Covid-19
Bambos Charalambous Excerpts(3 years, 2 months ago)
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Edward Argar
My hon. Friend was a distinguished Minister in the Department for some time and rightly highlights the situation that we faced at the height of the first wave of the pandemic. It is testament to the phenomenal efforts to procure PPE of the officials in my Department, in the Paymaster General’s Department and others that we did not run out of PPE in this country. Indeed, credit for that should also go to my right hon. Friend the Secretary of State for Health and Social Care, who ensured that throughout he put the provision of PPE and people first, even when, as we have seen, that may have led to challenges and to process not being entirely adhered to in respect of the timings for the publication of contract details. He and I have the greatest respect not only for the recent judgment, which we will consider carefully, but for the importance of transparency. I believe that my right hon. Friend did the right thing: he did everything he could to ensure that his No. 1 priority was to get that PPE procured and to the frontline to protect those who were protecting all of us and helping to save lives.
As on so many occasions over the past year, in recent weeks the British people have once again made huge sacrifices to comply with the necessary restrictions. It has been incredibly hard for individuals and businesses up and down the country, but in the figures that I have set out, we can see the impact that those sacrifices have made in helping to suppress the spread of this virus.
Despite the progress, over the past week an average of 449 people still lost their lives each day—449 families and friends who have lost loved ones. It is still far, far too many. It reminds us that, even now, as we map a brighter course forward, we must never lose sight of the threat posed by this virus.
Bambos Charalambous (Enfield, Southgate) (Lab)
When I asked the Prime Minister a question about his road map a short while ago, he said that he supported a public awareness campaigns for people who cannot wear face coverings but are subject to abuse because people are not aware of their exemption. Does the Minister support such a campaign and will he make the same commitment as the Prime Minister, so that people do not face abuse, and so that people are educated and know that there are reasons why people cannot wear face coverings?
Edward Argar
The hon. Gentleman makes a typically measured and sensible point. He is absolutely right: those who are exempt from wearing face coverings for medical reasons should be able to go about their lives without fear of abuse or verbal or other attacks on them for not doing so. I heard what the Prime Minister said and I echo those words. The Paymaster General and I will look carefully at what the hon. Gentleman has just suggested in respect of what we can do as a Government to raise awareness of the fact that there are people who, for entirely legitimate reasons, are not wearing face coverings.
Finally, I turn to the third factor that has changed the situation for the better. That, of course, is our vaccine roll-out, which throughout has been key to the future. As of today, we have provided a first dose to over 17.5 million people. That is almost one in three adults in the United Kingdom. Vaccine take-up has surpassed our expectations. In England, for example, we have now given a first dose to 93% of the over-80s, to 96% of those aged between 70 and 79, and to 94% of eligible care home residents. Those are phenomenal achievements—the result of a huge team effort. In that context, I pay tribute to our NHS, to pharmacists, to the armed forces and, of course, to the army of volunteers who have done their bit to help make this process run as smoothly as it has.
Those are vital achievements because we know that vaccines save lives. The cohorts we are currently working to vaccinate by mid-April represent some 99% of covid deaths, but we will not rest until we can offer that protection to everyone. We urge, and I would urge, everyone who has been offered the vaccine to take up that offer, as I will certainly be doing when I become eligible to receive it. It is safe and it is saving lives.
With an average of 358,341 doses being given each and every day in the UK and more vaccines coming on stream in the spring, I believe that we can confidently begin to look to the future. That is why a few moments ago, at this Dispatch Box, the Prime Minister set out his road map for how we will carefully but irreversibly unlock our country. As he set out, it is based on four tests: first, that the vaccine deployment programme continues successfully; secondly, that evidence shows that vaccines are sufficiently effective in reducing hospitalisations and deaths; thirdly, that infection rates do not pose a risk of a surge in hospitalisations that would put unsustainable pressure on the NHS; and fourthly, that our assessment of the risks is not fundamentally changed by new variants of the virus that cause concern.
Our road map out of lockdown will be taken, as my right hon. Friend set out, in four steps, each step reflecting the reality on the ground, not just our understandable expectations and desires. At every stage, our decisions will be led by data, not dates, with at least five weeks between steps; we will review the data every four weeks and give one week’s notice of any changes. The dates that my right hon. Friend set out today are not target dates; they are, importantly, “no earlier than” dates. We will continue to undertake statutory reviews, including the one taking place today. Yet in doing so, we are ever mindful of those expectations and desires.
