Mental Health Act 1983

Debate between Dan Poulter and Sarah Newton

Tuesday 11th July 2017 Commons Chamber

[Sarah Newton]

My hon. Friend makes a very good point and he will be pleased with recent legislation that has reduced that timeframe from 72 to 24 hours. That is a big step forward. Whether an incident happens in a public place or in someone’s home, we are working towards a situation where a mental health professional will be with the police when they attend. That means that there will be no delay similar to that described so vividly by my hon. Friend. I think that some of the examples he gave happened some time ago. As a result of investment, particularly in the work of the crisis care concordat, which has created the framework for police forces to work with mental health services in their community, all kinds of innovative measures have been introduced to ensure that resources, including mental health nurses routinely working with police officers on the beat and specialist back-up to deal with situations similar to those we have heard about this evening, are planned and delivered locally. That is how we want things to happen.

As I have said, we are putting the resources in place. Although these services are working in most of the country, additional investment is being provided where that is not the case. There is also support through the crisis care concordat to fill those gaps and to ensure that everyone everywhere has the same experience.

[Dr Poulter]

My hon. Friend is making some thoughtful and good points about the extra resources that are going in to support people with a mental illness. On section 136 powers, the mental health professional who accompanies the police is often a nurse, and they do not have powers to section people. A section 12-approved doctor who accompanies the police, however, does have powers to section people, and the same is true under sections 2 and 3 of the Mental Health Act. I think that is where my hon. Friend the Member for Mole Valley (Sir Paul Beresford) is coming from.

[Sarah Newton]

I thank my hon. Friend for his contribution. The point I was trying to make is that a range of health professionals are working alongside the police in different settings to make sure that their response is appropriate. Sometimes it is mental health nurses who will be on the beat with police officers. My hon. Friend the Member for Mole Valley said that the police were called because somebody was in a very aggravated and stressful situation and they might have been prepared to take their own life. A call handler at the emergency centre would triage that situation, understand its severity and send the appropriately qualified medical professional so that they can make those decisions.

I think we are largely in agreement on the progress we have made. I want to focus on my hon. Friend’s key point, which is that he does not think that the police have sufficient powers to act quickly in relation to people in private homes who are mentally distressed. I have read through his previous contributions and I am sympathetic to his point. I appreciate how utterly frustrating it must be for police officers who find themselves in a situation where they feel helpless to take action in a reasonable amount of time when they would have those powers if they were in a public place. Having read previous debates and contributions, however, I think it is right that we consider somebody’s home differently from a public place. For most people, their home is their refuge. It is a special place. We allow people to do all sorts of things in their homes that we do not allow them to do in a public place. We have to reflect carefully before taking more powers on the state to allow us to intervene in people’s private space. We seek to strike the right balance so that we can intervene to keep people safe and ensure that they get access to services without violating their privacy. We have consulted quite widely on the matter, and we considered it when we were looking at a review of the legislation. There was a lot of discussion about it, and the view was that we had struck the right balance and did not need to take the extra step that my hon. Friend wants us to take.

New powers have been introduced, as I mentioned, in the Policing and Crime Act 2017, and we are monitoring how they are working. I reassure my hon. Friend that if that monitoring suggests that we can or should do more, we will take further action. We expect to see a lot more data from the police this autumn about how sections 135 and 136 are implemented on the ground. We will be analysing the results of a new annual data return to establish whether there are any new trends or patterns that need further response. We will have the opportunity to consider the whole issue in the round as we look, as promised, at the Mental Health Act.

I am happy to meet my hon. Friend and any other colleagues who have a close interest in this policy area, along with Professor Rix and officials from the Department of Health and the Home Office, to make sure that we have this absolutely right. We want to join up mental health professionals and police professionals appropriately to prevent the sorts of situations that we have heard about this evening. I look forward to building on the good progress that we have made, and I will continue to work well with my hon. Friend to make sure that that happens.

Question put and agreed to.

Oral Answers to Questions

Debate between Dan Poulter and Sarah Newton

Tuesday 24th February 2015 Commons Chamber

[Dr Poulter]

There is certainly a lot of benefit from having general practice co-located alongside A and E so that people with more minor ailments or concerns can be seen by GPs. That can often take the pressure off A and E services, but more senior expertise is also on hand when required.

