Social Care Reform

Alex Sobel Excerpts

Wednesday 23rd June 2021 Commons Chamber

[Helen Whately]

One thing I will say is that during the pandemic GPs and primary care in general have really stepped up to support those in care homes in particular, with every care home having a point of contact in primary care to ensure the support from GPs that those residents require. Yes, quality is at the centre of our proposals for social care reform.

[Alex Sobel (Leeds North West) (Lab/Co-op) [V]]

We all know that commissioning in social care is broken. The price paid for care is too low, the wages paid to carers are too small and there is a lack of training and professional development for carers. I would like the Minister to address the issue of home care being commissioned by the minute—it is the only publicly funded service commissioned or measured by time. Will the social care plans address that? She could do worse than look at the GMB’s ethical care commissioning charter to see a way forward.

[Helen Whately]

Some really interesting and important work has been done on commissioning, looking at the outcomes of care rather than being so focused on inputs, which sometimes leads to the situation described by the hon. Member. One of the opportunities of the oversight system that we propose through the health and care Bill is that it will shine a light on the different ways in which local authorities commission care and give more visibility to what works. Those ways of commissioning that do not lead to such good outcomes can therefore learn from others. We look forward to seeing an improvement in how care is commissioned and, therefore, the care that people receive.

NHS Pay

Alex Sobel Excerpts

Wednesday 24th March 2021 Westminster Hall

[Alex Sobel (Leeds North West) (Lab/Co-op)]

It has been a year now since hospital beds started filling up. Since then, there have been more than 126,000 deaths: our mothers, fathers, brothers and sisters, friends, neighbours and colleagues—in the NHS, more colleagues than most. Last night, like many others, I reflected on a heartbreaking year of loss, but while last year was tragic, what happened was not unavoidable. Implementing the first lockdown just one week earlier, as advised, could have halved the early mortality rate. Our hospitals and NHS staff weathered a storm of the Government’s making.

Let us cast our minds back to March 2020. It seems implausible now that the Prime Minister was boasting about shaking hands with every person he met on a visit to a hospital with covid-19 patients. Edwina Currie compared him with Princess Diana. Others were less favourable. It has been revealed by the BBC this week that the Prime Minister said that the best thing would be to ignore the virus and that overreaction would do more harm than good.

The NHS is facing immense challenges, and overcoming them will be fundamental to its survival. There is the pandemic, of course, and the small matter of rolling out the most ambitious vaccination programme in the nation’s history. Not only is our NHS asked to bear the brunt of the pandemic; it is forced to do it with one hand tied behind its back. In February, NHS hospitals, mental health services and community providers were reporting a shortage of nearly 84,000 staff; 38,000 of those vacancies were for nurses—the enduring backbone of our national health service. A decade of underfunding, lack of accessible training and failure to prioritise healthcare workers have hit the NHS hard, but the Minister knows that—it is a situation of Government design.

The NHS is sick. It is underfunded and understaffed. Just as a sick patient is not aided by removing their medicine, the NHS will not be healed by cutting the pay of its workers. The Government’s and their spin doctors’ praise for the NHS has been almost evangelical. We have seen the Prime Minister clapping on our TV screens. We have heard Tory Ministers refer to NHS workers as heroes and angels. We saw the hyperbolic outburst reach fever pitch when the Health Secretary cried on national breakfast television. Most of the NHS workers I know have no desire for constant praise and adoration. They do not want to be called angels. They are skilled professionals who have worked and are working through a deadly pandemic. Most would be happy for their hospitals to be properly funded, for their patients to be given the best chance of survival and, finally, for a pay packet reflecting their workload. To cry hero, and then cut pay, is as manipulative and cruel as it is unsurprising, from a party that has systematically sought to undermine the health service and its workers.

The NHS has done so much more than just jobs during the pandemic. Its staff risked their lives every single day for our most vulnerable. They held the hands of those in the their final moments whose loved ones could not. They have been a bright flame of hope in a year filled with anxiety and fear. NHS workers have given us more than we can ever give back. Their compassion, bravery and will is something we may not ever be able fully to repay. The recognition of their work can be fulfilled by a decent pay rise.

