a defibrillator is adequate?

As the House will know, there is a national database of locations of defibrillators. It is called The Circuit and is maintained by the British Heart Foundation and the NHS. I pay tribute to Resuscitation Council UK and St John Ambulance for their work, but the database is not complete. The Circuit currently has more than 70,000 defibrillators mapped, but there are estimated to be between 100,000 and 200,000 devices in the UK. This means that emergency services, including the ambulance service, might not be able to direct people to a defibrillator to save someone’s life. Will the Minister explain how that can be acceptable and what the Government are doing to rectify the situation?

[Jim Shannon]

The hon. Lady is right to outline the fact that many people do not necessarily know where defibrillators are located, and there is a need to ensure that that happens. Does she agree that one thing that should happen—maybe the Minister can answer this question—is the teaching of CPR, which is crucial to ensuring that people feel confident enough to use the apparatus of a defibrillator? Does she feel that the Minister should take that issue on board as well?

--- Later in debate ---

[Abena Oppong-Asare]

I thank the hon. Member for making such an important point. He literally took the words out of my mouth, because I was going to mention that later. He is right, because there is no point having all these defibrillators if no one knows how to use them. There are some located in my constituency and more widely, and people do not even know about them. I went to my local station recently, and some of the staff did not know that there was a defibrillator in the station. That lack of awareness is quite concerning.

I warmly welcome the Complete The Circuit campaign being run by the Daily Express and the British Heart Foundation. The campaign seeks to have every defibrillator listed. If Google Maps can list every pub and restaurant, which I know we all like, surely we should be able to see every defibrillator on our smartphones. I congratulate the Daily Express and its editor, Gary Jones, for this initiative—I think that is the first time I have ever said that.

I thank the Daily Mirror, which has run a lengthy campaign to install defibrillators in public spaces. Martin Bagot has been the driving force behind the campaign, and I know that people will be interested to know more about the current availability of defibrillators, such as the sorts of public venues that are more likely to have them and the public venues where there is an acute absence of them. Is the Minister aware of any blackspots, particularly in rural areas, where there is a lack of defibrillators? As the hon. Member for Strangford mentioned, if someone can find a defibrillator, will they be able to use it?

There is a strong case for a public information campaign to explain what a defibrillator is and how to use it, which should be supported by workplace training courses and much greater awareness. There are examples of defibrillators from abroad where the information is much clearer and easier to understand. Can the Minister tell us what assessment the Department has made of accessibility for people who cannot read or who do not have English as their first language? Is there a case for reviewing signage and instructions to make defibrillators even more accessible?

Lastly, what about our workplace? According to information released under the Freedom of Information Act 2000, there are 25 defibrillators on the parliamentary estate, including in Central Lobby and Portcullis House—do we know where they are? No. We should be shouting that information from the rooftops; it should not be released through an FOI request. How many right hon. and hon. Members know the whereabouts of those defibrillators? I do not know where the 25 are. How many of our staff know where they are? How many of us have had training in CPR or using defibrillators? This is a classic case of “Physician, heal thyself.” In other words, we in this place should model good behaviour in all things, including access to defibrillators.

There are so many tragic stories from every constituency of lives lost when a defibrillator could have saved them, and I have heard some of them through interventions. Of course, there are many stories in which people have survived because of access to a defibrillator and the quick thinking and swift action of a stranger. That is the ultimate reminder that we are interconnected by shared humanity, that we rely on the kindness of strangers and that, one day, any one of us might need a passer-by to save our lives.

--- Later in debate ---

[The Minister for Health and Secondary Care (Will Quince)]

It is a pleasure to serve under your chairmanship, Sir Charles. I assure you that, although I will try to address as many of the points and themes raised during this very constructive debate as possible, I do not intend to take the full time available to me.

I congratulate the hon. Member for Erith and Thamesmead (Abena Oppong-Asare) on securing a hugely important debate, and I thank all hon. Members for their contributions. Although I did not agree with all the points made by the Labour Front Bencher, the hon. Member for Tooting (Dr Allin-Khan), I thoroughly agree that there is considerable consensus. What has been displayed is Parliament working at its best, with all hon. Members raising constituency cases and rightly campaigning for greater access to and awareness of defibrillators in their communities and across our country. I put on record my condolences to those who have lost loved ones due to sudden death caused by an undiagnosed heart issue.

