(3 years, 11 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
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Yes. The NHS covid-19 app, which will be available this month, will, as one of its features, ensure that people can go to a pub, restaurant or hospitality venue and scan the QR code quickly. Contact details will then be safely collected in case they are needed for contact tracing purposes. We are making the scheme mandatory. It has been very successful voluntarily and we are going to roll it out mandatorily, so I urge hospitality businesses in Bridgend, and right across England and Wales, to download a QR code for themselves and put it where it is very easy to use and obvious, so that all of us, when we go to the pub in Bridgend or anywhere else, can very easily scan in. If there is an outbreak, we can then contact trace that outbreak and keep the virus under control.
I do not underestimate the challenges the Health Secretary has faced over the past few months, but six months on, after many, many warnings of the likelihood of a second wave and of what would happen without a fully operational test, track and isolate system in place before lifting the lockdown, unfortunately the Government are still not getting the basics right. That is happening in my constituency in Oldham. We did not have a mobile testing unit turn up and we are still not getting the data we need to trace covid-positive cases.
For starters, will the Secretary of State sort out the private contractors for the national test and trace system; make sure that public health directors are getting timely, high-quality data on covid cases, including occupational workplace details; and, fundamentally, make sure our local authorities have the resources they need to trace all contacts, and ensure restrictions are understood and observed?
The answer is yes. In Oldham in particular, where there has been a very serious outbreak, making sure we have that connection between the national system and the data flowing through to local contract tracers is incredibly important. We are working on some innovative solutions proposed by the local authority and others in Manchester to enhance that system as much as we possibly can to keep control of the virus.
(4 years, 1 month ago)
Commons ChamberI will look precisely at putting mobile testing units in Maltby and Dinnington and look, again, at the local data, along with the local authority, to see what we can do.
I, too, welcome the Health Secretary’s change of heart and his assurance that complete pillar 2 testing data will be sent to local public health departments each day and not each week. The delay has inhibited local public health departments’ ability to contact and trace covid-infected people, letting the virus spread in some areas. Given that many of us have been asking for these data for a number of weeks now, what is his assessment of the number of people who have been infected as a result of the delay, the impact on public confidence, and the hit that local economies will take because of these failures?
We have been building the test and trace system and improving the data that flows from it and underpins it all the way through this crisis, and I am glad that the hon. Lady is pleased by the continued progress that we are making. That is the way to look at this. We have been building this extraordinary service at extraordinary pace, and I am really glad we are able to get more.
(4 years, 1 month ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
My right hon. Friend the Secretary of State for Business, Energy and Industrial Strategy is working closely with the beauty industry regarding how it can open in a covid-secure way, taking into account clinical advice. We have, however, been able to change some advice to allow for the reopening of camp sites. I am very pleased about that, and it will help lots of families to enjoy summer safely. It is disappointing to hear of the blanket approach taken to not having any camping in the New Forest—I went camping there as a child, and enjoyed it very much. On a campsite people must be particularly careful of shared facilities, and ensure that they are cleaned properly, but there is a way to open campsites safely and securely, and doing that in the New Forest, and elsewhere, will help people to enjoy summer safely.
The Secretary of State’s comments on Sunday, when he suggested that my Greater Manchester public health colleagues needed help in interpreting the pillar 2 data that they received from centrally contracted private labs, was nothing short of insulting. These are some of the most talented, dedicated and professional people with whom I have had the privilege to work. They do not need help; they need timely, patient-identifiable, and complete data, which they have not been getting. Instead of trying to shift the blame for the Government’s mess in handling the covid crisis on to our amazing public health teams and care home staff, what is the Secretary of State doing to ensure that people get those data? Why will he not announce local thresholds for easing and reinstating lockdowns, as Germany and other countries have done? Finally, will he apologise for his patronising remarks to my public health colleagues?