[Sarah Newton (Truro and Falmouth) (Con)]

Will my right hon. Friend update the House on what steps he is taking to prevent avoidable deaths from sepsis?

GP Services

Debate between Dan Poulter and Sarah Newton

Thursday 5th February 2015 Commons Chamber

[Sarah Newton]

My right hon. Friend makes a good point. The plan that NHS England has put forward is about shifting resources from the acute emergency care sector into primary care sectors, especially GP practices. The point that he makes about flexible working fits well with my point about enabling more women to stay in the NHS or to return to it. Many walks of life are addressing the issue of enabling women to combine their caring responsibilities with their desire to play a full part in society, whether that is in public service as a GP, as a Member of Parliament or in business. Much more work needs to be done by the NHS to look at ways to enable women to combine caring for children or elderly parents with being a GP or fulfilling other roles in the NHS.

Women often take a break to look after their families—it is something that I did myself—and it can be difficult for women in their late 30s or 40s to find the ladder back into their previous careers and occupations. I note that many former GPs could make excellent GPs again if they were given the opportunities to retrain and reskill. They could contribute enormously, through working flexibly, to enable GP practices to open more hours.

[Dr Poulter]

My hon. Friend makes an important point. I hope that she will welcome the opportunity we may have to revisit the issue of the annual performers list. At the moment that means that if a GP is out of practice for a year, it is very difficult to return. That is something that we need to address, and I hope that she will be supportive of the Government’s efforts to address it with NHS England.

[Sarah Newton]

I welcome the Minister’s intervention. That sounds like an excellent initiative and I am sure that more will follow, because we need to use the talents of everyone in our nation to address the challenges that we face. Women can play an enormously important role in the NHS, as they can in all other walks of life.

--- Later in debate ---

[Dr Poulter]

The hon. Gentleman and I do not often agree, but I agree with him on this. We have to do more to support medical students and to encourage people from all backgrounds to become medical students. It was a sad indictment of the previous Government that social mobility into many degree courses was falling, and that was particularly the case in medicine. We have been working with the medical schools to look at the importance of early engagement, supporting people from a much younger age, and universities engaging with local communities, as is the case at my medical school, Guy’s, King’s and St Thomas’, where people from more deprived backgrounds are supported and encouraged into medicine by the medical school’s engagement with schools and with pupils from an early age. That is the sort of approach that works.

One of the challenges is the distribution of medical schools and medical places often around our larger cities. The challenge is to support smaller and important medical schools, such as Lancaster, which does a great job of supporting local young people to become medical students and then into medical careers. We need to support those universities to expand where that is appropriate. Many of our traditional models of medical training at medical schools tend to focus from day one on encouraging people to become surgeons. We know that we need to support more people to become general practitioners. What works well and what Lancaster and Keele universities in particular do through their syllabus is to encourage more young people to undertake more placements in general practice. That has a good effect in encouraging those medical students to want to become GPs in their later medical careers.

[Sarah Newton]

Does my hon. Friend agree that the university of Exeter medical school at the Royal Cornwall hospital is an important medical school because it enables people to see general practice in remote rural communities? We know from previous contributions to the debate that that is important in attracting people into remote rural areas.

[Dr Poulter]

My hon. Friend is right. I spoke to medical students and those teaching them in Cornwall on a visit earlier this year. It is important, particularly for rural areas, to encourage more placements in rural areas in general practice. Often at my hon. Friend’s medical school and other medical schools in remote rural areas, there is a good track record of recruiting more local young people so that they are being educated locally. The hope is that those people will stay and work in the local work force and contribute to the local NHS after they graduate. I hope all hon. Members will agree that that is a good thing, particularly in more deprived areas.

I must make progress as I do not want to intrude upon the House’s time for too much longer. There are two or three important points that I want to make. I mentioned that in the health education mandate in 2014 we mandated to increase the number of GP trainees from 40% to 50% of all trainee doctors. That will make 5,000 extra GPs available by 2020. It is important to note, however, that as well as having the appropriate size work force, we must plan for the future shape of the work force. The new models of care set out in the NHS England “Five Year Forward View” will require different models of staffing, and we need to plan with that in mind. That is why Health Education England has established an independent primary care work force commission, chaired by Professor Martin Roland of the university of Cambridge.

