NHS Workforce

Claire Hanna Excerpts

Tuesday 6th December 2022 Commons Chamber

[Wes Streeting]

I totally agree, and I heard of a really awful case in Warrington the other day. A Warrington resident who contacted me said that they waited 12 hours in agonising pain in accident and emergency before giving up and going home after midnight because she simply could not take it any more. The A&E department was so packed that she could overhear other patients’ conversations with clinicians, including sensitive medical information. Those are the kinds of conditions that patients are experiencing and in which the poor NHS staff have to work. It is simply unacceptable.

[Claire Hanna (Belfast South) (SDLP)]

I thank the hon. Gentleman for being so generous in giving way. Does he agree that keeping the working environment safe is core to workforce planning, retaining the people who are trained and stopping spending eye-watering sums on agency nurses? He outlined many scenarios in which staff are forced to work in unsafe conditions. Does he agree that the core message coming from health unions is their desire to have appropriate staffing levels to provide the service on which all our constituents rely?

[Wes Streeting]

I strongly agree. In fact, I spoke to the general secretary of Unison last week. She said that as the unions look at safe staffing levels in critical services, in their determination to maintain patient safety in the event that industrial action goes ahead, they have found that on non-strike days, the NHS already operates at staffing levels below what the union would intend to operate on a strike day. That is an unbelievable state of affairs.

I am really worried about industrial action. Like patients across the country, I do not want industrial action to go ahead—it will mean ambulance delays, cancelled operations and even greater pressures on the NHS—but the tragedy is that we see the conditions that I just described every single day in the NHS. Pat Cullen from the Royal College of Nursing said, “We are striking for patients”. I have heard that line time and again from RCN members. It is partly about NHS staff’s pay and the conditions in which they work, but more than anything else, they are telling me that they voted for industrial action—some for the first time in their entire careers—because they have had enough and can no longer suffer the moral injury of going to work, slogging their guts out and going home petrified that, despite their best efforts, they still did not deliver the care that patients deserved. What an intolerable situation they find themselves in. Their backs are against the wall, and that is why the Government should negotiate.

Menopause

Claire Hanna Excerpts

Thursday 9th June 2022 Westminster Hall

[Claire Hanna (Belfast South) (SDLP)]

It is a pleasure to serve under your chairmanship, Mr Robertson, and I offer my warmest commendations and congratulations to the hon. Member for Swansea East (Carolyn Harris), who has done such a magnificent job of raising awareness and understanding of the menopause. She has ensured that many women feel heard and understood, but crucially has also galvanised change—information, services, policy, and a strategy—to normalise and support something that half of the population are going to go through at some point. Many of us share her righteous frustration about the delay in implementing many of these changes, but the conversations and actions of the hon. Member and others now constitute a real movement for change and progress in this area, so that fewer women will suffer in silence or experience anxiety and ill health.

I also commend the Chair of the Women and Equalities Committee, the right hon. Member for Romsey and Southampton North (Caroline Nokes), whose Committee is on the frontline of so many of the issues facing women, and the all-party parliamentary group on menopause that is capturing and organising all of the actions and ideas that are now flowing.

I particularly want to speak up for women in Northern Ireland, who feel that this—like other issues that affect women, women’s health and women’s lives—is an area in which we are lagging behind other parts of these islands. Over the past couple of years, primarily through the entry point of HRT supply issues, which Members have referenced, I have been engaging with constituents and others about the need for a co-ordinated approach to menopause support, one that is funded and joined up between the many Departments and areas of responsibility that have been identified today, and hopefully will be ultimately underpinned by legislation. That approach, of course, starts with awareness and understanding, which thankfully is improving as a result of many of the people in this room and others pushing the issue.

Last night, I posted on social media that I would be taking part in today’s debate. I was amazed by the number of replies from people who are experiencing challenges with the menopause and those who are just delighted by this fresh climate of support and action. Many had very developed and constructive ideas for how to improve the situation.

I am grateful to all the people who got in touch, particularly Siobhan Kearney of At One Wellbeing and Anne McGale at Menopause Wellbeing NI for sharing with me the benefit of their research and experience as practitioners. I also pay tribute to Marie-Louise Connolly, BBC Northern Ireland’s redoubtable health correspondent, who has been brilliant at forcing this issue on to the agenda in Northern Ireland and keeping it there; Members will appreciate that the policy agenda in Northern Ireland is fairly cluttered at the best of times.

