Building an NHS Fit for the Future

Debate between Caroline Johnson and Jackie Doyle-Price

Monday 13th November 2023 Commons Chamber

[Jackie Doyle-Price (Thurrock) (Con)]

My hon. Friend is making some compelling points. It strikes me that disposable vapes are often available at the point of sale where we used to find things such as chewing gum and packets of Polo mints. That makes it very easy for children to access them. Does she think that regulating point-of-sale products is a massive tool to tackle the problem? Let us remember that established tobacco companies have to have their multi-use vapes on sale behind the screens that tobacco is sold behind.

[Dr Johnson]

I completely agree that putting vapes where children can see them makes them more available and makes children want them more. That is why they need to be in plain colours and flavours and out of the sight and reach of children. My understanding is that that is part of the Government’s consultation, and I hope they legislate and make regulations as soon as they can.

Overall, the King’s Speech is a good one, and I am proud to support it.

Social Care

Debate between Caroline Johnson and Jackie Doyle-Price

Tuesday 25th February 2020 Commons Chamber

[Jackie Doyle-Price]

The issue is that local authorities are commissioning care from local care providers and paying the rate that the individual resident is incurring. It is about what they are prepared to pay for that bill and not the local authorities paying living wages directly to employees. However, that is pushing the risk on to care providers, and we need to acknowledge that there will be workforce challenges for those providers. They will be competing more and more for people. While there is that downward pressure from local authorities on what they are prepared to pay and the upward pressure on wages, the risk is being borne by providers.

Part of the solution is also not just about who pays. We need to be a lot more imaginative about this. We all know that we will live longer—beyond 70—and that we will have more years in life in retirement. Just as we make plans for our pensions, we need to make provision for our homes and how we are going to live in old age. The simple fact is that our housing requirements when we are in our 40s and are raising a family are rather different from what we might require in our 90s. We know that falls are one of the biggest burdens on the NHS, so the fact that we are not encouraging people to make sensible lifestyle decisions about their homes is causing additional cost to the NHS, as well as, potentially, the need for more long-term residential care. One reason why we have that issue is that we have allowed, collectively over decades, so much wealth to be stored in our housing stock that we have encouraged people to behave in a way that makes them want to cling to it. I would like us to look more imaginatively at incentives through the tax system to encourage people to downsize and look at different ways of living. We want to use the planning system to encourage the development of retirement villages where people can purchase extra care.

[Dr Caroline Johnson]

Some people like to care for relatives at home, and it is not uncommon to create a small annexe within or adjacent to the property for an older relative to be cared for, but currently, the council tax system means that if that relative passes on, after that—within two years—people will be charged double the council tax for that part of their dwelling. Does my hon. Friend think that that is something that we can improve on and change to encourage people who wish to look after their relatives in their properties to do so?

[Jackie Doyle-Price]

I completely agree. That is exactly the kind of incentive that we should encourage. The longer that we can encourage people to live independently, the better their quality of life and the better it is for the taxpayer, because there will not be those ongoing bills. The point is exactly that as we live longer, we will spend many years in a condition of frailty, and that needs to be properly managed through the system.

Every parent, with the best will in the world, will wish to hand on as much of their assets to their offspring as possible, but that could also encourage behaviours that are bad for their health. I want my parents to realise the value of their assets rather than protect their inheritance for me. I am sure that most people would think that about their parents, but there is a lot we can do on the tax system and incentives to encourage families to manage those issues collectively and in a way that is good for people’s welfare as they become elderly and enables them to do more for their children.

It is high time that we tackled this issue. We should also not look at this entirely in isolation from the issues regarding working-age adults, which are also a major challenge for local authorities as they manage their finances in this area. We must look at the issue of people with learning disabilities and autism being increasingly placed in areas of long-term care. The issue is that, although we have been broadly successful in moving out people with learning disabilities through the transforming care programme, sadly the pipeline afforded by those people moving out has been filled by people with autism. The Government have to give a much clearer challenge to commissioners. When faced with people with complex needs, the first instinct should not be to put them in residential care. Too often we have seen how those kinds of placements do harm. We need to challenge local CCGs and NHS England to put much better care upstream by providing early diagnoses for people with autism and giving them the tools to protect themselves.

Mental Health Act: CQC Report

Debate between Caroline Johnson and Jackie Doyle-Price

Tuesday 27th February 2018 Commons Chamber

[Jackie Doyle-Price]

The hon. Lady raises an issue that is close to my heart. In my opening statement I highlighted the discrimination faced by black people in detention, but I could just as easily highlight the discrimination faced by women. As she says, if they become victims of domestic abuse or coercive relationships, they often face mental health challenges as a result, and they are more likely to be detained in those circumstances. I co-chair the women’s mental health taskforce with Katharine Sacks-Jones from Agenda, and towards the end of the year we are looking to bring forward concrete actions to tackle exactly this kind of discrimination and make mental health services more responsive for women.

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

As a doctor, I know how carefully doctors and other health professionals consider individuals before resorting to detention under the Mental Health Act. Does the increase in detentions under the Act reflect a general increase in mental health problems in the population, or can it be better explained by a greater proportion of people becoming so unwell that they need to be detained in order to support their care? What research is the Minister doing to determine which is the better explanation, and to ensure that we identify those people who are going to become severely ill in time to treat them?

[Jackie Doyle-Price]

Clearly, if we can determine the causes of the increase in mental health detention, that will become part of the toolkit that we use to tackle the issue. This is one of the things that we are asking Sir Simon Wessely to look at. There are anecdotal examples of why this might be happening, but the fact that we are seeing higher rates of detention among the black community and among women raises some interesting questions that will bear further examination. I recognise my hon. Friend’s point completely. Good medical practitioners will use detention under the Mental Health Act only as a last resort, and we must ensure that that good practice is spread as far as possible.

Oral Answers to Questions

Debate between Caroline Johnson and Jackie Doyle-Price

Tuesday 6th February 2018 Commons Chamber

[Jackie Doyle-Price]

The hon. Gentleman is right to highlight that, and we are always keen to respond to any representations made on this very important issue. We are also very keen to learn from the other nations about this area, because it is clear that the more we can do with early intervention in childhood, the better we protect people’s long-term health. I will look more specifically into that.

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

As a children’s doctor, children’s health is very important to me, and the case of children’s doctor, Dr Bawa-Garba, worries me and doctors up and down the country. In NHS practice, I have seen the adverse effect on reflective practice and the impact that it has on staff morale. Ultimately, that will impact on patient safety. I know that the Secretary of State shares my concerns, and I ask him to tell the House what he is going to do about it.

[Jackie Doyle-Price]

My right hon. Friend the Secretary of State will be addressing that in a little while. The whole issue of reflective learning is important. We should not, through this case, prevent people from being honest about the experiences that they have had.