Public Health

Andy McDonald Excerpts

Tuesday 14th December 2021 Commons Chamber

[Sajid Javid]

I will consider that. My right hon. Friend is right to point out that this is a fast-moving situation and it is right that the Government continue to monitor it and respond when necessary, but I hope my right hon. Friend will agree that right here and now the matter being debated and the regulation before the House is the best possible response that can be given by this Parliament today.

[Andy McDonald (Middlesbrough) (Lab)]

Will the Secretary of State give way?

[Sajid Javid]

I will, but then I will need to make some progress.

[Andy McDonald]

I am grateful to the Secretary of State for giving way. If he is going to consider those matters will he also consider the following issue? The virus spreads if people are not able to isolate, so will he think about addressing the issue of statutory sick pay, and in particular spreading the scope of SSP and raising it to a proper rate so that people can isolate and therefore not spread the virus and not end up in our hospitals?

[Sajid Javid]

The hon. Gentleman will know that some measures are already in place such as the ability to get sick pay from day one and that there are hardship funds, but I understand the hon. Gentleman’s question: he asked us to look at that further and we will do so. All these matters are under review.

--- Later in debate ---

[Wes Streeting]

I have no doubt whatsoever that opinion in the workforce is divided. I do not dispute that, and it is divided partly because people resent the mandate. Ultimately, however, it comes down to this. It is not just about the broad arguments I have outlined or the specific cases we might be confronted with without this protection; we have to ask whether we as a House think it is acceptable for people working in health and social care, who have a duty of care to their patients, to say, “I am making a choice to put them at greater risk. I am working against the very principles that encouraged me to sign up to my vocation in the first place.” That is why, on balance, I think it is the right measure, but I will come on to talk about the way in which we need to take the workforce with us and what we need to do ahead of April.

[Andy McDonald]

My hon. Friend is setting out his response to these proposals with great care. On the vexed issue of mandatory vaccinations, does he acknowledge that 97% of those in my trust have been properly vaccinated and that a significant proportion of the remaining 3% are new starters making their journey towards proper vaccination? It is therefore not that clear. We have heard the responses from the British Medical Association, Unison, the Royal College of Nursing, Unite, the Chartered Society of Physiotherapy, the GMB and the Royal College of General Practitioners, who are opposed to making vaccination mandatory and prefer persuasion to coercion. Does he not think that we should be adopting that approach?

[Wes Streeting]

That is a helpful intervention from my hon. Friend. Let me be clear: I absolutely acknowledge the views that have been put forward by the royal colleges and by staff trade unions. Government ought to take them seriously and work heavily with them in this next phase, where there is still a window for persuasion. I also point the Government to the success that the Welsh Labour Government have had in persuading the workforce; there is much to learn and time available, and we have to work in a spirit of partnership.

--- Later in debate ---

[Paula Barker (Liverpool, Wavertree) (Lab)]

Given time, I will concentrate my comments on mandatory vaccinations for NHS staff. I find myself really torn on this emotive subject, and I also find myself trying to apply logic to what is quickly becoming an illogical argument from the Government Benches. If it is really about patient safety, the Government should already have identified workers in the NHS who are still unvaccinated and have been working with them to alleviate fears and concerns and remove barriers. The Secretary of State should explain to the House why it is acceptable for those in the NHS who remain unvaccinated to work on the frontline to assist with the omicron crisis but, come 1 April, to be dismissed. Quite frankly, it makes no sense.

Comparisons have been drawn with the requirement for NHS staff to be vaccinated against hepatitis B. The reality is that chapter 12 of the Public Health England Green Book, which provides the latest information on vaccines and vaccinations, states:

“Hepatitis B vaccination is recommended for healthcare workers who may have direct contact with patients’ blood or blood-stained body fluids.”

It is not the law. The Government proposal will see these workers work around the clock during the next few weeks and months, only to be dismissed on 1 April if they do not succumb to mandatory vaccination.

[Andy McDonald]

Does my hon. Friend agree that if these measures will come into force at the beginning of April and the parties concerned are to participate in a framework agreement for their roll-out, there is an ideal opportunity for those parties to work through how they may be implemented? By rushing the measures today, we are being robbed of that opportunity, despite the noises from the British Medical Association, the unions and the royal colleges.

[Paula Barker]

I thank my hon. Friend for that excellent point, which I agree with wholeheartedly.

The workers I am talking about are the workers who worked around the clock at the start of the pandemic, despite having inadequate personal protective equipment, because they were putting the nation first. They are the workers who will continue to work around the clock over Christmas and the new year. In an institution that is built on consent between patient and clinician, the Government are ripping up the rulebook to suit their own ends, while at the same time we are seeing the 17th reorganisation of the NHS since 1993.