Covid-19 Update
Bambos Charalambous Excerpts(3 years, 6 months ago)
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Matt Hancock
My hon. Friend is right to raise these issues, and these are difficult choices that we face. She has raised with me previously the need for a plan for exit so that we can motivate people to do what is needed to get the disease under control in London. In her constituency, almost more than any other, decisions to restrict social life have a significant direct impact. On economic and health grounds, getting this virus under control helps on both counts, particularly if we take into account, for instance, the mental health impacts. Having spoken to the Royal College of Psychiatrists, it is clear that the mental health impacts if the virus gets out of control are worse than the mental health impacts of the measures necessary to keep it in control, but nevertheless we have to ensure that the services are there to support people.
Bambos Charalambous (Enfield, Southgate) (Lab)
I wrote to the Secretary of State on 16 September about the inadequacies of track and trace, and I acknowledge what he has said today about the need for local and national teamwork, but I need to be further reassured that he will get track and trace right, because that is central to dealing with the covid-19 pandemic. London is now in tier 2, and we have seen Manchester go from tier 2 to tier 3. We need to have a national circuit break for that to work, because otherwise we will have tier 2 going piecemeal to tier 3, and that is not a plan.
Matt Hancock
First, yes, we want to work more closely with Ealing to make sure we get that national and local link-up in the test and trace system—I can give the hon. Gentleman that assurance. [Interruption.] And in Enfield as well. Just to be clear, no decisions have yet been taken on Greater Manchester, and I want to reassure colleagues from Greater Manchester who are in the Chamber of that. Finally, having this targeted approach is clear for people to understand. There are three levels. Everyone knows what is in each of the three levels, and it is very easy for someone to know which level their area is in.
Covid-19 Update
Bambos Charalambous Excerpts(3 years, 7 months ago)
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Matt Hancock
Yes, of course. My hon. Friend makes the point well. We are putting more localised testing in and making sure that it is as accessible as possible. Of course, the challenge is to ensure that those tests get to the right people, prioritised appropriately, and I look forward to working with my hon. Friend to deliver that across Kent.
Bambos Charalambous (Enfield, Southgate) (Lab)
At least six care homes in my borough of Enfield have seen the return of covid-19 cases. At the same time, they are experiencing delays in receiving pillar 1 and pillar 2 test kits, and results are taking more than a week to arrive, potentially leading to a rise in the spread of the virus. What steps is the Minister taking to ensure that testing is not taking as long? What does he intend to do to fix this mess?
Matt Hancock
Making sure that test kits get returned rapidly is incredibly important, including in social care. I am glad to say that the backlog has come down over the past week. At its core, our response to the problems in social care, because so many people who live in care homes are older and therefore vulnerable, is to protect the amount of test kits. The weekly testing of staff and the monthly testing of residents has been delivered and is being protected, even despite all the other pressures on testing capacity.
Covid-19 Update
Bambos Charalambous Excerpts(3 years, 8 months ago)
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Matt Hancock
Yes. My hon. Friend, who speaks so clearly for his constituents and for the young people who enjoy those facilities, will I am sure be pleased to know that youth groups are exempt from the rule of six, because they have their own covid-secure guidelines, in the same way that schools do and in the same way that organised sport is exempt.
Bambos Charalambous (Enfield, Southgate) (Lab)
In his statement yesterday, the Prime Minister said he would introduce an army of covid marshals to help ensure social distancing in town centres. Can the Secretary of State tell me how these covid marshals will be recruited, how much they will be paid, how they will be paid for and what powers they will have?
Matt Hancock
This programme will be rolled out by the Ministry of Housing, Communities and Local Government, because we will be working very closely with local authorities to make it happen, and we will publish the details in due course.
Covid-19
Bambos Charalambous Excerpts(3 years, 8 months ago)
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Matt Hancock
My hon. Friend is absolutely right to raise these issues, which are very important. I acknowledge and can see the challenges that mental health services face. Some cautiously positive news announced today by the Office for National Statistics shows that the number of suicides during the peak of the pandemic was down from 10.3 per 100,000 to 6.9 per 100,000, but of course we have to ensure that mental health services are there for people as we come out of lockdown, so that they can access them again more easily, and that we do all we can to support those who need them.
