Oral Answers to Questions

Ben Howlett Excerpts

Tuesday 9th February 2016 Commons Chamber

[Mr Speaker]

Order. As in the health service, so at Health questions: demand always exceeds supply, so we need short questions and short answers.

[Ben Howlett (Bath) (Con)]

T4. I am sure Ministers will join me in congratulating Number 18 surgery in Bath on being ranked in the top 10 GP practices in the country. Do they agree that patients having a choice of where they are treated will increase patient satisfaction in the NHS?

[The Minister for Community and Social Care (Alistair Burt)]

Yes, it certainly will. That is another reason why we hope to have 5,000 more doctors and 5,000 more allied health professionals working in general practice, to expand the primary care service by 2020.

Junior Doctors’ Contract Negotiations

Ben Howlett Excerpts

Monday 8th February 2016 Commons Chamber

[Ben Gummer]

I am not sure the hon. Lady has been listening because otherwise she would have heard that the negotiations have already been taken on by leading negotiators from NHS Employers and, latterly, by Sir David Dalton, one of the leading chief executives in the country. Significant progress has been made, contrary to what she has just suggested. Negotiations have worked. We have managed to nail down—[Interruption.] The hon. Lady shakes her head, but the fact is that Sir David Dalton has managed to secure agreement on every single point of contention other than pay rates for plain time, unsocial hours and Saturdays. This dispute on Saturday and the kind of results we are going to see across the country on Wednesday will, in essence, be about pay rates on a Saturday, with the BMA wanting preferential rates over nurses, porters, cleaners and other workers in the NHS.

[Ben Howlett (Bath) (Con)]

May I join colleagues in thanking the Minister and the Secretary of State for all their work in negotiating a contract, which is obviously a tough discussion to have? Although many of my constituents may have sympathised last year with the BMA’s case, patients and their families, including my father after a recent heart valve replacement, will be concerned that the BMA is not getting around the negotiating table and thus placing a lot of undue stress on the most vulnerable. Does the Minister agree that the BMA should seriously consider those patients as it protracts its negotiations?

[Ben Gummer]

If the BMA was truly representing its members, it would be thinking about patient welfare during the strikes. Just now, we heard my colleagues describe with great eloquence the kinds of effects on individuals that a strike will cause. These strikes will get us no nearer to a solution; the only way to come to a solution is by negotiation.

NHS Trusts: Finances

Ben Howlett Excerpts

Monday 1st February 2016 Commons Chamber

[Ben Gummer]

I recognise the problems that the hon. Gentleman has identified at Northern Lincolnshire and Goole Hospitals NHS Foundation Trust and in north Lincolnshire. NHS Improvement is looking at them in detail at the moment. I hope that by working with the trust’s existing management, we will see an improvement over the next year. That is the point of what NHS Improvement is trying to do. I reassure the hon. Gentleman that if Jim Mackey produces the kind of results that he produced in his own hospital trust, his constituents will see NHS outcomes of a quality that has so far eluded them.

[Ben Howlett (Bath) (Con)]

I had the great displeasure of seeing at first hand the catastrophe that was NHS Connecting for Health under the last Labour Administration. It was therefore a bit rich of Labour Front Benchers to table this urgent question. Does my hon. Friend agree that this Government have introduced a strong regulatory regime and that joint investigations by NHS Improvement, the Care Quality Commission and Monitor will prevent future contractual failures?

[Ben Gummer]

I can give my hon. Friend that reassurance. Every Monday when I meet leading officials in the NHS, the people in the room are from the Care Quality Commission, NHS Improvement and NHS England. We make joint decisions. That is important because the system has to work as one. If the different parts pull in different places, we will not provide the solutions that we need. That is what has happened throughout the history of the NHS. For the first time, we have a system-wide response to the challenges facing the health service.

Oral Answers to Questions

Ben Howlett Excerpts

Tuesday 5th January 2016 Commons Chamber

[Mr Jeremy Hunt]

None whatever.

[Ben Howlett (Bath) (Con)]

In the previous Parliament, many people who suffer from a rare disease were pleased with the publication of the Government’s rare diseases strategy. What progress is the Minister making on publishing the ultra-rare diseases strategy?

