(7 months, 1 week ago)
Commons ChamberI am extremely grateful for the hon. Gentleman’s support. We understand the level of lobbying that has been undertaken by both the vaping industry and the tobacco industry. We know that the vaping industry has pushed that as one of its lines. In the current vapes market, when walking into a local shop or a newsagent the vape products can be seen on sale next to the till, often next to the sweets—the part of the shop that children will be very attracted to, if my experiences are anything to go by. The industry markets them in very cynical ways. We are saying that it is already unlawful to sell vapes to under-18s, but we want to take the powers in this legislation to consult on flavours, design and so on, to ensure that vapes are sold as they are intended—to help adult smokers to quit, because no child should ever vape.
I am going to make a little progress, if I may, because I want to come to the age of sale.
On the point raised by my right hon. Friend the Member for Rossendale and Darwen (Sir Jake Berry) about the age of sale and the black market, tobacco industry representatives claim that there will be unintended consequences from raising the age of sale. They assert that the black market will boom. Before the smoking age was increased from 16 to 18, they sang from the same hymn sheet, but the facts showed otherwise. The number of illicit cigarettes consumed fell by 25%, and smoking rates for 16 and 17-year-olds dropped by almost a third. Consumption of illegal tobacco plummeted from 17 billion cigarettes in 2000-01 to 3 billion cigarettes in 2022-23. That is despite the further controls that this House has put in place in the meantime. Our modelling suggests that the measures in this Bill will reduce smoking rates among 14 to 30-year-olds in England to close to zero as soon as 2040. I hope that many of us in the Chamber today will still be here in 2040. This is our opportunity to play that part in history.
Thanks to constructive engagement with colleagues across the devolved Administrations, the measures will apply not just in England but across our entire United Kingdom, saving lives and building a brighter future. Having listened carefully to colleagues’ concerns about enforcement, we are making sure that local authorities will be able to keep every penny of the fixed penalties they bring in to reinvest in rigorous enforcement. In other words, we are looking not just at national enforcement, but at helping our very important and valuable local trading enforcement officers to keep the proceeds from the fixed penalties they hand out.
First of all, I completely reject my hon. Friend’s suggestion that he is a dinosaur. He brings a great energy and effervescence into the Chamber—or indeed any social situation. He articulates really well the struggle of addiction to nicotine and how tough it can be to give up. That is not a judgment on anyone; the substance is designed to addict. That is how the sales pitch is made. What we are trying to do is stop children being ensnared in that way. He is also right that at the moment the evidence suggests that vaping is a good way to help existing smokers to quit. If you do not smoke, please do not vape. Certainly, children should never vape. What we have tried to do with the Bill is build a balance in, so we are taking powers to look at packaging, flavours and so on. There will be a thorough consultation before any regulations are set, because we want to ensure that we are helping adults to quit, but in a way that is considered and well designed. I am extremely grateful to him for raising that point.
I am listening very carefully to what my right hon. Friend is saying. She outlined how the consumption of cigarettes has collapsed over the last couple of decades, and my right hon. Friend the Member for Chelmsford (Vicky Ford) talked about how the young people she reached out to do not want to smoke any more. Is that not the heart of the matter? That is why I think the Bill is fundamentally wrong and misguided. Young people are not smoking. It is not cool to smoke. The Bill should be focused more on the vape side of things: illegal vapes, supercharged vapes, the colour and flavour of vapes. We are debating cigarettes, which are naturally going out of existence anyway, rather than focusing on the dangerous vapes that are addictive for young children. That is where the Government should put their focus, rather than wasting time talking about something that is dying out anyway.
Sadly—I say this genuinely—there is nothing inevitable about a decrease in smoking rates. Indeed, in 2020 the United States saw the first increase in tobacco sales in 20 years, and in Australia in 2022 the proportion of teenagers smoking increased for the first time in 25 years. I am reminded by a Minister that here in the United Kingdom 100,000 children and young people take up smoking every year. We must not be lulled into a sense of inevitability and security, mindful as I am of how very clever the tobacco industry is at lobbying its messages because we are threatening its business model. As Conservatives, we must take into account that this is happening today, so we must ensure we tackle it head on.
I am grateful to the right hon. Lady for her intervention. I think she makes a perfectly sensible point, actually, and I am perfectly open to lobbying from Conservative Members on how a Labour Government will behave after the general election—she seems to think it is a foregone conclusion, but I certainly do not; we will be working hard for every vote. I can reassure her that our concern has been about children becoming addicted to nicotine. In relation to adult use of vapes as a tool for stopping smoking, I think she makes an absolutely reasonable point about flavourless vaping, and of course she is right that we need to ensure that we get the regulation right on that so that we do not unwittingly deter people from stopping smoking. However, as I will come on to talk about when I come to the vaping section of the Bill, there is no excuse whatsoever for the kinds of flavourings and marketing of vapes that we have seen, which I believe have been deliberately and wilfully designed to addict young people to what is, let us not forget, a harmful substance. I make that very clear.
Anyway, back to the Bill—someone has to defend it, and I get the sense that there are not going to be too many on the Government side, so I will have a go at doing what the Prime Minister is too weak to do and take on the arguments of his own party. They say that the progressive ban on smoking is unconservative. Let me tell them what is unconservative: the heaviest tax burden in 70 years, and it will get heavier if we do not act to prevent ill health.
If we continue down the road that the Conservatives have put us on, with more and more people suffering, falling sick and falling out of the workforce, we will not just be letting those people down; we will all be paying a heavy price for it too. The costs of sickness and disability benefits are due to rise on the Government’s watch, from £65 billion this year to over £90 billion by the end of the next Parliament.
