Army Size

Debate between Barry Sheerman and Dan Poulter

Tuesday 5th July 2022 Westminster Hall

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

I beg to move,

That this House has considered the size of the British Army.

It is a great pleasure to serve under your chairmanship, Mr Davies. The subject of this debate is more relevant this week than many others. After the NATO summit in Madrid, at which the Secretary-General called for a “fundamental shift” in the alliance’s deterrence and defence, there is an increasing realisation that British defence policy needs some urgent updating. When Russia began its bloody and brutal invasion of Ukraine, the world changed. Not only is it the largest armed conflict since world war two, but the rules and norms that govern war are being torn up daily by the Kremlin. Today, all our thoughts and prayers are with the families of those killed and injured in the barbaric attack on the supermarket in Kremenchuk, and with the people of Ukraine as they face even more hostilities.

What should UK defence policy look like in the face of this new geopolitical reality? The answer is an approach that reflects the new world we live in, where alongside our friends in Europe, we take more responsibility for our own defence and that of our allies across the world. There is plenty in the integrated review and the defence Command Paper that I agree with: clearly, the Army must modernise, and the £24 billion that will be spent on emerging technology will help us tackle new types of threats. However, the lesson from Russia’s invasion is that we cannot continue to slim down the size of our Army. We must be clear-headed and steely-eyed when it comes to assessing the threat we face from Vladimir Putin. That means a renewed commitment to our conventional military capability and an end to cuts.

[Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)]

I congratulate the hon. Gentleman on securing the debate. I agree with much of what he has said and, I am sure, what he is about to say. Does he agree that one thing we are going to have to look at much more seriously now is putting more boots on the ground in other NATO countries, particularly those in the eastern parts of Europe that face towards Russia?

[Mr Sheerman]

I totally agree. I got into some trouble in certain quarters when I said that early on in the conflict; it was not something people wanted to hear at the time.

The Minister will know that I have consistently challenged the Government on this issue—I have form. Over the past 10 years, I have warned against cuts to the size of the Army. In 2013, I said that cuts to capacity would seriously restrict the ability of our country to defend itself. At the time, with the number of armed personnel at around 140,000, I felt as though we were retreating from being a significant player in the western alliance. In 2016, that number went down to 100,000, and there I was in the House, warning the Government that their course of action simply was not the right one. We now face the grim reality of soon having a limited capacity of 72,000 armed personnel. The fact of the matter is that those numbers are nowhere near good enough for a key player in NATO. As the Minister knows, I usually engage in constructive criticism, but it is crystal clear that the Government have their heads in the sand on this issue—or more specifically, the Prime Minister does.

Oral Answers to Questions

Debate between Barry Sheerman and Dan Poulter

Tuesday 24th February 2015 Commons Chamber

[Dr Poulter]

My hon. Friend and I have discussed this many times and I do not agree with him, as he knows. What is important is that patients are assessed on their clinical needs. A rehabilitation ward will need a different number of nurses—indeed, it may need physiotherapists and occupational therapists—from intensive care nursing, which often requires one-to-one care, so setting arbitrary staffing ratios is not in the best interests of patients.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

Does the Minister accept that the issue is not just broad numbers, but the shortage of specialised nurses in many departments, certainly in Calderdale and Huddersfield, where we are finding it difficult to recruit the right qualified nurses for very specialist tasks, as well as the doctors to go with them?

[Dr Poulter]

In many parts of the country we are seeing more specialist nurses working, particularly in areas such as diabetes, and supporting patients with complex care needs. As we need better to support people with those complex care needs at home in their own communities, the Government will continue to invest in specialist nurses not just to provide care in hospital, but to work in the community at the same time.

Oral Answers to Questions

Debate between Barry Sheerman and Dan Poulter

Tuesday 13th January 2015 Commons Chamber

[Dr Poulter]

My hon. Friend is absolutely right to highlight the challenges posed by perinatal mental illness. The damage it does to women’s lives, and indeed to the wider family, was highlighted in the recent independent inquiry into maternal deaths. It is therefore important for the Government to invest, as we are doing, in improved care for the perinatal mental health of women. That is why we have made it a priority for each and every maternity unit to have staff specially trained in perinatal mental health skills by 2017.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

The Minister will know that I have been part of an all-party group campaigning on post-natal depression, which is the most likely thing to kill a healthy young woman. Is he aware that this area of mental health is under-resourced, and that mental health facilities for children and young people are desperately under-resourced? That is partly because clinical commissioning groups have been commissioning in the wrong way, which has disturbed existing arrangements and demoralised staff.

National Health Service (Amended Duties and Powers) Bill

Debate between Barry Sheerman and Dan Poulter

Friday 21st November 2014 Commons Chamber

[Dr Poulter]

I will give way one more time in a moment, and then that really will, I am afraid, be the lot, because I know that Mr Deputy Speaker would like me to come to a conclusion.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

On a point of order, Mr Deputy Speaker. I do not know what is going on with this speech. I know that the Minister is a distinguished medical person, but he is presenting the speech with so much jargon and such technical terms that very few people out there will understand the main thrust of it. The only thing many people have understood in the last few minutes is the back-door privatisation.

