International Health Regulations

Andrew Gwynne Excerpts

Tuesday 14th May 2024 Commons Chamber

[Andrew Gwynne (Denton and Reddish) (Lab)]

This country has a role and a responsibility in protecting global health. It is a part we played during the covid pandemic. British science stood tall on the world stage, and our country donated 84 million vaccine doses to help vaccinate the world. We learned from the omicron variant that, when it comes to global pandemics, none of us is safe until all of us are safe. We also benefited from researchers around the world sharing early knowledge about covid-19, collaboration that was crucial in protecting British people and ultimately in developing the vaccine. However, there is a clear principle when it comes to national security. It is the same one we follow when we get on to an aeroplane: we apply our own oxygen mask before we help others apply theirs. The Minister says the draft text is not acceptable, and I want to be clear that a Labour Government will not sign anything that would leave our population unprotected in the face of a novel disease.

We are debating a treaty that is still being negotiated by member states, and none of us knows the final content or wording, so can the Minister reconfirm for the House that the Government will not sign up to anything that would compromise the UK’s ability to take domestic decisions on national public health measures? Has he consulted the UK’s life sciences sector ahead of these negotiations, and what conversations has he had with international counterparts and our allies about this treaty and our joint pandemic preparedness? As we work with colleagues around the world to bolster our efforts to tackle novel threats, it is vital that we get the balance right between sharing knowledge and protecting intellectual property, so can he set out his approach to any requirements for time-limited waivers of intellectual property related to vaccines and therapeutics in the event of a global disease outbreak? Finally, it is vital that we are led by science and evidence when tackling the threat of global disease epidemics, so can the Minister tell us what his Department is doing to tackle misinformation about pandemics and vaccines?

[Andrew Stephenson]

I thank the shadow Minister for his remarks. I confirm that we are firmly fighting in Britain’s interests for an accord and strengthened international health regulations that fully respect national sovereignty but can save lives and protect people both in the UK and around the world. They have to fully respect national sovereignty, and that is at the heart of our negotiating position. It will therefore always be up to nation states to decide what is implemented within their own borders.

Just to answer a couple of the hon. Gentleman’s specific points, yes, I have met representatives of the life sciences sector to discuss this and some of the specific proposals—the last meeting we had was last week. With regard to dealing with international counterparts, I will be attending the World Health Assembly in Geneva myself.

My final point is that the hon. Gentleman is right to pay tribute to what this country did globally during the pandemic. Of course, in 2021 we used the G7 presidency to mobilise G7 countries to donate surplus vaccines, and by May 2022 the G7 had donated 1.18 billion doses against the target of 870 million. The UK alone donated over 80 million doses, benefiting 40 countries.

World ME Day

Andrew Gwynne Excerpts

Wednesday 1st May 2024 Westminster Hall

[Andrew Gwynne (Denton and Reddish) (Lab)]

It is always a pleasure to serve your chairmanship, Dame Siobhain. I congratulate the right hon. Member for Bromsgrove (Sir Sajid Javid) on securing this important debate and on the work he not only did as Health Secretary, but continues to do as a Member of Parliament on ME, which we know is a profoundly debilitating and chronic condition that affects various systems across the body. Figures estimate that at least 250,000 people in the UK live with it. However, it is estimated that upwards of 1.3 million people live with ME or ME-like symptoms following a covid-19 infection. As we have heard, women are five times more likely to develop ME than men, and they experience more symptoms than men.

Many parallels have been drawn between ME and long covid, given that research has indicated that at least half of those living with long covid have symptoms that directly mirror those of ME. As someone who continues to suffer from the effects of long covid, those symptoms are all too familiar to me: a draining fatigue that never seems to go away; constantly disturbed sleep and an endless feeling of exhaustion; and a debilitating brain fog that can strike at the most inconvenient of moments.

I just want to place on the record that I have managed to control my long covid for the best part of two years, but this week has been a very bad week for me; I was in bed for all of today, and I have only come in to give this speech. The reason that there is a bundle of tissues here is because the sweats just hit me while walking into work. I do understand—I have lived with the experience of symptoms similar to ME—and I agree with my right hon. Friend the Member for Hayes and Harlington (John McDonnell) about the impact it has on people in work, because we do not know which days will be our good days and our bad days, and sadly we are judged against our bad days. That is true.

We need to educate employers about ME and long covid so that reasonable adjustments can be made, and about changes to the welfare system. When I was on my very worst of days, very early on after I contracted covid-19, I would have been signed off work if I had turned up for a work capability assessment, because it was obvious to all. On my best days, though, people would think, “There’s nothing wrong with him,” so if I had the misfortune of having a work capability assessment on one of my better days, I would then be put into work when I was not capable. We must attend to those issues across Government.

We know that ME costs the UK economy about £3.3 billion a year, and that number is growing. We need far better understanding of this debilitating condition and its impact on the day-to-day lives of too many people. That is why Labour is committed to putting Britain at the front of the queue for treatments by boosting clinical trial activity in the NHS. We will speed up recruitment to trials and give more people the chance to participate. We will link up clinical trial registries to create national standing registries, and harness the power of the NHS app to invite eligible participants to take part in research studies for which they are eligible. We also need to rebuild the system so that it recognises the impact of post-viral conditions like ME and equips people with the tools needed to work with it.

