(1 day, 12 hours ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Dr Danny Chambers (Winchester) (LD)
It is a pleasure to serve under your chairship, Mr Vickers. This is an important debate, secured by the hon. Member for Uxbridge and South Ruislip (Danny Beales), but it is quite something to have to follow an eminent and experienced ENT surgeon, the hon. Member for Bury St Edmunds and Stowmarket (Peter Prinsley), when speaking about hearing and hearing loss—especially as I am just a rudimentary vet.
It is quite common that people bring in a dog that they assume has hearing loss because it can no longer hear its name being called in the park, yet for some reason it can still hear a treat packet or a fridge being opened in another room. On comparative anatomy, the hon. Member for Bury St Edmunds and Stowmarket may be interested to hear that one reason why up to 20% of a caseload in a day of treating small animals can be on ear-related issues is that in humans the ear canal goes straight to the eardrum whereas in dogs it bends around 90° before it gets to the eardrum. Around that corner it is often quite warm and moist, and a lot of bacteria and yeast grow in those conditions.
Peter Prinsley
I am very interested in the story of dogs and the shape of a dog’s ear canal; that is such a helpful explanation. I was often brought dogs, particularly spaniels with big floppy ears, who had ear infections and blockages, and I was always puzzled why it was that the dogs got into such difficulties. The hon. Gentleman’s explanation of the right angle at the bottom of the ear canal is so helpful and I thank him for it.
Dr Chambers
I am honoured to have educated an ENT surgeon. Spaniels do have worse ear problems, given that there is a lack of airflow, and one thing that vets can get experienced at is taking a swab so that we are not using unnecessary antibiotics or inappropriate antibiotics. With a bit of experience, it is fairly easy to smell the difference between Malassezia yeast, pseudomonas bacterial infection or streptococcus intermedius—to anyone who thinks being a vet is glamorous, I say, “Spend a day sniffing ears to determine what type of microbes are down there, and it will change your mind.”
It is very interesting that many Members spoke today about the impact of hearing loss on dementia. We know that dementia is multifactorial—there is no single cause—but certainly my father had hearing loss for a long time, and he developed dementia. Hearing loss certainly affected his quality of life, dementia aside. He lost the confidence to go out to socialise and barely left the farm unless he had to. We are pretty sure that a significant factor in that was that he felt he could not hear what other people were saying. He could not perform business at the market as he used to, because markets are very noisy places.
The Father of the House touched on the fact that one in three adults have either deafness, tinnitus or some other type of hearing issue. What surprised me was that only 38% of people who suspect that they have hearing loss themselves have contacted a professional about it. I read that stat and was quite surprised, but I then realised that for years my partner Emma and other family members have often said, “Why do you have the TV so loud?”. I have also often noticed in a pub everyone else is talking, and I find it really hard to hear the conversation over any external noise, yet I have never gone along and had a hearing test. Quite clearly, I do not hear as well as everyone else in my vicinity, so I should probably get one. That could be a new year’s resolution for me—to go and work out whether I actually have some kind of hearing issues as well.
I also note the weight given to the importance of community audiology, especially when such a high percentage of hearing loss is age-related. Those people have no need to go to a hospital to get the initial assessment, and community audiology could free up hospital time for children and other people with more acute hearing issues that need to be investigated. Audiology is one of the worst performing diagnostic services in the NHS for speed of assessment, with 40% of patients waiting more than six weeks simply for the initial assessment. That is one reason respondents to the British and Irish Hearing Instrument Manufacturers Association are advocating for open self-referral and expanded community clinics simply to minimise those delays. Delivering audiology services in the community costs 15 to 20% less than from a hospital, so it is an economically sensible model as well.
We often call for more community-based services for a whole variety of medical issues to keep costs down. It should be the default for most people with age-related hearing loss. We also urge the Government to consider trialling hearing tests as part of routine health checks for people over 70 and at-risk groups and to investigate how best to support everyone, from GP surgeries to high street pharmacists and opticians, to deliver free earwax removal. They are already being successfully run by some GP practices with positive impacts on health outcomes, and the cost can be small, especially where GPs co-ordinate to pay for a service that covers a large area.
The hon. Gentleman makes a good point that we often hear about national screening programmes. It has just occurred to me that if everybody over the age of 70 was sent a text message through the NHS, summoning them into a screening programme, we could make huge advances in this area, particularly with things such as dementia—because, as he made clear, many people are either embarrassed by hearing loss, or not aware that they have it.
Dr Chambers
I completely agree. As we approach the busiest and loudest time of the year and every shop and pub has music playing, which is fun for most people, it is a good time to urge people to go for a hearing test in the new year, as I will be doing. We urge the Government to look at supporting community-based services so that everyone can get the hearing assessment they need. People need information to be able to act, and if someone does not know their hearing status, they will not know what other problems they will be dealing with in the future.
