East Kent Maternity Services: Independent Investigation

Caroline Johnson Excerpts

Wednesday 19th October 2022 Written Statements

[The Parliamentary Under-Secretary of State for Health and Social Care (Dr Caroline Johnson)]

I wish to inform the House that the independent review into maternity and neonatal services at East Kent Hospitals University NHS Foundation Trust has today published its report, which can be found here:

https://www.gov.uk/government/publications/maternity-and-neonatal-services-in-east-kent-reading-the-signals-report

NHS England commissioned Dr Bill Kirkup CBE to undertake an independent review into maternity and neonatal services at East Kent Hospitals University NHS Foundation Trust in February 2020, following concerns about the quality and outcomes of care. On behalf of the Government, I would like to thank Dr Kirkup, the families, and all those who contributed to the report.

The report details the poor maternity care that over 200 families received at East Kent Hospitals University NHS Foundation Trust between 2009 and 2020. The trust failed to provide safe care and treatment which resulted in avoidable harm for mothers and babies, causing tragedy and distress that no family should have to experience. I am profoundly sorry to all the families that have suffered and continue to suffer from these tragedies. I also wish to pay tribute to the families who have come forward to assist the review.

In line with the review team’s families first approach, I am pleased to hear that the families were able to see an advance copy of the report this morning ahead of the publication.

I, and the Government, take the findings and the recommendations from the report extremely seriously and I am committed to preventing families from experiencing the same pain in the future.

My Department along with NHS England has already established the independent working group, chaired by the Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists. The independent working group will help guide the implementation and next steps of the immediate and essential actions from the Ockenden report and the recommendations from the East Kent report. The group has met twice to date, and the next meeting will focus on reviewing the recommendations for the East Kent report.

In March 2022, NHS England also announced a £127 million funding boost for maternity services across England that will help ensure safer and more personalised care for women and their babies.

I will be reviewing and considering all the recommendations from the report, and I will issue a full response once I have had time to consider the recommendations.

[HCWS329]

Covid-19 Vaccine Supply

Caroline Johnson Excerpts

Wednesday 12th October 2022 Written Statements

[The Parliamentary Under-Secretary of State for Health and Social Care (Dr Caroline Johnson)]

It is normal practice when a Government Department proposes to make a gift of a value exceeding £300,000, for the Department concerned to present to the House of Commons a minute giving particulars of the gift and explaining the circumstances; and to refrain from making the gift until 14 parliamentary sitting days after the issue of the minute, except in cases of special urgency.



I am writing to inform you that while Parliament was in recess the Department of Health and Social Care has started to donate approximately 30,000 doses of surplus covid vaccines to Barbados and Antigua & Barbuda. The combined value of these donations exceeds £300,000 and the donations will be accounted for as gifts since both countries are not eligible for official development assistance (ODA).

I want to take this opportunity to explain that we proceeded with these donations as a matter of urgency. The doses were surplus to the requirements of our domestic vaccination programme and were requested urgently by the recipient countries, including to vaccinate children before schools returned during September. Donating these doses with maximum available shelf life meant that they could be used rather than expiring and having to be destroyed.

The Permanent Secretary of the Department of Health and Social Care has written to the Chairs of the Public Accounts Committee and the Health and Social Care Committee to notify them of these gifts. This statement provides retrospective notification to the House of Commons.

HM Treasury has approved the decision.

[HCWS318]

Liver Disease and Liver Cancer: Diagnosis

Caroline Johnson Excerpts

Tuesday 11th October 2022 Westminster Hall

[The Parliamentary Under-Secretary of State for Health and Social Care (Dr Caroline Johnson)]

I thank the hon. Member for Rutherglen and Hamilton West (Margaret Ferrier) for securing a debate on this important issue. She has been a great advocate on this topic, and I share her commitment to tackling this serious disease. I also thank my hon. Friend the Member for Darlington (Peter Gibson) for his kind words and for sharing his family story and speaking about some of the personal, family impact of these terrible conditions.