[Jane Ellison]

I am happy to look into that and get back to my hon. Friend. With regard to the 51 recommendations made in the UK rare diseases strategy, he will be pleased to know that the first report on that will be in spring. I will take up the other issue with him after questions.

Mental Health

Ben Howlett Excerpts

Wednesday 9th December 2015 Commons Chamber

[Ben Howlett (Bath) (Con)]

May I join many other hon. Members in what they have said about the courage and bravery of Members standing up in this Chamber to speak about their own mental health issues? They are no longer in their places, but I refer in particular to my right hon. Friend the Member for Sutton Coldfield (Mr Mitchell) and my hon. Friend the Member for Broxbourne (Mr Walker). Listening to their speeches has given me enough confidence to think about my own mental health issues. I have to admit that trying to confront those issues was difficult in my first couple of months as a new Member of Parliament, but with the help and support of people in this place and in my constituency, I am managing to get through this period.

When someone comes to my constituency surgery to talk about their mental health issues, I completely understand the difficulties they face in finding the correct signposting. I completely agree with hon. Members who have said that we have a responsibility as MPs to be advocates for our constituents and to speak about mental health in this place. I have decided to hold a regular constituency surgery to work on mental health with Sirona Care and Health in my constituency. I will also hold hearsay information hubs, as I have done recently. I must admit that I have been pretty startled by the number of people coming forward to my surgeries with mental health issues during the past six months. I am at the very end of the journey on mental health: they should have been picked up well before they come to my office.

I have, however, seen a radical improvement during the past five years, having worked alongside the NHS for the past seven years. Avon and Wiltshire Mental Health Partnership NHS Trust in my constituency has Hillview, which is an excellent facility. It is increasing the number of psychiatric beds, which is definitely a benefit. We also have a range of community organisations and charities such as Bath Mind, which the Secretary of State visited just before the general election. I will never forget some of the work that it is doing, and I am currently helping it out. We play a vital role in this debate, and hopefully we will be able to signpost more of our constituents to the right place.

Junior Doctors Contract

Ben Howlett Excerpts

Monday 30th November 2015 Commons Chamber

[Mr Hunt]

I hope that the hon. Lady will understand that, because I very much hope that the BMA’s junior doctors executive committee will agree to go ahead with the agreement we have made with its negotiators, I do not want at this stage to go into further details about its contents. Obviously, the agreement will be published as soon as it is made, but I think that I would be pre-empting that decision by going into detail. It is a reasonable period of time for negotiations to take place.

[Ben Howlett (Bath) (Con)]

Thank you, Mr Speaker—it appears that I need to bob more often.

I am pleased to hear that all parties might be back around the table. I join the Secretary of State in hoping that the strike action is called off. Following a meeting with Bath junior doctors this weekend, it was clear to me that they, too, will be delighted. Will he confirm that safeguards will be a central part of the renegotiation?

[Mr Hunt]

Absolutely. We want to reduce the number of doctors working unsafe hours and make sure that we have binding ways of ensuring that hospitals cannot ignore the intention of any agreement we make and ask doctors to work extra hours that they do not want to work and that might be unsafe, or indeed to trade on the good will that means many doctors work extra hours unpaid. That is an important part of the discussions that I hope we will now be able to enter into.

Oral Answers to Questions

Ben Howlett Excerpts

Tuesday 17th November 2015 Commons Chamber

[Ben Gummer]

The financial settlement from the Government is more generous than the one promised by the hon. Lady’s party at the last election. We are committing £10 billion over the next few years. I would ask her trust to look at the savings suggested by Lord Carter, who has identified considerable savings that can be made within hospitals. If it feels that it needs to increase car parking charges, it should refer to the Department of Health guidance, which makes it clear that there should be concessions for blue badge holders.

[Ben Howlett (Bath) (Con)]

Hospital car parking charges are clearly too high in the UK. I am sure that my hon. Friend agrees that the Minister without Portfolio, my right hon. Friend the Member for Harlow (Robert Halfon), led an amazing campaign during the previous Parliament to reduce the charges. Will my hon. Friend confirm that he is pursuing his commitment to reduce hospital car parking charges and explain how that will help patients and visitors to the Royal United hospital in my constituency?