(1 week, 2 days ago)
Commons Chamber
Dr Danny Chambers (Winchester) (LD)
I thank the Secretary of State for his statement. People will be hugely alarmed at the threat of more industrial action right before Christmas, and we cannot forget how we got here. We know that the previous Government under-resourced the NHS. It was overburdened, people felt underappreciated, and the whole system was being held together by the good will of the staff.
Having said that, the timing is terrible, because we have the worst winter flu outbreak in decades, right before Christmas. We have to urge the BMA to work constructively to resolve this dispute in a way that is fair for both patients and taxpayers. Given that resident doctors received a 29% pay rise last year, I think most of the public feel that pushing for another 28.9% this year is unaffordable and unreasonable.
The Secretary of State touched on resident doctors’ legitimate concerns. The previous Government increased medical school places without increasing the facilities to deliver the necessary specialist training placements, so this was a predictable bottleneck that we are now up against. Waiting lists are long, we need more doctors, and we have doctors who have been trained largely at the taxpayer’s expense struggling to find work. We very much welcome the extra 4,000 placements that were announced today, which are hugely necessary. Can we ensure that they will address the acute shortages in general practice and psychiatry? To put those 4,000 places in context, 10,000 doctors applied for 500 psychiatric training places last year, and the Secretary of State said that about 40,000 doctors have applied for 10,000 places this year. Is there work to try to increase places as quickly as possible in the next few months and years?
At Winchester hospital, one in five beds is taken up by people who do not have any social care packages. That is not good for them, because they are stuck in the hospital, and we want to get them home for Christmas, but it will also affect the flow through the hospital right now, during a winter flu crisis.
We welcome this action and urge the BMA to call off the strikes, but can we address the legitimate grievances that the Secretary of State has mentioned?
I thank the Liberal Democrat spokesperson for his support, as well as for the constructive challenge. He is absolutely right to describe the challenge that we inherited, and we are seeking to deal with it. We have taken a number of steps along the way. For example, we promised to recruit an additional 1,000 GPs to the frontline in our first year. We expanded the additional roles reimbursement scheme in order to do that, and we were actually able to recruit an extra 2,500. The international medical graduate dimension of the deal means that the extra speciality training places go even further.
Although I would never pretend that the steps we have taken in our first 18 months in office have solved everything all at once—there is no shortage of things to solve—I say to those BMA members considering how to cast their vote that we have delivered a 28.9% pay rise, have taken action on international medical graduates through urgent legislation, and have expanded speciality training places. This is real progress. It is meaningful change in people’s pockets and to their lives, working conditions, career progression and prospects.
The BMA should please not let the perfect be the enemy of the good. We have a lot of fires to put out on a lot of fronts as a Government, and that does take time. We are committed—and I am personally committed—to working constructively with the BMA on things like workforce planning to address those issues, if it is willing to work with us. That is all I ask. It is all I ask from any part of the NHS workforce. It should work with us constructively, understand our constraints, work through the challenges with us, and we will all get to a better place and create a rising tide in the NHS that lifts all ships.
(1 week, 4 days ago)
Commons Chamber
Dr Danny Chambers (Winchester) (LD)
I thank Members across the House for the constructive way in which they have all contributed towards this long-awaited Bill. In the last 40 years, attitudes to mental health and the treatments available have changed significantly, so these reforms and updates are very much needed and very much supported by everyone here.
On Lords amendment 19B, we welcome the important addition. All children and young people deserve appropriate care and support when undergoing treatment for mental health problems, including the safeguarding of a nominated person. Each and every child going through the system deserves to be properly represented by a responsible adult, so we are grateful for the amendment and we are pleased to lend it our support. While we understand that the remit of this Bill very much focuses on in-patient mental health care, we cannot ignore the wider context in which this Bill needs to operate. Even the best in-patient system will struggle if we fail to invest in the preventive and early intervention services that keep people well in the first place.
The hon. Member for Hinckley and Bosworth (Dr Evans) mentioned the difference between mental wellbeing and mental health issues, and ensuring that we protect people’s mental wellbeing before they go on to develop mental health issues. If we are serious about preventing people from reaching crisis point, we need to ensure that the many community-based initiatives, which the Minister and others have spoken about, are strengthened. That is why we will continue to champion walk-in mental health hubs, having a mental health professional in every school and a sort of mental health MOT check-up at key points in individuals’ lives.
It has been an honour to contribute to this Bill. I want to thank the Minister for his meaningful engagement with all Members across this House for the best part of a year. My one ask of him tonight is to again consider restoring the suicide prevention grant to voluntary, community and social enterprise organisations, because I keep meeting charities and organisations that have benefited from it. It is really important that we support community organisations that can help identify when someone is reaching crisis point, because so many people who take their own lives are not in contact with NHS services.