As has been said, defibrillators provide vital treatment, with the latest research showing that the use of such devices within three to five minutes of a cardiac arrest increases the chance of survival by over 40%. It is therefore crucial that we have enough defibrillators in public spaces to provide life-saving interventions when needed. I join the hon. Member for Erith and Thamesmead in paying tribute to and thanking the APPG and its members for all their work in this area. She mentioned the need for steady pressure, and I think that she is absolutely right to use that phrase. It is vital that we keep that steady pressure up, not just on the Department or the NHS but on organisations up and down the country, to ensure that we have as much access to these vital AEDs as possible.

The hon. Member for Erith and Thamesmead set out very articulately and eloquently the compelling case for access to and awareness of defibrillators, and I think that she did her constituents and the House a huge service today. I would also like to thank the charities, businesses, clubs and societies that go out and fundraise for AEDs; they are doing their communities a huge service too. Investing in devices and treatments that can prevent the most serious cardiac arrythmias is a priority for the Government. The hon. Lady also rightly raised the issue of inequality. That certainly preys on my mind when considering many aspects of health. She made a very powerful case, and I hope to address that point in my contribution.

As the hon. Member for Tooting mentioned, in December the Government announced a £1 million fund to design a grant scheme for the expansion of publicly accessible AEDs in the community. That fund was designed to provide an estimated 1,000 new defibrillators in spaces across the country. Whether at a town hall, a post office or a favourite green space outside the local Co-op, having access to AEDs in easy-to-reach areas, as we know and as has been very articulately set out this afternoon, can be a lifeline that keeps loved ones with us.

The fund builds on work by the Government, the NHS and stakeholders to improve survival from out-of-hospital cardiac arrests via the use of defibrillators and cardiopulmonary resuscitation—from now on I will use “CPR”, as I do not have the health expertise of the hon. Member for Tooting. The Department of Health and Social Care will invest the funding through an independent partner—I think this directly answers the question from the hon. Member for Erith and Thamesmead—which will be selected from the Government’s Crown Commercial Service list of approved suppliers. Successful applicants will then be asked to demonstrate that the defibrillators will be placed in areas where they are most needed.

To address the hon. Lady’s point about inequality, although Ministers will have no involvement in deciding where defibrillators are sited—it would be totally inappropriate for them to have that kind of involvement— I understand her concerns. It is inevitable to some extent that where an item of medtech is purchased by local communities, there will be a higher prevalence in more affluent areas, where it is easier to fundraise. Where there is Government funding available, it is important that wherever possible we use it to redress the balance in favour of areas that find it more difficult to fundraise. We must ensure that we target areas where there is a shortage of AEDs and do not just top up provision in areas where coverage is already good. I will certainly speak with the Minister for Social Care to see what more we can do to involve local Members of Parliament and interested groups, including the APPG, with the selected partner, to ensure that we get that right, because the hon. Member for Erith and Thamesmead has made a compelling case.

[Abena Oppong-Asare]

That is really good news to hear. Something that I also want to suggest to the Minister, which I think is really important, is about mapping areas of high need, because one of my concerns is that I am seeing community organisations fundraise for defibrillators, unaware that that fund has been available since late last year. I appreciate that these things take time and it is important that we get it right—we are not just flashing money around anyhow—but will review mechanisms be put in place to ensure that over time the funding is going to the right areas and that the right individuals are receiving the benefits of it?

[Will Quince]

I thank the hon. Lady for her intervention. She is absolutely right. It is important that whenever we spend Government money—taxpayer-funded money—in this way, there is a proper evaluation process. Having said that, although looking back and asking if we got it right is key, the most important thing for me is to get it right first time. We do that by ensuring that there are clear criteria.

The hon. Lady is also right that we have to map and look at not just areas where people do not have access to AEDs, but areas of social deprivation and areas with a higher prevalence of cardiovascular disease or higher footfall. Those are all factors that we absolutely need to consider when designing the criteria that the independent third-party provider would scope. I am keen to work with the hon. Lady and the APPG to ensure that we are getting that right.

Alongside that—and this is the reason why the number of AEDs that will be available through the fund is an estimate—there is a plan to ask for the match funding that some organisations receive. I am conscious that some areas will be able to do that but others will struggle, which is why it can be full or partial. Potentially, however, that could double the number of AEDs available. Some communities might be able to make only a small contribution, but others could match-fund it entirely. It is important that we set criteria that make it available as widely as possible to communities, especially those less affluent areas where fundraising is difficult.

