Covid Pandemic: Testing of Care Home Residents

Barbara Keeley Excerpts

Wednesday 1st March 2023 Commons Chamber

[Helen Whately]

My right hon. and learned Friend is exactly right; we are having a public inquiry and the Government are fully co-operating with it so that it has all the information required to look through all that happened, to investigate it and, rather than trying to score political points, to truly learn lessons for the benefit of the country.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

On 2 April 2020, I wrote to the former Health and Social Care Secretary, jointly with my right hon. Friend the Member for Leicester South (Jonathan Ashworth), highlighting the urgent need for testing in care homes for staff and residents and, in particular, for patients being discharged from hospital. I knew at the time, as did other colleagues, that without that testing, care homes in my constituency and those across the country were suffering a heavy toll of deaths of residents. Indeed, one of our care home managers died of covid in my constituency.

Furthermore, at a session of the Select Committee on Health and Social Care in July 2021, I asked the right hon. Member for West Suffolk (Matt Hancock) why the Government had not taken up the offer from care providers of facilities to isolate people discharged from hospital before admitting them to care homes. He told me that he did not know anything about the letter, despite it being sent by Care England. Will the Minister now admit that the Department and Ministers failed to understand and to involve social care in the key decisions about the covid pandemic, and ignored letters offering help that could have saved lives?

[Helen Whately]

The hon. Lady is right about the importance of testing. It is a view that she has and that I had at the time; some of the exchanges will show how I, as Social Care Minister, was arguing very hard for testing for care homes, as Members would expect. I know that other Ministers and other people were arguing for the things that they had oversight of. Ultimately, of course, the Health Secretary and the Prime Minister had to make decisions, based every step of the way, clearly, on the scientific advice on these things, as we did. To that point, during the course of the pandemic, as the capacity allowed, millions of tests were distributed to care homes. As I have said, as the capacity increased, care homes were prioritised in that process. Specifically to address one of the points she made, let me say that the guidance set out on 15 April was not only that everyone discharged from hospital to a care home should be tested, but that they should be isolated.

NHS Strikes

Barbara Keeley Excerpts

Monday 6th February 2023 Commons Chamber

[Will Quince]

The right hon. Gentleman says that many who work in the NHS are worried about patients: I spend every single day worrying about patients; I spend every single day ensuring the NHS has the resources it needs to provide the level of care and service our constituents rightly expect. I have a budget, and that budget has already taken into consideration a 4.75% on average pay award, with more than 9% for some of the lowest earners. There is an independent pay review body process for a reason; it is only two months away, in April, and I encourage the unions to take part in it. Of course I meet with unions, and of course I do and will meet with nurses and those who work in our NHS. I believe some of the points the right hon. Gentleman makes are correct, and I know those who work in the NHS genuinely want to ensure we are attracting and retaining the very best; that is all the more reason for us to get it right, and the way to get it right is the independent pay review body process.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

There were no strikes in the NHS over 13 years of the last Labour Government, and the cavalry is coming to rescue our health service with the next Labour Government. The Minister just asked where the funding is coming from to pay for NHS staff: we will train a new generation of NHS staff paid for by abolishing non-dom tax status so that the NHS has the workforce it desperately needs. Why will the Government not do as the Chancellor has suggested and adopt this policy now?

[Will Quince]

The hon. Lady says the cavalry is coming; how many more unfunded pledges—[Interruption.] Labour Members say they are fully funded: absolute tosh. I have heard the Opposition spend that non-dom money more times—

Urgent and Emergency Care Recovery Plan

Barbara Keeley Excerpts

Monday 30th January 2023 Commons Chamber

[Steve Barclay]

I am happy to give my right hon. Friend that assurance. I assure the House that our commitment to the cancer mission and the dementia mission through the Office for Life Sciences is absolutely there. He is right that we are bringing that together in one paper—I think we should take a holistic approach—but I share his ambition on prevention. In early January, I set out a three-phased approach: first, the £250 million immediate response to the pressures we saw from the flu spike over Christmas; secondly, as I announced today, building greater resilience into the system looking ahead to next winter; and thirdly, the major conditions paper on prevention, which is about bringing forward the innovative work that colleagues are doing through the Office for Life Sciences to impact the NHS frontline much sooner than might otherwise have been the case.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

I want to raise the case of a constituent who described to me the state of Salford Royal’s A&E earlier in January, saying:

“My partner was taken by ambulance yesterday at about 11am. He has a severe chest infection and breathing problems. He was left sitting in a chair on oxygen until 10pm when a trolley was found for him to sleep on. There are no beds available.”