Finally, I pay tribute to all the frontline workers in mental health in clinical and community settings. Nurses, counsellors, psychiatrists, doctors, therapists, support staff, carers and charities prop up a system that is complicated, underfunded and challenging to work in, and we want them to know that we appreciate all the efforts that they continually make. The Liberal Democrats will keep pushing until mental health is given the same urgency, care and attention as physical health.
With the leave of the House, I will make some brief concluding remarks. I am very grateful to Members of this House for their contributions both today and throughout the passage of this Bill. I believe that by drawing on the lived experience of both Members and our constituents, we will be able to strengthen the intended impact of this legislation on people with serious mental illness and their loved ones. The passage of this Bill has seen the best of parliamentary commitment and co-operation, and the conduct of Members and peers has been collaborative and well-intentioned throughout.
For too long, mental health reform legislation has sat on the shelf. This Government made a manifesto commitment to modernise the Mental Health Act 1983, and we have delivered that within our first Session, providing an opportunity to transform the way we support those with severe mental illness and providing patients with greater choice and autonomy. I am reminded of what a patient in the 2018 independent review said:
“I felt a lot of things were done to me rather than with me”.
This Bill takes forward many of the changes put forward by the independent review, the recommendations of which were rightly shaped by the views of patients, carers and professionals.
Many have asked about next steps and implementation. Post-Royal Assent, our first priority will be to draft and consult on the code of practice. We will engage with people with lived experience and their families and carers, staff and professional groups, commissioners, providers and others to do that. The code will go to public consultation, as well as being laid before Parliament before final publication. Alongside the code, we will develop the necessary secondary legislation. We will then need time to train the existing workforce on the new Act, regulations and the code. We estimate full implementation will take around 10 years due to the time needed to train the workforce and the need to ensure that the right community support is available. This timeframe necessarily spans multiple spending review periods and multiple Parliaments, so we are limited in the detail we can give about future spend and timelines. But we have committed to an annual written ministerial statement on implementation. This commitment will last for the 10 years or until the Bill is fully implemented, whichever is sooner.
(2 weeks, 2 days ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Dr Danny Chambers (Winchester) (LD)
It is an honour to serve under your chairmanship, Sir Jeremy. I thank the hon. Member for Altrincham and Sale West (Mr Rand) for securing this debate and for speaking so movingly and emotively.
I can only imagine the mixture of emotion someone feels when they receive a terminal diagnosis. We know that around six in 10 people referred for hospice care have significant psychological support needs, but there is a lack of good, standardised mental health provision for people receiving hospice care. More than 10% of suicides in the UK are in some way linked to either chronic or terminal physical illnesses, so there is a mental health undercurrent running through the heart of end-of-life care.
Like many other Members, I want to pay tribute to the extraordinary hospices in my constituency. I have visited them and taken part in local fundraising events for them. I did 12 hours of exercise for Winchester hospice —I was doing boxing around midnight, and I can still feel it now, even though it was about a week ago. The inspiration I got from seeing so many members of the community raising money for Winchester hospice, or for children’s hospices Naomi House and Jacksplace, is unbelievable; so is the dedication of the staff and the volunteers, working in some of the most emotive jobs possible. It is a lifeline for the families affected by having a relative or a child with a terminal illness.
Hospices across the UK are under immense strain, and only 16% of people attending them believe that their psychological support is adequate. Too many people approaching the end of life are pushed towards the overstretched NHS mental health services. If someone ends up on the conventional mental health path, they may be put on a waiting list that is more than a year long—and, I am sorry to say, they may not have that long to live. We must also recognise the quiet heroism of unpaid carers. They give up work, rest and any sense of normality to care for someone they love, and most of them receive no formal bereavement support at all. Their contribution is vast, but their support is minimal.
As an aside, since many Members here have an interest in hospice and medical care, and a couple are doctors, one of the best books I have read on the subject is Atul Gawande’s “Being Mortal”. It is about the wishes of people who receive terminal diagnoses, how they want to die, the experiences they want to have while they are on that journey, and the amount of fulfilling experiences and the sense of purpose that they can have while suffering from sometimes incredibly painful diseases.
As the Government develop the new modern service framework for palliative and end-of-life care, we want to ensure that mental health is absolutely at its core. That means regular mental health assessments throughout a person’s illness, embedding psychological support in palliative care teams and creating a sustainable, long-term funding model for hospices so that they can plan with certainty. It also means real support for family carers, paid carer’s leave, guaranteed respite and proper access to bereavement services.
This debate is not about dying badly; it is about helping people to live really well and to live really fulfilled until the end. If we truly believe that every life has worth, that worth does not diminish in someone’s final months or days, so mental health support must be built into palliative care, and not bolted on as an afterthought.