The budget for the NHS is £165 billion this year, and the health service is not coping with existing demands. If society continues to get less healthy, those demands will only rise. If the health service and our welfare service are to be made sustainable for the future, then we must act to prevent ill health in the first place. What better way to do that than by wiping out the leading cause of cancer? It is not just our public finances that are held back by ill health; so too is our economy.
I am trying to follow the hon. Gentleman’s argument to its logical conclusion. He talks about substances that are bad—addictive and harmful to people’s health—and have a huge impact on the NHS through those costs, but there are so many more things that are in fact worse for health. Sugar and salt are highly addictive. Does this mean that Labour’s plan is to ban foods with high levels of salt or sugar? Logically, that is the next step, and therefore, if we need to protect the NHS and cut costs, we should be banning anything that is slightly bad for us, rather than actually taking a better enjoyment of life and saying, “A little bit of what you fancy every now and again is okay, and good for your mental health.”
I think that is extraordinary. I do not think that smoking is slightly harmful; I think it is the single biggest cause of cancer, and I think that the costs to people’s health, to our national health service and to our economy are enormous. This sort of argument—that if we ban smoking for young people, we have to ban everything else—is absurd. I think that the Secretary of State just pointed out the absurdity of it when she pointed to a whole range of harmful things in our country that are already banned.
Let me put the question back to the libertarian wing in the corner of the Chamber. Will the new modern Conservative party not ban anything? Will we have a libertarian dystopia in which people are free to do whatever they want in the name of liberty? [Interruption.] I am just trying to help the Secretary of State by taking on the libertarians in the corner. I would be very sad if she wants me to give in to them but, with 187,000 people on the waiting list in the local area of the hon. Member for Rother Valley (Alexander Stafford), I think we should do something about it.
I wish to declare almost an opposite interest: I have never smoked a cigarette or a cigar in my life. I have never even put one to my very lips, yet I am against the Bill. That is not because I have any vested interest in the tobacco lobby or because I am a smoker or an ex-smoker; it is because I am a lover of freedom, a lover of choice and a lover of information. To me, that is vital.
I am neither one of the older Members nor one of the younger Members of the House, but I remember that throughout my time at school the evils of smoking were drummed into us. I do not think that any Member of the House, or any person in this country, does not know the evil of smoking, including health degradation and damage to lives and families, because it is drummed in every single step of the way—as I think it should be, because smoking is wrong.
I do not like smoking, and I wish people would not do it, but if we believe in freedom of speech, independence of mind and people making informed choices, we should let people do what they want as long as they have the facts before them—and we do provide the facts. The NHS stop-smoking policies have done an amazing job over the past few decades of ensuring that everyone knows the facts, so no one can say when they start smoking or vaping that they do not know the full implications of what they are doing—they do. We know that they do because, as has already been said, the number of young people smoking has absolutely collapsed over the past few decades. My hon. Friend the Member for Windsor (Adam Afriyie) correctly mentioned that only 1% of schoolchildren smoke. That 1% statistic is terrible and represents far too many children, but compared to what it was, it is really good news.
As I said in my earlier interventions, children generally do not smoke anymore, so that is not where the battle is. I believe that the battle against smoking has been won—we are just fighting the last rearguard action—which is why I think the Bill is fundamentally wrong. It is fighting yesterday’s wars, not tomorrow’s wars. The vaping aspect is incredibly important and is what we must focus on. We and the Government need to focus our attention on super-strength vapes and marketing to children. That is incredibly important, and I am glad that the Bill goes some way towards rectifying that. The ban on the free distribution of vaping products to under-18s is also great news.
However, we are dividing our time between that and focusing on a dying industry in a bizarrely puritanical way by stamping out some people’s choice and freedom. Who is to say that, in a few years’ time, a 21-year-old cannot celebrate their graduation with a cigar? If they want to, why not? Why shouldn’t someone celebrate the birth of a child with a cigar, or maybe with a pinch of snuff? Who are we to say that that is not their choice to make? Who are we to say, “You shouldn’t celebrate in this way”?
I have many vices, Madam Deputy Speaker. I like a glass of beer or a pint of wine every now and again. I know in my heart of hearts that they are wrong for me and probably limit my health, but I drink them. I eat burgers and chips, accepting that they are fundamentally life-shortening. But do they make my life better? Do I enjoy doing it? Yes, and I do so in the full knowledge of what I am doing. This is the crux of the matter: we are talking now about cigarettes, cigars, snuff or shisha, but what is to stop us from saying tomorrow or the next day that burgers, red wine and all the little things that people sometimes enjoy in moderation—that make life worth living—are bad for them? Sometimes people want that bit of enjoyment, but we sit here and say, “No, you cannot have that choice; we know better and we are taking that choice away from you.”
As long as everyone has the knowledge about what tobacco products do, we should give them the choice—that is terribly important. I am also confused by the fact that, once again, we are using a sledgehammer to crack a nut by banning all tobacco products. How many people in this country do snuff, say? Not many, so why are we impinging on their liberty? There is not an epidemic of children taking snuff at school, so why are we banning it? Snuff does not represent a massive health risk or have a huge impact on the NHS, yet we are banning it—that is crazy. We are banning things that are not having a huge impact on the economy or the health of our nation, and that concerns me greatly.
