Coronavirus

Debbie Abrahams Excerpts

Tuesday 7th July 2020 Commons Chamber

[Matt Hancock]

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.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab) [V]]

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?

[Matt Hancock]

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.

Covid-19 Update

Debbie Abrahams Excerpts

Monday 29th June 2020 Commons Chamber

[Debbie Abrahams (Oldham East and Saddleworth) (Lab) [V]]

The 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?

[Matt Hancock]

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.

Coronavirus

Debbie Abrahams Excerpts

Wednesday 11th March 2020 Commons Chamber

[Matt Hancock]

Yes, 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.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

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.

[Matt Hancock]

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.

Health Inequalities

Debbie Abrahams Excerpts

Wednesday 4th March 2020 Commons Chamber

[Jo Churchill]

If 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.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

Will the Minister give way?

[Jo Churchill]

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.

[Debbie Abrahams]

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?

[Jo Churchill]

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.

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That this House notes the publication of Health Equity in England: The Marmot Review 10 Years On, notes that Government is committed to level up outcomes to reduce the health gap between wealthy and deprived areas, and supports the Government’s commitment to delivering long-term improvements for everyone no matter who they are, where they live or their social circumstances.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

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.

[Mr Speaker]

Thank you. We need say no more. It is now on the record.

Social Care

Debbie Abrahams Excerpts

Tuesday 25th February 2020 Commons Chamber

[Matt Hancock]

The 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.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

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.

[Matt Hancock]

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.

[Debbie Abrahams]

It is flat.

[Matt Hancock]

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.

[Debbie Abrahams]

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.

[Matt Hancock]

As I said, life expectancy is rising, Madam Deputy Speaker.

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[Matt Hancock]

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.

[Debbie Abrahams]

rose—

[Matt Hancock]

I will give way to the hon. Lady one more time and then I will move on, because we need to make some progress.

[Debbie Abrahams]

Again, for the record, let me say, as a former public health consultant, that healthy life expectancy is also going down.

NHS Funding Bill

Debbie Abrahams Excerpts

2nd reading & 2nd reading: House of Commons
Monday 27th January 2020 Commons Chamber

[Matt Hancock]

Exactly. 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.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

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.]

[Madam Deputy Speaker (Dame Eleanor Laing)]

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.

[Debbie Abrahams]

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?

The National Health Service

Debbie Abrahams Excerpts

Wednesday 23rd October 2019 Commons Chamber

[Jonathan Ashworth]

No 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.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

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?

[Jonathan Ashworth]

Absolutely.

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[Matt Hancock]

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.

[Debbie Abrahams]

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.

[Matt Hancock]

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.

Mental Health Act 1983

Debbie Abrahams Excerpts

Thursday 25th July 2019 Westminster Hall

[Neil Coyle]

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.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

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?

[Neil Coyle]

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?

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[Dr Lewis]

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.

[Debbie Abrahams]

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.

[Dr Lewis]

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.

Living with Dementia

Debbie Abrahams Excerpts

Tuesday 25th June 2019 Westminster Hall

[Ian Paisley (in the Chair)]

It is very warm in the Chamber today. Hon. Members may want to remove their jackets: please feel free to do so—I would not want anyone parboiled. Before I call Debbie Abrahams, who will move the motion in her own time, I ask Members to prepare, because of the interest in the debate, to make speeches of about five minutes. We shall keep that informal, but hopefully we will be able to get everyone in.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

It is lovely to see you in the Chair, Mr Paisley. I thank the Backbench Business Committee, which granted the debate, and I want to recognise my hon. Friend the Member for Cambridge (Daniel Zeichner) as its co-sponsor. I also thank the Alzheimer’s Society, which provides superb support to the all-party parliamentary group on dementia, and the parliamentary digital team for promoting the debate. We hope to hear the views of many people from across the country on the recommendations in the report we shall discuss.

The subject of dementia and people living with dementia is particularly close to my heart. As many Members will know, my mum was diagnosed with Alzheimer’s disease at 64 and I was one of her principal carers. Having had that caring experience and seen some of the issues my mum faced, I wanted to raise awareness about dementia and the many different brain diseases that cause it. As many will know, dementia is now the leading cause of death in the UK, having overtaken heart disease and cancer. It is estimated that 850,000 people in the UK have a dementia, and Alzheimer’s disease is the most common. That is expected to increase to 2 million by 2050. Globally, there will be 152 million people living with dementia by 2050—a 204% increase. If there is anyone who does not now know someone with dementia, they soon will.

