Elective Care Recovery in England

Andrew Mitchell Excerpts

Monday 7th February 2022 Commons Chamber

[Edward Argar]

I am grateful to the hon. Gentleman for his remarks. He speaks often on this topic from experience, and it is right that we listen carefully to him. I take his point about the importance of language and how different terms and approaches to it will be interpreted by people who are undergoing treatment or a diagnosis for cancer, and I take the point in the spirit in which he meant that observation. On the Prime Minister’s target, the Prime Minister is unapologetically ambitious in seeking to tackle waiting lists and improve performance on cancer care. That is why we are investing record levels in our NHS and bringing forward new diagnostic hubs. It is also why the hon. Gentleman will see measures in the plan, when it is published imminently—coupled with the plan that the Secretary of State set out on Friday—that will help to reassure him, but I am always happy to talk to him about these issues.

[Mr Andrew Mitchell (Sutton Coldfield) (Con)]

My hon. Friend is surely absolutely right, first, to prioritise this vital catch-up programme for our constituents and, secondly, to ensure that we deliver real value for money. At a time of high taxation overall, my constituents want to ensure that for every pound of hard-earned taxpayers’ money spent on this vital programme they are really getting 100p of value as a result in delivery. I assume it is for that reason that this programme is slightly delayed.

[Edward Argar]

The reason this plan is delayed is, as I have alluded to, the omicron variant and the impact it had on our NHS. My right hon. Friend makes an important point about our prioritising tackling waiting lists and waiting times. He is also absolutely right: this is a once-in-a-generation challenge, and it is right that we get the right answer—the right outcomes for patients and for taxpayer. That is what we will do with this plan.

Dignity in Dying

Andrew Mitchell Excerpts

Wednesday 8th December 2021 Commons Chamber

[Mr Andrew Mitchell (Sutton Coldfield) (Con)]

I express my thanks to Mr Speaker for granting this Adjournment debate.

Assisted dying is an immensely sensitive and emotive issue of conscience over which each of us individually, as Members of this place, must wrestle, and which this House will have to address collectively before much longer. In my role as co-chair of the all-party parliamentary group for choice at the end of life—I have the pleasure of co-chairing it with the hon. Member for Bristol South (Karin Smyth) in this House—I have had discussions with many colleagues, including the Prime Minister, and I know how seriously this issue is taken. I know that many colleagues are yet to come to a firm conclusion on it. I respect that position. I respect it not least because I have completely changed my mind on this issue since I arrived in the House of Commons. After listening to many constituents in my office in Sutton Coldfield, often with tears of solidarity in my eyes, as with inordinate sadness they have told me of the painful and undignified death of someone they loved, I have concluded that I want the law changed to benefit my constituents, to benefit those who I love, and possibly, indeed, to benefit myself.

Our constituents are, according to every single opinion poll over the past three decades, in strong support of this change in the law. I remind the House that the Bill introduced by the noble Lady Meacher in the other place, which has recently commanded their lordships’ support and builds on the consensus so painstakingly and skilfully assembled over many years by Lord Falconer, sets out that those who are within six months of the end of their life and who, in the opinion of two doctors and a High Court judge, have reached the decision independently and in sound mind that they wish to end their life to avoid the often undignified and extraordinary suffering that would otherwise assail them, should be able to do so.

[Fiona Bruce (Congleton) (Con)]

Is it not extremely difficult to assess when a life will end? Is that not one of the challenges that we have with regard to this proposal of a timed end to a life?

[Mr Mitchell]

My hon. Friend is right, but I used to be a junior social security Minister, and I know that social security law means that the Government—society—already have a way of determining a period six months before the end of someone’s life. We can of course reflect on this, and on whether there is a better way of doing it, but that facility in fact already exists.

[Sir Geoffrey Clifton-Brown (The Cotswolds) (Con)]

How would my right hon. Friend’s Bill prevent relatives or others from putting pressure on the person to ask for this procedure to be put in place?

[Mr Mitchell]

My hon. Friend makes a very good point, and I will come directly to that.

My aim in this debate is not to persuade all colleagues of the rightness of this cause but to make two clear points: first, that this is a debate about the real-life consequences of our blanket ban on assisted dying; and secondly, that there are real examples from overseas of how it can be done better.

In the past several days, we have seen the rules on international travel tighten once again; in the space of a week, the Swiss Government closed their borders to travellers from the UK unless they undertook a quarantine of 10 days, before changing the rules back a few days later. The dismay that that has caused people seeking an assisted death in Switzerland is overwhelming, with their having to spend their final days confined to a hotel room, scrambling to update plans when time and energy are in such short supply, and unable to have all—or perhaps any—of their loved ones there to accompany them. The already cruel situation where British citizens can have the death they want only if they travel to another country becomes yet more unacceptable when even that most exceptional option can be withdrawn with such short notice. That is not to blame Switzerland; it is the fault of our own failure as a country to provide that option at home, preferring to outsource our compassion to another country.