It is a year ago this month that our colleague, Sir David Amess, was tragically taken from us. He had a huge interest in liver disease. He was the co-chair of the APPG for hepatology and did so much to raise awareness of this disease in Parliament. One of the many ways we can take forward his legacy is to improve the lives of those with liver disease. That is why, although the Minister responsible for this topic was unable to attend, I wanted to ensure that I took forward this important debate and updated hon. Members on the work we are doing.

Many have talked about the scale of the problem, so I will not go further into that, but I want to talk about what we will do to address it. First, the NHS plan will help us to do that. It recognises the importance of preventing avoidable liver disease through targeted policies to address alcohol consumption and obesity. Unfortunately, most people are diagnosed with liver disease at a late stage, when it is less treatable, and they are often diagnosed during an emergency hospital admission. It is for that reason that liver disease is often called the silent killer.

To help detect early signs of liver disease, NHS England has a number of trials in train. One is evaluating intelligent liver function tests. That is when patients get a normal liver function test, and the laboratory has a process in place, based on those results, to test the same sample further, not necessitating a further appointment, so we can work out which patients need further investigation and treatment.

The NHS health check for 40 to 74-year-olds also identifies people particularly at risk of alcoholic liver disease and refers them in for further treatment and investigation. On top of that, we have the fibroscans, which have been rolled out through community diagnostic centres. They help to identify fibrosis in the liver at a time when we can try to treat it and before it becomes worse. Last year’s spending review allocated £2.3 billion for diagnostics to increase the number of community diagnostic centres to at least 100 by March 2025. That will boost diagnostic capacity to diagnose liver disease and improve earlier diagnosis and health outcomes.

The hon. Member for Strangford (Jim Shannon) talked about education for children about alcohol. Education on alcohol is now a statutory component of relationships, sex and health education in England.

My hon. Friend the Member for Totnes (Anthony Mangnall) talked about a review of liver disease and liver care. That is taking place in 2022-23, and there should be a report after that. He and my hon. Friend the Member for Warrington South (Andy Carter) raised transplant care. I will ask the responsible Minister to write to them with further details about what is being done in that area.

The hon. Members for York Central (Rachael Maskell) and for Strangford said that many liver diseases can be prevented and are preventable, particularly in relation to alcohol, obesity and hepatitis, and I want to talk a little about what we are doing in those areas. Alcohol is the leading risk factor for liver disease, and identifying disease early in those at risk and supporting them to stop drinking is critical. If they stop drinking, that can halt or even reverse damage to the liver. People at risk of alcoholic liver disease are being identified and given early access to tests, to detect emerging liver disease through the health check and other means.

The NHS has also invested in the treatment of alcoholism: £27 million has been used to establish specialist alcohol care teams in hospitals with the highest rates of admissions related to alcohol dependence. Those specialist teams will help identify alcohol-dependent patients, start them on specialist alcohol treatment in hospital and support their transfer to community alcohol services.

Since April 2022, NHS England has introduced a measure known as commissioning for quality and innovation, which incentivises providers to improve earlier detection of liver disease for alcohol-dependent in-patients in acute and mental health services. We are also committed to increasing liver health investigations in community treatment settings. Through the drugs strategy, we are making the largest ever single increase in drug and alcohol treatment and recovery funding, with £780 million of additional investment over the next three years.

As hon. Members said, another major risk factor is obesity. Tackling obesity is a major priority for the Government. We have seen some important successes since 2016. The average sugar content of drinks subject to the soft drinks industry levy decreased by about 43% between 2015 and 2019. This month, regulations have been brought in about store placement of products that are high in fat, salt and sugar, so that they cannot be displayed in areas of the store that are attractive and available to children. There have also been the provisions set out in the Calorie Labelling (Out of Home Sector) (England) Regulations 2021 and an investment in further weight management services for people living with obesity.

I would like to turn to hepatitis B and C, which are also important risk factors for liver disease and primary liver cancer. Through the NHS hepatitis C virus elimination programme, we have reduced the number of people living with chronic hepatitis C virus infection in England by 37% since 2015. New treatment with direct-acting antivirals has massively improved the success of the treatment, with mortality from hepatitis infections falling by 35% since 2015. So that has already reaped rewards.