In line with the contributions to the debate from a number of hon. Members, including my right hon. Friend the Member for Sutton and Cheam (Paul Burstow), the commission will identify models of primary care that will meet the needs of the future NHS, including a greater emphasis on community and primary services and the more integrated delivery of care, which will involve the better use of multidisciplinary teams. We have been talking about GPs today, but delivering better care in the community is also about nurses, physiotherapists, occupational therapists, pharmacists, speech and language therapists and the many other health care professionals who play a part in delivering high-quality care to patients in general practices and in the community every day through our NHS.

In response to concerns raised by hon. Members about access to services, GP services need to be available to patients in a convenient place and at a convenient time. Achieving improved access to general practice not only benefits patients, but has the potential to create more efficient ways of working, which benefits GPs, practice staff and patients. The previous Government attempted to improve access to GP services by establishing a 48-hour access target. We know now that that target did not work. From 2007 to 2010, the proportion of patients who were able to get an appointment within 48 hours when they wanted one declined by 6%.

A 48-hour target can make it more difficult for some of the more vulnerable patient groups who GPs look after, particularly people with complex medical co-morbidities, to get the important routine appointments that they need. We should bear in mind that targets can be perverse. That target did not work in its own right, and could make it more difficult for people with complex needs and the vulnerable and frail elderly to get the routine appointments that keep them well and properly supported in the community.

Many points have been made about Labour’s disastrous 2004 GP contract. I do not need to rehearse those. The single biggest barrier to access to care is not being able to see their GP when people need to, in the evenings and at weekends. We have put together the Prime Minister’s fund with £100 million to back it to improve access to GP services in the evenings and at weekends, to make sure that patients receive the better service that they deserve.

NHS Funding (Ageing)

Debate between Dan Poulter and Sarah Newton

Tuesday 25th March 2014 Westminster Hall

[Dr Poulter]

It may be helpful if I outline the way the new formula works and how some of the weighting has changed, which will help to address the point my hon. Friend has just made and shed more light on the direction of travel that is under way.

The new formula uses a new indicator to recognise how health inequality should be reflected, which is based on the standardised mortality rate for those aged under 75. Previously, adjustment has been made on the basis of a measure of disability-free life expectancy. The new indicator is technically better, in that it can pick up pockets of deprivation within more affluent areas. The formula focuses much more on real population need, rather than taking a blanket approach across the population.

The new formula moves to the more powerful method of using individual rather than small area utilisation data—this is fundamental to the formula—to derive estimates of need. The main factors in the model are age, gender and 150 morbidity measures from the diagnoses of admissions to hospitals. That picks up on the point that my hon. Friend just raised. The formula looks at the pressure of long-term illness. Those 150 morbidity measures will pick that up. The increased need for health care in deprived areas is captured in the base formula by directly taking account of much of the increased need in deprived groups. In addition, further adjustments are made for factors such as the claimant rate for key benefits. That ensures that the model captures increased need that is linked to deprivation but is not linked to earlier utilisation of hospital services.

The new formula reflects more up-to-date data on population growth and measures population based on registered GP lists, rather than population projections based on the census. I am sure we can all recognise that where there has been growth in a population or changes are happening at local level, basing the formula on up-to-date GP lists is a much more accurate way of reflecting the health care needs of the local population than basing it on a 10-yearly census.

The new formula also reflects the responsibilities of CCGs rather than PCTs, as my hon. Friend outlined in her contribution. CCGs are not responsible for specialist services or primary care, although of course NHS England is now also taking over responsibility for the GP contract, as she will be aware. As a consequence, it is important to stress that the new formula for allocating funds to CCGs follows the advice provided by ACRA. A strong element of the allocation is focused on age. The primacy of age, an ageing population and the needs of older patients are very much built in, as are the needs of patients with long-term conditions. There is still a strong weighting for deprivation.

[Sarah Newton]

How does my hon. Friend the Minister feel that the market forces factor is reflected in the new formula?