My constituent said that patients and staff

“feel that no one cares”.

After such a long wait, my constituent’s partner was found to have pneumonia and he has been very poorly. Now the Secretary of State is talking about a target of 76% of A&E patients being seen within four hours by next March. Will he tell me and my constituent why he thinks it is acceptable for patients to wait longer than is safe?

[Steve Barclay]

We are bringing times down; I think the current mean response for C2s is much more in the region of 25 or 26 minutes than it was in late December-early January, because across the UK there was a massive spike in flu. The hon. Lady will have seen exactly the same in the Labour-run NHS in Wales. Over December there was a 20% increase in 999 calls, for example. That is why we need to put in place greater resilience, as the plan I have set out to the House does.

NHS: Long-term Strategy

Barbara Keeley Excerpts

Wednesday 11th January 2023 Commons Chamber

[Barbara Keeley (Worsley and Eccles South) (Lab)]

First, I want to share with the Health and Social Care Secretary my constituent’s recent battle to get medicine for his son, who had a high fever and symptoms that could be strep A. Unable to get a GP appointment, my constituent and his son had to travel out of the area to a local walk-in centre. They were then sent to the hospital, where they endured a six-hour wait. When the child was eventually examined, he was prescribed amoxicillin, but it was another long battle to find a pharmacist who stocked the antibiotics needed. My constituent said:

“Even I am shocked with what I have experienced over the last 24 hours.”

More and more people are finding out that the health service is no longer there for them when they need it. When someone has a child with serious symptoms and a temperature over 40°C, they should be able to access care quickly and not be forced to drive around for miles in desperation. My constituent also told me that he ran into several other parents that day who were experiencing the same issues in trying to get appointments and medicine for their children, who were very ill.

Nurses, doctors, ambulance workers, pharmacists, administration support staff and all those who, as part of our national health service, pour their energy into helping people when they are sick are worthy of our deepest respect and our thanks. The NHS crisis is not of their making. It is caused by the inability of the Conservative Government to plan or to support our health services adequately.

Many clinicians and commentators looking at the NHS crisis this week have raised the question of social care. Every year we revisit the pressures on social care and the desperate need for reform. Every year we see the consequences of Government inaction. We have had promise after promise of reform, but that reform is always dropped in favour of sticking-plaster solutions.

This week’s sticking-plaster solution gave the NHS some extra money, apparently to buy care beds. The deeper issue in social care is not beds, but the crisis in the social care workforce, with 165,000 posts vacant, representing one in 10 of the workforce. The NHS can buy beds in care and nursing homes, but that home may not have the appropriate staff available for the needs of the person being discharged. Unsuitable care will only lead to readmissions to hospital, so the cycle carries on. We know that in some parts of the country there are care deserts where there are no care home places. Does that mean that hospitals will start buying care home places tens or even hundreds of miles away?

The scandal of out-of-area placements is already a reality for many autistic people and people with learning disabilities. Chronic underfunding of social care and the lack of appropriate community services have entrenched a reliance on expensive in-patient care for autistic people and people with learning disabilities—care that is often far from home and not suited to the person’s needs. There is no extra funding to solve that problem. Indeed, the budget for those community services has been reduced this year from £62 million to £51 million.

We know that 2,000 autistic people and people with learning disabilities are trapped in that inappropriate in-patient care, which is often found to rely on the overuse of punitive seclusion and restraint. The fact that many placements are hundreds of miles away from family and friends makes the problem worse. Despite the steady stream of scandals, from Winterbourne View 11 years ago to the Edenfield Centre more recently, it is an issue that the Conservative Government choose to forget, even though it is destroying the lives of many of those detained and their families.

Our Opposition motion rightly ends with a call on the Government to

“end delayed hospital discharges…and reform primary and community care”.

Thirteen years of Conservative failure have led to this crisis. It will take a Labour Government to make the NHS fit for the future.

NHS Winter Pressures

Barbara Keeley Excerpts

Monday 9th January 2023 Commons Chamber

[Barbara Keeley (Worsley and Eccles South) (Lab)]

It is one thing to talk about blocked beds but, as many Opposition Members have said, care is also about staff. How does the Secretary of State expect care homes to cope with this increased pressure when one in 10 social care posts remains empty and when staff feel overworked, underpaid and exhausted?

Last year, a report commissioned by the Department of Health and Social Care found that the rapid discharge of people from hospital to care homes during the first wave of the pandemic, without adequate covid testing, was “highly likely” to have caused some outbreaks. How will the Health Secretary avoid the fatal mistakes of the past by militating against the seeding of more infections in care homes and, as my hon. Friend the Member for Ilford North (Wes Streeting) said, the danger of unsuitable care leading to hospital readmissions?

