Learning Disabilities Mortality Review
Caroline Dinenage Excerpts(4 years, 2 months ago)
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The Minister for Care (Caroline Dinenage)
Government response to the third annual learning disabilities mortality review (LeDeR) report.
Following the publication of the third annual report from the learning disabilities mortality review (LeDeR) programme on 21 May 2019, and the statement I made at the time, I am today pleased to be publishing the Government’s response to that report. A copy of the response can be found at: https://www.parliament.uk/business/publications/written-questions-answers-statements/written-statements/
The LeDeR programme was established in 2015 to help reduce early deaths and health inequalities for people with a learning disability by supporting local areas in England to review the deaths of people with a learning disability and to ensure that the learning from these reviews lead to improved health and care services. The programme is led by the University of Bristol and commissioned by the Healthcare Quality Improvement Partnership (HQIP) on behalf of NHS England.
The programme has found that the quality of care offered to people with a learning disability sometimes falls short of the standards we expect. The existence of the LeDeR programme demonstrates our ongoing commitment to ensure that people with learning disabilities can access the best possible quality care and support.
The third annual LeDeR report covers the period 1 July 2016 to 31 December 2018, with a particular focus on deaths in 2018. From 1 July 2016 to 31 December 2018, 4,302 “in-scope” deaths were notified to the LeDeR programme. The majority of these, 2,926, were notified in 2018. In 71 of the cases reviewed, people received care that fell so far short of expected good practice that it significantly impacted on their well-being or directly contributed to their cause of death.
Based on the evidence from completed LeDeR reviews, the third annual report made twelve recommendations for the education, health and care system. As I said at the time of the LeDeR report’s publication, it is essential that we take appropriate actions to learn from the issues raised by the LeDeR programme. In the Government response, we have set out how we and our system partners are taking action to deliver the improvements to services that will make a real and significant difference to people's lives. Actions identified relate to reviewing guidance; publishing new data on the progress of LeDeR reviews and sharing best practice.
In November, we set out our most significant action in response to the third annual LeDeR report, when we committed to introducing the Oliver McGowan mandatory training in learning disability and autism for all health and social care staff. This training is named after Oliver McGowan, in recognition of his story, his family’s tireless campaigning for better training for staff, and to remember him and others whose lives were cut tragically short.
The Government remain committed to gather learning from deaths reviewed under the LeDeR process ensuring that measures are put in place to address the persistent health inequalities that people with learning disabilities experience. Since the start of the LeDeR programme, nearly 3,200 reviews have been completed and over 2,700 are currently in progress. Although increases in the number of reviews carried out is welcome, we acknowledge that the pace with which reviews are conducted needs to increase further.
The LeDeR programme was introduced to ensure that local, evidence-based action is taken to improve support for people with a learning disability, and while we clearly have a great deal further to go to improve outcomes, we must continue to build on the momentum of the past five years and work together to learn from the past. Our response, published today, sets out how we will do that.
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Acquired Brain Injury
Caroline Dinenage Excerpts(4 years, 3 months ago)
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The Minister for Care (Caroline Dinenage)
It is a great pleasure to serve under your chairmanship, Mr Robertson. I add my congratulations to the hon. Member for Rhondda (Chris Bryant) on again securing a really important debate on this issue. He is such a brilliant and effective champion of people with acquired brain injuries. His passion is incredibly infectious and set the tone for the rest of the debate, which I think everybody would agree has been incredibly constructive and thoughtful; there have been excellent contributions from everybody. The hon. Gentleman leads the all-party parliamentary group on acquired brain injury, about which all its members are very passionate. They have done superb work.
I thank everybody who took part in the debate: my right hon. Friends the Members for South Holland and The Deepings (Sir John Hayes) and for Hemel Hempstead (Sir Mike Penning) and the hon. Members for Airdrie and Shotts (Neil Gray), for Mitcham and Morden (Siobhain McDonagh) and for Washington and Sunderland West (Mrs Hodgson).
As hon. Members will know, it is estimated that the total cost of brain injury in the UK is at least £1 billion per annum and that the number of people living with ABI is more than half a million and could be as high as 1 million. Many hon. Members have explained that, as with many long-term conditions, the impact of ABI is not limited to an individual’s health but is felt across many aspects of their life, including family, work, relationships and finances. Of course, such an injury could happen to any one of us. My right hon. Friend the Member for Hemel Hempstead spoke about traffic incidents and collisions. That could happen to any one of us on our way home today.
I join the hon. Member for Rhondda in taking this opportunity to recognise, first, the outstanding work done by professionals in this field and, secondly, the wonderful work undertaken by charitable organisations such as Headway, the United Kingdom Acquired Brain Injury Forum and the Children’s Trust, which he mentioned. They are incredibly highly valued by those affected. They do invaluable work in raising not only money but awareness and by providing incredible support to those with the condition, as well as to their families and carers.
I have had quite a long-standing involvement with Headway in my region of Portsmouth and Gosport, since before I became an MP; as an MP, I have met my local team on a number of occasions. They are remarkable and offer the most fantastic support to people in my area. They certainly make a difference to people’s lives and they are so inspiring. On one occasion, I visited them with a member of my team, and she was so buoyed up by the visit that she decided to go off and do the Great South Run to raise funds for the Headway charity. I am not going to follow her example: literally nothing apart from someone chasing me would make me run 13 miles, but people can see how—
Caroline Dinenage
Thank you; that is a very generous offer. People can see what an inspiring group Headway is.
We have heard a lot about the excellent and wide-ranging APPG report from 2018. As the hon. Member for Rhondda said, the Department of Health and Social Care co-ordinated with officials from across Whitehall to deliver the response, which was a truly cross-Government response, but I certainly feel his frustration at how silo working across Whitehall can be an impediment to getting the change that he wants. A number of right hon. and hon. Members have mentioned that today, and I will certainly take forward the idea of a real, collaborative cross-Whitehall group to discuss this. Even from the issues raised today, the Department of Health and Social Care, the Department for Work and Pensions, the Department for Digital, Culture, Media and Sport, the Department for Transport, the Department for Education, the Ministry of Defence and the Cabinet Office—I am sure there will be others—all need to be involved in the conversation.
Neil Gray
I thank the Minister for her contribution thus far. It was remiss of me, not just as someone who comes from an armed forces family but as a constituency MP with cases involving constituents who have been medically discharged from the armed forces, not to highlight and focus on the contribution from the right hon. Member for Hemel Hempstead (Sir Mike Penning) on the greater work that needs to be done within the MOD and across Government to ensure that we are treating our armed forces personnel, particularly when they leave service, with greater respect, and to ensure that we are providing for them, given the level of service that they have provided to all of us.