[Dr Poulter]

These are obviously factors that NHS England will keep under review and take advice on from ACRA, but importantly, the new funding formula is not based on census data every 10 years but on real-time information coming in from GP practices. It looks at the health care needs of local populations, at deprivation, at areas where there are groups of patients with multiple medical co-morbidities. We know that as people live longer and our NHS is more successful, that will of course throw up new challenges. People are living longer not just with one long-term condition, but sometimes with two, three or four. Someone with dementia may also have heart disease, diabetes and a whole host of other conditions. A much more accurate reflection of real-time patient information is used to help set and adjust the formula for future years, and I think we would all welcome that. It is all part of having an independently set formula, rather than one based on the whims of a particular Government.

Almost two thirds of total NHS funding, as we are aware, now goes to clinical commissioning groups, which have the clinical expertise and local knowledge to best commission health services according to local needs and priorities. We are very proud that, as part of our reforms in 2012, we ensured a clinically led NHS at local level. Doctors and nurses are now making decisions for patients, which is already leading to improved services not just in Suffolk but throughout the country, because it is ensuring that the money from the increased budget that we are giving the NHS is being spent in a way that focuses on the needs of patients.

The Government have been able to ensure real-terms growth in funding until 2015-16, despite the stark financial challenges that we face as a country, and we should be very proud of the fact that we are continuing to put more money into the NHS. That means that NHS funding in England will be almost £15 billion higher in cash terms in 2015-16 than it was in 2010-11, and spending will rise from £100.4 billion in 2010-11 to £115.1 billion in 2015-16. Importantly, transforming care and delivering more personalised care under the integrated health fund—the £3.8 billion fund that my right hon. Friend the Chancellor of the Exchequer set up last year—is an important part of ensuring that that money is spent not just more efficiently, but in a more patient-centred way, particularly for patients with long-term conditions, both in Suffolk and in other parts of the country where there are many older patients.

In concluding, I want to highlight the fact that although, as we have already discussed, every CCG is receiving an increase in funding, the three CCGs in Suffolk in particular have seen funding growth. Ipswich and East Suffolk CCG’s funding allocation will increase by 2.85% in 2014-15 and by 2.19% in 2015-16 to reach £412.4 million in that year. As a result of the new funding formula that has been put in place, Suffolk is doing well, as are many other parts of the country.

Having a formula that is independently set according to clinical need and population information, and that is up to date and accurate, puts us in a much better place properly to look after the needs of patients, be they young or old, in the years ahead. That formula and the Government’s bold decision to ensure that it is independently set puts us in a strong position to deliver high-quality care for older people. That, together with the £3.8 billion integration fund, means that we will radically transform and improve the way in which we deliver care.

Care Bill [Lords]

Debate between Dan Poulter and Sarah Newton

Tuesday 11th March 2014 Commons Chamber

[Dr Poulter]

As a Member of the previous Government, it is a pity that the hon. Lady did not take these issues more seriously at the time. It has been left to the current Government to fix the problem through the 2012 Act and the amendments that we have tabled today. That is not good enough and she knows it. It is also the case that she has not read the 2012 Act properly, because I have just outlined the section 245 powers that the Secretary of State has. That is parliamentary oversight in anyone’s terms.

Finally, let me turn to amendment 29 tabled by the hon. Member for Copeland (Mr Reed). As he has said:

“The importance of such data in medical research, and in the synthesis of new treatments and better care, cannot be overstated. In research terms, more information about how people with certain conditions react to treatments can led to better research being undertaken, which uses resources more efficiently and improves a patient’s quality of life.” ––[Official Report, Care [Lords] Public Bill Committee, 30 January 2014; c. 513.]

I completely agree with that. It is important that we uphold a person’s right to confidentiality while enabling the use of information to improve the current and future health and care of the population, with appropriate safeguards to protect confidentiality.

The Health Service (Control of Patient Information) Regulations 2002 made under section 251 of the National Health Service Act 2006 modify the common law obligations of confidentiality. It allows researchers, public health staff and other medical practitioners to access information where there is no reasonably practicable way of obtaining consent to use such information for the purposes of medical research. That is in the interests of improving patient care or in the public interest.

Amendment 29 requires the Secretary State to give approval for the processing of confidential patient information for research purposes. In January 2011, the Academy of Medical Sciences published a review of the regulation and governance of health research. It criticised the complexity of the arrangements for regulating the use of patient information, saying that they are a significant barrier to research. None of us in this House wishes to put barriers in the way of medical research. The Secretary of State has already delegated the function of the approval of processing confidential patient information for research purposes to the existing Health Research Authority special health authority. The 2002 regulations as amended by this Bill would give the new HRA this function directly.