We need to refocus our services away from hospital settings to be rooted in the community, so that patients can access care when and where they need it, and we need to bolster a workforce that can better understand ME so that people can get timely care. Above all, we need to get that delivery plan published sooner rather than later. I implore the Minister for World ME Day: he has cross-party support, so let’s get it published ASAP.

Glaucoma and Community Optometry

Andrew Gwynne Excerpts

Tuesday 30th April 2024 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I beg to move,

That this House has considered glaucoma and community optometry.

First, a special thanks to the Backbench Business Committee for selecting the debate for this morning. I am my party’s health spokesperson—it is no secret—and am particularly interested in health issues. As such, I secured this debate off the back of a number of people who had contacted me. What I am particularly pushing for—I am sorry for the short notice; I put the request in the Minister’s hand only two minutes ago—is that we do something now so that we can save sight further down the line. If I were pushing for one thing only, that is the one thing I would wish to have.

Optometrists in my Strangford constituency—I will send them a copy of this debate in Hansard afterwards—asked me to secure this debate. A number of bodies here on the mainland asked me the same thing. That is my purpose, but the issue of sight and sight-loss problems affects every constituency equally throughout this great United Kingdom of Great Britain and Northern Ireland. Therefore, the approach to making the system more fit for purpose must also be UK-wide.

I am pleased to see the shadow Minister, the hon. Member for Denton and Reddish (Andrew Gwynne), in his place. We are sparring partners, although when I say that I do not mean that we hurt each other—we fight things together. I am also especially pleased to see the Minister in his place. He has a deep interest in this subject, as well as a deep interest in Northern Ireland, which I much appreciate. He has told me about his times in Northern Ireland in the past month or so, and how much he loves going there. Indeed, every MP who visits Northern Ireland—including you, Dame Caroline—always comes back with the most wonderful memories of the occasion and of the people they meet. Just this morning, a Conservative Whip was telling me that he was in Hillsborough two weeks ago, and about how much he enjoyed it.

[Andrew Gwynne (Denton and Reddish) (Lab)]

I want to place on the record the fact that a month ago I made my first visit to Belfast. I had an incredible time meeting Members of the Assembly at Stormont, and going to Harland & Wolff, around Belfast and to an inclusive school. It is a remarkable place, and I just wanted to add, as the hon. Gentleman is putting on the record that everyone else has been to Northern Ireland, that so have I—although I know that is not the subject of our discussion, Dame Caroline.

[Dame Caroline Dinenage (in the Chair)]

Order. I gently remind Members that, charming as it is to hear about Northern Ireland—we are all wildly in favour of going there at every available opportunity—this is a debate on glaucoma.

--- Later in debate ---

[Andrew Gwynne (Denton and Reddish) (Lab)]

I start by passing on the apologies of my hon. Friend the Member for Birmingham, Edgbaston (Preet Kaur Gill), who leads for the shadow health team on the issues we are focusing on today. She is otherwise detained on the Tobacco and Vapes Public Bill Committee, which is taking place at the same time.

I sincerely thank my hon. Friend the Member for Strangford (Jim Shannon)—I know that the custom in this place would be for me to call him “the hon. Gentleman”, because he is not of my party, but he is a friend—for securing this crucial debate and for the positive spirit he always brings to these proceedings. Glaucoma is a common yet serious condition that, if left untreated, can cause real damage. Anyone is at risk of developing glaucoma at any age, but it particularly affects people as they get older.

I declare a bit of an interest here: my grandmother had glaucoma. Because my mum died at the age of 50, they do not if the condition was hereditary, so every time I go to my opticians I have to have the glaucoma test in case it is hereditary. However, it is really important that people are tested routinely, because it is a serious condition that, if left untreated, can cause real damage.

Several factors increase an individual’s risk of glaucoma, including a family history of the condition; being of African, Caribbean or east Asian origin; and having long or short sight, diabetes or blood pressure problems. Glaucoma tends to develop gradually, and it is often entirely symptomless for a long period. As a result, many glaucoma patients are diagnosed only during routine eye tests. The impact of glaucoma can vary greatly, ranging from misty or blurry patches in vision to struggling to complete day-to-day tasks such as reading, and permanent sight loss.

When it comes to accessing basic care, many glaucoma patients face significant challenges. Across eye care, more than 600,000 patients are currently on waiting lists for treatment. Given the risk that glaucoma poses if left untreated, such extensive waiting lists are a serious threat to patient outcomes. Sadly, that statistic shows no sign of changing, and demand for ophthalmology services is set to increase by more than 40% in the next two decades. Given an estimated annual cost to the economy from sight loss of more than £25 billion, the case for action could not be clearer.

I have a degree of frustration with the Government’s approach to the issue. Given the statistics, I would like to see the Minister commit today to turbocharge access to ophthalmology services and make eye tests more commonplace for people who do not routinely test their eyes, but also to get people access to eye care services once conditions have been diagnosed.

The next Labour Government are committed to reforming the system so that those with glaucoma and other eye health conditions can access care when and where it is needed. We will provide 2 million more operations and appointments on evenings and weekends, paid for by clamping down on tax dodgers, so that patients can be seen on time again. We will have a laser-like focus on prevention, tackling the social determinants of ill health and ensuring that eye conditions such as glaucoma are tackled at source. We will ensure that the NHS shifts from an analogue to a digital service, embracing the latest developments in technology and artificial intelligence to provide the best possible care and deliver the best possible patient outcomes.