A country that has gone through this process is New Zealand, which banned tobacco sales. However, it then overturned the ban. If the policy was such a success, why did New Zealand not double down on it and go further? My biggest issue with the measure is the rolling age of consent, which is fundamentally discriminatory. Adults are adults, and they make their own choices and own their failures. A 28-year-old does not know better than a 29-year-old; someone of 18 years and one day does not know any better than someone of 17 years and 364 days. We are creating cases in which people are unequal before the law, and that is wrong.
Also, let us not kid ourselves: we know that having a rolling age of consent is completely impractical and unworkable, and it will have to be got rid of. Let us be honest: we are not going to have a situation in 10 or 20 years’ time where a 34-year-old is ID’d at a tobacconist or a newsagents and told, “You look 33, sir.” “Oh, thank you very much for flattering me.” It is going to be banned outright, and we know that. This is the thin end of the wedge. It will create inequality in the law, cut down on freedoms and fundamentally make life that bit harder for everyone.
Many years ago, as has been described, this place was a bastion of puritanism. There were so many roundheads fighting the King many years ago in the civil war, but I say that at the moment there are too many roundheads in this Parliament—too many naysayers, too many people banning things. What we need is a few more cavaliers: a few more people trying to enjoy bits of life while making informed choices. For that reason, I oppose the Bill, although it does contain some good bits about vaping. We should be fighting the next battle, which is fully against vapes, rather than wasting our time fighting yesterday’s battles.
(7 months, 1 week ago)
Commons ChamberI refer the hon. Lady to the answer I gave earlier about funding. In relation to the waiting list, we have already removed the Tavistock as the single provider of these services. We have now set up two sets of services in highly respected—world-respected—children’s hospitals, and we will add more. Again, the issue goes back to giving GPs and other practitioners the confidence to look after these children as they would if they were presenting solely with, for example, ADHD symptoms or concerns about mental health. This is about saying that this issue is one part of the patient they must treat, not isolating and siloing it in the way that has happened historically.
Providing hormone blockers to children is wrong; encouraging and giving cross-sex hormones to children is wrong; and encouraging breast binding for children is wrong. In the future, I believe we will look back on this scandal—and it is a scandal—with incredulity about how we did this to our children, especially our girls. We should all be embarrassed that this is the situation we are in. It is not just carrying on in our hospitals and the medical profession; this sort of ideology is going on in our schools. Does the Secretary of State share my concerns and those of my constituents, who have raised the issue with me in private because they cannot raise it publicly, that a school in Rother Valley is fundraising for Mermaids, a charity that is accused of encouraging young people to transition simply because they do not confirm to gender stereotypes, even though they are too young to understand the consequences? Does the Secretary of State share my belief that Mermaids and other such charities have no place in our schools, and no place to help to hinder our children?
I thank my hon. Friend, and I will set out the practical and important steps NHS England has already taken, which I hope other parts of the United Kingdom will follow. NHS England has banned the prescription of puberty blockers for gender dysphoria to children under the age of 18. On the advice of Dr Cass, cross-sex hormones can be prescribed only with extreme caution for those aged 16 and older. No cross-sex hormones may be prescribed to those under 16 for gender dysphoria. There are medical caveats to that for other medical conditions, and we need to be very careful about unintended consequences, which is why this is such a complicated piece of work. We want to ensure that these drugs are prescribed to the right people, if they should be prescribed at all.
On my hon. Friend’s point about campaigning organisations, part of our collective frustration is that our public spaces have become politicised. I would say there is no space for that sort of campaign activity in any of our public institutions. I appreciate that a range of views must be represented. Young people must be helped to discover their path in life, their sexuality and all of the things that are such a wonderful part of growing up, but we have to do so in a way that is fair and rigorous, and does not give way against the evidence into the realms of ideology, which sadly we have seen in some instances.
(1 year, 8 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
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The questions about the discharge policy have been interrogated on a number of occasions, including by Select Committees. The hon. Gentleman will well know that in general, and in the work that we are doing now on discharge, it is rarely good for somebody who is medically fit for discharge to continue to be in hospital beyond that time. So of course it is right that when people are medically fit, they should be discharged home. The guidance of how that was done was set out on a number of occasions during the pandemic, and that guidance was updated both as we learned more about the virus and as greater testing capacity became available.
I am very proud of this Conservative Government’s record during the pandemic: 400 million tests, a world-leading and world-beating vaccine programme, and £400 billion spent to keep jobs and people’s prospects going. Clearly, hard decisions were made, and hindsight is a wonderful thing, but we should not be reflecting with hindsight now; we should deal with the facts at hand. Does the Minister agree that this Government will continue to take measures, and that if—God forbid—there is another pandemic, we will not let party politicking get in the way of making decisions to protect lives, fund jobs and keep our country going?
My hon. Friend is absolutely right to point out the extraordinary things that were done during the pandemic. I do not think that the Government should seek to take credit for that; so many people worked incredibly hard, whether in local authorities, social care or the NHS, or through their involvement in supply chains and the huge efforts to secure personal protective equipment when that was incredibly hard to get hold of across the world. I am glad that he draws attention to some of those things. He is absolutely right that, in the context of the public inquiry, we should reflect overall.
(1 year, 11 months ago)
Commons ChamberI can reassure the hon. Gentleman on that. I would have thought that he would also welcome the commitment to a £15 billion to £20 billion increase in R&D investment, the championing of life sciences that the Minister for Health, my hon. Friend the Member for Colchester (Will Quince), has been leading on, and the opportunity we have to address greater variation within the NHS by bringing forward the innovations from our life industry and applying them much more quickly.