Under this Bill, the HRA would be responsible for overseeing the ethical review of health and adult social care research. As access to patient information may involve the consideration of ethical issues, it makes sense for the HRA to make decisions on applications for access to confidential patient information for research purposes.

Robust legislative safeguards ensure approval for access to patient information for research purposes is given appropriately by the HRA. These include a condition that the HRA may approve processing of patient information for research purposes only if approval has been given by a research ethics committee, established or recognised by the HRA, and a requirement that the new HRA appoints an independent committee to provide advice on applications to process patient information. This provides continuity for the committee known as the confidentiality advisory group, which I spoke about earlier in my opening remarks.

[Sarah Newton]

rose—

[Dr Poulter]

If my hon. Friend will forgive me, I will not give way. I have only two minutes left, and I want to address some of the other points made in the debate.

The HRA was set up to streamline approvals for research. The Academy of Medical Sciences has said that the transfer of responsibility for the research use of confidential patient information to the HRA provides a good opportunity to reduce the complexity in this area of regulation and governance that has in the past led to conflicting interpretations of it by researchers, trusts, patients and other stakeholders. It brings important clarity to the people whom we care about the most—the patients and the users of our health and care services.

Given those reassurances, I hope that the hon. Member for Copeland (Mr Reed) will withdraw his amendment and that Members will feel able to support the Government’s revised clauses in the interests of bringing greater clarity to safeguard patient confidentiality in the use of health and care information.

I am also grateful to my hon. Friend the Member for Totnes and other colleagues for tabling amendments (a) and (b) to new clause 34. It is clear that we share the desire that the huge wealth of data available through the health and care information system must support research to improve health and care. Although I welcome the intention behind amendment (a), which is to clarify that data should generally be disseminated only for purposes that improve health and care, the proposed wording would have the unintended effect of closing down access to data for some wholly legitimate purposes. For example, it might effectively block the Health and Social Care Information Centre from disseminating data that could be used to ensure that a particular health care service change will not have a negative impact on current levels of safety and quality of care or, worse, on the prevention of harm. I am sure that we would all want to avoid such an unintended consequence in the wake of the Francis report and the need to use health and care data properly to expose the rare examples in our NHS and care system of care that does not meet the standards we expect.

I have done my best to address many of the concerns raised in the debate. The care.data programme is a good one that we should all support. This Government, unlike the previous Government, are ensuring that we have proper safeguards in place to protect patient confidentiality.

Question put and agreed to.

New clause 34 accordingly read a Second time, and added to the Bill.

Oral Answers to Questions

Debate between Dan Poulter and Sarah Newton

Tuesday 14th January 2014 Commons Chamber

[Dr Poulter]

I make two points. First, the eligibility criteria began to change under the previous Government, so it is wrong of the hon. Lady to try to make political points which do not stand up to scrutiny. Secondly, I am disappointed that she is unable to recognise that there is very good integration of health and social care in Salford, in her own constituency. That is a model that we could look at to see how good care can be delivered elsewhere.

[Sarah Newton (Truro and Falmouth) (Con)]

I am delighted that Cornwall has been chosen as a pioneer area for joining up health and social care. It is the only pioneer area to be led by the voluntary sector. Will the Minister meet me and the Cornwall team to enable us to deliver that care in Cornwall?

[Dr Poulter]

I can confirm that the Minister of State, Department of Health, my hon. Friend the Member for North Norfolk (Norman Lamb), will be delighted to meet my hon. Friend to take that further, and that he and I will be visiting Cornwall in the next few months to see at first hand the excellent work that is being done there.

Adult Social Care

Debate between Dan Poulter and Sarah Newton

Monday 16th July 2012 Commons Chamber

[Dr Poulter]

My hon. Friend makes an important point. Social care and NHS care do not recognise county borders, which is why portability is so important. They certainly do not recognise the boundaries between England and Wales or between any other parts of the United Kingdom. We have devolved responsibility for the NHS, and the fact that there are different funding priorities in the different parts of the UK, with the Government in England supporting investment in the NHS and the Labour Administration in Wales cutting NHS spending, highlights the importance of my hon. Friend’s point. I am sure that the Minister will be able to reassure us that the coalition Government are taking steps to ensure that portability can take place across those borders wherever possible.