(3 weeks, 3 days ago)
Commons Chamber
The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)
My hon. Friend is absolutely right. As announced in the 10-year health plan, David Lock KC is providing expert policy advice on the rising legal costs of clinical negligence and how we can improve patients’ experience of claims. That review is ongoing, and following initial advice to Ministers and the recent report from the National Audit Office, the results of David Lock’s work will inform future policymaking in this area. I am happy to update my hon. Friend as soon as that happens.
Dr Danny Chambers (Winchester) (LD)
(1 month ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Dr Danny Chambers (Winchester) (LD)
It is an honour to serve under your chairship, Mr Mundell. I thank my hon. Friend the Member for Richmond Park (Sarah Olney) for securing this hugely important debate. I thank all the Members who have spoken today, especially the hon. Member for Cannock Chase (Josh Newbury), who was vulnerable and honest, which can be difficult in a public forum. His example will help a lot of people to understand that no matter what job we do and how much support we have around us, people still have these kinds of thoughts.
Many people know that I was involved in a mental health charity that offers support to the veterinary profession. Vets have a suicide rate about four times the national average. It is a tiny profession, so everyone knows everyone, and everyone has lost friends and colleagues to suicide. Vets have challenges similar to farmers, another demographic who we know struggle quite a lot.
I pay tribute to Mr Pirie for being here today. The most difficult and emotional conversations that I have had since becoming an MP have been with parents who have lost children to suicide and wives who have lost husbands. Amid the frustration and anger that they all experience, they feel that if they had just known how much someone was struggling they could have done more to support them. Even worse are the cases where someone was actively trying to access support, but did not get the right type of support at the right time and so fell through the net.
I think about my own friends, Sarah Brown and David Bartram, two vets who were also trustees of a veterinary mental health charity. When we lose people, it is important that the memory of their life is not defined by how they died. Sarah was one of the funniest people I have ever met. She never missed a night out. David was an ultramarathon runner and one of the best speakers I have ever seen giving lectures. He was a hugely engaging person. It is a real shame that people get remembered for the way they died and not the positive contribution and the fun and happiness that they brought when they were here.
As a mental health spokesperson, I get really concerned when I hear people from other political parties, specifically Reform, belittling mental health issues and saying that it is the new back problem, it is over-diagnosed or people should man up. Are they seriously saying that farmers, who are some of the toughest people we could ever meet, working all hours in all weathers and earning a living in the hardest way possible, and veterans, who have experienced situations that most of us can only ever imagine, are a bunch of snowflakes who need to man up and toughen up? Mental health is a real problem that can affect even the hardest people on the planet, and no one is immune to those sorts of challenge.
Other Members have talked about 2023 having the highest rate of suicide for 25 years. That rate, thankfully, is slightly declining. It is interesting that the World Health Organisation states that depression is the No. 1 global disease. It affects people in all countries; it is a very prevalent issue. We are much better than we used to be at talking about depression and mental health issues, but suicide is the one aspect of such issues that still carries a lot of stigma. People still do not want to talk about suicidal thoughts, or sometimes there is shame in having a relative who died from suicide. It is not talked about as openly as it could be.
I thank the Minister for his diligent work over the last year on the Mental Health Bill. We have all worked closely on that, including the Opposition spokesperson, the hon. Member for Hinckley and Bosworth (Dr Evans). It is fantastic work and I know the Minister cares very much about this issue. I also welcome the £3.6 million over three years provided under the men’s health strategy specifically for suicide prevention, although I am concerned that it is very much less than the previous £10 million-a-year suicide prevention grant fund for voluntary, community and social enterprise organisations. How will the £3.6 million be targeted? Will there be scope to support in other ways the many organisations and charities, such as the Samaritans, that have contacted me to say that the grant is a significant part of their funding to deliver their services to help prevent suicide?
There are so many amazing community groups all over the country. I meet some quite regularly. The Farming Community Network, the Bishop’s Waltham men’s breakfast, the men’s sheds that are everywhere—we have one in Alresford and one in Hambledon—and Winchester Youth Counselling do brilliant work bringing people together. We must do everything we can to keep those organisations viable, running and thriving. It is so much more economic if people are prevented from heading down the route of depression, with a good social network and a lot of community support, than if they end up needing to engage with clinical services.
I also thank all those on the frontline: the clinical staff, the nurses, the counsellors and the carers caring for people who are struggling with mental health issues. The mental health of carers is another huge issue.
Chris Vince
I apologise for that; it happens to me a lot as well. The hon. Gentleman mentioned carers. That is particularly important because tomorrow is Carers Rights Day. I worked for a charity that supports young carers and we have seen an increase in the number of young carers supporting people with mental health issues. There should be recognition of carers, including young carers, so I thank him for mentioning them.
Dr Chambers
I thank the hon. Member for intervening just in time. I reiterate how pleased we were that the Minister looked at the amendments to identify children of mental health patients. Sometimes those children are essentially carers as well, and it is really important that we know they exist and that they get the support they need.