That is something that we are working on very actively. As well as financially supporting GPs to roll out new and better ways of managing their appointments, we are looking at what criteria we expect from GPs. We already set out some moves in our summer action plan, but we will be looking further at preventing the lamentable situation my hon. Friend describes of people being asked to ring back or being held in long phone queues. That is not acceptable.
(2 years, 9 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
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I remind Members to observe social distancing and to wear masks. I will call Alexander Stafford to move the motion; I will then call the Minister to respond. There will not be an opportunity for the Member in charge to wind up, as is the convention in 30-minute debates.
I beg to move,
That this House has considered social prescribing in England.
I wish first of all to make clear to the House my interest as chair of the all-party parliamentary group on health and the natural environment. I am delighted to be sponsoring what is, to my knowledge, the first dedicated debate in the UK Parliament on social prescribing. There is no doubt in my mind that this debate is timely, if not overdue, given that social prescribing as an effective and respected field of medicine has come to the fore in the past few years and accordingly has an important role in the future of our health system.
So what is social prescribing? Put quite simply, social prescribing embraces the need for psychosocial support to be considered alongside biomedical interventions, to take us back to a more natural way of keeping well and improving our health when things go wrong. Importantly, social prescribing is about being connected to activities in our communities to improve health and wellbeing, whether by joining a community choir or running group or volunteering at a local nature reserve.
To understand why social prescribing is crucial to the future of care, we must understand its place in the health and social care context. All Members can agree that biomedicine is brilliant, and there is no better example than the Government vaccination programme for covid-19. Biomedicine will always play a crucial role in supporting people’s health and wellbeing. However, we have also known for a long time that what determines our health is not what goes on inside hospitals and GP practices. We also know that biomedicine has limitations—for example, addiction to opiates.
Recent guidance from the National Institute for Health and Care Excellence promotes the use of exercise for pain, alongside drugs. In fact, the NHS chief pharmacist’s recent report into over-medicalisation demonstrated that one in five over-65s are in hospital not for a condition they have, but due to the medicine they take, while 10% of prescriptions dispensed address the symptom and not the cause of a person’s depression. Evidence also shows that one in five GP appointments are for non-medical needs, such as mental health, relationships, housing, loneliness, social isolation, managing a long-term health condition and debt.
I congratulate my hon. Friend on securing this debate. I am not sure if he was aware, but I was the world’s first Minister for loneliness. We produced a strategy to tackle loneliness, of which social prescribing formed a significant part. As a consequence, social prescribing was beginning to be rolled out, to the benefit of our GPs up and down the country, supported by a dedicated team of link workers, who really grasped the importance of tackling loneliness through social prescribing. Will he join me in thanking all those link workers, who get why social prescribing is important and continue to signpost people towards organisations that tackle loneliness?
I thank my hon. Friend for that intervention and for all the work she did as Minister for loneliness to address this important issue, which she continues to drive forward, including in all-party groups. She is exactly right: link workers are vital. Indeed, a big part of my speech is about them, because it is so important to give them the support they need and thank them for their great work to improve the health of our nation.
Demand for GP appointments has increased by 30% compared with pre-pandemic levels, but the ecosystem of social prescribing support is fragmented. Healthcare professionals have limited visibility of what local support is available, as directories of services are often outdated and the referral pathway to different agencies is complex. There is also significant inequality of access to nature. About one third of the population accounts for 80% of all visits taken, and 2.69 million people do not live within a 10-minute walk of a green space. People from low-income households are about 25% less likely to live within a five-minute walk of a green space. Someone from a black, Asian or minority ethnic background is nearly four times as likely as a white person to have no access to outdoor space at home. Almost 40% of people from ethnic minority backgrounds live in areas most deprived of green space.
The inequality of access to green space seen for adults in England is also seen among children and young people. Most of our children spend not nearly enough time outdoors. Unequal provision means that those at greater risk of poor physical and mental health often have the least opportunity to benefit from green space. In other words, inequality breeds greater inequality. Improving contact and connection to nature is one way to help break that cycle of inequality.
It is exciting to see the positive impact of social prescribing borne out by the evidence. When we talk about health, we should always talk about evidence. Data indicate that people who visit nature regularly feel that their lives are more worth while. There are links between a greener living environment and higher life satisfaction, including improved mental health and reduced stress, fatigue, anxiety and depression. Among people who have good access to nature, inequality and mental wellbeing between different social groups are vastly reduced.
People who visit nature at least once a week are almost twice as likely to report good general health. However, it is an individual’s feelings of connectedness with nature that are important for their wellbeing. When controlled for time spent outside, people with high nature connectedness were 1.7 times more likely to report that their lives were worth while, versus those with low nature connectedness. Evidence shows that living in green environments is associated with reduced mortality, and green space may mediate detrimental health effects of long-term deprivation.
Since the pandemic, 43% of adults say that visiting green spaces has been even more important for their wellbeing. The evidence is equally impressive for children, reinforcing the point that schools and other educational settings are crucial gateways, if we are to ensure that all children have contact and connection with nature, especially those who otherwise have little opportunity to access the outdoors.
We have already made great progress rolling out social prescribing across health and social care services. For the NHS, social prescribing is a relatively new model of care that improves the health and wellbeing of individuals. It builds community capacity and reduces demand for statutory services, particularly GPs—we all know the pressure GPs are under at the moment. Social prescribing sits at the heart of NHS ambitions for system change, as a practical embodiment of personalised, joined-up, preventive, community-based care that addresses the social determinants of health.