Caroline Dinenage
The hon. Gentleman is absolutely right to raise that issue. NHS England has a veterans trauma network, which delivers comprehensive medical care to veterans, including those suffering from brain trauma. It does excellent work, but there are also many individual charities up and down the country that work to support veterans who may not have been diagnosed; they may have been diagnosed with post-traumatic stress disorder or something else, but never actually had the original head injury diagnosed.
Almost as if to highlight the fact that this is a hugely cross-Government issue and the inadequacy of Ministers working in their individual silos, I will today be able to focus massively only on the issues relevant to our health service, but I will try to come on to a lot of the questions that right hon. and hon. Members asked.
Sir John Hayes
I am extremely grateful to the Minister for giving way. We had meetings as an all-party group with the former Chancellor of the Duchy of Lancaster, the former right hon. Member for Aylesbury. I believe that at that point there were suggestions, at least, that a Cabinet Office piece of work would be initiated. Can we take it from the Minister’s assurances that she will write to the Cabinet Office colleagues who are now responsible for these matters and copy that letter to participants in this debate?
Caroline Dinenage
Yes, I am very happy to commit to doing that.
Before I go on to talk about the health implications of ABI, I want to deal with a couple of other things. They are not within my realm of expertise, but I want to touch on them.
The hon. Member for Mitcham and Morden spoke about the Headway brain injury identity cards—how important they are and how important it is that they are recognised across the criminal justice system. I wanted to mention how Headway has been integral in partnering NHS England’s health and justice liaison and diversion services programme team, to provide workshops in London and Leeds to raise the awareness of the prevalence of ABI within criminal justice populations. The objectives were designed in a “train the trainer” format, so that the attendees could return to their services and cascade the learning on how to identify people with brain injury, how to identify the brain injury cards that Headway has brought forward and how to understand the implications. I thought that was quite positive.
My right hon. Friend the Member for Hemel Hempstead was right to mention the positive progress that has been made in some sports. The Rugby Football Union’s Headcase campaign and the British Horseracing Authority have also made great strides in this area. However, he was also right to say that other sports have a long way to go.
The hon. Member for Rhondda spoke about trauma centres. As he knows, in 2012 22 regional trauma networks were developed across England to ensure that those with the most serious brain injuries received the best care. Two years after their introduction, an independent audit showed that patients had a 30% improved chance of surviving severe injuries. Since then, as he says, the network has saved literally hundreds of lives.
For people who have ABI, neurorehabilitation that is timely and appropriate to their circumstances is a massively important part of their care. Access to high-quality rehabilitation saves money and, more importantly, significantly improves outcomes for patients. NHS England commissions specialised rehabilitation services nationally for those patients with the most complex level of need. As we have already heard, trauma unit teams work to assess and develop a rehabilitation prescription for brain-injured patients. At the unit, patients can access care from specialists in rehabilitation medicine, whose expert assessment helps to inform the prescription.
These rehabilitation prescriptions are an important component of rehabilitation care, because they reflect the assessment of the physical, functional, vocational, educational, cognitive, psychological and social rehabilitation needs of a patient. The APPG argued that all patients should benefit from an RP; as I understand it, at discharge, all patients should have a patient-held record of their clinical information and treatment plan from admission as they move to specialist or local rehabilitation, supported by the RP. However, I take on board what the hon. Gentleman says about ensuring that the letter and the prescription itself are written in language that people can understand, are easily accessible and are available to them and their family members.
The “National Clinical Audit of Specialist Rehabilitation for Patients with Complex Needs Following Major Injury”, published in 2016, found that, on average, 81% of patients had a record of a rehabilitation prescription. That audit appears to have had a significant impact, because the latest data shows a rise to an average 95% completion rate. In April 2019, the third and final report of the Audit Commission to NHS England’s audit programme was published, and it is encouraging to see that 94% of patients accessing specialist rehabilitation have evidence of functional improvement.
However, the audit report also suggests that much more work needs to be done to ensure that all patients who could benefit from specialist rehabilitation can access it. Using data provided from participating centres, the audit’s authors estimate that the current provision caters for about 40% of those who need the services. To address the capacity issues highlighted, the audit makes a range of recommendations.
It is important to recognise that these audits play a massively valuable role in helping services to improve. They shine a light on variation and help to support services to best meet the needs of patients. However, there will always be different models of improving access to specialist rehabilitation, depending on the set-up of the services around the country. Therefore, local service providers and commissioners should review capacity in the pathways for specialist rehabilitation in the light of this audit, taking action where they can.
The majority of rehabilitation care is commissioned and managed locally, and NHS England has produced some documentation and services plans to help with that. “The Principles and Expectations for Good Adult Rehabilitation” describes what good rehabilitation care looks like and offers a national consensus on the services that people should expect. The NHS long-term plan has also set out some key actions on this, designed to improve care, treatment and support for people with long-term conditions such as ABI.
Community services, which play a crucial role in helping people remain as independent and well supported as possible, are going to receive significant investment, with £4.5 billion of new investment in primary and community care. Furthermore, NHS England has set out plans to roll out the NHS comprehensive model of personalised care, which includes self-care care planning, personal health budgets and social prescribing. It will reach 2.5 million people by 2023-24 and is particularly relevant to people with acquired brain injury. The model is currently implemented across one third of England, but by September 2018, more than 200,000 people had already joined the personalised care programme.
The hon. Member for Mitcham and Morden asked about free car parking. From April, all hospital trusts will be expected to provide parking to groups who may be frequent visitors. I interpret that to mean families visiting people who are in hospital for a long period of time, which I think is what she was asking me.
Siobhain McDonagh
I thank the Minister for giving way on this important issue. There are many terrible stories of people spending their life savings in an effort to keep being able to visit children and partners. Could the Minister specifically say, or could we have a response in writing to this effect, that that includes the families of people with acquired brain injury? I have been seeking some clarification from the Department, but all the responses have so far been obscure.
Caroline Dinenage
I will certainly seek to get that in writing for the hon. Lady.
My right hon. Friend the Member for Hemel Hempstead spoke about continuing healthcare. I know that that is a concern for many people, but what concerns me is that actually, CHC is needs-based, not diagnosis-based, so eligibility should be assessed by looking at all of an individual’s needs and considering their nature, complexity, intensity and unpredictability. If he wants to drop me a line about an individual case that he is concerned about, I will be more than happy to look at it.
