(2 days ago)
Commons ChamberI thank my hon. Friend for highlighting this crucial issue. The majority of the more than 70 HRT products are in good supply, but we are aware of shortages affecting certain estradiol patches, and we are engaging with suppliers to expedite deliveries wherever we can. We have issued guidance to healthcare professionals under the serious shortage protocols methodology to enable community pharmacists to supply alternatives where appropriate. Furthermore, we are committed to funding research into women’s health, and we have invested approximately £5 million through the National Institute for Health and Care Research scheme into menopause research, including studies for new treatments to improve outcomes for women experiencing the menopause.
It is being reported in the press this week that women are being exploited by a menopause “gold rush”, enabled by tech giants such as Instagram. What steps can be taken to ensure that women have access to the very best of information and that misinformation on the internet is brought under control?
I thank the hon. Lady for highlighting this issue. The best way to do that is to beef up NHS digital services, as we are doing to the NHS digital app, so that women and all patients can have confidence in the advice that they receive.
(1 week ago)
Commons ChamberI wholeheartedly welcome the Government’s announcement this morning, in anticipation of this afternoon’s debate, of £80 million of support for children’s hospices over three years. I thank the Minister for listening to the calls of the children’s hospice sector and the Liberal Democrats.
The three-year settlement will enable hospices to plan and deliver services over a longer period. Above all, it will ensure that seriously ill children and their families can continue to access hospice care. However, providers tell me that this level of funding does not solve the children’s hospice funding crisis, nor does it put children’s hospices on a genuinely long-term, sustainable financial footing. Bluntly, this funding will only slow the rate at which children’s hospice services are being cut.
Across the south-east—indeed, across the whole of England—children’s hospices support thousands of seriously ill babies, children and young people, and the families who love and care for them. One such organisation is Shooting Star Children’s Hospices. A parent recent said:
“Without the support of the team at Shooting Star I believe our family would be under enormous strain and feel unable to know where to turn.”
They are places of compassion, expert medical care and human dignity. They provide everything from end-of-life care to vital symptom management and psychological support, but our children’s hospices are in crisis. Unless urgent action is taken, many may disappear.
Since 2019, the number of children and young people needing end-of-life care has doubled. The demand for symptom management has surged by 108%. Hospices are having to provide more care and support than ever before, yet they are struggling to keep their doors open. At the same time, inflation and rising costs, particularly in recruiting and retaining highly skilled staff, has driven hospice expenditure up by an average of 15% in the past year alone.
The Government’s disastrous national insurance hike has only exacerbated the existing pressures. For example, Southern Hospice Group is a local charity made up of three Sussex hospices: Chestnut Tree House children’s hospice near Arundel, Martlets in Hove and St Barnabas House in Worthing. The national insurance rise has collectively cost them £500,000. Yes, the Government have increased funding in cash terms, but it is simply not enough. Local NHS funding from integrated care boards remains 18% lower than it was three years ago, even as hospices stretch to meet rising demand. Children’s hospices are now dipping into their reserves to stay open. In 2024-25, 59% of them ended the year in deficit. In 2025-26, that figure is expected to rise to a staggering 91%. This is clearly not sustainable.
Meanwhile, a postcode lottery in funding continues. Recent freedom of information requests conducted by the charity Together for Short Lives showed that some integrated care boards in London spent over £400 per child needing palliative care, while others spent less than £25. We see that too in the south-east: one ICB spent over £260 per child, while another spent just over £100. Only 32% of ICBs could even say how many children accessed hospice care in their region. This gap in data must be filled.
The announcement this morning suggested that funding being distributed via ICBs would tackle the postcode lottery issue, but the results of these FOI requests suggest that there is an awfully long way to go. How will the Minister ensure that ICBs commission children’s hospice services equitably? What guidance will they be given to ensure that these vast variations in support are eliminated?
If I can emphasise one thing, it is that people are the beating heart of the hospice movement. Highly qualified specialists, passionate volunteers and generous donors all make the seemingly impossible happen, but the work- force is in crisis. Incredibly, there are only 24 full-time equivalent paediatric palliative medicine specialists serving the entire UK, when we know the need is for at least 40 to 60. If we followed the guidelines of the Royal College of Nursing, we would have nearly 5,000 community children’s nurses; right now, we have under 1,000. The professionals who care for our sickest children are being stretched to breaking point.
I urge the Minister and the Government to build on today’s announcement by first fixing the broken commissioning system. We must instruct NHS England and the Department to model what each local NHS body should be spending on palliative care and to hold them accountable. We must commission services at regional and national levels, where appropriate, to create economies of scale, and we must use the new pan-ICB commissioning offices to ensure consistent and equitable access to care across England.
Secondly, we must tackle workforce shortages and invest an additional £2.4 million per year in GRID and SPIN training for paediatric palliative medicine. We must fund and implement safe staffing ratios for nurses and aim to employ the 4,960 community nurses that England truly needs.
I congratulate my hon. Friend on securing this debate. An amazing children’s hospice that serves constituents in my patch is Demelza, which has an amazing array of staff, volunteers and the rest, including Queen’s nurses such as Donna Mole. Will my hon. Friend congratulate Donna on being a recipient of that award? Will she also congratulate the fabulous Fia, one of the children served by the hospice, on a book that she has written, and will she encourage the Minister to order a copy?