[Abena Oppong-Asare]

That is really good. Another thing to highlight is that, as we see in data from The Circuit, not everyone is registering their defibrillators. Is the Minister coming to the point about organisations ensuring that when they receive the funding, they register it as well?

--- Later in debate ---

[Abena Oppong-Asare]

Would those who receive funding from the £1 million fund for the community be required to register with The Circuit? Where there is Government funding, I think we should be encouraging registration. The more people who are aware, the better.

[Will Quince]

I totally agree. I will check whether registering will be among the conditions for grant funding; I would like to think that it will, and I will work with the Minister for Social Care to ensure that it is. We know that there are many defibrillators that are not on The Circuit, and—short of legislating, which would not be a quick or easy solution—we have to get them on it as quickly as possible. We have to urge as many organisations and individuals as possible to register.

The hon. Lady asked what steps we are taking to promote that. I recently wrote to all local authorities to ask them to check and, if they have not done so already, to consider adding their defibrillators to The Circuit. I also asked them to reach out and share that message with parish councils, town councils, community groups, village halls, businesses and others that may have a defibrillator that is not registered on The Circuit. I am keen to work with local authorities, which have a reach into their communities that neither central Government nor the national charities could possibly have. I also urge all right hon. and hon. Members to encourage those organisations that have a defibrillator to ensure that it is registered. I join hon. Members in paying tribute to and congratulating the Daily Express on its important campaign, which I am happy to support.

I hear what the hon. Lady says about raising more public awareness about AEDs and where they are located, not on just the parliamentary estate but across communities and the country. I will continue to look at what more we can do centrally, but also by working with national and local charities, to raise that awareness.

The hon. Member for Plymouth, Sutton and Devonport asked about businesses. Some organisations—such as the Premier League, which the hon. Member for Erith and Thamesmead referred to—are leading the way, but we want to encourage more to do so. I will give further thought to how we can encourage other businesses to do the same.

The hon. Member for Tiverton and Honiton asked about first aid, and particularly about CPR. Better awareness and education around first aid training is key to improving survival rates from cardiac arrest. I am pleased that NHS England has partnered with St John Ambulance to, in effect, co-ordinate skills development to significantly increase the use of AEDs by individuals in community settings. That includes a national network of community advocates to champion the importance of first aid training. The plan is to reach 60,000 people, which will help to save up to 4,000 lives each year by 2028, empowering local communities to act more quickly to save people’s lives.

Finally, I cannot speak about cardiac arrest without speaking about prevention, which the hon. Member for Plymouth, Sutton and Devonport referred to. The prevention of heart disease is critical to reducing the number of sudden cardiac arrests. I will set out some of the work that NHS England is doing to reduce preventable deaths from heart disease. Currently, £2.3 billion is being spent to increase the number of centres diagnosing heart disease to at least 100 sites by March 2025. NHS England has developed a new fast-track echocardiography training scheme, which has led to 150 additional echocardiographers, with further support available in 2023-24.

The NHS health check programme, which the Secretary of State recently spoke about, is a core component of NHS England’s CVD prevention pathway. Over 15 million people are eligible for a NHS health check every five years. For every 1 million checks delivered, the NHS health check could prevent an estimated 400 heart attacks and strokes. Something like 10.8 million checks have been delivered between 2013 and December 2022, but it is important that we work hard to ensure that more people benefit from that lifesaving service and get a health check. I am keen that we make it easier and more convenient for people to do so.

I hope that today I have demonstrated the Government’s commitment to increasing the number of AEDs in our local communities. I am keen to see how we can turbocharge that and work with businesses and local communities to go much further. We can all agree that this agenda really matters. Once again, I thank the hon. Member for Erith and Thamesmead for highlighting this vital issue. I look forward to working with her to bring about the change in this area that we all want to see.

--- Later in debate ---

[Abena Oppong-Asare]

I thank the Minister for his remarks about what can be done. This debate was very much about a collaborative approach. Indeed, it is one of the rare debates that I have attended where there has been much consensus.

I thank hon. Members for sharing their experiences, particularly the hon. Member for Tiverton and Honiton (Richard Foord), who also shared some best practices on defibrillators. I am not familiar with the defibrillator dash, but it is something that we can all look into. I thank my hon. Friend the Member for Barnsley East (Stephanie Peacock) for her comments about the community groups fundraising for defibrillators in her constituency, and my hon. Friend the Member for Plymouth, Sutton and Devonport (Luke Pollard), who talked about the importance of corporates, the work that they have done in Plymouth and what can be done in supermarkets.