In 2019, the NHS long-term plan committed to the recruitment of 4,500 social prescribing link workers. Link workers take a holistic approach to health and wellbeing, connecting people to community groups and statutory services for practical and emotional support. The NHS long-term plan envisions that social prescribing link workers would work alongside other roles being created in primary care, as part of multidisciplinary teams. Those teams include other personalised care roles, such as community pharmacists, mental health workers and health and wellbeing coaches.
Social prescribing is part of a wider suite of community-based interventions, including programmes around hospital discharge and higher intensity use of accident and emergency services. Together those programmes are part of an overarching shift towards greater collaboration between health services, systems, capacity and assets of wider local communities. The plan envisions that that would be funded by bringing together resources across systems to support thriving health communities.
Making that shift is now more urgent than ever. The covid-19 pandemic laid bare the devastating realities of health inequalities across our communities. It has shown that we need to do better at reaching out to marginalised communities, closing the gaps in the support available in the most deprived areas. The pandemic has also increased the urgency of finding a way to support people to stay well within their communities, reducing pressure on health and care services. Social prescribing in its broadest sense encompasses a whole ecosystem of support for people’s health and wellbeing in the community. It is a core priority for much of the voluntary community and social entrepreneur sector.
My seat of Rother Valley is a former coalmining area with deep pockets of poverty and deprivation, and many of my constituents suffer from lung conditions caused by exposure to harmful particulates in the mines. I have witnessed at first hand the poor health outcomes associated with a lack of access to high-quality green space, the mental and physical costs of social isolation from one’s community, and the price of late stage reactionary overmedication, in contrast to early preventive measures. In my experience, it is true that those at greater risk of poor physical and mental health are the most likely to benefit from green space, but the least likely to able to access it. Members of my family who work in the NHS have made me acutely aware of the pressures on the national health service from preventable conditions. I am thus determined to increase access to nature for left behind communities, and therefore to improve my constituents’ lives.
I recently announced my campaign for the creation of a Rother Valley leisure arc, stretching from Treeton dyke through Rother Valley country park via Gulliver’s Valley theme park resort, taking in the award-winning Waleswood caravan park and family favourite Aston Springs farm, to the Chesterfield canal, where I wish to see the construction of the Kiveton Park marina and the reopening of the nine-mile stretch of canal, including a Rother Valley link to the rest of the waterways system. The Rother Valley leisure arc aims to make Rother Valley the heart of tourism in South Yorkshire, bringing jobs, wealth and farming to our area. It will be a vibrant and dynamic leisure cluster, with provision for exercise and hobbies, physical and mental health, education and skills, business and employment, and tourism.
The Chesterfield canal is a crucial part of the Rother Valley leisure arc. Accordingly, I am pleased that the Canal & River Trust is focusing on the concept of blue health, which recognises the health and wellbeing associated with spending time by the water. The South Yorkshire and Bassetlaw integrated care system social prescribing pilot, funded by the Department for Environment, Food and Rural Affairs, seeks to better understand the best ways to connect residents with their local green spaces. Rotherham Titans rugby club also hosts a great social prescribing programme, which is already achieving great things.
Members and my constituents will know that I am a history buff, so it will be no surprise that I welcome the growing body of evidence about the wellbeing benefits of engaging with heritage and the historic environment. Local to Rother Valley, Heeley City farm’s community heritage team have engaged thousands of people from the Sheffield area, including many volunteers, work placements and general participants of all ages, in a variety of local heritage and wellbeing projects. In 2020, it played an important part as a community hub in Sheffield’s voluntary sector response during lockdown.
As a result of my strong belief in social prescribing, in April 2021 I founded the all-party parliamentary group on health and the natural environment to investigate the benefits that connecting with the natural environment might have on health and wellbeing. Recent sessions have focused on evidence and transforming delivery. We would welcome the Minister coming to speak at one of our sessions in the near future, if she is available. Our secretariat, provided by the National Academy for Social Prescribing, is working on fostering closer working relationships with other all-party groups that are focused on the theme of wellbeing, such as that of my hon. Friend the Member for Chatham and Aylesford (Tracey Crouch).
The National Academy for Social Prescribing, known as NASP, was established in 2019 by my right hon. Friend the Member for West Suffolk (Matt Hancock), who was then Secretary of State for Health and Social Care, to work with the NHS to accelerate the development and expansion of social prescribing activities delivered by voluntary organisations and community groups across the country. Over the past two years, NASP has worked with a wide array of partners to develop a number of ambitious and varied programmes.
One such programme is Thriving Communities, a national support programme for voluntary, community, faith and social entrepreneur groups. It works alongside social prescribing link workers to support communities impacted by covid-19 in England. Another programme is Accelerating Innovation, a partnership between NASP, the Royal Voluntary Service, NHS England and NHS Improvement that supports national voluntary organisations to develop their social prescribing ideas so that they can develop projects and approaches that have a greater impact and a wider reach, and that help to reduce health inequalities.
Furthermore, NASP has formed a Global Social Prescribing Alliance in coalition and collaboration with the World Health Organisation, the UN and the World Health Innovation Summit, with the aim of establishing a global working group dedicated to the advancement of social prescribing information, collaboration and innovation. The membership is currently 18 countries and growing. NASP is working through academic partnerships and NHS England to bring together leading researchers in the field of social prescribing to ensure that the evidence on it is accessible, useful and compelling. All of those programmes work closely with NHS England with a focus on outcomes for people, local systems and communities.