Covid-19 Vaccination Roll-out

Alex Sobel Excerpts

Monday 11th January 2021 Westminster Hall

[Alex Sobel (Leeds North West) (Lab/Co-op)]

It is an honour to participate in a debate under your chairing, Sir David. It is an extremely important and timely debate, and I thank all the people who signed the two petitions that brought it forward.

For almost a year, covid-19 has impacted all our lives in ways we could never have expected or imagined. Young people have missed vital time in the classroom, businesses have been forced to close, families have been kept apart and, shockingly, more than 80,000 lives have now been lost. The correspondence I receive every day from constituents represents their vast and varied concerns. The common thread is an overwhelming sense of fatigue and the desperate wish for the country to get back to normal.

The vaccine is our way out, our golden ticket to some sense of normality. I put on record my thanks to all those who have worked to make it possible. It should amaze us all that in less than 10 months humans have been able to learn about the virus, develop a vaccine to combat it, test it, conduct three phases of trials and get it approved. That could not have been done without enormous sacrifice, talent and a level of international collaboration that should inspire us all and be applied to a range of areas. Because of that hard work, we can now see light at the end of the tunnel.

The pandemic has demanded huge sacrifices from people all over the world in the name of beating the virus. Now that we have a vaccine, it is incumbent on the Government to hold to their end of the bargain and ensure that the roll-out is done correctly. The stakes are painfully clear. If we can get a vaccine for people most at risk, in the fastest amount of time, we will be able to save countless lives.

That is why, alongside the Daily Mirror and the TUC, my party has started the Let’s Vaccinate Britain campaign. We are working with trade unions to demand that employers give workers paid time off to get vaccinated. We are encouraging people to sign up to the NHS to volunteer and to speak to their friends, neighbours and relatives about the importance of getting vaccinated. I call on everyone listening to the debate to get involved in that campaign.

Many of my constituents and others in Leeds are already contributing to the national effort. Fittingly, Leeds’s first covid vaccine was given Sylvia Harris, an 80-year-old ward housekeeper who has worked for the NHS since she was 26, but has had to shield at home since March last year. Soon, she will finally be able to return to what she does best—caring for her patients. I thank Leeds United football club for offering its stadium, Elland Road, to be a vaccination centre, and all those across Leeds who are devoting time and energy to making the vaccine administration possible.

We need a huge national effort to get this country vaccinated, starting with key workers and those most vulnerable to the virus. That means conducting round-the-clock vaccinations, 24 hours a day, seven days a week. It makes perfect sense for key workers to be vaccinated overnight, allowing daytime vaccinations for the age priority groups.

Unfortunately, the Prime Minister has said that there is no public appetite for vaccinations 24 hours a day. I do not believe that is correct. Key workers, and people who want the vaccine in order to get back to normal, will take it on whatever day or night is offered to them. Older age groups might not be prepared to have the vaccine during the night, so maybe the strategy is to vaccinate the key workers in the nocturnal hours and the older age groups in the daytime hours. [Hon. Members: “Hear, hear.”] There is agreement about that across the House.

As the hon. Member for Montgomeryshire (Craig Williams) said, politicians across the House have been keen to emphasise the importance of getting children back into school. I declare an interest, as I have a 10-year-old and a 12-year-old, and it is sometimes difficult to motivate them for home learning. I am sure we all know that feeling. We cannot get them back in school until it is safe. Schools cannot operate in a socially distanced way, without access to proper personal protective equipment. Vaccination is the only way we can ensure staff are protected.

It is not just teachers who need to be added to the priority groups. I submitted a written question last week on hospices. The Minister who has just finished in the Chamber, the Under-Secretary of State for Health and Social Care, the hon. Member for Stratford-on-Avon (Nadhim Zahawi), can listen to this debate now and to what I have to say. He responded by saying that the JCVI based its advice on the data it reviewed from a number of sources, including the Office for National Statistics and Public Health England. For the purposes of covid-19 vaccine prioritisation, the definition of care homes is all care home premises licensed and registered with the Care Quality Commission. This definition does not include hospices. I want to ask the Minister on duty, the Under-Secretary of State for Health and Social Care, the hon. Member for Bury St Edmunds (Jo Churchill), and the Minister who is hopefully watching, why hospices should not be added, because they are just as important as other care settings.