Although many will experience few or manageable menopause symptoms, for some women the menopause is intense and bleak, and women often enter into it without having the right information or the right access to decisions. One woman—a robust and well-regarded professional at home—told me:

“I’m going through it. It’s something I find difficult to discuss. I’m surprised at myself but just can’t. Rotten symptoms, making life miserable. Open to HRT but due to personal and family medical history, it might be difficult. GP says I need to see specialist at the clinic in Belfast but the waiting list is 4 years...It feels like a death sentence, bringing back trauma about family and my own medical conditions, and my physical symptoms make me feel like a stranger in my own body which is attacking me. It feels like a death sentence, there is no escape.”

I found that really difficult to hear from somebody I regard as strong and confident and able to articulate herself well. I feel so much for others who may be unnecessarily going through this situation in the dark, without knowing that there is a definable cause and without knowing that there are things that can be done to help them. I also heard from other women who had been in a very difficult place but who now, having received the right support, are on the other side and desperate to ensure that other women need not fight the same battle that they have.

The dearth of appropriate services is a core problem. Although many GPs have been brilliant, and able to guide and advise their patients, we know that primary care is overwhelmed and under-resourced. Many people cannot get access to their GP, or there is inadequate continuing professional development and education for GPs on this issue, and insufficient time for them to explore and pinpoint some of the issues, so that they can holistically address them. Then, of course, there are few or no specialists to refer to. Enhanced specialist clinics now available in the south of Ireland. There are two in Northern Ireland, but the majority of NHS trusts do not have one, and I have already referred to the long waiting lists.

We know that many doctors are either not sold on HRT or are cautious about complicating factors, and people often tell me about the pushback that they have experienced. I am not sure whether other Members are watching “Borgen”; if they are not, I warmly recommend it, as it is an excellent series. I was struck, while watching the new episodes on Sunday night, that the brilliant character of Birgitte Nyborg, a former Prime Minister and former Foreign Minister, had a scene in which she explained her menopause symptoms and the impact they were having on her work. I was struck by her being, I suppose, brushed off. I mean, medical reasons were discussed, but I thought it was telling that a woman with all of that character’s powers of communication also felt unable to access the services that we need.

Numerous constituents report feeling brushed off or—of course—being offered inappropriate antidepressants. Members have addressed the acute problems caused by shortages of HRT drugs and I ask the Minister when the HRT tsar is expected to be able to report. That issue is causing real concern for people who are worried that, having finally found this solution to their problem, it will suddenly drop. I am hearing of people sharing medication, which obviously brings its own complications.

Menopause is also very much a workforce issue. Currently, about 9 million women in the UK are experiencing or will experience the menopause, and around 3.5 million of them are in the workplace. Policy is not in place to support and protect those women, who might be experiencing some of the symptoms that have been referred to here today, including tiredness, anxiety, brain fog, mood swings, headaches, joint pain and the spill-over effects from things such as insomnia and relationship challenges that the menopause can exacerbate.

There is no policy in place to protect and retain the huge skills and experience bank that these women offer. Other Members have referred to the point in people’s lives and careers when they are particularly valuable for the workplace, so the menopause is also an economic issue. If more women have to leave the workforce, that will exacerbate existing issues such as the gender pay gap. We are all increasingly aware of the benefits for public policy, decision making and economic activity when women are at the table. We know that childbearing and caring responsibilities mean that many women are deleted from that area of their lives and face marginalisation and exclusion later in their careers or soon after.

A growing number of employers are taking the issue very seriously and putting policy and guidance in place, but that is far from universal, perhaps due to lack of awareness, embarrassment, or not understanding the relevance. Workplaces need guidance and, in time, legislation to ensure that that guidance is in place. They also need support. Some practitioners have developed a really good skillset and go into workplaces big and small.

Menopause is an economic issue and an equality and public health issue. We need to normalise all aspects of women’s health so that they can be addressed like every other health and wellbeing issue, so that people do not feel alone, inadequate, confused or unprepared, and so that they feel empowered to make choices, whether about their lifestyle or medical support, to help them walk this path.