[Steve Barclay]

The hon. Lady makes a good point about the risk of introducing infections into care homes, as happened in the past. It is worth the House reflecting on the fact that we are in a very different position from the start of the pandemic. First, we now have vaccines in place for care home residents and staff. Secondly, we now have antivirals. Thirdly, we now have huge knowledge about covid. From an infection point of view, the risk of releasing people into care homes is now in a very different place.

On the wider workforce, part of the reason for the £500 million announced in the autumn statement is to support measures for the workforce, but we are also looking to boost numbers through international recruitment.

Oral Answers to Questions

Barbara Keeley Excerpts

Tuesday 1st November 2022 Commons Chamber

[Helen Whately]

My hon. Friend is absolutely right about patients spending too long in acute care in his own hospital. We know this is affecting other people around the country. I am very happy to meet him and I would very much like to visit his hospital and speak to his NHS, the local authority and other stakeholders to ensure we can improve the situation.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

Tony Hickmott is an autistic man who was detained in an in-patient unit for 22 years, often in near total seclusion, against his wishes and those of his parents, Pam and Roy. Tony now has his own home in the community, but the NHS spent £11 million on his detention in the last nine years after doctors considered him fit for discharge. Can the Minister comment on the wasted years Tony and his family spent fighting to get him free? What will she do to release the 2,000 other autistic people and people with learning disabilities detained in in-patient settings who would receive far more effective care in the community?

[Helen Whately]

The hon. Member raises Tony’s individual case, which is very hard to hear about. She and I know there are too many others in this situation. She will know, too, that I listened to this when I was formerly a Health Minister. It is a difficult problem to solve, but we should absolutely continue to work with the NHS, the Care Quality Commission and local authorities to ensure people who are not benefiting from being in in-patient settings are able to get the care and support they need in the community.

Edenfield Centre: Treatment of Patients

Barbara Keeley Excerpts

Thursday 13th October 2022 Commons Chamber

[Will Quince]

The Government are absolutely committed to ensuring that all patients receive safe and high-quality care in all settings. As the hon. Lady pointed out, we are investing more than ever before in NHS mental health services through the NHS long-term plan, which will see an additional £2.3 billion in funding per year by 2023-24.

The hon. Lady asked what work is underway. There is work under way at a national level to improve the way we safeguard patients and ensure they receive high-quality care through a new mental health safety improvement programme, which has set up new mental health patient safety networks across all regions in England. We are reviewing everyone with a learning disability and all autistic people in long-term segregation in a mental health in-patient hospital. The Care Quality Commission is introducing a new approach to inspections from next year, which will be more data driven and targeted, and we have commenced the Mental Health Units (Use of Force) Act 2018.

I can absolutely assure all hon. Members that this Government will continue to work with our partners across the NHS, social care and other sectors to consider what more action is needed to tackle toxic and closed cultures, looking at the available evidence base and, most importantly, hearing from the people affected and their families.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

NHS guidance has been clear for many years that abuse of this kind, including punitive seclusion and overuse of restraint, should never be allowed, yet it has persisted, as other hon. Members have said, including at Winterbourne View, Whorlton Hall, Cygnet Yew Trees, Cawston Park and now the Edenfield Centre. There will be other places, too, that have not had media attention, but where families of patients are seeing abuse and have no mechanisms to change things.

Harley is a young autistic woman who was detained at the Edenfield Centre and experienced punitive seclusion for weeks at a time. She said in the programme:

“Staff provoke a patient and then my reaction is used against me. But they’re provoking us. It’s disgusting. I’ve been treated like I’m an animal.”

There are over 2,000 autistic people and people with learning disabilities locked in inappropriate in-patient units in this country, often for 10 years or more. The policy of the use of inappropriate in-patient units for autistic people and people with learning disabilities is a choice. They could have support in the community with skilled and experienced staff. Will the Minister promise to end the culture of abuse for Harley and so many people like her?

[Will Quince]

The hon. Lady is right. I believe what I saw to be disgusting too. She specifically referenced those with learning disabilities and autistic people in long-term segregation. NHS England is undertaking independently chaired care education and treatment reviews for everyone with a learning disability and all autistic people in long-term segregation in mental health in-patient hospitals. A senior intervenor pilot is also underway. These actions will help support people in long-term segregation to move to a less restrictive setting or to leave hospital. A programme of safety and wellbeing reviews for the care and safety of people with learning disabilities and autistic people is now complete, and NHS England will be publishing the findings of a national thematic review later this year.