I thank my hon. Friend for celebrating the work of Queen’s nurses and fabulous Fia for what she has done in writing a book—I am not sure that I could do that. It is truly impressive, and I am happy to encourage the Minister to buy the book; it sounds like I had better buy it too.
This is about real children like fabulous Fia. It is about real families and real suffering that could be eased. Children’s hospices provide £3.32 of care for every £1 invested by the state, which is extraordinary value, so they deserve more support. These children deserve dignity, comfort and skilled care, and their families deserve the support that only children’s hospices can offer.
My hon. Friend has brought forward a critical debate on children’s hospices. While we are looking at children’s hospices, let me say that this issue is also critical for adult hospices. In South Cambridgeshire, we have the fabulous Arthur Rank hospice, which at the moment is looking toward the cutting of its adult hospice beds. The outcry from constituents and members is huge. Does my hon. Friend agree that the ICBs could look at strategic commissioning of that care across both adult and children’s hospice beds?
I thank my hon. Friend for the campaigning she is doing with her colleagues on Arthur Rank hospice in Cambridgeshire, and she is right. When I went to visit Chestnut Tree House in Sussex last week, I saw that it is talking to adult hospices in the area about where that more strategic view can happen.
These children deserve dignity, comfort and skilled care, and their families deserve the support that only children’s hospices can offer. Will this Government truly support the vision laid out in the NHS 10-year plan in which neighbourhood health centres, hospitals and hospices work together to deliver high-quality end-of-life care in the community, or will we continue to let these vital services be ignored, underfunded and unconnected? There is an opportunity for more action than that in this morning’s announcement and for a longer-term commitment. I urge the Minister to do what is necessary and right and ensure that no child is left without the care and dignity that they deserve.
I thank the hon. Member for Mid Sussex (Alison Bennett) for securing this vital debate. I also thank all those who work or volunteer in the palliative care and end-of-life care sector for their care and support—the compassion that they provide to patients, families and loved ones when they need it most.
This Government want a society in which every child receives high-quality, compassionate care from diagnosis through to the end of life, irrespective of condition or geographical location. In England, integrated care boards are responsible for the commissioning of palliative care and end-of-life care services to meet the needs of their local populations. To support ICBs in that duty, NHS England has published statutory guidance and service specifications. It has also developed a palliative care and end-of-life care dashboard, which brings together all relevant local data in one place. That dashboard helps commissioners to understand the palliative care and end-of-life care needs of their local population.
While the majority of palliative care and end-of-life care is provided by NHS staff and services, we recognise the vital part that voluntary sector organisations, including hospices, also play in providing support to people at the end of life and their loved ones. In recognition of this, we are supporting the hospice sector with a £100 million capital funding boost for eligible adult and children and young people’s hospices in England, to ensure they have the best physical environment for care. I am pleased that the first £25 million tranche of that funding, which Hospice UK kindly allocated and distributed to hospices throughout England, was fully spent by hospices on capital projects. An additional £75 million has been transferred to Hospice UK for onward allocation to individual hospices for use in the 2025-26 financial year, and I know that many hospices are already spending that funding this year.
Hospices in London and the south-east are receiving over £28 million of that £100 million capital funding. That includes over £4 million for children and young people’s hospices in London and the south-east. We are also providing £26 million in revenue funding to support children and young people’s hospices for 2025-26. This is a continuation of the funding that, until recently, was known as the children and young people’s hospice grant. Children and young people’s hospices in London and the south-east are receiving almost £8.5 million of that £26 million of revenue funding.
As confirmed in my written ministerial statement laid earlier today, I am delighted and proud to be in a position to announce that we will continue that centrally administered funding for the next three years of this spending review period. That includes the 2026-27 to 2028-29 financial years, as well as 2025-26. Each year, children and young people’s hospices in England will receive at least £26 million—adjusted for inflation—from NHS England via their local ICBs. This amounts to at least £78 million over the next three years to support hospice care for children and young people, mirroring current and previous years’ transaction arrangements. By doing this, we are promoting a more consistent national approach and supporting commissioners to prioritise the palliative care and end-of-life care needs of their local population. Further details on the delivery of this funding will follow in due course.
This Government’s commitment to provide that much-needed funding until the end of the spending review period recognises that the ability to plan for the long term is vital to our children and young people’s hospices. I am proud that this Government have removed the cliff edge of annual funding cycles, so that our children and young people’s hospices will now be able to operate on the basis of far greater certainty and stability.
I agree that increasing the time period covered by this grant to children’s hospices to three years will really help. Can the Minister comment on whether there are plans to do the same for the adult hospice sector?
The hon. Lady will know that children’s hospices are in a different situation from adult hospices: there has always been a centralised grant for children’s hospices, whereas the funding for adult hospices goes through ICBs and is part of the broader budgeting and commissioning process. Clearly, we will need to set an overall financial framework for adult hospices. We are currently going through the final stages of negotiations, both with the Treasury and within the Department of Health and Social Care, to finalise the financial envelopes and allocations for each part of my portfolio and the portfolios of my ministerial colleagues.