In her excellent speech, the right hon. Member for Romsey and Southampton North was right to say that this is not an ideological issue, but there is no doubt in my mind that if men experienced a similar, universal change, it would be a massive part of political discourse and culture. I can imagine all the movies and books that would be made and written about this time in life. Given that issues such as menstruation, women’s reproductive health, low-paid care work, the pension changes experienced by WASPI women, and childcare primarily affect women, they do not reach the top of the policy agenda. We need to address that.

We also have an opportunity to establish menopause as a rite of passage—hopefully, a rite of passage to a stage in a woman’s life when they are valued for the benefits, talents and wisdom that come with having lived decades of life. I commend the motion, the work and all the policy suggestions that have been made here today.

Irish Diaspora in Britain

Claire Hanna Excerpts

Thursday 17th March 2022 Commons Chamber

[Claire Hanna (Belfast South) (SDLP)]

I am very grateful for this opportunity to take part in a debate to celebrate the contribution of the Irish in Britain and the very deep bonds of friendship and neighbourliness between our two islands. The other quote I remember from Edmund Burke was when he said that, for most English people, their ambition about Ireland was to hear no more about it, but I thank all the Members participating today for having a much wider ambition.

It is a pleasure to follow Members from across the House who have done so much to honour and deepen the contribution of the Irish to the fabric of Britain. In particular, I thank the hon. Member for Rochdale (Tony Lloyd) for securing this debate and the others who have spoken. I also thank the hon. Member for St Helens North (Conor McGinn) who played such a key role in events yesterday and who has exemplified and represented the Irish in Britain for many years with inclusivity, practicality, confidence, wit—lots of wit—and stories, and we are very proud of him for it.

It was not always an easy landing for Irish people in Britain. We know that many faced discrimination and isolation, but Britain, and England in particular, provided refuge, acceptance and opportunities for people who, in many cases, had been rejected by Ireland. Perhaps that was because they were pregnant, because they were gay, because they were different in some way or because there was no work for them. Ireland, to our great shame now, pushed out many unwanted people to England, who then found acceptance, solace and opportunity here, and for that we are very, very thankful.

Irish people and their descendants have not only found a good home in Britain; they have helped to make it a good home for other people. The work of Irish people across all classes of work, skills, vocations, talents, enterprise, creativity and service is rightly a source of pride—from roads and buildings in decades past to those at the very top of industry and the creative sectors today, and throughout many decades and very much during covid’s curtailments, within the National Health Service. It was lovely to see that represented and celebrated in the parade at the weekend.

As a result of that contribution and mutual support, I have no doubt that the Irish centres and networks in Britain will be stepping forward to offer support, service and space to Ukrainian refugees in their time of need. While the common travel area privileges the Irish in Britain and the British in Ireland, as befits our close neighbourly relationship, the Irish stand in solidarity with others across the world who have had to leave their homes because their home was not safe or because they could not make a life there. We know how it feels to be cast at times as a suspect community, and to be at the bottom of the pile. That experience is reflected in the internationalism of the Irish community and the support that they offer to migrants and minorities from elsewhere.

The deep integration of Irish people on this island has not come at the expense of pursuing distinctive Irish sports, traditions and arts, which, as others have mentioned are flourishing. Indeed, in many parts, British TV presenters and journalists frequently claim some of Irish people as their own. The only surprise is that our current Home Secretary has not spotted British citizenship being conferred on people and come down on it like a house of bricks.

Fosta, Seo Seachtáin na Gaeilge, coicís go deimhin, agus tá imeachtái ar fud an tír, agus ar fud an domhain a thugann faillí dúinn cultúr, teanga agus oidhreacht na hÉireann a cheiliúradh. Indeed, what better opportunity than this to celebrate Seachtáin na Gaeilge, Irish Language Week, which is taking place now and is an opportunity to celebrate Irish language and culture across the island and across the world.

Irish people in Britain are a strong thread in British-Irish relations and a critical part of the ethos and architecture of the Good Friday agreement. John Hume always saw, and the Social Democratic and Labour party to this day have always seen, those three strands of the agreement as interdependent, indivisible and mutually reinforcing. Cherishing and nurturing the strand 3 relationship is core to the role of SDLP MPs taking up our mandated place in this House. That is something we take very seriously.

