Social Media and Young People's Mental Health

Alex Chalk Excerpts

Wednesday 2nd November 2016 Westminster Hall

[Alex Chalk (Cheltenham) (Con)]

I beg to move,

That this House has considered the effect of social media on the mental health of young people.

It is a pleasure to serve under your chairmanship, Sir Alan. I called this debate because I have become increasingly concerned about the mental health problems afflicting our young people and about the role of social media in adding to the strain that they are under. I should perhaps declare an interest: as the father of two young children, I look with an increased sense of foreboding to the day when they acquire their first smartphone.

From the reaction I have received to this debate within Parliament and beyond, I sense that there are many parents and carers up and down the country who are concerned about this issue. The problem is that parents today can feel particularly helpless. Unlike in the past, when parents could draw from their own experience to help navigate their children through the minefield of adolescence, the extraordinary pace of change means that many parents simply cannot do that now. They are not digital natives, so it is hard for them to prepare their children for the digital deluge to come.

Let me start with the background. It is not an exaggeration to say that it sometimes feels as though this generation of young people is one of the most unhappy since the second world war. No MP can fail to be aware of the pressures on young people’s mental health. As the MP for Cheltenham, I see it in the brave young people from local schools who come to my surgery to talk about in-patient care and waiting times for talking therapies. I see it in the growing workload for staff at the excellent Brownhills eating disorder clinic at St Paul’s Medical Centre. I see it in the statistics provided by Teens in Crisis, which provides counselling services across Gloucestershire for young people: in 2013, it was receiving 20 to 30 self-referrals per calendar month; in 2016, the figure was around 70.

This debate is not principally about how we, as a society, pick up the pieces. It is not about NHS resources, or about what more we need to do to bring parity of esteem. Both of those issues are very important and were extensively debated last week in an excellent debate arising out of the publication of the Youth Select Committee report on young people’s mental health. Instead, this debate is about what we can do to address problems upstream, before they have caused damage. My view is clear: we need to be as focused on preventing these problems as we are on curing them, and that means focusing on causes.

Today, my focus is on what an increasing number of studies suggest is playing a very significant part in this precipitate decline in young people’s mental health: social media. Social media are, of course, utterly pervasive among young people. They are totally immersed in a virtual world. That world can be very positive but it can also be harmful, to both the way they perceive the world around them and the way they perceive themselves. Increasingly, young people seem to be finding it hard to distinguish between the real and virtual worlds.

Let me make it clear that this is an emerging topic in academic research. Association and correlation are not the same as causal link, but it is becoming tolerably plain that social media can have a damaging impact. Turning to some of the studies, the Office for National Statistics’ 2015 publication, “Measuring National Well-being: Insights into children's mental health and well-being”, found that there is a “clear association” between longer time spent on social media and mental health problems. While 12% of children who spend no time on social networking websites have symptoms of mental ill health, the figure rises to 27% for those who are glued to the sites for three or more hours a day. That is particularly worrying for girls, because research shows that girls are far more likely to spend excessive amounts of time on social sites than boys. One in 10 girls was found to be in the top category for time spent on the websites, compared to just one in 20 boys.

How can social media have this negative impact? Embryonic research suggests that there are three principal routes: first, online bullying; secondly, the phenomenon of what I call “compare and despair”; and thirdly, sleep deprivation.

Taking bullying first, a study in 2014 by the National Society for the Prevention of Cruelty to Children found that bullying or trolling was by far the single largest category of upsetting experience encountered online. MentalHelp.net found that 95% of teenagers who use social media have witnessed cyber-bullying and 33% have been victims themselves. Bullying is as old as the hills—there is nothing particularly new about it, unpleasant as it may be—but the power of social media to amplify its impact is so transformational and can be so damaging. Social media provide new and inventive ways to be cruel, such as body shaming and hurtful posts, excluding children from online games, setting up hate sites, creating fake accounts and hijacking online identities, and they have the power to scale up that bullying by using the technology to spread its impact widely through a school community or even beyond.

[Stuart Blair Donaldson (West Aberdeenshire and Kincardine) (SNP)]

I thank the hon. Gentleman for securing this incredibly useful and important debate. Does he agree that in the past children who were bullied at school would be able to escape that by going home, but now with social media, bullying is constant and they can be exposed to it every hour of their lives?