Sir Mike Penning
It might be a lot of cases; I think the Minister will have had a lot of cases from across the House. I completely agree that that is what the principle should be. In practice, however, I ask her to look at the amount of appeals that have taken place, and she will realise it is not quite working.
Caroline Dinenage
I will very much take that on board.
The hon. Member for Washington and Sunderland West asked me a number of questions. I may not have written them all down, but she asked about workforce. We have the people plan, which Baroness Harding has been working on, which will be released later this year. It will look at all forms of medical professionals, but also the allied health professionals that the hon. Lady mentioned.
The hon. Lady asked what conversations I had had with the Department of Education. That Department is currently undertaking a review of special educational needs and disability, which will look at all aspects of supporting young people through their education. We are playing a key role in that SEND review. She also asked what conversations I had had with the Department for Work and Pensions about training. Case discussions about claimants with ABI now form part of a new entrant training for all healthcare professionals undertaking work capability assessments, and they all have access to a learning module on ABI, which was updated in 2018 and has been quality assured by Headway.
I hope that today’s debate has continued to demonstrate how seriously the Government take ABI. We are committed to ensuring that people get treatment, care and support when they need it.
User-led Social Care
Caroline Dinenage Excerpts(4 years, 3 months ago)
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The Minister for Care (Caroline Dinenage)
It is a great pleasure to serve under your chairmanship, Sir Christopher. I congratulate the hon. Member for Ealing North (James Murray) on securing this important debate. I welcome him to his role—I know that he was only recently elected—and hope that he will have a long and enjoyable career in Parliament.
I join the hon. Gentleman in recognising and paying tribute to user-led organisations, carers, care professionals and the army of incredible unpaid carers working in adult social care, striving for the best possible care and support for people across our country. They do a remarkable job every single day, and they work with great skill and compassion.
The hon. Gentleman is absolutely right to stress that the sector is under enormous pressure, but he is wrong to say that this is new or the result of Government cuts. Unfortunately, I am a very elderly lady—he has the benefit of being a lot younger—and I can recall successive Governments over past decades wrestling with how to fund adult social care.
We have had unpleasant exchanges where adult social care was used as a political football, with unhelpful language on both sides of the argument—nobody is blameless—describing attempts to solve adult social care issues as a dementia tax or a death tax. In the 2017 general election, the Labour party committed in its manifesto to tackling adult social care and putting it on a sustainable footing and never actually got around to doing it. Successive Governments have wrestled with this. We have had numerous Green Papers, White Papers and independent papers and, one after the other, every Government has put this in the “too difficult” pile.
Jim McMahon (Oldham West and Royton) (Lab/Co-op)
Surely the Minister recognises that, notwithstanding our need for a long-term, cross-party solution to this issue, it is a fact that more than 1 million people who do not receive care today would have been entitled to care in 2010.
Caroline Dinenage
I think those facts are a little misleading. We often read about the facts that the hon. Gentleman cites—the Age UK fact that 1.4 million people out there have unmet care needs. In fact, that is a little misleading, because it suggests to me that there are people out there whose care needs are not being met at all. A large number of those people are actually self-funding.
We do need to have a conversation and to try to build a consensus on how much people should be contributing to their care, and whether they should be contributing to it at all, but their care needs are being met. However, the fact is that one in 10 of the population will have catastrophic care costs—care costs in excess of £100,000—and of course that is not acceptable, and we need to find a way to address it. There are more than 10 people in this room, and one of these 10 people will have catastrophic care costs, but the terrible thing about it is that we cannot predict—there is no way of predicting—which one of us it will be. That is why we need to work collaboratively, in a cross-party way, to seek some kind of consensus on how we move forward and address the issue.
Let me talk about some of the things that this Government have done. We have provided councils with access to £1.5 billion for adult and children’s social care next year. That includes an additional £1 billion of grant funding for adult and children’s social care and a proposed 2% council tax precept, which will allow them to raise a further £500 million in council tax. Let us just think about those sums for a moment. We throw around the words “billion” and “million” as if this were pocket change. They are huge sums of cash, which just shows the extent of the issue that we are dealing with. The new funding is on top of maintaining £2.5 billion of existing social care grants. That will support local authorities to meet the rising demand, which has been referred to, and continue to stabilise the social care system. I often hear talk about cuts to the social care system, but thanks to that investment, public spending on adult social care in 2018-19 reached £17.9 billion in cash terms. That is the highest level on record, and since 2016-17 that sustained investment has enabled spending to increase by 7% over this period, so we do need to be up front with the facts.
There has also been a much more open and competitive market in adult social care. For more than 30 years, private providers and voluntary sector organisations have increasingly been responsible for providing services, which leads to increased choice and better outcomes for individuals. That results in improvements in quality. In January 2020, for example, 84% of all registered adult social care locations were rated good or outstanding by the Care Quality Commission, which of course is independent. High-quality, personalised care and support can be achieved only where there is a vibrant and responsive market of service providers. The role of local authorities is of course critical to achieving that, both through the actions that they take to directly commission services for providers to meet needs and through the broader understanding and interactions that it facilitates with the wider market for the benefit of all local people and communities.
The Government want to give people much more choice and control over their care and support, and user-led, strengths-based approaches will help to deliver on our ambitions to achieve better outcomes for all. That is why I am pleased that the hon. Member for Ealing North has brought this debate to the Chamber today; I really welcome the opportunity to talk about this issue. I am delighted that we have taken substantial steps to embed person-centred care and support at the heart of our social care system. Personalised care has demonstrated the ability to improve outcomes and enhance quality of life, enabling people to take a level of control and responsibility that they feel comfortable with. Fundamentally, it recognises what we all know: a person is an individual, with their own unique needs, wishes and opportunities. That is why in the Care Act 2014 we enshrined personal budgets—including user-led, co-produced personalised care and support plans—as the default model of delivery. It is a bespoke way of meeting their needs and circumstances.