We clapped for our care workers and NHS staff on a Thursday, and they will get us through the latest crisis over Christmas and the new year. But now the Government, who ripped up the rulebook last Christmas while the rest of us obeyed the rules, sacrificing seeing our loved ones—some in their final moments—are going to dismiss workers in April. And all this while No. 10 and the Department for Education not only had Christmas parties but told this House and the nation that they did not. The message is inconsistent and makes no sense.

We are told to trust the Government, but it is increasingly concerning that they are reviewing the Human Rights Act and want to replace it. We should be very afraid, because this could be a sign of things to come from a Government and a Prime Minister who believe they are above the law. Even worse, if they do not like the law and it does not serve their purpose any more, they will rip it up and start again until they get the policy or the outcome they want, irrespective of civil liberties or economic damage.

The right to choose, particularly when it comes to our own bodies, is something we should all take very seriously. I implore everyone to get vaccinated and boosted to protect themselves and others, but the Government have set a precedent that should worry every citizen. For the first time ever, we have seen the profession of care workers singled out; they have had conditions attached to their employment status that were never there to begin with.

There is so much that the Government could do in the weeks and months ahead, from constructive negotiations with the trade unions, which remain opposed to mandatory vaccinations, to ensuring that local authorities and health services have the resources and capacity required to deliver the ambitious daily targets for boosters, and that statutory sick pay is set at the Living Wage Foundation rate. Most importantly, they could follow the rules themselves, to give the public confidence that any measures introduced are proportionate and necessary.

Before entering this place, I represented care workers, NHS staff and public servants, many of whom are now my constituents. I take very seriously my responsibility to ensure that their voices are heard, while trying to balance that with the unprecedented situation before us and the importance of public health. I think we can do just that by consensus rather than compulsion.

I implore the Government to pause on the issue of mandatory vaccinations, withdraw the relevant statutory instrument and work on the issue with the trade unions, the Labour party and all those in the House who offer cross-party support. The Secretary of State himself has said that we have seen an increase in vaccination rates since the start of the consultation. Please, remove the SI and let us work together to get the country vaccinated.

Oral Answers to Questions

Andy McDonald Excerpts

Tuesday 23rd November 2021 Commons Chamber

[Sajid Javid]

Yes, I will. I looked at the previous bid and have been trying to understand why it was not taken forward. However, I would like to look carefully at the revised bid. I reassure my hon. Friend that more funding is available for such capital projects, and I would be happy to discuss that with him.

[Andy McDonald (Middlesbrough) (Lab)]

T4. Now that the cap on care costs has unravelled, many of my constituents feel misled and betrayed, especially those with modest capital in the value of their home. How can it be that those with the most will contribute the least and that those with the least will contribute the most? Where is the equity, where is the fairness, and where is the justice in any of that?

[The Minister for Care and Mental Health (Gillian Keegan)]

I thank the hon. Gentleman for his question. We are trying to solve something that has not been solved for decades, and the Labour party does exactly what it always does when it comes to this point: it picks one specific part without looking at the package as a whole and misleads the whole country. I want a better system not only for our grans and grandads, but for our mums and dads and all of us. If this system had been in place for my grandmother when she had dementia before dying in 2018, she would have been a lot better off. While we sit here doing nothing, the reality is that everybody loses—

Medical Cannabis under Prescription: Children with Epilepsy

Andy McDonald Excerpts

Wednesday 3rd November 2021 Westminster Hall

[Andy McDonald (Middlesbrough) (Lab)]

It is a pleasure to see you in the Chair this afternoon, Ms Bardell. I pay tribute to the hon. Member for South Leicestershire (Alberto Costa) for securing this debate, for his articulate and forensic analysis, and for the coherent account we have heard from him.

It is three years since we were able to celebrate the change in the law that should have helped the children and families we have been hearing from this week. Sadly, after three long years, they are no further forward. As we have heard, since 2018, only three NHS prescriptions have been issued for the type of medical cannabis that was shown to be so life-transforming for the likes of the then six-year-old Alfie Dingley, whom the hon. Member spoke of earlier. It was Alfie and his mum who were at the forefront of this campaign. They and many others achieved the change in the law that they had all worked so hard for.

Heartbreakingly, while the law has changed, it has not been properly implemented and utilised for those crying out for help. Families have been left at breaking point emotionally and financially, having to find up to £2,000 a month to pay privately for this medicine. I cannot begin to imagine how on earth these loving parents cope with such massive monthly costs— £2,000 a month is the equivalent of an additional and very substantial mortgage. In fact, it would dwarf many people’s mortgage payments. Not even we MPs on over £80,000 a year could cope with that. How on earth can we expect those families to withstand such huge costs, simply trying to keep their children alive and free from the ravages of seizures by accessing a known and proven prescriptive solution?