Last year, I raised the question of travel during the pandemic with the Secretary of State for Health and Social Care. He confirmed that the ban on travelling overseas did not apply to those travelling for an assisted death in another country. That announcement was a welcome relief to many, although it once again highlights our heavy reliance on other jurisdictions to provide our own citizens with the deaths that they want.

[Christine Jardine (Edinburgh West) (LD)]

rose—

[Mr Mitchell]

I will get a little further with my case, and then I will certainly give way.

Furthermore, this leniency does nothing for those who cannot afford a trip to Switzerland; who cannot access the necessary medical records; who cannot travel due to illness or disability; or who cannot access the services of Dignitas for a host of other reasons. It forces all those who accompany the dying person to break the law and run the risk of prosecution on their return to this country.

I am saddened to tell the House that David Peace has today died at Dignitas; it is a coincidence that he happened to die today. Many colleagues may have seen a touching interview with David over the summer, in which he spoke about his desire to control his death, rather than let motor neurone disease choose his death for him. Earlier this week, before he left this country—his home—for Switzerland, David said:

“I have terminal motor neurone disease, a fatal illness for which there is no treatment or cure. It has robbed me of my ability to speak, swallow, balance and walk. It is rampaging through my body, paralysing my muscles. Nothing will stop it. Palliative care cannot give me the death I want, I simply want the right to die on my own terms...My only option has been to plan an assisted death at Dignitas in Switzerland, which I have done in meticulous detail over the past few months. Though stressful and hugely expensive, this has given me comfort and peace of mind. Covid-19 measures have been a real concern throughout this year, knowing that travel restrictions or lockdowns could jeopardise my plans”.

He continued:

“The emotional and logistical nightmare I have endured over the past few days would have been avoided entirely under the Assisted Dying Bill, which would have enabled me to go peacefully and with dignity in my own home at a time of my choosing.”

David’s call is echoed by another proud Englishmen, Ray Illingworth, the legendary English and Yorkshire cricketer, who was diagnosed with oesophageal cancer a year ago. He said this of having to go abroad to obtain an assisted death:

“If that was the only option I would, but we shouldn’t have to do that. I’d like to be put to sleep in peace in my own home in Yorkshire.”

Ray has represented his country, and is now asking his country to help him have the choice of dying on his own terms.

Those who cannot travel to Switzerland have only a few agonising choices here at home. For many, our world-leading palliative and end-of-life care will ensure a peaceful and dignified death, but even with the very best care, 17 people a day will die in excruciating pain, to say nothing of those who die with uncontrollable symptoms, or without dignity in their final days. For those who wish to hasten their death, the option remains open of withdrawing from life-sustaining treatment, or voluntarily stopping eating and drinking with the intention of hastening death; but there is no option to take direct steps to end one’s own life with medical support.

Perhaps most tragic are the cases in which dying people, trapped in pain and despair, decide to end their life by suicide. The best estimates are that hundreds of suicides every year are of people living with a terminal illness. I know from speaking to people who have direct experience of losing their loved one to suicide that these dreadful decisions are taken not lightly, but as a last, desperate choice, due to the lack of a safeguarded assisted dying option.

We must be honest about recognising the victims of our laws—the dozens of our citizens who feel they must travel overseas to achieve the death that is right for them; the hundreds of terminally ill people who die by their own hand; and the thousands of people who die beyond the reach of the very best end-of-life care we can offer. Every year, we condemn too many people to becoming casualties of a law that lacks compassion and public support, and belongs to a bygone age.

[Danny Kruger (Devizes) (Con)]

My right hon. Friend is making a powerful speech, as expected. He refers to a very small number of people to whom he wants to give this new right. I recognise the extraordinary pain and distress of those individuals and their families, but is he aware that in Oregon—the legislation being proposed in the other place is based on the law there—over half the people who apply for assisted death do so not because of terrible pain and suffering, but because they do not want to be a burden on their family? That is the consideration that motivates them. Does he not agree that that is likely to be replicated here, given the sad prevalence of abuse and neglect of elderly relatives in our country?

Surely the answer to the distress of people facing death is to improve palliative care, which, as he says, though it can be excellent in this country, is tragically patchy, which is not good enough. Surely we should invest significantly in palliative care to ensure that everyone in this country has the opportunity to die with all the care that they need, and does not have a terrible, distressing death, before we ever consider this terrible step of allowing assisted suicide.

--- Later in debate ---

[Mr Mitchell]

My hon. Friend and I will no doubt continue this argument for many months. He and I are as one on the importance of improving palliative care, but alas, there are those who will never benefit from those improvements because of the nature of their illness. I will come to Oregon in a moment, but to address the very point that he made, we emphasise the importance of a High Court judge being involved.

What can we learn from overseas, as others like us struggle with this issue? We know that this can all be done better. Indeed, with each year that passes, yet another jurisdiction takes a step forward to provide choice at the end of life for its citizens. Eleven states in the USA and five Australian states have legalised assisted dying, with New South Wales likely to follow suit very shortly. New Zealand permits assisted dying, following a nationwide referendum that found an overwhelming majority of New Zealanders supported a change in the law. In Europe too, in the past couple of years, laws have been passed by the Spanish and Portuguese Parliaments, and court judgments have overturned the bans on assisted dying in Germany and Austria.