Having had this ministerial role for two years, I have met some of the individuals who have benefited from personal care budgets and seen the immeasurable impact that they have had on their lives. They included one incredible lady called Jackie, a former Metropolitan police officer who was injured in the line of duty, and who had quite extensive health and care needs. She is in a wheelchair and has a whole range of physical and mental health needs, to the extent that she was being blue-lighted to hospital about 70 times a year. By using her personal care budget, she now has an assistance dog, called Kingston. He is quite remarkable and fabulous: he understands about 200 commands, which is incredible, and he has changed her life. He is able to predict an epileptic fit about 45 minutes before she has one, and he can ensure that she is in the right position to be able to cope with it. Also, without any training, he can predict a diabetic attack about 15 minutes before she has one, and he then brings her the insulin kit. Since having Kingston, Jackie has not been blue-lighted to hospital at all. That shows that, as well as being an amazing friend and companion to her, he has had an immeasurable impact on her health and wellbeing. That is the strength of a personal care budget. It is really remarkable.
Ultimately, our ambition is for high-quality, personalised care to become the norm across the health and social care system. I am confident that we will maintain the energy and commitment necessary to meet that goal, but the ambition cannot be achieved without a cultural shift to holistic, strengths-based practice. What I mean by that is shifting the focus to what people can do—their strengths—not what they cannot do. It concentrates on the things that really matter to the individual, their family and their local community. It engages and empowers people to identify solutions that will allow them to experience the care and support that they need to live as independently as possible and to fulfil their wishes. Through that approach, social care practitioners and commissioners can connect people to the types of support and community organisations that will enable them to improve their overall quality of life. It is gaining ground across the country and working very well in areas such as Wigan, Hertfordshire and Thurrock.
Person-centred practice and co-production are at the heart of social work. The hon. Member for Ealing North mentioned social work, and it comes as no surprise that social work has led on developing and applying strengths-based approaches. In 2017 we published a report, alongside the Social Care Institute for Excellence, on strengths-based social work, and last year the chief social worker for adults produced a practice framework for supporting practitioners. Social workers are unique in working alongside people to consider the totality of their life and advocate for their freedom, dignity and human rights. They are also key in working with our communities as a whole, supporting people to live independently and to live much more included lives.
To achieve the transformational, personalised care across the country that we want to see, we must work much more collaboratively. Cutting across multiple agencies and professions, social workers undoubtedly play a role in ensuring that that happens. Together with the chief social worker, we will continue to support local authorities to embed that kind of practice in adult social care. We will also continue to collaborate with leading—they are incredible—user-led organisations such as Think Local Act Personal, which encourages good person-led practice locally.
The hon. Gentleman spoke about co-operatives. Under the Care Act, local authorities are required to shape their whole local markets to ensure that they are sustainable and diverse and that they offer high-quality care and support for people in their local area. Clearly, there will be local areas where co-operatives can play a really important role in the provision of care services. More- over, as part of their Care Act responsibilities, local authorities have successfully worked with individuals and communities to develop preventive and community-led social care opportunities.
We know of course that social care is under pressure, because of growing demand from the ageing population. Sometimes I get frustrated because we all talk as if the ageing population is a terrible thing. That people are living longer is a good thing and something to be celebrated, but we need to ensure that those additional years of life are happy and healthy for as long as possible, that people are able to live independently for as long as possible and that care is there when people need it. That is why we are providing councils with a £1 billion grant for children’s and adult social care, on top of maintaining £2.5 billion of existing social care grants. The additional resources will help councils to commission care services that are sustainable and diverse and that offer sufficient high-quality care and support for people in their areas.
The Government have been very clear that fixing the issues with social care is a significant priority. As my right hon. Friend the Prime Minister has said, the Government will deliver on our promises: we will bring forward a plan for social care this year. These are complex questions to address, which is why we are seeking to build a cross-party consensus, but we have been very clear that everybody will have safety and security, and nobody will be forced to sell their home to pay for their care.
Question put and agreed to.
Innovation in Hospital Design
Caroline Dinenage Excerpts(4 years, 3 months ago)
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The Minister for Care (Caroline Dinenage)
It is a huge pleasure to serve under your chairmanship for the first time, Ms Nokes.
I congratulate my right hon. Friend the Member for Basingstoke (Mrs Miller) on securing this incredibly important debate about innovation in hospital design, which I know is an important subject for her. She has worked tirelessly to secure a new and better hospital to serve her constituents in Basingstoke, who I know are grateful for the enormous amount of work that she done. I also know that she will continue to hold our feet to the fire in the Department of Health and Social Care, to ensure that the new hospital is the very best that it can be.
As my right hon. Friend said, the Department has invested heavily in the NHS, providing large amounts of capital investment to hospitals, as announced last year by the Prime Minister and the Secretary of State for Health and Social Care. Ensuring that this investment delivers innovation in health infrastructure is absolutely vital, as we move forward towards a health estate that is fit and able to face the challenges of the future.
We announced a new health infrastructure plan, or HIP, to deliver a long-term programme of investment in our NHS estate, buildings and equipment. This will be the biggest and boldest hospital-building programme in a generation, supporting our health service so that dedicated NHS staff, who are quite marvellous, can give patients world-class care in world-class facilities.
Under the new HIP, we have made a long-term commitment to build 40 new hospitals over the next decade, including to the Hampshire Hospitals NHS Foundation Trust in my right hon. Friend’s constituency. As she knows, the trust will receive £5 million in seed funding to develop plans to renew the ageing estate and better align services at the hospitals in Basingstoke and Winchester.
The 20 hospital upgrades that we previously announced are already under way. That is on top of a capital commitment, amounting to around £3.3 billion, provisionally awarded to over 170 sustainability and transformation plans since July 2017. That capital investment is going into a wide variety of programmes right across the country, including new urgent care centres and integrated care hubs—which bring together primary and community services—and, of course, new mental health facilities.
This investment programme will totally transform the health infrastructure in this country. It presents a unique and exciting opportunity to implement the latest innovation in healthcare design, with all the benefits and advances of modern methods of construction. Getting this right will ensure that patients receive the right treatment—treatment that speeds up their recovery and makes the most of the working environment, ensuring that our wonderful NHS staff can work in facilities that support them to deliver the very best in patient care.
The impact of the built environment on patient outcomes and staff satisfaction is increasingly clear. My right hon. Friend has already referred to it, but academic research conducted by the University of Sheffield shows that patients make significantly better progress in new, purpose-built and designed buildings than in old ones. There are a range of impacts, including reductions in pain medication needs and shortening hospital stays. In the mental health sector, treatment times were reduced by 14%, and in the general medical sector, non-operative patient treatment times were reduced by a staggering 21%. That is the prize here.
There is also growing evidence that access to and visibility of green space is vital to promoting therapeutic environments that aid recovery, with positive health outcomes including reductions in stress and anxiety, increased social interaction and, of course, an improved healthcare experience.