(1 month, 2 weeks ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Dr Danny Chambers (Winchester) (LD)
It is an honour to serve under your chairpersonship, Ms Jardine. I congratulate the hon. Members for South Norfolk (Ben Goldsborough) and for Isle of Wight West (Mr Quigley) on securing this debate. I wish the hon. Member for South Norfolk all the best in his treatment. I have to say, it was hugely brave of him and emotive to hear him talk about the journey he is going through at the moment, and to hear him paying such tributes to all the staff involved in his care. I also thank Zoe’s family for coming here today, because it cannot be easy to hear people talk about this disease after everything they have been through.
Many of us will know, some from personal experience, how frightening it can be to face a possible or actual cancer diagnosis. When words such as “biopsy” or “diagnostic tests” enter the conversation, that provokes deep concern, and yet those tests, as everyone has been reiterating, are absolutely vital. Early diagnosis is the single most important factor in improving survival rates. The sooner any type of cancer is identified, the sooner treatment can begin, and the more likely the outcome will be favourable. The tests are very important for people’s mental health, because sometimes the test is clear: a person knows that, and knows there is no need to worry unnecessarily.
In an ideal world, someone who notices a suspicious mole or mark would call their GP; be seen within two weeks, as set out in the National Institute for Health and Care Excellence guidelines; if necessary, a biopsy would be taken; and, if cancer was confirmed, treatment would begin within 62 days. In an ideal world, that treatment would be available to everyone, regardless of their postcode.
We know that is not the reality for everyone, either in Winchester or the rest of the country. We know GP access is a growing concern. In Winchester, I regularly hear from my constituents that they are waiting weeks for appointments, which means we are falling at the first hurdle. The second hurdle—treatment within 62 days—is just as worrying. In Winchester, in July 2025, only 73.6% of cancer treatments began within 62 days, well below the operational standard of 85%.
The truth is that, at almost every stage of the process—from initial concern to diagnosis and treatment—we are letting too many people down. It is one of the reasons that the Liberal Democrats have been calling for a two-month cancer treatment guarantee for a long time now: a new target so that 100% of patients will start treatment within 62 days. We must also replace ageing radiotherapy machines and expand provision so no communities are left in what have rightly been called radiotherapy deserts. We do not want anyone to have to travel hours and miles when they are feeling ill for lifesaving care.
The last Government’s decision to close the National Cancer Research Institute, which had co-ordinated cancer research since 2001, was a grave mistake. One oncology professor compared this to
“turning off air traffic control and hoping the planes will be fine”.
We owe it to patients and their families to build confidence in the system, and that means faster access to GPs, earlier diagnosis, better treatment, proper investment in research and a comprehensive long-term plan to boost survival rates. I really welcome all the comments about regulating the private medical sector to ensure they are taking biopsies, as well as the regulation of sunbeds.
I wanted to be here at the beginning, but unfortunately I could not because I had other things to do in the Chamber. I declare an interest—like the hon. Member for South Norfolk (Ben Goldsborough), I am going to get one of mine done very shortly, but in Northern Ireland the wait list is 56 weeks. If it is red-flagged, it is five weeks. There is anxiety and stress for everyone—not for me, but for all the others—because it is not about me but everyone else. Does he agree that the NHS, wherever it may be in this great United Kingdom of Great Britain and Northern Ireland, needs to ensure that those who have melanoma and a biopsy get the urgency that is absolutely critical? The Minister is in her place—there is no better person to answer these questions than her—and I look forward very much to what she says. Does the hon. Member for Winchester (Dr Chambers) agree that a concerted campaign across this great United Kingdom of Great Britain and Northern Ireland to address those issues might be a way forward?
Dr Chambers
I totally agree with those comments.
I will finish by paying tribute to one of my friends from vet school, Polly Birch. She was diagnosed with a melanoma in 2016 and had it removed, but in 2017, a few months after giving birth to her baby girl, Ada, she discovered it was metastatic, and she passed away. Her final post on social media was beautiful and moving. A couple of days before she passed away, she said:
“Appreciate the people around you, adventure with them, buy less stuff and go out and experience the world…and look after the bees.”
Finally, and perhaps most poignantly, I will quote Mary Schmich:
“If I could offer you only one tip for the future, sunscreen would be it.”
(1 month, 3 weeks ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Dr Danny Chambers (Winchester) (LD)
It is a pleasure to serve under your chairmanship, Mr Efford. I thank the hon. Member for Worthing West (Dr Cooper) for securing this really important debate.
We have a lot of medical professionals in the room. It might surprise colleagues that, although I am a rudimentary vet, we treat fatty liver disease quite commonly in animals as well. It is most commonly seen in very large, fat cats that are really cuddly and people like to have on their lap. It is really common for them to get fatty liver disease if they stop eating, and it is genuinely very serious and takes intense treatment. The other time we see it commonly in animals is in cows that are in good body-weight condition, immediately after they give birth; often, they end up with hepatic lipidosis, which can be quite difficult to manage.