Again, I declare an interest: being a bespectacled Member of Parliament, I obviously have routine eye tests. I am short-sighted, although age is catching up with me, and this is the first time that I have had varifocals for reading and for distance. However, my optometrist, Dr Shen of Boots opticians in Denton, has brought in and embraced some of the latest technological advances for testing different eye conditions. At my last eye test, I was amazed at the wizardry and machinery they have brought in, revolutionising the way they can diagnose.

[Jim Shannon]

The hon. Gentleman is speaking very powerfully and I endorse those comments. What I have seen with optometrists in Newtownards in my constituency of Strangford is the amount of money and investment that they have put in. They have not asked for any help from the NHS for those things. They are doing it themselves. I think there is a wonderful opportunity for a partnership with optometrists who are investing money—all they need is the people to come in for testing—and that, I believe, is a role for Government.

[Andrew Gwynne]

I could not agree more with the hon. Gentleman. Boots Opticians in Denton is a franchise, and the owner of that franchise has invested in this remarkable technology. I have now seen parts of my eyes that I never believed it would be possible to be able to see. It is incredible digital technology, and it allows opticians to diagnose eye stroke. That is particularly important for people with diabetes, glaucoma, high blood pressure and cardiovascular disease. The technology can also be used to diagnose diabetic retinopathy, in which people’s retinas are leaky, which can lead to temporary vision loss, and age-related macular degeneration. That detailed eye care allows other eye problems, which ordinarily would have gone unchecked, to be found and the appropriate treatments to be provided. I have seen how transformative the use of modern technology by my own optician can be for testing for a whole range of conditions and eye health.

That is why this debate is relevant and why changes across the system are clearly needed. That is most evident in community optometry. There is a real potential to utilise, as the hon. Member for Strangford has said, the existing capacity on our high streets and in our town centres—crucially, where people are—to get a firm grip on the crisis in eye care. That is why the next Labour Government have committed to seeking negotiations with high street opticians to strike a deal to deliver more NHS outpatient appointments. That partnership, which the hon Gentleman was rightly discussing, will underpin Labour’s eye care policy.

With 6,000 high street opticians serving communities across the country, we cannot afford to sit back and waste their incredible potential. We will work with high street opticians to beat the backlog and to get the system moving again. By utilising community capacity, we can free up specialists in the NHS to support those patients with the greatest need, providing greater accessibility, convenient care and, most importantly for all of us taxpayers, better value for money for the public purse.

This approach is backed up by evidence, proving the tangible impact of community-based eye care and eye health services. A 2014 study of the introduction of minor eye care services in Lewisham and Lambeth showed how significant that impact is. GP referrals to ophthalmology specialists in Lambeth decreased by 30%, with an even greater reduction—75%—in Lewisham. Costs in areas without minor eye care services increased, while there was a drop in costs in Lewisham and Lambeth of 14%.

Given that the sector is in clear need of reform, with patient outcomes continuing to suffer, will the Minister back Labour’s plan to unlock the potential of community optometry? With more than 550 patients suffering sight loss because of delays in the NHS since 2019, does the Minister accept that further inaction is simply not an option? These are people whose lives, and those of their loved ones, have been fundamentally changed through no fault of their own. We owe it to them to fix this system once and for all, working in partnership with the devolved Administrations across the United Kingdom, as the hon. Member for Strangford says, so that there is not a postcode lottery on these services, and we get the best outcomes for all British citizens across the United Kingdom. We owe it to them to ensure patients with glaucoma and other eye health conditions get the care they need, when they need it, and where they need it.

We will support the Government in the remaining weeks or months that they have to get this policy right, but mark my words: the next Labour Government see this as a priority and we will act.

Oral Answers to Questions

Andrew Gwynne Excerpts

Tuesday 23rd April 2024 Commons Chamber

[Mr Speaker]

I call the shadow Minister.

[Andrew Gwynne (Denton and Reddish) (Lab)]

Back in the real world, the record of the last Labour Government is that we increased life expectancy by three years. Under this Government, it has stalled for the first time in a century, with people in Blackpool, for example, expected to live four and a half years less than the national average. Is the Secretary of State proud of this shocking record, or will people have to wait to elect Chris Webb in Blackpool South and a Labour Government at Westminster to finally turn the tide on health inequalities?

[Victoria Atkins]

As someone who is proud to have gone to school in Blackpool, I do not need a lecture from the hon. Gentleman about what Labour has done to the town centre, or about the important work that Conservatives in Lancashire are doing to help communities such as Blackpool. On Labour’s record, I gently point out, as I try to do at every orals, that the record of the Labour-run NHS in Wales is lamentable. People are almost twice as likely to be waiting for treatment in the Labour-run NHS in Wales. That is not a record of which to be proud.

Hospice Funding

Andrew Gwynne Excerpts

Monday 22nd April 2024 Commons Chamber

[Andrew Gwynne (Denton and Reddish) (Lab)]

It is a pleasure to respond to the debate. We have had a very thorough discussion over the past few hours, so let me start by thanking not only the Backbench Business Committee for granting the time for us to debate this important issue—albeit a week later than most of us had expected—but the hon. Members for Hastings and Rye (Sally-Ann Hart) and for Darlington (Peter Gibson) for securing the debate; I congratulate them on their speeches.