[Alex Chalk]

I am sure the hon. Gentleman must have had a copy of my speech; the next paragraph says precisely that.

Whereas in the past, children could physically escape their tormentors, nowadays social media make that impossible. The way I put it is that platforms such as Facebook, Snapchat and Instagram bring bullies into the bedroom, so children’s homes are no longer the sanctuaries that they once were.

[Simon Hart (Carmarthen West and South Pembrokeshire) (Con)]

Does my hon. Friend agree that part of the problem is the anonymity that some of these platforms provide? As our colleague, the hon. Member for West Aberdeenshire and Kincardine (Stuart Blair Donaldson), just pointed out, children cannot escape from this kind of bullying, but nor can they necessarily identify the perpetrator. Does my hon. Friend believe, as I do, that the platforms need to do a lot more by way of regulation to try to minimise that?

[Alex Chalk]

I absolutely agree and will be developing those points in due course, because it seems to me that social media providers have to do more. It is no good simply to give us these vague blandishments, saying, “Oh well, you can click to get some advice.” They have to become far more robust about it. The anonymity also creates an element of menace about the whole thing and simply adds to the level of bullying.

The second route is the phenomenon of “compare and despair”. What do I mean by that? I am referring to the fact that young people observe imagery online that can inspire profound feelings of inadequacy. In many cases, they are not yet mature enough to realise that everyone has apparently become their own PR agent: people are increasingly projecting an online image of their lives that is beautiful and perfect in every way, and even though that may be misleading in reality, it may not feel that way to a 12, 13 or 14-year-old.

[James Cartlidge (South Suffolk) (Con)]

I congratulate my hon. Friend on securing this debate and on delivering a very eloquent speech. He is coming to a point I want to raise about teenagers in particular who have eating disorders. I have found that to be quite a prevalent problem, often involving people who feel under pressure. That pressure can come from social media because people are looking at the success of others and feel they have to aspire to it. As my hon. Friend said, they look at other people who seem to have a perfect body and so on, and that seems to be a growing problem in teenage mental health.

[Alex Chalk]

That is absolutely right. At the end of my hon. Friend’s intervention, he hit on a particularly important point in mentioning the growing problem. Let us be clear: negative body image has long been with us. When I was growing up, the finger was pointed at hard-copy magazine publishers and the size zero models that were in those magazines, but once again social media have the power to magnify the impact.

Interestingly, a study compared the impact on women of Facebook images against those on a fashion website. It found that the former led to a greater desire among them to change aspects of their appearance. One can speculate about the reasons for that: is it because people think, “Well, I recognise that in a fashion magazine things may be airbrushed and stylised, but I do not expect that on a Facebook post,” so it is somehow more damaging? I offer that as a possibility but there may be plenty of others.

As well as body image concerns, there are issues about popularity and feeling inadequate. Anecdotally, it is clear that teenagers make a habit of comparing their own posts’ popularity with those of other people. We increasingly get the sense that young people fear that their existence compares unfavourably with others. Much—probably too much—gets read into the absence of “likes” or “views”.

Finally, there is the effect that social media have on sleep patterns. That might sound rather prosaic, but it is important. A study presented by the British Psychological Society in September last year in Manchester found that the need to be constantly available and responding 24/7 on social media accounts is linked to poor sleep quality. Research from the Headmasters’ and Headmistresses’ Conference that was tweeted to me this morning suggests that almost half—45%—of students admit that they check their mobile device after going to bed, and that a staggering 23% check it more than 10 times a night. The concern is not just that they turn up to school exhausted but that sleep deprivation is well known to be a trigger for depression.

I know that the Government are very mindful of that issue and that a lot of excellent work is being done to support parents and schools to help children to use social media safely. The Department for Education funded MindEd to set up a new site, MindEd for Families, which was launched earlier this year and which I have looked at. It provides free online advice on a range of mental health issues affecting children and young people; it includes, of course, a section on social media. This morning I read the Department’s advice sheet entitled “Advice for parents and carers on cyberbullying”. It is really helpful and very good. I also pay tribute to the fact that the Government are continuing to provide funding to the YoungMinds parents helpline, which is a national service providing free and confidential online and telephone support, information and advice.