Bambos Charalambous (Enfield, Southgate) (Lab)
Following on from the Secretary of State’s answer to the question that my hon. Friend the Member for Rhondda (Chris Bryant) asked about cancer, obviously winter is a time of huge pressures on NHS services, with pressures on acute beds in recent years. Can he tell us more about his plan to tackle the backlog and deal with cancer patients, and about the treatments they will receive in the wintertime?
Matt Hancock
Yes; the hon. Gentleman is right to raise exactly this point. Now is the time to get through as much of the backlog as possible. At the same time, we have introduced changes to the way that the NHS operates so that it is more risk-based, so that infection control procedures, which are important, can also be more risk-based, to try to increase the amount of surgery that can happen, essentially splitting the NHS into areas that are deemed “covid green”, which are secure from covid, and “covid blue”, which means the areas where there may be covid, to allow the throughput of surgery to increase. Of course, cancer services have continued all the way through, but obviously they were diminished during the peak. With winter coming, we want to put the extra funds into the NHS to try to ensure that those services can continue all the way through, as much as is possible. The flu vaccination programme is also an important part of protecting the NHS from higher demand this winter.
Oral Answers to Questions
Bambos Charalambous Excerpts(3 years, 8 months ago)
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The Minister for Patient Safety, Mental Health and Suicide Prevention (Ms Nadine Dorries)
We welcomed the Cumberlege report and we are looking into the recommendations made, but the hon. Lady knows that, as a result of live litigation, I am not able to comment further.
Bambos Charalambous (Enfield, Southgate) (Lab)
The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)
Guidance to explain the Government’s policy on face coverings continues to be updated and fully takes into account groups with protected characteristics. This guidance makes it clear that there are exemptions for people who are unable, for a variety of reasons, to wear face coverings. We have also run a proactive communications campaign to ensure that people are aware that some people are unable to wear a face covering in certain circumstances.
Bambos Charalambous
Georgina Fallows is a rape survivor who suffers from post-traumatic stress disorder when her mouth is covered. Georgina and others like her have been challenged for not wearing a mask in shops and on public transport, and this causes further stress and anxiety. Does the Minister support Georgina’s campaign for a badge to identify people who legitimately cannot wear a mask, and will she consider raising awareness of this issue via a public information campaign?
Jo Churchill
I was incredibly sorry to hear what Georgina has been through, and fully understand that she and others who have undergone traumatic experiences cannot wear a face covering without distress. That is why our guidance and public messaging have been very clear that there may be people who should be exempt from wearing a covering for a variety of reasons. It is also clear that people do not need to prove it when challenged. We are actively engaging with stakeholders and charities to ensure that these messages sensitively get across, and we will continue to do so, but I would welcome a fuller discussion with the hon. Member about anything we can do further to help individuals such as Georgina.
Oral Answers to Questions
Bambos Charalambous Excerpts(3 years, 10 months ago)
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Matt Hancock
Yes. David Rosser is a great leader of a very, very impressive trust. I was speaking to him only last week. There is an important lesson from covid, which is that many of the NHS central rules and much of the bureaucracy was lifted to allow local systems to respond as a health system. That has worked well. We need to learn from that. We need to not only make that permanent, but see where we can go further in that sort of system working.
Bambos Charalambous (Enfield, Southgate) (Lab)
Matt Hancock
We were scrupulously fair in the allocation of funding to local authorities, ensuring, for instance, that the support for social care went according to the number of beds. We have taken a great deal of care to make sure we get this right.
Covid-19: BAME Communities
Bambos Charalambous Excerpts(3 years, 10 months ago)
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Bambos Charalambous (Enfield, Southgate) (Lab)
I congratulate my hon. Friend the Member for Brent Central (Dawn Butler) on securing this important and timely debate, and on her excellent speech.
Some 16% of the population in my constituency come from a black and minority ethnic background, and even before we knew the hard data about covid-19 deaths, the BAME community could sense that it was disproportionately affected. My local community joined in mourning the tragic death of 26-year-old care worker, Sonya Kaygan. Sonya died from covid-19 in mid-April after being exposed to coronavirus in the care home where she worked. Sonya leaves behind a three-year-old daughter, who is now growing up without a mother.
