Healthcare: Hampshire
Andrew Gwynne Excerpts(1 day, 13 hours ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)
I congratulate the hon. Member for Winchester (Dr Chambers) on securing the debate, and echo his thanks to all health and social care staff who do incredible work in very difficult circumstances. We know that our NHS is broken. Whenever MPs from across the House come to me with issues affecting their constituencies, I repeat the same mantra: this Government will be honest about the issues facing our NHS, and serious about tackling them. Lord Darzi has already completed his review of the current state of the NHS, and his report laid bare the true scale of the challenges facing our health service.
We will not sugarcoat the problems faced by the health service in each and every part of the country, because colleagues from across the House are right to raise issues with me, and we will fix them together. We have already launched our national conversation on the future of the NHS, and we want patients, families and staff to join that conversation and make their voices heard. If Members have not already been to the website, the address is change.nhs.uk. Please let us have some sensible suggestions—not firing the Secretary of State out of a cannon.
In her spring Budget, the Chancellor of the Exchequer announced an extra £22.6 billion to protect NHS day-to-day spending. Every penny of that investment will come alongside vital health reforms; they are two sides of the same coin.
As the Secretary of State outlined last week, this Government intend to publish a league table of providers, allocating the best talent to the most challenging areas and ensuring that there are no rewards for failure. Where necessary, we will remove failing managers, and we will reward senior leaders who successfully improve performance.
Paul Holmes
On failing organisations, just before the general election a cross-party group of MPs, including Labour MPs, had a meeting with the then Secretary of State, my right hon. Friend the Member for Louth and Horncastle (Victoria Atkins), about the performance and management of Hampshire and Isle of Wight ICB. Members of Parliament from across the political divide have serious concerns about its leadership, communications and funding—not Government funding, and I welcome the increased funding, but the way that it is distributed to services in Hampshire. Frankly, I do not think the leadership is up to running that ICB. Will the Minister agree to meet me and other Members from across the House to discuss the urgency of the situation? Will he find out from his civil servants where the request for a two-week action plan went and come back to Hampshire MPs?
Andrew Gwynne
I am sure the officials in the Box will have noted the concerns the hon. Gentleman rightly raised about his ICB. I will ensure that that is communicated back to the Minister for Secondary Care, my hon. Friend the Member for Bristol South (Karin Smyth), so she can look in more detail at those concerns and communicate with the Hampshire MPs. If a meeting is necessary at the end of that, I am sure she will be more than willing to meet him and his colleagues.
We want to ensure that every part of our NHS is working as well as it can and, as I say, good performance will be rewarded as part of our reforms. Alongside a college of executive and clinical leadership, that will ensure the NHS continues to develop and attract the best talent to top positions, bringing the best outcomes for patients and taxpayers alike.
Let me turn to some of the specific issues that the hon. Member for Winchester raised. On local hospital provision, patients deserve to have safe, compassionate and personalised care in a fit-for-purpose environment. That is why this Government have committed to building and refurbishing hospitals across the country. The new hospital programme includes a new hospital for north and mid Hampshire and a major refurbishment at Winchester to provide specialist and emergency care. As part of the proposal, I am aware that the local trust explored changes to the current obstetrician-led maternity services at the Winchester site. I know the hon. Member has been a strong champion of that, having raised it with the Prime Minister in October.
As announced in the Chancellor’s autumn Budget, my right hon. Friend the Secretary of State will set out further details of the review of the new hospital programme in the coming months, alongside a new and realistic schedule for delivery. The Hampshire hospitals scheme is in scope of the review, and I acknowledge the local concern over the proposal and the impact on the Winchester site and on maternity services.
Damian Hinds (East Hampshire) (Con)
My constituents use both Winchester hospital and Basingstoke hospital, as well as others, such as Frimley Park, the Queen Alexandra and Guildford. I understand that a clinical assessment was made about urgent treatment and services at Winchester, but there is a need for a new hospital in or near Basingstoke. In what the Minister said about a review of the new hospital programme, I accept he says a statement is coming soon, but will he confirm that it is about timing and that he or a colleague will come forward to the House soon with the certainty that people in Hampshire need?
Andrew Gwynne
Absolutely. I will try to be as unpartisan as I can, but the hospital programme that we inherited from the right hon. Member’s Government did not have anything like the money it needed to back it up. Conservative Members can shake their heads, but it is true. It had nothing like the money needed to bring forward those hospitals. As I have said, we will review that. Our intention is to bring forward those schemes, but that has to be done in an achievable programme, with the finances to back it up. When we announce to the House how we will schedule the hospital programme, I expect that all the answers he wants will be there. We intend to introduce the hospital building programme, but it must be done with money—we cannot build them with fresh air.
Dr Chambers
any potential new hospital is decades away, while the hospital we have needs to be maintained and improved. The quickest way forward is to provide 160 new social care packages for Winchester hospital. Will the Minister meet me and the chief executive officer of Winchester hospital to work out how we can deliver those packages as quickly as possible, and provide good A&E, hospital and social care services for everyone in and around Winchester?
Andrew Gwynne
It is crucial that we have the best possible health and care services in place for today’s needs while we plan for the future. I understand the hon. Gentleman’s concerns, and I will ensure that they are communicated back to the Minister for Secondary Care, so that she can consider them. I will ask her to report back to him on that. Ultimately, all decisions are best made locally, so that they can cater to local interests, and are clinically led. This is no exception. I know that the hon. Gentleman’s trust will consider all feedback from the public consultation held earlier this year, including from those who will access the new facilities, as well as wider bodies of evidence. The result of the public consultation on location and services will be put to the local integrated care board, and we look forward to hearing the outcome of that.
Dr Chambers
I apologise for intervening again so soon. One of my main concerns about the public consultation is that the NHS had assessed sites in Winchester as suitable, but they were not then included in the consultation. The people of Winchester want to know why those suitable sites were not included in the consultation. Can the Minister assure me that that will be addressed by the ICB, and anyone else publishing the consultation?
Andrew Gwynne
As I said before the hon. Gentleman’s intervention, ultimately these are local decisions, and they must be clinically led. If the trust has decided that certain outcomes that he would like to see are out of scope of the consultation, we must take it as read that there are sound clinical reasons for that. If he thinks otherwise, I am sure that he can bring that up with my hon. Friend the Minister for Secondary Care, but ultimately we must be guided by the clinicians. They know, more than we Ministers in Whitehall will ever know, what the better outcomes for their areas are.
The hon. Gentleman mentioned primary and community care. We know that patients nationally and in Hampshire find it increasingly difficult to see a GP. We are committed as a Government to fixing the front door to the NHS, to ensure that patients receive the care that they deserve. If patients cannot get a GP appointment, they end up at accident and emergency, which is worse for them and more expensive for the taxpayer. That is why we will shift the focus of the NHS out of hospitals and into community. One of our three big shifts is from hospital to community; the others are from analogue to digital, and from sickness to prevention. Those three things, taken as a whole, could be quite transformative in how we deliver primary care.
Gregory Stafford
I agree entirely with the Minister on the shift from hospital to community. I do not want to labour the point that I made when I intervened on the hon. Member for Winchester (Dr Chambers), but in the Hampshire part of my seat, we have a debate about whether we will still have Chase community hospital or a new health hub there. They are both essentially local services. The ICB is dragging its feet and will not make a decision on which it will be. Local people do not know what will happen, and decisions are being kicked down the road by the ICB. As my hon. Friend the Member for Hamble Valley (Paul Holmes) said, the leadership of the Hampshire and Isle of Wight ICB is not fit for purpose. Will the Minister meet us and them to ensure that we can get this moving?
Andrew Gwynne
I hear loud and clear what Conservative Members say about the leadership of their ICB. I hope that the ICB management will obtain a copy of today’s Hansard and read not only those comments, but the Minister’s reply. I expect them to make decisions in a timely fashion, so that there is some certainty for the local population about the new make-up of health and care services in that area—not just for the sake of patients and the local population, but staff. As we redesign services and change towards more preventive, community-focused care, some parts may become obsolete, and it is absolutely crucial that we take the workforce, as well as the population, on that journey of change in services. I very much hope that the hon. Gentleman’s ICB leadership will have heard the message from the Minister at the Dispatch Box, which is that they really need to crack on, make a decision, communicate it and work with Members of Parliament, the public and staff on whichever changes they propose.
I return to primary and community care. As I said, our manifesto commits to moving towards a neighbourhood health service, with more care delivered in local communities, so that problems are spotted earlier. We will bring back the family doctor by incentivising GPs to see the same patient, so that ongoing or complex conditions are dealt with effectively. In doing so, we will improve continuity of care, which is associated with better health outcomes for patients, and our plan will guarantee a face-to-face appointment for all those who want one; we will deliver a modern booking system that will end the 8 am scramble. That is crucial in improving access to general practice.
The hon. Member for Winchester rightly raised the huge problems with dentistry in his area, which are not that uncommon across the whole country. I do not believe that the previous Government’s dentistry recovery plan went far enough; too many people were still struggling to find an NHS appointment. We are working to ensure that patients can start to access additional urgent dental appointments as soon as possible, and we will target the areas that need the most—the so-called dental deserts. Integrated care boards have started to advertise posts through the golden hello scheme. This recruitment incentive will see up to 240 dentists receive payments of £20,000 to work in the areas that need them most for three years. The common reason why children aged five to nine are admitted to hospital—this is absolutely shocking in the year 2024—is tooth decay. We will work with local authorities to introduce supervised toothbrushing for three to five-year-olds in the most deprived communities. These programmes are proven to reduce tooth decay and boost good practice at home.
To rebuild dentistry in the long term, we will reform the dental contract with the sector, with a shift to focusing on prevention and the retention of NHS dentists. To be fair, this has been an issue for all Governments, going back to the Labour Government who introduced the dental contract. They did so for the right reasons, but in 2010, we recognised that the dental contract was not working in the way we envisaged, and that it had to change. It is shocking that 14 years have passed since then with no real action having been taken—we are determined to fix that. At the same time, we will not wait to make improvements to the system to increase access and incentivise the workforce to deliver more NHS care. We are continuing to meet the British Dental Association and other representatives of the dental sector to discuss how we can best deliver our shared ambition of improving access for NHS dental patients.
I have to say that the statistics for Hampshire and Isle of Wight integrated care board make sorry reading. Only 36% of adults were seen by an NHS dentist in the 24 months to June 2024, compared with 40.3% across England, and 54% of children were seen by an NHS dentist in the 12 months to June 2024, compared with 56% across England. In 2023-24, there were 46 dentists for every 100,000 people in the hon. Gentleman’s trust, whereas the national average across all ICBs in the same year was just under 50 dentists, and in 2024, the general practice patient survey success rate for getting an NHS dental appointment in the past two years in the Hampshire and Isle of Wight ICB area was 72%, compared with 76% nationally. They are not great statistics nationwide, but they are certainly not brilliant in the ICB of hon. Members present, and we look for real improvements there.