[Ben Gummer]

The principles that the Department publishes are clear that charges, if they are set, should be proportionate and fair and should be set at a level that assures people of a car parking space. One of the problems of free car parking is that it often means there are no spaces for carers and for the sick when they turn up. Clearly, hospitals should exercise judgment in making sure that carers and people making frequent visits get a heavily discounted rate so that such charges do not become an impediment to free access to healthcare.

Gay Conversion Therapies

Ben Howlett Excerpts

Tuesday 3rd November 2015 Westminster Hall

[Mike Freer (Finchley and Golders Green) (Con)]

I beg to move,

That this House has considered gay conversion therapies and the NHS.

It is a pleasure to serve under your chairmanship this afternoon, Mr Bailey.

I am conscious that this subject has been raised before; however, it remains possible for people in the UK to be referred by a national health service professional to a psychotherapist for gay conversion therapy—the so-called gay cure. Being gay is not a disease, it is not an illness and it is not something that I or any other gay man or woman can be cured of. To suggest otherwise is not only demeaning, but morally and medically wrong. Not a single medical body supports the concept of a gay cure. The Royal College of Psychiatrists, the UK Council for Psychotherapy, the British Association for Counselling and Psychotherapy and the British Medical Association have all concluded that such therapy is unethical and potentially harmful.

Various techniques and methods have been used, and I will list a few to give a bit of colour to the level of quackery available. Exorcism is one method—in The Times today is a story about a young man taken to a backstreet exorcist because his parents were concerned that he was gay. Cycling, too, was thought to be a cure for being gay, although as a keen cyclist I can tell colleagues that it does not work. Then there is prayer—pray away the gay, apparently—although that does not appear to work either. An Austrian doctor trialled testicular transplants: he took the testicles of a heterosexual man and transplanted them into a homosexual man to see whether that curbed his homosexual desires. Unfortunately, I could not find the outcome of the trial anywhere on the internet, although I am sure that it was of interest to both recipient and donor of the testicles.

I mention those as examples of how far from the mainstream some so-called cures can be. They are also a far cry from mainstream psychotherapy—I need to put that on the record. However, I want to focus on current techniques and to debunk the thought that so-called cure therapies might simply be gentle counselling, laying on the couch and talking about one’s feelings. They are not gentle therapies.

Such therapies purport to change a person’s sexual orientation or to reduce attraction to people of the same sex. Dr Christian Jessen, for a television programme in only 2014, underwent treatment for homosexuality, including one of the most extreme cures, aversion therapy, which looks to teach patients to associate same-sex attraction with pain or nausea. Patients are given a drug that makes them extremely ill and they are then played pornographic images and sound recordings while they vomit violently. That is not counselling. Usually patients experience a session every two hours, night and day, for three whole days. That is not counselling. Similarly, in electric-shock treatment, people who respond to same-sex stimuli are shocked so that their response is associated with pain. That is not counselling.

Imagine the outcry if Parliament were to give tacit approval to curing heterosexual men and women of their heterosexuality. There would be uproar. Allowing conversion therapy to try to turn our straight colleagues gay would not last a day, yet we allow therapists to peddle the myth that they can cure people of being gay.

If such views were held only by crackpots on the fringe of society, it would be laughable. It is not. Some psychotherapists and some NHS staff hold the view that a gay cure is possible. YouGov polling in 2014 for Stonewall, the excellent lesbian, gay, bisexual, and transgender organisation, found that one in 10 health and social care staff have heard other staff express a belief in gay cure therapy; in London that figure rose to one in five. Only six years ago the BMC Psychiatry journal surveyed over 1,300 accredited medical professionals and found that more than 200 of them—over 15%—had offered some form of conversion therapy. Those 200-plus professionals said that 35% of their patients had been referred to them by GPs, and 40% of the patients receiving the so-called treatment were treated in an NHS practice. For any health professional to refer someone for such therapy is fundamentally abhorrent and it is time to call a halt to it once and for all.