I thank my hon. Friends the Members for Enfield, Southgate (Bambos Charalambous), for Coventry North East (Colleen Fletcher), for Birmingham, Erdington (Mrs Hamilton), for Hammersmith (Andy Slaughter) and for York Central (Rachael Maskell), my right hon. Friend the Member for Hayes and Harlington (John McDonnell) and my hon. Friend the Member for Leeds East (Richard Burgon), as well as the hon. Members for Colchester (Will Quince), for Southport (Damien Moore) and for Eastleigh (Paul Holmes), the hon. and learned Member for Eddisbury (Edward Timpson), the right hon. Member for Basingstoke (Dame Maria Miller), the hon. Members for North Devon (Selaine Saxby) and for Bolton West (Chris Green), the right hon. and learned Member for South Swindon (Sir Robert Buckland), the hon. Members for Loughborough (Jane Hunt), for Isle of Wight (Bob Seely), for West Dorset (Chris Loder), for South Dorset (Richard Drax), for Waveney (Peter Aldous), for St Austell and Newquay (Steve Double) and for Bracknell (James Sunderland)—not forgetting, of course, the hon. Members for Strangford (Jim Shannon) and for Glasgow North (Patrick Grady). I also congratulate all those who took part in the London marathon; I was not one of them.

Let me now turn to the subject that we are here to debate. End of life care is a subject that has touched the lives of most of us. It is a time when our loved ones, and the family and friends who surround them, can be at their most vulnerable and in need of the greatest support. Managed well, it can be a healing time for families to come together, but managed badly, it can leave deep and traumatic scars. I need only look at the experience of my family—the experience that I had during the deaths of my parents to know how this bears out. It was 30 years ago that I lost my mum to ovarian cancer—I was 19. Her final hours were spent at the end of an old Victorian ward with the curtain pulled around her, and she was in immense pain and suffering, which I remember vividly to this day. That was incredibly hard for our family to manage.

More recently, in 2022 I lost my dad following his own battle with cancer. Unlike my mum, he died at home, with my wife and I taking him in for the last few months of his life, and we were supported by a superb army of care staff. In fact, when the time came for my dad to decide whether he wanted to go to the local hospice, Willow Wood, or stay at home with us, the final words that he communicated to me and my wife were, “Stay here.” I come back to the point made by the hon. Member for Colchester about how we talk about death, how we deal with death and the end of life, and the fact that many people want dignified end of life services at home; we should do all we can to facilitate that.

In my dad’s case, the whole system worked. It came together in a way that, as I know from my constituency casework, it rarely does. The hospital, social services, Macmillan, Marie Curie, the GP, the pharmacy, the district nurses and Willow Wood hospice all worked together seamlessly, and my died passed away in comfort, peacefully and surrounded by those who loved him most in the world. We have heard from my hon. Friend the Member for Coventry North East and other Members that we have to get the end of life choice right for people, and hospice at home plays an important role in that.

The sharp contrast between my parents’ journeys emphasises to me, in a deeply personal way, just how impactful end of life care can be. For all of us, death should be about choice and what we want, and we should leave this planet with dignity. We talk about the integrated care boards, and the clue is in the name: they should be integrated, with both social care and other services, including hospice services. In my dad’s case, that worked, but as we have heard from Members across the House, in too many cases the integration just is not there yet. The Government have rightly devolved money to the ICBs for a specific purpose, but it is not being spent as we would want.

Hospices play such an important part in that deeply personal journey for hundreds of thousands of people and their families every year, right across the country. Working in partnership with existing local systems, hospices ensure that people receive the care that is most appropriate for them, considering all their needs. I pay particular tribute to one of my local hospices, Willow Wood hospice in Ashton, Tameside. The tireless work and dedication of its staff was a vital support when we were caring for my dad in his final days. Those staff showed hospice care at its best, and they have my immense gratitude for all that they continue to do. But they, like so many others, find themselves in a perilous financial position; Willow Wood faces a structural deficit of £750,000 this financial year. Without finding a way to plug the gap, its services will have to be reduced.

There is real pressure on all hospices to generate their own income, with Hospice UK estimating that as much as two thirds of income for adult hospices is generated through fundraising, with some, like Willow Wood, having to raise 80% of their funds themselves. Many hospices do incredible fundraising work, with armies of volunteers finding ever more ingenious ways to keep the money coming in, but with the incredibly hostile economic climate that hospices are finding themselves in, including as a result of energy costs, funds are being squeezed more than ever—[Interruption.] Someone put 50p in the meter; obviously the House cannot afford those costs now!

The sector as a whole is on track for a deficit of £77 million for the last financial year, the worst figures for two decades. As a result, hospices are starting to pare back some of their services. As we have heard, there is also a legal requirement placed on integrated care boards by the Health and Care Act 2022 to commission palliative care services in keeping with local need, and we need to ensure that that funding is passported down to the hospices where they need it. We know that delivery is far from consistent, leaving patients in some parts of the country without adequate services in their own community. The clear pressure on the sector shows no sign of letting up, because we are an ageing population and demands on hospice services are set to increase further, with Office for National Statistics data suggesting that a further 130,000 people will die each year in the UK by 2040.