Turning to the pharmacy sector, we want to take pressure off GPs by increasing the services offered in community pharmacies. There is so much more that our pharmacists could and should be doing to deliver basic healthcare services on the high street and in the community, as part of the shift from hospital to community. That would free up thousands of GP appointments in cases where people do not really need to see a general practitioner for their condition. We are committed to looking at how we can further expand the role of pharmacies and better use the clinical skills of pharmacists as more become independent prescribers—that is where the potential gets really exciting. Now that the budget for Government has been set, we will resume our consultation with Community Pharmacy England shortly. I hope Members will understand that I am unable to say more until that consultation has concluded. Suffice it to say that Pharmacy First and community pharmacies have a huge role to play in improving health outcomes in the community.
Jim Shannon
In my former role as an Assembly Member back home, we had a very close relationship with pharmacies. The consultation process that the Minister is outlining for England would be very much welcomed in Northern Ireland, so can I ask the Minister a favour? When that consultation concludes, will he share his findings with the Northern Ireland Assembly, and particularly with the Minister in Northern Ireland? What the Minister is hoping to achieve is what we would also like to achieve.
Andrew Gwynne
The hon. Gentleman raises an important point. No part of the United Kingdom holds a monopoly on wisdom, and if we are doing something good or if there is innovation in one part of the United Kingdom, it is incumbent on Health Ministers across the devolved Administrations and here in Whitehall to share best practice—to work together and, where possible, take a four-nation approach. I hope I can reassure the hon. Gentleman that since this new Labour Government came into power, we have really tried to reset our relationships with the devolved Administrations and with the various Ministers. I have had several meetings with Mike Nesbitt on a range of health issues that appertain to the whole United Kingdom on which we want to ensure there is consistency of approach. I am more than happy to communicate further with Mike Nesbitt and colleagues in the Northern Ireland Executive on how we reform our health and social care services in England to see whether things can be taken by them in Northern Ireland. Vice versa, if there are good ideas from Northern Ireland, I am more than happy to consider them in how we transform NHS services in England.
The hon. Member for Winchester mentioned social care, and he is right to raise winter resilience. I have spoken about fixing the front door to the NHS through primary care reforms. We also have a serious job to do to fix the back door and ensure that patient flows through the system are not held up because of a lack of social care. On winter resilience, I hope he will understand that we are working to ensure that there are no crises and that we tackle the issues of social care. Getting beds in appropriate places is a key part of our plan.
In the long term, there are no quick fixes. The Dilnot reforms were announced by the previous Government, but it is fair to say that, when we came into office, we found that the money apparently set aside for the Dilnot reforms had already been spent on other NHS pressures. Laudable though it may have been to spend that money to try to get waiting times and waiting lists down and to fix some of the problems that that Government had created, it left us with a bit of a social care issue, given that the reform money had gone, had disappeared and was no longer there to be spent.
Over the next decade, this Government are committed to building consensus on the long-term reform needed to create a national care service based on consistent national standards, including engaging across the parties. It is good to see the shadow Secretary of State, the right hon. Member for Melton and Syston (Edward Argar), in his place, and I am sure he will be very willing to work with us, as indeed will the Liberal Democrats. We genuinely want to make sure that we get cross-party consensus on the future of our adult social care, so that we can finally grasp this nettle once and for all, and to fix it without it becoming such a contentious issue, as it became, sadly, in 2010 and 2017. Neither of the two main parties has a good story to tell on this, because we have both shamefully used it as a political football from time to time. It is now appropriate that we set aside those politics and get on with fixing social care. I hope that, in due course, we will be able to move forward on that agenda.
I assure the hon. Member for Winchester that we are acutely aware of the problems with mental health services. We both agree that waiting lists are unacceptably high. Indeed, the people of Hampshire and most of England are not getting the mental health care they deserve. He has spoken previously about Lord Darzi’s report, which has shone a searing spotlight on the waiting lists that young people face, in particular. I am immensely proud that this Government are intent on tackling the issue head on, with specialist mental health professionals in every school in England. That is our aim. These NHS-funded mental health support teams in schools and colleges will work with young people and parents to manage mental health difficulties and to develop a whole-school approach to positive mental health and wellbeing.
Damian Hinds
Can I just check whether I heard the Minister correctly? Did he say there would be a mental health specialist in every school in England?
Andrew Gwynne
Yes, that is our manifesto commitment. There will be mental health specialists for every school in England. In Hampshire, there are mental health support teams assigned across the area, including schools in Winchester, Eastleigh, Andover and Havant. In addition, we will introduce young futures hubs in every community and recruit an additional 8,500 mental health workers across children and adult services. We have also set aside £26 million in capital investment for new mental health crisis centres, and we are expanding NHS talking therapies, alongside individual placement and support schemes.
This Government are committed to fixing the NHS so that patients, including those in Hampshire, can access excellent care when they need it. It is true to say that every Labour Government have inherited an NHS in a far poorer state than that which they bequeathed to their successors. It turns to this Labour Government to fix our NHS once more.
Question put and agreed to.
Infected Blood Inquiry
Andrew Gwynne Excerpts(2 days, 13 hours ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)
I stand here as the Minister for Public Health and Prevention, humbled and with a large degree of humility. The Department of Health and Social Care is rightly hated and despised by the infected blood community. We let them down. For that, I am personally sorry and my Department collectively is sorry.
I say that in a heartfelt way because for the past decade and a half, both as shadow Public Health Minister and as a Back Bencher, I have raised the issue of the infected blood scandal on behalf of the campaigns and of my constituents who were infected and affected. Now that I stand here as a Minister in the Department responsible, I feel it is incumbent on me to give that heartfelt apology. It is too late coming for so many, but I hope that those who are still here and their families and loved ones will accept it in the spirit in which I give it: I am sorry. We let you down and we must make sure it never ever happens again.
I welcome the two new Opposition spokespeople, the right hon. Member for Basildon and Billericay (Mr Holden) and the hon. Member for Kingswinford and South Staffordshire (Mike Wood). I want to start in the way the right hon. Member for Basildon and Billericay finished, by assuring him that the Government will work collectively and constructively with Members from across the House, from whichever party they come and whichever part of the United Kingdom they represent. This is an issue that has stained the body politic of our country for too long, and it is incumbent on us to work together across parties and across artificial divisions to make sure that we get the best deal for our constituents and their families.
I also thank all right hon. and hon. Members who have contributed to the debate. I thank my hon. Friend the Member for Blyth and Ashington (Ian Lavery) and my hon. Friend the Member for Gedling (Michael Payne), who made an incredibly powerful maiden speech, setting out how he will be a champion for the people of Gedling in the years to come. The people of Arnold, John and Joan, and his husband Kyle are all rightly proud of him today, from wherever they were viewing the speech. I also thank my hon. Friend the Member for Eltham and Chislehurst (Clive Efford), who has played such a pivotal role in this campaign over a large number of years, as well as my hon. Friends the Members for Swindon North (Will Stone) and for Portsmouth North (Amanda Martin).
On the Opposition Benches, I thank the right hon. Member for Salisbury (John Glen), who led on this matter in his former ministerial position. We thank him for his work. I know that sometimes I was frustrated with him, from just behind where he is sitting, but I appreciate the work he put in behind the scenes as well as at the Dispatch Box. The hon. Member for Perth and Kinross-shire (Pete Wishart) has similarly been a tireless campaigner, as has the right hon. Member for East Hampshire (Damian Hinds).
The infected blood scandal is one of the most appalling in our nation’s history. It was an institutional failure of the highest order, spanning decades. From the national health service to the civil service to Ministers across successive Governments, at every level, those the public trusted to protect them fell short in ways that were both tragic and catastrophic. They let down victims, their families and our country. In the course of this debate, we have heard the names: Sean, Gary, Thomas, Jean, Ade and Joe. They remind us of the real people—those who are deceased, those who were infected, and those who are affected. They are real people, not statistics, and it is important that we never forget that. Victims were denied the truth; many passed away before they saw justice. The state worked to protect itself, and those people paid the price.
I must echo the tributes that have been made to Sir Brian Langstaff and his team by Members from across the House. Their steadfast pursuit of the truth finally brought this decades-long scandal to light. Sir Brian and his team have set us on a path towards beginning to right the terrible wrongs that were committed. They uncovered a litany of collective and personal failures, as many hon. Members have highlighted by sharing stories from their communities and constituencies. Each one is significant in its own right and together they add up to a complete disaster.
Sir Brian found that this national scandal could have been prevented. It was already known that these treatments were contaminated, yet the warnings were disregarded time and again. People in positions of power and responsibility had multiple opportunities to halt the transmission of these infections, but, on each occasion, they chose not to act.
Many in this House have campaigned for justice for a long time, giving voice to those who had been repeatedly silenced. In particular, I wish to pay tribute to my right hon. Friends the Minister for Policing, Fire and Crime Prevention and the Secretary of State for Wales. I thank my hon. Friends the Members for Gower (Tonia Antoniazzi), for Hornsey and Friern Barnet (Catherine West), and for Newport East (Jessica Morden), and the hon. Member for Thirsk and Malton (Kevin Hollinrake). I also thank the former Member for Worthing West, Peter Bottomley, and the now Mayor of Manchester, Andy Burnham. In this debate today, we have again heard from my hon. Friends the Members for Eltham and Chislehurst and for Blyth and Ashington, the hon. Member for Perth and Kinross-shire, and the former Paymaster General, the right hon. Member for Salisbury.
As a Government, we will do our utmost not to repeat the mistakes of the past. We were elected on a manifesto that committed to act on the inquiry’s findings and to put right historical injustices. The public rightly expect nothing less of this Government than fulfilling our moral obligation to compensate victims, and we aim to do so without delay.
In October 2022, the previous Government spent £440 million on initial interim payments of £100,000 to the living infected. Following the publication of the inquiry’s final report in May, a further £728 million was paid as a second interim payment of £210,000 to all UK-registered living infected victims. The Government have also committed, in legislation, to paying £100,000 to the estates of the deceased infected to recognise those who have not yet received a payment and to ensure that some of those affected—such as parents, children and siblings—are supported. That scheme opened on 24 October. We recognise that money can never make up for the heartbreak that victims and their families have experienced, and much of the inquiry’s criticisms apply to the way that my Department—the Department of Health and Social Care—and its predecessors operated.