That these families cannot secure NHS prescriptions for their children, when it has been proved beyond any doubt that cannabis is efficacious, is a monumental shame. The campaign group that the hon. Member mentioned, End Our Pain, rightly said that this saga has dragged on for far too long. Those families have petitioned, marched and campaigned with such dignity. They should not and must not be ignored.

The new Secretary of State for Health and Social Care was pivotal in the change in law when he was Home Secretary. I urge him and his Department to give effect to that change and remove all barriers to getting medical cannabis to those patients. The campaigning families will do whatever it takes to help Government remove any barriers to doing the right thing and give them and their loved ones access to medical cannabis as they would any other therapeutic drug.

We lost our 16-year-old son to epilepsy over 15 years ago. I do not know whether medical cannabis would have helped him, had we even known about it then, but I will do everything I can to assist these families in their determination to get the medication that their children need. The memory of seeing our beloved Rory locked in status; to hear my wife scream for me to get an ambulance; to see the paramedics come upstairs to his bedroom; to hear the consultant in the hospital tell us that we better call a priest; and to hold my child as he died is something that I never want any of these families to suffer. I beg the Government to do the right thing and remove whatever barriers there may be and guarantee them access to this life-changing, life-saving treatment.

--- Later in debate ---

[Maria Caulfield]

These are clinical decisions. No one is saying that these products are not safe, but there is not the evidence base to get the licence. The MHRA does this for every single medicine, not just medicinal cannabis.

I want to set out how we can get to a place where we can get these drugs licensed and clinicians will feel confident in prescribing them. We recognise that, for many children, these drugs improve their quality of life—individuals have reported improvements—but without that research evidence base, the MHRA will not give a licence. The MHRA is an independent body—it is not controlled by the Government—and the clinicians will take advice and guidance from it. We may agree or disagree with how the MHRA licenses a medicine, but that is the process for all drugs. It is not just the MHRA—no country in the world has licensed this product. The Food and Drug Administration has not; the European Medicines Agency has not; the MHRA has not. The solution is in pushing the clinical research needed for a licence to be granted, which would open up prescribing for clinicians around the country.

[Andy McDonald]

Do the Minister and the MHRA not recognise that there is an abundance of practical evidence from the families who have scrimped and saved and raised money through charitable activities to fund the administration of the drug, and that it works? Surely that is persuasive. These families have not got time to wait for the research that the Minister is talking about, and I am yet to hear anybody tell me what harm would be done if that drug were to be given to those who need it and want it.

[Maria Caulfield]

There are concerns, particularly around the THC element, that there could be some effect on the developing brain and on heart conditions. Research is needed not just on the effect of the drugs, but on their safety.

I want to point out that the Government have made funds available for good-quality research. That does not have to be done by the manufacturers; it can be done by charities, clinicians or researchers. A range of people can come forward to carry out clinical research. The MHRA—

Dame Carol Black’s Independent Review of Drugs Report

Andy McDonald Excerpts

Wednesday 27th October 2021 Westminster Hall

[Andy McDonald (Middlesbrough) (Lab)]

It is great to see you in the Chair, Ms Fovargue. I congratulate my hon. Friend the Member for Liverpool, Walton (Dan Carden) on his bravery and on securing the debate.

I very much welcome the review by Dame Carol Black, but I note with great sadness her stark observation that Governments have de-prioritised these problems—from drugs entering the country, right through to helping drug users access appropriate treatment and achieve recovery. It is that second aim on which I will concentrate my brief remarks because, sadly, Office for National Statistics data show that the north-east is the worst area in the country for drug-related deaths. That makes it all the more important that programmes to address addiction as a health and public protection issue are successful. Accordingly, I was delighted in 2019 that the then Labour police and crime commissioner for Cleveland, Barry Coppinger, provided the essential funding, derived from the proceeds of crime, for the heroin-assisted treatment programme based in my Middlesbrough constituency—the first and only one of its kind in the UK.

This is undoubtedly a hard road, but there is no doubt that the programme has been immensely successful. The first cohort accepted on to the scheme were 14 of the most at-risk individuals in Middlesbrough, who caused the most concern to the criminal justice agencies and the health and social care services. Some had been using street heroin for over 20 years, and all other treatment had failed. Whereas six of them had committed 541 detected crimes before the scheme, with an estimated cost to victims and the public purse of £2.1 million, their combined crimes fell to three lower-level offences after starting their treatment.

