(5 years, 3 months ago)
Commons ChamberI will absolutely look at the matter raised by my hon. Friend, as it is alarming and distressing to hear about it. Amazon sells physical goods for the most part and surely has a duty of care to those who buy them, in the same way that a shop has a responsibility for what it sells. My hon. Friend makes an important point, which I will follow up. I will write to her with more details.
I, too, welcome the statement by the Secretary of State, not least because I survived measles as a very small child and my family talked for a long time about how worrying and scary it was. On the other issue, as well as taking action against the social media companies, the long-term NHS plan talks about an increase in proportionate spending on child and adult mental health services. What will he do about that? What will the proportion be? I ask because it is crucial to fighting this problem.
The hon. Lady is absolutely right that there will be an increased spend on mental health services across England—a £2.3 billion increase. It is the fastest-growing area of spend in the long-term plan. We are investing £33.9 billion in the NHS in cash terms, and the fastest proportionate rise in spend is in mental health services. That is an important part of this, although there is an awful lot that the social media companies can do to reduce the demands on those services by reducing the negative impact on mental health. The whole House can agree that the hon. Lady being alive and here, having survived measles, is another reason why it is important to get this right. It would have been the House’s loss had the measles won.
(5 years, 4 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Yes, I think that is exactly the right approach and it is what we are working towards.
I thank the right hon. Member for Hemel Hempstead (Sir Mike Penning) for raising this important issue, which affects one of my constituents, Murray Gray, directly. His mother is one of those parents who is now desperate, having been given hope.
Does the Secretary of State agree that we have the evidence from abroad that these medicines can work and we have the willingness of everybody in this House to make it work, but somehow there is a gap between our willingness and our ability to make it happen? Will he assure the House that he will speak to the Home Secretary and to the devolved Administrations who have NHS responsibility to try to get some kind of action through co-operation to reassure the parents who are desperate not just because their children will suffer but because they may not survive?
Yes, of course; I am very happy to do that. Perhaps I should take this opportunity to welcome the new public health Minister, the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for South Ribble (Seema Kennedy) to her post. She will, no doubt, have listened to all the questions today. She and I will be working on making this happen.
I would add to the hon. Lady’s list, because this is not just about the Home Office and the Department of Health and Social Care; it is about making sure that the independent medical establishment has confidence in the evidence that is presented. It is not enough for her and I to have confidence as lay politicians; it is important that the professionals who put their signature on the line have confidence in the evidence as well.
(5 years, 6 months ago)
Commons ChamberIt is unusual, but I am delighted to be able to agree with the thrust of the hon. Gentleman’s question. As he knows, we both come from Nottinghamshire mining stock, and it is surprising that we do not agree on more, but we do agree on the importance of having a properly funded NHS. That is why we have put the largest ever, longest ever cash injection into the NHS, because we care that it should be fit for the future.
Poor air quality is the largest environmental risk to public health in the United Kingdom. Long-term exposure to air pollution can cause chronic conditions, such as cardiovascular and respiratory diseases, as well as lung cancer, leading to reduced life expectancy. It has a particular impact on children as they grow. There is evidence to suggest that the process of normal lung function growth in children is suppressed by long-term exposure to air pollution.
In Edinburgh West we have two of Scotland’s most polluted roads, St John’s Road and Queensferry Road, according to recent figures. Studies show that if someone lives with 75 metres of any major road as a child, they have a 29% increased risk of lifetime asthma. Given that across the country there are 2,000 nurseries close to roads with dangerously high levels of pollution, what action can the Minister assure us is being taken, along with counterparts in Scotland and in the Department for Environment, Food and Rural Affairs, to tackle this on a UK scale?
(6 years, 6 months ago)
Commons ChamberI thank my right hon. Friend for that intervention. I think he must have read my speech, because I will be talking about the prevention of type 2 diabetes, and how important it is that we are aware of that and also make the population aware of the measures they can take.
There are more people living with diabetes in the UK than with any other serious health condition—more than dementia and cancer combined. The complications of diabetes are many. They include eye, foot and skin complications; anxiety and depression; hearing loss; gum disease; neuropathy; infections; slow wound healing; strokes; heart failure; heart attacks; lower limb amputations; renal problems; and early death.
The diabetes crisis is one of the fastest growing health crises of our time. As the hon. Lady says, the physical consequences are well known, but recent research by Diabetes Scotland has shown that the stress, isolation and trauma of managing an invisible but life-threatening condition can have serious implications for a person’s emotional wellbeing. Does she feel that we need to look at offering support and increased provision of psychological support for diabetes sufferers?