Alex Baker (Aldershot) (Lab)
My constituent Brendan lost his left leg while serving with the British Army in 1979. Decades later, he discovered that he had been infected with hepatitis C during the operation that saved his life. I know having talked to Brendan that, while he is pleased that the Government have committed to providing compensation, he is keen for us all to understand that, because of his community’s lived experience, there is an inherent distrust of the state. His instinct on being told that the state will spit out a number is understandably not to trust the process. Will the Minister reassure Brendan that all compensation offers will include a detailed breakdown of the data and rates used to make the calculations?
Andrew Gwynne
I can give my hon. Friend and Brendan the commitment that we will do just that, to reassure those who rightly have lost all trust in public authorities, and particularly in my Department, because of the dreadful actions that led to their infection. She has my assurance that we will do what we can to reassure Brendan and many others like him who rightly have no trust left in us that we will rebuild that trust.
Sir Julian Lewis (New Forest East) (Con)
I am sorry not to have been here for the opening speeches. Does the Minister recognise the fundamental similarity between the way in which the victims of this scandal and those of the Post Office scandal, and no doubt other terrible scandals, were treated by the state? Does the Government have any plan, possibly on a cross-departmental basis, to try to educate the bureaucracy that when terribly difficult and potentially expensive things like this crop up, they should not follow this well-worn path of denial and cover-up?
Andrew Gwynne
The right hon. Gentleman raises an important point. Indeed, it was acknowledged by my right hon. Friend the Paymaster General and Minister for the Cabinet Office in his opening speech that this is just one of a number of scandals that follow a similar pattern—when the scandal has been uncovered, rather than trying to protect the victim, the state has tried to protect itself. It is absolutely crucial that the state learns not just from each individual scandal, but collectively; that it is the same mindset that has led us to all these different scandals with similar outcomes for victims. That level of learning has to be genuinely across Government, and I know my right hon. Friend will lead on that in the Cabinet Office.
The Government will set out our formal response before the end of the year, but given that there is absolutely no time to waste, I want to take this opportunity to update the House on the work already under way to address some of the inquiry’s recommendations. To prevent future harm, the Department continues to explore options to enhance candour and openness across the national health service. To empower patient voices, the NHS is reviewing clinical audits related to haemophilia services to identify any gaps in patient involvement, alongside work on a new clinical service specification, which will set standards for services across England. To protect haemophiliacs, the NHS has convened an expert group to hear advice from the specialised blood disorders clinical reference group. A dedicated taskforce has been set up to consider its recommendations. The General Medical Council is working with NHS England and others to look at ways to ensure that lessons learned are reflected in training for doctors, nurses and other healthcare professionals.
Let me be clear to the House: the Government do not see this scandal in isolation. Sadly, repeated patient safety failings have eroded public confidence in our health and social care system, so we are taking steps to fix the culture of the national health service. My right hon. Friend the Secretary of State for Health and Social Care has been clear that we will not tolerate NHS managers who silence whistleblowers. Openness and honesty are vital to ensuring patient safety. NHS staff must have the confidence to speak out and come forward if they have concerns. There will be no more turning a blind eye to failure.
Our wider reforms to NHS performance will provide greater transparency for the public who pay for it. Measures will ensure that top talent is attracted to the most challenged areas, and persistently failing managers will be sacked. That is about ensuring that the right people are in post to lead our NHS with the resources they need to do their job. If we get that right, we will be able to look back on this moment as a turning point for patient safety and for leadership.
Sorcha Eastwood (Lagan Valley) (Alliance)
I apologise, Madam Deputy Speaker; I was in Committee at the start of the debate, but I did have my name down to speak. Some of my constituents were impacted by the scandal, and it has taken them this long to summon the courage to come forward. Obviously, I represent them and Northern Ireland. We have talked about the Hillsborough law and the need for a duty of candour. Does the Minister agree that it is important that that is rolled out not just in England and Wales, but right across the UK, so that, as he said, those families are never again impacted in that way?
Andrew Gwynne
I hope that I can reassure the hon. Lady that although health is devolved across the four nations, and I can speak only on behalf of the NHS in England on a number of the recommendations, both the Department of Health and Social Care and the Cabinet Office are working closely and collaboratively with Ministers in the devolved Administrations. Indeed, I and my right hon. Friend the Paymaster General recently had a meeting with Ministers from Scotland, Northern Ireland and Wales to talk about how to take forward the recommendations, on a four-nation basis where possible, and with mutual support across the four nations where there are individual recommendations pertinent to the devolved parts of the United Kingdom. I hope that that reassures her that we are working together. Although I cannot comment on the changes that will be needed for health services in Northern Ireland, which are a matter for the Minister of Health in Northern Ireland, Mike Nesbitt, I am quite certain that those services will carefully and closely consider our work here in England, and the work in other parts of the United Kingdom.
We have waited too long for these actions. People have waited too long for compensation. Indeed, right hon. and hon. Members have waited too long for this debate. More than 3,000 people died before they saw justice; families and our country were let down. There was a level of suffering that is so difficult to comprehend, because questions were not asked at the time, institutions did not face up to the failings, and facts were covered up. Now we know the truth. As we reflect, we are making a concerted effort to improve, because that loss need not be in vain.
I will respond to some of the questions raised throughout the debate, and will refer to other questions directly in the relevant part of my contribution. Should I miss anything because of time constraints, I will write to Members. In opening for the official Opposition, the hon. Member for Kingswinford and South Staffordshire talked about destigmatisation of HIV and hepatitis C. I hope that he understands that the Labour party made a clear manifesto commitment to ending HIV transmission in England by 2030. Officials at the Department of Health and Social Care, the UK Health Security Agency, NHS England and a broad range of system partners are now working together to develop a new HIV action plan, which we aim to publish by summer next year, and destigmatisation will be a key part of that plan.
My hon. Friend the Member for Blyth and Ashington asked about psychological support for family and friends. I reassure him that NHS England has established the infected blood psychological support service in England, which supported its first patients in late August. That includes supporting not just the infected, but the families and friends affected.
I want to turn to departmental failings. The report outlines a comprehensive condemnation of the organisation of blood services, licensing decisions, blood safety and patient safety, with harm compounded by the reaction and handling of Government. I again recognise humbly the criticism of the Department that I stand at this Dispatch Box to represent and its predecessors, and I am committed to ensuring that a tragedy such as the infected blood scandal can never happen again. This Government will prioritise patient safety to ensure that the NHS treats people with the high-quality, safe care they deserve.
Repeated inquiries and investigations have highlighted significant issues with patient safety, which has caused a deterioration in public confidence, as we heard from my hon. Friend the Member for Aldershot (Alex Baker) in an earlier intervention. We must absolutely fix that. The Health Secretary has been clear that we will not tolerate NHS managers who silence whistleblowers. A culture of openness and honesty is vital to ensure patient safety. We want NHS staff to have the confidence to speak out, and we will give them that.
The hon. Member for Eastleigh (Liz Jarvis) raised the question of the safety of blood products. While no medical treatment can be completely risk-free, current safety standards for blood donation and transfusion are rigorous, and England’s blood supply is one of the safest in the world. Processes are in place throughout the blood donation journey to ensure the safety of blood and blood products, including the donation safety check form, testing for specific infections, donor deferrals, regulations and informed consent. According to Serious Hazards of Transfusion, the risk of serious harm because of blood transfusion in the United Kingdom is low, at one in 11,000 blood components issued.
Turning to timelines, so far more than £1 billion has been paid in interim compensation payments to victims of the infected blood scandal. As we heard earlier, applications opened on 24 October for interim payments of £100,000 to the estates of deceased people whose deaths have not been recognised. Parliament has now approved regulations that give the Infected Blood Compensation Authority the powers necessary to pay compensation through the core route to the infected, both living and deceased. The Infected Blood Compensation Authority has begun to process its first claimants under the infected blood compensation scheme.
Jim Shannon
In my intervention on the hon. Member for Perth and Kinross-shire (Pete Wishart), I asked about the siblings who qualify. One sibling seems to be worth more than another sibling, and that seems absolutely wrong. I understand that there has been no reply to that in the Minister’s summing up. Maybe he is coming on to it—if he is, I apologise—but I would love to have a response, because my constituents have asked me to ask that question and ensure that we have a response.
Andrew Gwynne
I can assure the hon. Gentleman that the Minister for the Cabinet Office is carefully considering this matter. If the hon. Gentleman would like, the Minister for the Cabinet Office will write to him, but he is considering it.
We expect the Infected Blood Compensation Authority to begin making payments to people who are infected under the infected blood compensation scheme by the end of this year. Payments to the affected are expected to begin in 2025, following a second set of regulations.
Turning to a question raised by the hon. Member for Perth and Kinross-shire about the independence of IBCA, it is rightly operationally independent. Parliament would clearly expect the Government to have oversight of a scheme of this size and for there to be proper management, given the amount of public money going into the scheme. It is true that there are only two non-departmental public bodies that are independent of the Government: one is IBCA and the other is the National Audit Office. It is absolutely right for IBCA to have that independence.
Clive Efford
On that point, the National Audit Office is directly accountable to Parliament through the Public Accounts Commission. Is the intention to create a similar sort of arrangement, as envisaged by Sir Brian Langstaff, in which there is direct accountability to Parliament, rather than to the Department?
Andrew Gwynne
I should clarify for my hon. Friend that IBCA is operationally independent—that is important —but it is absolutely right that Members of this House are able to scrutinise its operations, its working and, indeed, its use of public money. We are talking about a great deal of public money, and IBCA has to be democratically accountable to this House, albeit operationally independent of Government Ministers in its day-to-day business.
Pete Wishart
This is a really important point—both myself and the hon. Member for Eltham and Chislehurst (Clive Efford) have now raised it with the Minister. He has rightly identified the experiences of so many people caught up in this crisis, and the fact that they do not trust the Government or Government institutions. Would it not be more of a comfort to them to know that IBCA is like the National Audit Office: accountable to Parliament, rather than to Government?
Andrew Gwynne
I agree with the hon. Gentleman, which is why IBCA is operationally independent—that is the crucial thing here. It does not have the fingerprints of Ministers all over it, because that is where the distrust comes from. It operates independently, but as a public body it is accountable to this House for how it spends that money and how it operates as an organisation. While IBCA is operationally independent to ensure a separation between Executive Ministers and the functioning of that body, it is accountable to this House. I think that is absolutely the right balance.
John Glen
I endorse what the Minister has said about the way in which IBCA has been set up. It seems to me an entirely sensible arrangement that respects the need to have some distance from Government, but clearly there cannot be a bespoke arrangement for every single entity that is set up. This was the point I was trying to make, respectfully, about Sir Brian Langstaff earlier: he did a brilliant job, but some aspects of this issue will need a slightly different judgment made by Ministers. I welcome the decision that the Minister and his colleagues have made.