Although the investment is important, there are big opportunities around reform. A lot more needs to be done around the early identification of people in need of palliative care and people reaching the end of life. The interface between hospitals, hospices and primary care is nowhere near where it needs to be. A big part of our neighbourhood health strategy will therefore be about how we ensure that hospices have a strong voice at the table in the holistic integrated planning that is such an important part of the journey. The hon. Lady made some powerful points about that in her speech, and we are looking at the issue as we speak. I am meeting officials to determine how to reform the system. It is not just about the money, but about how the system works. We think that there is huge room for improvement.
I was truly inspired to visit Noah’s Ark children’s hospice in Barnet yesterday to understand the key issues that it is facing and see how our three-year funding commitment will support it to continue delivering essential palliative care and end-of-life care services to children and young people in its community. When I chatted to the chief executive yesterday, it was very clear how pleased she is to have some stability and certainty in planning the staffing and the services provided at Noah’s Ark. It is a wonderful place; I pay tribute to everybody who works there, and to the families.
We recognise the challenges facing the palliative care and end-of-life care sector, particularly hospices. The Department and NHS England are looking at how to improve the access, quality and sustainability of all-age palliative care and end-of-life care, in line with our 10-year health plan. The Government and the NHS will closely monitor the shift towards strategic commissioning of palliative care and end-of-life care services to ensure that services reduce variation in access and quality, although some variation may be appropriate to reflect both innovation and the needs of local populations. Officials will present further proposals to me over the coming months, outlining the drivers and incentives that are required in palliative care and end-of-life care to enable the shift from hospital to community, including as part of neighbourhood health teams.
Furthermore, through the National Institute for Health and Care Research, the Department is investing £3 million in a policy research unit in palliative and end-of-life care. The unit launched in January 2024 and is building the evidence base on palliative care and end-of-life care, with a specific focus on inequalities and on ironing out the regional variations to which the hon. Lady rightly pointed.
I hope that those measures and our plans reassure hon. Members of this Government’s rock-solid commitment to building a sustainable palliative care and end-of-life care sector for the long term. Alongside key partners, NHS England and others will continue to engage proactively with our stakeholders, including the voluntary sector and independent hospices, to understand the issues that they face. We will continue working with NHS England in supporting ICBs to effectively commission the palliative care and end-of-life care needed by their local populations. I reiterate my thanks to the hon. Member for Mid Sussex for bringing this vital issue to the House, as well as to all hon. Members who have intervened in the debate and are passionately committed to it on behalf of their constituents.
Question put and agreed to.
(1 week, 2 days ago)
Commons ChamberThe code of practice will be statutory. It is better to have these provisions in the code, because clinical practice evolves, and it is much easier to revise a code of practice than to go through primary legislation.
We understand the concerns expressed about young carers in new clauses 26 and 27, and recognise that despite existing duties, the right questions are not always being asked to identify children when someone is detained. While we do not agree that additional legal duties are needed, especially as multi-agency working is already being strengthened through the Children’s Wellbeing and Schools Bill, we do agree that we need to make the requirements more explicit. The revised code of practice will therefore specify that when someone is detained, steps must be taken to identify the children of the patient. Information about support that is available must be shared, and if a young carer’s needs assessment is required, the appropriate referral must be made.
I am really struggling for time. I am sorry, but I cannot take any more interventions, because it is not fair to Members who have tabled amendments.
Amendments 41 and 42 would prevent children with competence from choosing a step-parent or kinship carer as their nominated person if that is the most appropriate person for them. A nominated person can be overruled or displaced if acting against the child’s best interests. Parents will always maintain their rights under the parental responsibility.
Many amendments concern statutory care and treatment reviews designed to help to ensure that people with a learning disability and autistic people receive the right care and treatment while detained and barriers to discharge are overcome. Reviews will happen within 28 days of detention, and at least once a year during detention. This can be more frequent, depending on needs. Patients’ families and advocates can request a review meeting at any point. In respect of new clause 32, we have consulted on making some restrictive practices, including long-term segregation, notifiable to the Care Quality Commission within 72 hours.
Let me now deal with amendments 14 and 26 and new clauses 31 and 37. I acknowledge the importance of having a clear plan to resource community provision for people with a learning disability and autistic people to implement these reforms. We have committed ourselves to an annual written ministerial statement on implementation of the Bill post Royal Assent. Following conversations with my hon. Friend the Member for Thurrock (Jen Craft), we will work with stakeholders, including people with lived experience, to shape our road map for commencing changes to clause 3. The written ministerial statements will give updates on progress, as well as setting out future plans. It is not possible at this stage for us to commit ourselves to the specifics of implementation and community support, which depend on the final legislation passed, future spending reviews, and engagement with stakeholders to get implementation planning right.
As for the concerns raised by my hon. Friend the Member for Shipley (Anna Dixon) about the detention criteria in the Bill, it is vital that the work “likelihood” is included in those criteria to set clear expectations of what clinicians need to consider. However, we are clear about the fact that our intention is not to set a threshold for detention. Under the new criteria, a harm does not have to be likely to justify detention. The criteria require likelihood to be considered holistically, alongside the change, nature and degree of the harm.
I know that the shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans) is keen for me to deal with the question of public safety. The key point is that there are detention criteria in clause 5, which makes a clear reference to harm either to the patient or to other persons. That is clearly a consideration of public safety, and we therefore believe that amendment 40 is surplus to requirements.