Sadly, Sonya is one of thousands of people from the BAME community who worked in frontline services and have lost their lives. As we watched the news and heard about the disproportionate number of BAME lives being lost, people rightly asked, “Why is this happening to our community?” Although some of it can be put down to social gatherings between different communities, that is by no means the only explanation.
Two weeks ago Public Health England published its first report on the disparities in the risks and outcomes of covid-19, but although it showed the bare facts it provided no explanations, which led to more questions than answers. Why were BAME Britons who contracted coronavirus twice as likely to die as white Britons? Why do black and Asian groups have the highest death rates from coronavirus? Why was race and ethnicity such a prevalent factor in the death stats?
Last week, we learned of the existence of Public Health England’s second report “Understanding the impact of COVID-19 on BAME groups”, which had not been released. It made for shocking reading. The report stated that structural racism had significantly impacted the effect of covid-19 on the BAME community, and that historical racism had made BAME NHS staff less likely to speak up about a lack of personal protective equipment or the increased risks they faced. Dr Chaand Nagpaul, who chairs the British Medical Association, said in response to the report that more than 90% of doctors who died during the pandemic were from BAME backgrounds, and that BAME staff were three times as likely to say that they felt pressured to work without sufficient PPE.
The PHE report echoed those comments and stated:
“Historic racism and poorer experiences of healthcare or at work mean that BAME individuals are less likely to seek care when they needed it”
and they are also less likely to speak up if they have concerns about risks in the workplace. The report further states:
“The unequal impact of covid-19…may be explained by a number of factors ranging from social and economic inequalities, racism, discrimination and stigma,”
as well as differing risks at work and underlying health conditions.
Data published in the Health Service Journal on BAME deaths from covid-19 highlighted that BAME groups accounted for 21% of NHS staff, but 63% of covid-19 deaths. Among medical staff, those from BAME backgrounds accounted for 44% of the staff, but 95% of the covid-19 deaths. These figures are truly shocking, and we cannot shy away from the fact that underlying racism is a key factor in these covid-19 deaths.
During the course of this debate, other colleagues have made the point that the BAME community is also over-represented in other frontline services, leading to more public interaction and exposure to covid-19. I shall not dwell on that now, but we must also remember those public transport workers, such as Belly Mujinga, who contracted the virus and died.
The Government’s failure to release the second report on time does not inspire confidence that they are serious about taking action. Action is needed to tackle the inequality among health workers. Viewed together with the failure of the Government to implement the recommendations of the Lammy review, the Wendy Williams Windrush review and Baroness McGregor-Smith’s review on race in the workplace, we have to wonder whether they have any intention on tackling structural racism at all. I challenge the Government to prove me wrong. Implementing the recommendations of the reports in full would be a start, but if the Government truly believe that black lives matter then they will be judged on their actions.
Social Care Funding
Bambos Charalambous Excerpts(4 years, 7 months ago)
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Caroline Dinenage
That is an excellent intervention, and the hon. Gentleman is right to say that we must do more to recognise and support young carers. The hon. Member for Plymouth, Sutton and Devonport said that we must do more to help schools to identify young carers, and that was a key part of the carers action plan that was announced last summer. A young carers’ takeover day of Parliament is planned in the months ahead: every MP across the country will be encouraged to invite a young carer from their constituency, which will give us a real in-depth understanding of what an amazing job young carers do.
We all recognise the challenges that the social care system faces. As a population, we are getting older: by 2040, one in four people in the UK will be 65 or over, as the right hon. Member for Twickenham pointed out. It is also important to understand that social care is not just a service for older people; the number of people under 65 who have carers is growing and accounts for more than half of social care spending. That can have quite a disastrous impact on local authority budgets, as the hon. Member for Plymouth, Sutton and Devonport pointed out. I will certainly take forward the points that he made.
These long-standing trends put increasing financial pressure on local authorities. In response, we have taken steps to ensure that the social care system has the funding to meet urgent challenges in the short term. In 2017, we announced an additional £2 billion in grant funding for social care, which we supplemented with a further £650 million in the 2018 Budget. Councils have responded by increasing their spending on social care, which has risen in real terms in each of the past three years.
