World Health: 25-Year Environment Plan

Debate between Derek Thomas and Melanie Onn

Tuesday 9th April 2019 Westminster Hall

[Derek Thomas (St Ives) (Con)]

I beg to move,

That this House has considered the effect of the 25-year environment plan on world health.

I am grateful for the opportunity to lead this debate. It is only right that following World Health Day on Sunday we put time aside for an issue that I believe presents significant challenges and opportunities for Great Britain. The Prime Minister, who arguably is in a stressful job, takes time to go on walking holidays. A walking holiday I particularly remember was in 2017 but, if we put that to one side, what an endorsement that is of our countryside, and what a reminder it is for us to ensure that everyone has access to the natural environment.

I am greatly privileged as a west Cornwall MP. Some show pity that I have to travel such a distance to Westminster, but they forget that I go home to one of the most beautiful natural environments in the UK, which lays claim to areas of outstanding natural beauty, sites of special scientific interest, marine conservation zones, national nature reserves and special protection areas, to name just a few. My constituency attracts tens of thousands of visitors who flock to appreciate and soak up the good that comes with that largely unspoilt natural environment.

[Melanie Onn (Great Grimsby) (Lab)]

I notice that the Government are planning a nature recovery network. Does the hon. Gentleman agree that that should include in law the protection of nesting sites of returning migratory birds such as swallows, swifts and martins, rather than the current law as it stands, which is just about bird nests with live birds in them?

[Derek Thomas]

I welcome that intervention and I am grateful for it. I shall come on to that point later on, particularly because I am the species champion for the Manx shearwater, a bird that is recovering faster than any other species and is rare to the UK, nesting only on Lundy island and the Isles of Scilly. I will talk about that very point in a minute.

I invite the Minister to come on holiday to west Cornwall —she would be welcome—and to really get the benefit of the natural environment by going on our open-top buses. At speed, people get an awful lot of fresh air, but they also come close to the vegetation that is all around—sometimes too close. It is a great way to see west Cornwall’s natural environment in all its beauty, so I ask hon. Members to come and make use of our open-topped buses, which are also better for the environment in that they take cars off the road.

I understand why people come to west Cornwall to enjoy our natural environment. I can give testament to the fact that after recent weeks, and after last week in particular, time in nature can bring clarity of thought, perspective and resolve.

--- Later in debate ---

[Derek Thomas]

That is all part of the agenda on climate change and caring for our environment, so that we can all enjoy it. I am glad that schoolchildren who care about our planet can take action by planting trees and clearing our beaches and seas of the plastics that threaten to suffocate the health of our oceans.

[Melanie Onn]

On tree planting, just this week in my borough Persimmon Homes has cut down 260 trees, outside planning permission. How does the hon. Gentleman see the balance between the future built environment and the 25-year plan?

[Derek Thomas]

I thank the hon. Lady for her intervention. I will come to that, because the environment plan commits to environmental net gain measures in planning. That is why, as was mentioned earlier, it needs some teeth. We need to see the environment Bill, which I will ask the Minister to comment on later.

I am an enthusiastic advocate of the challenge from DEFRA to make 2019 a year of action for the environment, working with Step Up To Serve and other partners to help children and young people from all backgrounds to engage with nature and improve the environment. The hon. Member for Great Grimsby (Melanie Onn) is right that if we are tearing down perfectly healthy trees to build the houses and buildings that we need, that is not the example our children need to see. The Woodland Trust can provide up to 400 trees for schools to plant, and many of my schools have done so. It has 40,000 trees left—and I am hoping to get half of them, so hon. Members will need to get in there quick.

Hospice Funding and the NHS Pay Award

Debate between Derek Thomas and Melanie Onn

Wednesday 31st October 2018 Westminster Hall

[Derek Thomas (St Ives) (Con)]

I thank the hon. Member for Heywood and Middleton (Liz McInnes) for securing the debate. “Fantastic” is probably the wrong word to use, but this is an important opportunity for us to speak about the great work that hospices do, the part that they play in all our local communities and how they help people and their families at the most difficult times of their lives. It is an honour to take part in the debate. I want to talk about the role of hospices, how they contribute to the desire to integrate health and social care and, as a result, how they must be funded to deliver the great work that they do.