I trust that, on the basis of the assurances I have given, Members will be content not to press their amendments and new clauses.
(1 week, 3 days ago)
Commons ChamberThe hon. Members for Rossendale and Darwen (Andy MacNae) and for Sherwood Forest (Michelle Welsh) and the right hon. Member for Godalming and Ash (Sir Jeremy Hunt) must be thanked, not just for securing this debate to mark Baby Loss Awareness Week, but for their tireless advocacy to improve maternity services across the United Kingdom—work that they have been carrying out for many years.
The pain of baby loss is multifaceted. It involves not only the unimaginable grief that accompanies losing a baby, but the emotional and psychological suffering that comes with facing the prospect of a life without your child—a future completely different from the one you had hoped for. Losing a baby can be loud, fast and chaotic, but it can also happen quietly—almost unnoticeably. Some parents arrive home from the hospital to a wardrobe full of baby clothes and piles of newborn toys, but an empty cot. Other expectant mothers may wake up in the morning excited to be another day closer to their baby’s arrival, only to find out that it was not meant to be.
Half of adults in the UK said that they or someone they know had experienced pregnancy or baby loss. According to Sands, every day in the UK 13 babies die shortly before, during or soon after birth. These families, as we have heard tonight, have to try to pick up the pieces, maintain their relationships, work and continue with daily commitments, all while tackling the emotional and often physical trauma of their experiences. They often walk that path alone, feeling like there is nobody they can speak to about their indescribable grief, or that they should not speak about it, as though they themselves have somehow failed. That is not the case, and no woman should have to suffer in silence.
In the case of my constituents, Hannah and Simon, not only did they have to come to terms with the fact that they would not be taking their baby boy, Austin, home from the hospital, but they had to face the reality that this tragedy was avoidable and that their baby would have survived, had the trust recognised and responded to concerns identified in the foetal and maternal monitoring. Hannah and Simon are not the only ones. Connecting with other parents in Sussex resulted in them hearing stories from other families whose experiences were concerningly similar to their own.
Between 2019 and 2023, the University Hospitals Sussex NHS Foundation Trust paid £58 million in compensation for 60 medical negligence claims related to maternity and obstetric care. That is the second-highest amount of compensation and the third-highest number of claims across all NHS trusts in England. That, and Hannah and Simon’s story, points to a larger systemic problem at the heart of maternity care. It was clear then, as it is now, that successive Governments have been asleep at the wheel on maternity care, and it is the families at the heart of it who pay the price—families such as Hannah and Simon’s. Their baby Austin would have been starting school next year if things had been different, and their daughter, just three when her little brother died,
“should not have to continually ask us why her friends got to bring their siblings home, and she had to say goodbye instead.”
That family, like too many across the country, deserved better. Now, they themselves are calling for change so that no one else misses out on a lifetime of memories with their child as a result of avoidable mistakes.
As part of her inquiry into maternity care, Donna Ockenden provided a blueprint—a starting point from which we could put an end to this scandal, make maternity care fit for purpose and put an end to these unnecessary deaths. However, not only have the nationally applicable, immediate and essential actions of the Ockenden report not all been implemented, but the Government have dropped the requirement for every ICB to have a women’s health hub, and they have announced cuts to the national service development funding for maternity services from £95 million in 2024-25 to just £2 million the following year.
Is it any wonder, therefore, that the UK is underperforming compared with other OECD countries on infant and newborn mortality, or that, according to a Care Quality Commission report in September 2024, 65% of units are not safe for women to give birth in? We want our country to become the safest place in the world to have a baby, but that can only be achieved if accountability is taken for these failings, lessons are learned, and concrete steps are taken by the Government to put an end to this national scandal.
We have heard from a number of Members this evening about the impacts of deprivation and ethnicity on outcomes for maternity and for babies. The colour of someone’s skin, their bank balance or where they live should not be deciding factors in whether they and their baby live or die. Quite simply, maternity care should not be a lottery.
I very much welcome the Secretary of State’s presence this evening, and I endorse the comments made by the right hon. Member for Melton and Syston (Edward Argar) and my hon. Friends the Members for Horsham (John Milne) and for Chichester (Jess Brown-Fuller), who said that families who have lost babies through medical negligence need to be taken with the Government on this journey towards reviews. I think that the Sussex families would be furious with me this evening if I did not say to the Secretary of State that they are not happy with the way in which the reviews announced in July are going so far, so I urge him to do everything in his power to listen to the families and take them on that journey together.
Let me pose a question to the Secretary of State on behalf of Hannah and Simon. These Sussex families have waited over a year for the Government to appoint Donna Ockenden, the one person with a proven record of exposing failings and driving improvement. Thus far, their patience has been repaid with delay, confusion and avoidance. When will the Government act to stop these preventable deaths by appointing Donna Ockenden to lead the Sussex review, and by confronting what has become a national shame for our country’s children with a full public inquiry?
My hon. Friend the Member for Carshalton and Wallington (Bobby Dean) spoke movingly about his and his wife’s experience of miscarriage, and I endorse his call for mental health support following every miscarriage, not just after three.