It is clear that we need proper joined-up supportive policies for the hospice sector. We need to ensure that the money that the Government have ensured is there for the hospice sector gets down to where it needs it: at the hospices themselves. We need to focus on creating a health and care system that is genuinely joined up and has end of life care as part of the health and wellbeing policies for each and every one of us. This can no longer be the taboo subject it once was, and the hospice sector underpins so many care pathways that have a tangibly positive impact on patients and their families. End of life care matters. This current Government will have our support in ensuring that the hospice sector is protected and supported.

Parents and Carers of Infants: Support

Andrew Gwynne Excerpts

Tuesday 12th March 2024 Westminster Hall

[Andrew Gwynne (Denton and Reddish) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Henderson.

This has been a small but perfectly formed debate. I congratulate the hon. Member for Hastings and Rye (Sally-Ann Hart) on securing not just the debate, important though that is, but a Bill. I wish her Bill well on Friday, because, as the hon. Member for East Worthing and Shoreham (Tim Loughton) rightly said, there is a degree of consensus on these issues across the House. We all understand the need for children to have the best start in life, and for parents to have wraparound support as and when they need it. Those first 1,001 days are crucial to the development of a child to ensure that they start out in life with the best chances that we can give them.

I was interested in what the hon. Member for East Worthing and Shoreham said; my ears pricked up to attention when he mentioned Stockport. Being a partly Stockport Member of Parliament, I am keen to promote it as one of the two boroughs that my parliamentary constituency sits within. Stockport children’s services are good. They provide decent support to families when they need it, and there are some challenges. Stockport is a unique borough in many ways, in that it is a microcosm of the entire United Kingdom. It has some of the richest, most prosperous parts of Greater Manchester within its boundaries, and some of the poorest parts. It is almost a perfect make-up of the country.

[Tim Loughton]

Although it was 14 years ago when I went there, I have been back since. I am delighted to confirm to the hon. Gentleman that Stockport had a fantastic children’s services department then and it has remained so, with some impressive, experienced social workers. Where I went was not in his constituency; I visited nearby, with the full compliance and support of the then Member.

[Andrew Gwynne]

I would hazard a guess that the hon. Gentleman visited Brinnington, which is just over the border. Irrespective of that, he is absolutely right to support the Best Start for Life programme, and he is right that we should not change it for the sake of it. We can tinker around at the edges, but the ethos behind it is absolutely right.

I would also hazard a guess that if this Government had their time again, they might well have done the same with the Sure Start programme, which was starting to make a big difference. I will talk very briefly about my experience of Sure Start in my constituency. I was given the privilege of opening one of a number of Sure Start centres. This one was in the Dukinfield part of my constituency, in the Tameside borough. It was attached to a primary school in the middle of a 1960s deck-access council estate. The centre had been open and providing services to the community for about six months before it had its official opening. As the guest of honour cutting the ribbon, I was introduced to a number of people who used the services within the Sure Start provision.

I was introduced to a young mum called Sarah. She was very young, and had been ostracised by her family because she had become pregnant. She had no natural support network around her. Her only existence had been the four walls of her flat in the deck-access estate. Understandably, she had become very depressed post pregnancy, and the life of her young baby was essentially sitting in front of the television while mum was in her dressing gown eating crisps. Her brilliant Sure Start worker eventually convinced mum to go to the new provision across the way, and got her out of those four walls of the flat.

Dukinfield is a very white, very working-class community. The Rive Tame, which runs through Tameside—the clue is in the name—is only very narrow, probably no wider than this room. On the opposite side of the river from Dukinfield is Ashton-under-Lyne, and that part of Ashton-under-Lyne is very heavily south Asian, with predominantly Pakistani and some Bangladeshi communities. Never the twain shall meet. That river may as well be a wide ocean. Those two communities did not mix, but this Sure Start centre was shared by both communities.

Sarah very excitedly introduced me to her best friend Ameena, who lived in Ashton. Those two would never have met but for that Sure Start provision. She said to me, “Mr Gwynne, let me introduce you to my best friend Ameena. Her daughter plays with my daughter. They’re best friends, and I go to her house. Mr Gwynne, before I came here I couldn’t boil a pan of water. She’s now teaching me to cook curry.” I just thought: Wow! Not only is it a safe space for different communities to come together by accessing support through mainstream statutory services, but they are informally helping one another. I thought that was great. If we could bottle that and spread it out, that is what we should be doing.

That is why I will always argue passionately that Sure Start was working and why I am pleased that the Minister has brought in family hubs. Although they are not yet on the scale of Sure Start, from small acorns grow great oaks. I believe that, whoever is in government, supporting the family and nurturing them in those first 1,001 days really matters. In terms of the Bill from the hon. Member for Hastings and Rye, some really simple changes can make a big difference. She mentions that for many it is not easy to access information for support and that local authorities should publish the Start for Life offer on its website.

I know we are not supposed to use props, but I draw Members’ attention to the website of Grow in Tameside, which has a page for key Tameside contacts for early years support and information. It is all there on the website, in part because early years has been a passion of Tameside Metropolitan Borough Council for a long time. In the 1980s, before it was fashionable, they had child and family centres in Tameside. Those centres were used as the evidence base for Sure Start when the Labour Government came in in 1997. The Minister made sure that Tameside was one of the pilots for the family hubs, so we have family hubs operating already in Tameside and doing great stuff. They could do more, but it is great what they do.