The White Paper also contains a commendable commitment to improving integrated care and ensuring that more joined-up working takes place between the NHS and social care.

[Sarah Newton]

Would my hon. Friend like to comment on some of the Opposition’s assertions that the efficiency savings from reductions in management levels in NHS are not being put back into front-line services to enable integration, and that they are somehow being siphoned off to the Treasury? I do not believe that—

National Health Service

Debate between Dan Poulter and Sarah Newton

Wednesday 26th October 2011 Commons Chamber

[Dr Poulter]

I thank the hon. Lady for her intervention. Any period of transition will be difficult, and must be managed. Will the mechanisms and bodies that the Health and Social Care Bill will put in place be better able to deliver community-focused, integrated care than the existing system? I want to consider two matters that we will come to later: health and wellbeing boards, and basing commissioning fundamentally in the community. Both are good mechanisms for delivering better integrated care, and I will return to that.

We have too many silos in the NHS. The primary care sector often does not integrate with the secondary care sector as well as we would like. For example, hospitals are paid by results, but they have no financial incentive to ensure that they prevent inappropriate hospital admissions. We talk about better looking after the frail elderly and about ensuring that we prevent people with mental health problems from reaching crisis point and having to be admitted, but there are no financial incentives and drivers in the system to ensure that that is achieved to the extent we would like. A and E admissions in many hospitals are rising year on year—in rural areas that is partly because we do not have an adequate out-of-hours GP service—and far too often the frail elderly are not properly supported in the community.

If we put the majority of commissioning into the community with local commissioning boards, that will provide a more integrated and joined-up approach to local commissioning, which will undoubtedly help to prevent inappropriate admissions. We no longer want an NHS in which people with mental health problems or the elderly present in crisis because they have not been supported in the community. That must be the focus of care, and the focus of delivery of services.

[Sarah Newton]

I wholeheartedly agree with my hon. Friend about the importance of integrating social care and the NHS. I want to share with him the good, concrete steps that are being taken in Cornwall, where we have a pilot health and wellbeing board, and the beginning of integration. That has not happened before in Cornwall, and we are about to have the first joint commissioning of services. That is the way forward to improve patient experience in the NHS.

[Dr Poulter]

I thank my hon. Friend for a helpful intervention, which makes the point very well that we need integration through community-based commissioning.

The other key factor is how better to integrate adult social care—the right hon. Member for Leigh made the point, as did the Secretary of State—into the current NHS system. At the moment, integration of services is sometimes variable. There is a good example in Torbay of a more integrated system, but what are the Government proposing that will at least facilitate the integration of services? Local health and wellbeing boards are definitely a step in the right direction because for the first time they will bring together adult social care from local authorities with housing providers, the NHS, and primary and secondary care. That must be a step in the right direction for delivering the integrated care that we all want. It will help to provide more community-focused care.

I referred to the concern about inappropriate admissions, and the fact that elderly people are not supported in their own homes. The savings in adult social care from doing things well are NHS savings, but at the moment there are different cultures in two different organisations, which do not always talk to each other in different parts of the country, and that will not benefit patients. Bringing people together on a health and wellbeing board must be good for patients and integrated care.

For all those reasons, I hope that we will have more positive Opposition day debates on the NHS, and I hope that the Opposition will at least concede that some good things are happening as a result of health care reform.

Dairy Farming

Debate between Dan Poulter and Sarah Newton

Tuesday 7th June 2011 Westminster Hall

[Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)]

I am pleased to see that, despite the recess, a number of colleagues are arriving, and more will join us later.

It is important that we debate the future of British dairy farming. It is an important matter throughout the country, but especially so for East Anglia, and particularly for Suffolk and south Norfolk and for Waveney valley in my constituency. All Members here today would like to see the re-establishment of a thriving, profitable and sustainable agriculture sector in the United Kingdom. About 15 or 17 years ago, the country produced 70% of its own food, but we now produce only 40%. There is a strong case for supporting the development of much greater food security and food sustainability, and the dairy sector has an important part to play in that.