Oral Answers to Questions

Debate between Barry Sheerman and Dan Poulter

Tuesday 21st October 2014 Commons Chamber

[Dr Poulter]

My hon. Friend is right to highlight the fact that the annual cost of PFI left by the previous Administration is £1.79 billion, which will rise to £2.7 billion. It is right that we do all we can to support hospitals to reduce the costs of PFI that have been inflicted upon them, and we will continue to do that and work with the Treasury to make sure that that specialist advice is available for the NHS to reduce the cost.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

I am worried that the members of the ministerial team are living in some sort of parallel universe. At the Calderdale and Huddersfield Trust we had a PFI. A hospital that has a long history of success is now struggling because it cannot get a management that works between the clinical commissioning groups and the trust. That is the truth—it is chaos.

[Dr Poulter]

There is nothing wrong with PFI schemes in principle; the point is the way in which they were put together by the previous Government. In 2011, the right hon. Member for Leigh (Andy Burnham) said:

“We made mistakes. I’m not defending every pen stroke of the PFI deals we signed”.

Those PFI contracts have damaged local hospitals and damaged local health care provision—

Oral Answers to Questions

Debate between Barry Sheerman and Dan Poulter

Tuesday 1st April 2014 Commons Chamber

[Dr Poulter]

That is a good point. On screening, we have to listen to the advice of the national screening committee, as I am sure hon. Members on both sides of the House would agree, but on the enriched culture medium test, I have had further meetings with Group B Strep Support and with the former editor of the obstetricians and gynaecologists journal, the BJOG. On the back of that meeting I have written to the Royal College of Obstetricians and Gynaecologists to ask it to look at the clinical evidence on that test, and it will take the matter forward.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

I thought that answers to questions were improving after 12 noon, but the last answer on post-natal depression was not as good as I expected. We have a campaign on post-natal depression, which is the biggest killer of healthy young women through suicide. The Minister is being complacent. Early diagnosis and good GPs are essential. What is he really doing about that?

[Dr Poulter]

The hon. Gentleman is absolutely right. I thought it was disgraceful, when we came to power and inherited the legacy of the previous Government on post-natal depression, that only 50% of maternity units had perinatal mental health support. That was not good enough, and that is why I have ensured that in the mandate to Health Education England, and working with NHS commissioners, all maternity units will have specialist perinatal support by 2017. There is more training going in for the work of the Royal College of General Practitioners on mental health support for GPs in helping women, and we are now increasing the number of health visitors by almost 2,000, and health visitors do a fantastic job in providing perinatal mental health support to so many women.

Atrial Fibrillation

Debate between Barry Sheerman and Dan Poulter

Wednesday 12th March 2014 Westminster Hall

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

It is a pleasure to serve under your chairmanship for the second time, Mr Turner. It is also a pleasure to congratulate the hon. Member for Huddersfield (Mr Sheerman) on securing the debate, and to thank my hon. Friend the Member for Montgomeryshire (Glyn Davies) for his important contribution about his own experiences of atrial fibrillation and its consequences. Although he spoke about the cardioversion treatment he received for sudden onset AF, much of the debate today has been about those who have chronic AF, which is often undiagnosed. The debate provides a good opportunity to raise such issues and ensure that those who are listening—in particular, bodies such as the Royal College of General Practitioners —take away messages about what more they can do to support GPs in earlier detection and diagnosis, where that is possible, and to make sure that the right treatment pathways and proper medications are provided to patients.

It may be useful if I talk briefly about the condition. The heart is not my area of medical expertise, but as a junior doctor I looked after several patients with AF, some of whom came through the front door of the hospital in a similar condition to that described by my hon. Friend the Member for Montgomeryshire, so I have seen it at first hand. AF is the most common sustained heart rhythm disturbance, and it occurs as a result of rapid, disorganised electrical activity in the heart’s upper chambers—known as the atria, hence atrial fibrillation—which results in an irregular heart rhythm. As we have heard, AF is a major predisposing factor for stroke and it accounts for approximately 14% of all strokes.

[Mr Sheerman]

On that point, would it not be a fine idea for the Minister or one of his colleagues to write to every Member of Parliament with the statistics? In the Calderdale and Huddersfield NHS Foundation Trust in my constituency, liaison between hospitals and GPs is not as good as it should be. When someone such as the hon. Member for Montgomeryshire (Glyn Davies) comes out of hospital after having an episode, there is no linkage of treatment between the hospital and the GP. Would it not be a fine idea to send a letter to every Member of Parliament giving them the statistics and urging them to talk to their clinical commissioning groups and GPs about the matter?

[Dr Poulter]

The hon. Gentleman is absolutely right about the importance of raising awareness of AF. He is also right to point out that co-ordination between primary and secondary care is not always as strong as it could be, not only in this area but throughout the NHS. Part of the reason the Government are investing in the £3.8 billion integrated health fund is to ensure that health and social care are better joined up, to achieve a more co-ordinated and holistic approach that is about individuals’ needs.