I also want to make a plea for early years. Why is early years treated differently from teachers or other settings? They should not be. Early years settings are suffering at the moment because they are open, and the financial pressures are immense because of the different pressures on their time. Today the leaders of Leeds City Council wrote to the Minister for Children and Families and copied in the Minister for COVID Vaccine Deployment. Councillors Blake and Venner wrote, “We are requesting that early years staff, to include childminder staff working in group settings and wraparound care, are prioritised for the covid-19 vaccine. Early years providers support a large number of children, provide personal care and do not wear PPE. It is of course vital that the NHS and care home workers as well as other priority groups more vulnerable to the virus receive the vaccine first. But we are asking that early years staff form an additional priority group after this.” That is another group that can be vaccinated in the evening or at night, putting our youngest away from harm in those settings.

I will conclude by asking about transparency on data, which the hon. Member for Montgomeryshire gently touched upon. We have a lot of data around testing. We know how many tests are being conducted in each local authority area. We know where the roll-out is and where the centres are. If we can have that level of data for testing, why can we not have it for vaccinations? I am sure that other Members, like me, look on the Worldometer website, which has started recording vaccination data as well as testing data, cases, mortality and so on. Soon there will be global comparisons around vaccinations and we will be able to see where the UK stands. We can see that now, but we need to be able to dig right down to see how many vaccines have been supplied to each primary care network, how many centres there are, and how many first and second vaccines have been given. That will start to give the public confidence that there is not a postcode lottery, that roll-outs are happening and that centres are open. That will encourage more people to come forward, not just to receive the vaccine but to support the roll-out.

Data and public confidence are really important. I hope that the duty Minister, the hon. Member for Bury St Edmunds, will take that away and provide us with that data. I asked the hon. Member for Stratford-on-Avon about that in a private call just before Christmas. He said he would get back to me. Now that I have raised it in this Chamber, I hope that he will.

Family Visits in Health and Social Care Settings: Covid-19

Alex Sobel Excerpts

Wednesday 11th November 2020 Westminster Hall

[Alex Sobel (Leeds North West) (Lab/Co-op)]

I thank the hon. Member for Beaconsfield (Joy Morrissey) for securing the debate and I congratulate her on her moving speech on Jamie’s behalf. I lived in her constituency through my teens, and in fact I stood against her predecessor a long time ago. My mother is still one of her constituents. She is living very much independently, but maybe one day I will need to go to the hon. Member for help with my mother regarding the issue that we are debating today.

I will also place on the record my thanks to those working in the social care sector. Their courageous work during the pandemic, delivering quality care in horrendously difficult circumstances, has not gone unnoticed. The pandemic has been difficult for everyone, but for those residing in care homes, or for those with loved ones living in them, it has been nightmarish. Over 40% of covid-19 deaths have taken place in care homes—more than 26,000 deaths. The combination of fear and isolation, coupled with a dearth of familiar emotional support, is creating a mental health crisis in our care home settings.

Recently, I received this letter from a constituent:

“Dear Alex, my letter is concerning my bedbound 81-year-old mother. who is currently resident at a care home in Leeds North West. My mother, Patricia, has been a resident for many years. Along with many families, we had no contact with mum over the course of the pandemic, apart from a very short video, which lasted around a minute, sent when requested at desperation in the early months of the pandemic.

We requested that should a window room become available, could mum be moved, so we could at least visit her from a safe distance without entering the premises. Six weeks ago, a room did become available and we have been visiting mum at a window since. Today, however, I was contacted by the care home manager to inform me that we can no longer visit mum.

We are devastated that our family is being so cruelly torn apart. I thought that, as a strong woman, I would be able to deal with the mental impact, but it is destructive. Surely, there are humane options which can keep families together.”

I am thankful to the Minister and to the Government that guidance has now been released that says visiting through screens or windows is allowed, which is welcome news for my constituent. However, for many residents with dementia or other cognitive impairments, the distress that would cause makes it untenable. Similarly, the British winter makes outdoor visits impractical for older and vulnerable visitors.