This may seem a strange thing to say, but I have spent my most special moments at the bedside of someone in a hospice. Over the years and even as an MP, I have taken the opportunity to sit alongside people and their families in our local hospice, St Julia’s, which is just on the edge of my constituency, and I always leave with an incredible sense of gratitude for the work that the hospice does and how it helps people at that difficult time. It helps people to live and die well, which is what I am sure we would all love to be able to do when the time comes.

Let me explain what I have learned in recent years. Even now, the word “hospice” assumes that that is where we will die if we have—dare I say it—the right kind of illness to justify that, but I am learning that hospices are actually far from just places to die. People can go into one when they are very sick and come out a week or two later, having had various things done to help them, to get their body working again and to identify the right medicine. Hospices can give people time to work out what medicine or drug is really the right one for them. My mum was ill for a very long time. She was given a few weeks to live, but actually lived for more than a year. She spent 10 days in a hospice when we really thought it was the end and then she went on for a good six or seven months after that, simply because the hospice was able to correct her medication and—well, “flush her out” is probably the way to put it. It was lovely to come together as a family and sit alongside her, and to give my dad a break; he had about 10 days of really important respite. The hospice movement across the country, in my constituency and across Cornwall is fantastic. When I go there, it is a different experience from when I go to sit beside the bed of someone in an urgent care setting who is also reaching the end of their life.

In Cornwall, we are learning that hospices are not just about taking people in the closing days or months of their lives, but about alleviating pressure on urgent care by taking people out of a ward where it is not really appropriate for them to be in their last few days, and on community care. In response to trying to get the money it needs, our hospice has done a great bit of work by going out to homes and supporting people there in their last few days and weeks.

The point is that, by properly funding hospices and all the work they do, I am convinced that we would create a saving for the wider NHS as well as the beds that are needed for other people. That is important in my constituency, because our main hospital is in special measures—“requires improvement” is where we are at the moment—and one area of that is about palliative care. The frustration is that there is a desperate need for beds in the hospital, but in the hospice, beds are available all the time. It is simply about a lack of commissioning joined-up thinking and working together, and not having enough money in the hospice system.

Hon. Members have given various quotes about how much NHS funding hospices receive. Some time ago, my first question in Prime Minister’s questions, when the then Chancellor was replying, was about how little Cornish hospice care was funded. At that time, about 11% of the money came from the NHS. That is in a part of the world where there is a lot of deprivation and average earnings are low, so the rest of that money was being found by people who were not awash with cash. I do not know that it has improved much since; we are still one of the areas that receives the least money for our hospice care.

That is frustrating, because people are dying in the urgent care centre who should be in a hospice. Three weeks ago, I spent time with a family who were desperate to get their mum out of my local hospital, which is part of the urgent care set-up. I do not want to be unfair to the hospital team, but unfortunately, they were so keen to get the lady home that they waited for care packages that did not arrive, and she died in the hospital when she could have been in the hospice.

[Melanie Onn]

I thank the hon. Gentleman for making that important point, which raises an issue that I have had with a constituent. His wife was sent home supposedly well after going into hospital for urgent treatment but sadly she died two days later. Going to the local hospice, St Andrews, would probably have been a much better option for her, but it had not been thought of in that process.

[Derek Thomas]

The hon. Lady is absolutely right, and I have heard several stories where that has been the case. Separate to the debate, there is an obsession—I use that word because it might get the Minister’s attention, although it may be the wrong one—with getting people home at every possible opportunity. When I sit with those people, some of whom are desperately lonely, I ask whether that is right for them or whether hospices, community hospitals and other settings would be more appropriate. I want us, as leaders and politicians, to be careful not to create an assumption that home is always the best place, because I do not believe that. It certainly was not for my mum in the last days and weeks of her life.

Addressing some of the challenges requires an uplift in the funding available to hospices across the board, and we must pass on pay increases to nursing staff. I say again that when I go into my hospice, the working environment is very different from that in the urgent care centre, but I have already said that Cornwall is a low-wage area with a high cost of living due to the beautiful environment that we live in, which attracts people and pushes up the cost of housing. It is expensive to live in my part of the world, so nurses are not choosing to leave the hospice setting because they prefer urgent care—obviously, we need them there as well, so I am not trying to discourage that—but because they need the money to live. We should not be saying, at any stage, “It is okay, because hospices are a different environment to work in and they might prefer it there, so they will settle for lower wages.” I hope that we would never assume or expect that.