Andrew Gwynne
I thank the right hon. Gentleman for that intervention. I hope that Members across the House can see why we have set IBCA up in the way we have. It is for precisely that reason: we have to have that operational separation from Ministers and the Executive, but there also has to be political oversight from all quarters of this Chamber, because this is a public body spending public money—and a great deal of public money at that.
As I have said, we are aiming for the second set of regulations to be in place by 31 March 2025. That will support our intention that payments to the affected begin next year. There are important details, especially in relation to Sir Robert Francis’s recommendations, the majority of which the Government have accepted, that must be worked through ahead of the second set of regulations. This includes details such as the eligibility criteria for people who are affected, and how the Government should define the parameters of the definition of unethical testing.
Turning to payments, the selection of those who have been contacted for first payments was a decision for the Infected Blood Compensation Authority. The first group of people who are receiving invites to claim are: first, those who are known to be already eligible for compensation; secondly, those registered with support schemes, which means we are likely to have much of the necessary information for these people already; thirdly, those from areas across the UK; and fourthly, those who represent a range of infection types and of severity within those infections.
Let me turn to some of the questions raised about this area. The hon. Member for Eastleigh mentioned people dying before compensation is awarded. I hope I can reassure her that when a person with an eligible infection has, tragically, died before receiving compensation, we will ensure that their personal representatives can claim compensation on behalf of the deceased’s estate. I hope that clarifies the point for her.
My hon. Friend the Member for Swindon North talked about the exclusion of victims with hepatitis B from the compensation scheme. People with chronic hepatitis B and those who die in the acute period are eligible for compensation, as are their loved ones as affected. I suggest that my hon. Friend writes to the Minister for the Cabinet Office with his constituent’s details, so that we can look more closely at his case. My hon. Friend the Member for Eltham and Chislehurst asked whether there will be payments by the end of the year. The answer is yes, and as I have said, there will be payments to the affected from next year, when we have the new regulations in place.
The right hon. Member for East Hampshire asked about the steps taken to provide accessible information on compensation. I want to spell out to him that Sir Robert recommended that there should be a higher award of £15,000 for children subject to unethical research at the school in his constituency. That is why there is a difference, which I hope clarifies that point for him. As I have said, at the start of November the Infected Blood Compensation Authority invited the first cohort of people to make compensation claims.
Candour in the civil service and in Government was raised by my hon. Friend the Member for Eltham and Chislehurst and the hon. Member for Perth and Kinross-shire in their contributions. The King’s Speech set out the commitment to bring forward legislation to introduce a duty of candour for public authorities and public servants. This legislation will be the catalyst for a changed culture in the public sector. The Prime Minister confirmed at the Labour party conference that legislation on the duty of candour would be delivered by this Government. He confirmed that the duty will apply to public authorities and public servants, and it will include criminal sanctions. The Bill will be introduced to Parliament before the next anniversary of the Hillsborough disaster in April 2025.
In closing, today I hope the House has heard how we are starting to deliver compensation and how we are starting to respond to the inquiry recommendations. Admittedly, they are still small steps, but they are steps in the right direction. This work is far from over. We owe it to the victims and their families to see it through, and we will of course regularly update the House as this progresses. I reiterate on behalf of the Government and the Department of Health and Social Care, and as a mere ordinary Member of Parliament for Gorton and Denton, representing some of the infected and affected, that we are truly sorry. We let you down. We will learn from these lessons, and we must never ever let anything like this happen again.
Question put and agreed to.
Resolved,
That this House has considered the Infected Blood Inquiry.
Oral Answers to Questions
Andrew Gwynne Excerpts(2 days, 13 hours ago)
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Abtisam Mohamed (Sheffield Central) (Lab)
The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)
Lord Darzi found that mental health waiting lists have surged, with more than 100,000 children waiting a year for their first appointment. That is why we will recruit 8,500 more mental health workers, provide access to mental health support in every school and roll out young futures hubs in every community. I am delighted to tell my hon. Friend that a Bill to modernise the Mental Health Act 1983 was introduced in the other place on 6 November. That was a promise that we made before the election—a promise that we kept.
Abtisam Mohamed
I welcome the Minister’s comments. My brother has very complex mental health needs. We as a family know at first hand the difficulties not only of accessing the services and of the long waiting times, but the challenge of support staff who are not constantly on a churn and the lack of community-funded support services. Our experience is no different to that of many other families. Will the Minister meet me to discuss how we will make mental health services more accessible in communities, invest more in preventive services and fund more community-based provision?
Andrew Gwynne
I will be pleased to meet my hon. Friend. This Government think it is unacceptable that too many people are not receiving the care that they deserve, and we know that waits for mental health services are far too long. We are determined to change that with the measures I set out in my opening. The Government have also introduced NHS 111 for mental health so that people who are in crisis or are concerned about a family member or loved one can now call 111 and speak to a trained mental health professional.
Josh Babarinde (Eastbourne) (LD)
Facilities such as leisure centres and swimming pools—like the Sovereign Centre in Eastbourne where I learned to swim—are critical in supporting people’s mental health locally. Will the Minister support me in putting pressure on the Ministry of Housing, Communities and Local Government to expand the criteria of the towns fund to allow us to be able to spend it to invest in our leisure centres and sports and fitness facilities for local people?
Andrew Gwynne
I am grateful to the hon. Member for his question. We are a mission-led Government and, of course, tackling health inequalities is a job not just for the Department of Health and Social Care, but for all Government Departments. I will be very happy to raise the role that Ministers can play in improving mental health and wellbeing in my bilaterals with the Ministry of Housing, Communities and Local Government.
Jerome Mayhew (Broadland and Fakenham) (Con)
Mark Ferguson (Gateshead Central and Whickham) (Lab)
The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)
The UK rare diseases framework aims to improve the lives of people living with all rare diseases. I am more than prepared to meet my hon. Friend to look at the adequacy of support available to people with Usher syndrome.
Sarah Olney (Richmond Park) (LD)
Dr Beccy Cooper (Worthing West) (Lab)
Andrew Gwynne
We will confirm the 2025-26 local authority public health grant allocations in due course. Local government plays a critical role in delivering the Government’s health mission and driving action on the prevention of ill health. We are committed to working in partnership with local government to tackle the wider determinants of ill health.
Martin Wrigley (Newton Abbot) (LD)
Wera Hobhouse (Bath) (LD)
Respiratory health conditions are one of the main drivers of NHS winter pressures, yet only 32% of asthma sufferers in Bath and across the country can access the most basic level of care. What will the Government do to improve access to basic levels of care for the 68% of asthma sufferers who are currently missing out?
Andrew Gwynne
NICE is reviewing its guidelines for the diagnosis, monitoring and management of chronic asthma, and an updated version is due to be published in late November 2024. I am happy to meet the hon. Lady to discuss it further.
Andy McDonald (Middlesbrough and Thornaby East) (Lab)
Women with spinal cord injuries face significant challenges in accessing core health services, including breast screening, cervical screening and gynaecological care. Research shows that women with disabilities, including spinal cord issues, are 30% less likely to attend routine breast screening appointments, in significant part due to the physical inaccessibility of the screening equipment. Will the Minister meet me and representatives of the all-party parliamentary group on spinal cord injury to discuss these unacceptable disparities and ensure that women receive the equitable and accessible care they deserve?
Jacob Collier (Burton and Uttoxeter) (Lab)
My constituent Ollie Horobin’s life has been completely transformed after contracting covid, leaving him wheelchair-bound with a feeding tube and battling debilitating symptoms every single day. His story is a stark reminder of the devastating impact that long covid can have. Will the Minister commit to meeting Ollie and me to hear about his experience at first hand, and prioritise further research into the causes, treatments and long-term impacts of extreme long covid?
Andrew Gwynne
As somebody who still suffers from long covid, I know how debilitating and complex it can be, and I am committed to improving support for people affected by it. There are now more than 100 long covid services across England, and £57 million is being invested in long covid research. I recently co-chaired a roundtable on strategies to stimulate further research into treatments. I am more than happy to meet my hon. Friend and Ollie for further discussion.
David Mundell (Dumfriesshire, Clydesdale and Tweeddale) (Con)
Opt-out testing for HIV at A&E has been a great success since it was announced last year, particularly in identifying those who were not aware they had the disease and among difficult-to-reach communities. Can the Health Secretary confirm whether the programme will continue?
Karl Turner (Kingston upon Hull East) (Lab)
My constituent Craig Eskrett was diagnosed with motor neurone disease 12 months ago. He says that the services are there in the local NHS trust, but there is a distinct lack of co-ordination. Will the Minister meet me to discuss what improvements can be made to co-ordinate those services for sufferers of MND?
Andrew Gwynne
My hon. Friend raises a real issue about how we join up the whole of the patient journey. Once diagnosed, patients need appropriate treatment and wraparound care. I am more than happy to meet him and his constituent.
Richard Foord (Honiton and Sidmouth) (LD)
At the weekend in Devon, I met a psychiatric nurse who previously worked in London and has been recruited to the south-west. She does not have a start date, and is still subject to routine checks after waiting months. Can the Secretary of State expedite these routine checks, given waiting lists for mental health?
Folic Acid Fortification of Flour
Andrew Gwynne Excerpts(3 days, 13 hours ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)
I wish to update the House that on Thursday 14 November the Government laid legislation to fortify flour with folic acid to reduce the risk of life-changing conditions in pregnancies, such as spina bifida. Neural tube defects happen in the first few weeks of pregnancy, often before a woman even knows that she is pregnant. These can be devastating conditions for individuals and their families.
Flour is already fortified with calcium, niacin, thiamine and iron for public health reasons. Adding folic acid will mean foods made with non-wholemeal wheat flour, such as bread, will actively help avoid around 200 neural tube defects each year—around 20% of the annual UK total.
This significant development in improving the health outcomes for women and babies has been many years in its development and many Members across both Houses have shown a keen interest in its progression. I am extremely pleased we have now reached the point of implementation and acknowledge the dedication and efforts of all those involved.
We have worked in close collaboration with the Department for Environment Food and Rural Affairs, as well as colleagues in devolved Governments, to agree this policy. These changes will be implemented by DEFRA through the Bread and Flour Regulations 1998 in England and similar legislation in Scotland, Wales and Northern Ireland will be brought forward very soon. The legislation on folic acid will come into effect across all four nations in December 2026, giving industry 24 months to implement the changes.
The 24-month implementation period is in recognition of the considerable efforts required by industry to add folic acid to flour and relabel the large number of products that contain flour. The Government will continue to engage with industry on these challenges.