I will not allow a divisive approach to tackling this crisis. We will all work together. We will work together with local authorities, local Mayors and local areas, and we will do that in Manchester and across the board. I just hope that the hon. Lady will take the message back to Manchester about how keen we are to work collegiately and together. That is the right way forward.
I have already answered the question on thresholds for changes to local lockdowns. We have to apply judgment. Again, we do this in consultation with and working hand in glove with the local area. On the point about data, the hon. Lady might want to have a word with her friend, the shadow Secretary of State, because he was right to acknowledge that the sharing of this sort of data, which is a complicated task, is constantly improving.
(4 years, 1 month ago)
Commons ChamberThe age- standardised covid mortality rate for severely disabled men is nearly 200 per 100,000, and for severely disabled women, it is over 141 per 100,000. That compares with death rates of 70 and 36 per 100,000 for non-disabled men and women respectively. When poverty is factored in, it will show even higher death rates for disabled people. Will the Secretary of State undertake an immediate analysis of the impact of covid on disabled people living in poverty? Will he speak to his counterpart in the Department for Work and Pensions about releasing data on the disabled social security claimants who have died during the covid pandemic, as to date those data have been very limited?
I am absolutely determined to address the questions and the impact of covid on those who live with disabilities. The hon. Lady’s point is important and this will form part of our work on inequalities and the response to covid. The Minister for Equalities is taking that work forward.
(4 years, 5 months ago)
Commons ChamberYes, Ofsted absolutely will take a lenient view of the impact of coronavirus on what happens in schools. When it comes to the broader point about what households should do when one person tests positive, that is of course something we are considering very closely. At the moment, the number of cases is at a level such that we can give individual advice to each household. It is likely that that will not be possible throughout this situation, so we will make sure that there is formal public guidance for everybody, so that everybody knows what to do.
Will the Secretary of State clarify a point that was made by the Secretary of State for Work and Pensions on Monday? She said that social security claimants who were due to take a work capability or work-related activity assessment would not have their social security support stopped, but those claimants were omitted from the group that the Chancellor talked about in the Budget statement, so will the Secretary of State clarify who is right? Will he also make sure that information is available for the deaf and the visually impaired? There is a gap in the information in that respect.
On the latter point, I entirely agree, and it goes with the earlier point about communications in foreign languages. On the first point, I will ensure that the Work and Pensions Secretary writes to the hon. Lady with the answer.
(4 years, 5 months ago)
Commons ChamberIf the hon. Gentleman will bear with me for just a few minutes, I want to push on rather than incur the wrath of Madam Deputy Speaker.
I am clear that there must be integration across Departments, because dealing with these issues is about having a warm home that is suitable for you and those you love, and about having an environment that sustains your health. It is about good education, so that people are equipped with the skills to look after their health. It is about having jobs that are purposeful and rewarding.
The health inequalities challenge is stubborn, persistent and difficult to change, and I recognise the enthusiasm, energy and frustration that those who will speak in this debate will bring. The Government have firmly signalled their intention to take bold action on these issues. We are committed to reducing inequalities and levelling up. To be effective in reducing health inequalities, we need a long-term sustainable approach across all Departments. Early onset diseases, disability and avoidable mortality are concentrated in poor areas, so this is where we must act if we are going to make the system fairer.
I ask the hon. Lady to bear with me for just a minute.
It is important that we improve those with the worst-affected health the fastest. It is unacceptable that a man born in Blackpool today can expect 53 years of healthy life, while a man born in Buckinghamshire gets 68 years. We know that there is also inter-area variation, which is unacceptable. We have an opportunity to seize the initiative to do this across the country. The ageing grand challenge is to ensure that everybody can enjoy a further five years of healthy life by 2035, while narrowing the gap between rich and poor.
We set out our intentions in the prevention Green Paper published last year. The public consultation closed in October, following significant engagement. We had some 1,600 responses, which is more than double the average the Department usually receives from such public consultations. We are analysing the responses and developing our reply, which we will publish shortly. We want to shift the focus from treating illnesses to preventing illnesses and driving healthy lives. The NHS long-term plan contains commitments that outline the role the NHS can play in supporting that shift.