In addition, the cost of implementing measures that have been suggested to create environments that are safe from covid-19 are to be met by care providers. There is no commitment of additional money, excluding the infection control fund, to cover the costs associated with purchasing screens or visiting pods. Government shortcomings will doubtless result in convenient finger-pointing at individual care homes, which are unable to front the additional costs for safe visiting.

We also need to give family members the same rights as key workers, who are afforded regular access to testing and trained to wear personal protective equipment. The Government must know that that is the best way forward, as they promised a pilot scheme on those lines, but that was nearly a month ago and no date for the pilot has been forthcoming. I look forward to hearing the Minister say when we can expect to see that pilot begin.

The wellbeing of residents must be placed at the forefront of the Government’s plans. That should include a recognition of the important role that social workers play in facilitating providers’ and residents’ decision making about visits. Social workers must be recognised as professional visitors, to ensure that residents’ views and wishes are central to decision making about visits, and to support care providers to explore thoroughly rights and risks alongside all the other factors that must be considered in making bespoke visiting arrangements.

Practice is different across the care sector. Hospices such as the Sue Ryder Wheatfields Hospice in my constituency have given social workers access, unlike many care homes, which have denied them access. Social workers are mentioned briefly in the guidance issued for lockdown, which states:

“Social workers can assist with individual risk assessments, for visits, and can advise on decision-making where the person in question lacks capacity to make the decision themselves.”

But social workers do so much more, and are pivotal in promoting strengths-based human rights models of good practice. Social workers undertake a variety of statutory and non-statutory functions on behalf of public bodies. Recognition of the importance of safe access to care and health settings for social workers as professional visitors is essential. I look forward to hearing the Minister’s comments on this matter.

Residents, staff and the families of those in care homes have been failed by this Government since the beginning of the pandemic. From woefully inadequate PPE—I had to deliver PPE myself to care settings—to inadequate testing, I am afraid that the social care sector has been treated with contempt. On top of a decade of underfunding, that has created a crisis within a crisis that is entirely of the Government’s own making.

Beyond the pandemic, long-term reform of the social care system is urgently needed. But for now, at the very least families should be able to see their loved ones, so I urge the Minister for Care to press forward with the pilot, to ensure that it begins as quickly and safely as possible.

Local Contact Tracing

Alex Sobel Excerpts

Wednesday 14th October 2020 Commons Chamber

[Rachel Reeves]

Local councils are desperate to take on the responsibilities from Serco. They are begging the Government: “Hand over the resources and the responsibilities, because we can do it better than you.” I will come later to the issues relating to what the Government are doing with tier 3 compared with the other tiers.

[Alex Sobel (Leeds North West) (Lab/Co-op)]

My hon. Friend and parliamentary neighbour is making an excellent speech. If local authorities undertake similar procurement, they have to utilise best value and have a social value framework. If they conducted procurement as the Government have, the Government would bring in commissioners. This is an absolute scandal.

[Rachel Reeves]

I could not agree more. My hon. Friend will know that in Leeds, which we both have the privilege of representing, with the expertise we have on the ground, our local authority and director of public health could be doing a much better job than Serco is doing. Indeed, when we have had local outbreaks in Leeds, it has been the local authority going out and knocking on doors to ensure that people know what is going on—something that Serco cannot or does not do.

Covid-19 Update

Alex Sobel Excerpts

Tuesday 5th May 2020 Commons Chamber

[Matt Hancock]

Yes, of course; if I get the details, I am very happy to do that. I would also be very happy to know where my right hon. Friend had his hair cut, because it is extraordinary. No one else has such smart hair. Everyone is looking increasingly bushy.

[Alex Sobel (Leeds North West) (Lab/Co-op) [V]]

Dozens of dentists have got in touch with me, saying that the measures put in place are not protecting them and their practices. They take on a combination of private and NHS patients. Many are fearing bankruptcy and, ultimately, closure. This will leave NHS dentistry in an existential crisis. What steps is the Secretary of State taking to ensure that NHS dentistry survives the current crisis?

