Health and Care Bill

Caroline Nokes Excerpts

Report stage
Tuesday 23rd November 2021 Commons Chamber

[Dawn Butler]

My hon. Friend makes a valid and valuable point. One way we can show our appreciation for nurses’ work is to protect their title, but we should not do that instead of addressing any of the issues she mentioned, along with ensuring that they receive a pay rise.

I thank the people who have petitioned for the change in my new clause for a number of years, including the former Secretary of State, the right hon. Member for South West Surrey (Jeremy Hunt), who is no longer in his place but supports my new clause; the Labour Front-Bench team; Ann Keen; the chief nursing officer for England, Ruth May; Professor Mark Radford, the chief nurse at Health Education England; the previous chief nursing officer for Northern Ireland, Charlotte McArdle; Andrea Sutcliffe, Matthew McClelland and the Nursing and Midwifery Council; Mr Paul Trevatt; Professor June Girvin; Dr Crystal Oldman; Ms Shamim Donatta Ayiecho; Ms Leanne Patrick; Mr Gerry Bolger; Ms Catherine Eden; and the Florence Nightingale Foundation leadership scholars. The Government know that there is a lot of support for new clause 12 and I hope it passes today.

[Caroline Nokes (Romsey and Southampton North) (Con)]

It is a pleasure to contribute to this debate and specifically to speak to new clause 1, tabled in my name and the names of the right hon. Member for North Durham (Mr Jones) and many other Members throughout the House. First, though, I pay tribute to my right hon. Friend the Member for South West Surrey (Jeremy Hunt) for his incredibly important amendment on the workforce. I also pay tribute to my hon. Friend the Member for North West Durham (Mr Holden) for his crucial new clauses on virginity testing and hymenoplasty. As the Chair of the Women and Equalities Committee, I was pleased to be able to support those amendments and am delighted that the Government have introduced their own new clauses on those issues.

I wish to talk specifically about aesthetic non-surgical cosmetic procedures, which may seem quite trivial in comparison with the important matters I just referred to, but I vividly remember visiting a doctor in my constituency and talking to her about her experience when a patient came to her after she had had far too much lip filler placed into her lips by an unqualified and inexperience practitioner. The poor girl’s lips had, frankly, exploded, leaving her permanently scarred and with the prospect of many years of corrective surgery to try to rebuild her face. That is the stark reality.

The hon. Member for Brent Central (Dawn Butler) spoke about people being able to call themselves nurses when they are not nurses; aesthetic cosmetic practitioners can not only call themselves that but perform all sorts of procedures, some of which we would find it bizarre and disturbing to talk about and, indeed, at some of which we might look with absolute horror when they are reported on the internet and in the pages of national newspapers. I am talking about semi-permanent make-up and permanent tattooing, which can leave people permanently disfigured. The semi-permanent variety can fade to leave people with bizarre blue eyebrows that require many different procedures to be put back to normal. The list is long: we are talking about tattooing, botox and laser treatment—just imagine the damage that high-powered lasers can do to somebody’s skin when in unqualified, untrained hands.

[Dr Whitford]

Along with the damage to patients who trustingly go for such procedures, is it not also about the fact that when they go horrifically wrong, as sometimes they do, it is the NHS that ends up having to pick up the pieces?

[Caroline Nokes]

I thank the hon. Lady for using exactly that term because she is right: it is about the NHS picking up the pieces and spending taxpayers’ money trying to correct something that should not have been done in the first place. If it is to be done to somebody, it should be done only by the qualified, trained and, as my new clause argues, licensed. I call today for some form of licensing or regulation. I absolutely accept that the Minister may view my new clause as deficient and not doing what he would want it to do. I appreciate the fact that he took the time to meet me and other Members last week to discuss the issue, because there are concerns throughout the House.

I pay particular tribute to my hon. Friend the Member for Sevenoaks (Laura Trott), who has done so much work on injectables in respect of under-18s and deserves absolute credit for getting her private Member’s Bill on to the statute book. That is amazing work and I really appreciate the fact that she has done it. Nevertheless, we need to do more and to go further.

I pay tribute to a number of my constituents who, following the work I did last year on the beauty industry, approached me on this issue. In particular, I pay tribute to Dr Chris Rennie of Romsey Medical Aesthetics, and to Dr Mitra Najafi, who has developed an incredible process by which plasma-rich platelets are extracted from a patient’s blood and injected back into them. It is a highly medicalised procedure and her big worry is that if it falls into the hands of somebody who is unregulated and unlicensed, it could be extremely dangerous indeed. Those with medical qualifications absolutely understand how they have to treat blood products; the stark reality is that those without do not.

I pay tribute to aestheticians—I struggle to say that word—such as Naomi O’Hara who came to me, as someone who practises, to call for regulation and licensing.

I pay tribute to a lady who is not my constituent but travelled to Romsey to see me: Tania Gough, who publishes the Image Directory. Her concern was that it is perfectly possible for someone to set themselves up in practice with next to no training whatsoever. She spoke to me of some of the horror stories that she herself had seen and some of the training courses she had gone on that she said were quite simply not worth the money she paid for them or the waste of her time. She said that certificates were issued at the end of such courses that gave the impression that people were qualified and trained when in fact they had had no more than a couple of hours—in one case it was 90 minutes—of training.