There is strong evidence that many neural tube defects can be prevented by increasing women’s intake of folic acid, which is why existing pregnancy advice to women who are trying to conceive or who are likely to become pregnant is to take a daily supplement of 400 micrograms of folic acid before conception and up until week 12 of pregnancy. We will continue to offer this advice as the fortification of flour is intended to support, not replace, current supplementation advice for individuals.
These changes will also support the Government’s commitment to improving women’s health and their ambition to raise the healthiest generation of children ever.
[HCWS224]
Oxford Nanopore Technologies: Strategic Partnership
Andrew Gwynne Excerpts(2 weeks, 1 day ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)
My noble friend the Under-Secretary of State for Health and Social Care, Baroness Merron, has made the following written statement:
We have announced the Government’s intention to enter into a strategic partnership with Oxford Nanopore—a world-leading UK-based life sciences company whose technology is used to advance biomedical research and translate discoveries for improved patient care across cancer, genetic disease and infectious disease. This collaboration also involves NHS England and two of our world-leading scientific institutions—Genomics England and UK Biobank.
The collaboration will seek to utilise Oxford Nanopore’s technology to enhance research and, using insights from the UK’s genetic databases, could pave the way for new treatments for cancer and rare diseases.
The collaboration is another vote of confidence in the UK’s life sciences sector, which will help kickstart economic growth and support the 10-year health plan’s ambition to shift the health service from analogue to digital and from sickness to prevention, helping keep patients out of hospital. The collaboration also builds on the Chancellor’s commitment to support UK spinouts announced as part of the Budget.
Separately, following a successful pilot at Guy’s and St Thomas’ Hospital, we are announcing the scale-up of NHS England’s respiratory metagenomics programme, offering fast-track genetic testing for patients with suspected respiratory infectious diseases. Through this programme, Nanopore’s sequencing technology will be rolled out from 10 to up to 30 NHS sites to detect new pathogens emerging in the UK. Patients suspected of having severe acute respiratory infections will now be diagnosed within six hours thanks to this technology, compared to the previous norm of around three days.
This will create an “early warning system” for future pandemics, supporting the Government to take quicker action on emerging infectious disease, and monitor the threat of future pandemics.
I will provide further updates to the House on this collaboration as it develops
[HCWS199]
Woman and Equality: North of England
Andrew Gwynne Excerpts(2 weeks, 2 days ago)
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Westminster 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
The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)
It is a pleasure to serve under your chairmanship, Sir Christopher. I am grateful to be responding for the Government to this vital discussion brought to the House today by my hon. Friend the Member for City of Durham (Mary Kelly Foy) about the issues raised by the “Woman of the North” report. The report highlights the challenges facing women across the northern regions of England and I am pleased that the Government’s women’s health ambassador, Professor Dame Lesley Regan, delivered a keynote speech at the report’s launch in September, in which she spoke about the importance of addressing the health inequalities faced by women living in the north of England.
While the report brings into focus the striking health inequalities that women in the north contend with, our Government are committed to addressing those regional inequalities head on. I will be clear, up front, that the conditions outlined in the report are unacceptable in a country as resourceful as ours. Women in the north face stark inequalities, not just in health but, as we heard from my hon. Friend, in economic security and social support. Our response must be to tackle those on multiple fronts, and that work has already begun.
We are committed to working across Government to tackle wider inequalities that lead to poor health, focusing our health and care system on preventing ill health, shifting more care into the community and intervening earlier in life to raise the healthiest generation of children in our country’s history. We will improve healthy life expectancy for all and halve the gap in healthy life expectancy between different regions of England.
The Government are committed to prioritising women’s health as we build an NHS that is fit for the future, and women’s equality will be at the heart of our missions. We are considering how to take forward the women’s health strategy developed by the last Administration, but we want to align it with the Government’s missions and the forthcoming 10-year health plan. The report is therefore timely. As my hon. Friend set out so powerfully, reducing inequalities must be a central focus in our strategy going forward. We will carefully consider each of the report’s recommendations as we do that, and I will ensure that Ministers across Government have sight of the report and consider those recommendations that relate to their policy areas.
My hon. Friend mentioned women’s health hubs, which will be key to improving access to women’s health services and reducing the inequalities we care so passionately about tackling. They will do that by providing a set of integrated women’s health services in the community, centred on meeting women’s needs across their life. The Department has invested £25 million over the past year and over 2024-25 to support the establishment of at least one pilot women’s health hub in every integrated care system. I am pleased to say that integrated care systems in the north of England are making good progress on setting up their pilot hubs. For example, the funding is being used to set up three pilot hubs—two in Sunderland and Gateshead in the north-east and one in north Cumbria—with a strong focus on tackling inequalities and community outreach.
My hon. Friend also mentioned smoking, which is a huge driver of inequalities in too many communities, particularly, but not exclusively, in the north of England. She is right, and I can confirm—on the day the tobacco and vapes Bill receives its First Reading—that good-quality smoking cessation services remain a big part of the jigsaw in achieving a smoke-free UK. I can report that financial incentives are working well.
I mentioned some of the wider social inequalities that underpin poorer health chances, as did the hon. Member for Strangford (Jim Shannon). It is shocking that a woman in the north, working full time, may earn £56 less per week than the national average, and £188 less than a woman in London. Every part of the country has a vital contribution to make to our economy, but too many areas have been held back because decisions are often taken here in Westminster and not by local leaders who understand the ambitions, strengths and opportunities—and the weaknesses and threats—of the local population.
That is why the new Labour Government are committed to empowering local government, enabling it to pursue growth, create jobs and improve living standards, with support from central resources. Providing central support where needed, we will ensure that the places we are talking about have the strong governance arrangements, capacity and capability to deliver. In addition, as my right hon. Friend the Chancellor of the Exchequer set out in our first Budget last week, the national living wage will increase from £11.44 to £12.21 next April. That boost—one of the largest since the creation of the national minimum wage in 1998—benefits women, who make up a significant proportion of minimum wage earners.
Turning to mental health and domestic violence, the “Woman of the North” report revealed stark challenges facing northern women, with rising rates of mental illness and domestic violence. We have committed to taking a number of important measures to improve support for women, which we are already introducing those across Government. We are committed to an NHS that is responsive and accessible, with 8,500 new mental health workers to reduce waiting times, and a specialist mental health professional in every school. Young Futures hubs in every community will also offer open-access mental health support for young people, including girls.
Recognising healthcare’s role as a frontline for survivors, all NHS staff undertake mandatory safeguarding training, which includes a focus on domestic abuse. Furthermore, my Department has published and disseminated a working definition of trauma-informed practice for the health and care sector. NHS integrated care boards enable provision of more integrated services for victims and survivors. The Victims and Prisoners Act 2024 also places a new legal duty on integrated care boards to work with local authorities and with police and crime commissioners to join up the commissioning of victim support services.
One of the most striking points raised in the report is the extraordinary burden of unpaid care on northern women. Women who give over 50 hours a week in care duties deserve our utmost respect, as well as the support of this Government, and we are working to ensure that they have it. Our recent increase in the earnings threshold for carer’s allowance will help 60,000 more carers to maintain work while receiving financial support. For the first time, carers can now earn more without reducing hours, due to minimum wage rises. That will bring much-needed financial stability to carers and allow them to retain their links to the labour market, which is crucial.
We will continue to monitor and respond to the needs of carers, ensuring that they have the resources to support their families and wider communities. Moving forward, we will continue to assess the needs of carers, in the north and beyond, to ensure that we are offering tangible, effective assistance to those unsung heroes.
I put on record that the Government’s commitment to our northern communities, and to the women who drive them forward, is unwavering. We recognise that the strength of our nation rests on the health, security and potential of all women, regardless of where they live. But we know, as northern MPs, the stark inequalities that are far too prevalent in far too many parts of the regions that make up the north of England. For women in the north of England, we will ensure that we rebalance not only their health outcomes but the economic opportunities offered to them. It is not a matter only of justice, but of building a society that values every woman’s contribution equally and that provides her with the means to thrive.
Let me affirm that this Government, and I as the Minister responsible for public health and prevention—albeit a man—stand ready to support the women of the north, and every woman in this country, by addressing the entrenched inequalities that hold too many women back. Through our co-ordinated efforts across health, economic policy and social care, we will see the real benefits of a mission-led Government who do not work in silos but across the whole of Government to tackle the needs of the citizen—in this case women, including women in the north—as we march towards the decade of national renewal that the country voted for on 4 July.
That co-ordinated effort will be across health, economic policy, social care, housing, planning, transport, the environment and all public policy, such as education, skills and training. We will work towards a future where all women, wherever they are in this country—although I and my hon. Friend the Member for City of Durham are northerners, and this debate is about the north of England—can look forward to lives filled with good health, economic security and the opportunity to achieve their potential.
I will leave the House with just one thought. On my first day as public health Minister, I had lots of presentations to bring me up to speed on a range of policy areas, and the first was on life expectancy. There was a simple bar chart that showed two women: one who has the privilege of living in a less deprived part of England and one who has the misfortune of living in a more deprived part of England. The life expectancy of the woman in the less deprived part was just shy of 80—79.9 on average. For the other woman, it was 70—10 years were shorn off her life.
But that was not the most shocking part of the chart. The two bars were shaded in part in orange, which signified the healthy life expectancy of the two women. The woman who lives to nearly 80 in the less deprived part of England falls into ill health at 75. All of her working adult life is spent in good health, and she falls into ill health only in the final five years of her life. The other woman, who lives to 70, falls into ill health at 52. That shocked me to the core. Those are not statistics; they are people—people I and my hon. Friend represent. Indeed, there are inequalities across the country, and they are people you too represent, Sir Christopher.
Each person falling into ill health with another 15 or 16 years of adult working life to go is a tragedy on a personal level. It is the economics of the madhouse, because those people have potential—they have economic ability and hopes and dreams that are whipped away because of inequalities. It is the duty of Government to push that orange bar as close to retirement age as possible for those women, and preferably into retirement age. Look, let’s be ambitious: let’s put sickness beyond death. It is the duty of Government to tackle those health inequalities. I hope I have assured the House, and my hon. Friend the Member for City of Durham, that while I am in this ministerial post, it will be my No. 1 aim to make sure that we live healthier, happier, longer lives. Here’s to the women of the north.
Question put and agreed to.
Draft Human Fertilisation and Embryology (Amendment) Regulations 2024
Andrew Gwynne Excerpts(1 month ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)
I beg to move,
That the Committee has considered the draft Human Fertilisation and Embryology (Amendment) Regulations 2024.
It is a pleasure to serve under your chairmanship, Mr Mundell. This is important secondary legislation, and before I begin to unpack its content, I would like to pay tribute to the campaigners that have pushed for these reforms, including the National AIDS Trust, Stonewall and the Elton John AIDS Foundation, to name just a few.