There has been some really interesting recent work in this space, which the Department welcomes. For instance, the Royal Horticultural Society donated its feel-good garden from the 2018 RHS Chelsea Flower Show to Camden and Islington NHS Foundation Trust. Its permanent home is now at Highgate mental health centre, one of the trust’s two in-patient psychiatric sites, and it is dedicated to improving the care of older adults with acute mental illness.
As my right hon. Friend said, there is nothing new about that approach. Florence Nightingale—who I know is deeply ingrained in your constituency, Ms Nokes—had it right from the beginning. My constituency of Gosport houses Haslar, a military hospital built in 1756 that has long, well-lit buildings, beautifully landscaped gardens overlooking the Solent and, critically, many out-buildings—smaller structures where the war-wounded would be wheeled out to take the air and look at the beautiful views of the Solent that we still enjoy today. Buildings designed to maximise natural light and views of green space, with increased natural ventilation and reduced noise levels, make for a much more pleasant environment, not only for the patients, to aid recovery, but for the staff going about their work.
As my right hon. Friend said, there is mounting evidence that there are strong links between the design or layout of buildings and the job satisfaction of staff, thereby improving staff retention. Buildings should be designed in a way that makes it easier for staff to do their job. For instance, designing the layout of a health building in a way that aligns with patient flow and clinical pathways also contributes to increased staff satisfaction, which makes sense. Staff can dedicate more time to patients because the time spent walking between linked wards and clinical services is reduced.
Naturally, we want to ensure that the modern clinical design of buildings is also cutting-edge in the way it supports environmental sustainability. The large hospital projects selected for phases 1 and 2 of the Department’s health infrastructure programme have been instructed to ensure that they combine and contribute to the reduction in the NHS carbon footprint by following the framework developed by the UK Green Building Council on net zero carbon buildings.
As well as seeing innovation in hospital buildings, we want to see environmentally conscious design. The NHS has led a new-for-old programme, which improves delivery of local community-based infrastructure as well, so these things are not only for the big new acute hospitals. The new-for-old programme is adopting a variety of sustainability measures, including something called BREEAM, which stands for the Building Research Establishment environmental assessment method—that slips off the tongue. It will be incorporated as standard, as independent third-party verification of sustainability performance in infrastructure.
The design of estate has a massive part to play in achieving net zero carbon targets, and carbon efficiency measures can have a positive effect on both patients and staff. For example, installing energy-efficient LED lighting in every hospital will produce average energy cost savings of up to £33 million and, importantly, improve the clinical environment for patients and staff. Adopting renewable energy solutions in the design of clinical facilities also contributes to cleaner air for our communities and better health outcomes.
Our building programme will take advantage of innovative design and innovative construction methods, and we are encouraging the NHS to take advantage of a range of modern construction approaches, including off-site manufacturing and standardisation, such as repeatable room design. Such methods can enable new and better buildings to be built quicker than otherwise would be possible. They can open their doors to patients sooner.
Mrs Miller
The Minister rightly talks about new and innovative methods to build buildings quicker, and that is very important, but my concern about getting these things finished is not about the building; it is about the approvals processes. Given the benefits that she so eloquently outlines in having the additional 40 new hospitals—benefits to patients, but also to the taxpayer—what space is there for the NHS to speed up the programme? It is clearly long overdue and to the benefit of all our constituents.
Caroline Dinenage
My right hon. Friend is absolutely right to raise that point, and I will come to it later in my speech. The key thing is to ensure that all the relevant stakeholders and partners are brought to the table very early so that everybody understands exactly what the plan is and has a feeling that they have bought into and invested in how that plan unfolds.
Earlier, I mentioned the importance of innovation, repeatable room design and standardised components, which very much lead to the flexibility that my right hon. Friend talked about. That means that the NHS can adapt to future advances in delivering modern patient care, and it delivers time, cost and efficiency benefits. For example, the Wrightington Hospital orthopaedic centre uses repeatable rooms, and that is already delivering benefits to patients and staff, but it also means that the rooms can be changed in future as modern innovation delivers changes. It is also critical that innovative building design integrates the benefits of technology and infrastructure to make full use of its transformative potential for service delivery and patient care.
As my right hon. Friend says, it is important to ensure that the designs are delivered fast. The schemes must be built in a way that works with the local community. The buildings must be easily accessible, sustainable and integrated with the local planning infrastructure, and scheme proposals and business cases developed in partnership and in alignment with sustainability and transformation plans, integrated care systems and clinical and estate strategies. They need written commissioner support, alongside evidence of engagement with local stakeholders and their support for the plans. We hope that will speed up delivery of the buildings.
I hope that goes some way towards reassuring my right hon. Friend that the Government are absolutely committed to maximising innovation in the high-quality hospitals that we are delivering. We are going to seize this once-in-a-generation opportunity, and we will work tirelessly to ensure that the people of this country are receiving the care they deserve in buildings that are modern, functional and beautiful. I thank her for securing this debate, because it has given me an opportunity to outline how we intend to do that, but I am sure she will continue to hold us to account when it comes to delivering on that commitment.
Question put and agreed to.
Oral Answers to Questions
Caroline Dinenage Excerpts(4 years, 3 months ago)
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Marsha De Cordova (Battersea) (Lab)
The Minister for Care (Caroline Dinenage)
The Government have enshrined in legislation through the Care Act 2014 a council’s statutory duty to meet eligible needs for adult social care. We have given councils access to up to £1.5 billion more dedicated funding for social care in 2020-21 to help them to meet this requirement.
Liz Twist
Figures from Age UK show that 1.5 million people aged 65 and over have an unmet social care need, and Age UK estimates that this figure will rise to 2.1 million by 2030 if we carry on as we are. In my constituency, that equates to 3,012 older people with unmet needs and 2,517 older people providing unpaid care. Those are real people who are not getting the help they need. The Prime Minister said last summer that he had a plan to “fix” social care. Where is it?
Caroline Dinenage
As I have explained, the Care Act sets out the requirement that entitles individuals to a care needs assessment and sets a minimum national threshold at which care should be delivered. We have backed councils up by giving them access to £1.5 billion in additional funding in the next financial year. In the hon. Member’s constituency, that will equate to an additional £5.1 million from the new social care grant. This is something that the Government take very seriously.
Marsha De Cordova
According to the Institute for Fiscal Studies, more than 1.8 million older and disabled people are currently going without the support that they need to live independently. This crisis has come after the Conservative Government abolished the independent living fund and cut nearly £8 billion from adult social care budgets. In 2017, we were promised a Green Paper, but there has been nothing. Months ago, the Prime Minister stood on the steps of 10 Downing Street promising to “fix” social care, so when will the Government finally publish those plans?