Order. I am sure that the hon. Lady will want to conclude her remarks very quickly.
The theme of this year’s Baby Loss Awareness Week is “Together, we care”, and we do care. We care about all kinds of baby loss, and we care about babies like Austin. Hannah told me:
“We lost an entire lifetime. Our son never had the chance to grow up, to take his first steps, to speak his first words, to make friends”—
Order. The hon. Lady must have misunderstood what I meant by “quickly”.
(3 months, 1 week ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
It is a pleasure to serve under your chairmanship, Sir Edward. I am grateful to my hon. Friend the Member for Bournemouth West (Jessica Toale) for securing this debate and raising this extremely important topic. We know that, sadly, autistic people are at the wrong end of statistics on a range of mental health conditions: 70% to 80% of autistic people will experience mental health problems during their lives, and tragically many are more likely to die by suicide.
We have heard the devastating impact that can have on individuals and families. I pass my heartfelt condolences to my hon. Friend’s constituent, Ms Bridges, on the loss of her daughter. My hon. Friend spoke of the campaign for Lolly’s law, and I commend her for her tireless work to ensure that autistic people get the mental health support and treatment they deserve. As my hon. Friend said, that is exhausting, and too many parents are forced into campaigning roles. As she rightly said, Lauren should still be here.
It is clear that the number of autistic people and those with a learning disability who are in mental health hospitals is unacceptable. There are still too many people being detained who could be supported to live well in their communities. We want to ensure that people get the support they need in the community, improving care and keeping people out of hospital. The Mental Health Bill, currently before Parliament, would limit the scope to detain autistic people and those with a learning disability, so that they can be detained under part 2 section 3 only if they have a co-occurring mental disorder that requires hospital treatment.
The Bill would also introduce a package of measures to improve community support for autistic people and those with a learning disability. It is also critical, however, that when autistic people do need to be admitted to mental health in-patient settings, due to a co-occurring mental health condition, they receive the right care and support.
My constituent, Annabel, who is a teenager, has parallel experiences to Lolly, as set out by the hon. Member for Bournemouth West (Jessica Toale). She also had a terrible experience being detained in a secure unit, which her parents did not think was safe. Does the Minister agree that when teenagers—children—are detained in secure units, more needs to be done to ensure that they are safe and fit for purpose to protect those children’s welfare?
The hon. Lady raises another terrible case concerning a teenager on behalf of her constituent. We must of course be mindful of that provision for children and young people. My hon. Friend the Member for Bournemouth West spoke of her constituent’s campaign to retrain mental health staff, to improve understanding and acceptance of autistic women and girls. As we have heard, we know there can be differences in how autism presents in males and females, which can make autism harder to identify in girls.
(3 months, 1 week ago)
Commons ChamberI would like to begin by paying tribute to a wonderful charity based in Mid Sussex called Group B Strep Support. Ever since its founder, Jane, lost her own baby, Theo, 30 years ago, Jane and the team have been campaigning for better outcomes for pregnant women who contract group B strep, because the impact on their babies can be profound; it is the most common cause of life-threatening infection for newborn babies. I open by asking the Minister whether she will meet the team from Group B Strep Support so she can better understand the potential of better screening of pregnant mothers.
As a mother myself, I do not take for granted the health of my children. All of us who are parents know that the health of our children can turn on a sixpence. We also know that the system that surrounds children and families and keeps children healthy has been allowed to crumble. As hon. Members have said, we are in the middle of a children’s health crisis in this country. This week, the Children’s Commissioner produced a damning report on the health of children across the country. The review told us that children in England are facing “Dickensian levels” of poverty, and are going without basic needs like heating, a place to wash, somewhere to eat breakfast or safe transport to school. Hon. Members use the word “unacceptable” a lot in this place and it may be overused, but in this case it is very true. We should be ashamed that children are facing this reality in 2025.
Our young people, who should expect to grow up to be part of a prosperous, happy and successful nation in the coming years, are being let down. Under the Conservatives, things got worse and worse. On their watch, in the period from 2022 to 2024 alone, the number of children waiting for over 52 weeks for an appointment increased by 60% for elective paediatric services and by 94% for community health services. However, this situation is not inevitable. The UK has world-leading researchers, passionate healthcare workers and a proud tradition of protecting public health. Britain’s children should be among the healthiest in the world. We are a wealthy country with a welfare state and universal healthcare.
However, we lag behind our peers. One in 11 children lives with asthma, and our country has one of the highest emergency admission rates for school-age asthma in Europe; it is avoidable, yet it is still happening. The number of children living with life-limiting conditions has risen by 250% in less than two decades. Some 2.5 million children in England are living with obesity, as other hon. Members have mentioned this afternoon, and over 1 million of them already have health complications. Almost one in five children now struggle with their mental health, which is a 50% increase in just five years.
However, children are waiting longer than ever to be seen. Since 2020, paediatric waiting lists have grown by over 166,000 children, but the number of consultants has barely budged, with over 50,000 children now waiting for more than a year to be seen. The Conservatives let those problems pile up; now the Labour Government cannot afford inaction.