There is a new opt-out pilot programme of testing for HIV, hepatitis B and hepatitis C in emergency departments in areas of the country where HIV is most prevalent, which is a proven way of identifying new cases. During the first 100 days of the pilots in London, Blackpool, Brighton and Manchester, 328 people with hepatitis B were newly diagnosed, with 30 found to be lost to care. Each of them is an individual who will now be able to be treated effectively for the condition, which will reduce the risk of passing it on. Similarly, 137 people were newly diagnosed with hepatitis C, of whom 23 were found to be lost to care. Those are promising early results in just the first 100 days, and we now looking at what we can do to perhaps roll this programme out to other centres.

Many hon. Members talked about primary liver cancer, which has a tragic impact. As my hon. Friend the Member for Darlington said, the number of recorded deaths has more than doubled in the last two decades. Cancer Research UK statistics show that there are around 6,200 new cases diagnosed each year and, tragically, 5,800 deaths. Unfortunately, the five-year survival rate for people with liver cancer is poor, at only 13%, and that could be markedly improved by earlier diagnosis, as I mentioned.

To contribute to achieving a long-term plan ambition to diagnose 75% of cancers at an earlier stage by 2028, the NHS cancer programme has launched the early diagnosis liver programme. The programme aims to detect more liver cancers at an earlier stage, so that more patients can benefit from treatment. More people at a high risk of liver cancer are referred to six-monthly liver surveillance. The national cancer programme is working in partnership with the hepatitis C virus elimination programme to deliver 11 community liver health check pilots.

The pilots aim to support early detection and diagnosis of liver cancer by identifying and referring people with cirrhosis or advanced fibrosis into a liver surveillance pathway, and providing them with a peer supporter who can help and guide them through future appointments. The pilots will target people experiencing significant inequalities and those who disengage from the healthcare service, including homeless people, those with alcohol and substance addiction, sex workers, people in the justice system, disabled people and others. The hon. Member for Enfield North (Feryal Clark) mentioned the workforce; she will be interested to know that over the last five years there has been a 20% expansion in the number of consultant hepatologists.

This is an important debate on a very important issue. We have heard some heartfelt contributions about the pain that liver disease and liver cancer bring to so many people and their loved ones across the United Kingdom. This Government are determined to take action and to make the changes that are needed to tackle this deadly disease.

[Mr Clive Betts (in the Chair)]

Margaret Ferrier has one minute to wind up.

Access to GP Services and NHS Dentistry

Caroline Johnson Excerpts

Tuesday 21st June 2022 Commons Chamber

[Wes Streeting]

I wholeheartedly agree with my hon. Friend; it is the trend with this Government to seek division, sow division, pass the buck, devolve the blame and not take responsibility for anything. What Opposition Members would not give for just one day of being able to govern in the interests of the people in this country! This Government want to give the appearance of being in office but not governing at all. That is what is happening on their watch. If that is not bad enough, against a difficult economic backdrop, with scarce resources, not only is the way in which they manage and govern bad for patients, but it is squandering taxpayers’ money.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

rose—

[Wes Streeting]

I will give way in just a moment. The problems in general practice are storing up problems for the rest of the NHS; as we have heard, people are presenting in accident and emergency because they cannot see a GP. That failure is costing the taxpayer dearly. A GP appointment costs the NHS £39, but a visit to an urgent care centre costs it £77 and a visit to the emergency department costs it £359. The Government’s failure to invest in new GPs may be penny-wise but it is pound-foolish. It is wasting money and inconveniencing patients, and it is not the way to manage the NHS. One of my constituents wrote to me yesterday to say that if she wants a same-day appointment for her baby, her GP sends her to A&E. She wrote:

“I was sent to A&E to check a newborn baby’s suspected ingrown toenail that had no sign of infection. How is going to A&E for a non-urgent matter a good thing for anyone.”

Yet that is what our constituents are forced to do, because they cannot get a GP appointment. I hope the hon. Member for Sleaford and North Hykeham can give us some insight as to why.