Caroline Dinenage
I will make some progress, if the hon. Gentleman does not mind.
As a result of our investment in social care, 65% of local authorities were able to increase home care provision in 2017-18. Local authorities have increased the average fee paid for older people’s home care by 4.7% in 2018-19, bringing some much-needed stability to the provider market. I am very pleased that the Care Quality Commission has rated 84.1% of social care settings as good or outstanding.
I am delighted to say that in our most recent spending round we announced further investment in adult social care. We will provide councils with access to an additional £1.5 billion for adult and children’s social care next year, including £1 billion in new grant funding over and above the £2.5 billion of existing social care grants. In the spending round, we confirmed that all the existing funding streams would be maintained next year—hard-wired into the Budget, if you like. The Government will also consult on a 2% adult social care precept that will enable councils to access a further £500 million. This increase in funding is part of the biggest increase since 2015 in overall core spending power for local government: it will increase by 4.3% in real terms next year.
The new funding from the spending round will support local authorities in meeting the rising demands that they face, while helping them to continue to stabilise the wider social care market. This additional funding is the first step towards putting adult social care on a fairer and more sustainable footing. We have already started preparing for the multi-year spending round due next year.
The challenges facing social care are not purely financial, as hon. Members across the parties, including my hon. Friends the Members for Central Suffolk and North Ipswich (Dr Poulter) and for Newton Abbot (Anne Marie Morris), have said. It is important to point that out, because stakeholders across the sector tell MPs: “Even if money were no object, we would not necessarily continue to provide this service in the current system.” The current system is not working in so many respects, and it is not working properly for some of our most vulnerable citizens, which is why we are continuing to support the system through a programme of sector-led improvements to help councils to make better use of funding to deliver high-quality personalised service, with more than £9.2 million committed by the Department in 2019-20.
We are also breaking down barriers to encourage much better integration of health and care, and we are looking at what more we can do to support the workforce and carers, as I have mentioned. In terms of integration, the better care fund has helped to enable much better co-operation between health and social care partners at a local level. It has also been instrumental in reducing delayed transfers of care, which has been mentioned: they have decreased by 2,147 since February 2017. We are looking at how we can use the fund to drive better integration.
My hon. Friend the Member for St Ives (Derek Thomas) spoke about bed vacancies and people stuck in hospitals. There is a lot more integration going on between care providers and health settings that are using those beds to provide the step-down care and discharge to assess that we want to see.
Body Image and Mental Health
Bambos Charalambous Excerpts(4 years, 9 months ago)
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Jackie Doyle-Price
I thank the hon. Lady for raising that point—I have heard of that campaign. It is disturbing that so many people alter their images. None of us is perfect—God help us if we all were—but for people to think that they need to alter their appearance because they are unhappy with it, and for that to become normalised, is quite a sinister development in society. At the risk of being trite, perhaps we should be telling everyone to learn to love themselves.
Bambos Charalambous (Enfield, Southgate) (Lab)
Is the Minister aware of the Good Childhood report, which states that girls who share pictures or videos of themselves are less happy with their appearance than those who do not? Is she aware that the Children’s Society is campaigning for a greater understanding of what makes children unhappy, and does she agree that we need to focus on that?
Jackie Doyle-Price
Yes. The Children’s Society is doing some excellent work in this space and it always has a lot of expertise to share. We have to address this issue collectively as a society, because if we do not start equipping children with the tools to look after themselves and the right attitudes, that damage is set up for life. The hon. Gentleman is absolutely right to raise that point and I encourage the Children’s Society to engage with us more on what we can do to support it.
The Government recognise that poor body image is a common problem. Approximately 70% of adolescent girls and 45% of adolescent boys want to change their body weight or shape. We also recognise the impact that idealised body image can have on lesbian, gay, bisexual, and transgender people particularly, on ethnic minorities, and on those with disabilities or serious illnesses.
The Mental Health Foundation recently published a very informative report on body image. Some of its findings are shocking: 20% of adults feel shame, 19% feel disgusted, and 37% of teenagers feel shame in relation to their body image. This should make us all stop and think. When it comes to teenagers, we all recognise that going through adolescence is a difficult time, when we are at our most vulnerable, including to the outside influences that tell us that our body shape is not as it should be and that we are not as perfect as we could be. I welcome the recommendations made in the foundation’s report, which is aimed at public and commercial organisations and gives us things that we can do to help ourselves.