Milk prices affect dairy farmers from time to time, but the dairy industry has faced a particular crisis over the past few months and, as a result, at least eight farms in East Anglia close to my constituency are no longer in business. The key factor is the price that dairy farmers receive for their milk. There is a tension between the price paid by the consumer, particularly given the current economic climate, and the price that retailers pay milk producers. Nevertheless, if we want to maintain a profitable and thriving agricultural sector, we need to ensure that milk producers receive a fair price. At the moment, Britain is third from bottom in the European league table for the price that our milk producers receive, which is unacceptable.

I know that the Minister is familiar with a number of these factors as they affect Suffolk, having originally been with AtlasFram farmers, but the point of this debate is to focus on what the Government can do to support the British dairy industry over the next few years, particularly in the current crisis.

[Sarah Newton (Truro and Falmouth) (Con)]

I congratulate my hon. Friend on securing such an important debate. The future of dairy farming is important to people throughout the country, as we need greater food security and must produce more of our own food. Does he agree that it is about not only the supply of milk, but the products that are made from it? Those products are important to the economy of Cornwall. They include not only our famous clotted cream but our ice cream, cheese and yoghurt, which all depend on healthy supplies of milk. Many dairy farmers in my constituency, like those in my hon. Friend’s, face the prospect of having to give up that important part of their livelihood, along with their farming traditions.

Hospice Care

Debate between Dan Poulter and Sarah Newton

Wednesday 2nd February 2011 Commons Chamber

[Dr Poulter]

My hon. Friend is absolutely right. He talks about a children’s hospice, but hospice care, and the valuable service that it provides to people with terminal and progressive illnesses, is particularly pertinent to adults. It is also important to children, however, because there is nothing more distressing than a very sick child whom we know is going to die.

I shall explain why we need to invest in hospices and palliative care. The UK population is ageing significantly, and we will have to look after a lot more people with more than one terminal and progressive illness. By 2033, the number of people aged 85 and over is projected to more than double to 3.3 million, and it is predicted that 8.7 million people will be 75 years or older. There is an ever-increasing strain on the palliative services that help to support people with co-morbidities, or several illnesses, and we need to recognise that and invest properly in those services. It is often through the hospice movement that such people are properly looked after and their families properly supported during the terminal illness.

Hospice charities have many concerns, because in the past the top level of government paid insufficient attention to the role that hospices play in easing the burden on the NHS, as well as in providing a vital service for local communities. We are of course in a time of economic belt-tightening, but given the Government’s investment in the big society, there is a unique case for supporting hospices and the valuable services that they provide, alongside their role as a provider of NHS services and a key provider of support for families in the community.

[Sarah Newton (Truro and Falmouth) (Con)]

On the point about invaluable support services, does my hon. Friend agree that hospices, such as Children’s Hospice South West, which aims to build a new hospice in Cornwall to add to those it has in Devon, offer vital support to families through respite care for the children whom they look after who, sadly, have terminal illnesses?

[Dr Poulter]

My hon. Friend is absolutely right, and I am delighted to hear that a new hospice is emerging in her part of the country. I am sure that it will provide a valuable service. I shall focus most of my comments on the provision of adult care, but she is absolutely right to talk about children’s hospices, because a sick child—especially one with a terminal illness—needs a lot of support and care, as do their families in particular, during their illness. I am delighted that the communities in her part of the world are investing in that service.

I shall now discuss the hospice movement’s background, because it teases out the key areas of support that hospices provide. We all probably know that St Christopher’s hospice in Penge, south London, is likely to be identified as the first modern hospice, and I am delighted that in my constituency we have a hospice, St Elizabeth’s hospice, which provides a key service, supporting most of central and eastern Suffolk. St Elizabeth hospice delivers a number of services. It has 18 in-patient beds, some of which are for respite care, to which my hon. Friend the Member for Truro and Falmouth (Sarah Newton) alluded. These provide care to give families time off when dealing with a relative who has a terminal illness, and look after people in the very last days of their life.

However, hospices do more than that. One thing that is often forgotten when we talk about the hospice movement is the very valuable outreach service that they provide to their communities. People will want to have as good a death as possible, and part of that is about supporting them in being able to die, where possible, in their own homes in as comfortable an environment as possible. What St Elizabeth hospice does very well, as do many others, is invest in those outreach services to ensure that people can die comfortably at home.