This is not just about statutory services but about the wider support network, whether that includes religious organisations, community organisations, the voluntary sector or others. There are lots of things going on. I am a very proud patron of Home-Start in Oldham, Stockport and Tameside. Sarah and the team there do great work. The Dad Matters team under Kieran does great work engaging with dads. They have a breastfeeding service, and they have Cascade, where people can donate toys and clothes to families who need them. That work is being done, but we need to turbocharge it. That is why Labour will always support any measure that means the best start in life for children and families.

Oral Answers to Questions

Andrew Gwynne Excerpts

Tuesday 5th March 2024 Commons Chamber

[Mr Speaker]

I call the shadow Minister.

[Andrew Gwynne (Denton and Reddish) (Lab)]

It was the Minister’s party that promised to fix the crisis in social care “once and for all”. With vacancy rates almost three times above the national average and turnover rates for new staff at more than 45%, it is clear that the Government failed. Labour’s plan for a national care service with clear standards for providers and a new deal for staff will give social care the fundamental reset it needs. The Government have done it with our workforce plan, and they have half-heartedly tried it with dentistry. Does the Minister want to copy our homework once again?

[Helen Whately]

Let us be honest, Labour has no plan for social care. Whatever the shadow Minister says, it is unfunded. There is no funding committed to it and it is not meaningful. Those of us on the Conservative side of the House are reforming adult social care. We not only have a plan, but it is in progress.

Internationally Recruited Health and Social Care Staff: Employment Practices

Andrew Gwynne Excerpts

Wednesday 31st January 2024 Westminster Hall

[Andrew Gwynne (Denton and Reddish) (Lab)]

It is a pleasure to serve under your chairmanship this afternoon, Mr Hosie. I shall begin by congratulating the right hon. Member for Spelthorne (Kwasi Kwarteng) on securing this important debate and on the way in which he opened the debate; it was incredibly insightful and certainly chimed with a number of the issues that have been raised by Members across the House, as well as with the concerns we share about the role of an international workforce and how we look after those people who come to this country to help those in our social care service.

I also thank my friend, the hon. Member for Strangford (Jim Shannon). I know that it is convention to call him “hon. Member”, because he is from a different party, but he is my friend, because—I do not know whether I am stalking him or he is stalking me—we are always at the same debates. He made an important point about how we get workforce planning right across the United Kingdom. I am aware that if, at some stage in the future, I were to have the Minister’s job, it would be very easy to come up with a workforce plan for social care that plugs the gaps in England by pinching staff from Northern Ireland. We have to ensure that, as we go forward with our workforce planning, there are enough people in the social care workforce across the whole of the United Kingdom. We must not create a perverse situation whereby working in social care in England becomes very attractive at the cost of social care in Scotland, Wales or Northern Ireland. We must work together on this journey of upskilling and building a workforce for the future.

Likewise, the hon. Member for Westmorland and Lonsdale (Tim Farron)—I will call him a friend too as we are all friends in this Chamber—made some really important points. He spoke about the challenges—not just workforce challenges but general challenges—in delivering quality social care and other public services in sparsely populated areas such as his constituency in the Lake district, which are linked to other issues that he speaks passionately about in the Chamber, including housing and transport. We need to join up those things if we are to attract the right kind of social care workforce to meet his constituents’ needs.

I disagree profoundly with the desire of the hon. Member for East Dunbartonshire (Amy Callaghan) for Scotland to be separate from the rest of the United Kingdom. I am a proud Unionist. I have Welsh heritage, as my surname, Gwynne, indicates. I am half-Scots, as my first name, Andrew, suggests. My Scottish gran from Lochwinnoch was very adamant that I have a Scottish name. And obviously I am English—I am Mancunian—and proud of that. I see the benefits and the strength that comes from the people of the islands that make up the United Kingdom working together for the common good. I get that under the devolution settlement Scotland has the ability and the responsibility to develop, provide and plan social care services that meet the needs that are particular to the towns, villages and cities in Scotland, but migration is a reserved power. There must therefore be a relationship between the way in which the Scottish Government meet those needs and plan health and social care, and the United Kingdom Government’s wider responsibilities on migration.

We can be in no doubt that we have a workforce crisis in health and care services right across the country. Members have said that there are 152,000 vacancies in social care alone. I have been meeting providers and representatives of local authorities, and they tell me that the challenges are massive. That is why we need a proper grasp of how we build the workforce of tomorrow responsibly. It takes only the opening of a new supermarket in somebody’s area for social care to lose a whole swathe of low-paid workers because they get paid more to stack shelves, so there is something fundamental there.

We are failing to recruit the staff we need, and staff in the services are leaving. That is not sustainable. Our health and care workforce so often represents the best of Britain, going above and beyond to keep us and our loves ones safe. We cannot and must not exclude from that recognition those who come from overseas to support our health and care system. They make huge sacrifices day in, day out, and they deserve our immense gratitude and respect. They must not be used to score political points, as is too often the case.

As we have heard, overseas workers, particularly those in social care, often face very challenging environments and are vulnerable to shoddy employers, so it is vital that we ensure we have a system in which the exploitation of overseas workers is simply not tolerated. Steps must be taken to stop those who perpetrate abuse. That is not only good for them; it is essential if we are to ensure a decent quality of care. That should not detract from recognising that most workers from overseas come here to do legitimate jobs and are employed by legitimate care companies, including some that enjoy high CQC ratings for the quality of care they provide. However, those people still face abuse and exploitation in the workplace.