Having a negative body image affects the way that we feel about ourselves and it can affect people’s aspirations and confidence. In the most extreme cases, it can lead to eating disorders, depression and even feeling suicidal. I know that the hon. Member for Dewsbury (Paula Sherriff) is as concerned as I am about this issue, and I commend the work that she has been doing specifically on eating disorders. The increases that we are seeing in suicide and self-harm among young people are incredibly worrying. Much of this is being driven by young women and girls, but we must not forget the boys either. It is important that we work to raise awareness of the problems of body image that many people face and hopefully prevent them from developing issues in future.
Clearly, social and digital media companies are key players in this debate, because they contribute to the volume of material that encourages people to think negatively about themselves. Young people are put under such pressure to have the perfect image, the perfect body, the perfect relationship and the perfect clothes—the perfect everything—and that places unrealistic expectations on them. As hon. Members will know, we are in close dialogue with social media companies to encourage them to act more responsibly over the content on their platforms. We have held three summits so far; the most recent was only last week. We have said that, ultimately, we will consider legislation if they do not clean up their act. That said, Governments can always be three steps behind the development of technology, so I would much rather that we worked collaboratively and co-operatively to address this content.
So far, I have been encouraged that the companies have committed to increasing their efforts to protect users from harmful suicide and self-harm content online by coming together to establish and fund a strategic partnership with the Samaritans. That work is commencing. They will look not only at self-harm and suicide, but at pro-eating disorder content. We will continue our meetings with social media companies.
I was particularly concerned to see that a number of sites and materials are available that contain harmful content such as pro-anorexia messages. It is completely unacceptable that this sort of content is easily accessible to vulnerable young people. We are having talks with Amazon about removing books from its retail sites, but we need to ensure that social media companies are vigilant about taking down content published on their sites as well.
In the face of these modern challenges, central to tackling the problems in future is empowering our young people to improve their emotional resilience and wellbeing, so that they feel confident in themselves and in seeking support if they feel they need it. We are investing in massive improvements in mental health provision in schools. We have a new workforce that we are rolling out. We also need to make sure that children can access mental health support and we are investing in more provision in child and adolescent mental health services. As part of making health education compulsory in schools from September next year, it will be absolutely essential that we teach children how to protect their mental wellbeing. That will cover unrealistic expectations about body image. I hope that that will allow young people to recognise what is normal—what is normal, and is there any such thing as normal?—and what is an issue for them and others, as well as to know how to seek the right support when issues arise and to know that it is accessible to them.
Another issue I would like to talk about is gender identity, which has been the subject of quite a number of negative reports in our newspapers in recent months and, indeed, on Radio 4 this week. This is about people’s sense of self and physical appearance and about them wanting to change their gender identity. We have been aware of the issue of gender dysphoria, but there has been quite a lot of comment, and the House and the public need reassurance that the treatments available on the NHS, particularly for children, are appropriate.
To put the issue in context, gender dysphoria is where a person experiences discomfort or distress because there is a mismatch between their biological sex and their gender identity. That is incredibly difficult for anyone to deal with, but young people, in particular, will find it difficult. Many Members will have had representations from constituents about access to services to cope with gender dysphoria—I know that because I have signed many letters on the issue. It is essential that someone suffering with gender dysphoria receives the right support—support that really considers their holistic needs—because gender dysphoria often exists alongside other morbidities, and we must make sure we treat the whole person. Where appropriate, people should receive specialist treatment.
The Gender Identity Development Service for children and young people is provided by the Tavistock and Portman NHS Foundation Trust. There has been lots of concern in the press about that trust, but having discussed the service with NHS England and visited it, I would like to try to give Members some reassurance and to address some of the points that have been made about the service.
The first thing I think the service would like to get across is that gender should be seen as a spectrum. The whole treatment pathway is based on allowing children to explore their feelings in a safe environment. Not all children referred to the service will go on to transition. That is an important point to recognise, because if children have the time and space to work through their feelings, that will perhaps lead to a different treatment pathway.
I know there has been lots of concern that too many children are being referred to the service, but I would like to reassure the House that the service takes children through treatment in a very exploratory way around gender, and more than half of the children referred do not go on to transition. The service will treat each case as individual and complex and will address some of the co-morbidities that come along with gender dysphoria—lots of concern has been raised about the fact that some of these children are also on the autism spectrum.