In all cases, the individuals concerned either completed their probation or showed improved compliance with a probation order, and there was a 98% attendance rate at the twice-daily sessions, which continued through covid and lockdowns. None of the participants went back to sleeping on the streets, their use of illicit substances declined markedly, and their mental wellbeing improved. I am delighted that the clinical lead on the programme, Danny Ahmed, has been in Parliament today, and I pay great tribute to the superb work that he and his colleagues have done in showing the country the way to address this most complex of issues.

In closing, I would also like to pay tribute to the courageous stance taken by the chief constable of Cleveland, Richard Lewis, in his recent article in The Guardian where he said amongst other things that,

“The heroin-assisted treatment programme offers hope, if scaled up on a national level, that demand for heroin can be cut. When the state offers a meaningful alternative to the street drugs that can be bought from organised crime groups, the demand for them decreases.”

Finally, he said that the programme in Middlesbrough

“could possibly represent the beginning of the end for the ‘war on drugs’ that has already taken too many lives.”

I wholeheartedly agree, and I trust that the Government will take on board each and every one of the 32 recommendations that Dame Carol Black makes.

Medical Cannabis under Prescription

Andy McDonald Excerpts

Monday 20th May 2019 Commons Chamber

[Andy McDonald (Middlesbrough) (Lab)]

Thank you for giving me the opportunity to address the House on this very important debate, Madam Deputy Speaker.

I want to restrict my remarks to the subject matter of medical cannabis under prescription, particularly in respect of epilepsy. Comments have been made about the wider application of cannabis, and recreational and casual use, but that is not what we are talking about here today. We are dealing with the most serious medical issue, and I want to congratulate the right hon. Member for Hemel Hempstead (Sir Mike Penning) and my hon. Friend the Member for Gower (Tonia Antoniazzi) on securing this debate on a matter of critical importance.

I too pay tribute to our good friend Paul Flynn for the work he did. I had the great honour of accompanying him when the Leader of the Opposition extended the octogenarian’s career development plan by appointing him as our shadow Leader of the House; many a chuckle we had on a Thursday morning, and we were the better for it.

I also pay tribute to Professor Mike Barnes. It is funny how our paths have been intertwined. When I was a lawyer representing the victims of serious injuries—particularly brain injuries—and their families, Professor Mike Barnes was a terrific fount of knowledge and expertise. It comes as no surprise to me that he has decided to devote his entire career to this critical issue, and no finer advocate or expert could we have in this cause.

I pay tribute to the parents of children suffering from epilepsy. I know Hannah is here, and I pay tribute to her and to Charlotte for the work they have done over the years.

May I also pay tribute to my wife, Sally? I have to put that right, because I never said it in my maiden speech—she will be pleased to realise that I am putting that right. As the parents of two boys with intractable epilepsy, we had the most incredible journey, and I am so grateful to her for everything she did for our children over the years. It was enormously difficult, as the seizures came with such regularity and force, and we had to become experts in the area. I will say some more about parents a little later, but when you have to understand the condition and the science of the drugs behind it, that is a huge demand on parents. We had suddenly to become not only expert in the condition, but expert dieticians, as we tried to embrace the ketogenic diet. Parents who have ever tried to deploy that as a way of dealing with the issue know just how difficult it is. It is a high-fat diet, where you are trying to starve your children, in the first instance, in order to put them in a state of ketosis, and that is incredibly difficult when you have your little one screaming at you that they are starving hungry.

Curiously, that technique was used in the middle ages. If someone was having a seizure, they were deemed to be possessed of the devil and they were thrown into a cell, where they were starved. The ketones would work and people would come back to the individual to find, “The devil has gone. The seizure is over.”

Some of the pain that people are suffering to this day is equally barbaric. We are hearing stories about parents who have not had access to treatments. The hon. Member for South Suffolk (James Cartlidge) made a point about this not being an issue; I do not want to misquote him, but I want to take on this point. This can be not only an issue of pain relief, but the difference between life and death. We know that from our own case, because we lost our son on 4 February 2006, after he entered into status. I look around and I am absolutely determined that no parent should have to run the risk of not having had the opportunity to explore this as a possible way of dealing with their child’s epilepsy.

Some terrific contributions have been made today. I pay tribute to all the speakers, because they spoke with such intelligence and expertise. There is a real common purpose to get this right—I know that that is the case—which is this House of Commons at its absolute best. I congratulate each and every one of the speakers who has contributed.

We have had an intelligent conversation about CBD and THC. Other jurisdictions have satisfied themselves that this is efficacious and a legitimate way of treating this intractable condition. We do not even need to look to those other jurisdictions; we need only to look at the parents who are having to go to such extraordinary lengths to deliver the treatment that they know works for their child. If it is acceptable across Europe, particularly in the Netherlands, and in Canada and New York, the evidence base is there. The evidence base is in other jurisdictions and it is in the benefits derived by the children that we know about all too well.