I met the chief executive of Cornwall Hospice Care soon after the pay award, and he expressed concern that the money being offered to NHS nurses and staff would have a negative impact on hospices and other parts of the system where people are not directly employed by the NHS. I agreed to raise that in the House at the first opportunity, which I have done, and I am grateful for this opportunity to do so as well.

I know that I am among friends when I say that the value of hospice care is not underestimated. The work that hospices do for children and adults is fantastic. They are an essential part of bringing health and social care together and ensuring that people are cared for in the right setting and as close to home as possible. We all know that it is better to be near our families, whatever our health situation, and certainly during the last moments of our life.

As I have said, people are dying in my urgent care centre, which has already been judged as poor for palliative care, when there are beds in the hospice not far away. That must be addressed, and I want the Minister to intervene to put pressure on the system—or systems, at the moment—on the question of why we cannot do more. There has been progress in the last three years towards working better together, but making the right decision is painfully slow for somebody who does not actually have the time for that decision to be made. There have been improvements in working together, and the managers in all the systems in Cornwall, including the hospices, have healthy relationships, but things seem to be getting stuck at ward level, so patients are potentially not getting the best care.

As I have said, hospices now do fantastic work in the community, which has been a response partly to funding but also to need. They are going out into people’s homes to help families and individuals to manage their care properly. I have made fairly clear the two things that are needed to help hospices to deliver that vital role. In the discussions around the NHS pay award, what engagement opportunities have the Minister and the Department had with hospices? Have they been included in discussions about how that can be addressed and passed on? I would love the Minister to look closely at the situation in Cornwall, which will be true elsewhere too, where the money available for hospices is not enough. That is a choice made at a local level by commissioners, not the Department.

We should also assess whether we are making full use of what is available in hospices. If there are 12 beds with people in who are being cared for in the right place, that care is far more cost-effective than if there are eight beds, as is the case in my local hospice. It is not just about throwing more money at hospices, but about making better use of resources. That will reduce the cost of care while ensuring that those people, who have such a challenge ahead of them in the days and weeks to come, are given the care, love and attention that they absolutely deserve and that we would expect in the great nation in which we live.

Term-time Leave

Debate between Derek Thomas and Melanie Onn

Monday 26th October 2015 Westminster Hall

[Derek Thomas (St Ives) (Con)]

I thank my fellow Cornish MP, my hon. Friend the Member for St Austell and Newquay (Steve Double), for introducing the debate so well.

I fully understand the Government’s intention behind the legislation on taking children out of school during term time. I am sure that every Member present and throughout the House understands the need to address absence from school and to reassure people that the education of their children in school is hugely important. I am glad to live in a country where education is free, good and easily accessible. We do not want to do anything to undermine that value and the priority given to education. It is fantastic that our children have the opportunity to go to school and learn and grow into young people who are able to enter the world of work.

I also understand how children being absent and not taking part in their normal class or group at school can affect the learning of the whole class and its progress over the school year. We are not trying to undermine the Government’s intention to support schools in dealing with absence, and we recognise the contribution that children make to their class. Nevertheless, we are asking for change.

I too am a Cornish MP, and we have seen a huge problem in Cornwall. Part of the problem is how the legislation is interpreted. I have two small children in school. They have cousins of a very similar age, but their schools interpret the law differently. My children’s school is very strict. I have to confess that I took them out of school without permission so that we could go to a family wedding. I needed to take them out on the Thursday to travel to a Friday wedding, and we were not permitted to do that. My children’s cousins’ school, however, regularly allows holidays and provides educational material for the parents to use while they are away. That different interpretation causes tension among schools and among families. Whatever the Government choose to do after this debate, they should provide clear guidelines to schools about their intention for the legislation.

I think something has been lost. Before the legislation and guidance on school holidays were introduced, schools worked very well on this matter. I took my son on holiday for a week away from school, and the school provided a stuffed toy—if I remember correctly, it was an elephant called Elmer, although I may be wrong about that. We were encouraged to take Elmer to different places during the holiday, take photos and send postcards back from Elmer. When my child went back to school, he was able to talk about the experience. The class discussed where Elmer had been and learned important and interesting things about each visit he made. That has been lost, because that can no longer happen.