Covid-19

Alex Sobel Excerpts

Monday 16th March 2020 Commons Chamber

[Matt Hancock]

We are trying to address the precise point of the supply of medicinal cannabis products through a change to the Home Office regulations anyway. The advice is against unnecessary travel, and the sort of travel that the hon. Gentleman describes sounds very necessary to me.

[Alex Sobel (Leeds North West) (Lab/Co-op)]

Later, at the height of the crisis, the Secretary of State will be judged on the answers he gives today. At the beginning of the crisis, there were estimated to be only 5,000 ventilators in the NHS. Can he tell us exactly how many ventilators he has purchased, what the modelling says about how many ventilators will be needed at the height of the crisis, and whether we will be able to get everybody on a ventilator at that point?

[Matt Hancock]

As the hon. Gentleman knows from my previous answers, that is not the way we are addressing this question. The way we are addressing it is that we will buy as many ventilators as are made. It is not a question of putting a target on it. We are just going after as many as we possibly can.

Coronavirus

Alex Sobel Excerpts

Wednesday 26th February 2020 Commons Chamber

[Matt Hancock]

I thank my hon. Friend; I will certainly do that. I agree with him on the importance of mitigation. The mitigation strand is really about what would happen should this become a full-scale pandemic, and the very significant impact that that would have on the country— including, of course, on the NHS. On the purpose of the delay strand of this work, even if we do not succeed in containing the virus, we want to delay its arrival so that it does not all arrive in one big peak, but arrives over time so that we can better cope with it. Of course, the contain strand is about trying to stop that from happening at all.

[Alex Sobel (Leeds North West) (Lab/Co-op)]

As the House knows, I was in self-isolation last week because Harry Horton of ITV alerted me to the fact that there had been a confirmed case at the UK bus summit, which I attended. I rang 111 and the advice was that, if I had been in contact with the person who had coronavirus, I should self-isolate, but if I had not, I need not. Yet no agency could confirm or deny whether I had been in contact. So more work on tracking needs to be done. Will the Secretary of State consider developing, like the Chinese Government, a tracking app to help people in that situation?

[Matt Hancock]

I am very happy, subject to consent, to look at that. I would also say that the way that contact tracing works is that, once the positive case is identified, you trace out from the positive case, rather than starting from the wider population—including attendees at the bus conference—and focusing in. Contact tracing was undertaken in the correct way. Indeed, the majority of cases that we have found in the UK have been found through the proactive contact tracing undertaken by Public Health England; that commends its approach.

Acquired Brain Injury

Alex Sobel Excerpts

Thursday 6th February 2020 Westminster Hall

[Chris Bryant]

Interestingly, I had a phone call yesterday morning with Dawn Astle, the daughter of the famous footballer Jeff Astle, who was particularly renowned for heading the ball. I am a Welshman, and we have been boycotting the World cup for very long time—certainly the finals, anyway—so football is not my area of expertise. However, something I have been particularly disappointed about since the APPG produced its report “Time for Change” is that, even though we have been making recommendations about concussion in sport for quite some time, the Government want to wash their hands of it.

There is legislation in every state in the United States of America about sport’s duty of care to participating individuals. Sport is good for you; playing football, rugby and all these things are good for you. I do not want to mollycoddle or wrap anybody in cotton wool, but there may be subtle changes that one can make to each sport to prevent unnecessary damage to people’s brains. Also, I still think that there has not been a cascade of information and understanding of concussion from the professional medics in the organisation down to the grassroots of each sport. That will happen only when there is a shared set of protocols for all sport.

There is clear evidence that a professional footballer is three-and-a-half times more likely to suffer from dementia. There is lots of evidence to suggest that that is to do with heading the ball—not the weight of the ball, as may people say, but the physical process of heading the ball, because it pulls the brain from one side and hits it on the other, which leads to a significantly increased risk of dementia. It seems bizarre that that is not thought of as an industrial injury, which football needs to look at seriously. It also seems bizarre that, at the very highest level of football, a footballer who is taken off to be tested for concussion cannot be replaced, and that player gets only three minutes, which is nowhere near enough time for a proper analysis of whether somebody has suffered concussion.

Football still has some considerable way to go. The Department for Digital, Culture, Media and Sport must play a role in bringing all the sports bodies together round a table to analyse this problem. Otherwise, sports will end up facing massive court cases and very big fines, as has happened in the United States of America. I would prefer us not to go down that route.