There is already much work under way at the UK Dementia Research Institute, where there is a search for programmes to identify people at risk of different dementia types and prevent them from contracting the disease, as well as for treatments and cures. In spite of the commitment by the former Prime Minister, David Cameron, to invest in dementia research, it still receives only one tenth of the research funding that cancer receives. However, there is also a need to invest in dementia research that could improve the lives of people affected by dementia today. I have campaigned with many others to raise the issues affecting people living with dementia, including becoming the first MP to be a Dementia Friends champion, working with Oldham Dementia Action Alliance to develop a dementia-friendly Oldham and Saddleworth, and undertaking various all-party group inquiries on how to improve the quality of life of people living with dementia.

The report from our latest inquiry, on dementia and disability, was launched last week. More than 2,500 people affected by dementia responded to our call for evidence—one of the largest responses to any all-party group inquiry. What the respondents had to say is very important. According to the Equality Act 2010 and the United Nations convention on the rights of persons with disabilities, dementia is a disability. As one family carer put it:

“If this isn’t a disability then I don’t know what is.”

However, the all-party group was told that society is lagging behind in that understanding and failing to uphold the legal rights of people with dementia. Evidence presented to the inquiry revealed that, across the country, the disability rights of people with dementia are not being upheld. Shockingly, 98% of the survey respondents thought that people living with dementia are treated differently from people with other health conditions or disabilities. They believe that that is due to the hidden nature of dementia, and the stigma that surrounds the condition. That is simply not good enough, and we need to do more.

[Mr Jim Cunningham (Coventry South) (Lab)]

I congratulate my hon. Friend on obtaining the debate, and those who supported her. I hope she will touch on the cost of care. The cost of looking after people with dementia is astronomical, as it is with care generally. I hope she will also touch on progress with dementia research.

[Debbie Abrahams]

I thank my hon. Friend, who anticipates me. I shall certainly talk about social care in relation to people living with dementia and their carers. My speech is focused on our inquiry report, but other hon. Members may want to touch on progress being made in research.

A central finding of the inquiry is that the public, employers, organisations, Governments and public bodies need to do more, and need to recognise the rights of people with dementia. The inquiry also revealed that a range of societal barriers prevents people with dementia from living independently. Action needs to be taken across a number of key areas to ensure that people with dementia receive the protections and safeguards provided by legislation and convention. The key areas that were identified as having a direct impact on people’s daily lives include employment, social protection, which is also called social security or welfare benefits—I consider that a misnomer because most people who receive so-called welfare benefits have contributed, so they are an entitlement, not a benefit—social care, transport, housing and community life.

On employment, the importance of work in giving people a sense of purpose, self-esteem, status, companionship and income was raised. Work can also provide a routine. Without it, people can feel a loss of identity and sense of purpose. One person with young onset dementia told us:

“I applied for so many jobs and I just got rejections. I used to lecture at a university and now I can’t get a job collecting trolleys. Any job is worthwhile. Not having a job destroys self-esteem.”

At the launch of the inquiry report last week we heard of a woman who had worked in a Government Department and had been diagnosed with early onset dementia. She became ill because of the condition, was then disciplined about that and, ultimately, was forced to take ill-health redundancy. I know that the Minister will be as concerned as I am about that disgraceful position. If Departments are setting out how we should lead, we must make sure we have our own house in order.

There needs to be more awareness among both employers and employees of the employment rights of people with dementia. People need to feel empowered to tell their employers about their diagnosis and employers should feel supported in fulfilling their responsibility to make reasonable adjustments so that people with dementia can continue to make a meaningful contribution in the workplace. The Government have a hugely important role to play, by providing guidance and support for employers. The Access to Work programme could go some way to addressing the unmet needs of people with dementia in relation to employment. However, as I know the Minister recognises, that is a small pot of money, which currently supports only about 35,000 of the 4 million or so disabled people who are fit and able to work. We need to make sure that that is extended.

In relation to social protection, people raised issues about the extra costs associated with living with a disability. Access to extra financial support can provide a lifeline for people with dementia and help people to continue getting out and doing the things they enjoy. One of the key challenges for people affected by dementia is knowing what financial support is available to them. One family member told the all-party group that they felt that

“people with dementia are effectively ignored by the disability benefits system.”