I thank the Minister for saying that he will consider what engagement and what encouraging conversations there can be with businesses. I am a bit concerned about the £1 million fund, in terms of inequality and little groups being missed out, particularly because we know that the groups that know how to do slick bids are the ones that are very good at getting the money. I am feeling a bit reassured by the Minister that the Government are looking at work to ensure that it is distributed equally, but I think a review needs to be done to make sure that nobody is left behind. It would also be good to get some clarification about whether those receiving funding are being required—

[Will Quince]

indicated assent.

[Abena Oppong-Asare]

They are? That is good to hear.

May I take this opportunity to thank you, Sir Charles, for saying that you will look at defibrillators in Parliament in your role as Chair of the Administration Committee? I am very impressed that you have taken that on board straightaway. I also want to thank the organisations and charities that have been driving this campaign for their excellent work and briefings.

I thank Bonnie for campaigning on this issue in memory of her dad. I want every citizen, no matter where they live or what they do, to know about defibrillators, where they are and how to use them. I want us all to know how to use one, just as surely as we know how to use a cashpoint. I have had training in how to use a defibrillator—it is so easy to use. I also welcome what the Minister says about the Government’s work in schools and particularly about starting with very young people. I remember receiving first aid at school, so it is good to start this from a really young age.

All these things are possible with the political will to make them happen. I know we will keep up the fight on this issue. I thank everybody for their contributions to this debate.

Question put and agreed to.

Resolved,

That this House has considered public access to defibrillators.

Hospice Services: Support

Abena Oppong-Asare Excerpts

Wednesday 14th June 2023 Westminster Hall

[Liz Kendall (Leicester West) (Lab)]

It is a pleasure to serve under your chairmanship, Ms Nokes. This has been a really important and good debate; we do not always say that about debates in this place. I thank the hon. Member for Eastleigh (Paul Holmes) for securing it. He spoke with great passion and personal insight, and I am sure Sue’s family and friends will thank him for what he said. I also thank all hon. Members who spoke about their personal experiences. It is not always easy to do that here, but they have shown great courage.

Many Members thanked the amazing hospices in their constituencies. I hope they will forgive me for also paying tribute to LOROS Hospice in Leicester West, which I have visited many times. I am blown away by the care and compassion there, and the complete humanity shown to others. I am very grateful for that.

The argument I want to make today is that we need a much bigger, more serious debate about what makes for a good death, in the words of the hon. Member for Strangford (Jim Shannon). Policy really needs to change across the board. When the welfare state and the NHS were created, average life expectancy was 63. Now it is over 80, and one in four babies born today is going to live to 100. Back then, most people died of infectious diseases or accidents. Now, it is long-term chronic conditions. That means we are now experiencing death in a very different way. Often, death is not sudden; it may be long and difficult, both physically and emotionally.

Hospices—including hospice at home, because that is where many people want to die—need to be seen as an essential part of our health and care system, not an optional extra, a luxury or an add-on, as part of that much bigger debate about what makes for a good death. “A good death” is not perhaps a great campaigning slogan for any political party to focus on, but it is the truth of what we face, and politics needs to keep up with the changes in society. We need to start looking at that. The vital role of hospices and the need to properly plan a funding system, our workforce, training and how we link services and support is the context within which I see today’s debate. Quite frankly, people do not want to die in hospital. They want to die in the community and at home, with integral support for family and friends. That is our vision; that is what we need to deliver.

[Abena Oppong-Asare (Erith and Thamesmead) (Lab)]

I thank the shadow Minister for giving way. I completely agree with the points she has raised. I thank the hon. Member for Eastleigh (Paul Holmes) for bringing the debate forward and for sharing his personal story, as have others in this room. It is not easy to share those stories, but it is important that we do.

I have seen first hand how hospices play a vital role in communities. They go over and beyond, and are truly heroic. I am patron of Greenwich and Bexley Community Hospice in my constituency; I have seen how they provide compassionate end of life care. Does my hon. Friend agree that it is vital that the Government recognise the issues hospices face, particularly during the pandemic and with the cost of living crisis?

[Caroline Nokes (in the Chair)]

Order. I remind the Member that interventions should be short.

Car Parking: Care Workers

Abena Oppong-Asare Excerpts

Thursday 16th March 2023 Westminster Hall

[Damien Moore (Southport) (Con)]

I beg to move,

That this House has considered the matter of car parking charges for care workers.