Savings Accounts and Health in Pregnancy Grant Bill

Debate between Dan Poulter and Sarah Newton

Monday 22nd November 2010 Commons Chamber

[Dr Poulter]

We are not talking about child benefit this evening. We are debating the pregnancy grant. On the principle that the hon. Lady outlines, if we want to provide an intervention and if we want to make a gift of money effective, we need to target it effectively. We have no evidence to show that the grant is an effective intervention in pregnancy. No one on the Labour Benches has shown that the intervention is effective in improving nutrition in pregnancy.

Granted, in my clinics I obviously did not discuss in detail where the grant was spent. Nevertheless, I saw in my clinical practice far too high a rate of women smoking during their pregnancy. I would much rather see effective and targeted advice, independent of any grant, being focused on making sure that women do not smoke while they are pregnant. That would be a much better way of dealing with the issue.

[Sarah Newton]

I endorse what my hon. Friend is saying. I took the time to read in Hansard the entire debate that took place when the Bill was first introduced. The very points that my hon. Friend is making now were made then—that the grant is not the right way to encourage good nutrition in women of child-bearing age, which we all agree is vital.

--- Later in debate ---

[Sarah Newton]

Thank you, Mr Deputy Speaker, for calling me to speak in the last moments of the debate. It was an enormous privilege to serve on the Public Bill Committee and to listen to my colleagues on the Opposition and Government Benches, as well as to the many organisations that gave evidence.

Listening for all that time brought home to me why I am so pleased to be sitting on the Government Benches and not on the other side. I believe absolutely that Government Members will form the most reforming Government that I have seen in my lifetime—a Government who are prepared to make the tough decisions that will provide the solutions to the problems, as the Bill seeks to do.

There is no doubt in my mind about the good intentions of the Opposition when they introduced these three measures some years ago. There is also no doubt in my mind from reading Hansard from that time and from re-examining the evidence that we have been given over the course of the past few weeks that there is no evidence base to show that the measures will tackle the vital issues of alleviating poverty and helping the most disadvantaged people in our society.

[Dr Poulter]

On that note, does my hon. Friend agree that it is a great pity that it has taken the advent of the deficit for us to examine properly some of the previous Government’s policies? We all want to look after the most vulnerable, but the only way to do that is to target our resources properly. At the moment, in difficult economic times, there are fewer resources than there once were, and the only way to do it is to base that targeting on the evidence and to ensure that the resources go to the most vulnerable. That is what the Government are about. We are getting rid of universal policies that do not work.

[Sarah Newton]

I am delighted to agree with my hon. Friend. It is essential that we use the evidence base, and I find it frustrating that the evidence was available when the legislation was introduced a couple of years ago. Let us consider the debate on maternal health—I know that my hon. Friend has great expertise in this area. It was very difficult for my colleagues who were in the House at the time to get evidence on maternal health from the then Government, but it was demonstrated that the data set that could reasonably be used to measure the impacts of any additional nutrition on maternal health did not exist. When hon. Members are pouring out their crocodile tears, as we have seen for weeks, saying how poor the affected people will be and how we must take more time and evaluate these measures, they know full well that the data set does not exist to measure the impacts.

We should listen to my hon. Friends, and to midwives and clinicians up and down the country as they give their practical experience of working with women of child-bearing age to improve maternal health. We have heard about policies and projects that deliver. For example, we know that not enough women understand how to cook nutritious meals on a low income. Much more needs to be done about cooking in schools and in the community so that people on low incomes can cook nutritious food, and plenty of evidence supports the idea that that is an effective thing to do.

As my hon. Friend said earlier, we know that the single most important thing that we can give to a mum in her early stages of pregnancy is folic acid. All the support that the Government are putting in place through their reforms to the NHS will target help at women of child-bearing age and at those who are the most vulnerable in our society and who need such effective services from the NHS.

This Government are all about giving people a hand up, not a handout. Week after week we sit here and Opposition Members’ answer to every problem is to throw some money at it. We in the Government will ensure that hard-earned taxpayers’ money is spent where the evidence shows it will be most effective.