In places such as Oregon, which my hon. Friend mentioned, assisted dying has been legal for a quarter of a century, and the eligibility criteria and processes remain essentially the same as the day they were introduced. Of the jurisdictions that have introduced assisted dying solely for people who are terminally ill and mentally competent, not a single one has subsequently extended its laws beyond that point.

The other important point is the direction of travel in this area: we are told by those who oppose law change that other countries provide clear warnings of the horrors that would befall the elderly, the vulnerable and others in society if we were to legalise assisted dying. Not only is there no evidence to that effect, but no single jurisdiction has legalised assisted dying and then subsequently repealed that law. Do we as a House consider ourselves to be more blessed with wisdom and foresight than the parliamentarians of all of these other jurisdictions or think that they have simply turned a blind eye to those concerns? The truth, of course, is that these fears, as seriously as we take them, simply have not come to fruition.

Very close to our shores, change is on its way. Two weeks ago, the States Assembly of Jersey voted by a large margin of 36 votes to 10 in support of a proposition on assisted dying, with draft legislation to be introduced by 2023. A widely signed petition led to the establishment of a citizens’ jury of islanders, which found that more than 75% of participants wanted to legalise assisted dying.

Ireland’s Parliament has given its support in principle to assisted dying in October 2020 and a new special committee has been established to begin working on legislation that will command the support of their MPs. That work will commence early next year and demonstrates the renewed commitment of the Irish Parliament to progressive causes.

Perhaps most important is the proposed legislation in the Scottish Parliament, introduced by the long-serving and well respected Liam McArthur MSP. Indications are that the resulting legislation is likely to secure the support of MSPs, as long as it is tightly drafted and contains robust safeguards. Scotland would become the first constituent nation of the United Kingdom to legislate on assisted dying and, inevitably, that may shine a light on our successive failures to progress law changes here in Westminster.

[Christine Jardine]

The right hon. Gentleman is making a very powerful speech on a highly emotive issue. He mentioned Liam McArthur’s Bill in the Scottish Parliament, which was the subject of consultation, and there is movement in Scotland. The right hon. Gentleman spoke of the reticence of some Members or their reluctance still to make their minds up. Does he share my hope that they will take confidence from what is happening in the Scottish Parliament and the support among the public to have the courage of their convictions, if and when legislation comes before this place?

[Mr Mitchell]

I thank the hon. Lady very much for her intervention. It must be the case, and I am sure my hon. Friend the Member for Devizes (Danny Kruger) will agree, that all Members of Parliament will be following what happens in Scotland with the greatest possible care. It is an issue that, wherever we stand on the debate, greatly exercises Members of the House of Commons.

I wish to draw colleagues’ attention to the process envisaged by the Scottish Parliament for a debate on this issue. A proposal has been lodged in the Parliament and the initial consultation will close in two weeks’ time. In the new year there will be an analysis of the responses to the consultation, which will feed into the drafting of the Bill. Once drafted, the Bill will be examined in detail by Select Committees, calling for evidence from stakeholders across society. Only once that pre-legislative scrutiny has been completed will the legislation be debated on the floor of their Parliament.

Here in this House we lack anything like such a comprehensive system. Our system for considering private Members’ legislation is entirely inadequate when debating such an important issue. The Government have rightly determined that it should be neutral on the principle of assisted dying, but I invite my hon. Friend the Minister to recognise that neutrality on the legislative process, rather than on the principle, has the effect of siding with the status quo. A refusal to facilitate the debate is a de facto opposition to law change.

Finally, I will ask the Minister some questions about specifics of how the laws in neighbouring jurisdictions would work together. As she will no doubt be aware, the General Medical Council, the Nursing and Midwifery Council and other healthcare regulators operate on a UK-wide basis. Can she confirm that if either Jersey or Scotland were to legalise assisted dying, any health and care professional who participated in and followed the requirements of that law would not face prosecution?

The Minister may also be aware that the issue of conscientious objection has previously been treated as a reserved matter by the Scottish Parliament. It should be common ground that, whatever our view on assisted dying, health and care professionals should not have to actively participate in the practice if they believe it contravenes their conscience and beliefs. I understand that the Government’s position is that conscientious objection is in fact already within the competence of the Scottish Parliament: can she confirm to the House that that is the case, and to what extent any legislation on conscientious objection in the Scottish Parliament would contravene the devolution settlement or require the approval of the UK Government?

Finally, I ask the Minister to update the House on the work commissioned by the former Secretary of State, my right hon. Friend the Member for West Suffolk (Matt Hancock), to be undertaken by the Office of National Statistics on the number of terminally ill people who end their own lives by suicide. All of us in this House wish to tackle and reduce the number of suicides, attempted suicides and incidents of self-harm, but in order to do that, it is imperative to understand why many people take that most desperate decision.