[Dr Johnson]

As part of that, I suggest that the hon. Gentleman remembers that GPs take 10 years to train. He is right to say that we have been in government for 12 years, but most of the current GP shortage is because the previous Labour Government did not train those GPs at the time. One of the first things the Conservative Government did was to set in train the opening of five medical schools to increase the number of medical students. We had enough doctors but they do take 10 years to train. The reason I stood up to intervene on the hon. Gentleman was to say that one of the challenges that doctors—I refer to my entry in the Register of Members’ Financial Interests, as a doctor—and members of staff face is being abused in a surgery. I wonder whether he would like to apologise for some of the comments he has made on social media—

[Mr Speaker]

Order. Interventions are meant to be questions. I know that the hon. Member is down to speak. I would not want you to use up your speech now; I want you to save something for later.

--- Later in debate ---

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

I draw the House’s attention to my declaration in the Register of Members’ Financial Interests. The debate is about GPs and dentists, and I will deal first with GPs. I pay tribute to the GPs who work in my constituency, and in particular those at the New Springwells practice and at Caythorpe and Ancaster medical practice, which have outstanding CQC ratings. I also pay tribute to the GPs who delivered the vaccine service. Not only did they work during covid with its challenges, but they delivered a vaccine service as well. They are a very hard-working, admirable group of people.

I agree with the Opposition that much of the overall problem with the NHS is a workforce problem. That is true. There are too many staff overall, and not enough of them are directly delivering or improving clinical care. We have expensive, very highly trained clinical decision makers being asked to do admin tasks that take them away from the clinical tasks that we are paying them for and which we need them to do. That contributes to our longer waiting times. So we need to increase the number of doctors.

The Opposition are making a big point about 12 years, but it takes 10 years to train a GP, and it takes longer than that to train a consultant. So, actually, the shortage was created during Labour’s time in government and we are trying to fix it. That is indeed why the number of medical schools has been increased by five. I am pleased that one of them is in Lincoln, just outside my constituency. It is training a new generation of doctors who will provide services locally—people predominantly stay where they train—which will help the people of Lincolnshire to have more access to doctors. However, the Government should go further. In the year when we had challenges with A-levels caused by covid and more people than expected got the grades required to get into medical school, places were exceptionally increased. There are challenges with that—only so many people can get around a bedside and a patient will be happy to have only so many people listen to their heart or feel a lump or bump or suchlike—but, nevertheless, it has been managed for one year, and I think that it could be managed for more. The best thing that the Government could do for the health service in that regard would be to massively increase the number of doctor places. At the moment, we are turning away keen, enthusiastic potential young doctors doing their A-levels because places are so oversubscribed, but then we find that we have a shortage. That surely cannot be right.

I turn to ease of access. The Secretary of State mentioned making it easier for people to be referred into secondary care, which of course is a good thing, but we need to ensure that training is in place for that. Since I became a consultant, we have seen the number of patients referred into secondary care increase rather rapidly—certainly in the department that I work in—but the quality of referrals has not always been right, and undoing an unnecessary referral can be more time-consuming than just seeing the patient. We need to be mindful of the need to have clinical decision makers doing what they need to do and, as such, if we are to broaden the scope of people making referrals, we need to ensure that either referrals are done with specific guidance or that training is provided so they are good-quality referrals, and not those that add to waiting lists.

On dentistry, we have heard much talk about children having whole-mouth teeth extractions. Clearly, that is a horrific thing to happen—it is unimaginable, really, that a child needs to come into hospital to have all their teeth removed. I look to the Minister to tell us what she doing about that, because it is not, as some have suggested, all the Government’s or the NHS’s problem. In part, it must be about diet, teeth brushing and dental care—whether the teeth are being properly looked after—as well as potentially fluoride enhancement of water and the availability of dentists. Several stages need to be looked at in a more holistic way to prevent these children from having to go through such an awful experience.

In Lincolnshire, NHS dental care is good, but the service’s availability is relatively poor. In the last two years, only 41% of adults in Lincolnshire have seen an NHS dentist, and less than a third of children saw an NHS dentist in the last year. The Minister will be aware that I had an Adjournment debate on the topic in October. I thank her for her engagement with me since and for her support in identifying potential solutions, as well as local dentists, the local dental committee, Professor Juster from the University of Lincoln and Health Education England for their time. They are just some of the people I have met to discuss Lincolnshire’s dental issues and how we can improve care.