The Human Fertilisation and Embryology Act 1990 provides the legislative framework for regulating fertility treatments and the use of gametes and embryos in the UK. The draft regulations seek to amend two aspects of schedule 3A to that Act.
Thank God, HIV is no longer the death sentence it once was. What is more, advances in retroviral treatment mean that people living with HIV can achieve a viral load that is undetectable and therefore untransmissible. In our constituency work, many of us have come across male same-sex couples who wish to start a family through surrogacy, where one or both have HIV. There are hundreds of such cases across the United Kingdom.
The first aspect of the regulations we propose to change would help people seeking donation from a friend or relative with HIV, and it would allow people living with HIV to donate their gametes to known recipients, where certain conditions are met. Those conditions are the following: first, that they have an undetectable HIV viral load of less than 200 copies per millilitre, shown by two tests prior to donation; secondly, that they have been receiving antiretroviral treatment for at least six months prior to donation; and thirdly, that the recipient knows of the donor’s HIV diagnosis and provides informed consent.
To be clear, opposite-sex couples where one or both partners have HIV can have fertility treatment using their own gametes under the current legislation, but they cannot donate to others, and no other people with HIV can donate. The policy change is based on crystal-clear scientific evidence that shows that advances in the treatment of HIV have meant the risk of transmission is now regarded as “negligible”, whether that is through unprotected sexual intercourse or gamete donation.
The Government have adopted this new approach following advice from the independent Advisory Committee on the Safety of Blood, Tissues and Organs. In short, the world has moved on, and our legislation must move with it.
The statutory instrument would also enable female same-sex couples to donate eggs to one another in reciprocal IVF—in vitro fertilisation—or shared motherhood arrangements. Donations within same-sex female couples would undergo the same testing requirements as opposite-sex couples, by modifying the definition of “partner donation”, currently defined as exclusively being between a man and a woman who are in an intimate physical relationship.
Following advancements in assisted reproduction technologies, it is now possible for women in same-sex couples to undergo reciprocal IVF where one partner donates an egg to the other partner, who then carries and gives birth to the child. That allows couples to both play a part in that child’s conception.
Under the current definition, female same-sex couples who have reciprocal IVF must go through additional screening for either infectious or genetic diseases. That can cost more than £1,000 compared with heterosexual couples undergoing IVF using their own gametes. SaBTO, the independent committee that I referred to earlier, has advised that there is no longer any clinical reason for these tests, and this Government agree.
The subject matter of the 1990 Act is reserved, so the regulations will apply across the UK. The instrument is made in exercise of different powers in respect of Great Britain and Northern Ireland. For Great Britain, it is made under the 1990 Act, which provides that regulations may specify technical requirements in relation to the election of donors and laboratory tests for donors of gametes and embryos. For Northern Ireland, the instrument is made under the powers in section 8C of the European Union (Withdrawal) Act 2018.
This Government are committed to resetting our relationship with the LGBT community. I am proud to say that we have engaged extensively with LGBT and HIV organisations to get their thoughts on the proposed regulations, which have been received very positively. We have not prepared a full impact assessment for the instrument because the costs for business fall below the threshold. However, a de minimis assessment has been completed, and the changes should cost the fertility sector within the range of £46,000 to just over £92,000. The costs are expected to be passed on to patients accessing private IVF provision.
In summary, the regulations will unlock the ability for people living with HIV to have a family using their own gametes. The measures would benefit men in same-sex relationships where one or both have HIV and people seeking a donation from a friend or relative with HIV, and they will bring much needed parity between women in same-sex relationships undergoing reciprocal IVF and opposite-sex couples. The draft amendments may seem technical, but they mark another few steps on the long road towards equality. We should not hesitate to take them, and I commend the regulations to the Committee.
Andrew Gwynne
I thank hon. Members from across the House for their clear indication of support for these landmark measures. I jest with my hon. Friend the Opposition spokesperson—I call her my hon. Friend, because we have known each other for a number of years—and often remind her that she was once in this ministerial position for a very short period. I hope that she gets to shadow me longer than I shadowed her—I think she has already broken the record. I always enjoy the fact that she comes to these proceedings with a really open mind. As I hope I was supportive to the previous Government on these measures, she has proven the cross-party worth of being supportive to the new Government on measures that we both want to see put in place. I thank her sincerely for the official Opposition’s support.
We want to ensure that people who want to start a family do not face barriers without good reason. I thank the LGBT and HIV charities that have pushed for and supported these reforms, and the Human Fertilisation and Embryology Authority for its constructive work. I am also pleased to welcome Adam Freedman from the National AIDS Trust to the House today to see the SI debated. He has patiently encouraged Governments of both stripes to move in the right direction.
I note that safety about receiving donations from those with HIV will be a concern to some. Let me offer further reassurance that the Advisory Committee on the Safety of Blood, Tissues and Organs has given these issues intense scrutiny, reviewing the most up-to-date clinical evidence, to ensure that such donation by people with an undetectable viral load is safe. The evidence is published on its webpage on gov.uk.
The changes will help to benefit hundreds of couples. That includes same-sex male couples where one or both have HIV in a surrogacy arrangement, female same-sex couples planning shared motherhood, and those seeking known donation from a friend or relative with HIV. The SI also clearly demonstrates this Government’s intentions to address equalities and opportunities for all, regardless of gender, race, sexual orientation or how they wish to form a family.
I will take the points made by the Opposition spokesperson in reverse order. On the Windsor framework, it is not for me to decide whether that is a bonus of Brexit. We operate under that different legal framework in this brave new world—having left the European Union and respecting the Good Friday agreement—when we legislate on certain areas relating to Northern Ireland, as opposed to the conventional legislative processes that cover the rest of Great Britain. I will leave it to others to judge whether that is a bonus or otherwise, but that is the system that we are in.
On NHS screening, the implications for the NHS, and the family issues that she raises, I will write to the Opposition spokesperson and the Committee to give assurances about those areas, as the powers that be from God have not reached mortal man in time. But I will ensure that all Committee members get that divine guidance when it comes—[Interruption.] If you will forgive me, Mr Mundell, I have just been passed a tablet of stone from Mount Sinai. It tells me that the HFEA code of practice prevents incestuous donations and provides guidance on donations to achieve that end—somebody could obviously write a prescription with the note I am reading as well. On anything else that is left outstanding, the offer of writing to Committee members still stands.
The Chair
I know that many new Members are finding their way in relation to these Committees, but it is important that people attend on time. These sittings, as you have seen, tend to be rather short, and therefore being here for the full proceedings, if you are going to attend, is important.
Question put and agreed to.
Oral Answers to Questions
Andrew Gwynne Excerpts(1 month, 1 week ago)
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Lee Anderson (Ashfield) (Reform)
The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)
I thank the hon. Member for raising awareness of this important issue. He has spoken powerfully about the experiences of patients in his constituency and his wife’s personal battle with sepsis. The long-term complications of sepsis can have a devastating impact long after discharge from hospital. Through the National Institute for Health and Care Research, the Department is funding research to improve outcomes for sepsis survivors.
Lee Anderson
Last year, Abbi Hickson from Ashfield lost both her hands and her lower legs to sepsis. The local hospital was very slow to diagnosis her condition, and since then she has been suffering from shortness of breath, fatigue and a lack of sleep. This could be post-sepsis syndrome, yet nobody at the hospital has spoken to her about it. Does the Minister agree that every single sepsis patient and survivor should be advised about this condition?
Andrew Gwynne
I absolutely do, and I pay tribute to Abbi, a beautiful woman whom I was privileged to meet after the Westminster Hall debate last week. Although care after sepsis will vary hugely on a case-by-case basis, we need to make sure that the needs of each individual are met. In this case, it sounds like they have not been met. If the hon. Gentleman wants to meet me to discuss this issue further, I am more than happy to do so.
Jim Dickson (Dartford) (Lab)
Given that last month was Sepsis Awareness Month, will the Minister join me in paying tribute to the courage of John Snow and his family in my Dartford constituency? Tragically, he has just experienced a quadruple amputation due to sepsis. He has received amazing support from the Dartford community, who have rallied around to help fund support for his family. Will the Minister use that as a spur to improve treatment for sepsis more generally across the country?
Andrew Gwynne
I pay tribute to John Snow and, indeed, my hon. Friend’s constituents, who have rallied around him at his time of need. This matter highlights the need to have better joined-up care to ensure that people who have sepsis receive the best care possible, that those who tragically lose limbs as a consequence of sepsis are able to have good-quality aftercare, and that we continue to raise awareness of sepsis and the risks it poses.
Mike Wood (Kingswinford and South Staffordshire) (Con)
We think that about 48,000 people a year lose their lives to sepsis, but the truth is that we do not know, because the data is inconsistent. Will the Minister look at establishing a national registry to track sepsis cases, so that performance can be measured, published and improved?
Andrew Gwynne
Given the national standards and framework that have been put in place in this regard, I hope very much that the NHS will be able to do precisely what the hon. Gentleman wants it to do.
Sonia Kumar (Dudley) (Lab)
Yesterday was Allied Health Professions Day, which raises awareness of 14 professions, including physios, speech and language therapists, and radiographers. Does the Minister agree that all the hard work of those professionals is really important for patient care?
Andrew Gwynne
My hon. Friend makes a really important point. The wonderful staff we have working across health and care ensure that our constituents receive, within a very tightly constrained health service, the best possible care that we can give them. The NHS is broken. We have to fix our broken health service, and having good-quality staff at the heart of it is how we are going to achieve that aim.
Karl Turner (Kingston upon Hull East) (Lab)
Johanna Baxter (Paisley and Renfrewshire South) (Lab)
The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)
As Lord Darzi identified in his NHS review, primary care is broken, with 1,600 fewer fully qualified GPs than in 2017. We recognise that men can face particular challenges in accessing services, which is why we are committed to fixing the front door to the NHS, bringing back the family doctor and shifting the focus of care away from hospitals and into the community. Health is devolved in Scotland, but I welcome opportunities to share learning across our two nations.
Johanna Baxter
In my Paisley and Renfrewshire South constituency, the rate of premature death in men is 47.9% higher than the UK average. According to National Records of Scotland, the number of people who have died by suicide in Renfrewshire as a whole has increased to the highest level in 10 years. Does my hon. Friend agree that this is a damning indictment of the SNP Government’s record on health? Will he commit today to holding a summit in November, with Movember, to raise men’s health up the agenda?