There is a spectrum stretching from those who have suffered the worst traffic accidents or have had a severe stroke to those who have had a minor head injury and have lost consciousness for less than 15 minutes. Incidentally, there is a lot of misunderstanding about what losing consciousness and concussion means—I will not go into that, but there are different parts of the brain that might be affected.

[Alex Sobel (Leeds North West) (Lab/Co-op)]

My hon. Friend is making an excellent speech. Regarding road traffic accidents, there is a spectrum of vulnerability, and cyclists are some of the most vulnerable road users. There have been many studies about the efficacy of cycle helmets. The Cochrane review found that using a cycle helmet reduces the likelihood of brain injury by up to 88%. Should the Government not do more to encourage the use of cycle helmets for cycle safety?

[Chris Bryant]

I will not go beyond my area of expertise, so I hope my hon. Friend does not mind that I hesitate to respond. I have read the piece of work that he refers to, and he is right. Other work suggests that there are other things we must do to ensure that cyclists are safe. We need a mixture of all those measures because in future more people will cycle, and we do not want that to lead to a significant increase in road traffic accidents.

The one thing I must praise the Government for, though, is the development of the major trauma centres in England. Despite in many cases not being particularly popular, because it has felt like a service is being made less local and a more regional centre of excellence, the centres have undoubtedly led to at least 1,000 extra lives being saved every year. I praise the Government for their work on that, and I am glad that we will have something similar in south Wales soon. I will not go into the issues about the accident and emergency unit at the Royal Glamorgan hospital today.

The downside of saving lots of lives is that there is a duty of care to provide the neurorehabilitation needed to ensure that those people have a decent quality of life. It is perfectly possible to do that, but at the moment a quarter of major trauma centres do not have a neuro-rehabilitation consultant. There has been significant progress in relation to neurorehabilitation prescriptions. When I last raised that subject, the Government said that around 90% of people were receiving such prescriptions, but whether they are going to the individual and their families, to ensure that that can be pursued, or whether those prescriptions remain with the doctors only, I do not know.

If the Minister looks only at one specific issue, I am keen she looks at how patients get written to. Some doctors, such as consultants, always write to the patient’s GP or other doctor, sometimes in highly technical language. Some local health trusts copy that letter to the patient, but some doctors are now doing something far more effective—certainly far more effective in this area. They are writing not to the other doctor, but to the patient and copying that to the doctor. Of course, they have to use language that the patient can understand, but it is about empowering the patient. One message that I have heard more than any other from many patients and families I have talked to is that they feel completely powerless. Lots of other people are making decisions about them, but they do not understand how those decisions have been reached. They do not know whose door to knock on—or whose door to knock down for that matter—to ensure that their loved one gets the care and support they need. I wonder whether turning those letters on their heads so that the doctor writes to the patient, putting that information in their hands and empowering them, and similarly giving the prescription to the patient and family rather than to somebody else in the medical establishment, would not have a profound cultural effect.

I want to talk briefly about prejudice, because a degree of prejudice is another thing that sometimes comes with a brain injury. Perhaps the person in front of us in the queue in Morrisons or Sainsbury’s or wherever is slurring their words. It is all too easy to get judgmental and think, “Oh well, they’re drunk, and it’s only eight o’clock in the morning,” or whatever, but it might be because they have had a brain injury. It is great that work has been done on the London underground—it needs to be rolled out across the whole country—to explain that some disabilities are not visible, so we should suspend our tendency to be judgmental. We should probably suspend it more often in life generally, but we should do specifically in relation to potential disability.

In commenting on a story from earlier this week, I make absolutely no criticism of my hon. Friend the Member for Salford and Eccles (Rebecca Long Bailey), who I think mistakenly used the word “vegetable” when she meant to say “vegetative state.” Actually, I would like to get rid of the concept of vegetative state. It just sounds wrong. To any ordinary person, it sounds like vegetable, but these are people with all their humanity still in there, even if their personality may have changed in all sorts of ways because of the damage. The Minister will not do this, but I beg the medical establishment to come up with another term that is more sympathetic and genuinely expresses not just the downside of the condition, but hopefulness about the possibilities that may still be to come.