That is all hugely welcome—there is great deal more as well, and I look forward to hearing about that from the Minister—but the fact remains that young people’s mental health does not appear to be moving in the right direction. Against that context, I will make two points. First, if we are going to maximise the effectiveness of our response, I believe we need a more thorough and scientific investigation of the causes, because although strong emerging evidence shows a correlation between social media use and declining mental health, the time has come to bottom it out with something more robust.

Back in February 2014, the House of Commons Health Committee launched an inquiry into child and adolescent mental health services. A subject it took evidence on was the impact of bullying and of digital culture. It recommended that

“in our view sufficient concern has been raised to warrant a more detailed consideration of the impact of the internet on children’s and young people’s mental health…and we recommend that the Department of Health/NHS England taskforce should take this forward”.

That was eminently sensible and I invite the Government to do so, if they have not already. Again, it may be that we will get more information, but I was a bit concerned that that view may not be finding favour, because in answer to a question from Lord Blencathra, the Government said:

“The Department does not itself conduct research, but funds research through the National Institute for Health Research…and the Department’s Policy Research Programme”,

which they said

“have not funded specific research into the possible mental and psychological impact on children of using Twitter and Facebook and have no plans to commission research on this topic.”

Of course, I entirely recognise that public funding is tight and we cannot fund every single project, but it seems to me that the sheer weight of the evidence is now sufficiently strong that it calls for that robust study to take place.

My next point echoes one that was made earlier: social media platforms need to face up to their responsibilities. We rightly hold headteachers accountable for bullying and abuse that takes place on their premises. Social media platforms also need to take their fair share of responsibility for what takes place on their own digital premises. Creating safety guides is not enough. Suspending people from Facebook or even expelling them is perfectly sensible in theory, but does it happen in practice?

As my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton), in an excellent debate last week, said about social media companies:

“They are huge companies employing many thousands of people, yet the numbers in their scrutiny and enforcement departments are woefully low.”—[Official Report, 27 October 2016; Vol. 616, c. 481.]

I am not here to beat up the social media companies. I think they do some important work and what happens is a fact of life, but I think they need to step up and face up to their responsibilities, because they have to recognise that they can be a force for good but that they can also be a force for something far less welcome.

In conclusion, social media are the phenomenon of our times. They have the ability to take all the ordinary experiences of growing up—the triumphs and disasters—and magnify them beyond anything we could ever have imagined a generation ago. They can create heroes in seconds, but they can crush people too. Their capacity to intensify bullying, enhance body anxiety and exaggerate exclusion is becoming increasingly clear. If we want a society that truly tackles those problems upstream, builds resilience in our young people and prevents as well as cures, the time has come to ramp up our response.

[Sir Alan Meale (in the Chair)]

This is only a 60-minute debate and seven Members of Parliament have written in to take part, if they can. As is laid down by the Chairman of Ways and Means, I have to provide the Front Benchers a total of 20 minutes of speaking time, which only leaves a short period for all the hon. Members who have indicated that they want to speak. Therefore, I will impose a time limit of four minutes per Member. If hon. Members go over that limit, I may drop the limit further.

--- Later in debate ---

[Stewart Malcolm McDonald (Glasgow South) (SNP)]

It is a pleasure to see you in the Chair, Sir Alan. I thank the hon. Member for Cheltenham (Alex Chalk) for bringing the debate forward, and I will try to be brief.

I want to take part in the debate to tell the story of one of my constituents, Declan Duncan, an incredibly brave young man from Castlemilk in my constituency. His life was made a complete misery by the use of social media, and he wrote to me to tell me about some of the experiences he has been through. I have met him on a number of occasions and was moved to tears when he told his story in public at Castlemilk Youth Complex, which gave him enormous support. I pay tribute to the people there, particularly to the youth worker, Christopher Lang, who really helped Declan.

Declan was bullied throughout primary school and high school, starting off from the fact that, since birth, he has had a tracheostomy because of a collapsed windpipe. When he was in high school, he came out as gay at a very young age—something that I certainly would not have had the bravery to do when I was in high school. The bullies used social media, in addition to face-to-face bullying, which we would understand to be traditional bullying.