People with dementia and their carers need access to more support to enable them to know what financial help they are entitled to and how to make a successful claim. The Minister knows my views on both the fit-for-work and personal independence payment assessments. Until those assessments are scrapped, people with dementia deserve to be assessed by professionals who understand the condition, and they should not have to undergo unnecessary reviews or reassessments, as currently happens.

Assessment processes need to be clear and appropriate for people with cognitive impairments. That is why we are calling for the Government to mandate the Department for Work and Pensions to convene an expert group to review access to social protection for people living with dementia and their carers, recognising their specific needs. This group must include those who are experts by virtue of their own lived experience. The Government should also mandate the DWP to exempt personal independence payment claimants below the state pension age and with a dementia diagnosis from reassessments, which are unnecessary and cause a lot of distress for people living with dementia and their families.

A further key issue was social care. The inquiry received considerable feedback about inadequate or inaccessible social care for people affected by dementia living in England. There are many ways to improve the lives of people with dementia, but it is difficult in the current context of the well-documented social care crisis across the country. It is now recognised that that social care crisis is a dementia crisis. We need to fix the broken care system, and I am proud to support the Alzheimer’s Society’s “Fix Dementia Care” campaign. I know the Minister is eager to publish the Green Paper as soon as possible, and I urge the Government to recognise that.

In the context of social care reform, I will mention the Alzheimer’s Society’s campaign for a dementia fund. The system of dementia care in this country is in urgent need of reform and extra investment. In May, I tabled early-day motion 2360 in support of the campaign, calling for a financial injection into the social care system in the short to medium term, allowing for greater provision of safe and quality care, longer visits and savings to the NHS. My EDM now has the backing of more than 100 MPs of all parties, and I know that thousands of Alzheimer’s Society campaigners have written to their own MPs as well. I would welcome a commitment from the Minister to look at the proposal, and her support in getting the Government to include a dementia fund in the forthcoming spending review, to end the unfairness for people with dementia.

Another key area is transport. Access to public transport can have a huge impact on the lives of people affected by dementia, helping to reduce loneliness and social isolation by linking someone to their community and friends, and providing links to essential services such as necessary respite care. Access to public transport is therefore critical to maintaining someone’s quality of life. However, accessing transport can be very challenging for people with dementia. We heard many stories of how poor or inaccessible transport is, preventing people with dementia from participating in society, despite rights to accessible transport being enshrined in the Equality Act 2010.

Our report stresses the importance of reviewing any changes to bus and community transport services in the context of the public sector equality duty, to ensure that reasonable adjustments are made to enable people with dementia to continue to use public transport. Local authorities have a huge role to play here, and I hope that they will take steps to support people living with dementia in their communities.

On housing, the inquiry found that people with dementia are frequently being denied their right to live independently in their own homes, where they are able to make their own choices. It is important that people with dementia are supported as much as possible to stay as long as possible in their own home or to access suitable supported housing. People with dementia have the right to personal choice over where and how they live. We believe that people living with dementia must have access to adaptable housing, trained home care staff, and specialised supported housing schemes.

The final area is community life. The evidence supplied to our inquiry reaffirmed the importance of supporting people with dementia to continue to lead full and independent lives. That means creating communities where no one is excluded or has to face dementia alone. The all-party parliamentary group praised the work of the Dementia Friends programme, which helps to raise awareness of the condition and has created almost 3 million Dementia Friends in England, Wales and Northern Ireland—5,000 of them in my constituency of Oldham East and Saddleworth, a fact that I am very proud of.

A particularly relevant recommendation of the report is for Westminster to become the world’s first dementia-friendly Parliament, including ensuring that the parliamentary estate is a safe and welcoming place for people affected by dementia to work and visit. I have met a number of people today who are visiting Parliament; I hope they will be able to report positively on how they have been received today.

Our report is wide-ranging and covers a number of different issues that need to be addressed if the disability rights of people living with dementia are to be realised. Over the coming months, the all-party parliamentary group on dementia will work with the Alzheimer’s Society and other partners to turn the report’s recommendations into reality. That has the potential to have a huge impact on the lives of people living with dementia and their carers, and I hope that everyone in the Chamber today and beyond will offer their support.