We are passionate, and I am passionate, about our commitment to an NHS that is fit for the future. That is why we are funding it with an extra £33.9 billion.
I commend the Minister for many of the points she is making. I want to clarify the point about interdepartmental work. We know from seminal works such as “The Spirit Level” that when we reduce the gaps between rich and poor, focusing not just on income but on wealth and power inequalities, we get increases in life expectancy across the community, as well as in social mobility, educational attainment and so on. If the Government recognise that, will they commit to considering what impact policies will have on health inequalities as they are being developed?
The hon. Lady will appreciate that I cannot speak for all Departments, but it is my job to drive home the value of health in those Departments and to ensure that, as she says, we think about the broader consequences across the policy-making piece.
In answer to my right hon. Friend the Member for South West Wiltshire (Dr Murrison), smoking does remain one of the most significant public health challenges. It affects disadvantaged groups in particular and exacerbates inequalities. That is particularly apparent when looking at smoking rates in pregnancy. Three weeks ago, I visited Tameside Hospital in Greater Manchester to see its smoking cessation work. It started with a much higher than average smoking rate, and having a tailored public health budget in the locality has allowed it drive down into the inequality within the community. It has a specialist smoking cessation midwife to help these young women, their families and their partners give up smoking—for their own health, yes, but also for the health of their babies.
On a point of order, Mr Speaker. On 24 February, during my speech in the Adjournment debate on the deaths of social security claimants since 2014, I incorrectly stated that Daniella Obeng had taken her own life. I would like to correct the record. In fact, Daniella died from bronchopneumonia. She also had a brain tumour that resulted in multiple epileptic fits.
Daniella’s family told me that she was a talented singer with a caring, supportive boyfriend and a wonderful 13-year-old son. After her social security support was stopped in 2016, she struggled to work because of her health conditions. Daniella managed to get a singing contract in Qatar for six months, but after just six days was found dead in her bedroom. The guitarist who was supporting her said that she was having fits during her performances and went to bed to recover. Unfortunately, she never woke up.
I offer my sincere condolences to Daniella’s family. She sounds an absolutely amazing woman.
(4 years, 6 months ago)
Commons ChamberThe hon. Lady is dead right, and I have changed that direction of travel. This year is the first year for a generation when there has been an increase in the proportion of the NHS budget going to primary and community care. That change was at the core of the long-term plan. I insisted on that because I entirely agree with her analysis that getting more support out into the community is critical. This has been going in the wrong direction for a generation, and we are just starting to fix it.
I want to pick the Secretary of State up on the point that he made a few moments ago. We had an exchange at the end of January about life expectancy. He says that life expectancy is increasing. It is absolutely clear from Professor Sir Michael Marmot’s report, and it has been clear since 2017, that life expectancy is stalling. Sir Michael said that
“life expectancy actually fell in the most deprived communities outside London for women and in some regions for men.”
I have written to the Secretary of State and I have not yet had a response, but he has an opportunity to correct the record now.
I saw the letter and I absolutely will reply to the hon. Lady. What I have said before, and I repeat now, is that life expectancy in this country is rising. There are parts of the country where that is not true.
It is not flat, it is rising, and it is really important that this debate, which is so critical, is based on the facts. The increase in life expectancy should be shared right across the country, and it is not, and we are determined to fix that. We are determined to ensure that life expectancy in this country rises everywhere. That is not the case and it needs to be the case, but life expectancy overall is going up. That is the fact.
The report says that it has almost ground to a halt since 2011. These are the facts, and there is an onus on the Minister to be absolutely clear about this. We cannot fudge this issue.
My hon. Friend is absolutely right, and that is the sort of analysis on which we can make decent policy progress, because it based on the facts, rather than on making things up.
I will give way to the hon. Lady one more time and then I will move on, because we need to make some progress.
Again, for the record, let me say, as a former public health consultant, that healthy life expectancy is also going down.