Caroline Dinenage
We just do not recognise the figures that the hon. Lady is parroting. Public spending on adult social care in 2018-19 reached £17.9 billion in cash terms, which is the highest level on record. Since 2016-17, our sustained investment has enabled spending to increase by 7% over this period. But do not take it from me—the Local Government Association said last year:
“This is the biggest year-on-year real terms increase in spending power for local government in a decade and will allow councils to meet the rising cost and demand pressures they face in 2020/21.”
Martyn Day (Linlithgow and East Falkirk) (SNP)
While the Scottish Government spend 43% more per head on social care, this Government’s NHS Funding Bill does nothing to address the £6 billion funding gap in England. Does the Minister accept that she cannot fix the NHS without fixing social care?
Caroline Dinenage
I completely agree with the hon. Gentleman that adult social care and the NHS are indelibly linked. The one must support the other, and the one drives costs with the other. The over-65 population is projected to rise over 50% by 2035, so putting social care on a sustainable footing where everyone is treated with dignity and respect is one of the biggest challenges we face in society. That is why it is one of the Prime Minister’s biggest priorities.
Martyn Day
Scotland introduced free personal care for the elderly in 2002, and this has now been extended to those under 65 who need it. Will the Minister follow the Scottish Government’s lead and introduce free personal care so that people can live with dignity in their own homes?
Caroline Dinenage
The Prime Minister has set out his plans. He wants to seek political consensus and bring forward a plan for adult social care this year, and we are looking at a whole range of solutions, including free personal care. The issue we see in Scotland is that the initiative must be backed up with a huge amount of money. The money that the Scottish Government used to give to individuals covered around 50% of their care home costs and now only covers around 25%. That is why we must ensure that we address this issue with a long-term view.
Barbara Keeley (Worsley and Eccles South) (Lab)
It is time to tackle unmet need, which is clear from my hon. Friends’ questions. Ministers say that they want to seek a consensus on the future of social care, but we already have a proposal with wide-ranging support, including from former Conservative Chancellors in the Lords, major national charities, and the official Opposition: free personal care funded from taxation. Will the Minister accept that the way to move things forward is for the Government to join the existing consensus on introducing free personal care?
Caroline Dinenage
The Prime Minister said that the Government will deliver on our promises. We will bring forward a plan for social care this year—
Caroline Dinenage
This year. However, there are complex questions to address. A Joint Committee of the Housing, Communities and Local Government Committee and the Health and Social Care Committee came up with an entirely different solution—a social insurance model—which shows why we want to build a consensus. Even the Liberal Democrats have said that they want to build cross-party consensus, but we know the hon. Lady’s view on cross-party consensus: her way or the high way.
Jeremy Hunt (South West Surrey) (Con)
Given that we will not end the annual cycle of winter crises until we fix the problems in adult social care, does the Minister agree that, however important the commitment that people will not have to sell their home, the absolute priority in any discussions with the Treasury must be to get more money to local authorities so that they can discharge their responsibilities to older and more vulnerable people?
Caroline Dinenage
My right hon. Friend did some incredible work in this area when he was Secretary of State for Health and Social Care. In fact, he presided over the Department being renamed to draw reference to the importance of social care. He is absolutely right that we must ensure that councils have the money they need for the short term, but we must also work towards a consensus so that everybody will have safety and security and that nobody will be forced to sell their home to pay for their care.
Mr Philip Hollobone (Kettering) (Con)
I declare my interest as a member of Kettering Borough Council. Taking advantage of imminent local government reorganisation in Northamptonshire, will the Minister continue to encourage local councils and the two local hospitals to bring forward innovative proposals under one budget for an integrated health and social care pilot in Northamptonshire?
Caroline Dinenage
My hon. Friend has already been a really good champion of collaborative health and social care work. He has made some excellent suggestions, and we have seen how things such as the better care fund, through which health and care pool their resources, can have a positive effect for local communities. I encourage his local area to look closely at how that sort of work can be maximised and moved forward.
Anne Marie Morris (Newton Abbot) (Con)
As the Minister will know, the particular problem in rural areas is that need is not just unmet, but unseen. What steps has the Minister taken, or what does she have in mind, to fix the situation and find that need so that it can be met?
Caroline Dinenage
My hon. Friend is right to draw attention to rural sparsity and the challenges facing rural communities. We are committed to undertake a review of relative needs and resources, and it will be a thorough evidence-based review of the costs facing all authorities, including how factors such as rurality, sparsity and other geographical features affect the cost of delivering services across the country and how to account for them in a robust manner.
David Simmonds (Ruislip, Northwood and Pinner) (Con)
For the record, I declare my interest as the spouse of an NHS doctor. The Pinn Medical Centre in my constituency is due to close its walk-in service so that the Harrow CCG can save money, but the likely diversion of patients to local A&E services will end up costing the NHS more. Will the Minister join me in encouraging the CCG to consider the wider context of NHS budgets and to support the service while local NHS providers consider how to increase access to GP appointments in line with our manifesto commitments?
Caroline Dinenage
My hon. Friend is right to highlight the importance of access to primary and community services within Pinner. My right hon. Friend the Secretary of State will be happy to meet him to discuss the matter further, but we will support anything he is doing to assist his local services.
Peter Kyle (Hove) (Lab)
David Simmonds (Ruislip, Northwood and Pinner) (Con)
The Minister for Care (Caroline Dinenage)
We are very committed to hospice services, which is why an additional £25 million went into hospices last year. I am certainly happy to meet my hon. Friend to discuss the hospices in his area.
Alex Norris (Nottingham North) (Lab/Co-op)
Cuts to local government budgets have led to cuts to public health budgets, which have led to cuts to preventive services, which have led to greater demand in A&E and social care. It is bad for individuals, and it is terrible for the health and social care system, yet this weekend, we saw media reports that there are more cuts coming to local government, especially in the poorest communities. Can the Secretary of State assure us that he will tell colleagues in the Treasury and the Ministry of Housing, Communities and Local Government that those cuts cannot take place?