Where are we today? In spite of numerous calls for an outright ban, the practice continues, although I accept that there has been some progress. In January, the “Memorandum of Understanding on Conversion Therapy in the UK” was launched. It was developed by the UK Council for Psychotherapy and signed up to by some major organisations, including the NHS. It is welcome as far as it goes, but a number of regulators have not yet signed up to the memorandum—and it is voluntary. The memorandum seems to cover only sexual orientation, not gender identity—and it is voluntary. The memorandum states that practitioners need to be aware of the ethical issues relating to such cure therapies and that the public should be made aware of the risks of such therapies—and it is voluntary. The memorandum seeks to apply standards to a sector of therapy that has no statutory regulation—because it is voluntary. We regulate dentists, but we have no statutory regulation for psychotherapists.

My hon. Friend the Minister has an impeccable record on LGBT issues, especially in health, and I put on the record that on this issue and many others she has a deep commitment to helping to eradicate flaws in the system and to pursuing equality. So I have to ask: why we are allowing this abuse, this so-called cure therapy, to continue? Why are we allowing the practitioners, the psychotherapists, to have merely a voluntary code of practice—a memorandum of understanding?

I acknowledge that psychotherapy has a role to play for adults who need support when dealing with a range of issues connected with their sexuality and sexual identity. Dealing with conflicting feelings is difficult at the best of times and I do accept the role of proper, regulated counselling.

[Ben Howlett (Bath) (Con)]

I congratulate my hon. Friend on securing the debate. Does he agree that availability of such programmes would have a serious effect on the mental health of LGBT individuals?

[Mike Freer]

My hon. Friend makes a good point, given the evidence. I am about to quote the Royal College of Psychiatrists, which states that such therapies are damaging not only to the physical health, but to the mental health of individuals who have such therapies inflicted upon them.

--- Later in debate ---

[Jane Ellison]

My hon. Friend speaks from a position of great knowledge. I am well aware of the challenges to the current position, which I will outline, from hon. Friends and other Members. I will try to respond to those.

I want to make this point, for the record: we are not saying that lesbians, gay men and bisexual people should not seek counselling or therapy if they are distressed about a particular aspect of their sexuality. It is important we recognise that family arguments over sexuality or hostility from other people might well be a reason for someone to seek support for that aspect of their life. That is obviously a core part of what many therapists do, so I want to be clear that there is a place for that in supporting people appropriately.

[Ben Howlett]

May I pick the Minister up on a point? She referred to lesbians, gay men and bisexual people, but it is transgender people as well.

[Jane Ellison]

I am duly chastised, having recently given evidence to the excellent inquiry being led by the Women and Equalities Committee, of which my hon. Friend is a member. The Chair of that Committee, my right hon. Friend the Member for Basingstoke (Mrs Miller), has just joined us in the Chamber. I duly correct myself and thank my hon. Friend for his intervention.

I fully understand the concerns about so-called gay conversion therapy, but the Government have no current plans to ban or restrict it via legislation, or to introduce statutory regulation for psychotherapists. I say that in the knowledge that that position is challenged, and I will go away and reflect on that after the debate.

The Health and Social Care Act 2012 introduced provisions to enable the accreditation of voluntary registers for unregulated healthcare professionals and healthcare workers across the UK, social care workers in England and certain students. We should not underestimate the fact that these voluntary registers are having an effect and can be effective. They are accredited by the Professional Standards Authority For Health and Social Care where statutory regulation would be neither proportionate nor an effective response to patient safety. These accredited voluntary registers already provide some safeguards for the public. We feel they are working, and we have examples of that.

Both the Government and the PSA recommend that when a patient or service user chooses to visit a health or care practitioner who is unregulated, only those on an accredited register are consulted. That ensures that organisations holding an accredited voluntary register have been thoroughly assessed by the PSA. The PSA also ensures that those organisations handle complaints fairly and thoroughly. If a practitioner is removed from one register, they are not allowed to join another. We have seen some recent examples. In one case, the British Association for Counselling and Psychotherapy removed a practitioner from its register for professional malpractice after they were associated with this sort of therapy. The Department is clear that it encourages employers and commissioners, when recruiting, to choose practitioners who are committed to the highest standards and who are on accredited registers.