As others have said, the conflict playing out in Ukraine reinforces the need to protect what has been the most successful peace and reconciliation project in generations. It is a fact that the violence and at times the depravity of the troubles—all of it, and all that went before it—drove a wedge between people that has been difficult to bridge, but it is precisely because of those painful aspects of our history that we must continue to work to deepen and maintain friendship, co-operation and reconciliation, to put that cycle of mistrust in the past and to realise the reciprocal benefits of cultural, personal and trade ties. It is a statement of fact that a strong, pluralist Britain is in Ireland’s interests and vice versa. Nothing will change that.

Thanks to the Good Friday agreement, Irish people here have been able to step forward even more. We encourage them to keep doing that and not to be afraid to lead in British-Irish relationships at the many cultural, social, business and sectoral levels where they provide a natural nexus.

We live in the shadow and the shelter of each other, as President Michael D. Higgins acknowledged during his historic state visit and address here in 2014. Confident in our relationship as equals and with mutual interest, we can

“embrace the best versions of each other”.

The Irish in Britain are doing so every day; many are moving on from the traditional binaries of the past and embracing the “or both” part of the Good Friday agreement, not feeling that they have to decide between being British and Irish if they do not wish to do so. The tensions of the past five years, as the hon. Member for Rochdale said, are probably a topic for another day—indeed, we probably do talk about them every other day of the year, so I am happy to park them for today.

Though our relationship has been turbulent in the longer past and in the recent past, it can and should be mutually beneficial, warm and reconciled. I say thank you to the Irish people in Britain and the British people in Britain and in Ireland who make that so and wish everyone a happy St Patrick’s Day.

Abortion Services Commissioning: Northern Ireland

Claire Hanna Excerpts

Tuesday 14th December 2021 Westminster Hall

[Claire Hanna (Belfast South) (SDLP)]

It is a pleasure to serve under your chairmanship, Mr Pritchard, and I thank the hon. Member for Pontypridd (Alex Davies-Jones) for securing this debate. The issue of abortion in Northern Ireland is challenging for many people. Many of us, myself included, have had to go on a real journey of compassion and learning over several years. I am very aware of the sensitivities around it and of the strongly held views. However, it is very clear that there is nobody who this affects more, and nobody that this is more distressing for, than women and girls.

As with many issues over the years that the Executive found too hard to deal with, the changes in Northern Irish law were brought about via interventions from this place from Members of the Opposition. The inadequacy of the previous regulations was very clear for many years. Many women had to go to court and relive the most distressing experiences, in order to build momentum and support for change. This is in many ways a rule of law issue. Despite what other Members have said today, without a plebiscite, we do not know exactly what every single member of the public thinks in Northern Ireland. However, I would be very surprised if any Member could tell me, with a straight face, that a majority of people support the previous provisions under the Offences Against the Person Act 1861, which carried a sanction of up to life imprisonment for those involved in an abortion—regardless of the circumstances.

Whatever people have to say about how they came about, these regulations are the law; this is a rule of law issue and it is entirely inappropriate that these services have yet to be fully commissioned. We are all very much aware of the pressures that the health service and health professionals are under. However, if we are honest, we know that healthcare and health service pressure is not at the core of this issue. We also know that it is not acceptable to duck our responsibilities and force women to travel to Britain—especially in a pandemic.

People know, in their heart of hearts, that to deny these services is simply exporting the issue. They know that this legislation does not actually reduce the number of people who require an abortion; it just has the impact of making a stressful situation even worse for those who are going through it. Despite the pandemic, we know that 371 women and girls still travelled to Britain for abortions, which by law, they should have been able to access in Northern Ireland. We know that many others had to resort to unregulated abortion pills—with all the potential health and legal complications that would result from that.

I am a deep believer in devolution, and it is a matter of regret to me that the Executive failed to commission services in line with their legal obligations. It is also a matter of regret to me that in 23 years, to the best of my knowledge, the Executive have not delivered any piece of equality legislation. Those who believe they are holding some imaginary line should realise that in fact, they are growing the belief among many people in the centre ground in Northern Ireland that the only way they can have the rights and entitlements they wish to have is by changing the constitutional paradigm.