People made up fake profiles in Declan’s name using his photographs and said that he was doing all sorts of vulgar things that were completely false and untrue. They also set up petitions and shared them on Facebook, Twitter and all the rest of it, encouraging people to—to quote from one post—“run him out” of Castlemilk. There was even a concerted effort to get people to turn up to school one day with things such as tomatoes and eggs, and to run him out of school. All of that was organised on Facebook. Declan sent me some screengrabs of some of the stuff from the time, and people even complained that their posts had been deleted. His life was made a complete misery.

The Castlemilk Youth Complex told me about a phenomenon that is happening at the minute: there seems to be a website that is being used by people to create what is made to look like a genuine news article. People can type in anyone’s name, use any photograph they wish and claim that they have done anything, and it is then spread all around Facebook and Twitter. The youth complex has cases of particularly vulnerable individuals being targeted by these rancid people in the most vulgar fashion.

[Alex Chalk]

A lot of people hearing this horrific story, which the hon. Gentleman is articulating powerfully, will want to know what the social media platforms did to clamp down on those who were posting and perpetrating such vile abuse.

[Stewart Malcolm McDonald]

That is a fine point, on which I will aim to end. Social media platforms need to do more but, in addition, teachers need to be better empowered. Although I respect that that specific matter is for our Government in Scotland, I think that the social media platforms need to engage better with educators to combat bullying in their schools.

Declan has since left high school. He is now studying social care at college and doing very well. The last time I met him, he was a happy young man at the gay pride event in Glasgow. Castlemilk Youth Complex will go on to support other young people who are being targeted in such a way. I hope that all of us here, other Members of Parliament, local councillors and teachers will work better with and get on to the social media companies, as the hon. Member for Cheltenham suggested, to ensure that all those other people like young Declan out there in our constituencies get better support, which they so badly need.

--- Later in debate ---

[Alex Chalk]

This has been an excellent debate but a debate in name only, because there is a profound consensus about the potential for social media—as well as being a force for good, it can cause harm.

I was very pleased to hear from the Minister that some embryonic research may develop into something more robust. Such research is welcome. That is important because we need that platform to press the social media platforms to do more.

I reiterate the point that, in schools, we expect headteachers to take control, in Parliament, we expect the Speaker to take control and, if people are not behaving properly on social media, the platforms should be robust in dealing with them.

Community Pharmacies

Alex Chalk Excerpts

Monday 17th October 2016 Commons Chamber

[David Mowat]

The hon. Lady mentions the five year forward view. If she reads the “General Practice Forward View”, she will see that central to it is the recruitment of 2,000 pharmacists into GP practices across the country by 2020. That is how we will embrace the pharmacy profession and link it much more closely to GPs. I am not in a position, because we have not yet announced it, to discuss in detail today the final form of the access scheme and how it will work. Let us be very clear, however, that we do not expect people to have appreciably more of a journey to any pharmacy. We are talking about tens of metres, if any. The fact is that we will protect the pharmacies that need to be protected, so that everybody in the country has access within a reasonable time.

[Alex Chalk (Cheltenham) (Con)]

Where sensible savings can be made, it is absolutely right that they should be explored, particularly if they are ploughed back into the health service. However, at a time when people in Cheltenham are turning increasingly to expert pharmacists for minor ailment support, can the Minister assure me that no changes will take place that undermine the welcome trend of going to pharmacies and not GPs?

[David Mowat]

As I said, that is our intention. Our belief is that the package in its entirety, which we will announce shortly, will actually enhance the role of pharmacies in providing services.

NHS Sustainability and Transformation Plans

Alex Chalk Excerpts

Wednesday 14th September 2016 Commons Chamber

[Heidi Alexander]

That is the story we hear from all over the country. This is not profligate overspending on the part of NHS bosses or local government leaders; it is chronic underfunding on the part of Government. There was much fanfare associated with last year’s comprehensive spending review and what it meant for the NHS, but when we look at that financial settlement, along with the one in the last Parliament, we see a flatlining budget to deal with soaring demand.