[Rachel Hopkins (Luton South) (Lab)]

I thank the right hon. Gentleman for giving way. As a fellow member of the all-party parliamentary group on choice at the end of life, is this not fundamentally about enabling everyone to have a good death—be it through palliative care, if that is their wish, or the choice of an assisted death? It is a matter of choice at the end of life. Does he agree?

[Mr Mitchell]

I very much agree with what the hon. Lady says. She has thought about this very carefully. We all want to see choice extended wherever possible in our daily lives, and she is right in what she says.

Many colleagues and former colleagues, including Lord Field of Birkenhead, have changed their mind on assisted dying, whether informed by their constituents or by their personal experience. This House is in a very different place from when this issue was last voted on, more than six years ago. I am afraid that we as a House will continue to find ourselves running to catch up with the public view on this unless a serious process for consideration of this issue is put in place.

Adult Social Care

Andrew Mitchell Excerpts

Wednesday 1st December 2021 Commons Chamber

[Gillian Keegan]

I agree with the right hon. Gentleman. Unpaid carers are an essential part of the system, and I want to pay a massive tribute to all the people who have been offering care, usually to their loved ones, during this period. As the right hon. Gentleman suggests, during the pandemic many vital services on which carers generally rely, such as respite or day care services, have not always been fully open to everyone, so I have urged all local authorities and providers of those services to ensure that they are.

The White Paper provides for money to help local providers to develop the services that carers would appreciate. There is a specific fund for them to work with carers, and there will obviously be input into that as well. We will ensure that we build services to support this vital sector, and, in addition, carer’s allowance will rise to just over £67 in April 2022.

[Mr Andrew Mitchell (Sutton Coldfield) (Con)]

Notwithstanding the somewhat churlish approach of the Opposition Front Bench, today’s announcement marks good and steady progress on the part of a Government who have, after many years, started to tackle this important problem, and I think the House should give the Minister credit for that.

Does the Minister appreciate how much this matters to us in Sutton Coldfield, which has a more elderly demographic? In this context, I agree with my right hon. Friend the Member for Ashford (Damian Green). We need coherent policies enabling older folk to stay in their homes for as long as possible. In particular, the newly agreed and enhanced role of the services emanating from the Royal Sutton Coldfield Cottage Hospital in keeping people in their homes is at the front and centre of our plans for ensuring that the White Paper and the accompanying policy have a real impact in Sutton Coldfield.

[Gillian Keegan]

Of course I am trying not to be too disappointed by the reactions of Opposition Members; I did not really expect an awful lot more.

Areas such as Sutton Coldfield and Surrey are expensive to live in, and we need to recognise that. Most of us, when asked about our future care arrangements, would say that we would like to stay in our own homes, and we want to make that possible. There is a great deal of technology that will help, but it is also important to adapt more supported housing and to work with local groups to deliver the right approach for the right areas, and that will include local hospitals as well.

Health and Care Bill

Andrew Mitchell Excerpts

Report stage
Tuesday 23rd November 2021 Commons Chamber

[Margaret Greenwood (Wirral West) (Lab)]

The Health and Care Bill allows for

“a profession currently regulated to be removed from statutory regulation when the profession no longer requires regulation for the purpose of the protection of the public.”

Labour voted against the relevant clause in Committee, but we were defeated by the Government. I therefore tabled amendment 57, which would remove clause 127 from the Bill and ensure that a profession currently regulated cannot be removed from statutory regulation, and that statutory regulatory bodies cannot be abolished. I am grateful that the amendment received cross-party support.

The removal of a profession from regulation is deeply concerning because, once a profession is deregulated, we can expect the level of expertise in that field to decline over time, and along with that the status and pay of those carrying out those important roles. It also brings with it serious long-term implications for the health and safety of patients. In the White Paper that preceded the Bill, the Government stated:

“This is not about deregulation—we expect the vast majority of professionals such as doctors, nurses, dentists and paramedics will always be subject to statutory regulation. But this recognises that over time and with changing technology the risk profile of a given profession may change and while regulation may be necessary now to protect the public, this may not be the case in the future.”

It is notable that the Government only “expect” that the vast majority of professionals will be subject to statutory regulation, but they give no guarantee. The fact is, if the Bill passes, Ministers will be able change their mind at any point and make changes through secondary legislation.

The Government appear to be arguing that technological advances may change roles to such a degree that the high level of professional expertise that currently serves the NHS will no longer be needed. I will make two points about that. First, if the work of an NHS profession has changed to such a degree that regulation is no longer needed, I would argue that it is a different profession and needs a new job title. Secondly, when deploying new technology, there is always a need for professional staff with a high level of expertise and understanding of not only the functionality of that new technology, but its shortcomings. Technology has the power to improve productivity, but it should not be used as an excuse to deregulate professions.

It is important to consider where the impetus for that proposal may be coming from. The recent lobbying scandal certainly gives us a clue when we consider the number of MPs on the Government Benches with private interests in medical technology—I do not want to elaborate on that today, but to make the point. Certainly, big business is keen on deregulation, because it allows them to pay lower salaries to staff.