Tomorrow, we will be back in this Chamber discussing the impact of Brexit in Northern Ireland, and there are Members who will rehearse in that debate a very uncompromising position about the need for there to be no divergence whatsoever between Britain and Northern Ireland. As recently as yesterday, the Democratic Unionist party leader repeated his calls to bring down the Assembly over the principle of divergence between Britain and Northern Ireland. The mantra is that there can be no divergence in Northern Ireland—that everybody in Northern Ireland has to have the right to exactly the same sausages as people in Britain have—yet they are willing to fight and stand against people in Northern Ireland having the right to the same healthcare services as those in Britain. The prospect that many more women will be forced to either travel or go to court in order to change the current situation is cruel and distressing.

I will briefly reference the Severe Fetal Impairment Abortion (Amendment) Bill, which in a weird echo is being debated in the Assembly as we speak, and which targets some of the most distressing cases of women seeking an abortion. Those cases are incredibly rare—less than 0.1% of abortions, as I understand it—but that Bill has still invited hours and hours of discussion by MLAs about the plight of those women. By all credible assessments, the Bill is legally incompetent and unlikely to receive Royal Assent. It is found by many disability campaigners to be a fairly cynical and exploitative move that undermines many of the efforts that are being made for people with disabilities, and I believe it is effectively a campaigning opportunity for some people to play out the most distressing experiences in the lives of people who, in nearly all cases, are facing a heartbreaking diagnosis after a much-wanted pregnancy.

The hon. Member for Pontypridd has also referenced the safe spaces—the exclusion zones. While abortion is a conscience matter for the Social Democratic and Labour party, that is a piece of legislation that we are all strongly in support of, and I welcome the ruling of the Human Rights Commission that it does not diminish the right of people to protest if they so wish.

In conclusion, the issue of abortion is not something that I take lightly. I know that many people who have arrived at a different position than I have arrived at come from a place of sincerity and compassion, but I also have no doubt that the decision that many women take requires the same level of compassion and dignity, and it is long past time that we make available the services that the law provides for them. There are clearly wider conversations to be had about how we can improve the circumstances of people who are faced with these sorts of choices, such as more adequately securing people’s belief that the state will meet their needs and support them if they are dealing with a very disabled child, because that is not the case at the moment. I am sure that every Member of this House meets families who are living a hell, given the inadequacy of the services that are provided to their families. Perhaps if those services were more comprehensive, people would not feel that abortion was the best choice for their family.

We also fully support better reproductive services, better education, and better information around relationships and consent in school—all the things that we should do to reduce the number of occasions on which people feel abortion is the only choice for them—but quite clearly, for those who do, that is their choice, and the services should be there to meet that choice.

Long Covid

Claire Hanna Excerpts

Thursday 14th January 2021 Commons Chamber

[Claire Hanna (Belfast South) (SDLP) [V]]

I thank the hon. Member for Oxford West and Abingdon (Layla Moran) for bringing about the debate, which will bring at least some comfort to some of those dealing with the effects of long covid in isolation, without access to some of the NHS support that we hope they will be able to access in the future.

We know so much more about the disease now than we did at the beginning of the pandemic, including that it is not only a respiratory disease but can be a multi-system disease, which makes it even more regrettable that some persist with the false narrative that covid only affects the vulnerable. Not only is that dehumanising and dismissive of older people and those with long-term conditions, but it is also false; statistics are coming through of many people who were previously young, fit and healthy who are now experiencing these lingering symptoms more than a month after the acute phase of their illness. Members have outlined many of those symptoms, and we are seeing research from other countries about the lingering impacts and about how these compare with previous severe acute respiratory syndrome epidemics.

Members have also laid out some of the necessary courses of action on guidance and ongoing research so that those experiencing long covid can have access to a pathway. Currently, certainly in Northern Ireland, in the absence of formal definitions, there is no recording, and therefore there will be no tracking of those affected. Extrapolating from the wider numbers of those who have contracted covid, we anticipate that around 9,000 people in Northern Ireland may be experiencing long covid. That is in the context of already horrendously long NHS waiting lists. For example, we already have 20,000 people waiting for a first neurology appointment. People seeking long-term care will be added to these lists.

The key point for Members is that an adequately funded and staffed NHS is key to caring for these individuals and others in the long term. Years of underfunding have been laid bare as the NHS struggles to cope with the peaks of the pandemic. We owe it to those who have contracted covid and those who are living with long covid and other long-term conditions, and crucially to NHS staff, to ensure that it is never again left in such a perilous state.