As a country, we have a growing and ageing population. The reality is that in the last 10 years, the number of people living beyond the age of 80 has increased by half a million, and the NHS and social care are buckling under the strain. Although we should never give up on trying to organise the NHS in the most efficient and effective way possible, we have a choice. Do we want to cut services to match the funding available, or do we want to pay more to ensure that our grandparents and our mums and dads get the sort of care that we would want for them? If the NHS is to provide decent care for older people we need not only to fund social care adequately, but to find better ways of organising services to keep people out of hospital for as long as possible.

That leads me to the next problem. STPs are being used as a catch-all process to bring about change in the NHS, but many run the risk of focusing on the wrong things. They are being used as a vehicle to do different things in different places, and although some may lead to better treatment and better outcomes, the danger is that there will be knee-jerk, blanket opposition to everything. Some proposals will inevitably be controversial—the closure or downgrading of an A&E or maternity department will never be easy—but, in other cases, the plans may end up focusing on something that is not the burning issue.

Let me take my local area as example. The STP for south-east London proposes two orthopaedic elective care centres. The sites for them have yet to be decided, and the STP plan has yet to be signed off by NHS England. On the face of it, there is little wrong with the proposal to create centres of excellence so that all hip and knee replacements are done in one of two places. The problem is that when the front page of a national newspaper talks about the “secret” STP plans under which A&Es will close, my constituents fear the worst. “We’ve been here before,” they will say. They will smell a rat, even where one might not exist.

[Alex Chalk (Cheltenham) (Con)]

Will the hon. Lady give way?

[Heidi Alexander]

I will not give way. I am aware that many Members want to speak, and I wish to conclude my remarks.

My constituents ask me these questions. What happens if Lewisham is not the site of the new centre, its elective work is shifted elsewhere and the hospital then struggles to staff the emergency department? Is orthopaedic care really the burning issue in south-east London? What about the queues of ambulances outside the Queen Elizabeth hospital? What about the homeless young man who pitches up in A&E because he has nowhere to sleep and there is no support for him in the community?

Where will the money come from physically to redesign the NHS buildings that such a care centre would entail? With £l billion taken out of capital budgets and switched to revenue last year, it seems fanciful to think that there will be money lying around for such projects. The NHS is on its knees. Everyone knows that hospitals ended up £2.5 billion in deficit last year. We have all seen the reports of A&Es closing overnight because they have not got the staff. We all know that GPs are run ragged, that ambulance crews are stressed out and that nurses are demoralised, and that is before mentioning the junior doctors.

This is the main problem for the Government: if you do not fund the NHS adequately and if you do not staff it properly, do not be surprised when the public do not trust your so-called improvement plans. There is deep public cynicism when it comes to anything this Government wants to do to the NHS. People believe Ministers are trying to privatise it. They believe services are contracted out to the private sector to save money, not to improve quality, and in many cases they are right. The problem is not STPs as such, but the context in which they are being developed—inadequate funding, an inability to make the case for change, a workforce crisis that is leading to overnight closure of services and, as a result of all of these, a deep public mistrust of the Government’s intentions.

Junior Doctors: Industrial Action

Alex Chalk Excerpts

Monday 5th September 2016 Commons Chamber

[Mr Hunt]

It absolutely should. The BMA has been out of step with both the British public and its own members this week. My hon. Friend’s own hospital in Hereford—Hereford county hospital—is in special measures. It has a huge number of problems, which it is working really hard to sort out, and we are helping it to sort them out. Is that not what we should be focusing on in the NHS, rather than having to do contingency planning for these damaging strikes?

[Alex Chalk (Cheltenham) (Con)]

Does the Secretary of State agree that the actions of the BMA in warmly backing the contract in May only to condemn it in August and call for these extreme strikes have seriously damaged its credibility? On the issue of pay, which we know from the leaked WhatsApp messages is the only red line, can he confirm that no doctor working legal hours will be paid less?