My first charity visit as an MP—it was the week after I was elected—was to the British Liver Trust in Winchester. I met Pam Healy, its chief executive officer, who is here today. It is a brilliant organisation. I thank everyone for all the briefings we were given; the hon. Member for Stroud (Dr Opher) mentioned how much he learned from them, despite being a trained GP. On that note, I know he is doing some social prescribing—when is the comedy show?
Dr Chambers
Fantastic. Hopefully it will improve people’s mental health—and if they leave halfway through, it will probably improve their physical health, too. That is a fantastic initiative.
Other Members have talked about the soaring rate of liver deaths, which has shot up in the last 20 years. The hon. Member for Worthing West talked about it costing the NHS £6.9 billion directly, and some studies show that it has cost the economy over £100 billion in other ways, such as from people being off work.
Ben Coleman (Chelsea and Fulham) (Lab)
I suggest to the hon. Member that one of the principal reasons that non-alcoholic fatty liver disease has shot up so radically in recent years is the increasing prevalence of food that is simply bad for people and is causing them damage—in particular, food that is high in fat, sugar and salt. For that reason, the Health and Social Care Committee, of which I am a member, is currently doing an inquiry on food. Does the hon. Member agree that the Government need to focus on making healthy food more affordable and accessible, and to tackle the advertising and marketing of so much of the unhealthy food that is out there?
Dr Chambers
I completely agree—that is hugely important. The sugar levy has been a huge success: between 2015 and 2019, the amount of sugar in soft drinks reduced by about a third, which reduced sugar intake in our collective diet by 48,000 tonnes. If we expect the Government to pay for people’s treatment when they are sick, as we rightly do, there is also an onus on them to help people to maintain their health. That is both a moral and an economic imperative.
It is often not noted that as well as the direct implications of obesity, diabetes and liver issues related to genetics and diet, there are also indirect costs that affect the NHS, such as the number of hip replacements and knee replacements, and other types of expensive and intense interventions that could probably be significantly avoided if we had healthier diets.
As we know, the issue with many liver problems is late diagnosis. The liver can take a huge amount of abuse in many forms until it stops functioning to the level at which it appears compromised. When symptoms are finally seen, there has often been sustained damage for quite a long period of time. The scanning that is done by the British Liver Trust and others—I encourage everyone to get their liver scanned when they come into Parliament—can pick up diseases such as fatty liver disease before the clinical symptoms are seen, which is absolutely key.
The UK ought to be one of the healthiest countries in the world, but we know we are not. Winchester is a relatively wealthy constituency, yet 54% of adults are overweight or obese, along with 27% of children. We are a country with a long history of world-leading medical research, grassroots sport and high-quality food production, yet over the last 14 years people have been becoming sicker for longer. That is multi-factorial, but it is in part due to the gradual erosion of public health funding by the previous Conservative Government.
The issue of improving health is multifaceted, and obesity is certainly an example of that. Factors such as poor mental health and the broken food system contribute towards the growing numbers of people who are overweight or obese. The hon. Member for Stroud talked about the importance of free school meals in helping to reduce childhood obesity, the hon. Member for Blackpool North and Fleetwood (Lorraine Beavers) talked about inequality and poverty levels, and the hon. Member for Bootle (Peter Dowd) highlighted the issues of different demographics and incomes. I spent seven very happy years in Liverpool and have very happy memories; ironically, my liver probably does not, as I was a student there for many years.
There has been a political failure. As has been said, over the past 30 years successive Governments have proposed more than 700 policies to tackle obesity, yet none has ever been successful. We have never had a coherent strategy. We cannot underestimate the scope that must be taken into account when discussing how we tackle obesity. We need to look at every intervention possible, including having a robust, well-supported food production system, ensuring that everyone can afford good-quality, locally produced food, and ensuring that we expand free school meals even further to help to keep children healthy.
The Tobacco and Vapes Bill is a really good example. When Chris Whitty gave evidence to the Bill Committee, he said not only that it was the biggest piece of public health legislation in 30 years, but that it is probably going to be the most significant piece of legislation to help to address inequalities, because smoking rates are one of the most significant reasons why there is such a difference in life expectancy between some of the more deprived postcodes and the wealthier ones. That type of intervention is not only good for health but really good for addressing inequality.
As other Members have said, we cannot tackle this problem without also ensuring that food is produced to high enough standards, that we have limits on junk food advertising, and that we force big food manufacturers to reduce salt and sugar in their products and have a much better labelling system, so that people can make more informed and affordable choices.
I am so impressed with the hon. Member for Strangford (Jim Shannon) for being able to lose 4 stone. I have put on the best part of a stone in the last 18 months, since I was elected, partly because of my increased food intake since I have been here and also because the strange hours mean that I lack time for exercise. I used to have a fairly active job, which I do not really have any more.