It is a pleasure to serve under your chairmanship, Sir Robert. I thank all hon. Members here in Westminster Hall today and the Backbench Business Committee for granting the application for this debate.

Care workers play an immeasurably important role in our society, looking after our loved ones and being with them through what for many will be the most difficult times of their lives. If it were not for their selflessness, diligence, dedication and good humour, our loved ones would have a far more difficult time and the knock-on effects on the older generation could be huge. Being a care worker is a difficult job, requiring hands-on work to support a diverse range of needs. For the 490,000 domiciliary care staff in England, delivering care and support to people in their own homes can involve dozens of short journeys every day. These workers must be trained and knowledgeable in so many things, including taking blood pressure, administering medicine, assisting patients with eating and even the art of making a good cup of tea.

Care work is undoubtedly a complex role that requires strong interpersonal skills. Given the demands of this tough and skilled job, it is perhaps not surprising that the vacancy rate in March last year stood at almost 11%, representing 165,000 vacancies. That was up from 7% a year earlier, which represented 110,000 vacancies. In domiciliary care, the vacancy rate is 13%—a figure far higher than in residential care, where the vacancy rate stands at almost 9%.

Yet as the number of vacancies grows, demand for social care is rising and that is expected to continue. I have noticed it especially in my constituency of Southport, which has an ageing population; we would greatly benefit from an uptake in the number of people wishing to work in the care sector. The increase in vacancies will place yet further stress on our hardworking care workers, so it is no wonder that Skills for Care estimates that the turnover rate of directly employed staff working in adult social care was 29% between 2020 and 2021, which is equivalent to approximately 400,000 leavers.

I appreciate that I am painting a bleak picture, but the situation is not all doom and gloom. Covid shone a spotlight on what many of us have been arguing for years: that we need to do more to support those who work hard in social care. The Government’s adult social care reform White Paper, published in December 2021, set out a 10-year vision for adult social care, along with funded proposals to be implemented in the following three years. Yet 10 years is simply too long for my hard-pressed constituents to wait, especially when a cheaper and simpler solution lies much closer to hand.

A few years ago, a particularly memorable constituent came to see me at one of my weekly constituency surgeries, held at the Atkinson library every Friday at 11 am. She worked in social care and was clearly excellent at her job; I felt confident that the elderly and vulnerable in Southport would be fine in her safe hands. However, she had a major problem with our local authority, Sefton Council. Every time she parked outside one of her clients’ houses, she would have to pay 90p for a parking ticket, and this was happening up to two dozen times a day. The cost of these tickets adds up, especially for those who are already earning close to the minimum wage.

[Abena Oppong-Asare (Erith and Thamesmead) (Lab)]

I thank the hon. Gentleman for securing this debate; it is important that we discuss this issue. I thought it would be helpful to give the example of a constituent of mine who has contacted me—a home care provider who has difficulties in driving from one client to the next and often struggles with parking. Does he agree that we should consider measures to help to ease the pressures on hardworking care workers, particularly because such measures would help to alleviate stress and save them time as they try to help their clients?

[Damien Moore]

The hon. Lady is absolutely right. What we are trying to do is remove from care workers’ lives the stress of paying for parking tickets and finding a parking space. There are times when a carer will pay for a half-hour parking ticket, although when they are in a client’s house they might find that they need to call an ambulance. That could take a few hours to arrive, during which time they will not be able to pop out and top up the parking meter. When they receive a parking penalty charge, which can lead to a lengthy challenge process for which few people have the time or energy, that causes additional stress.

I am sure that all Members here have at some point engaged with the Chancellor to see what he can do to better support our constituent care workers. His Majesty’s Revenue and Customs already offers tax relief on mileage incurred for work purposes, but there is currently no nationwide scheme in place to help with parking charges. Consider instead if care workers were simply allowed to keep their money in their pockets and did not have to go through complex bureaucracy; that will be possible only if we get this right and end needless car parking charges.

After speaking with my constituents, I immediately wrote to Sefton Council to raise the issue, but was quickly told that it was not interested in changing policy. I then wrote to the Government to ask if they could compel the council to change the policy by providing ringfenced funds to support my hardworking constituents. I was delighted when the then Health Secretary, my right hon. Friend the Member for West Suffolk (Matt Hancock), announced that the Government would be introducing the covid-19 parking pass, proving that we can do this if we really want to.