Excess Winter Deaths

Alex Chalk Excerpts

Monday 6th June 2016 Commons Chamber

[Dan Jarvis]

I am grateful to the hon. Gentleman for his intervention. He is absolutely right to draw attention to the heavy costs that his part of the world has borne. He is right to point out that in a prosperous, wealthy nation—yes, of course we have challenges—it is simply unacceptable that anyone should die as a result of the cold. The numbers that he has outlined in Northern Ireland and the national numbers that I outlined are simply unacceptable. As I said, this not the fault of any single Government—this is an issue that has challenged successive Governments. The Prime Minister recently said to me that these figures act as a standing rebuke to all Governments. The issue for us in the House tonight is what practical measures and action the Government can take to reduce the numbers and get to the point, as the hon. Gentleman suggested, where no one dies in this country as a result of the cold.

I was outlining some of those practical measures and was asking the Minister about the conversations that I hoped she would have with her colleagues at DECC on home insulation. Any measures that the Government seek to take should be targeted at those groups such as the elderly who are the most vulnerable to the cold. That brings me to a crucial point about the importance of cross-government working. Excess winter deaths are clearly an issue that requires a cross-government approach, but despite the fact that nearly 44,000 people died unnecessarily in the most recent winter for which we have figures, there is not a joined-up cross-government plan to reduce excess winter deaths.

A number of Departments, including the Department of Health, the Department of Energy and Climate Change, the Department for Work and Pensions, the Cabinet Office and the Department for Communities and Local Government, have policies which could contribute to reducing excess winter deaths. As yet, there is no overarching cross-government strategy to join up those policies and ensure that they contribute in the best possible way to reducing excess winter deaths. It is often left to local authorities to develop their own approach to reducing excess winter deaths. In Barnsley, we are fortunate that our local authority takes this issue very seriously. The council is making a concerted effort to ensure that vulnerable and elderly people live in heated homes.

[Alex Chalk (Cheltenham) (Con)]

The hon. Gentleman is making a powerful speech. Does he agree that it is not just about the responsibility of Government or of local authorities? Fuel companies have a duty to ensure that as wholesale prices come down so too do the bills that people, including the most vulnerable people in our society, pay.

[Dan Jarvis]

I agree, and it is important that we seek to have a debate with the energy companies about what practical measures they would be prepared to take to reduce fuel poverty, particularly for the most elderly and vulnerable members of the community. I recently had the great privilege of engaging in a webchat on Mumsnet, and this was an issue that many people raised. What practical measures are energy and utility companies prepared to take? That is partly a matter for the regulator, and it is partly a matter for Government, but it is also, as the hon. Gentleman pointed out, a matter for the energy companies. I hope that they will look and listen carefully to the content of our debate. It is not in their interests for elderly people to freeze to death, and I look forward to having a constructive dialogue with them ahead of the winter months to see what measures can be taken to reduce the number of deaths this winter.

I was talking about the work that is taking place locally. My local authority is making a concerted effort to ensure that the vulnerable and the elderly live in warmer homes. The most recent practical example was the council securing funding for a warm homes programme, which offers free central heating replacements for people on low incomes who have no gas central heating system. I recently met one of my constituents, John Key, who had benefited from the scheme. At 84 years old, he had never had gas central heating and had never been able to heat the top floor of his home. Now, thanks to Barnsley Council, he is able to do that.

However, as I frequently say, not everyone is lucky enough to live in Barnsley, and I fear that what we have developing across the country is a patchwork approach to preventing excess winter deaths. That may well explain why there is substantial regional variation in the national figures, with the excess winter death rate in the south-west almost 20% higher than the rate in Yorkshire and the Humber.

Tonight, therefore, I am calling for the Government to bring forward a national strategy to reduce excess winter deaths. The strategy should be cross-government and should incorporate the following elements: a clear plan for reducing the number of excess winter deaths, with regular assessments to review the plan’s success; an independent assessment of what additional policies would help to reduce excess winter deaths; and a cross-departmental working group to co-ordinate current policy efforts to reduce excess winter deaths.

Defending Public Services

Alex Chalk Excerpts

Monday 23rd May 2016 Commons Chamber

[Heidi Alexander]

I am grateful to the hon. Gentleman for his intervention, but he will just have to watch this space.