(4 years, 7 months ago)
Commons ChamberExactly. That is precisely true, and what is so frustrating is this—perhaps my hon. Friend knows the answer to this question: what did they do with the half a billion pounds that they did not put into their NHS? It is a disgrace.
As well as the question of what the money will be spent on—and I welcome the extra investment—there is the question of—[Interruption.]
Order. There is a separate Scottish debate going on, and, however interesting it might be, it is not good if I can hear that and cannot hear the hon. Lady.
I could not hear myself, Madam Deputy Speaker.
It is also a question of who and where. We know that life expectancy is flatlining, that healthy life expectancy is flatlining, and that in some parts of the country, including the north-west, it is actually going backwards. How are we to ensure that we target the money where it is most needed?
(4 years, 10 months ago)
Commons ChamberNo they don’t; none of the hospitals the right hon. Gentleman announced at the Tory party conference includes mental health trusts. He knows there are 1,000 beds in old-style dormitory-style wards in desperate need of upgrade. He knows that we have problems with anti-ligature works that desperately need doing in mental health trusts because they are putting lives at risk every day.
On social care, we were told we were going to have the big solution to social care. The Secretary of State was briefing that a previous Chancellor, the right hon. Member for Runnymede and Weybridge (Mr Hammond), was holding him back and he was going to give us a solution on social care. And what do the Government say? They say, “We have not got a social care Green Paper, we have not got social care proposals, we will get proposals on social care in due course.” The Secretary of State is kicking the can on social care down the road again.
Let me come to the Health and Social Care Act 2012. On Second Reading, it was described by the new Minister, the hon. Member for Mid Bedfordshire (Ms Dorries)—I welcome her to her elevation to the Treasury Bench; it was remiss of me not to do that earlier—as one of the most exciting Bills to be put before Parliament in the 62 years since the NHS was established. We were told that there was going to be legislation to undo the worst excesses of that Lansley Act, but all we are getting apparently is draft legislation, again, “in due course”—that is the wording in the explanatory notes to the Queen’s Speech.
I had the privilege of sitting on both Committees that considered the Health and Social Care Bill, as it was then. Section 75 is particularly punitive in terms of its requirements for clinical commissioning groups to put all contracts out to tender. Some £25 billion-worth of public money has gone to the private sector, with the implications of an increase in health inequality, both in access and outcomes. Does my hon. Friend agree that this is an absolute travesty?
Yes, I can give that confirmation. I have seen some reports from the local Labour party putting fears into people’s minds about the future of the Parsons Green walk-in centre. There are no plans to close the centre, and anybody who says so is simply scaremongering. I am absolutely delighted at the campaign that my right hon. Friend ran to save the A&E and to save the services in west London; it was thanks to him and his efforts that we managed to do exactly that.
Does the Health Secretary not feel ashamed that we have the highest rate of child mortality in western Europe? We also have a declining life expectancy; for women it is getting worse and for deprived areas it is getting worse. We are one of the only developed countries where that is happening, and it is partly as a result of the underfunding of the NHS but more widely because of austerity.
I have great regard for the campaigning that the hon. Lady does on many topics, but I am afraid to say that she was factually inaccurate in what she said just now; it is not true. We are putting the largest and longest investment into the NHS in its history, and I think that that is the right thing to do.
(5 years, 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
I completely agree. Sadly, the figure for people with schizophrenia in work remains at about 5%. It is just 5%, because the support simply is not there and the medication and treatment are not there on a routine basis to ensure that they are able to work.
Figures suggest that one in four of us will experience mental ill health at some point in life, often because of bereavement or a relationship breakdown. I pay tribute to all the organisations involved in the Time To Change campaign, which has done brilliant work to challenge the stigma and discrimination that affect people with mental health conditions in employment and elsewhere.
The change in language and awareness of conditions is one reason to seek reform now. For example, the Mental Health Act 1983 is defined as:
“An Act to consolidate the law relating to mentally disordered persons.”