We must also recognise that the contribution of overseas care workers to our care economy has been, and continues to be, crucial to the functioning of health and social care. We should be deeply grateful; without them, many more care services would have closed in the last few years, leaving thousands without the support they need. Even with their contribution, Age UK estimates that 1.6 million older people in our country have some form of unmet need for care, and because our population is ageing, the demand for care is increasing all the time.

The hon. Member for Westmorland and Lonsdale referred to Beveridge and old age. An ageing population is a massive challenge to this country because of care needs and things such as pensions and the sustainability of the welfare state, but the real challenge in adult social care—this links to the issues related to our ageing population—is that in the past, people born with severe learning or physical disabilities did not live long into adulthood, if at all, and they are now living way into adulthood. Huge cost pressures are building in the system around working-age adults with disabilities, which we also need to address; it is not just about the ageing population.

We need to recruit and retain more care workers to give the sector the workforce it needs to deliver for those needing care, and we will support that. That is why we do not just have a workforce plan for the NHS; we have ensured that we have considered social care as well. The next Labour Government will introduce the first sectoral fair pay agreement in adult social care, which is testimony to the persistent battling of my right hon. Friend the Member for Ashton-under-Lyne (Angela Rayner), who started her working life as a social care worker. We will ensure that pay, terms and conditions and training and development meet the needs of staff. As part of our 10-year plan for fundamental reform of the sector, which culminates in the creation of a national care service in England, we will ensure that social care is no longer a route for those seeking to abuse overseas staff and fuel the perception of care being the bottom rung of a ladder.

We must make sure that we build a career pathway that incorporates training and has parity with caring responsibilities in the NHS as part of our workforce plan, so that there is more fluidity between the NHS and social care. Somebody who starts off as a nurse should be able to have a career pathway that ultimately leads them to be the chief executive of a major care provider. Why shouldn’t somebody who starts as a social care worker have a career pathway that leads them to be the chief executive of an NHS trust? We can only do that by building a workforce that has some form of parity.

We will ensure that, in future years, comprehensive independent workforce assessments are made, so that NHS and social care staff can keep up with the demands of a growing and ageing population, rather than falling behind. I get so frustrated at the lack of progress on some of these issues. I know the Minister is trying her best, but for too long, under too many different Governments, social care has been seen as that lean-to, as the hon. Member for Westmorland and Lonsdale put it. It is time that we have a Government committed to fixing social care and to developing the services we need, built around the needs of the people who require social care services, and it is time that we have a workforce plan that drives up quality, ensures career progression and fills those gaps. We need that general election—the country is crying out for change after 14 years of this Tory Government delivering an NHS and social care system that is broken. It is time to fix that broken system—it is time for Labour.

Oral Answers to Questions

Andrew Gwynne Excerpts

Tuesday 23rd January 2024 Commons Chamber

[Mr Speaker]

I call the shadow Minister.

[Andrew Gwynne (Denton and Reddish) (Lab)]

But according to Care England and Hft, 54% of social care providers have increased their reliance on agency staff; 44% have turned down new admissions; and 18% have had to close services altogether. Labour’s fair pay agreements will ensure that staff in the sector are treated with the dignity and respect that will make them want to stay, but after 14 years, why do Ministers not have a proper plan to address the workforce crisis facing adult social care? Is it because it is a crisis of their making?

--- Later in debate ---

[Mr Speaker]

I call the shadow Minister.

[Andrew Gwynne (Denton and Reddish) (Lab)]

Mike Reader, Labour’s candidate for Northampton South, shared with me the horrific experience of Stanley, who had severe abdominal pain and called an ambulance, only to be told it would take hours and to go to A&E. There, he was told to wait for assessment on a patio chair outside. It was 3°. Who is to blame?

[The Minister for Social Care (Helen Whately)]

I am very sorry to hear of the experience of that specific constituent. Because of challenges that the NHS faces, particularly our urgent and emergency care services, almost a year ago we set out our urgent and emergency care recovery plan, to speed up care for people in A&E and reduce waits. That plan is working. We are seeing ambulances get to people quicker, and people treated quicker in A&E.

[Andrew Gwynne]

That is not a one-off. Why will the Minister not take a shred of responsivity for the chaos that her party has caused our NHS? The last Labour Government achieved the shortest waits and the highest patient satisfaction in NHS history. The Conservatives have delivered the longest waits and the lowest patient satisfaction in history. Let us have that general election, so that she can defend her abysmal record to the public.

[Helen Whately]

The hon. Gentleman obviously was not listening to my answer; in fact, he was reading aloud. Our urgent and emergency care plan is working. It is reducing rates in A&E, and ambulances are getting to people faster. Meanwhile, I am sorry to say that in the Labour-run NHS in Wales, more than half of patients are waiting more than four hours in A&E.

World Stroke Day

Andrew Gwynne Excerpts

Thursday 23rd November 2023 Westminster Hall

[Andrew Gwynne (Denton and Reddish) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Hollobone. Like others, I begin by thanking my hon. Friend—I will call him that, because we are friends—the Member for Bromley and Chislehurst (Sir Robert Neill) for securing this important debate to mark World Stroke Day. I thank him for not just his continued advocacy and the work he does here in Parliament, but sharing his personal experiences. On behalf of the whole House, we send our love to his wife and to him for the work he does to look after her.