I am glad that we have a former teacher here who is able to confirm that in parts of the school year, learning—certainly formal learning—drops off. I have done a lot of school assemblies and been involved with schools for probably 20 years, and I have often been frustrated, because there used to be a time in the school year, often after the SATs finished, when formal education changed and parents could take advantage of it to take their children on holiday. That is no longer allowed, yet some schools still have a more informal attitude towards teaching in the latter weeks of the summer term. There are good reasons for that, but it is a shame that parents are not allowed to take their children out of school during that time.

I am concerned because, although the Conservative party does not want to intrude on families—we often say that families know best—I believe that this legislation does so. Some families in Cornwall, as we have heard, are not able to take their children on holiday during peak school holiday time because of their jobs. They may work in the public services or run business that rely heavily on the school holidays for their income. By introducing this legislation, we have intruded on those families and told them that they are not able to take their children on holiday.

My hon. Friend the Member for Stroud (Neil Carmichael), who has left the Chamber now, spoke about weekend holidays, but that would not work in Cornwall because families would spend the whole weekend stuck on the A30, which would be a completely inappropriate and unfortunate way of spending their holiday. I therefore do not accept the argument that weekends can be used to go on holiday; that would not work. I have to travel for longer than any other MP to get here on a Monday, and we cannot assume that weekends are an alternative.

As my hon. Friend the Member for St Austell and Newquay said, the cost of taking a holiday during the school holidays is prohibitive for many families. Like my hon. Friend, my constituency neighbour, I come from one of the poorest areas in the country. Our average wage is considerably less than the national average.

That brings me on to the disruption to business. Businesses in my constituency have closed since the legislation was introduced because the owners are no longer able to run them all year round. The business they get in the summer, at half-term and even at Christmas is not enough for them to continue their work, so they have had to close their business and lay people off as a result. The impact on our local economy is considerable, and I am sad that the Government were unable to look at that before they introduced the current advice.

Last summer was phenomenal for the holiday industry in Cornwall. We had more visitors than we have had for many years. Our summer season has been compressed into the six-week school holiday period, and I do not know how long the holiday industry will survive in Cornwall, because the A30 was gridlocked pretty much continuously every day. If I travelled to Cornwall, using the precious holiday I have with my children, and got stuck on the A30, I do not know whether I would choose to do that again next year and the year after. The situation indirectly affects the potential of Cornwall’s tourism businesses, because if people cannot go on holiday to Cornwall because of the increased traffic on the roads, they will choose to go elsewhere. The holiday companies that cannot operate during the summer will close, and the businesses that rely on the summer trade will lose business and may not be able to continue.

I urge the Government to look carefully at this issue. We are not asking for parents to be able to compromise their child’s learning. We are asking the Government to look at the impact that this measure has on our tourism and family life. We seek an agreement that would allow holiday to be taken outside holiday time in a way that contributes to the child’s learning. We are asking the Government to relax the legislation, not to backtrack on their good efforts to address habitual absenteeism. It is very important that we address the issue of parents who regularly take their children out of school for no good reason; we recognise that that has a detrimental effect on the classroom. However, we ask the Government to recognise that parents are able to complement their child’s education with a school holiday. We need a change in the law, and schools need clear guidelines and absolute clarity about the Government’s approach. All schools need to use the same guidelines for their children.

[Melanie Onn (Great Grimsby) (Lab)]

Is the hon. Gentleman aware that the National Association of Head Teachers surveyed its members, and 90% said that they would welcome additional guidance?

[Derek Thomas]

That has already been discussed, but the hon. Lady is absolutely right to bring it up. The headteacher at my children’s school would love the Government to say, “This is what we want from your school,” and for Ofsted to reflect that in how they judge the school. I believe that an allowance of up to two weeks a year would not be detrimental if, as has been said, it is at a quiet time for formal learning. Children’s holidays should be celebrated and made part of the learning of the child who goes on holiday and of the class, which, the following week, is able to look at where that child and Elmer have been.