I take the point so eloquently made by the hon. Member for South Suffolk: our wonderful clinicians have only one thought in mind—to bring about an improvement in a child’s condition and to alleviate the symptoms. He makes a very valid point. Not only does any clinician who has been put under the sort of pressure that the hon. Gentleman described have our sympathy, but the people who put them under such pressure really need to look at themselves in the mirror, because that is not how we go about addressing such a difficult issue.

I say to clinicians that if we need to address issues of training and expertise, let us get on with it. I suspect, and have heard from others, that some clinicians may feel somewhat inhibited and unable to respond in the way they wish. If it is a matter of sufficient knowledge and training, that should be addressed. It may be that clinicians are suffering under a misapprehension and are reluctant to act because of the spectre of clinical negligence claims. I say to them, as I say to all medics: please put that consideration to the back of your mind. Any practitioner who relies on evidence will not be criticised. If no reasonable practitioner would have prescribed that way forward, there is an issue, but if it is within the bounds of competence and of reasonable skill and there is a body of knowledge that would allow a practitioner to prescribe, they can dismiss those thoughts from their mind.

Like my hon. Friend the Member for Liverpool, West Derby (Stephen Twigg), I very much welcomed the change in the Government’s tone and approach not many months ago, for which they were rightly applauded. The tragedy is that that change has not been acted on since. Thousands of families across these islands are crying out to be given the facility that that change afforded. It has not happened and we are in grave difficulties.

I shall finish where I started. We must look to those parents who understand the condition and what works, and we must listen to them, because they are experts. I encourage clinicians to listen to their detailed evidence and the expertise they have built up. We simply cannot tolerate hard-working mums and dads having to go into hock to pay for these medications. The all-party group hears about the utter scandal of couples who are paying £1,500, £2,000 or £2,500 per month. I have no idea how they are carrying that burden. They have enough on their shoulders. There is a solution that we know works. Parents should be given the opportunity to bring some stability to their child’s condition and, while they are at it, some solace and peace to their own lives. They have their expertise; we should listen to them and do the right thing by them. The evidence is there and we should embrace it and get this logjam unblocked at the earliest possible opportunity.

Eurotunnel: Payment

Andy McDonald Excerpts

Monday 4th March 2019 Commons Chamber

[Andy McDonald (Middlesbrough) (Lab)]

(Urgent Question): To ask the Secretary of State for Transport to make a statement on the payment of £33 million to Eurotunnel over no-deal ferry contracts.

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

I would like to update the House on the settlement that the Government have reached with Eurotunnel, which will help to deliver the unhindered supply of vital medicines and medical devices in the case of a no-deal Brexit.

The best way to ensure a smooth and orderly exit from the EU, both for the NHS and for the wider economy, is to support the deal that the Attorney General is currently finalising. Anyone in this House who cares about the unhindered supply of medicines should vote for that deal, but leaving the EU without a deal remains the default position under the law, and it is incumbent on us to keep people safe. It is therefore vital that adequate contingency measures are in place for any Brexit scenario.

Preparing for a no-deal exit has required significant effort from the NHS, the pharmaceutical industry and the whole medical supply chain, and I pay tribute to their work and thank them for their efforts on these contingency measures. The settlement struck between the Government and Eurotunnel last week is an important part of these measures. Because of the legal action taken by Eurotunnel and the legal risks of the court case, it became clear that, without this settlement, we could no longer be confident of the unhindered supply of medicines. Without this settlement, the ferry capacity needed to be confident of supply was at risk. As a Government, we could not take that risk, and I doubt anyone in this House would have accepted that risk, either. With this settlement we can be confident, as long as everyone does what they need to do, that supply will continue unhindered. Under the settlement, Eurotunnel has to spend the money on improving resilience, security and traffic flow at the border, benefiting both passengers and business.

The Department for Transport, on behalf of the whole Government, entered into these contracts in good faith. Our duty is to keep people safe, whatever complications are thrown up. Although we continue to plan for all eventualities, it is clear that the best way to reduce all these risks is to vote for the deal in the days to come.

[Andy McDonald]

Once again, the Transport Secretary is not in his place to answer a question directed to him. His disregard for taxpayers and this House is clear. On Friday he reached a £33 million out-of-court settlement with Eurotunnel to provide services in the event of a no-deal Brexit because the Government were going to lose the case.

The Transport Secretary’s decision to bypass procurement processes in awarding a contract to Seaborne Freight, a ferry company without any ships, breached public procurement rules, and Eurotunnel had the Government over a barrel. Will the Minister now detail the total cost to taxpayers of this decision, including legal costs? How much money will be paid up front?