I will not give a commitment at the Dispatch Box, but I know the JDRF well. I have supported it in my constituency through various events, including the Alresford music festival, which I am sure the right hon. Gentleman is familiar with. I will take a look at what he said and if he wants to chat to me offline about that, I would be very happy to do so.
The diabetes prevention programme has been mentioned. Wherever possible, the aim is to prevent type 2 diabetes from developing in those most at risk. I am proud to say that NHS England, Public Health England, for which I am responsible, and Diabetes UK have had some success working on the NHS diabetes prevention programme—the first such programme that we have delivered at scale nationwide. I know that a lot of other countries are looking at what we are doing.
The programme is putting in place support for behavioural change in people who have been identified by their GP, or through the NHS health check, as being at high risk of developing diabetes. Individuals can then get tailored, personalised help to reduce their risk of developing the condition, including bespoke exercise programmes and education on healthy eating and lifestyle. It is incredibly positive.
I am aware of the time, so I will move on to treatment and care programmes. After successfully securing significant new investment in diabetes through the spending review, NHS England has developed a diabetes treatment and care programme, which is aimed at reducing variation and improving outcomes for people living with diabetes. As part of that, NHS England will invest £42 million in proposals from individual CCGs, collaborations and sustainability and transformation partnerships to improve the treatment and care of people with diabetes.
I will not take another intervention, because I will conclude in just a second. The spending review made provision for significant transformation funding through to 2020-21, and I expect that to be spent in line with the priorities set out in NHS England’s mandate, including for diabetes.
We have talked about the childhood obesity programme and the national diabetes prevention programme. I am responsible for other public health initiatives, such as Change4Life and the One You programme. People like me with young children will see the Change4Life branding coming through in book bags for them. It has been an incredibly successful campaign. The programmes are crucial in both encouraging a healthy lifestyle and promoting exercise among young people, as are such things as the Golden Mile, which is almost universal in primary schools across England. The benefits of such programmes should be acknowledged in reducing not only the incidence of diabetes, but other debilitating and life-threatening conditions such as cancer and heart disease, in which I also have a great interest.
(6 years, 10 months ago)
Commons ChamberWe have all seen the figures about everyone getting older. If we look over the lifetime of the NHS from 1948 to the predictions for 2030, we see that the number of people over 65 will double and the number of people over 85 will increase by 10 times, yet the number of funded places for care has gone down by a quarter. Those two things simply do not match up. As the Minister mentioned, those under 65 with disabilities or learning disabilities are also, thankfully, living longer. The problem is to provide them with care. As a doctor, I obviously tried to do my little bit for people living longer. We should not look at this as a catastrophe; we must celebrate it. We are all heading there, so it is in our own vested interest to ensure that the services will be there for us.
We know that a lot of people’s state of health in older age is laid down in the early years. In Scotland, we are focusing on the early years collaborative—from the baby box for every newborn child, the 30 hours’ early learning entitlement, doubling active transport and rolling out through schools what is called the daily mile. However, we will not get a financial return on that for 50 or 60 years, so we must also invest in our older citizens. In Scotland, we are trying to expand elective services to meet the demand for operations on hips, knees and eyes, but the King’s Fund reports that hip and knee joint replacements are being rationed, and we know that three quarters of trusts have set such strict limits on accessing cataract surgery that people are, in essence, losing their sight, and certainly losing the ability to drive, with half of the trusts fixing only one eye.
Doing such things means driving people into their own homes and into isolation, as well as increasing their need for care and increasing the speed, or lowering the age, at which they need care. It really does not make sense. Age UK points out that 1.2 million people are not getting the care they need, and that matches almost exactly the 1 million family carers who are actually providing the bulk of the care required. In Scotland, we have already committed to raising carer’s allowance from £60 to match jobseeker’s allowance, but that is pretty paltry for someone working, in essence, seven days a week, while 40% of them are reported not to have had any respite or break in a year.
Such a situation arises because the statutory system is not supporting carers, and we need to look at this. Care homes are closing because of the extra costs brought in by the national living wage, and part of that is simply because the price paid is being driven down. As has been mentioned, over half of local authorities are seeing either home care providers or nursing and care home providers closing. The thing is that we need to pay people a decent wage—not the national living wage, but the real living wage. This needs to become a profession that attracts and retains people. Who would we like to look after us or our mother or father—someone who is doing it only for six months until they can get something better, or someone who actually believes in looking after our older population with the greatest possible love, care and dignity?