Andrew Gwynne
Those statistics are both damning and shocking. Health inequalities in any part of our United Kingdom need to be tackled, and the SNP Government have real questions to answer on these shocking statistics for men in my hon. Friend’s constituency and across Scotland. I will take up her challenge. A summit with Movember, and with her and other interested Members, to talk about men’s health issues is a cracking idea, and I will get straight on to it when I get back to the Department.
Seamus Logan (Aberdeenshire North and Moray East) (SNP)
I appreciate that the Secretary of State is unlikely to comment on the Chancellor’s forthcoming statement, but he and his Front-Bench colleagues have already mentioned funding issues a number of times this morning, so will he confirm that it is the policy of his Government to take steps to increase the UK’s health spending to the average of other countries in north-west Europe? That would lead to an increase of around £17 billion for the national health service and would help address some of the issues referred to by the hon. Member for Paisley and Renfrewshire South (Johanna Baxter).
Mr Speaker
Order. Questions ought to be linked to the subject being dealt with, which is access to primary care. I am sure that the hon. Gentleman meant to ask, “Will there also be funding to improve access to primary care?”, which I am sure the Minister can answer.
Andrew Gwynne
This Labour Government were elected to tackle health inequalities, fix our NHS and ensure that more people live longer, healthier lives. That will require a concerted Government effort, which is why we have the health mission board in place. My right hon. Friend the Secretary of State is making the case for investment and reform at every opportunity, but let us be clear: every single Labour Government have left the country with a better NHS than they inherited, and this Labour Government will fix our NHS once more.
Sir Iain Duncan Smith (Chingford and Woodford Green) (Con)
Michelle Scrogham (Barrow and Furness) (Lab)
The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)
Lord Darzi’s report concluded that the health service is in a critical condition across the country. District hospitals have a vital role to play in meeting the needs of their communities, and this Government will support them to reduce waiting times, to improve urgent care and to play their part in building a neighbourhood health service.
Michelle Scrogham
Critical care at Furness general hospital in Barrow has been temporarily downgraded, meaning that those in most need of the highest level of care are now exposed to potentially life-threatening delays during a 50-mile transfer on difficult roads. Will the Minister please look at this worrying decision by the University Hospitals of Morecambe Bay NHS foundation trust and do everything to enable the reopening of this service as soon as possible?
Andrew Gwynne
My hon. Friend is a doughty fighter for her constituents. I am aware that the decision she mentions is an interim measure made by the critical care network, the Lancashire and South Cumbria integrated care board and the NHS trust. The decision will be kept under review and patients impacted will receive the appropriate support. The Government recognise that more must be done to improve the sustainability of the NHS both nationally and in rural and coastal areas.
Gregory Stafford (Farnham and Bordon) (Con)
Services at Chase community hospital in my constituency, in Whitehill and Bordon, are being run down by the ICB. This is based on a promise that a brand-new health hub will be built in place, which is much welcomed. It has the support of the Defence Infrastructure Organisation, which owns the land, East Hampshire district council and the community, but the ICB is suffering from inertia. Can the Minister speak to the ICB and suggest that it either builds this new health hub or refurbishes and renovates the Chase community hospital?
Andrew Gwynne
I have every sympathy with the case that the hon. Gentleman has put forward. This Government want to see a shift of health services from hospital to community, from analogue to digital, and from sickness to prevention, but these decisions are not taken through inertia; they are taken because of the Government’s inheritance from the Conservative party. We have had 14 years of running down our health services, with needless reorganisations that have destroyed and set back the progress that the last Labour Government made on the NHS. This Government will fix the NHS, including in the hon. Gentleman’s local area, but he has to recognise that the root cause of many of the problems faced by Members across the Chamber lies at the feet of the former Secretary of State and the last Government.
Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
We have heard about the challenges facing Whipps Cross hospital. The Secretary of State’s decisions to pause capital projects across the country and put them under review has caused worry and uncertainty for staff in hospitals nationwide. Can he say when the review will be completed, so that we have certainty about when things will go ahead?
Andrew Gwynne
The review will be completed when all the information has been analysed. The hon. Lady should not just be a little more patient; she should be a little more apologetic for the fact that the Government found a hospital rebuilding programme that was not worth the paper it was written on, because the ultimate paper we needed—the cash—was not there.
Mr Tanmanjeet Singh Dhesi (Slough) (Lab)
The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)
We are committed to expanding community diagnostic capacity to build an NHS that is fit for the future. However, we are clear that independent sector providers have a role to play in supporting the NHS as trusted partners to recover elective services.
Blake Stephenson (Mid Bedfordshire) (Con)
Gareth Snell (Stoke-on-Trent Central) (Lab/Co-op)
Andrew Gwynne
I agree with my hon. Friend, which is why we have set a goal for fewer lives being lost to cardiovascular disease. We will make it easier for people to have checks in the comfort of their own homes through, for example, the digital NHS health check and the new workplace trials.
Jerome Mayhew (Broadland and Fakenham) (Con)
Labour’s cut to the winter fuel payment will cause 262,000 cold pensioners to seek NHS treatment, according to the End Fuel Poverty Coalition. Do the Government agree with those figures, and if not, what are their own estimates?
Rachael Maskell (York Central) (Lab/Co-op)
Andrew Gwynne
My hon. Friend is incredibly knowledgeable about public health matters both at national and local level. Lord Darzi’s investigation into the NHS set out the impact of past reductions in local government public health funding. We will confirm public health grant allocations for the next financial year as part of the forthcoming spending review, but the points she made have been made loudly and clearly.
Esther McVey (Tatton) (Con)
Can the Secretary of State update the House on the status of Alan Milburn? Does he still attend meetings in the Department and have access to confidential information? Does he now have an official role in the Department? Does he still have private sector interests in the healthcare sector?
Mary Kelly Foy (City of Durham) (Lab)
October is Breast Cancer Awareness Month, and I stand here today as someone who was diagnosed, treated and cured of breast cancer this year by the amazing staff in the north-east, but not enough women are taking up their breast screening appointments. Will the Minister do more to raise awareness of, and access to, breast screening appointments, and may I urge all women to check themselves regularly?
Andrew Gwynne
I pay tribute to my hon. Friend for her work in this area and for setting out eloquently her own personal experiences. Of course this Government will do more to raise awareness and enable more women to access breast screening services.
Simon Hoare (North Dorset) (Con)
A significant impediment to improving adult social care is the split of budget and responsibility and policy between the Secretary of State’s Department and the Ministry of Housing, Communities and Local Government. Will he and colleagues work to remove that hurdle, to have better outcomes more cost-effectively delivered to improve the lives of all our constituents?
Mental Health Support
Andrew Gwynne Excerpts(1 month, 1 week ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)
It is a pleasure to serve under your chairmanship, Mr Dowd, and it is also a pleasure to respond to this debate on World Mental Health Day. I am grateful to my hon. Friend the Member for Ashford (Sojan Joseph) for securing the debate and for drawing on his long-standing experience of working in mental health care to raise so many important points in the debate. As several others have, including the shadow Minister, I thank everybody who works in the field of mental health, whether as a mental health practitioner or as one of the very many volunteers who give up their time freely to help people who are facing particular difficulties in their lives.
I am responding to this debate on behalf of Baroness Merron, the Minister with responsibility for mental health, so apologies if I do not answer everybody’s questions. I have taken copious notes and am sure that the powers that be sitting behind me have taken even more. If I do not answer all the points raised, Members can expect to receive something from the relevant Minister in due course.
It has been a great debate. I thank my hon. Friend the Member for Folkestone and Hythe (Tony Vaughan) and the hon. Members for Epsom and Ewell (Helen Maguire) and for Hinckley and Bosworth (Dr Evans). The latter made a really important point about the interrelationship between education and health in the whole sphere of special educational needs, autism and so on. I reassure him and others who made that point that the beauty of being part of a mission-led Government that has five missions—one is the health mission and another is the opportunities mission—is that it allows Ministers the opportunity to look at things in the round and break out of departmental silos. I assure him that on these issues I am having bilateral meetings with counterparts in the Department for Education about how we drive forward key elements of the health mission, and also about the role that the Department of Health and Social Care can play in achieving the Government’s opportunities mission. That work is taking place at departmental level.
I thank my hon. Friend the Member for Gateshead Central and Whickham (Mark Ferguson) for his contribution, and the hon. Member for Leicester South (Shockat Adam), who is not in his place but made some really important points, particularly about the impact of the Mental Health Act on black and minority ethnic groups. I, and the Government, think it is shameful that under the existing Mental Health Act black people are three and a half times more likely to be detained than white people and eight times more likely to be placed on a community treatment order. Our mental health Bill will give patients greater choice and autonomy and enhanced rights and support, and we will ensure that it is designed to be respectful in terms of treatment with the aim of eradicating inequalities. I put that on the record because the hon. Member for Leicester South made an important point.
I thank my hon. Friends the Members for Gravesham (Dr Sullivan) and for York Central (Rachael Maskell). My hon. Friend the Member for Hastings and Rye (Helena Dollimore) made a powerful contribution about Phoebe and about her ICB—I hope the ICB has listened. My hon. Friend the Member for Chatham and Aylesford (Tristan Osborne) made a contribution, as did my hon. Friend the Member for Stroud (Dr Opher). I reiterate to him that of course the arts have a powerful role to play in the health and wellbeing of the individual. I was fortunate last Friday to see the Manchester Camerata, one of the great orchestras in my home city, at the Gorton Monastery in my constituency, which is now a health and wellbeing hub. As well as understanding the work that it does, I also learned a lot more about social prescribing and about its powerful listening service.
Sonia Kumar (Dudley) (Lab)
As an NHS physiotherapist working in Dudley, I know very well that mental health is multifaceted. It affects not just one part of a person’s life, but everything: sleep deprivation, diet, overeating, undereating and building relationships. Does the Minister agree that we need more care in the community, including first contact practitioners, social prescribers and councillors in the community as the first line of treatment?
Andrew Gwynne
My hon. Friend is absolutely right. At the heart of the health mission that the Labour Government want to see is the shift from hospital to community, from analogue to digital and from sickness to prevention. What we do in the community really matters. Our ambition for the future of mental health services is wrapped up in those shifts, particularly the shift from hospital to community.
John Glen
Could I share my experience as a Minister? When we looked at social prescribing when I was in the Treasury, it was always difficult to establish an evidence base to justify the allocation of resources. I urge the Minister to continue that battle to make the case, because I am sure that the instinct of all Members throughout the House is that there is something in that ambition, and we must find a way of unlocking it so that we can get social prescription out into the community where a variety of provision is available.
Andrew Gwynne
The right hon. Gentleman is absolutely right. That will be one of the big challenges with the prevention agenda more generally, because often the investment we have to make today does not pay dividends immediately and there is a bit of a punt. Having been a Treasury Minister, he will know the challenges that that can present to the Treasury orthodoxy, but we have to push on this agenda.