Adult Social Care in Shropshire: Government Funding
Caroline Dinenage Excerpts(4 years, 3 months ago)
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The Minister for Care (Caroline Dinenage)
It is a great pleasure to serve under your chairmanship, Mr Stringer. I congratulate my hon. Friend the Member for Shrewsbury and Atcham (Daniel Kawczynski) on securing this important debate on the funding of adult social care in Shropshire. He is a strong and consistent champion for both his county and his constituency on a range of issues but, particularly today on the subject of adult social care. As he mentioned, he and his colleagues hunt as a pack; they work very effectively together, and I am pleased to see him joined by his colleagues. I do not know what the collective noun is for a group of Shropshire MPs, but it is clearly something very robust and effective. I am pleased to see them all here, and grateful for all the points they have raised.
Clearly, adult social care is one of the biggest challenges we face as a country, but it is not just our country that faces it; it is a global issue. How do we face the challenges of an ageing population? We have to preface this by saying it is not a bad thing that people are living longer; we should be celebrating that. This is not doom and gloom, but we need to make sure that we are equipped to support people in later life. People are also living longer with much more complex conditions. Over half of local authority budgets are spent on working-age adults; although that cohort includes a lower number of people, it is also more expensive, and we need to make sure that we are looking after those people sufficiently as well and supporting local authorities to do so properly.
Successive Governments have wrestled with the challenges of how to deal with the issues caused by an ageing population and of adult social care. Frankly, they have all then put those challenges in the “too difficult” pile, because the solution is very difficult and potentially very expensive. Unfortunately, the sand has run through the hourglass and we no longer have the luxury of being able to put those issues aside; we now have to face the challenges of an ageing population and of adult social care head on. That is why the Prime Minister, on the steps of Downing Street on his very first day, committed to tackle them. We will therefore set out much more on this issue in due course.
My hon. Friend is absolutely right to highlight the fact that by 2040, one in four people in the UK will be aged 65 or over. However, it is important to remember that this is not just about older people, as the number of those aged below 65 who access long-term support is growing year on year. Central to all our thinking are all those magnificent adult social care professionals, the social care workers, social workers and nurses, as well as the army of unpaid carers—loved ones, friends and family—who do so much in Shropshire and the whole country to look after their loved ones.
Daniel Kawczynski
The Minister has just reminded me of one thing. Of course, we should pay tribute to the millions of citizens out there who are carers and who look after their elderly relatives in a voluntary capacity, as we looked after my beloved grandfather in the latter stages of his life. It is very important to acknowledge what they do. It is true, is it not, that the way in which a country treats its senior citizens is an indicator of what sort of society and culture prevails in that country?
Caroline Dinenage
That is absolutely right. It is because of the army of paid and unpaid carers that my hon. Friend mentioned that there are many reasons to be positive about the care people receive in Shropshire.
As of 1 January, 86.5% of care home beds in Shropshire were rated good or outstanding by the Care Quality Commission, which is much better than the national average, and 90.3% of care home agencies in Shropshire are good or outstanding. Moreover, in the 2018-19 adult social care survey of users, more than 90% of people receiving care in the county reported that they were satisfied with the care and support that they received. However, we know that there is still a long way to go.
My right hon. Friend the Member for Ludlow (Philip Dunne) spoke about how Shropshire leads the way in technology. If we are to face the challenges of adult social care and tackle what might be regarded as a crisis, we need to look at not just funding but harnessing all modern technology. We need to look at the workforce, and at modern models of care and methods of housing to make sure that we are harnessing the best in all those areas. He was a fantastic Health Minister and a brilliant co-chair of the all-party group on adult social care.
Last autumn, the most recent spending round announced further investment in social care for 2020-21. That will give councils access to an additional £1.5 billion for adult and children’s social care, which includes an additional £1 billion of funding and a proposed 2% council tax precept that will enable councils to access a further £500 million specifically for adult social care. The £1.5 billion is over and above the existing £2.5 billion of social care grants that were rolled over in the spending review and is part of the biggest increase in overall core spending power for local government since 2015—an increase of 4.4% in real terms in 2020-21. A key stakeholder, the Local Government Association, said that it was delighted that the spending round
“has delivered a funding package of more than £3.5 billion for our vital local services...This is the biggest year-on-year real terms increase in spending power for local government in a decade”.
For Shropshire, the settlement puts considerable new resources into social care. It will receive an additional £7.9 million in funding from the new social care grant and £11.5 million through the improved better care fund, which will drive the integration to stop pressure being put on acute health services. Shropshire will also have the opportunity to raise an additional £15.1 million through the dedicated adult social care precept. That additional funding is an important step towards putting adult social care on a fairer and more sustainable footing. We recognise that it is important for local authorities to have security, predictability and certainty about future funding for social care, which is why the funding beyond 2020-21 will be set out at the next spending review.
On Shropshire Council’s wider funding, my hon. Friend the Member for Shrewsbury and Atcham set out beautifully the challenges facing local councils up and down the country. All Government Departments and local authorities had to make tough decisions to deal with the parlous finances and extremely high borrowing that we inherited from the last Labour Government. He is right to say that that put huge pressure on local authorities, which were also trying not to put up council tax to deal with the problem. That is why the Government are committed to undertaking a review of the relative needs and resources.
The review will consider the drivers of local authorities’ needs, the resources available to them to fund services, and how to account for them in a way that draws a more transparent and understandable link between local circumstances and local authority funding. In the my hon. Friend’s area, for example, the rurality and the relative size of the ageing population would have to be taken into account. The Government are working closely with local government representatives and others to examine all elements of the review, including adult social care. The aim is to share the emerging results with the sector shortly, followed by a full consultation in the spring. I hope that he will find good news for Shropshire Council in that.
I finish by assuring my hon. Friend that my Department and the Government are by no means complacent. Fixing the issues with adult social care is a huge priority for us. As the Prime Minister said, the Government will deliver on their promises and bring forward a plan for social care this year. There are complex questions to address, but we have been clear on two things: everybody will have dignity and security, and nobody will be forced to sell their home to pay for their care.
Question put and agreed to.
Surrogacy: Government Policy
Caroline Dinenage Excerpts(4 years, 3 months ago)
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The Minister for Care (Caroline Dinenage)
It is a great pleasure to serve under your chairmanship, Sir David. I want to start in the same vein as the hon. Member for Washington and Sunderland West (Mrs Hodgson) by heaping praise on my hon. Friend the Member for Brigg and Goole (Andrew Percy), who is, of course, one of my favourite Members of Parliament. In all seriousness, I want to thank him for his sterling work on this really important issue. For a very long time, he has been a strong, effective and vocal campaigner on it, and he has led the APPG, which has done an enormous amount of valuable and comprehensive work on this tremendously important issue. Westminster Hall debates have played an important role in highlighting the need for Government action in this area. The former Member for Erewash secured a debate on it in 2014, which set in motion a lot of the reforming actions that increased the chance of successful surrogacy arrangements and, importantly, the formation of new families.