I also pay tribute to the Chartered Institute of Environmental Health and the Joint Council for Cosmetic Practitioners; they have been incredibly supportive and helpful in the drafting of new clause 1. The Joint Council for Cosmetic Practitioners says:

“The creation of a national licensing scheme for practitioners of aesthetic non-surgical cosmetic procedures would ensure that all those who practise are competent and safe for members of the public.”

To my mind, that is the abiding word: safe. We want those who receive these sorts of treatments not to be putting themselves in harm’s way.

I look forward to the Minister’s response; I know he is listening on this issue. He can expect me not to push my new clause to a vote, but I very much hope he can show us a constructive way forward that may take us to the regime that we want to see.

[Tonia Antoniazzi (Gower) (Lab)]

I could speak about so many aspects of the Bill—such as the U-turn on the social care cap, the lack of action to include health inequalities, allowing private healthcare providers to access our NHS and, frankly, whether a reorganisation of the NHS at this time of crisis is what we need to support all our healthcare workers—but I am sure that colleagues will more eloquently cover a lot of those points in their contributions. As the chair of the all-party parliamentary group on cancer, I will restrict my comments to the amendment on the NHS workforce tabled by the right hon. Member for South West Surrey (Jeremy Hunt).

Staffing is the biggest challenge facing the NHS. The Prime Minister claims to be building 40 new hospitals; if that ever happens, they will be of no use to anyone if there are not the doctors, nurses, radiotherapists, pharmacists, porters, cleaners and other staff to look after patients. As we have already heard, the NHS had 100,000 vacancies before the pandemic started. That, coupled with the intense strain and burnout that staff have suffered over the past 18 months, is causing a crisis in staffing that needs bold action now.

The Budget was a missed opportunity to invest in the people who make the NHS great, but amendment 10 would go some way to rectifying that. According to research from Macmillan, it is estimated that we need an extra 3,371 cancer nurse specialists by 2030—that is a doubling of the number of cancer nurses in just over eight years if we are to have any chance of providing the care and support that patients deserve. Macmillan has worked out that it would cost £174 million to train and develop specialist cancer nurses to plug the gap. Any increase in funding would be passed on to devolved Governments through Barnett consequentials. In the grand scheme of things, £124 million in England, £31 million in Scotland, £12 million in Wales and £7 million in Northern Ireland is not too much to ask of the Government—it is probably in the region of the amount of money spent on security for the Prime Minister’s trip to Peppa Pig World at the weekend.

Health and Care Bill

Caroline Nokes Excerpts

Consideration of Lords amendments
Wednesday 30th March 2022 Commons Chamber

[Dame Diana Johnson]

I am talking about women’s experience, so I will continue, if the hon. Gentleman does not mind.

The woman may have to make arrangements if she has childcare or caring responsibilities, or she may have to take time off work. In the case of a coercive and controlling relationship, she would have to explain where she is going to a perpetrator, such as the Mumsnet user who said she had to visit a hospital to access abortion care and was “terrified” of her abusive ex-partner finding out where she was. She spoke of having to construct “various lies” about where she was that day and why she had to have someone look after her children.

I referred to NICE and the World Health Organisation in an intervention, but we should be aware that since telemedicine was introduced the risk of complications related to abortion has reduced, as women are able to access care much earlier in their pregnancy. I will rehearse the long list of supporters of the measure continuing: The Royal College of Obstetricians and Gynaecologists, the Royal College of Midwives, the Royal College of General Practitioners, the British Medical Association, the Royal Pharmaceutical Society, the Faculty of Sexual and Reproductive Health, the TUC, Women’s Aid, Rape Crisis, Karma Nirvana, the Terrence Higgins Trust, End Violence Against Women, Mumsnet, and many others. What I find most disappointing is that the Government are going against a wealth of robust and widely accepted peer-reviewed evidence from medical professionals and women’s charities, and appear to give greater weight to anecdote, erroneous opinion and misinformation focused on campaign groups with extreme views who bombarded a consultation. Sadly, that further emphasises that this is not an evidence-based policy decision.

[Caroline Nokes (Romsey and Southampton North) (Con)]

Will the hon. Lady give way?

[Dame Diana Johnson]

I want to address the issue of safeguarding. Let me be clear: creating more barriers to access does not help women; it helps abusers. The End Violence Against Women coalition and other major VAWG organisations reject the claim that telemedical abortions put women at greater risk of coercive abortions. The fact is that coercive pregnancies are far more common than coercive abortions, and since the introduction of telemedical abortions providers have seen a rise—a rise—in safeguarding disclosures, highlighting that the system provides a safe space for women to come forward if they are being coerced. Nurses are highly trained to assess safeguarding issues, and if concerned they will ask the women to come to the clinic for face-to-face assessment.

Finally and crucially, women themselves strongly favour keeping telemedicine for early medical abortion. A clear majority want it to continue.

As a country, we have an opportunity to be seen to be a shining light for women’s reproductive rights around the globe at a time when those rights are being rolled back elsewhere. The weight of the evidence in favour of maintaining this essential women’s healthcare pathway is overwhelming. I ask Members to support the amendment in lieu.