Ambulance Services and National Heatwave Emergency

Barbara Keeley Excerpts

Wednesday 13th July 2022 Commons Chamber

[Maria Caulfield]

Yes, and I thank my right hon. Friend for raising that point. Different response times are required, depending on the reason for the call. Strokes would be a C2 emergency, for which the target is 18 minutes. The latest figures we have are from May, when we were performing better than in April. The figures are not where we want them to be, but we are seeing month-on-month improvements. For C1 and C2 cases, which need urgent treatment as soon as possible, particularly for strokes, every minute counts and we want to see further improvements in those times.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

The Manchester Evening News is reporting that the North West Ambulance Service has raised its operational pressure level to “critical incident” level, which indicates a potential for failures as ambulance services try to cope with extreme pressure. A&E departments at the Royal Bolton and Stepping Hill Hospitals have admitted that they are extremely busy, with long queues of ambulances at some times. The Minister did not even mention social care in her response, which we know is so broken that it adds to delays and discharges. Twelve years of Conservative mismanagement and neglect have left those services, on which my constituents rely, so vulnerable. What does the Minister have to say to the patients suffering as a result?

[Maria Caulfield]

I am sorry that the hon. Lady did not hear my response. I specifically mentioned social care as well as the integrated care boards that we have set up to bring health and social care together—I think Labour Members voted against that. As I said, one factor affecting ambulance delays is the bed occupancy issue. Part of that—not all of it—is about delayed discharges and lengths of stay are 16% higher. We have a plan for fixing social care and it is unfortunate that Labour Members voted against it.

Health and Social Care Leadership Review

Barbara Keeley Excerpts

Wednesday 8th June 2022 Commons Chamber

[Sajid Javid]

I thank my right hon. Friend for her comments. I always listen carefully to what she has to say, given her important experience. On the pension issue, she will know that in the 2020 Budget, I believe it was, significant changes were made, especially to where the taper rate kicks in—it went from £110,000 to £200,000. That benefited the top 5% of earners in this country, but it was the right thing to do to encourage and incentivise doctors, in particular, to work more. She is right to talk about what more we can do. We are looking precisely at what further flexibilities we can offer on pension arrangements.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

The Health and Social Care Secretary talks about strong leadership and culture change. I point out to him his Government’s and his Department’s dismal record in meeting the pledge to close the in-patient units that are being used to trap more than 2,000 autistic people and people with learning disabilities rather than support them in their own homes. We have just passed the 11-year anniversary of the scandal at Winterbourne View. Not only has his Government failed in their pledge to close down these units, which was the original promise made after that scandal, but 560 people in those in-patient units do not need to be there at all, a quarter of them are more than 50 km from their own home, people are spending longer in units now than they were seven years ago, and more people have been admitted to the units year on year from 2015-16. This is one of the biggest scandals and the worst failures of his Department and Government. When is he going to act on it?

[Sajid Javid]

The hon. Lady is right to highlight the importance of this issue and she will know that my predecessor had asked for a review on it. It was done and we have accepted its outcome, and it is being implemented. I hope she will understand that in implementing the outcome of that review it is important that we listen to clinical advice from within the NHS and make sure that we put the interests of each patient first.

Ockenden Report

Barbara Keeley Excerpts

Wednesday 30th March 2022 Commons Chamber

[Sajid Javid]

Let me first thank my hon. Friend for her approach and her role in helping to make the report happen, and for the way in which she has worked with me, and with Ministers in my Department, on this most important of issues. She is right to talk about the importance of culture, especially given that, as the report makes clear, the voices of women were not heard time and again. I want to reassure her that we will implement all the report’s recommendations, but, more broadly, that women’s voices will be at the heart of the upcoming women’s health strategy.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

Today is an important day for maternity safety, and we rightly pay tribute to the families directly affected, so many of whom have given evidence to the Ockenden review.

James Titcombe, who lost his baby son Joshua during the Morecambe Bay maternity scandal, has said that one of the most harmful experiences for the Morecambe Bay families was

“seeing influential people in the maternity world diminish… the…findings”

of the investigation report. I join James Titcombe in saying that we must not allow that to happen with this report. I urge the Secretary of State to ensure that the bereaved families are allowed a process of truth, reconciliation and healing, rather than any denial of the truth of what took place.

[Sajid Javid]

I agree with the hon. Lady, and she is right to raise the importance of the Morecambe Bay investigation. That report, which I believe was completed in 2015, contained 44 recommendations. Eighteen recommendations that were specifically for the trust have been implemented, and the 26 for the wider NHS are in the course of being implemented.