We have had a small but perfectly formed debate. I want to thank my hon. Friend the Member for York Central (Rachael Maskell) in particular for her powerful contribution. She speaks with experience that I could only ever dream of; it is so important that her expertise, knowledge and past experiences should shape and inform the debate. I thank her for that. Likewise, I thank the hon. Member for Strangford (Jim Shannon) and the hon. Member for Motherwell and Wishaw (Marion Fellows), who leads on health issues for the SNP, for their contributions. We have had a good, thorough debate, covering a lot of issues. Hopefully we have marked World Stroke Day well in this place today.

It is stating the obvious to say that stroke can have a life-changing impact. As we have already heard, the statistics show that in the time we are here this afternoon, 14 people across the United Kingdom will have had a stroke—that is one stroke every five minutes. Although often a sudden event, the lasting impact of stroke for patients can be devastating. It is one of the leading causes of adult disability across the United Kingdom. Two thirds of stroke patients—let that sink in—will leave hospital with a permanent disability, often needing lifelong care. Sadly, stroke is often fatal, causing around 35,000 fatalities across the UK every year, making it the fourth leading cause of adult death.

What those statistics demonstrate to me is that however far we have come on the journey with stroke, we need more concerted action going forwards—not just from a patient care perspective, but given the significant impact that not acting on stroke has on the economy. There is an economic argument, not just a patient care argument.

I pay tribute to the work of the Stroke Association, which does incredible advocacy, campaigning and research in this area, as well as other organisations across the UK. Stroke Association research shows that by 2035, stroke is expected to cost the British economy £75 billion a year. That is up from £26 billion as recently as 2015—a rise of 190% in just two decades. Given the strain already on stroke pathways across our health and care system, that is simply unsustainable. The need is clear, and the need is now.

One of the issues holding us back in our fight against stroke is the workforce, as is so often the case and as we have heard today in other contributions. A well-skilled, well-resourced workforce is vital to saving lives and improving the outcomes for patients. However, for too many across the United Kingdom, the workforce is simply not there for them or not there for them in adequate numbers. Half of all stroke units across the country have at least one vacant consultancy post, with the average vacancy being left open for 18 months.

When it comes to thrombectomy—a life-changing treatment that can have a fundamental impact on patient outcomes, as the hon. Member for Bromley and Chislehurst set out—the postcode lottery for care only gets worse. A third of clinicians in this country who can perform thrombectomy are based in London. That is good for Londoners but not for other parts of the country. Given that speed of treatment is critical when it comes to long-term outcomes for strokes, this lottery facing so many people cannot be allowed to continue.

Further along the stroke treatment pathway, other issues persist. Only a quarter of community rehab teams and early supported discharge services are offering support seven days a week. That is not good enough. With patients waiting too long for treatment when they need it and too long for support in the community following treatment, it is clear that the system is broken. That is why I am proud of Labour’s firm commitments on giving our NHS the workforce it needs to get patients seen on time, by delivering an extra 7,500 medical school places, training an extra 700 district nurses each year and ensuring that at every stage of the treatment pathway stroke patients will have access to the care they need when they need it.

But there is so much more work we can do to break down the barriers that too many stroke patients face on their care journey. Breaking down those barriers will take innovation and all parts of the system to be pulling in the same direction. For stroke patients, that is exactly what is needed. Given the crucial role played by primary, acute and social care services in delivering positive, long-term outcomes for stroke patients, co-ordination is the key. However, in too many cases, that co-ordination is simply not happening, and patients are suffering as a result.

We have a primary care system with vast variety in detection of key stroke indicators, such as heart conditions, atrial fibrillation and so on. We have people not getting to the right place in hospital, with only 40% of stroke patients admitted to a stroke unit within four hours of arrival. We have a community care system without the resources it needs to deliver for patients, with the Stroke Association’s report about life after stroke highlighting that only 37% of stroke patients receive a six-month post-stroke review of their needs. It smacks of a system that is not working for anyone.

[Rachael Maskell]

My hon. Friend is making an excellent speech. When it comes to social care, people are often untrained and as a result could cause more harm than good if they do not know how to care for a patient who has had a stroke. Will he ensure that Labour discusses how it will train our care workforce to have the right skills to deliver ongoing care?

[Andrew Gwynne]

My hon. Friend makes an important point. Some of the discussions that I have had, including this week, with professionals in the care sector have been about how we upskill care professionals working in our social care system so that they are able to genuinely—in an integrated fashion, with the NHS—work in accordance with the interests of the person they are caring for and take that person’s needs as a whole. It is also important for these workers to have the professional development, and parity of esteem, terms and conditions and so on with the NHS, to be able to take on those extra responsibilities. My hon. Friend is absolutely right, and that issue is certainly on the radar of the shadow health and social care team as we develop our plans—not just Labour’s workforce plan for coming into government, but our plans on the road map to a national care service.

Whether it is by training more GPs to ease the immense pressure on our primary care system, by putting an end to dangerous hospital waits or through a 10-year plan for fundamental social care reform delivered in partnership with users and their families, Labour is determined to get the system working again. We are determined to build a national health service that is fit for the future, with a long-term vision for a national care service firmly integrated within it. Only by doing all that, getting it right and taking people with us on that journey can we deliver on our long-term mission of cutting stroke deaths by a quarter within the next decade. That is a mission. It is something we are determined to do, because at the heart of this are people’s lives and we want to ensure that we have in place the stroke services that patients deserve.