The Liberal Democrats believe that every child deserves the best start in life, no matter their background, postcode or parents’ income. We also think that it benefits us all to have happy and healthy children growing up across the country. We would start by fixing the NHS from top to bottom, which means ensuring that everyone can see a GP within seven days, or 24 hours if it is urgent. I welcome the announcement in the NHS 10-year plan that same-day appointments will become available where necessary. My colleagues and I will push the Government to ensure that that pledge becomes a reality.
Fixing the NHS also means ending the scandal of children turning up to hospital with a mouth full of rotting teeth because there is no dentistry nearby. It means rebuilding the primary care and community services that have been starved of funding for over a decade. I know from conversations with my constituents in Mid Sussex that those problems are very real, and with them happening in what is a relatively well-off part of the country, it is clear that they are systemic.
However, it is not just about treating illness; we have to be determined to prevent it. That is why we would reverse the Conservative cuts to public health and invest in programmes that get children moving, eating well and thriving. We would tackle the poverty that drives so many health issues by ending the cruel two-child limit and reversing the benefits cap. We would expand free school meals to all children in poverty and work towards universal free meals in primary schools. We were glad to see the Government listen to Liberal Democrat calls for an expansion of free school meals, and are campaigning for that to go even further, because no child should go hungry at school—ever.
When it comes to mental health, we would transform the system from the ground up. That means having mental health hubs for young people in every community, regular check-ups at key points in life, a dedicated mental health professional in every school and a proper cross-Government strategy to understand and tackle the root causes, from bereavement to bullying and social media pressure. Children’s mental health is not just a health issue; it is an education issue, a family issue and a justice issue. It needs more than one Department and more than one Minister.
My Liberal Democrat colleagues have led the fight for early intervention, for holistic support and for real accountability. We have championed ideas such as a register of bereaved children, because how can we help if we do not even know who needs support? I ask the Minister to therefore commit to implementing such a register.
We face a real challenge, but we have the ideas, the evidence and the plan. Now someone has to get on and deliver the change that children across the UK so desperately need, so I urge the Government to take action. Let us build a country where no child is left behind and where every child and parent has, at the very least, the opportunity to be healthy and to look to the future with confidence.
(3 months, 1 week ago)
Commons ChamberI call the Liberal Democrat spokesperson.
People across the country, and NHS patients in particular, will be disappointed to hear of yet more strike action by resident doctors this July, especially after the immense disruption of recent years. I and my Liberal Democrat colleagues fully recognise that this dispute does not come out of nowhere. The previous conservative Government left our NHS under unbearable strain, with doctors working under intense pressure in crumbling hospitals and often without the resources they needed. My constituents, and people across the country, need and deserve a well-functioning NHS.
Over the past three years, doctors have received a 28.9% pay rise following earlier strikes. The BMA is now calling for a further 29% increase, but we have to be honest: after years of economic mismanagement by the Conservatives, the public finances are in a dire state. That kind of increase does not feel affordable or realistic right now. That said, we cannot ignore the reality of working conditions in our NHS. Doctors are expected to save lives in collapsing wards and to deliver care in corridors, rather than in safe clinical settings. It is degrading and dangerous for both staff and patients. We need constructive dialogue, not escalation, to resolve this dispute swiftly and fairly, and most importantly, we need urgent action to rebuild our NHS and restore working conditions that our doctors and patients can be proud of.
First, will the Secretary of State improve staff morale by committing to end the dangerous and dehumanising practice of corridor care? Secondly, does he not see that by dragging out social care reform, delayed discharges and corridor care are only going to worsen doctors’ experiences of working in the NHS, weakening morale and lowering care standards?
I am grateful to the Liberal Democrat spokesperson, and I think I can reassure her on a number of fronts. First, she is absolutely right to call out the disgrace that is corridor care. Despite the best efforts of staff, who suffer the moral injury of treating patients in that situation, in too many parts of the NHS we have patients being treated on trolleys in corridors. In this decade of the 21st century, I think that is unacceptable, as is the emerging nomenclature that has started to describe these as “temporary escalation spaces”, because we are in danger of normalising what should be considered unacceptable practice. That is why this Government will shortly begin transparently publishing corridor care data showing the number of patients being treated on trolleys in corridors. I am sure there will be moments when that might cause Ministers and NHS leaders to blush, but frankly, until corridor care is consigned to history, so we should. Sunlight is the best disinfectant, and by publishing the data we will hold ourselves to account, and I am sure this House will hold us to account to ensure that we deliver the conditions that staff and patients deserve.
I also reassure the hon. Member that, while the Casey commission is under way, work on social care goes on, whether that is the £4 billion increase in investment in social care through the decisions taken by my right hon. Friend the Chancellor, or other improvements such as to carer’s allowance, the disabled facilities grant and uplifts in funding for local authorities. However, I am also committed to ensuring that, as we improve the flow of patients through our hospitals and deal with the scourge of delayed discharges, we are a lot better at thinking about how we use the taxpayer pound to best effect to deliver the right care, in the right place and at the right time. That will often mean using NHS resources to commission social care to help tackle delayed discharges, and we will be keeping a close eye on that.
Finally, I thank the hon. Member for joining the voices of reason in this Chamber. I hope it is not lost on the BMA and resident doctors watching that this is not a case of an intransigent Government unwilling to work with and support them who are trying to face down, for political and ideological purposes, a trade union speaking up for its members. This Labour Government have delivered a 28.9% pay increase and we are willing to work further to improve conditions for resident doctors. That work can start now, and I am ready to meet the BMA immediately.
