Sexual Harassment of Surgeons and Other Medical Professionals

Debate between Caroline Nokes and Andrew Stephenson

Wednesday 13th December 2023 Westminster Hall

[Caroline Nokes]

I thank the Minister for giving way, and welcome him to his new role, appreciating that he has only been in it a few weeks. I gently say to him that there is a real challenge in our NHS when 10% of women in one study reported unwanted sexual conduct in return for career opportunities. That is absolutely about power, and it is going to take a step change to break down those structures that enable such harassment to continue, behind a veil of silence, so that women are still afraid to speak out.

[Andrew Stephenson]

I pay tribute to my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes), who is the Chair of the Women and Equalities Committee, for her work in this area. I completely agree with her point; there needs to be a serious culture change. We would all recognise that over many years the NHS has been fantastic in treating patients. However, quite often the same clinicians, in many regards, have not been as compassionate when looking after each other.

The workplace culture that has developed in parts of the NHS need addressing. Even though I am new to my role, with only three weeks in post, as part of the NHS long-term workforce plan, I am looking at that culture and the staff leaver rates across a whole range of different parts of the profession. That is important because we must ensure that people have a safe and enjoyable working environment. At the moment, reports such as those detailed by the hon. Member for Canterbury show that in far too many trusts, employers are falling well short of providing that supportive environment, which is the least people should expect.

Turning to what has been happening, most NHS organisations now have trained staff to help colleagues raise concerns in this area. That includes a network of more than 1,000 local freedom to speak up guardians across all trusts, supported by an independent national guardian to help drive positive cultural change. We have also established a confidential helpline for staff who want to speak up but need guidance about what to do and where to turn. That, again, goes to the point made earlier by my right hon. Friend the Member for Romsey and Southampton North about the experience of people complaining but being passed from pillar to post between the GMC and trust. I hope that the confidential helpline will help make a difference.

NHS organisations must do everything they can to stamp out the unacceptable behaviours at all levels across the health and care system. In April, the former Secretary of State, my right hon. Friend the Member for North East Cambridgeshire (Steve Barclay), convened an urgent meeting with NHS England to ensure that NHS organisations are doing more to tackle such behaviours. We have made some progress, although I acknowledge that there is much more to do.

This year, NHS England broadened and strengthened the remit of its domestic abuse and sexual violence programme, which was established in 2022, to address sexual harassment and misconduct on NHS premises. All trusts and integrated care boards were asked by NHS England to appoint an executive and operational lead for domestic abuse and sexual violence. Those leads are reviewing their policies, training and support systems to enhance support for staff and patients.

In September, NHS England launched the first ever NHS sexual safety charter across the healthcare system. There are now 200 signatories, including NHS employers and the Royal College of Surgeons. Signatories commit to taking a zero-tolerance approach to any inappropriate or harmful sexual behaviours in the workplace by implementing all 10 charter commitments by July 2024. The commitments include establishing clear reporting mechanisms, implementing training programmes and providing essential support for those involved in investigations. NHS England will use the new network of domestic abuse and sexual violence leads to share and promote good practice and develop practical solutions in implementing the new charter.

Data capture is also a key commitment in the charter and to gauge the charter’s impact, the NHS staff survey now includes a question related specifically to sexual safety. That systematic approach reflects a commitment to transparency and accountability in creating a safer working environment. The Equality Act 2010 has also been amended this year to include a new duty on employers to take steps to prevent the sexual harassment of their employees. Implementation of the charter will assist NHS employers with meeting the duty when it comes into force next October.

The GMC is unable to consider complaints about registrants that relate to matters more than five years old unless it considers it to be in the public interest to do so, which has been raised during the debate. We are modernising the legislation that governs professional regulators, which includes removing the five-year rule as part of the reforms to regulatory legislation for doctors. It will allow the GMC greater discretion to consider whether a concern should be investigated. Introducing those changes remains a top priority for the Government.