Although we have decided at this stage not to take a legislative approach, I wholeheartedly agree with my right hon. Friend the Minister for Women and Equalities who my hon. Friend the Member for Finchley and Golders Green quoted at the outset of the debate as saying that these therapies must be eradicated. We want to keep up the momentum to do that. I suggest to the House that as we pass the anniversary of the MOU, we should convene another roundtable in the new year, at which we ask the original signatories to report on their progress and challenge them to identify where we can be more ambitious on ending conversion therapy. That would be an opportunity to pick up on some of the specific challenges mentioned by my hon. Friend in his opening speech, as well as one or two of the points made in interventions. I am open to discussing how we bring the concerns raised by Members to the attention of that group and to discussing who comprises it, although I think it originally included some organisations representing LGBT people, as well as professionals in this area. I commit to doing that.

As we work towards that event, I am happy to engage outside the Chamber with hon. Friends on where they think we can do more. I have taken on this brief since the election. Before that, I was a Minister for inequalities; I am now a Minister for inequalities and equalities—I think that makes me even. It is a brief I take extremely seriously and one that I have committed a huge amount of time to.

Cities and Local Government Devolution [Lords] Bill

Ben Howlett Excerpts

Wednesday 21st October 2015 Commons Chamber

[James Wharton]

My hon. Friend makes a very good point. If we want to drive forward the opportunities that devolution presents, the best model to use in many areas is that of metro mayor. We will have an answer to the question: who do I ring when I want to speak to the north-east, to Tees Valley and to Manchester? We will have a person who can bring together those opportunities and drive the potential that this devolution agenda delivers.

[Ben Howlett (Bath) (Con)]

rose—

[James Wharton]

I will give way for the final time for the moment.

[Ben Howlett]

I thank my hon. Friend and the Secretary of State for the reassurance that was given to my hon. Friend the Member for North East Somerset (Mr Rees-Mogg) that we in the west of England will not have a mayor forced on us. Does he not agree that having that clause taken out needs to be looked at on Report?

[James Wharton]

Perhaps I need to be clearer about the impact of this clause. This clause would put at risk some of those deals already done. It would leave them open to legal challenge and put in jeopardy the devolution packages that those areas expect, the deals they have made with Government and the commitments that we made in our manifesto. I am in danger of repeating myself excessively, but I will again point out that no area can have a mayor or devolution forced upon it. This is enabling legislation that allows us to deliver our devolution obligations.

A&E Services

Ben Howlett Excerpts

Wednesday 24th June 2015 Commons Chamber

[Ben Howlett (Bath) (Con)]

I, too, congratulate the two new Members, for Dewsbury (Paula Sherriff) and for Salford and Eccles (Rebecca Long Bailey), who have spoken. I made my maiden speech a couple of weeks ago and know what a terrifying experience it is.

As Members from all parts of the House may already know, I have watched the NHS provide first-class healthcare to my mother, who has had a debilitating long-term musculoskeletal condition for the past 20 years. I am absolutely certain that without the support of the NHS her pain and suffering would have been an awful lot worse. Having said that, I should note that on a number of occasions she has needed to visit A&E to make her condition a little better, and, although improvements have been seen, her experiences have been mixed. I appreciate that my family’s case is just one example of this care. Improvements have been seen but people from around the UK are facing a mixed picture on care received at A&Es.

From the outset, I wish to stress, in agreement with my hon. Friend the Member for Totnes (Dr Wollaston) and the hon. Member for Central Ayrshire (Dr Whitford), that turning this issue into a political football is not helpful and that this is not a new issue. I have worked alongside the NHS for seven years and have given advice and support to four Health Secretaries, both Labour and Conservative, with each saying that they would do all they could to improve A&Es across the UK and more than their predecessor to cut unnecessary bureaucracy for medical professionals. As I said, this issue is not a new one. Emergency medical professionals have been warning that a hiatus has been on the horizon for a decade or more. I am therefore pleased that this Secretary of State has recognised the need to look at the issue much more seriously and holistically.