Yesterday I went to the Winchester Boxing Club, where a guy called Glyn Parkin gave me a really good workout—I can still feel it today. I did the Compton 10K and the Alresford 10K this year—both big fundraising 10-kilometre events. Despite trying to keep up my exercise, however, it is really hard if I am not focused on food, because about 80% of weight loss is due to diet. At best, perhaps 20% is down to exercise. I am aware that if I do not get on top of my weight, it will affect everything from knees to hips, and in some ways, exercise will become more difficult. If I end up with knee or hip pain, I will end up exercising less—and when I exercise less, I make worse dietary choices as well. We need to encourage people to stay healthy and keep exercising, but if we do not get the diet right, those two things are almost impossible to achieve.
I again thank the hon. Member for Worthing West for securing this hugely important debate, and I thank the British Liver Trust for all that it does. I encourage everyone to go and get scanned by the British Liver Trust when it next comes to Parliament.
(2 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Dr Danny Chambers (Winchester) (LD)
It is an honour to serve under your chairship, Ms Lewell. I congratulate the hon. Member for Bolton North East (Kirith Entwistle) on securing this important debate. I also congratulate her and the hon. Member for Bolton South and Walkden (Yasmin Qureshi) on being such powerful advocates for health in their region. I was interested that both Members focused on poverty levels and inequality in health outcomes—a hugely important subject. The Opposition spokesperson, the hon. Member for Hinckley and Bosworth (Dr Evans), and I both served on the Mental Health Bill Committee, where we discussed repeatedly the fact that people who live in poverty are three times more likely to have mental health issues than those on an average income.
I also served on the Tobacco and Vapes Bill Committee, and I remember Professor Chris Whitty saying that it was not only the biggest piece of public health legislation in 30 years, but one of the biggest interventions to address inequality, because one of the significant factors in differences in life expectancy between more deprived communities and wealthier communities was smoking levels. Despite our economic troubles at the moment, we are still one of the wealthiest nations on Earth, and we can still be one of the healthiest nations on Earth if those resources are deployed in the right way. Everyone should have the right to see a doctor or dentist and to get mental health care as and when they need it.
We have touched on public health. At the moment, two thirds of adults are overweight and 10% of the NHS budget is spent on diabetes and diabetes-related illnesses. That is one reason that the Liberal Democrats are so keen on closing the loopholes in the sugar levy and extending it to sugary milk and juice-based drinks, on restricting the marketing of products high in fat, salt and sugar, on reversing cuts to the public health grant and on legislating for a right to clean air.
It is also why, like the Government, we are so keen on good-quality school meals. The hon. Member for Bolton North East talked about the levels of childhood obesity in primary school and their impact on not only the individual’s health, but the NHS in terms of cost. Having good-quality nutrition in all public organisations, whether schools, prisons or care homes, is an impactful way of not only helping people to have a healthier life, but reducing the burden on NHS services.
I will finish by saying that health is the No. 1 issue that comes up on the doorstep. There is a lot of concern and worry that people may not get healthcare when they need it. Whether in Bolton or Winchester, people need to know that they will be able to access healthcare, free at the point of use, as and when they need it. I commend the hon. Members for Bolton North East and for Bolton South and Walkden on securing this debate and speaking so powerfully on behalf of their constituents.
(2 months ago)
Commons Chamber
Dr Danny Chambers (Winchester) (LD)
I begin by thanking colleagues across the House who have worked so constructively on this long-awaited Bill. There has been a shared recognition that the current mental health system is failing too many people and that reform is urgently needed. I thank the Minister for engaging with us so constructively throughout the process, including as recently as yesterday; it is much appreciated.
When I speak to people in Winchester—I know that hon. Members have very similar stories—mental health is one of the issues that comes up the most. We have families waiting months or even years for treatment, we have parents watching their children deteriorate, and we have people languishing on waiting lists when they would rather be working or studying.
The Bill represents the biggest reform of mental health care in over 40 years. It strengthens patient autonomy, modernises detention procedures and rightly removes police stations from the definition of places of safety. These are vital and much needed steps forward and I know that Members on all sides welcome them.
I will speak briefly to several new clauses tabled in my name, each aimed at strengthening the Bill’s impact for some of the most vulnerable people it seeks to protect. New clause 26 would ensure that every hospital has a dedicated liaison service for the carers of patients detained under the Mental Health Act. This is a vital step to support carers during what can be an unimaginably difficult time and to close blind spots that too often exist when someone is caring for a loved one with serious mental illness.
We know that parental mental health concerns are now the most common factor in children’s social care assessments, and that those children are at much higher risk of developing mental ill health themselves. Yet only about a third of mental health professionals in in-patient settings ask whether a patient is a parent. These children and the carers who support them are too often invisible. By identifying and supporting carers properly, new clause 26 would help close those gaps and ensure that no family has to struggle in silence.