I hope that these measures show that we are committed to addressing the problem with targeted action. However, I acknowledge that there is more to do, and I would be happy to work with the hon. Member for Canterbury and Members across the House to ensure that we get it right. We will not be satisfied until the number of staff facing sexual harassment is down to zero. There must be a collective effort across our health service to enact change. Strong and effective leadership is crucial, and it starts from the top. The Government, with NHS England driving this work, are calling upon all NHS boards to sign the sexual safety charter and ensure that their healthcare settings are safe places for our current and future workforce.

I will close by acknowledging the bravery of all those women and men who have come forward with their experiences of sexual harassment and misconduct in the healthcare workforce. That includes the testimonies in the report from Surviving in Scrubs, some of which the hon. Member for Canterbury read out. It takes incredible bravery and selflessness to come forward. Thanks to those brave women, and some men, we are getting ever closer to ending the scourge of sexual assault in our health service. I thank the hon. Member for putting a spotlight on the issue today. We must not tolerate it.

Question put and agreed to.

Outdoor Recreation

Debate between Caroline Nokes and Andrew Stephenson

Wednesday 28th October 2015 Westminster Hall

[Caroline Nokes]

The hon. Gentleman is right that looking after and taking responsibility for an animal is crucial in teaching our young people skills that are not readily available in the classroom.

I thank my constituent Rob Powell, who contacted me this morning to point out the economic benefit of trail riding on motorbikes, not horses. I thought to myself, “How on earth could this be part of promoting physical wellbeing?” He educated me by explaining that motorcyclists who ride off road have lower blood pressure, lower levels of cholesterol and are less likely to suffer from heart disease if they ride their motorbike twice a week off the tarmacked road.

It is important that we find spaces that are available and accessible for different types of activity. We are lucky in Hampshire to have the country’s second highest number of green lanes available to the public, behind only Wiltshire, but it is the Government’s role to ensure that we have good networks available to ramblers, cyclists, horse riders, motorcyclists and all types of outdoor activity.

[Andrew Stephenson (Pendle) (Con)]

As president of the East Lancashire ramblers association, I congratulate my hon. Friend on raising that point. Will she join me in congratulating the Ramblers on its “big pathwatch” initiative, which is keeping an eye on the 140,000 miles of rights of way, including bridleways—this is not just for ramblers—across England and Wales?

[Caroline Nokes]

I thank my hon. Friend for that contribution. Like him, I have received emails from constituents highlighting the effectiveness of the “big pathwatch” campaign.

As might be expected, given my interests, I want to conclude by saying that we have to ensure that activity is accessible to all and is available to both genders. I hope that the Minister will commend the This Girl Can campaign, which has been reinforced across Hampshire. Our sports partnership in Hampshire and on the Isle of Wight has done a great deal to promote keeping young girls active once they leave school. The biggest drop-off in female physical activity occurs when they leave school and go to college, which is when most girls hang up their trainers and stop taking part in the team sports they took part in at school. It is imperative that we find pathways into sport for young girls. I commend the work of the This Girl Can campaign, which has made it less of a stigma to get hot, sweaty and physically active. We have to keep pushing that agenda.

Local Pharmaceutical Services

Debate between Caroline Nokes and Andrew Stephenson

Tuesday 3rd March 2015 Westminster Hall

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

It is, as ever, a pleasure to serve under your chairmanship, Mr Howarth. I appreciate your pointing out the clock to me. I might have thought I had got stuck in some sort of time warp and was forever on 7 minutes 29 seconds.

I want to put on the record my thanks to Mr Speaker for granting this debate on the essential small pharmacy local pharmaceutical services scheme, which has played and continues to play an important role in supporting small community pharmacies up and down the country. Pharmacies are an essential part of our health care system, and pharmacists play a key role in providing quality health care. They are experts in medicines and they use their clinical expertise and practical knowledge to ensure that medicines are safely supplied to and used by the public.

Over the past few years, a much greater emphasis has been placed on the role of the pharmacist. People have been encouraged to use their local pharmacy as the first port of call for the minor ailments—coughs, colds and skin rashes—that afflict us all from time to time. Pharmacists also play a significant role in programmes such as smoking cessation and emergency contraception, and they do great work with medicine reviews and in ensuring that people use their medicines properly and effectively. They play a huge role in the winter by providing flu jabs efficiently and cost effectively. If I recall correctly, my hon. Friend the Minister supported Westminster flu day last year. Your interest in diabetes is well known, Mr Howarth, and you will be aware of the important role that pharmacists play in helping those with long-term conditions to manage their diseases.