The language around mental health has changed much since the current law was enacted. We also need to consider its far reaching powers.
The independent review of the Mental Health Act, published seven months ago concluded:
“The Mental Health Act gives the state what are amongst the most significant powers that it has; the power to take away someone’s liberty without the commission of a criminal offence and the power to treat that person even in the face of their refusal. Because of that, we think that is important that the purpose of the powers is clear, as should be the basis on which they should be used.”
It is hard to disagree with that conclusion, especially given the number of people who are affected by those extensive powers.
I congratulate my hon. Friend on securing this debate, and on his personal and emotional contribution—I believe that adds everything. People living with dementia also fall under the Mental Health Act. There are concerns around section 117 and the right for aftercare support once someone is detained under the Mental Health Act, particularly those living with dementia. Does my hon. Friend share my concerns on that?
Certainly, there is insufficient support for a whole range of people. We have sadly seen a roll-back of support, independence of choice and control in a number of areas, including social care support, health services and direct benefits for some disabled people, particularly in the past nine years.
The extensive powers, which I described, were used to detain 50,000 people last year—a 47% increase in the past decade. The only other people detained in this country are those in criminal custody. Those citizens have safeguards to protect them from going to jail, but we do not have the same safe standards of support and safeguards for mental health care. Those who commit a criminal offence have a police investigation, the CPS evidence threshold, a trial, the right of appeal and advocacy throughout, but for the 50,000 detained under the Mental Health Act few such safeguards exist, despite the deprivation of liberty, choice and control.
We can turn this situation around. The independent review of the Mental Health Act, chaired by Professor Sir Simon Wessely, recommended that four principles be written into a revised Act. First, it recommended that choice and autonomy, even for someone detained under the Act, must be respected, enabled and enhanced wherever possible. Secondly, it recommended that the compulsory powers contained within the Act should be exercised in the least restrictive way possible. Thirdly, it recommended that services and treatments should be of therapeutic benefit and delivered with a view to minimising the need for Mental Health Act powers to be used. Fourthly, it recommended that the individual must be respected, and that care and treatment must be provided in a manner that treats them accordingly.
I seek the Minister’s views on those principles being incorporated in forthcoming plans. If those four principles had existed when my mum was detained—she has been sectioned more times in my lifetime than I can remember—I would have had more reassurance that her needs, rights and wishes would have been the starting point for the care and treatment she received. Sadly, that was not the case.
This is the first debate to be held on the Mental Health Act since that review was published, which is astonishing, given the level of use of the powers in the Act and the level of support for reform. The review made 154 recommendations. The Government accepted two immediately and agreed to publish a White Paper by the end of this year to bring forward full legislation. I welcome that; there is no one who does not want to see that. However, given the paralysis caused by Brexit, and the new Prime Minister and Cabinet, can the Minister confirm that that timetable has not slipped?
I am delighted to see the hon. Member for Bermondsey and Old Southwark indicating his agreement. It meant that they would not then suffer a much worse breakdown, which would have meant that they would have to be incarcerated, for want of a better word, for a much longer period.
To prevent people, including people living with dementia, from having to be admitted to hospital, there needs to be community support and after-care support once people are discharged, to ensure that they can be kept as healthy and independent as possible in the community for as long as possible.
The hon. Lady is absolutely right, as long as we recognise that what is needed is a range of facilities. Even the most ardent advocate of doing away with in-patient beds would, if pressed, admit that there will always be some people who at some point absolutely need to have some in-patient treatment.
If there are some people who need to go in for a considerable period of time, and hopefully there are a lot more people who do not need to be admitted to acute units at all, it follows almost logically that there will be some people who are on the borderline between the two, who can get by in society with a degree of self-awareness—either their own or that of their immediate family—and that when the warning signs appear, provided there is that network of specialist care with beds for very short-term stays, they can receive what I call a “top-up”, or, if we were talking about servicing a vehicle, something that will prevent a much greater collapse from happening later, with all the consequent horrors.