There are other voices of reason in this Chamber, including among the Liberal Democrats, who recognise the pressure on the public finances. They recognise that we are trying to do many things across the NHS that will also directly benefit resident doctors, such as making sure they have the right kit and are working in decent buildings. We are improving the conditions that they are working in and that patients are treated in so that, together, we are building in, working in and being treated in an improving NHS. That is the prize, and that prize is being thrown into jeopardy by the resident doctors’ actions. If they go down this path, with all of the consequences that will follow, I am afraid—for them, let alone for the NHS and for the country—things will get worse rather than better, and I urge them not to take that course of action.
(3 months, 4 weeks ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
It is very much appreciated that you have come to chair this important debate, Ms Butler, and I thank the hon. Member for Liverpool Walton (Dan Carden) for securing it. As the hon. Member for Strangford (Jim Shannon) just said, the number of people in this debate is not a reflection of its importance. All hon. Members who have contributed have spoken with real moral authority and have reflected the gravity of what we are talking about: the rights of some of the most vulnerable people in our society—those living in care homes, hospitals and hospices—and their right to maintain contact with and see their loved ones.
Throughout the covid-19 pandemic, thousands of people living in care settings in my constituency and across the country were forbidden from seeing those closest to them. That was especially devastating for residents living with conditions such as dementia or severe memory loss, which affect approximately 70% of care home residents. For those individuals, familiar faces are more than just comforting; they are essential to their sense of identity and stability. Let us imagine being cut off from the people we know best, who can calm us in moments of confusion, and who understand our needs in ways that no staff member possibly can. This is not an abstract issue but a painful reality that caused immeasurable harm during the pandemic.
Even as the rest of the country began to reopen in 2022, care homes continued to impose harsh restrictions. Data shows that between April and September 2022, 10% of care homes permitted no visitors at all during covid outbreaks, 20% confined residents to their rooms for up to 28 days and nearly half maintained some form of visiting restrictions even without any outbreak present. The impact of those policies was brutal. Vulnerable people in Mid Sussex and across the country were left isolated and confused, their symptoms worsening without the emotional and practical support that only loved ones can provide.
I want to share a story that will be distressing to some. Last week, I was horrified to watch a report on BBC South East about a 92-year-old gentleman, Donald Burgess, from East Sussex. Donald was a wheelchair user, having had one leg amputated, and on 21 June 2022, he was reportedly brandishing a knife in his wheelchair, having become irritable and confused. Care home staff failed to resolve the situation and so the police were called. Donald was sprayed with pepper spray, hit with a baton and tasered by police, all while still in his wheelchair. Donald was taken to hospital as a result of those injuries, and he subsequently caught and died from covid-19 a couple of weeks later.
On the BBC South East news report last week, Donald’s family were interviewed. Those family members only lived 10 minutes away from his care home. They said that if they had been called, they would have been able to go there and, potentially, calm him and resolve the entire situation. It is beyond tragic that that happened, and that it is how Donald’s life ended. If hon. Members present who are not from the south-east region are interested, the video and reports of the attack on Donald are available to view online.
I commend the tireless work of advocacy organisations such as the Relatives and Residents Association, Rights for Residents, Care Rights UK and John’s Campaign. Their efforts have been instrumental in raising awareness and pushing for change. I also commend the way that the hon. Member for Liverpool Walton set out the case for the required change.
The Government’s recent introduction of regulation 9A by the Care Quality Commission—a new fundamental standard on visiting and accompanying—is a welcome step forward. But while that regulation aims to ensure that care providers do not discourage visits, and that people can attend medical appointments accompanied by a family member or advocate, it falls short of what is needed. Regulation 9A relies on enforcement by the CQC, an organisation that is well understood to be stretched thin and facing a number of challenges. The CQC cannot prosecute providers for breaches of the regulation, and often lacks the resources for swift and consistent enforcement. Most importantly, the regulation does not create an enforceable right held by the individual resident. That gap leaves residents and their families vulnerable.
Without clear legal protections and a statutory right to visitation, we risk repeating the mistakes of the past. That is why my Liberal Democrat colleagues and I are calling on the Government to implement Gloria’s law without delay. Gloria’s law would enshrine in primary legislation the right for every person in a care or health setting to have at least one essential care supporter present, regardless of circumstances. As Rights for Residents says,
“only Gloria’s Law will guarantee that none of us will be forcibly separated from our loved ones again”.
I urge the Minister to answer the following important questions. First, does she believe that regulation 9A alone is sufficient to prevent isolation and ensure that residents can be supported in times of crisis or future public health emergencies? Secondly, are the Government confident that the CQC and the Department of Health and Social Care have the capacity, resources and real-time data systems to monitor visiting arrangements and act swiftly if restrictions become harmful? Thirdly, will the Government commit to going further by passing Gloria’s law, guaranteeing a statutory right to unrestricted in-person support from at least one essential care supporter?
The lessons of the pandemic are clear. Families are not visitors but vital partners in supporting those we love through their most vulnerable moments, so let us act now and give vulnerable people the rights they need and deserve. In doing so, perhaps we will save lives like Donald’s.