It is important to recognise that, compared with services internationally, the service is very much at the conservative end of provision, which has led to it being criticised as far too conservative by some aspects of the lobby in favour of more services. However, where we are dealing with children who have not reached the age of majority, and where some of the treatments they may go through may be irreversible, the whole issue of consent is clearly important.
It is important to note that this aspect of service has grown quickly, and it has done so in an absence of public scrutiny. I can understand why there will be some public concern about it, so I would like to reassure the House that I am working with NHS England to do a proper review of the research around this service and the ethics of it to establish a proper framework for consent, recognising that we are looking at treatments that may have long-term consequences.
I can assure the House that the service works hard to ensure that consent is robust and that young people who might receive hormone therapy receive adequate information about the nature and consequences of that treatment. Such consent is not a one-off decision; it requires ongoing dialogue with the service. It will also require some assessment of the capacity and competence of the individuals consenting.
It is important to assure the House that this issue is very much under review. My starting point is that nothing should be undertaken in this space that would be irreversible for anyone under the age of 18. With that in mind, NHS England is putting in place a new policy and a new service specification for children’s services, and will thoroughly consider the issues that have come up in the press recently. Clearly, those issues will be a matter for debate, and many Members will have an interest in them. It is important for public confidence, as well as to enable access to services, that we have a proper, ethical debate around consent and the clinical evidence behind prescribing long-term hormone treatments.
Finally, I want to say a little about cosmetic procedures and regulation. I am pleased to see the right hon. Member for North Durham in his place—he is my conscience on these issues. It is fair to say that they are becoming increasingly common, and as they do so, they are becoming increasingly risky. Increasingly, it is becoming normalised for young women, in particular, but not just young women, to seek cosmetic procedures to alter their appearance.
I was pleased to launch an awareness campaign around cosmetic procedures earlier this year, which I have driven forward to make sure not only that we encourage people to properly consider the risks of any procedure they might undertake, but that they do not just wander down to the hairdressers and book a Botox appointment or a filler but really take steps to make sure they are going to a reputable provider. It is important that people fully understand the risks and where to look for a safe procedure. We have made sure that there is good material on the NHS website, and we are encouraging people to access that information when they are considering having any kind of procedure.
However, there is a really important message that we must give, which is that anyone considering having anything done to their appearance should not seek an operation overseas. There are some very disreputable operators advertising—for example, there are holidays in Turkey with a procedure. That is hugely dangerous, and I am afraid that the NHS is picking up the costs of those procedures. That is obviously something we need to address properly.
We will look at stronger regulation of the sector. Again, I would say that no one under the age of 18 should seek a cosmetic procedure. We have come to think that having some kind of lip filler is just like going to have a haircut, but when it goes wrong the results are much worse than having to let our hair grow back. Therefore, no one under the age of 18 should be seeking such procedures, and we need to do a lot more to make people realise exactly what the risks are.
Bambos Charalambous
Obviously, the harm is done with young people early on, and they are very impressionable—we have mentioned reality TV, and the Digital, Culture, Media and Sport Committee is looking at its impact. Does the Minister not think that we should try to teach positive body image at school and provide support at school for people who have concerns about their body image? That would be a wise investment of Government funds and would actually help young people to address their concerns and anxieties at every stage.
Jackie Doyle-Price
I agree with that. Through the new personal education that will be rolled out next year, we will have the ability to address that issue. I would just say that we need to be careful about this and to give some scrutiny to what the content of that might be. We have to really make sure that people respect the fact that we are all different and we all come in odd shapes and sizes, but everyone is beautiful. That is a really important message to convey. It will be incredibly challenging to get that content right, and we do need to bring some scrutiny to that.
Body image is clearly a strong contributory factor in many cases of mental ill health. I am pleased that we are starting to tackle some of these issues, but there is a long way to go. We have reached a stage at which the herd has gone so far down the road that the idealised view that everyone is a size zero model, whose perfectly coiffed, long, naturally blonde or brunette hair has no shades of grey and no curls, has taken hold. It will take a long time to turn that juggernaut around, but in the interests of a healthy society we all need to get a grip.