[Andrew Stephenson (Pendle) (Con)]

I congratulate my hon. Friend on securing this important debate. I am a huge supporter of the role of local pharmacies, and I am kept regularly updated about developments by a number of Pendle pharmacists, including Mark Collins of the Barkerhouse road pharmacy in Nelson and Matthew Leedam of Leedams’ pharmacy in Colne.

Does my hon. Friend agree that expanding the crucial role of pharmacies to enable them to better care for patients with long-term conditions, help people to get the best from medicines and offer people the support and advice they need to live independently and stay healthy would benefit not only patients but our local communities and our NHS?

[Caroline Nokes]

I absolutely agree with everything that my hon. Friend said. Small community pharmacies often know their patients well, so they are at the forefront of helping people to manage their conditions and know whether they are taking the right amount of medicine. They are often a useful place for people to go for an informal chat about the conditions that affect them.

Community pharmacies are at the heart of our communities. They dispense advice as regularly as medicine, and they help people to make healthier lifestyle choices. Pharmacy Voice, the organisation formed from the three largest community pharmacy associations, strongly advocated the role of the community pharmacy as part of the solution to pressures on accident and emergency and GP services. It has encouraged people to think, “Pharmacy first”, and it has described community pharmacy teams as being perfectly placed to care for patients with common winter ailments. We are coming out of winter and into spring, but pharmaceutical services are there all year round. They are just as adept at dealing with allergies, stings and hay fever as they are at dealing with winter colds.

Last year, Pharmacy Voice identified that up to 8% of A and E visits could have been dealt with by a high street pharmacy, and approximately one fifth of GP visits could have been avoided by visiting the pharmacist. Last year, NHS England reinforced the role of the community pharmacy with the “Feeling under the weather?” campaign. Many Ministers, including my hon. Friend the Minister, have emphasised in responses to written and oral questions that pharmacists have a great role to play in helping people to manage long-term conditions and in helping people with their medication.

None of the pharmacists I spoke to prior to this debate is sure when the role of the essential small pharmacy was first recognised, but I can say with certainty that the essential small pharmacy in the village of Wellow in my constituency has benefited from support, reflecting its small scale and relative remoteness from other pharmacies, since it opened in 1990. The national contract for such pharmacies was first introduced in 2006, and it has been extended a number of times since then. About 100 pharmacies receive support from the essential small pharmacy local pharmaceutical services scheme. Many are located in relatively remote rural areas, but some operate in inner-city communities. Over the years, they have provided services that have been relied upon by residents for their health care as well as their dispensing needs.

The current pharmaceutical needs assessment, published in 2011, supports the continuation of the scheme. It states:

“ESPLPS pharmacies are used to ensure that access to pharmaceutical services is achieved in certain locations in line with the model of access to pharmacy services in ‘Healthy Horizons in Primary Care’.”

Rural bus services are being reduced and it is increasingly difficult to access other pharmacies by public transport, so small pharmacies can easily be described as essential to local communities. Certainly, that is true of Wellow pharmacy.

What is the problem, and why have I requested this debate? These arrangements have existed for many years and have provided modest support for small pharmacies, where they are needed for patients, but where they might not otherwise be economically viable. The national contract was introduced in 2006, and negotiations by the Pharmaceutical Services Negotiating Committee have seen it extended a number of times. But what is an essential small pharmacy? The criteria for eligibility are that the pharmacy must be dispensing fewer than 26,400 items a year and must be more than 1 km from the next nearest pharmacy. Their benefit to communities was deemed to be so great that a minimum level of remuneration was set. It is currently just under £80,000 a year. From the pharmacy global sum, a top-up payment would be permitted to ensure the continued viability of the pharmacy. However, NHS England confirmed last autumn that it is not possible to continue national arrangements, leaving individual pharmacies to negotiate with their own NHS area teams. Support has been available from the PSNC, but many local pharmacists have found those negotiations difficult, time consuming and stressful. Although some have been successful, other area teams have not been able to provide certainty.