Eurotunnel will seemingly make Brexit-related improvements at Folkestone. Can the Minister say exactly what sort of agreement the Government have with Eurotunnel? What makes him think that this contract with Eurotunnel will not be challenged on anti-competition grounds? A former Department for Transport adviser said:

“there is a risk it could be construed as another piece of public procurement without open and transparent competition.”

That would risk further legal action and yet more public money being squandered.

Even in this golden age of ministerial incompetence, the Transport Secretary stands out from the crowd. He leaves a trail of destruction in his wake, causing chaos and wasting billions of pounds, yet he shows no contrition, no acknowledgment of his mistakes and no resolve to learn and improve. He is now ridiculed in The New York Times. The mayor of Calais has banned him from his town. The Transport Secretary has become an international embarrassment. The Prime Minister is the only person in the country who retains confidence in this failing Transport Secretary, and she does so only because of her own political weakness. The public deserve to know: how many more calamities is the Prime Minister prepared to tolerate? How many more billions of pounds will she allow him to waste before saying, “Enough is enough”? This country cannot afford this Transport Secretary. He should be sacked without delay.

[Matt Hancock]

In listening to that, I notice that the hon. Gentleman did not disagree with the decision we made on Friday. That decision was to ensure that we have the ferry capacity in place so that whatever happens in the Brexit scenario we can have the unhindered supply of medicines. That is the duty of this Government and that is why the whole Government came to this decision. He asked some specific questions, which I answered in my statement. However, let me reiterate: this is a legal settlement with Eurotunnel; the maximum cost is £33 million, as was set out clearly on Friday; and the purpose of the decision is to ensure that unhindered flow of medicines. So, as I said in my statement, the purpose of this is to make sure that whatever happens in Brexit people can be safe. I was happy to support that decision, which everybody in this House would have made in the same circumstances.

--- Later in debate ---

[Mr Speaker]

Points of order are flowing from this urgent question and, exceptionally, I will take them, if they are relatively brief.

[Andy McDonald]

On a point of order, Mr Speaker. I seek your guidance. This is now the second time that I have tabled an urgent question asking the Transport Secretary to come to the House and respond. We are told that he is busy—presumably pouring more money down the drain. Should he not be here, and what can you do to secure his attendance?

While we are at it, will the Secretary of State for Health and Social Care come to the Dispatch Box and explain that he has inadvertently misled the House by saying that this has nothing to do with Seaborne Freight? It has everything to do with that contract. That was the reason Eurotunnel took the Government to court in the first place. He must put the record straight.

[Mr Speaker]

I am grateful to the shadow Secretary of State for his point of order. As he will know, the choice of Minister to respond to an urgent question is exclusively a matter for the Government. For example, it is commonplace for somebody other than the Secretary of State to appear. It is not altogether uncommon for a Department other than that at which the question was tabled to field a representative to respond. I recognise that it is relatively unusual for the Secretary of State in the Department questioned not to appear, and for someone who rejoices in the seniority of Secretary of State in another Department to appear instead, but we should never underestimate the enthusiasm, stoicism and commitment to regular performance in the Chamber of the Secretary of State for Health and Social Care, and he has demonstrated that again this afternoon. Colleagues will form their own assessment of how he has batted at the wicket of the governmental team.

As to what the Secretary of State said about the question not being about Seaborne Freight, I think I will say that he has placed his own interpretation on the matter, and colleagues will form their own assessment. I thought that most of the inquiries were about legal action flowing from the cancellation of the contract, but the Secretary of State does have a legitimate public policy interest in the matter, both as a member of the Government and because of his regard for the safe delivery of medicines. Some people will think that he was absolutely right, and others will think that his interpretation of matters was a tad quirky, but nevertheless he has offered us his own assessment and colleagues can now assess it at leisure, possibly over their tea.

Points of Order

Andy McDonald Excerpts

Tuesday 7th June 2016 Commons Chamber

[Andy McDonald (Middlesbrough) (Lab)]

On a point of order, Mr Speaker. As you know, the SSI plant on Teesside closed, with the loss of 9,000 jobs. Lord Heseltine, the Secretary of State for Communities and Local Government and the northern powerhouse Minister, the Under-Secretary of State for Communities and Local Government, the hon. Member for Stockton South (James Wharton) are in my constituency at the Riverside stadium, launching the noble Lord’s much-awaited report in response to that crisis. I received notification of that by email at 3.33 yesterday and a copy of the report at 6.20 this morning. In fairness, having contacted the Secretary of State, I accept that he is under the impression that I was contacted properly. However, I assure the House that I was not. I have searched for those emails. Colleagues have received them, but I have not.