(4 months ago)
Commons ChamberMy hon. Friend is right to highlight that issue. I commend her great work not just on the APPG but on leading the Health and Social Care Committee on behalf of its Chair, the hon. Member for Oxford West and Abingdon (Layla Moran). She is right to highlight that it is a priority for the Government to diagnose cancers earlier and improve survival rates. That is particularly important for the group of people with rare cancers. The APPG’s report will inform the development of our national cancer plan, which will seek to include all aspects of care throughout the entirety of the cancer pathway.
Part of a successful cancer journey is swift cancer treatment as well as swift diagnosis. My constituent Catherine was diagnosed last year with stage 3 breast cancer. She had a mastectomy and went through chemotherapy. She was then meant to begin a course of radiotherapy in December, but as of May that still had not begun. What can the Department do to ensure that those unacceptable delays do not happen and lives can be saved?
Many hon. Members across the House rightly highlight the actual experience of people throughout the entire pathway. We have heard about the investment we are making in machines and in staff to ensure, on exactly this point, that people get not just that faster diagnosis—that is so important, particularly if cancer is ruled out—but faster care across the entire pathway. The majority of people on waiting lists are on them for diagnostics, which is exactly why we are investing more in capital and investing in staff to ensure that the process is quicker and better for patients. If the hon. Member wants to write to me about any particular issues, I will obviously respond to her.
(4 months, 1 week ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
It is a pleasure to serve under your chairship, Dr Huq. I thank my hon. Friend the Member for Torbay (Steve Darling) for bringing forward this important debate.
We have been reminded by hon. Members that the Conservative legacy is pensioners left in agony, waiting for hours for an ambulance that may not come in time; women forced to give birth in unsafe, overstretched conditions; and people having to pull out their own teeth—in the 21st century—because they cannot find an NHS dentist. We have heard from hon. Members that the south-west has some of the longest ambulance waits in the country, some of the worst repair backlogs, and waiting times for GPs and dentists that are simply unacceptable. That is not just a strain on our health services but a daily struggle for families, carers and patients across our region.
The Liberal Democrats believe that people deserve better, and that they should be in control of their own lives and health. That means people getting the care that they need, when they need it and where they need it, without them having to fight every step of the way. Instead of lurching from one crisis to the next, as previous Governments have done, we have a plan. It starts with early investment in community health—in GPs, pharmacists and dentists—so that fewer people end up in hospital to begin with. We will finally fix the crisis in social care, so that people are not left stuck in hospital beds with nowhere to go.
If we expect to rely on our NHS in future, we simply must invest in it. We need not just big grand schemes but investment in the simplest yet most important things. For example, in my own patch in Mid Sussex, the Princess Royal hospital recently had only one of its four lifts working over a weekend.
Does my hon. Friend agree that it is much more expensive to provide services in rural areas than in urban areas? An example is the pharmacy funding model, which relies on footfall. On a recent visit to Modbury pharmacy, staff told me that they are really struggling to stay afloat because they do not have enough footfall, and they cannot reach the national payment threshold that would enable them to survive. Does she agree that we need to look at rural exceptions for critical services such as community pharmacies?
My hon. Friend makes an excellent point about rurality, which is obviously a big issue in the south-west. It is also a serious issue in Sussex where we have things in common with the south-west, such as having an older than average population and all the challenges that come with that, as hon. Members have mentioned.
Hospitals want to be able to sort those issues out, but they are left juggling priorities, barely scraping by with the current levels of funding. Things do not work if we do not look after them, and if we do not look after our health system, it will not be able to look after us or our loved ones. Although I am sure that the Minister will make the point about capital investment in the NHS, which is welcome, the future looks very uncertain and precarious for our ICBs, as a number of hon. Members have said.
Soon after ICBs were first created, they had to cut their budgets by 30%. They have now been asked to cut their budgets by 50% on average. Indeed, for Sussex, the cut is more than 50%—it is 53%. It is no surprise that Sussex and Surrey have formally proposed merging their ICBs, which, by running at the same time as local government reorganisation and the creation of a mayoralty, means we will end up with an ICB that does not have the same footprint as the new incoming mayor.
What does my hon. Friend think about how ICB funding is weighted? I contend that the formula overemphasises the size of each ICB and the size of the registered population, but does not account sufficiently for age, given that older people require more funding spent on them.
My hon. Friend makes a really good point. It is vital that when we look at per head of population funding, we think about the different factors that actually drive up the true cost of delivering healthcare across the country, which obviously varies by region.
On ICBs, I will press the Minister on three points. First, on the timescale for cuts to be delivered by ICBs, they have to be completed by the end of 2025. The Sussex ICB had about three weeks to make that initial submission to the Department. Does the Minister think that those timescales are realistic and achievable? Secondly, what will the cost of the redundancies be for ICBs? Has that calculation been done? For Sussex, we are looking at more than half the workforce losing their jobs. Thirdly, what is the impact assessment for patients and the service that they will receive as a result of cuts to ICBs?
For too long, social care has been treated like the back door of our public services. It has been overlooked, underfunded and taken for granted. That must change. That is why we must once again ask for more urgency on social care reform. I believe that personal care should be free at the point of use, just like the NHS—