We did not discuss this specifically in Committee, but I would be interested to know about the interaction between the independent mental health advocates, which are being expanded and which we all agreed with in Committee, and a new liaison service. I worry about the duplication. Will the hon. Member explain how that crossover would work in practice?
Dr Chambers
That is a prescient point. At the moment, there is no responsibility to ensure that children in particular, and other carers too, are identified. Even if they are put in advance choice documents, if the person making those decisions does not identify them, that will not come about. We would have to be careful that there is not unnecessary duplication; however, the initiative the hon. Gentleman puts forward is not a belt-and-braces approach to identifying young carers and other carers who are struggling.
New clause 7 seeks to end the detention of children on adult wards, requiring the number to be reduced to zero within five years—other Members have discussed that today—and the Secretary of State to set out how that will be achieved. It simply cannot be right that children are still being treated on adult wards. It is unacceptable and can seriously hinder recovery and effective care.
Although the Bill rightly focuses on hospital-based treatment, the process has also laid bare how fragile our wider mental health services have become, with the lack of early support in primary and community care and the shortage of initiatives that help people long before they reach crisis point. That is why new clause 14 would place a duty on integrated care boards to ensure that community services have the resources they need to meet the demand and report on that regularly. Keeping people well in their communities must be at the heart of any modern mental health strategy, because if we get the community care right, we prevent crises, reduce pressure on hospitals and help people live healthier, more independent lives.
Finally, new clause 22 would establish a veterans’ mental health oversight officer. That dedicated role would ensure that those who have served our country receive the understanding and tailored care they deserve when they come into contact with mental health services. Too often, veterans experience mental ill health, sometimes linked to their service, and they find themselves in systems that do not fully recognise their unique experiences. The proposal would help change that by providing proper oversight; encouraging joined-up working across the NHS, veterans’ services and the third sector; and ensuring that compassion and accountability sit at the heart of how the Mental Health Act is applied to veterans.
Taken together, the proposals are about making our mental health system even more humane, more joined up, and more focused on prevention and recovery. I hope the Government will take them in the spirit in which they are intended, which is to strengthen this important Bill, which we very much support, and deliver a system that truly supports those who need it most.
Abtisam Mohamed (Sheffield Central) (Lab)
I will speak on new clause 35, which sets out the conditions under which community treatment orders can be extended beyond 12 months. Like many across my constituency of Sheffield Central, I know personally how overstretched our mental health services are. My brother lives with complex mental health needs and our family has seen at first hand the impact of a churning workforce, long waiting lists and a lack of community support services, brought about by an unrelenting crisis in funding.
Our system has not been properly expanded or adapted to meet the challenges. Instead, far too many people are detained and restricted, rather than supported to recover. We see this nowhere more acutely than in the overuse of community treatment orders, which were supposed to be a bridge from hospital to home for those who are constantly readmitted to hospital. People have described them as
“a tag that nobody can see, but you know it’s around your mind.”
The evidence shows that they have not met their intended purposes, with three major studies having found no reduction in readmissions or hospital time through their use. Yet despite the previous Government having promised reform, community treatment orders have continued. Reform has been too slow and too narrow in scope.
Dr Chambers
The Liberal Democrats support the Bill, which makes mental health law much fairer and more compassionate. However, reforming detention law is only half the job, because without investment in prevention and community care, the Bill risks becoming an improved way of managing failure rather than preventing it. Without proper early intervention, people deteriorate until crisis is the only door open to them.
Melbury Lodge in my Winchester constituency shows what a good partnership can look like: NHS teams working with citizens advice to help patients sort out debts, bills and benefits before discharge—recovery is impossible if patients return home to a pile of threatening letters and bills. Yet schemes like that are the exception, not the rule. Debt, insecure housing, domestic abuse and bereavement are not side issues—they are often root causes—and care plans that ignore them are not truly caring.
Before I bring my remarks to a close, I pay tribute to the extraordinary people working at the frontline of mental health care—nurses, doctors, counsellors, therapists, support workers, carers and charities—who hold up a system that too often feels as if it is collapsing around them. Their compassion and professionalism are the reason so many people make it through their darkest moments. They deserve much more than just thanks; they deserve a system that supports them as much as they support others.
In my years of campaigning for better mental health, including as a trustee of a mental charity and, in the past year, as the Liberal Democrat mental health spokesperson, I have become more convinced that mental health cannot be seen as the responsibility of NHS services alone. It must be embedded across society, in education, healthcare, housing, farming and even in the way we support small businesses.
I thank the Minister and his team for all their work on the Bill and their cross-party engagement, as well as everyone who served on the Bill Committee and the Members who have turned up repeatedly to these debates. One thing that does unite the House is improving mental health care.
Question put and agreed to.
Bill accordingly read the Third time and passed, with amendments.