The scheme entitled on-duty NHS staff, health and social care workers, and NHS volunteer responders, to free parking in local authority off-street car parks and on-street bays in England. It was a fantastic scheme, and it worked wonders for not only the bank balances but the mental health of my social care worker constituents. No longer were they finding themselves squeezed even tighter by virtue of simply doing their job. With less time spent fumbling around looking for parking spaces, paying, and, sadly, often appealing a parking ticket, those workers could spend more time supporting people who draw on care in their own homes. It was win-win, for everyone.

Then the covid scheme came to an end. With the vacancy rate increasing, I felt all of the work had been undone. A permanent solution is required. Today, with the Minister present, I call on the Government to introduce a nationwide standardised green badge system—similar to the blue badge—for social care workers on duty and making care visits. It should be nationally recognised, with eligibility set at a national level. It should be available for all care workers who travel to provide care in clients’ homes. Care workers should be the permit holders, and, in keeping with the efficiency it would introduce, there should be a simple standardised application and issuing service. Engage Britain’s research shows that such a proposal has 80% support across all major political parties, as reflected by the diversity of Members who often bring up the issue.

Parking is normally an issue for local authorities, but we saw over covid that central Government can take the initiative in this area, and, with one sweep of the pen, put this easy and cheap solution in the hands of our care workers. After all, it is the Department of Health and Social Care’s responsibility to look after social care workers, so this parking protocol is its responsibility, not that of local councils. Similar arguments were made about the blue badge system, yet today’s standardised system is widely held up as being a great success. We need that success for our care workers too.

Some parking exemption schemes have survived the Government’s closure of their own scheme post covid, as hon. Members from Cornwall, Devon and Manchester will know. Those schemes would also benefit from the administrative simplicity of the central standardised system that I propose.

I finish with an impassioned plea. It is so rare that we are presented with such simple solutions. My proposed green badge has already been trialled nationwide throughout covid by the Government’s scheme, and was a resounding success. Both macro research from Engage Britain and micro research, such as anecdotal conservations with my constituents, show the huge benefits that free car parking has had and will continue to have if reimplemented. It is a low-cost, low-admin solution with tangible benefits for everyone who works in care, and for all those who have loved ones in care.

Public Health Funding: Bexley

Abena Oppong-Asare Excerpts

Tuesday 26th October 2021 Westminster Hall

[Sir David Evennett (Bexleyheath and Crayford) (Con)]

I beg to move,

That this House has considered public health funding in Bexley.

It is a pleasure to serve under your chairmanship, Sir Edward—I have a long-standing friend in the Chair, which is always good news. I am grateful of the opportunity to raise public health issues, which are of great concern and importance to my constituents in Bexleyheath and Crayford, as well as to the residents of Bexley borough in general. I am delighted to see my neighbour and friend the hon. Member for Erith and Thamesmead (Abena Oppong-Asare) in her place today.

In my opinion, Bexley is by far the best place in London to live, work or visit. We have great local amenities, considerable green open spaces, over 100 parks, and a variety of places to visit: Danson Park, Hall Place and Gardens, and the Red House, to name just a few. It is a well-run, Conservative-led borough, and I am pleased to live in Barnehurst myself, in the constituency.

Today I want to focus on the public health situation in Bexley and highlight a number of concerns about funding. This is a matter that I have raised before and held meetings with Ministers about, but regrettably it has not yet been satisfactorily addressed. There are areas of public health in which Bexley does better than elsewhere in England, but also a number in which we are lagging behind.

I commend the work done locally, particularly by Bexley Council and Bexley clinical commissioning group, which have done some fantastic work over the years on so many issues, particularly against smoking. The Bexley stop smoking services help thousands of people to stop smoking, which is saving lives and improving our community’s overall quality of life. The service has won a number of awards and was recognised by Public Health England for reducing smoking rates and introducing highly effective tobacco control initiatives. During the covid-19 pandemic, the team continued to provide specialist weekly support on the phone, and over the last year they have helped some 534 people to quit smoking.

That is a real achievement, yet in other areas we are not so fortunate. In Bexley we have problems such as obesity. Action is needed to improve the situation. For Bexley residents, obesity poses a significant challenge, as we have among the highest rates of obesity anywhere in London, with 23.4% of children classed as overweight or obese when they start primary school. This is a really concerning figure, which continues to rise as they get older, with 36.6% of children aged 10 to 11 leaving primary school with excess weight.