There are several areas of focus for my APPG and NASP in the coming months, in respect of forthcoming reports and policy developments. These include the implementation of the Government’s 25-year environment plan, the recently published Dasgupta review, the Environment Act 2021, the landscapes review by Julian Glover, and the Chief Secretary to the Treasury’s cross-Whitehall committee to set the direction for the comprehensive spending review on using access to outdoor spaces to support better health outcomes. I hope that the Minister will touch on those developments, and tell us more about their impact on the expansion of social prescribing in our health system.
As is relevant for all models of care, the Minister will be pleased to hear that social prescribing provides good value for money through reductions in GP appointments and financial savings in drug prescriptions and freed-up GP salaried time. For example, poor mental health is estimated to incur an economic and social cost of £105 billion a year in England, with treatment costs expected to double in the next 20 years. As for poor physical health, the cost of obesity alone to wider society is estimated at £27 billion. However, urban green spaces support 2.1 million people to adhere to their weekly physical activity guidelines, which is worth £5.6 billion and avoids health service costs of around £1.4 billion. These are good savings; they are better for people’s health and for the Government’s wallet.
A recent assessment of the economic impact of social prescribing by NASP, which drew on the best available evidence, concludes that social prescribing can be a cost-effective intervention that reduces pressure on primary care, especially GP services. NASP’s preliminary forecasts indicate that the NHS social prescribing link worker programme could save the taxpayer more than £480 million over three years by reducing the need for GP appointments, which would cover the total cost of the programme.
There is no doubt that investment in green space is good value for money. For example, a study into the economic values of Birmingham’s city-wide Be Active programme found that approximately £23 was recouped for every £1 spent, which is a huge return on investment. The valuation of urban parks in Sheffield, my constituency of Rother Valley’s local city, showed that for every £1 spent on maintaining parks, there was a benefit of £34 in health costs saved.
The Minister will appreciate that I have some policy asks of the Government to accelerate the development of social prescribing, in order to provide direct support for our recovery from the pandemic and the Government’s levelling-up agenda. To achieve these aims, I ask the Department of Health and Social Care to focus on eight main policy asks—so not too many.
First, we must accelerate the recruitment of social prescribing link workers, so that all 4,500 are in post by 2023. Secondly, we must ensure that the newly created integrated care boards have a duty to produce specific plans in their area for implementing social prescribing. Thirdly, we must build leadership, skills and capacity in the voluntary sector, by investing in NASP’s Accelerating Innovation and Thriving Communities programmes. Fourthly, we must commit to social prescribing being at the heart of the Government’s levelling-up and health inequality agendas.
Fifthly, there must be faster and greater levels of funding into social prescribing activities and services, particularly grassroots organisations such as charities, aligned to the health needs of the population within each of the 42 new integrated care systems. Sixthly, there must be greater investment in the digital infrastructure to facilitate social prescribing. Seventhly, every social care organisation and every hospital should have a dedicated team of social prescribing link workers. Eighthly and lastly, social prescribing needs to be integrated into the everyday processes of frontline health and care staff, to change the culture whereby it is easier and more natural to prescribe a pill than to make a social prescription.
It is clear that social prescribing can improve the physical and mental health and wellbeing of our population, improve people’s lives and save money. It not only helps to manage existing conditions, but addresses underlying issues that cause poor health and wellbeing, and so helps to prevent future illnesses. It is better to prevent future bad health than to cure it.
Social prescribing supports local projects in the community and fights social ills, such as loneliness and isolation, which traditional medicines do not address. By integrating social prescription into our health and care system, we will simultaneously save taxpayer money and take the strain off the NHS, freeing up capacity for essential treatment. Social prescribing has an enormous role to play in the future of health and care in England, so I am proud to be the first parliamentarian to make the case for it to the Minister.
(2 years, 11 months ago)
Commons ChamberMy right hon. Friend knows that I am completely against vaccine passports and mandatory vaccinations. Can he confirm that lateral flow tests will always be used? That would allay my fears and those of my constituents that we are creating a two-tier system with mandatory passports. If lateral flow tests are always used, everyone can have access to all parts of our society.
I can give my hon. Friend that confirmation and I am happy to make that really clear. It is vital that there is always an option for a lateral flow test. I would not support a vaccine-only option.
(3 years ago)
Commons ChamberThe VIP lane process was part of ensuring that we were aware of companies’ capabilities. At that point, they then went through a procurement process with highly trained, professional procurement people, whom I have spoken to and who would be quite insulted by the right hon. Lady’s thinking that they had not followed all the procedures.
This does not mean that we do not believe that there are lessons to learn; of course there are. No one can face such an unprecedented challenge and conclude that everything worked perfectly, and that is not what we are saying. We remain committed to procurement reform and are looking at coming forward with some. Last December, we published our transforming public procurement Green Paper, which provided commercial terms across Government. We have clarified the roles and responsibilities of everyone involved in decision making, and are determined to do all that we can to ensure that we have a simple and less bureaucratic system that is underpinned by the enduring principles of fair and open competition.
Does the Minister agree that this is a situation that happened across the United Kingdom? I am under the impression that the SNP Government in Scotland gave £500 million-worth of contracts without competition, so what happened in England and the UK was no different to what happened in other parts of the country; this is how everyone operates in a global pandemic.
The most important thing in a global pandemic is to secure supply of something that is not widely available across the world—to get security of supply—and that is what we did. We all know that there was a time when we were worried about running out of PPE, about not having enough testing capacity and about not having the large scale of supplies needed to meet the demand. Of course, any responsible Government would do that.
As I was saying, we are looking at procurement systems and are determined to do all that we can to ensure that we have a system that is simple and less bureaucratic, but which is still underpinned by the enduring principles of fair and open competition. We are also implementing the recommendations of the first and second Boardman reviews into improving procurement.