I always say that being an MP and a GP is only one letter apart. We are often dealing with the same people who present with the same problems but from a different angle. We go away as Members of Parliament trying to fix the issue as they have presented it to us, and the GP will write a prescription and send them off having sorted out the issue as it was presented to them. However, the beauty of social prescribing is that there is an opportunity to deal with the whole issue in the round. The argument has been won with almost everybody, and any tips from the right hon. Member for Salisbury (John Glen) so we can get this over the line with the Treasury will be welcome.
I should mention my hon. Friend the Member for Darlington (Lola McEvoy), and welcome the hon. Members for Winchester (Dr Chambers) and for Runnymede and Weybridge (Dr Spencer) to their Front-Bench positions.
In the minutes I have left, I want to say to the House that many of the issues raised by Members during the debate are symptomatic of a struggling NHS. If we look at the figures, the challenges facing the NHS are sobering. In 2023, one in five children and young people aged eight to 25 had a mental health problem, which is a rise from one in eight in 2017. The covid-19 pandemic has exacerbated need, with analysis showing that 1.5 million children and young people under the age of 18 could need new or increased mental health support following the pandemic.
Dr Luke Evans
I want to raise an issue as the Minister is the Minister responsible for prevention. One of the biggest and most shocking things we saw during the pandemic was the increase in eating disorders, which is a very difficult topic for any Government around the world to try to break down. We know that the impact of eating disorders lives with people for the rest of their life and can cause them to lose their life, so will the Minister ensure that they are looked at as a priority? There was previously a roundtable; will he look into doing something similar again to bring experts together?
Andrew Gwynne
I am reluctant to commit Ministers to roundtables when I am covering another portfolio, because then they will do the same when they cover me in Westminster Hall debates, but I will say that we take this agenda incredibly seriously. When we were in opposition we gave support to the then Government, and I assure the hon. Gentleman that we will do everything we can to support people who have eating disorders and to get the right provision and support at the right time to the people who need it.
As I was saying, the covid-19 pandemic has exacerbated the need for mental health support. Around 345,000 children and young people were on a mental health waiting list at the end of July this year, with more than 10% of them having waited for more than two years. Some groups of children and young people are disproportionately impacted by mental health problems largely driven by a complex interplay of social and environmental determinants of poor mental health, as we heard in the debate.
We are committed to reforming the NHS to ensure that we give mental health the same attention and focus as physical health. It is unacceptable that too many children, young people and adults do not receive the mental health- care that they need, and we know that waits for mental health services are far too long. We are determined to change that, which is why we will recruit 8,500 additional mental health workers across child and adolescent mental health services. We will also introduce a specialist mental health professional in every school and roll out Young Futures hubs. We are working with our colleagues at NHS England and in the Department for Education as we plan the delivery of those commitments.
Early intervention on mental health issues is vital if we want to prevent young people from reaching crisis point. Schools and colleges play an important role in early support, which is why we have committed to providing a mental health professional in every school. However, it is not enough to provide access to a mental health professional when young people are struggling; we want the education system to set young people up to thrive, and we know that schools and colleges can have a profound impact on the promotion of good mental health and wellbeing. Doing this will require a holistic approach, drawing in many aspects of the school or college’s provision. I know there are many schools that already do this work, and my Department is working alongside the DFE to understand how we can support best practice across the sector.
As I have said, our manifesto commits us to rolling out Young Futures hubs. This national network will bring local services together and deliver support for teenagers who are at risk of being drawn into crime or who face mental health challenges. The hubs will provide open-access mental health support for children and young people in every community.
On other aspects of our plans, the mental health Bill announced in the King’s Speech will deliver the Government’s manifesto commitment to modernise the Mental Health Act 1983. It will give patients greater choice, autonomy, enhanced rights and support, and it will ensure that everyone is treated with dignity and respect throughout their medical treatment. It is important that we get the balance right to ensure that people receive the support and treatment they need when necessary for their own protection and that of others. The Bill will make the Mental Health Act 1983 fit for the 21st century, redressing the balance of power from the system to the patient and ensuring that people with the most severe mental health conditions get better and more personalised care. It will also limit the scope to detain people with a learning disability and autistic people under the 1983 Act.
Finally, Lord Darzi’s report identified circumstances in which mental health patients are being accommodated in Victorian-era cells that are infested with vermin, with 17 men sharing two showers. We will ensure that everyone is treated with dignity and respect throughout their treatment in a mental health hospital, and we will fix the broken system to ensure that we give mental health the same attention as physical health.
If I have not answered Members’ questions, those Members will be written to by the relevant Minister. I again congratulate my hon. Friend the Member for Ashford on securing the debate.
Sepsis Awareness
Andrew Gwynne Excerpts(1 month, 1 week ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)
It is good to serve under your chairmanship, Sir Christopher. I start by welcoming new Members to this House. I know it has been three months since the general election, but this is my first opportunity as a Health Minister to welcome those who have a clear interest in public health and prevention matters. I assure Members of the House that I will work with all Members to try to get those better outcomes. Working across party is how I always operated in opposition, and I seek to do the same in government. I also want to welcome the shadow Minister, the hon. Member for Sleaford and North Hykeham (Dr Johnson), to her post. We very briefly went head to head in the past when I shadowed her—I hope that she gets to shadow me for longer.
I congratulate the hon. Member for Ashfield (Lee Anderson) on securing this important debate. He is a chap who always wears his heart on his sleeve. Whether we agree with him or not, he is always forthright and passionate about the causes that he cares for. This is a cause for which there is commonality across the House, and I want to thank him sincerely for putting forward such an eloquent case to me, as the new Public Health and Prevention Minister, and for setting out the story of his constituent, Abbi. I am going to make her blush, and we have all said it, but she has a wonderful smile—she really has. I hope she will still be smiling at the end of the debate because I want to ensure that the Government do more on raising awareness of sepsis.
I have always taken the view that Members vastly enrich our debates with their own experiences and those of their constituents, and we heard it again in contributions over the course of the debate. I want to start by saying as the Minister that my deepest condolences go to the families and friends of everyone lost to sepsis, including those watching the debate elsewhere. Sepsis is a devastating condition. Last month was Sepsis Awareness Month. I want to pay tribute to the outstanding sepsis charities, including UK Sepsis Trust and Sepsis Research FEAT. They do so much to raise awareness, support families and fund research.
The shadow Minister mentioned Martha’s rule, and I want to touch on that. Throughout the history of the NHS, families have been at the heart of driving change and, indeed, holding our health service to account. Members may have read, as I did, Merope Mills’ article in the Guardian describing her daughter’s last few days in hospital. It was a difficult read—there is no getting away from that—and I cannot even begin to imagine how difficult that article was to write. At just 13 years old, Martha was a bright, bubbly young girl and, in her mum’s words, a “feminist in the making.” She should not have died. Her parents should have been listened to, they should have been kept in the loop, and they should have been treated with the respect they deserved. Talking to families should never be some tick-box exercise. On the contrary, nobody knows their child better than a mum and dad, as we know. Families have a critical part to play in their own care, and we need to ensure that their concerns are heard and acted on.
Thanks to Martha’s parents and other campaigners, NHS England will roll out Martha’s rule across 143 hospital sites by March next year. That initiative will enable patients and their families to seek a second opinion or a rapid review from someone outside their care team if they are concerned that their condition is deteriorating.
On sepsis training, NHS England has developed specific sepsis training resources to improve sepsis recognition for clinical and non-clinical staff in the NHS. Guidelines for recognition, diagnosis and early management of suspected sepsis were updated earlier this year. It is critical that those updates are constantly implemented by frontline clinical staff to drive real improvements on the ground. It is also important that we recognise the life-altering complications of sepsis, such as multiple limb amputations, as again was so eloquently set out by the hon. Member for Ashfield. Again, I want to thank Abbi for being here today—there is nothing more powerful than her presence in the Gallery.
Physical rehabilitation is an important part of the recovery process. It can be a long, difficult and frustrating process, so it is important that the NHS continues to place patients at the heart of rehabilitation services and focuses on meeting individual goals and improving their quality of life.
On public awareness, as has already been said by numerous Members, we all remember that incredible moment when Lord Mackinlay, who had a life-threatening battle with sepsis, walked into the House of Commons Chamber just before the general election was called. His moving testimony shone a spotlight on the physical and emotional pain of sepsis survivors and their families. I welcome his advocacy in that area. In the NHS, our focus must be on improving the early recognition and clinical treatment of sepsis. We should thank everyone who has campaigned on that.
Sepsis is a clinically complex condition. The signs and symptoms vary hugely, particularly in the early stages. Moreover, sepsis is not a single disease; it does not have a single diagnostic test. The NHS has got better at recognising and treating sepsis by the introduction of the national early warning score, a screening and decision support tool now used by 100% of ambulance trusts, and 99% of acute trusts, in England. Last year, NHS England ran a financial incentive scheme to encourage the use of the national early warning score to improve responses to unwell and deteriorating patients, and several trusts have rolled out the national paediatric early warning score to ensure the recognition of deterioration in children. We need to maintain that momentum, continuing to improve care and reduce preventable deaths from sepsis—because they are preventable, and we should do all we can to prevent them.
I want to see patients and families empowered to seek timely medical help. The job of the healthcare system is to ensure that frontline staff can recognise sick patients and respond quickly to provide lifesaving treatment. To support that, in the last five years, the National Institute for Health and Care Research has invested over £19.7 million of funding in 20 research projects on sepsis diagnosis, management and treatment, and it welcomes applications for research on sepsis.
I want to touch briefly on antimicrobial resistance. Our treatment of sepsis relies on effective antibiotics. That is why the Government are focused on tackling antimicrobial resistance by implementing the UK’s five-year national action plan.
On improving awareness, I spend almost every day thinking about prevention—it is in the title of my job—and preventing infection is the best way to avoid sepsis. I agree with the hon. Member for Ashfield, and indeed other Members, that we should be doing all we can to better educate and inform. It is heartwarming that in the latest statistics we have, awareness of sepsis is not only increasing, it is at relatively high levels. But we should never rest on our laurels. We have to keep reminding people of sepsis. That is why I will work with the hon. Member for Ashfield and others to ensure that we get the support we need.
I will work on a four-nation basis with colleagues across the devolved Administrations. One of my first jobs was to talk to Mike Nesbitt, the Health Minister in Northern Ireland, and the Welsh and Scottish Health Ministers, about health issues to which we have a common approach. Sepsis has to be one of those.
Finally, I assure the shadow Minister, the hon. Member for Sleaford and North Hykeham, that the comms budgets will not be cut for public health measures.