As I was saying, the truth is that the cash crisis in the NHS is the fault not of migrants, but of Ministers. Cuts to nurse training places during the last Parliament have created workforce shortages and led to a reliance on expensive agency staff. Cuts to social care have left older people without the help and support they need to remain independent at home, putting huge pressure on NHS services. The underfunding of GPs has left too many people unable to get timely appointments, which means they are often left with nowhere to turn but A&E. The financial crisis is a massive headache for NHS accountants, but we all know it can mean life or death for patients. Waiting time targets, which exist to ensure swift access to care, have been missed so often that failure has become the norm.

[Alex Chalk (Cheltenham) (Con)]

The hon. Lady is making a very political attack. In that context, would she care to explain why the performance for accident and emergency admission is far worse in Labour-run Wales than it is in England?

[Heidi Alexander]

I would have thought better of the hon. Gentleman, but it is clear Conservative Members want to talk about anything other than their record in England. A&E performance is currently the worst since records began, taking us back to the bad old days of the 1980s, when patients were left waiting on trolleys in hospital corridors. The figures speak for themselves.

Junior Doctors Contract

Alex Chalk Excerpts

Thursday 19th May 2016 Commons Chamber

[Mr Hunt]

I agree. We need more doctors and we need more nurses. By the end of this Parliament, we will have over a million more over-70s in England alone, and I know that the demographic effects in Northern Ireland will be equivalent. We have a global shortage of about 7 million doctors, so we need to train more. We are training an extra 11,420 doctors over this Parliament as part of the spending review. The training is done on a UK-wide basis, so we will need to work closely with all the devolved regions on it.

[Alex Chalk (Cheltenham) (Con)]

I warmly welcome this draft agreement, which will be met with some relief in Cheltenham. Whatever our deeply held concerns about the behaviour of the BMA in the past, does the Secretary of State agree that it should be our ambition that the agreement will mark the beginning of a more constructive future? Will he join me in congratulating BMA negotiators, including Dr Malawana, for being prepared to address constructively issues such as Saturday pay?

[Mr Hunt]

I am happy to do that. I recognise that this was not easy for those people, because it involved changing a position that they had held for more than three years. When we looked at the details, the result that we got to was not difficult for them to sign up to because they could see that it really was better for their members, as well as better for patients. The lesson here is that the NHS faces huge challenges, and it can only be right to deal with them by sitting round the table and negotiating constructively.

NHS Bursaries

Alex Chalk Excerpts

Wednesday 4th May 2016 Commons Chamber

[Heidi Alexander]

We set out at the last election our clearly costed plans for how to recruit additional nurses, doctors and care staff to the NHS.

The NHS should have a workforce that reflects the population it serves—just as this place should, too. The mental health sector in particular relies on mature students and the additional life experience they bring to what is a very demanding environment.

A few months ago, I met Marina, a young woman who has not had an easy life, but who is now on a mission to become a mental health nurse. When Marina says that she thinks some of the people best placed to care for others are those who have experienced hardships themselves, I think she has a point; and when she says she would not have been able to start her training without the bursary, I believe her. Why is the Minister so convinced that the NHS can do without people like Marina in the future? Why does he think they should pay to train, and why will he not consider other options for increasing student numbers?

The quality of training that student nurses, midwives and other allied health professionals receive will also depend on the quality of their clinical placements. Government Ministers claim these changes could deliver up to 10,000 extra places over the course of this Parliament, so can they set out what capacity hospitals and other providers have to accommodate these extra students, and confirm whether Health Education England has sufficient funds set aside to fund these placements? Will the Minister be clear about how this 10,000 figure was arrived at? Is it the Government’s assessment of what the system needs, what Health Education England can afford to fund or simply a big-sounding number plucked out of the air at random?

An extra 10,000 compared with when? What is the baseline year on which we should judge the Minister’s policy? I have asked him that three times in written parliamentary questions, and each time I have not received an answer. Does he not understand that if his Department cannot even answer a simple question relating to one of its key claims about the policy, that does not exactly inspire confidence? There are so many questions that the Minister needs to answer that it is impossible to do all of them justice in a single speech.

[Alex Chalk (Cheltenham) (Con)]

As has been indicated, it is agreed that we need to expand the number of places. Thanks to this Government, however, an extra £10 billion has been put into GP services, acute services, cancer treatment and hospital care. Which of those services would the hon. Lady cut to fund the alternative bursary scheme that she has in mind?