There is no doubt that surrogacy can transform the lives of people who want to have their own children. We of course recognise the value of surrogacy in today’s society, where family structures, attitudes and lifestyles are increasingly diverse. It is all about building happy and loving families, and giving people the opportunity to enjoy the wonderful benefits and experiences—and, indeed, sometimes challenges—that that brings.
I thank the hon. Members for Hornsey and Wood Green (Catherine West), for East Renfrewshire (Kirsten Oswald) and for Washington and Sunderland West for their constructive comments. I also praise my hon. Friend the Member for Thurrock (Jackie Doyle-Price), who did some remarkable work in this area; she very much emphasised the positive role of surrogacy. She showed great leadership and commitment, and addled the brass, as my hon. Friend the Member for Brigg and Goole said, leading the way to the Law Commission review. I also thank the surrogacy community for the way it has helped to move this important issue forward. It has shared its knowledge and experience, which has been immeasurably valuable.
The UK is one of only a few countries in the world with a legislative framework for surrogacy. It is set out in primary legislation by the Surrogacy Arrangements Act 1985, with some aspects updated by the Human Fertilisation and Embryology Act 2008. Although that framework was appropriate for the time at which it was written, we all agree that it is clear that society, family formation and relationships have moved on in the interim.
Importantly, the current legislation sets out a number of fundamental principles, which my hon. Friend the Member for Brigg and Goole mentioned, that will continue to inform any future legislation. The arrangements should be based on altruism and should be coercion-free. They should fundamentally protect the welfare of any resulting children, and respect the rights of the surrogate and the intended parents. Although those basic principles are the right ones, my ministerial predecessors—one of whom is in the Chamber—recognised that the existing legislative framework has not kept pace with a changing society. That has led to tension between the law and current social norms, in many cases creating uncertainty and unnecessary upset. That is why the current legislation has been subject to a number of legal challenges in the courts over the years, including on how legal parenthood is applied in different situations and how the courts apply time limits for applications for parental orders.
To address the issues with the current legislation, in April 2018 the Government asked the Law Commission of England and Wales and the Scottish Law Commission jointly to review all surrogacy-related law and make proposals for improvement. That large, vital piece of work is a three-year project. To respond to the hon. Member for Hornsey and Wood Green, the Law Commissions have not published a draft of the recommendations yet. To respond to the hon. Member for Washington and Sunderland West, they are expected to publish a report alongside a draft Bill in 2021. As part of the review, they undertook extensive engagement with a wide range of stakeholders around the UK.
Based on this engagement, the Law Commissions developed a number of provisional proposals to improve surrogacy legislation and published a consultation paper in June—that might be what hon. Members are getting confused about—to provide an opportunity for people to discuss their views. They then ran a series of consultation events across the UK that were open to professionals, surrogates, intended parents and members of the public. It closed on 11 October 2019. The Commissions are now collating and analysing the enormous number of responses. That will inform the discussion and the development of the final recommendations, which will go towards changing the law.
I thank the Law Commissions for their very comprehensive engagement with all those involved in surrogacy in the UK. I intend to meet the lead commissioner to discuss the outcomes and next steps in the project. Of course, I would love to meet the APPG, surrogate parents and intended parents to talk about their views and experiences in the interim. I am thankful to all those who have engaged with the process and provided invaluable feedback.
Jackie Doyle-Price (Thurrock) (Con)
I welcome the Minister’s comments. I want to put on the record the enthusiasm with which the Law Commissions embraced the project. They are clever lawyers, and they fully recognised that a 35-year-old law that is no longer fit for purpose is leading to legal challenges that are potentially having bad outcomes for the child, and certainly for the parents involved in the process. I encourage the Minister, as she has discussions with the Law Commissions, to start to give a nod to the rest of society about how the Government are responding to the issues that they are readily highlighting.
Caroline Dinenage
I will very much take my hon. Friend’s advice on this. Hers have been particularly large and glamorous shoes to fill in this role. She makes some excellent points—the Law Commissions’ work is very thorough and is beginning to look at some old and out-of-date parts of the legislation.
My hon. Friend the Member for Brigg and Goole articulated some of the key proposals, why some changes are so needed and where the views of the APPG might differ slightly. I am sure he will forgive me that today I will not comment on specific Law Commission proposals, for obvious reasons. The commission has arrived at its proposals independently, and it would not be appropriate for me to pre-empt the result of its consideration of the feedback that it received in the consultation. I will, however, put it on the record that we recognise the many different voices in this space and that there will be some different views of the proposals.
No formal discussions have taken place, but we recognise that the House may take a view that a sensitive issue such as surrogacy is appropriate for pre-legislative scrutiny of any proposed Bill. We are definitely open to that. I also reaffirm that we are committed to the completion of the review and that we will continue to sponsor it until publication. I hope that that provides my hon. Friend with the reassurance that he wanted. The Government will continue to work closely with the Law Commissions to ensure that the proposed legislative changes offer more certainty, more clarity and real incentives for those involved to seek surrogacy here in the UK.
We have already taken some action to modernise surrogacy arrangements. The Government have enabled individuals to apply for a parental order, to gain legal parenthood after surrogacy arrangements. That was made possible by the remedial order, which was introduced in December 2018. I put on record my thanks to the Committee for supporting unanimously the remedial order, which provides legal certainty for those families.
The Government have also produced guidance on surrogacy arrangements in the UK. It was developed in partnership with surrogacy and professional organisations and published in 2018. The guidance provides authoritative information for people who are considering surrogacy, and emphasises the benefits of undertaking surrogacy in UK-licensed clinics, rather than going abroad. It has been widely welcomed and commended. My hon. Friend the Member for Brigg and Goole also mentioned the guidance that goes to NHS professionals and staff—published alongside the other guidance in 2018—which was updated in 2019. However, I thank him for drawing my attention to ensuring that those guidelines are followed properly and adopted in every case.
Finally, I want to make it clear that the Government recognise the value of surrogacy, which helps a range of people who might not otherwise be able to have children to create the family for which they so long. In that spirit of inclusiveness and equality, we look forward to updating the legal framework for surrogacy in the UK, to make it fit for the challenges of the future.
Question put and agreed to.
Resolved,
That this House has considered Government policy on surrogacy.