The first thing to be solved is, of course, the dental contract. The contract was created by Labour in 2006, but I agree that we have had time and should probably have sorted it out by now. I raised that with the previous Secretary of State when I was on the Health and Social Care Committee in the previous Parliament. The contract pays for units of dental activity. There are three levels covering wide ranges of levels of care. Why Labour signed off on a contract that created such variability in both the value of a UDA and the amount of work required to be paid for one, I do not know, but it is human nature for someone to expect to be paid more if they have done more work, and that someone given the option of earning more for doing the same work will choose to do so. There, fundamentally, are the problems we have with the NHS contract. I look forward to hearing what the Minister is doing on that. I understand that she is in negotiations with dentists at the moment. I hope that she will be able to update the House on progress and that it will be good progress.

The second issue is geography. We know that our medical students predominantly stay where they train, and there is no dental school in the east midlands or in East Anglia. I am grateful to Health Education England and Ministers for discussions about solutions to this following my question at Prime Minister’s questions. There are a number of ways of resolving it. In the longer term, a dental school at Lincoln University would be a good way of ensuring that we have locally grown, locally trained dentists. The university is very supportive of that in the discussions, and indeed we have the support of all Greater Lincolnshire Members of Parliament for ensuring that this goes ahead.

I appreciate that it will take time to plan and deliver that, so in the meantime we need more dentists locally. The Minister and I have recently been talking about centres of dental development. The principle of a centre of dental development, which I would like to see in Sleaford, is that postgraduate training is delivered. It is attractive work for the sake of recruitment. People want to work at a centre because they get to deliver training and it is a more attractively remunerated job, but also, the postgraduate people being trained are immediately delivering care. Such a facility could be up and running within 18 months to two years and actively delivering care to my constituents, which is what I am looking for. I am particularly keen to see a centre located in Sleaford, because we have relatively few NHS dentists. We have great local schools, we have a fabulous community and we have great rail links, both north-south and east-west. What progress is the Minister making on these proposals?

Does the Minister have any update on what progress is being made on support for military families? I have a number of RAF bases, including RAF Cranwell, in my constituency. People who have moved around from place to place find that they have dropped off the list in one area and are struggling to get on to one in another. We have a covenant that says that we will ensure that people who are serving in our armed forces, and their families, are not disadvantaged, but clearly in this regard they are. I would be grateful for those updates from the Minister.

Health and Care Bill

Caroline Johnson Excerpts

Consideration of Lords amendments
Wednesday 30th March 2022 Commons Chamber

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

I would like to draw Members’ attention to my entry in the Register of Members’ Financial International, and particularly, since these organisations have been mentioned, to state that I am a member of the British Medical Association and the Royal College of Paediatrics and Child Health.

The measure relating to amendment 92 was introduced in the context of the pandemic. The reason that the rules were brought in the first place was to protect women from coronavirus and to reduce its spread within society at a time when we did not have a vaccine. For me, this debate is not about ideology at all—it is not about the rights or wrongs of abortion, whether women should or should not be able to have abortions, whether or not life begins at birth, or anything of that nature. Society and Parliament have decreed that abortions may take place and that women should have the right to choose, and I support that. For me, this is a debate about women’s safety, particularly the safety of the most vulnerable and marginalised women and girls.

Previously, women would have attended a clinic and been given a tablet and another tablet to take a day or so later, and usually the bleeding would begin in the hours after the second tablet is taken. Under the new process, a woman or girl can speak to somebody on the telephone to arrange for the tablets to be delivered to her, or to be collected by her, and then take the tablets at home. It is very difficult for a clinician to tell whether the woman they are speaking to on the telephone is indeed pregnant. There are not necessarily visible signs of pregnancy below 10 weeks, and palpation of the abdomen would not be expected, so it is not clear to the clinician on the phone whether the woman is pregnant. Clearly, someone believes a woman when she says she is pregnant, but there is no way to be certain. In particular, there is no way to be certain of gestation. Although a woman may know when she has had sex and when her last period was, quite a number of women will bleed in the early stages of pregnancy, and some women mistake those early bleeds for a period, which means that women may believe that they are less pregnant than they are. If they go to a clinic, that can be determined, whereas over the telephone it cannot.