As I said, brain damage is not a pandemic and it is not catching, but it is in a lot of people’s brains. The damage has been done, and many people who have suffered that brain damage do not know that the reason why they find it terribly difficult to concentrate or to get up in the morning—they suffer from phenomenal fatigue that hits them like a sledgehammer—why they find it difficult not to lose their temper, or why they get frightened of loud noise or chaotic circumstances and so on is because they had a brain injury at some point. That is all out there and it affects so many Departments of Government. We have had many wonderful warm words from lots of Ministers—this is my fifth or sixth debate on the subject—but now I really do want the Cabinet Office or Downing Street to set up a cross-departmental body to look at the issue in the round, rather than in each of the different silos. I am serious about this, and I am not asking for lots of money. I hope that the Minister will take that back to the Cabinet Office and Government. At some point, I would like the Prime Minister to chair that body, because we could bring about real, positive societal changes if we get this right.

I will set out what specific Departments can do. In the Ministry of Justice, we should be screening all new prisoners coming in so that we can give them proper rehabilitation. We know there will be many people who have not had their needs met heretofore. That will make it easier to run prisons and much easier to rehabilitate those people not just physically, but back into society to lead fruitful lives. The Justice Committee produced a report in 2016 on youngsters in the criminal justice system, which made specific reference to brain injury. I really hope that all the recommendations in that report will be taken up by the MOJ.

I turn to the Department for Work and Pensions. All MPs have experience of the assessment process not being able to comprehend varying conditions. That is one of the problems with many brain injuries: someone might be all right today and, probably because of their brain injury, they want to please the person sitting in front of them, assessing them. They say, “Yes, I’m fine. I am absolutely fine. Honestly, I am fine,” but tomorrow they will not be able to get out of bed, not out of laziness, but because of completely debilitating fatigue. All assessors for personal independence payment, disability living allowance, universal credit DLA, universal credit, and employment and support allowance—everyone—must have a full understanding of brain injury and the way it works.

In the NHS, I know there are shortages in many categories of personnel. If I have one hope for something that might come out of a Government who have a significant majority, it is for more long-term personnel planning. Specific work needs to be done, because we are falling a long way short in the number of beds needed for neurorehabilitation and, in particular, in being able to take children out of hospital and into community services. I have already referred to the rehab prescription.

There are two other bodies that I want to thank as I end. The first is the United Kingdom Acquired Brain Injury Forum, run by Chloe Hayward. The all-party parliamentary group has worked extremely closely with it, and later this year we intend to do more roundtables to gather more evidence to take this work forward. I have discovered there are many spheres in medicine where all the organisations do not speak to one another or sit round the same table. I have been doing work on melanoma, and I would love to bring all the many melanoma charities together so that we have a co-ordinated approach. UKABIF provides that co-ordinated approach, I really want the Government to adopt that model. We could really crack something here if we manage to work on it not just with one Department at a time but with all of them co-ordinated together.

Finally, I am sure my hon. Friend the Member for Mitcham and Morden (Siobhain McDonagh) will refer to this in a moment, but I want to thank Headway. I had an amazing day speaking to the Headway conference last year. I have referred to some of the professionals, but the most amazing people are probably those who have been through a version of hell that none of us would ever want to experience, having sometimes lost significant members of their family as well. I remember one woman said to me, “I know I have to use all the energy in my head to make my head better, but I am using all the energy in my head to try to work out this DWP form.” That is not what the state should be doing. That is when we really do want a nanny-state to help, to sustain and to support. All too often, of course, it is charities that provide exactly that, and I pay an enormous tribute to Headway for the work it has done.

Health

Alex Sobel Excerpts

Tuesday 14th May 2019 Commons Chamber

[Jonathan Ashworth]

Absolutely. I hazard a guess that when the Secretary of State stands up, he will talk about the support for social prescribing that he has given to general practice so that GPs can send people for more of this activity. But, at the same time, public health budgets are cutting these very types of activities. One hand does not know what the other hand is doing.