During a seminar on wellbeing, development, retention, and delivering the NHS people plan and a workforce fit for the future, a representative of Virgin Care said:

“We should have flexible working for all. We should consider what that means. We should embrace what that means. Both of those things really push what has been quite a traditional work model across the NHS. We need to be more modern. We need to have a think about how we rip up the old rule book. But change in an area that is very risk averse because the nature of the work we do is really tricky, so we need our leaders and our workforce to embrace trying things”.

That was an alarming statement for her to make. I think we would all agree that healthcare professionals’ understanding of risk and the importance of mitigating risk is incredibly important. It is always a matter of concern when business says that it wants to “rip up” the rule book on employment rights and pay.

Yesterday, in the Minister’s summing up, he said that

“the Bill does not privatise the NHS.”—[Official Report, 22 November 2021; Vol. 704, c. 151.]

I have to say, however, that I disagree. ICBs—integrated care boards—will be able to delegate functions, including commissioning functions, down to provider collaboratives, and provider collaboratives can be made up of private companies. I do not understand what it is that the Minister does not understand about that.

Add to that the fact that the abolition of the national tariff will open up the opportunity for big business to undercut the NHS, this is a potent situation indeed, and one that will be exploited by big business if the Bill goes through. The late Kailash Chand, former honorary vice-president of the British Medical Association said:

“The core thrust of the new reforms is to deprofessionalise and down skill the practice of medicine in this country, so as to make staff more interchangeable, easier to fire, and services more biddable, and, above all, cheaper”.

The removal of professions from regulation is a part of that scenario he described.

I turn now to workforce planning. There is a workforce crisis in the NHS. In fact, that is probably an understatement. Earlier this year, I met members of the Royal College of Nursing in the north-west, who told me of the sheer exhaustion that they are experiencing because of staff shortages. I was struck by how, even at this point when they were describing how they are on their knees with exhaustion, their primary concern was patient safety. We owe it to them to address the matter. The British Medical Association highlighted:

“Burnout has led to significant numbers of medical professionals considering leaving the profession or reducing their working commitments”.

According to the latest figures, there are well over 90,000 full-time equivalent vacancies in England’s NHS providers. The best the Government can come up with is in this Bill is to require the Secretary of State to publish a report, at least once every five years, describing the system in place for assessing and meeting the workforce needs of the health service in England. That is woefully inadequate. The Royal College of Physicians says that this duty on the Secretary of State

“falls short of what is needed given the scale of the challenge facing the health and care system”.

The Royal College of Paediatrics and Child Health is among those who have called for this duty to be strengthened in the Bill. I ask the Government to listen to the expertise of those bodies.

The Government’s plans to remove NHS professions from regulations is wholly unacceptable and it is particularly alarming at a time when there are such acute shortages of staff, right across NHS professions. We all value the NHS highly and respect the high level of professionalism in the service. Instead of looking to deregulate professions, the Government should be investing in the training of the next generation of professionals.

[Mr Andrew Mitchell (Sutton Coldfield) (Con)]

I draw the House’s attention to my interests, which are set out in the Register of Members’ Financial Interests, and to the fact that my wife is an NHS GP and has been for the past 30 years.

I rise to support amendment 10, tabled by my right hon. Friend the Member for South West Surrey (Jeremy Hunt), as it seems to be absolutely right. I cannot understand why the Minister, an extremely good Minister, is not obliging the Government to accept it in full. It is clear from what is being said across the House that my right hon. Friend has achieved an unexpected unity. Even brilliant junior hospital doctors who in the past have marched against some of his policies are four-square behind what he is saying today and the work his Committee is carrying out so brilliantly.

I wish to make three points about why the House and indeed the Government would be wise to support my right hon. Friend’s amendment today. The first is that, for reasons he has set out eloquently, as has the hon. Member for Central Ayrshire (Dr Whitford), who speaks on these matters for the Scottish National party, burnout in the NHS is an incredibly serious issue. The need for us to project how many people we are going to need in all the different disciplines in the health service has never been greater, and the workforce requirements have never been more uncertain. As has been so eloquently set out, the cost of that uncertainty is paid in locums, with all the difficulties and downsides that have been mentioned.

I wish to quote a note I have had from Dr Rahul Dubb, the lead doctor in Royal Sutton Coldfield. He successfully led the roll-out of the vaccinations in our town hall and he is extremely experienced. He says, “A greater understanding is needed as to why doctors are leaving the profession. It is clearly multi-factorial across the generations. One of the reasons includes pension rules. These penalise staff wanting to work more hours due to capped taxation rules, deterring senior staff from staying, and may lead to a significant exodus from the profession. In these circumstances, it is essential that far more effort is put into projecting future workforce numbers and how many are required to meet future need.” In my judgment, Dr Rahul Dubb is absolutely right in what he is saying.