I absolutely take on board what the hon. Gentleman says, and I am sure the Government have heard it as well. There are many, many questions to be answered, including by Lord Bethell himself.
It is essential that this is done, because a stench of corruption is engulfing this Government, who now stand accused of making certain well-placed individuals fabulously wealthy during this pandemic, not because of their particular skill or acumen in business but primarily because of their political connections to the Conservative party. We should give thanks to Owen Paterson, because it was his behaviour and the bizarre attempt by the Prime Minister, the Tory Chief Whip and the Chancellor of the Duchy of Lancaster—albeit at the expense of the reputation of this House and all of us who sit in it—that has finally blown the lid off this scandal once and for all.
It was almost exactly a year ago that the National Audit Office revealed that companies with the right political connections who wanted to supply the UK with personal protective equipment had been directed to a “high priority” channel, purely on the recommendation of a Government Minister, an MP, a Member of the House of Lords or a senior Government official.
Out of 78 contracts awarded to Scottish firms for PPE, 29 were new contracts for £100 million-worth of PPE going to companies that did not have any experience before. Those 29 companies in Scotland with no background in PPE got contracts worth £100 million in Scotland, so what is the difference between that and what happened in the UK? At least Randox had the experience in these things. I am a bit confused—sorry.
The difference, quite simply, is that we never fast-tracked our pals, we never operated a get- rich-quick scheme for our pals, and we did not stuff unelected second Chambers full of people who bankrolled our party.
The hon. Gentleman makes an important point, but what has to be remembered is that nobody is above scrutiny, and if there is nothing to hide they should have nothing to fear. This is all about scrutiny and shining a light where I fear a lot of Conservative Members do not want a light to be shone.
No, I will move on.
Once in that “high priority” channel, these companies were 10 times more likely to be successful than companies that did not have links to politicians and senior Government officials, and who were therefore, by definition, “low priority”. In and of itself, the existence of this “high priority” channel is quite remarkable, but the fact that, according to the National Audit Office, the companies referred through this route were considered by the cross-Government PPE team to be somehow more credible and therefore to be treated with more urgency makes this particularly sinister. It turns out that there were no written rules as to how the “high priority” channel should operate, meaning that those companies who had given political support and had access to hundreds of millions of pounds of public funds were not subject to the usual rules of procurement. They could bypass the essential paperwork that would usually be a prerequisite for safeguarding against misuse of public funds and did not even have to go through the anti-corruption checks. It seems, as I said, that it was little more than a get-rich-quick scheme for the Conservatives and their pals.
Unfortunately not; I thank the hon. Gentleman for highlighting it. I think it is something in the air in which we live, and it is a very important point.
What we are seeing now is crony capitalism at its worst. It stinks, and the closer we get to it, the more it reeks.
I have in the past called for a full and independent investigation into this scandal, and I repeat that call again this afternoon. I believe that the actions of the disgraced former Member for North Shropshire strengthen that case further. As the right hon. Member for Ashton-under-Lyne (Angela Rayner) said, very serious questions need to be answered. If they are not answered, the reputation of this Government, who seem to be stumbling from one crisis and scandal to another, will be further damaged, but so too will the reputation of this place, the people in it and politics generally. I understand that the Government are desperate for this to go away, but it will not go away until these incredibly serious issues are addressed. I suspect that the Government know that, and they understand that despite this place being full of large carpets, there probably is not one large enough for them to sweep this under. It will not go away and it must be addressed.
We know that between November 2016 and July 2018, Owen Paterson lobbied officials on behalf of Randox, which paid him £100,000 a year to act as its adviser. We also know that in March 2020, Randox Laboratories was awarded a no-bid Government contract worth £133 million. Despite being fast-tracked and essentially handed this multi-million-pound contract, it appears that Randox was not equipped to perform the task it had been given a shedload of public money to do. As The Times reported last week, just days after being given the contract, the company informed officials that they would struggle to carry out enough covid-19 tests without Government help, resulting in the Government sending the Army in to help. In an internal memo seen by The Times, a Government official wrote that the company was
“nervous about having sufficient systems”,
and that the Army was
“on way to Glasgow to pick up”
two machines urgently needed for testing.
I am delighted to follow the hon. Member for Amber Valley (Nigel Mills), because I think he has tried to play this whole situation with a degree of integrity. The problem for us all is that it simply is not obvious whether that level of integrity has been followed all the way through.
Corruption does matter. The Prime Minister was very interesting at Question Time today when he used the defence of telling the House—and, through the House, the country—that we should not be talking about corruption because that lets our nation down vis-à-vis the rest of the world. The Prime Minister is absolutely wrong: when there is a whiff of corruption, it is vital that we talk about it and vital that we are seen to be working to uncover it. That is the problem we face.
I have no confidence, this House has no confidence, and nor even do Government Members. Government Back Benchers are not here in any numbers. [Interruption.] Many Conservative Back Benchers were not in for the opening speeches—the Opposition Benches were full—because many of them are concerned about this whiff of corruption. [Interruption.] The hon. Member for Rother Valley (Alexander Stafford) may want to ask me to give way, rather than chuntering away from a sedentary position. I am sure what he was saying was very interesting, but it was inaudible and therefore irrelevant.
I am just surprised that the Opposition Benches are empty for an Opposition day debate when so many people claim that they want to discuss the issue. It is your debate. Perhaps you could explain where your Back Benchers are? I am intrigued because your side called it. Do they really care?