It is widely recognised by experts that once weight is gained, it is difficult to lose. The Government have called childhood obesity one of the top public health challenges for this generation. This is most certainly the case for the residents of Bexley. Children who are obese are five times more likely to be obese as adults. This can put them at increased risk of long-term health conditions, including type 2 diabetes, cardiovascular diseases such as heart disease, stroke, cancer and musculoskeletal conditions, and can negatively impact on mental health, which is a real problem. In Bexley, 64.6% of adults aged 18 or over have excess weight, which is higher than in the rest of England and London in particular.

The Government are well aware of the problems associated with obesity nationally and are being proactive to address the concerns. Some of the welcome measures include the soft drinks industry levy, support for the Healthy Start voucher scheme to enable low-income families to buy fruit and vegetables, and action to increase physical activity in schools, but we also need a localised approach. It is in all our interests to live in a healthier borough, and in Bexley the local authority is always looking at innovative ways to help us live better and longer.

The Bexley obesity strategy does just that. Between 2020 and 2025, the strategy aims to reduce the rate of excess weight in children and adults by a minimum of 2%, with a stretch target of 5%, and to create healthy environments at school, in workplaces and throughout the borough. Just a few of the plans to achieve that include increasing the number of food businesses achieving the healthier catering commitment accreditation, developing a sustainable model for community cooking classes, reviewing compliance with school food standards across the borough, and installing public water fountains in town centres. While that will require hard work and dedication, it will also, as the Minister will be aware, require additional funding.

Aside from the work on stopping smoking and action to reduce childhood and adult obesity, Bexley of course has many other clear public health priorities, including diabetes, dementia, addiction and substance misuse, including alcohol. Mental health and children and young people’s emotional wellbeing are key public health challenges, on top of the additional challenges that the covid-19 pandemic continues to pose. However, good health also underpins a healthy economy. Bexley Council has a significant role to play in helping all Bexley residents to start well, live well and age well. That is why Bexley so desperately needs the unfairness in the public health funding formula to be looked at and addressed.

[Abena Oppong-Asare (Erith and Thamesmead) (Lab)]

I thank the right hon. Member for bringing forward the debate, which is very much needed in Bexley. As he has highlighted, Bexley’s public health grant is considerably lower per head than that of other London boroughs. My constituency includes part of Greenwich and Bexley. Does he agree that the Government should ensure that the public health allocation formula is updated, to guarantee that all his and my constituents have access to the high-quality public health services that they need?

[Sir David Evennett]

I am very grateful to the hon. Lady, my constituency neighbour, for raising that point. I totally agree, which is why we have the debate today. I am pleased she is here to reinforce the point for Bexley, and I am sure the Minister will be listening.

I have been provided with figures by Bexley Council to highlight inequalities in the public health grant received. The public health grant allocation for Bexley in 2021-22 is just under £10 million. That equates to a per head allocation of £39.84, giving Bexley the lowest funding across London. The average funding per head in London is £74.87. Therefore, Bexley’s mere £39.84 is just 53.2% of the London average, and a staggering £35 less per head.

To put that in perspective, if Bexley were to receive the same allocation as the London average, it would mean an additional £8.8 million for Bexley. That situation cannot be fair and puts our area at a significant disadvantage. Even if Bexley were funded at the same level as the second lowest London borough—Havering, across the Thames, and a very similar borough—an extra £750,000 would be added to Bexley’s allocation.

If we compare Bexley with other south-east London boroughs, the situation does not look good. If Bexley were funded at the average of all six south-east London boroughs—Bexley, Bromley, Greenwich, Lewisham, Southwark and Lambeth—it would result in an extra £8.25 million for Bexley. If Bexley were not included in the south-east London average and funded at that rate, it would mean an extra £9.9 million for our borough. If Bexley were funded in line with our neighbouring borough of Bromley, which receives £45.13 per head, it would see an additional £1.3 million for Bexley’s total allocation.

As we heard from the hon. Member for Erith and Thamesmead, our other neighbouring borough, Greenwich, has a grant allocation of £81.14 per head, which is more than double Bexley’s allocation. If Bexley were funded at Greenwich’s level, it would mean an additional £10.3 million for Bexley. I would point out, as the hon. Lady said, that Bexley and Greenwich share the town of Thamesmead, an area I represented in Parliament up until 1997. That is a community with some of our most complex and entrenched inequalities. Extra funding for Bexley would help to deal with those on the Bexley side of the Thamesmead divide.