All I am asking for is some guidance, Mr Speaker. A report about my constituency is going to be delivered in my constituency. Can better direction be given to Ministers on how best they can communicate such activity to Members of Parliament, rather than assuming that it has been properly communicated through emails?

[Mr Speaker]

I say to the hon. Gentleman and the House that there is a firm convention that if a Member intends to visit the constituency of another Member on official business, as opposed to purely private or personal business, the Member whose constituency is being visited should be notified in advance. Nothing is written down anywhere, but it would be a courtesy to notify the Member sufficiently in advance that he or she could be present, or at least in the vicinity, in his or her constituency if it was so wished. That would rather depend on the circumstances of the event, but there should be proper notice.

In the case of Ministers, the requirement is stipulated in the ministerial code. If that has not been complied with in this case, it is regrettable. The hon. Gentleman has made his point and it will have been heard by those on the Treasury Bench. Doubtless it will be communicated, in the forceful terms in which he typically expresses himself, to the Secretary of State.

I hope that it will not be necessary for this point constantly to be raised and then underlined by me from the Chair. It is an elementary courtesy and I think that a lot of people who are listening to our proceedings will think, “Surely colleagues can treat each other in a civil and grown-up way, as would happen in other institutions.” Indeed, I note in the distance some agreement with the point I have just made.

Oral Answers to Questions

Andy McDonald Excerpts

Tuesday 5th January 2016 Commons Chamber

[Ben Gummer]

My hon. Friend is right and there is a particularly complex series of circumstances in Worcestershire. I am determined to do something about that, and I want to meet him and his colleagues in the next few days to discuss possible options. I will then discuss those issues in turn with NHS England.

[Andy McDonald (Middlesbrough) (Lab)]

T5. The management at James Cook university hospital in Middlesbrough is seeking to increase nurses’ current 30-minute meal break, which they struggle to take, to a compulsory unpaid 60-minute break that will result in nurses effectively working one shift a month unpaid. In their judgment that will do nothing to address the real issues of staff shortages and patient safety, but will merely disadvantage patients and nurses alike. Will the Secretary of State investigate the matter and write to me?

[Ben Gummer]

I thank the hon. Gentleman for bringing that issue to the attention of the House. All contracts should be governed by the “Agenda for Change” contract, and I would be concerned if there were deviations from that. I would welcome further detail on that so that I can respond to him.

National Health Service (Amended Duties and Powers) Bill

Andy McDonald Excerpts

Friday 21st November 2014 Commons Chamber

[John Healey]

I did not want to open up all the old arguments that we fought in 2010-11, though it was extraordinary to see the extreme lengths to which the Government went—seen before only on matters of military information—to stop the disclosure of the risk register about the potential impact and likely consequences of their policy. My hon. Friend was a great supporter of mine in trying to use the Freedom of Information Act to allow the public and this House to see the terms of what the Government knew could happen to the NHS if they passed the legislation.

My second C is complexity. NHS services are now so much harder to plan and so much harder to hold to account because of the changes the Government have made. We saw new national quangos responsible for tens of billions of pounds of spending of public money in each and every one of our local areas in England. The commissioning role, which was previously undertaken by one body, the primary care trust, is now fragmented with at least five different bodies trying to do the same job.

On the third C, competition, the Secretary of State has his foot lightly on the accelerator of privatisation for now, but let us make no mistake, if the Tories win the next election, he will press it hard down to the floor immediately afterwards. Even though they are soft-pedalling on the privatisation that their Act put in place, we have seen in the 18 months since it came into force 131 contracts won by companies such as Care UK, Virgin Care and BUPA. According to the NHS Support Federation, that is already valued at £2.6 billion. At that win rate, the contracts already currently advertised will mean another £6.6 billion in the private sector—getting on for 10% of our NHS run by private companies in private hands.

[Andy McDonald (Middlesbrough) (Lab)]

Has it come as any surprise and is it just a coincidence that the very companies securing these major contracts are six-figure donors to the Tory party?

[John Healey]

It comes as no surprise, and I am grateful to my hon. Friend for underlining that point. I was not planning to make that point, but I am glad that it has been made so clearly.

My argument is with the Prime Minister. So much for what he said, and so much for his word when he said back in 2011 that

“we will not be selling off the NHS”.

Perhaps the most serious consequence of this fragmentation, this privatisation and this contractualisation is the fact that the most important and fundamental value at the heart of the NHS—an imperative at its heart—is the ability properly to plan, co-ordinate and deliver services. That is being made much harder, as the Health Select Committee has said, and sometimes impossible by the operation of the Health and Social Care Act and competition law. If anybody doubts it, they should look at the case of the two NHS trusts—the Royal Bournemouth and the Poole NHS Trusts—whose merger made great sense to patients, but was prevented by this Government’s legislation.