I would like to spend some time correcting a number of myths that have been espoused by the Opposition. First, and most importantly, I should say that the increase in A&E attendance is not because funding has been cut. The better care programme, designed to integrate health and social care services between national Government and local authorities, is predicted to reduce A&E admissions by 3%. The 111 service launched in 2013 directs 8% of callers to A&E departments, whereas 30% of these people would have gone to A&E if the service were not available. In addition, £150 million has been provided to fund evening and weekend GP appointments, through the Prime Minister’s challenge fund, meaning that people can access care through GPs instead of having to go to A&E.

Given that picture, we are clearly not going to be able to provide the high-quality care that is needed without proper investment. I am pleased that this Government have decided to take on board the recommendations of Simon Stevens and invest a further £8 billion in the NHS. That, of course, will have a significant positive effect on A&Es. Last year, the Government invested a record total of £700 million, ensuring local services had the certainty of additional money and time to plan how best to use it. As the Royal College of Emergency Medicine said:

“This represents the largest annual additional funding yet seen.”

I know from speaking to people at the Royal United hospital in my constituency that this additional investment has really helped.

The Opposition spend most of their time trying to do down our achievements, which the Under-Secretary of State for Health, my hon. Friend the Member for Ipswich (Ben Gummer), espoused in his opening remarks, but the protection of the NHS budget and the additional funding since 2010 has enabled A&E departments’ capacity to increase significantly since 2010. That additional funding has paid for 2,500 beds in both acute and community treatment, and the equivalent of 1,000 new doctors. We have now added almost 1,200 additional A&E doctors, including an additional 400 A&E consultants, and 1,700 additional paramedics since 2010. The additional £2 billion being invested in front-line care in 2015-16 will go a long way to supporting the NHS into the next winter.

My next point relates to weekly reporting of A&E data. The Opposition will be very much aware that the best healthcare decisions are clinically led, although it seemed as though they disagreed with that earlier on. As Sir Bruce Keogh rightly explained in his recent letter to the chief executive of NHS England:

“There is concern that, in a small number of instances, some targets are provoking perverse behaviours and the complexity of others is obscuring their purpose and meaning.”

I agree with him that the A&E standard has been an important means of ensuring that people who need to get rapid access to urgent and emergency care do so, and we must not lose that focus. I also agree with him that we do not need to review the four-hour standard at this time and that we need to look at a wider range of measures if we are to drive improved outcomes across the entire system.

I totally agree with the suggestion that we standardise reporting arrangements so that performance statistics for A&E, referral-to-treatment times, cancer, diagnostics, ambulances, 111 and delayed transfers of care are all published on one day each month. That fits very nicely with the calls from medical practitioners across the UK for a reduction in the burdens of bureaucracy that have been crippling productivity at the heart of our NHS. One key reason for my brother and his wife leaving this country to practise medicine in New Zealand was this overarching issue of bureaucracy. I very much hope this plan will show medical professionals and patients that we all look to improve the quality of data collection.

[Sir Oliver Heald (North East Hertfordshire) (Con)]

I do not know whether my hon. Friend had this experience, but during the election campaign a number of constituents told me how excellent the services were in A&E. Of course we have a brand new unit at the Lister hospital, but did he have the same experience?

[Ben Howlett]

Yes, absolutely, I did. When I was speaking to countless residents on the doorsteps across Bath, I found that the quality of provision of the Royal United hospital and other hospitals around the rest of the UK was tremendous. I spend a lot more time than Opposition Members do in thanking NHS professionals for the work they are doing in my constituency and elsewhere.

[Louise Haigh (Sheffield, Heeley) (Lab)]

rose—

[Ben Howlett]

I am coming to my conclusion, so I will not take an intervention.

In conclusion, I very much hope that the Secretary of State will continue to find the investment that is needed in our A&Es to keep up with the pressures; think about the need to encourage better access to primary care and community care; and reduce the burdens of bureaucracy that have afflicted our NHS for so long, and that resulted in my brother and his wife fleeing to New Zealand to escape.