The second reason is that the Government should listen carefully to what my right hon. Friend has said. During his time as Health Secretary—no one in the House has been so long at the crease and has as much experience as him—he significantly increased the number of doctors who will be trained. We were particularly pleased in Birmingham to see the additional work that Aston University has been able to do to bring those who might have felt themselves excluded from the medical profession into contention, so that they could go to university and achieve their ambition of qualifying as medics. Having that sort of analysis—the analysis that is behind his amendment—is right in securing value for money. I have been dismayed that when we had the measures to increase national insurance earlier this year—this was greatly to the credit of the Government for grasping a nettle that so many have not grasped before—those on the Treasury Bench were extraordinarily disinterested in checking that value for money for this additional taxpayer spend was achieved. When I suggested that we should account to our constituents through the Treasury, making certain that we understood where this £1.2 billion was going, the answer from those on the Treasury Bench was extremely lacklustre. Ensuring value for money and that we get these judgments right will save money and, for the reasons that have been set out, will make medicine and the treatment of our constituents that much safer. As my right hon. Friend set out, the whole sector is united behind this amendment, and the Government should hear that loud and clear.

Covid-19: Government Handling and Preparedness

Andrew Mitchell Excerpts

Thursday 27th May 2021 Commons Chamber

[Matt Hancock]

I have answered this question many times, and the challenge is that we had to build the testing capacity. At that time, of course I was focused on protecting people in care homes and in building that testing capacity, so that we had the daily tests to be able to ensure that availability was more widespread. That is at the heart of the importance of the then 100,000 target, and we are now up to a position where we have millions of tests available per day.

[Mr Andrew Mitchell (Sutton Coldfield) (Con)]

Surely it cannot be in anyone’s interests, least of all those who are mourning loved ones, for the mob to descend and judge and preoccupy my right hon. Friend at this point in the pandemic. The Government have made clear that there will be a full public inquiry, and that is when hindsight can and should prevail. Now, surely, it is in all our interests that he gets on with his work, bringing his experience to bear on saving lives and carrying out this excellent vaccination programme. Will he meet a cross-party delegation of West Midlands metropolitan leaders who are keen to work with him to deliver those common objectives?

[Matt Hancock]

Yes, those are common objectives. The way my right hon. Friend puts it is absolutely spot on. I would be delighted to meet him and west midlands leaders to ensure we can roll out the vaccination effort as quickly and as effectively as possible in order to both save lives and get us out of this pandemic.

Oral Answers to Questions

Andrew Mitchell Excerpts

Tuesday 12th January 2021 Commons Chamber

[Helen Whately]

The hon. Member has described, in fact, what is a really important partnership working between the national NHS Test and Trace system and local partners such as local authorities, as indeed is happening in his own area of Sheffield, where it is that combined working that enables us to contact the maximum number of people and therefore to get more people to self-isolate and break these chains of transmission.

[Mr Andrew Mitchell (Sutton Coldfield) (Con)]

What plans he has to improve the evidence base for future debates on the options available for terminally ill people at the end of their life.

[The Secretary of State for Health and Social Care (Matt Hancock)]

Care at the end of life is a crucial part of our health and care system, and we are committed to improving the quality of care for those at the end of life. Current practice is informed by a range of evidence, including guidelines issued by the National Institute for Health and Care Excellence. The Government are open to gathering data on the experiences of terminally ill people in order to inform the debate.

[Mr Mitchell]

May I also express my gratitude to the NHS in all its many forms in the Royal Town of Sutton Coldfield for their hard work over Christmas and new year, including giving me a new knee?

I thank the Secretary of State for managing to take an interest in this important subject when he is so stretched on so many other fronts. Nearly 10% of suicides are by people who are terminally ill, and the all-party group that I have the privilege of co-chairing will hear from a mother this afternoon whose terminally ill son took his own life by throwing himself under an HGV on the north circular.

To add to knowledge, information and understanding, will the Secretary of State and his Department make a point of working with coroners and the Office for National Statistics from across the country, so that we can understand the true extent of these tragedies?

[Matt Hancock]

I am very happy to look at the suggestion that my right hon. Friend makes on this very sensitive subject. We want to see the highest possible standards of patient safety and, of course, to reduce the number of suicides, and it is important in pursuing that to have as much information and evidence as possible.

Coronavirus Regulations: Assisted Deaths Abroad

Andrew Mitchell Excerpts

Thursday 5th November 2020 Commons Chamber

[Mr Andrew Mitchell (Sutton Coldfield) (Con) (Urgent Question)]

To ask the Secretary of State for Health and Social Care if he will make a statement on the impact of new coronavirus regulations on the ability of terminally ill adults to travel abroad for an assisted death.

[The Secretary of State for Health and Social Care (Matt Hancock)]

Issues of life and death are some of the most difficult subjects that come before us in this House, and the question of how we best support people in their choices at the end of their life is a complex moral issue that when considered, weighs heavily upon us all. My right hon. Friend the Member for Sutton Coldfield (Mr Mitchell) asked an important question and I want to set out the precise position. Under the current law, based on the Suicide Act 1961, it is an offence to encourage or assist the death of another person. However, it is legal to travel abroad for the purpose of assisted dying where it is allowed in that jurisdiction. The new coronavirus regulations, which come into force today, place restrictions on leaving the home without a reasonable excuse; travelling abroad for the purpose of assisted dying is a reasonable excuse, so anyone doing so would not be breaking the law. These coronavirus regulations do not change the existing legal position on assisted dying.