Of the 151 local authorities in England, there are only 20 other local authorities with a lower per head grant allocation than Bexley. The main hindrance to Bexley is that the allocations granted remain largely dependent on historical patterns of spend before local authorities took over responsibility for public health. Although there have been years when the grant has increased, for which we are grateful, and other years when the grant has not increased or has been reduced, which we are not so happy with, no progress has been made towards tackling the issue of a fair and rational allocation for Bexley.

The result is that Bexley’s public health funding does not reflect its current population, public health needs or its ambitions to reduce health inequality. That has to be addressed by the Government. The covid-19 pandemic has worsened our position and exacerbated the conditions of poor health in Bexley, especially in the north of our borough, where there are the greatest levels of pre-existing, underlying health inequalities. Covid-19 has also disproportionately impacted and exacerbated the health inequalities of our growing black, Asian and minority ethnic population, and our over-75 population, which is higher than the London average.

Bexley has also seen some of the highest covid-19 case rates in London, which reflects the underlying issues caused by the lower public health grant and therefore lower investment in public health measures to counteract the effects of disproportionality and inequality. Even the pandemic response in Bexley, which covers outbreak management, surveillance, monitoring, communications and engagement, community testing and contact tracing, would not have been possible without the additional grants made available by the Department of Health and Social Care, and the Ministry of Housing, Communities and Local Government. Other local authorities have more in-built capacity and workforce resilience, which allows them to divert resources to address a future health protection challenge, such as a major epidemic, or the pandemic that we are currently experiencing. Bexley does not have the flexibility in the core public health capacity.

We are also currently seeing the development of the NHS South East London integrated care system. The ICS has set out its key priorities to be tackling health inequalities, prevention, and improving the health and wellbeing of residents. Each place-based system will play a significant role in delivering those priorities. With Bexley having such a low base for the public health grant, it will be extremely difficult to achieve parity with what the other south-east London boroughs can offer their residents due to significantly higher budgets. That alone will create further inequalities and highlights the importance of levelling-up grant allocation.

Bexley experiences the same public health challenges as other London boroughs and has an ambitious prevention strategy. Bexley’s prevention strategy is a whole-system, five-year plan to prevent illness and poor health and social care outcomes, as well as to actively promote a positive state of health and wellbeing for our residents. However, its funding allocation does not allow us the same opportunities to make positive changes to residents’ lives.

Bexley is a diverse, quickly changing and growing borough. It is a collection of communities working together and it is a great place. We anticipate a 7.6% population increase by 2030 and a 7.2% increase in the number of children living in Bexley. Some 30% of Bexley’s residents are young people under the age of 25, and Bexley has the fourth highest rate of people aged 65 and over in London, at 16.5%. That will increase to 21.8% by 2050. Our infant mortality rate is also 3.7 per 1,000 population and our neonatal maternity rate is 2.75 per 100,000, both of which are higher than the London average.

Hospital admissions for young people due to substance misuse are higher than the London average and our vaccination rates for childhood illnesses and for adult vaccinations, such as flu, are nationally lower. We have done a great job during the covid situation and our health service, our council and the doctors and pharmacists have done a fantastic job on vaccinations.

[Abena Oppong-Asare]

Will the right hon. Member take this opportunity to encourage constituents in Bexley to take up the covid booster jab and the vaccine when they are called to do so?

[Sir David Evennett]

Indeed I will. I had my booster two weeks ago. I think it is very, very important that people should get the vaccine, whether it is the first or second jab or the booster. That is the only way we are going to defeat this terrible disease and pandemic, and I totally endorse what the hon. Lady said.

Bexley is very fortunate to have excellent leadership on Bexley Council, both from officials and the political leadership under Councillor Teresa O’Neill OBE. I have worked with Councillor O’Neill over many years on many different campaigns, including to highlight public health issues and quality of life. We have met Ministers and been involved in debates here before, but this time we really need some action. Teresa and I are working very hard to persuade the Government that they need to look at the formula for public health funding for outer London boroughs such as Bexley.

Bexley desperately needs our grant to be urgently reviewed and redressed to reflect our needs and to support our constituents. I know that Bexley Council is appreciative of the national real-terms increase in public health grant allocations for 2020 to 2022. However, this historic funding issue needs to be addressed so that we can be a lead on the challenges we have today, and those we face ahead. Bexley Council is innovative, takes the initiative and leads in many fields. We want to do it here too, but without additional funding we cannot. I urge my hon. Friend the Minister to take these representations on board and to take action to ensure that my borough of Bexley gets a fair deal in public health funding for the future.