The NNDHP, which my hon. Friend the Member for Congleton (Fiona Bruce) mentioned, has found a number of examples since March 2020 of women who have had babies delivered quite significantly later in gestation; they had mid-term to late-term abortions believing that they were early in pregnancy when they were not. The examples included 12 babies who were born with signs of life, so the pregnancy would have been quite advanced. The women thought that they were at less than 10 weeks, or told the doctor that they were at less than 10 weeks, but they were not. In six of those cases, the woman giving birth was herself a child. One can only imagine the distress felt by these women and children when they take an abortion pill to deliver what they believe to be a foetus of less than 10 weeks and out comes a baby of up to 30 weeks’ gestation who may at that point have been alive. It is not rare to have side effects from these tablets. One in 17 women have to attend hospital and 36 women call 999 each month because of complications of taking these medicines at home.

If this measure had been introduced in a proper fashion rather than as part of the coronavirus regulations, we would have discussed it quite thoroughly and made it very clear that it should not apply to children. I do not think that many people in this House would think that a 14-year-old girl should be ringing up and receiving abortion medicines over the telephone, but that is indeed what the legislation allows. People may say that doctors would not do that, but we know that six of the children who delivered babies that they thought were at a much earlier stage were themselves under the age of 18.

[Steve Brine]

Surely the point is that this measure was brought in hastily in a pandemic. Therefore, if Members are not sure today, far from abstain, they should be returning to the status quo pre-pandemic. Then this Government can should consider the issue properly and seriously on its own and ask the House to make a decision.

[Dr Johnson]

I can only absolutely agree with my hon. Friend’s intervention.

I also want to talk about coercion, because we know that some women may be coerced into having an abortion.

[Dame Diana Johnson]

Before the hon. Lady moves on, I want to raise something with her. Obviously she has a clinical background, and she will know jolly well about the range of safeguarding measures that all clinicians, the royal colleges and all those involved in abortion care have to follow. She makes it sound as though no safeguards are in place. For instance, if a 14-year-old telephoned a clinician to seek advice around abortion, that clinician may well say, “I want to see you face to face.” There is nothing to stop that happening, and that may well be a proper safeguard that would carry on, irrespective of whether telemedicine carries on today.

[Dr Johnson]

With respect, the right hon. Lady makes my point for me, because that is right: there is nothing to stop that happening, and it may be that the doctor would say that they wanted to see the patient, but they do not have to do so. We know that abortions are being prescribed by telemedicine to children under the age of 18. If this measure had been looked at properly by the House as a single issue, rather than as this amendment to something else, we would have stipulated that children under the age of 18 should not be receiving abortions over the telephone without proper appointments, as I think they should and as the right hon. Lady, if I understand her correctly, also seems to be saying that they should.

We know that sometimes women and girls can be coerced into having abortions that they do not want, perhaps because the baby is of a gender or sex that the father does not want, perhaps because they are being abused, or perhaps they are being trafficked or sexually assaulted. It is very difficult for a woman to tell someone about that over the telephone, whereas if a woman is seen in clinic, she has that one-to-one opportunity.

[Jess Phillips]

Will the hon. Lady give way?

[Dr Johnson]

I am going to finish my point. In person, the woman has a one-to-one opportunity with that clinician and a chance to say, “Please can you help me?” Clinicians are alert to that opportunity to provide that help. It is true that if the woman receives the abortion by post, the problem of her being pregnant is solved, but the problem of her being abused is not. That is what can continue.

[Jess Phillips]

Will the hon. Lady give way?

[Dr Johnson]

No, I am going to continue. The other problem with giving tablets—[Interruption.] The hon. Lady spoke for 16 minutes, which is considerably more than a fair share, given the number of Members who want to speak, so I will keep going.