As this is a matter of conscience, the Government do not take a position. It is instead a matter for each and every Member of Parliament to speak on and vote according to their sincerely held beliefs, and it is for the will of the House to decide whether the law should change. The global devastation of the coronavirus pandemic has brought to the fore the importance of high-quality palliative care, just as it has shone a spotlight on so many issues and, as difficult as it may be, I welcome this opportunity to have this conversation about assisted dying, as it is one of the most sensitive elements of end-of-life care.

I have the greatest sympathy for anyone who has suffered pain in dying or suffered the pain of watching a loved one battle a terminal degenerative condition, and I share a deep respect for friends and colleagues in all parts of the House who share and hold strong views. I am pleased that the House has been given this opportunity to discuss the impact of the pandemic on one of the most difficult ethical questions that we face.

[Mr Mitchell]

Thank you, Mr Speaker, for granting this urgent question, and thank you to my right hon. Friend for responding himself.

This is an issue of conscience for us as Members of this House. I respect those who take a different view from me, not least because theirs was previously my view. Colleagues may have seen, over the weekend, the news reports about a woman who this week travelled to Switzerland to end her life in order to avoid travel restrictions. As a frontline NHS worker with terminal breast cancer, she did not want to run the risk of dying in great pain and without dignity. The new regulations that have come into force today could deter anyone else from travelling to Switzerland for an assisted death. That will undoubtedly cause many more Britons to suffer as they die, due to a lack of a safeguarded law here in the UK, although I am most grateful to my right hon. Friend for clarifying the precise legal circumstances.

In the light of the radical shift of the views of the medical profession two weeks ago, the recent legislative change in New Zealand this week and groundbreaking progress in southern Ireland, along with the continuing and massive support for law reform from the British public, will the Government, from their position of neutrality, enable all of us to understand three things—first, the extent of suffering that the blanket ban on assisted dying is causing dying people and their families; secondly, the challenges that the current law is creating for healthcare professionals, police officers and other public servants; and thirdly, what the UK can learn from international evidence on the operation of assisted dying laws, and their safeguards, in the United States, Australia and Canada?

I am supporting a very tight reform that would allow someone who is terminally ill, within six months of the end of their life, and who has themselves decided that this is the end of life they want, independently certified by two doctors and confirmed as their independent decision by a High Court judge, to end their life, as is their choice.

[Matt Hancock]

I pay tribute to my right hon. Friend for the way in which he puts his case. Of course, we acknowledge the changing views of many, including many in the medical profession, and, of course, we observe the changes in the international debate. I think it is absolutely reasonable for this House to have a conversation and discussion on what is an important topic, and it is right that we locate that question within a broader discussion of how we care for people at the end of their lives, which, because of the coronavirus pandemic, has sadly become a central issue of public debate in this country.

--- Later in debate ---

[Mr Speaker]

I will be quite honest: I do not want to enter into personal arguments. I am not giving my view, and I do not think it is right to put the Secretary of State on the spot in that way.

[Mr Mitchell]

Unless he wants to.

Covid-19

Andrew Mitchell Excerpts

Thursday 22nd October 2020 Commons Chamber

[Mr Andrew Mitchell (Sutton Coldfield) (Con)]

I draw the House’s attention to my outside interests. This is the first time I have sought to catch your eye, Madam Deputy Speaker, in any of the covid debates. I want to express strong support for my right hon. Friend the Secretary of State. He has an impossibly difficult job to do, which in my view he is doing very well indeed, and we should all support him. I also want to express my gratitude and admiration for the health facilities in my constituency, in particular Good Hope Hospital.

I want to encourage a few small changes—to use a nautical metaphor, an adjustment on the tiller—to be made when possible. I am pleased to see that my right hon. Friend is working far more with Members of Parliament. The wisdom from our constituencies, as we report back in the House from the frontline, is very important and should play a critical part in the Government reaching their conclusions. Working closely with local authorities and Mayors is not easy and not always elegant, but it is vital for my right hon. Friend successfully achieving what he wants to.

For many years, I have not had many nice things to say about Birmingham City Council, but the public health authorities under Justin Varney are doing an exceptional job under the regional Mayor, Andy Street, whose leadership we all admire. It should also be said that Birmingham City Council did a first-class job in dealing with the homeless at the start of the pandemic and ensuring that they all had somewhere to go off the streets. Politicians in the west midlands, who I think it is fair to say never agree on anything, have worked closely together since March and established a good working relationship. This is not a political crisis; it is a health crisis. We should all play our part in keeping the aggro levels down, and the Secretary of State and the shadow Secretary of State set a good example today.

In the trade-offs that Ministers inevitably must make between protecting our health and the health service and protecting jobs, livelihoods and investment, I would push the tiller a bit more towards the economy and economic activities. I am lost in admiration at the ingenuity, impressive optimism and vitality of the private sector in Sutton Coldfield as I visit their businesses and hear their determination but also their anxiety.