If someone has been diagnosed in hospital, it is important that they are given the right support in general practice and in the community. There is a lot of good practice out there, and there are a lot of good and well informed GPs. NICE is producing new guidelines and new draft recommendations on treatment—it has been looking at issues such as the use of anti-coagulants—and it is important that that information is disseminated quickly and effectively. My commitment to the hon. Member for Huddersfield is that I am happy to write to NHS England, which oversees CCGs, to raise the matter and ask it to disseminate NICE guidelines to CCGs and ensure that they are mindful of them.

[Mr Sheerman]

That is excellent news, but as someone with medical training, is the Minister not shocked that 36% of those with AF are being prescribed nothing or aspirin? Was he shocked to find out that rather than the 20% that NICE expected, only 3.4% of sufferers were on the new anti-coagulants?

[Dr Poulter]

The statistics that I am aware of are slightly less positive than those that the hon. Gentleman has cited. It is not for us in this place to micromanage medical professionals or to do their jobs for them. However, it is our job to raise legitimate concerns about care for AF or any other health conditions. We must do our best, as stewards of the health system, to push for good local commissioning that is mindful of best practice. I have undertaken to write to NHS England about that, and I will be happy to share the reply that I receive with the hon. Member for Huddersfield and other hon. Members and hon. Friends.

The exact causes of AF are unclear, but it is important to get the diagnosis right and to diagnose the condition as quickly as possible. We believe that some 18% of cases of AF are undetected, so there is more work to be done. NHS England has recognised that, and has suggested that CCGs should work with local practices to target people who are at risk from AF. The issue is already on NHS England’s radar, but I will write to obtain further assurances that it is being taken as seriously as it should be; I am sure that that is the case.

Research is under way into the condition. The National Institute for Health Research is funding a study into automatic diagnosis of AF in primary care using a hand-held device, which may help identify more patients who have AF and reduce the number of related strokes. If someone does not know that they have the condition, they do not know that they need to see a GP to get help. We must do as much as we can to support people to recognise that they have a medical condition and that help and treatment are available. I hope that the research into that technology provides better early detection of AF, and that that comes forward in a rapid and timely manner.

[Dr Poulter]

My hon. Friend is absolutely right to highlight that work. When NICE draws up guidelines, it consults best practice and tries to engage with key stakeholders. In addition, the Royal College of Physicians has developed some national clinical guidelines for stroke with the objective of encouraging higher levels of anti-coagulation. That is directly linked to some of the things we have debated today.

It is a testament to the work of groups such as the Atrial Fibrillation Association that we are helping to raise the profile of the condition and to get early support and help for people. There is clearly more to do, and NICE must continue to develop strong guidelines to support understanding of the best care and pathways for people who have AF. NICE is updating guidelines at the moment and developing a quality standard on AF, which will set out what a high-quality AF service should look like and drive improvement locally by helping local commissioners and CCGs understand what good looks like in AF care.

[Mr Sheerman]

Before the Minister, who is uniquely qualified to have an opinion, sits down, does he agree that more people should be on the new generation of drugs that will keep them alive and prevent them from having strokes?

[Dr Poulter]

It is not my medical specialty, but if new medication is developed, we need to evaluate it. The priority must be to give treatment according to clinical need. I, as a doctor, the Government and hon. Members on both sides of the House believe that it is right to treat patients according to clinical need and clinical priority. It is for CCGs to work with national guidelines, and we look forward to seeing the NICE quality standard on AF, which I hope will put CCGs in a much better position. I have already committed to writing to NHS England to ensure that it puts the matter high on its priority list, and that it supports and encourages all clinical commissioning groups to take AF seriously and make it a priority across the country.

Oral Answers to Questions

Debate between Barry Sheerman and Dan Poulter

Tuesday 11th June 2013 Commons Chamber

[Dr Poulter]

I would be delighted to visit my hon. Friend’s constituency. He has been a tremendous advocate for maternity services, both nationally and in his constituency, in his time in the House. As I am sure that he has realised, if we want a genuinely personalised maternity service, we need to ask women about their experiences of care. That is why the Government are introducing a friends and family test in maternity from October this year.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

The Minister knows full well that post-natal depression is the thing that is most likely to kill a healthy young woman, and we know how to deal with it, but in many areas across the country we are cutting the number of visits from midwives after births, and the support given. We know how to tackle post-natal depression. Why should it be that in some parts of the country the support is wonderful, and in others, it is non-existent?

[Dr Poulter]

The hon. Gentleman is absolutely right to highlight that there has, in the past, sometimes been unacceptable variation in the quality of post-natal care. That is why we are increasing the number of midwives and have done so by nearly 1,400, and why we are putting money and effort into increasing the number of health visitors, who play a vital role in supporting mums, babies and families in securing that important bond, and in supporting mums so that they get the right help when they suffer from post-natal depression.