The other problem is who will take the tablets. If someone is prescribed something of such severity over the telephone, the clinician does not know who will take the tablets. Will they be taken by the woman speaking to the clinician on the telephone? Will they be given to somebody else? Are they going to be sold to somebody else? Is somebody else going to be forced to take them? The reality is that we do not know and we cannot know, and that is another safety issue.

I will summarise my concern by saying, as a woman— I have not had an abortion, but I guess in the future I could become pregnant and not want to be—if I were having an abortion, I would rather have the inconvenience of having to go to a clinic than the worry of knowing that some women are having abortions without going to a clinic. Essentially, for me this is an issue of whether we want to make things more convenient for the majority of women, or we want to protect the women who are the most vulnerable, the most marginalised and the most at risk.

[Mr Deputy Speaker (Mr Nigel Evans)]

I intend to call the Minister at 5 o’clock to give him 10 minutes to wind up. We have not got long, so will Members please keep their contributions as short as they can?

Children’s Mental Health

Caroline Johnson Excerpts

Tuesday 8th February 2022 Commons Chamber

[Maggie Throup]

I will make progress because we are short of time and I want to give plenty of time for Back Benchers to contribute.

More than 420,000 children and young people were treated through NHS-commissioned mental health community services in 2020-21, which was almost 100,000 more than three years ago. The NHS children and young people’s mental health workforce has seen growth of 40% from 11,000 whole-time equivalents in 2019 to 15,486 whole-time equivalents in 2021.

Early intervention and mental wellbeing support in schools and colleges can prevent poor mental wellbeing from developing into mental illness. We remain committed to the proposals set out in the Green Paper to roll out mental health support teams based in schools and colleges and staffed by mental health professionals. There are now more than 280 teams set up or in training, with 183 of those teams operational and ready to support young people in around 3,000 schools and colleges. I am really pleased that we have been able to accelerate that programme to meet our original target a year early and then reach around 35% of pupils through 399 mental health support teams by 2023.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

A number of parents in my constituency have contacted me with worries about their children and how best they can support them. We know that parental support in the family can lead to great improvements in children’s mental health. What information is the Minister making available to parents on how best they can support their children when they are having difficulties with their health?

[Maggie Throup]

My hon. Friend makes a really good point, and I know that she has lots of experience on this issue from a clinician’s point of view. She is right to say that families play a very important role. In her absence, may I offer my hon. Friend a meeting with the Minister for Care and Mental Health, because she will be able to go into much more detail than I can at the Dispatch Box?

Elective Treatment

Caroline Johnson Excerpts

Tuesday 8th February 2022 Commons Chamber

[Sajid Javid]

The hon. Lady is of course right to talk about the importance of health inequalities. I hope that when she has had time to look at the plan she will see just how seriously the NHS and the Government take that. More broadly, I will have a lot more to say about tackling health inequalities shortly. Of course, the hon. Lady is right that there need to be alternatives to digital access for those who cannot easily access digital, be it through a web platform or the NHS app. There are alternatives in place, but I hope she agrees that for those who can use digital tools, we should make them part of the offering. The new “my planned care” service will be hugely important in providing more transparency than ever before, but also in helping people prepare for their surgical procedures. She may have heard me say earlier than one third of on-the-day cancellations of surgical procedures happen because people were not prepared.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

I declare my interest as an NHS doctor and I echo much of what has been said by colleagues across the House about the workforce challenges.

As the Secretary of State said, covid has been a huge challenge to the NHS and it is a testament to NHS workers that cancer treatment was maintained at 94% of pre-pandemic levels throughout the pandemic and that 95% of people who needed cancer treatment started that within a month. However, I am sure the Secretary of State agrees that one month is a very long and frightening time to know that cancer is growing inside and that every day’s delay could be the day that costs your life. How does he intend to reduce that time and what will be his target from diagnosis to treatment?

[Sajid Javid]

I agree with my hon. Friend about the importance of the workforce. She is right to raise the importance of cancer care and to note that it has remained a huge priority for the NHS despite all the pressures of the pandemic. In the plan that we are publishing today, we have set out a number of cancer targets. They are all very ambitious with record amounts of investment. Once my hon. Friend has looked at the plan, I would be happy to discuss it further with her, either the cancer aspects or anything else.