Let me say a few words about the transatlantic trade and investment partnership. I have chaired the all-party group that has followed these negotiations for the last 18 months in order to try to encourage a better and more balanced public and parliamentary understanding and debate, as well as to put the Government on the spot and hold them to account for what they are doing. We are trying to ensure that if we get a deal, it will bring real benefits not just to British business, but to British workers and British consumers.

Two things have become clear. First, the NHS can be fully protected in TTIP. I am convinced of this, not just because other EU trade agreements have protected public services, but because if the Government want them, there are specific member state reservations to cover public services and because we have heard the confirmation, directly from the chief negotiator whom I have met twice about this, that even with ISDS—investor-state dispute settlement—provisions, which I do not support, nothing could prevent a future Labour Government from bringing parts of the NHS now in private hands back into public hands.

The second thing that has become clear is that these commitments have been secured despite, not because of, Government Ministers. It is clear that Ministers have done next to nothing to try to influence the negotiations and secure the full exclusion and protection we require for our NHS and wider public services. Indeed, rather as the right hon. Member for Banbury (Sir Tony Baldry) observed, the Minister for Trade and Investment, Lord Livingston, who is responsible in government for leading the British position, has said that he would welcome the inclusion of health services in any deal. When the Minister gets up to speak, perhaps he will—formally, in this House—make the Government’s position clear. What is clear is that if we are properly to protect our NHS in any future TTIP, we must have a strong British voice in Brussels, which we do not have at the moment.

--- Later in debate ---

[Andy McDonald]

Perhaps the hon. Gentleman would like to clarify, for the benefit of the House, whether his party is in favour of a private insurance-backed approach to health care or whether it actually believes in the NHS.

[Mark Reckless]

My party believes in the NHS as a service that is free at the point of delivery. My father is a doctor, and my mother is a nurse. That belief is core to my values, and to the values of my party. [Interruption.] That is our policy. Our policy is determined by our party, and it is to support an NHS that is free at the point of delivery.

Oral Answers to Questions

Andy McDonald Excerpts

Tuesday 1st April 2014 Commons Chamber

[Jane Ellison]

So desperate are the Opposition, I think the shadow Minister actually used the same opening line that he used at the last Health orals. It really is time to change the script. The NHS has seen more people in A and E than ever before. Waiting times have halved since the last Government left office. If he wants to come to the Dispatch Box and highlight problems in A and E, why does he not try the 86.6% of people being seen in Wales, which is a truly shocking performance statistic.

[Andy McDonald (Middlesbrough) (Lab)]

8. What progress has been made on achieving parity of esteem between physical and mental health.

[Paul Blomfield (Sheffield Central) (Lab)]

12. What progress has been made on achieving parity of esteem between physical and mental health.

--- Later in debate ---

[Andy McDonald]

If the Minister really believes in parity of esteem, how can he possibly justify cutting the funding for mental health trusts by 20% more than has been the case for other hospitals? Six leading mental health organisations warned that that decision will put lives at risk. Will the Minister now rethink the matter?

[Norman Lamb]

It is because I really care about parity of esteem that I described the decision by NHS England as flawed. It cannot be justified. It is not based on evidence. I am pleased to say that since then the former chief executive, David Nicholson, has written to all his area teams to make it very clear that in their commissioning plans and clinical commissioning groups, and in determining contracts with mental health providers, they must apply the principle of parity of esteem. Let us wait to see what emerges from that, but any reduction in funding for mental health this year would be unacceptable.

--- Later in debate ---

[Dr Poulter]

My hon. Friend has campaigned with great vigour on the issue, and rightly so. The European working time directive, to which the previous Government signed up in a headlong and reckless way, has damaged continuity of patient care and the training of the consultants of tomorrow. That is why we set up the independent review. We look forward to its recommendations and we will make sure that we respond to those appropriately in due course.

[Andy McDonald (Middlesbrough) (Lab)]

T8. The Health Secretary talks about Welsh patients flocking to the English NHS, but is he aware that the number of English patients going to Welsh hospitals has increased by more than 10% since 2010? Does that mean that the English NHS is in crisis?

[Mr Jeremy Hunt]

Unfortunately, a third of Welsh patients do not get things such as urgent scans within six weeks, compared with just 1% of patients in England. The Welsh NHS is struggling badly. I urge Labour, if it is to be consistent, to work closely with its colleagues in Cardiff to give a better standard of care to people in Wales, because they deserve a good NHS as well.