--- Later in debate ---

[Debbie Abrahams]

I thank everybody for their excellent contributions to a really important debate. I particularly thank those who shared their personal stories. Such empathy makes a difference to people who have dementia and to their carers, and I thank Members for that. There were examples of excellent practice. In different parts of the country, excellent work is going on, and we need to make sure that it goes beyond Members’ own constituencies. The key thing is national leadership. I know the Minister is committed. On the areas around housing, transport and social protection, which are not necessarily in her brief, I would be grateful if she made sure her colleagues are aware of the recommendations.

Motion lapsed (Standing Order No. 10(6)).

Health

Debbie Abrahams Excerpts

Tuesday 14th May 2019 Commons Chamber

[Matt Hancock]

Yes. We can only fund a stronger health service and we can only fund strong public services if we have a strong economy and that would be put at risk by the recklessness of the Labour party. Let us talk about the details of how we are going to improve healthcare in this country, but let us say first and foremost that we can fund public services only if we can ensure that the economy is run well.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

Would the Secretary of State like to address the issues that my hon. Friend the Member for Leicester South (Jonathan Ashworth) raised? We are seeing a flatlining of life expectancy, with the infant mortality rate having increased for the first time in 100 years. Will he address that in his response, please?

--- Later in debate ---

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

For the first time since the 1890s, we are seeing a slowdown in health improvements, including, as we have heard, a flatlining in life expectancy. However, that varies in different parts of the country. Men’s average life expectancy in Windsor and Maidenhead is 81.6 years, while in my constituency it is 77 years. As well as the data from the Office for National Statistics, we have information from the Institute and Faculty of Actuaries that falling longevity has accelerated. Last year’s analysis cut forecast life expectancy by two months, and this year it took off another six months. Since 2015, it has fallen by 13 months for men and 14 months for women. That renders the Government’s increase in the state pension age an absolute nonsense, and is rather cruel to women born in the 1950s.

Healthy life expectancy—how long we expect to live in good health—has also declined for women, by three months between 2009 and 2011. That, too, varies across local authority areas, by 21.5 years for females and 15.8 years for males. Our children have been affected as well. As the Royal College of Paediatrics and Child Health reported last year, infant mortality is on the increase for the first time in 100 years. Four out of 1,000 babies will not see their first year, which is an indictment of the fifth richest country in the world. We are also seeing increases in child mortality, linked closely to the poverty that children are experiencing.

Why is this happening? It is absolutely true that the cuts in public health spending which were described so eloquently by my hon. Friend the Member for Stockton South (Dr Williams) have played a part, but they are not the only cause of the decrease in life expectancy and other problems. We know that investment in the NHS has been far from perfect, and it should have been at least £30 billion by 2022 instead of the £20 billion that has been promised. The coalition Government have a lot to answer for with the Health and Social Care Act 2012, which championed the outsourcing of NHS contracts to the private sector among other things. There is also strong evidence that that has contributed to not only increases in inequality in access to health care but inequality in outcomes.

There is clear evidence, as many of us predicted, of the impact of the coalition Government’s and this Government’s wider austerity programme. It has widened the inequalities of income, wealth and power and contributed particularly to the premature deaths of many of our citizens.

I welcome the launch today of Sir Angus Deaton’s inquiry to review inequalities across our country, and I hope it builds on the evidence Kate Pickett and Richard Wilkinson produced in their totemic publication “The Spirit Level” a decade earlier. However, we also need to explore other aspects of inequalities that have been not yet been investigated, such as the inequalities in power and the rise of nationalism.

I also hope that the inequality review analyses evidence presented at a recent event I chaired. Professor Danny Dorling referred to Office for National Statistics data published the day after the EU referendum showing that there were 52,400 more deaths than the previous year. This was the seventh largest single-year increase in deaths after cholera caused an increase in 1849. The evidence showing a correlation with austerity, as people’s long-term care needs were most affected, is compelling. We now have the 10th lowest level of public spending out of 12 developed countries, and in 2018 some 1.4 million older people had unmet care needs.

Professor David Taylor-Robinson provided evidence showing that the impact of austerity is also taking its toll on our children. His report, “Due North”, provided evidence of the north-south divide and the impact on health, including child health. We now have the worst child health in western Europe and rising child mortality, which is clearly associated with child poverty.

The Government’s first duty is to protect their citizens. For our children, our old people and our disabled people, it is clear this Government have failed and I urge them to take this more seriously.