The question of what happens when people are admitted to acute units arose on a second occasion. I mentioned the first occasion, when I tried to introduce my private Member’s Bill in December 1997 and it was overshadowed by foxhunting. On a second occasion—on 9 December 2010, to be precise—I had secured an Adjournment debate on what happens about the information that is given to someone’s nearest and dearest when an adult is sectioned and goes into an acute unit. That occasion was on the day of the key debate about the trebling of student tuition fees, so once again we found mental health being somewhat upstaged by other matters that were of national importance. However, that is no reason not to persist or not to continue to try and emphasise to Ministers how these issues will never go away until they are finally tackled.
On that occasion in December 2010, I raised the case of the daughter of my constituents, Mr and Mrs Edgell. Sadly, their daughter—who was called Larissa but known as Lara—had taken her own life in 2006. For two years prior to that, the medical authorities had refused to share information about her with her parents; because she was an adult in her thirties, they refused to share vital information about her suicidal thoughts with her parents, on the grounds of patient confidentiality.
It subsequently turned out that there were very good guidelines that said that such information should be shared. So, I wrote to the then Minister with responsibility for care services, the hon. Member for Bury South (Mr Lewis), saying that there was clearly a breakdown in the system if adequate rules existed but were not being put into practice locally. The rather unsatisfactory answer that I received at the time was that the responsibility lay with the local medical authorities to ensure that the central guidelines were implemented.
As I say, that was at the end of 2010, so it was a long time ago. I wonder whether the Minister will be able to reassure me that there is now more central direction. In the case of Lara and her parents there was inadequate sharing of vital information, under the mistaken belief that patient confidentiality trumped the fact that an adult patient was incapable of making her own decisions. I would like to know whether that situation has been rectified, or whether we are still dependent on local medical institutions and authorities to apply a central guideline that ought to be better known.
This week, I received a letter from Lara’s mother, who asked me to attend this debate. I can do no better than to read from what she says, not so much about what happened to her daughter but about the continued interest that she has in the workings of the mental health services. She says that she would like to make her own recommendations; given what happened so tragically in her immediate family, we owe it to her to give serious consideration to those recommendations, which are as follows:
“1. The 1983 Act should be revised to prioritise the dignity of individuals who come to be in the Service’s orbit.
2. Such individuals should have their values and world views respected and have a significant say in the manner of their treatment.
3. They should have the option to refuse certain treatments.
4. Mental hospitals must be places where patients feel safe: there have been numerous allegations of staff members being abusive, provocative and/or intimidating.
5. Use of force should be absolutely minimised. This includes physical restraint, seclusion, or forced medication.
6. A reduction in ‘sectioning’.
7. A reduction in stigma”—
and finally:
“8. All aspects of the Mental Health Service should be more open, and subject to independent scrutiny from time to time.”
I will conclude by making one left-field observation relating to the armed forces. The Select Committee on Defence, which I have the honour of chairing, has been recommending for some time that we establish a centre of excellence for the mental injuries suffered by those who put their life on the line to defend this country, preferably alongside the national centre for physical rehabilitation at Stanford Hall. We have now raised this issue twice with the Secretary of State for Health and Social Care, who has given us a reasonably encouraging response. However, once again, we feel that he is coming up against resistance because of the philosophy that people must be treated locally when at all possible, not admitted as in-patients in centralised locations. That is causing a pushback against our idea.
Our idea is based on the fact that those who suffer injury in combat situations have experienced a peculiar and unique form of trauma, different from those that ordinary mental health professionals can be expected to understand. I am sure that my hon. and gallant Friend the Member for Plymouth, Moor View (Johnny Mercer) will want to expand on that topic, if he is lucky enough to catch the Chair’s eye. We believe that there is a case for a national centre of excellence, and that the welfare of members of our armed services who suffer mental injury should be no less important to us than the welfare of those who suffer other, physical forms of injury in the cause of defending our freedom.