We need to put in the funding. The Minister talked about the better care fund, which has indeed put in extra money, but that is at the cost of the new homes bonus in England, while local authorities are also being told to build more houses. What are they meant to do? We need to put this on a sustainable footing. We also need to address the issue of those under 65. In Scotland, our programme for government includes a commitment to the under-65s with what is called Frank’s law, in honour of a football player from Dundee who developed early dementia. We have people aged under 65 with the same needs—those with early dementia, multiple sclerosis or motor neurone disease. Why should their birth date dictate whether or not they get help?
The hon. Lady is painting quite a rosy picture of the social care system in Scotland, but does she not accept that it has serious problems as well? In my constituency, I know of a gentleman who was in hospital 150 nights after he could have been transferred because no care package was in place. Freedom of information inquiries have shown that people have spent 400 nights in care when they could have been transferred. Does she accept that the picture in Scotland is not entirely rosy?
I totally accept that the position is not entirely rosy. I said many times in the Chamber before the hon. Lady entered the House that we face the same challenges. Those challenges are increased demand, workforce needs—they will be made significantly worse by Brexit—and the fact that money is tight. We face exactly the same challenges. Some of the patients she refers to will have had particularly complex needs that it was a struggle to meet. We are talking about the fact that we are funding free personal care—it is not based on means-testing—and we are working towards providing it for under-65s.
Everything happening in England at the moment will seemingly be solved by the sustainability and transformation plans, yet they have been set backside forwards, with designers having to work backwards from the budget line, which is made the predominant thing. That will not produce the desired result, and it must be recognised that supporting people at home and in the community is desirable in its own right. None of us wants to be stuck in a hospital or in a care home if we could be looked after in our own home; that is the choice we would all make. That will not necessarily cut the money required by a hospital. The nurses will still be there, the lights will still be on. What it might mean is that that bed can be more effectively used and waiting times for surgery or other treatments can be achieved, and they are not at the moment.
On the news yesterday, there was talk about the inefficiency of operating lists, and the former president of the Royal College of Surgeons clearly said that this comes down to beds. The number of beds in England has been cut in half over recent decades, and the problem is that if a patient cannot be put in a bed before or after the operation, the operation cannot be done. That is often discovered only the day before, and we cannot just drum up another bed.
All sorts of things, not just delayed discharges, are driving inefficiencies within the system. The thing generating the biggest pressure on the NHS has been the cuts in funding to social care that mean that by 2020 in England a funding gap of more than £2 billion will have to be met. We all want to look forward to a dignified older age. We hope that we will be independent and healthy. We need to invest in that, yet public health spending has gone down 5%. Should we need care, we will also want care that is dignified and decent. That has to be funded.
Thank you, Madam Deputy Speaker, for allowing me to speak in this important debate. With the 70th anniversary of the welfare state approaching, it is appropriate to reflect on its promise of care from the cradle to the grave and to say that, in this country at the moment, we are perhaps getting that wrong.
We have heard much about the problems with funding and the delays in transfers. Perhaps the most important thing we can do, apart from raising money by putting a penny in the pound on tax as my party advocates, is to stop treating social care and the NHS as a political football. Perhaps it is time that we establish a cross-party health and social care convention to carry out a comprehensive review of the longer-term sustainability of the health and social care finances and workforce and the practicalities of general integration. Perhaps that way we might see a more efficient social care system that is fit for purpose.
(7 years, 1 month ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
That would be the normal procedure, so yes, I can give that commitment.
Will the Secretary of State assure us that, in the responsibility of this inquiry, there are real powers, which will enable the inquiry to ensure that it has proper access to all the witnesses and documents necessary? That will be vital to developing a just settlement for all those affected and their families. Can we also have an assurance that a fair financial system will be in place to support them, because this could take some time?
We are really looking to settle that question in this consultation. One decision that needs to be taken is exactly what shape the inquiry should take. Clearly, we would normally do this through a statutory inquiry, which would have the powers to which the hon. Lady referred, but equally, Members of the House have made representations that we should have a Hillsborough-style inquiry, which, by definition, would be more fleet of foot. One reason why we are pushing forward with this consultation is to get exactly that feedback, so that we put together an inquiry that inspires confidence among those who have been campaigning for this for so long.