[Alex Sobel (Leeds North West) (Lab/Co-op)]

I met Professor Paul Gately of Leeds Beckett University, who set up the applied obesity research centre. He also established Europe’s longest-running weight loss camp for young people, although only the better-off families can now afford it. He asked me to ask my hon. Friend and the Secretary of State why the sugar tax cannot be used to fund some of that work.

[Jonathan Ashworth]

That is an entirely sensible proposal, and I look forward to the Secretary of State’s thoughts on it. The sugar tax is supposed to be funding more physical activities for young people across the country.

At a time of rising demand, we have also seen £55 million cut from sexual health services. That has meant that half of councils have reduced the number of sites commissioning contraceptive services, with the result that 6 million women of reproductive age live in an area where one or more services have been closed. Prescriptions of long-acting reversible contraceptives—the most effective form of contraception—have decreased by 8% at the same time as abortion rates for women over 30 have been steadily increasing. We have seen an increase in sexually transmitted infections such as syphilis and gonorrhoea while, because of cuts, the number of sexual health checks has dropped by 245,000. I was particularly shocked to hear the evidence given recently at the Health and Social Care Committee by Dr Olwen Williams from the British Association for Sexual Health and HIV, who said:

“We are seeing neonatal syphilis for the first time in decades and neonatal deaths due to syphilis in the UK…We are seeing an increase in women who are presenting with infectious syphilis in pregnancy, and that has dire outcomes.”

That was the evidence presented to the Committee about the impact of these cuts on sexual health services in communities.

What about the cuts to health visitor numbers? Last week, we heard concerns across the House about falling vaccination rates, which fell for the fourth time in a row. Vaccinations are one of the most important public health interventions we can make, and our health visitor workforce is vital to ensuring their take-up. Yet public health cuts and wider local authority cuts have meant that we have lost 25% of our health visitors. Every 12 hours since October 2015, we have lost one health visitor, and there are no proposals to reverse those cuts in the long-term plan. School nurse numbers have gone down, and the case loads of health visitors and school nurses are increasing. As a consequence, parents and small children are missing out. According to the Government’s own figures, 14.5% of children are not receiving a six to eight-week review on time, and 24% are not receiving a 12-month review on time. With high caseloads, there are increased risks of abuse or poor health of babies not being picked up, of maternal mental health issues not being picked up and of domestic violence and trauma not being picked up.





We need investment in the wider public health workforce and we need to expand training opportunities. The Government should honour their commitment to pay the public health workforce properly, and especially those on “Agenda for Change” terms and conditions. Last year, when the Government announced a pay increase for staff, they said they would honour that for all public health staff working for local authorities or in the voluntary sector. We are now told that the Government and the NHS are refusing to honour a pay rise this year. I hope the Secretary of State will tell us whether all public health staff employed on “Agenda for Change” terms and conditions will get a pay rise this year.

We are pleased that the Secretary of State has joined us today from the leadership campaign trail. We look forward to his response but, whenever he is asked about public health cuts, he says, “Well, prevention is better than cure.” Who would disagree with that? He never tells us that he is going to stand up to the Chancellor and demand that these cuts be reversed. He simply says that individuals’ attitudes have to change. But it is not just about individuals; it is about the services that are available in local communities. He gives the impression that he just wants people to look after themselves. For example, he said that those who present at hospital with ailments related to alcohol abuse will be targeted for a “stern talking to”—that is his answer. He needs to take it up with The Sunday Times if that was not what he said.

We know that the Secretary of State loves an app, and one of his solutions is more targeted advertising on Facebook. Whenever there is a problem in the NHS, he says that we are going to have more apps; that is the solution to everything. I am told that he and his old friend George Osborne are now part of a WhatsApp group called “Make Matt Hancock Great Again”—there are some problems that even an app cannot fix.

This is not leadership. Real leadership would be reversing the cuts to public health services and intervening to stop the health inequalities and the rolling back of life expectancy advances. Only Labour is offering that leadership on health inequalities. We will fully fund public health services. We will not cut public health services. We will adopt a health in all policies approach; this Government will not. We will invest in the health and wellbeing of every child and meet our ambition to have the healthiest children in the world. Longer, healthier, happier lives will be our mission. I commend our motion to the House.