[Heidi Alexander]

The hon. Gentleman does not seem to realise that that money is plugging a very big black hole in NHS finances. I am sure that when the Minister responds to my speech, he will note that many people who apply to study for nursing and other healthcare degrees are turned away, but what proportion of those unsuccessful applicants actually meet the entry criteria? How can he be sure that his new system will deliver the required numbers of different types of nurses and other healthcare professionals in the right geographical areas? What guarantees has he given to higher education institutions that the new arrangements will fully cover the costs of delivering degrees, and what assessment has he made of the amount of un-repaid student debt that will accumulate, given that, over a lifetime, some nurses will not earn enough to repay the totality of their loans plus interest?

The proposal to scrap NHS bursaries is a massive gamble at a time when the NHS needs certainty. Put simply, it will shift the costs of training nurses, midwives and other allied health professionals from the state to the individual. If we are all happy to enjoy the benefits of the NHS, why should we not all contribute to the training of those who work in it?

I was the first member of my family to go to university. My tuition fees were paid in full, and I received a full maintenance grant. What really worries me is that people like me, and people like my friends, will be put off what could be a fulfilling and important career. We should be doing all we can to inspire today’s schoolchildren to become the nurses and healthcare professionals of the future, but, sadly, the Government are making a very good job of doing the very opposite. If Ministers want to continue to import staff from overseas, they are going the right way about it. We owe a debt of gratitude to those staff, but we want home-grown staff too.

Finally, let me return to the Government’s consultation paper. One section is entitled

“Nursing, midwifery and allied health professional students deserve the same opportunities as other students”.

Labour Members say, “No, they deserve better.” Those people should be treated differently from other students, because they are the people who will look after us when we are older, care for our relatives when they are sick and staff the NHS when this shambolic Government are long gone.

The Government should drop these proposals and think again. I commend the motion to the House.

Junior Doctors Contracts

Alex Chalk Excerpts

Monday 25th April 2016 Commons Chamber

[Mr Hunt]

Absolutely. My hon. Friend is quite right to point out that the seven-day NHS vision is not just about junior doctors but about support services for junior doctors that will make the provision of care to their patients at weekends not just better for those patients but much more rewarding for them. It is immensely frustrating for doctors not to be able to get diagnostic tests back quickly because it is the weekend. We want to sort out all those problems. That will be better for doctors and better for patients.

[Alex Chalk (Cheltenham) (Con)]

Whatever the objections to this contract, and however sincerely they are held, withdrawing emergency care for seriously ill patients cannot be on the list of options. On Saturday pay, will the Secretary of State bring absolute clarity to something that may have been misrepresented, or at least misunderstood: will doctors who work regular Saturdays —that is, more than one in four—continue to receive a pay uplift?

[Mr Hunt]

Yes, they will. That is the main outstanding issue of a very small handful of issues that were not resolved. We went a very long way towards what the BMA wanted. We are reducing premium rates for Saturday pay, but are making up for that with a 13.5% increase in basic pay. That will mean that hospitals can roster more doctors at weekends and that the doctors who work the most weekends will continue to get premium pay for that extra work. It is a good thing for doctors and for patients.

Junior Doctors Contracts

Alex Chalk Excerpts

Monday 18th April 2016 Commons Chamber

[Mr Hunt]

With respect, all the hon. Gentleman needs to do is look in Hansard at my response to the urgent question, which made it clear that we have the right to introduce a new contract. On the basis of the conventions that currently apply in the NHS, that contract will apply to all junior doctors. Foundation trusts do indeed have the right to set their own terms and conditions, but they choose not to do so.

[Alex Chalk (Cheltenham) (Con)]

This unprecedented withdrawal of emergency care seems to revolve principally around the issue of pay on Saturdays. Will the Secretary of State clarify whether pay uplifts will continue to be available to junior doctors who work regular Saturdays?

[Mr Hunt]

Absolutely. More to the point, any doctors who see an increase in their Saturday workload will see a significant increase in their pay, including their premium pay. The contract is designed to make sure that we reward people who work the longest and most antisocial hours, including women, but in a way that means that we can afford to deliver a seven-day NHS, which is why it is good for patients as well.