I wish to mention two sectors. The first is the events and exhibitions sector, which employs 600,000 people and has a turnover of about £80 billion each year, which is roughly the same as the automotive industry. A couple of weeks ago, I visited Solutions2 in Minworth in my constituency, which previously had a £6 million turnover but since March has had a turnover of precisely £8,000. It has 36 staff, 35 of whom are furloughed. They showed me a map of Europe, which showed that there was activity in their sector across Europe and in the middle east and far east but not, alas, in this country. They pointed out that an exhibition had taken place in Dusseldorf for the caravan show, which 107,000 people had visited.

The second sector that I wish briefly to mention is weddings and the marriage industry, which is flat on its back in Sutton Coldfield. More could be done to relax the tight restrictions in favour of covid-sensible arrangements, and I hope that the Government can show some flexibility on this. Venues such as Moor Hall and the wedding car industry, for example, are being badly affected.

I think I know the Prime Minister well enough to say that he is a social liberal at heart who dislikes the massive extension of the state as much as I do—the framework of restrictions and ways of living; the language of authority, with curfews, lockdowns, compliance and bans; and the machinery of coercion, with informing, policing, snitching and fining. I was horrified to hear this morning that four students in Nottingham have been fined £10,000 each—more than a year’s fees—for breaching the rules. The lives and opportunities of young people in particular have been blighted by this dreadful pandemic. We probably need to protect the elderly and vulnerable a little more and shield and curtail the young a little less. It is about a touch on the tiller, being a little less didactic and a little more trusting in the good sense of social solidarity of the vast majority.

Finally, I am a former member of the all-party parliamentary group on mental health, along with Alastair Campbell and Norman Lamb—probably one of the best public health Ministers we have had since the war. We are facing a mental ill health epidemic. People who are, inevitably, not being seen really should be seen. We must keep this issue at the front of all our minds as this crisis continues.

Public Health: Coronavirus Regulations

Andrew Mitchell Excerpts

Tuesday 13th October 2020 Commons Chamber

[Matt Hancock]

Yes, absolutely. We are doing precisely that. The way it works where it works best is that the big national system makes the immediate and rapid contact with people who test positive—for more than half of people that is immediately successful—and then when contacts are harder to make the data is passed to the local teams, which do not have the scale to do the immediate, rapid contacting but do have the boots on the ground and the local knowledge. That combination of the two is what works best where it works well.

[Mr Andrew Mitchell (Sutton Coldfield) (Con)]

My right hon. Friend is making a compelling case, but will he bear in mind that in the west midlands we are concerned that yesterday’s change was made on the basis of neatness, not of medical need? Will he reassure me that he will always listen carefully to the West Midlands Mayor, Andy Street, as these matters all develop?

[Matt Hancock]

Yes. The introduction of the three-level system means that, in some areas where the local area has been working so effectively to get the curve flattened, as in the west midlands, under the leadership of Andy Street—there has been a rise in the past few days of data, but essentially a huge amount of progress has been made—changes have had to be made. However, I will absolutely recommit to working with Andy Street, who is an incredibly effective voice for the west midlands, to make sure that what we can do together can best deliver to control the virus in the west midlands. I pay tribute to my right hon. Friend, who makes the case on this so effectively, because protecting our economy and protecting our health are not alternatives. We must act and keep the virus under control to protect lives and livelihoods. I strongly believe that every one of us, young or old, has the ability to suppress the virus through the actions we take and the best way to protect the vulnerable, support the NHS and protect the economy is to get the rate of transmission down.

I turn to the steps we are taking to do that and, therefore, the instruments before the House today. Yesterday, the Prime Minister provided an update on the measures we are taking, which centre on three local covid alert levels in England.

Covid-19 Update

Andrew Mitchell Excerpts

Monday 5th October 2020 Commons Chamber

[Matt Hancock]

I am delighted to have the chance to agree wholeheartedly with the First Minister of Scotland. We have been working closely together to ensure that the apps work together and interoperate in different parts of the United Kingdom. That upgrade is expected in the coming weeks. The two Governments are working very hard and very constructively on it.

[Mr Andrew Mitchell (Sutton Coldfield) (Con)]

May I thank my right hon. Friend for the way that he has worked so closely with us in the west midlands? He knows that, first and foremost, I am in favour of community solidarity and good sense, rather than legal diktat and Government fiat. Will he commend those universities that have already introduced student responsibility agreements as a way of furthering all of that? Will he bear in mind later on this week that our highly effective Mayor in the west midlands Andy Street, the Labour leader of Birmingham City Council and I are all of one mind, together with Justin Varney, the excellent head of public health in Birmingham, that the current level of infection rates mean that there should be no further changes there this week?

[Matt Hancock]

I concur with my right hon. Friend on the importance of personal responsibility. We all have a responsibility in this. I have not heard of responsibility agreements with students, but that is a very sensible approach. I spoke to Andy Street this morning, and he made clear to me the need for national and local government to work together. That is working very effectively across the west midlands and across party lines, exactly as my right hon. Friend says. We must continue to do that as we monitor the developments and the data and do all we can to keep this virus under control.