Order. Now that the hon. Gentleman has properly intervened and addressed the House not from a sedentary position, I can officially hear him, and I will just make it clear that he should not say “you”. The substance of what he says is not a matter for me, but he should not say “you”.
We have had quite a lot of that today, including during Prime Minister’s questions. Just do not do it. Let us try to keep to the rules.
If the hon. Gentleman is using that definition of corruption, does it apply to the £500 million-worth of contracts given out by the SNP Government in Scotland to companies without any competition? I am confused. On the one hand, the SNP Government in Scotland are giving out half a billion pounds-worth of contracts without any competition, but on the other hand the UK Government are doing something similar and that is corrupt. Either they are both corrupt or neither are corrupt—I am a bit confused.
I am eternally grateful to the hon. Gentleman for that contribution. He tried to make exactly the same point before and I think that this was pointed out to him. The key difference—the Minister herself said this—is that in a global pandemic steps need to be taken and everybody recognised that steps needed to be taken that are not necessarily in line with the normal process, but the UK Government employed a VIP lane open to Government Ministers and members of the Government party that was not open to anybody else. Contracts were handed out through personal contacts, WhatsApp exchanges and paid lobbyists for companies. That is the key fundamental difference here and I am so grateful that the hon. Gentleman gave me a chance to again highlight that point. [Interruption.] If he wants to try again, I am more than happy. [Interruption.] Okay.
It is very easy to get wrapped up in the day-to-day melodrama of this saga, but it is important to take a step back and look at the bigger picture. The real scandal is not that a couple of bad eggs broke the rules; it is that the system either consistently enables rule-breaking or completely lacks rules against this kind of behaviour. For instance, take the fact that the Government were completely within their constitutional rights to retro- spectively change the rules to let Owen Paterson off the hook. In what other system would that be acceptable? The system of government here works to enable corruption, not to constrain it, precisely because it gives the Government a blank check to make up the rules as they go along. The absence of a written constitution to constrain Governments means that this can keep happening over and over again, as it did in the ‘90s and ‘00s. If they do not like the rules that are currently there, they can just rip them up and put in new ones.
So the problem here is not bad eggs, it is the system. It is the fact that no UK Government can ever be accountable to anything but themselves. Parliamentary supremacy means that any Government can override past decisions. They can rewrite the rules to their own liking. It is no wonder that Brexiteers obsessed over it in 2016, because it is what has given them the green light to conduct themselves in the ways we are discussing today. The only thing that can ever constrain a Government is political pressure, which thankfully in this situation has worked, but that is an awfie shoogly peg to base your system of government on.
For that reason, this is not the first time that corruption has reared its ugly head in this place. Sadly, I doubt it will be the last time either. The very way that this Parliament is set up lends itself to allowing this to happen. If we do not change it, nothing will change it. I am under no illusion that this scandal will lead to some dramatic new system of government rising from the ashes like a phoenix—I cannot see it—but that is on the table in Scotland. Independence means we could have a written constitution that can guarantee in law that Governments are held accountable and transparency is guaranteed.
Openness and transparency benefits all of us in this place. It is in all of our interests to make sure that that is at the top of the agenda. Our constituents demand that and it should be our duty to make sure that they get that. Public servants should be here to represent their communities, not to line their pockets. Sadly, the lining of pockets has far too often recently been what has been on the table.
(3 years, 1 month ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
The hon. Lady is right to highlight that primary care and GP practices are often the front door for the vast majority of these people on the waiting lists, and I pay tribute to the hard work of GPs up and down the country over the past year and a half to two years. She will have seen the announcement a few weeks ago by my right hon. Friend the Secretary of State, in which he set out further support that would be made available to help GP practices.
Our GPs have done an amazing job across the country, but especially in Rother Valley, whether that is the Dinnington Group Practice, Swallownest Health Centre or the Stag Medical Centre. I note that there has been a 35% increase in the amount of junior doctors wanting to become GPs. Can we make sure that some of those new GPs and new applicants are in Rother Valley?
We should make sure that general practice is an attractive career for newly qualified doctors wherever they are in the country. I suspect it will be for those individuals joining the profession to determine where they wish to practise, but I suspect my hon. Friend will do a very good job of explaining to them the joys of working in Rother Valley.
(3 years, 1 month ago)
Commons ChamberI reassure my hon. Friend that many checks and balances will be put into the app and the scheme to make sure that they are used appropriately and effectively and that we get some good outcomes from them.
Can my hon. Friend reassure the House that we will look at best value for money with the scheme to ensure that we are saving money for the NHS? The last thing that any of us want to do is spend more money and not get financial rewards to protect our NHS and ensure that we have healthier lifestyles for everyone.
My hon. Friend makes a very good point. We are investing some money in the new pilot and we are confident that it will give us some outcomes that we can work on to take measures forward. If we can save a fraction of the £6 billion, it will be still be a huge saving for people’s health, but, obviously, we want to make sure that this is about saving money and saving lives.
(3 years, 5 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Actually what the hon. Member has just read out is completely untrue, completely misleading and does not reflect for a moment what has happened. I am very disappointed to hear her read it out.
Rotherham Council is benefiting from the £120 million that this Government are making available to councils to boost staffing levels, which helps residents across Rother Valley to receive the best quality care. Does my hon. Friend agree that, as we begin to work to build a world-class care system, ensuring care homes have the staff they need is a vital first step?
My hon. Friend is absolutely right. At the heart of care is the workforce. They are the individuals who are providing the care and who make the difference day in, day out for those who need their important care. Absolutely, I want to make sure that we have the workforce across social care. We need to ensure we have the training there and greater career progression opportunities for those who work in social care.