Elective Care Recovery in England

Caroline Johnson Excerpts

Monday 7th February 2022 Commons Chamber

[Edward Argar]

The hon. Gentleman and I have previously met to discuss this issue, and I share his view on the value of radiotherapy in helping to tackle the cancer backlog, and more broadly as a treatment. Ministers and I are always happy to meet him.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

My hon. Friend spoke earlier of this Government’s record level of investment in the NHS, but each patient waiting for cancer treatment is undergoing a very long and frightening experience as they wait longer than needed. As he focuses on reducing this backlog, how will he ensure that the record level of investment is focused directly only on measures that will reduce the backlog and is not wasted?

[Edward Argar]

My hon. Friend knows of what she speaks, as a serving consultant in our NHS. She is right that investment is important but that the outcomes are what really matter. We have set out measures such as the community diagnostic hubs, which are bringing diagnostic capacity to local communities and making it more accessible. That is just one example of how we will ensure that the money delivers the required outcomes.

Vaccination Strategy

Caroline Johnson Excerpts

Wednesday 12th January 2022 Commons Chamber

[Mr Speaker]

I am going to hand over to my colleague in the Chair, but before I do so, to help the Minister I remind Members that we still have some nurses who can give injections at a pop-up in the House of Commons.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

I declare my interest as a consultant paediatrician working in the NHS and as a volunteer vaccinator. I am very proud to be part of the vaccination programme that has undoubtedly saved so very many lives.

I want to focus on children. I have worked in hospital over the past month and have been looking after children who have had positive tests. That is not unexpected because the virus is high in the population and of course we test everybody. However, I have not been looking after children who were admitted because of covid. In September, we heard that the decision on whether to offer children vaccines was finely balanced. Indeed, the JCVI referred that decision to the chief medical officers, who finally decided, on the basis of educational disruption, to offer children vaccines. Given that omicron is less harmful than the variants we were considering at the time, has the Minister asked the JCVI and the CMOs to consider whether these vaccines are still, on balance, better for children than not—except, perhaps, in the context of travel?

[Maggie Throup]

I thank my hon. Friend for her role in vaccinating probably thousands of people by now. Everybody has played their part, using their skills and their time to roll out the vaccination programme in such an amazing way. I assure my hon. Friend, who obviously has an awful lot of expertise and knowledge, that JCVI continually looks at the data. We hear announcements from the JCVI and think they are just about what it has considered on that particular day, but I assure the House that it continually looks at the data to make sure that we move forward in the right manner.

Public Health

Caroline Johnson Excerpts

Tuesday 14th December 2021 Commons Chamber

[Sajid Javid]

I think both have a role to play. In the NHS and in social care, there is very frequent testing—lateral flow testing, in the case of the NHS, and often PCR testing—but I think vaccination has a role to play. At this point in time, many people still have two doses; that is rapidly changing. When they have a third dose or their booster dose, that gives them an even higher degree of protection.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

I draw attention to my entry on the Register of Members’ Financial Interests. The Secretary of State is making a very clear argument for the need to do something; he talks about how a very small proportion of a much larger number of cases could overwhelm the NHS in the way that a larger proportion of a much smaller number of cases might not. However, we know that the NHS has a huge backlog of people awaiting diagnostic and operative procedures. What evidence does he have that mandating vaccines for NHS staff will help? Given that we know that vaccination does not particularly reduce transmission, and given what he has said about the importance of choice, why does he not think that it would be reasonable to offer medical staff and nursing staff the option of daily testing instead of vaccination, should they make that choice?

[Sajid Javid]

In coming to this decision, we held an extensive consultation with thousands of responses. Importantly, we also consulted with the NHS itself; as I shall touch on in a moment, it has weighed up the decision. My hon. Friend is right if she is suggesting that there may be some people who choose to leave the NHS rather than stay and be vaccinated—that is a choice for them to make, but there is also an issue of patient safety. That is also the view of the NHS. As I said in response to my right hon. Friend the Member for Haltemprice and Howden (Mr Davis), testing can be used alongside, but vaccinations help as well.

I want to talk about settings.