(1 week, 1 day 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.
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I will call Jessica Toale to move the motion and then call the Minister to respond. I remind other Members that they may make a speech only with prior permission from the Member in charge of the debate and the Minister. As is the convention for 30-minute debates, there will not be an opportunity for the Member in charge to wind up.
I beg to move,
That this House has considered mental health support for women and girls with autism.
It is a pleasure to serve under your chairmanship, Sir Edward. I am grateful to have secured this debate today to discuss a matter of deep importance for one of my Bournemouth West constituents, Lindsey Bridges, as well as the thousands of families across the country affected by the failings in our mental health and autism care system. I rise today not only as a Member of Parliament, but as a voice for Lindsey and her daughter Lauren, known as Lolly to her friends and family, who is no longer here to speak for herself.
Lauren was just 16 when she died. She was a bright, compassionate young woman, and a straight A student who dreamed of being a doctor or a paediatric nurse. She was also autistic, and like many girls and young women with autism, she faced serious challenges getting the support she needed. In 2021, Lauren was detained under the Mental Health Act 1983. She was placed in an in-patient unit in Manchester six hours from her home in Bournemouth. As a result, her mental health deteriorated severely. In February 2022, Lauren went into cardiac arrest and died in that unit. Her mother Lindsey had begged for her to be moved closer to home, but her pleas went unheeded. This is not an isolated incident. Like too many others, she was let down by a system that promised care but failed in that promise.
(1 week, 6 days ago)
Commons ChamberI strongly agree with my hon. Friend—he is absolutely right. I am happy to stand corrected, but there is genuinely no historical precedent in the history of British trade unionism for a trade union to have successfully negotiated with the Government of the day a 28.9% increase for its members and then go out on strike. I think that undermines the BMA, and the more reasonable voices in the BMA with whom we continue to work constructively. It certainly undermines our NHS.
It also reinforces the grossly unfair caricature, which is often thrown at trade unions by the Conservatives, that they are all unreasonable, do not want to work with the Government of the day and are only interested in combat and agitation. In my experience, the vast majority of trade unions and trade unionists are interested in constructive engagement, striking good deals and moving forward the interests not just of their members, but of our whole country. I urge the BMA resident doctors committee to stand in that proud tradition of British trade unionism and in the proud traditions of the wider Labour movement, but I am afraid I do not see those traditions or behaviours reflected in the current approach of the BMA RDC.
We can all argue about the past, but if it helps the Secretary of State, I think we should just say today that the whole House absolutely 100% supports him in his robust attitude. [Hon. Members: “Hear, hear.”] Of course we all love doctors, but the starting salary is not so very bad. They have a job—a very good job—for life, which most people do not have, and he could also mention that they have a much better career structure than most people. A far higher proportion of them get the top job—namely, as a consultant—and the consultant’s starting salary of £110,000 a year is not a bad whack.
First, I think that the right hon. Member’s opening statement and the response across the House underline to the BMA and the resident doctors committee that they do not have support across this House—from the left across to the right, with maybe one or two noises off—and that is not typical in my experience of being in this House for the last decade.
I think the career of resident doctors and the prospects they can look forward to, which the right hon. Member described, have worsened. That is one of the things that is at the heart of the dispute they have taken up with the previous Government and now with this one. Many of the things doctors used to be able to look forward to—guaranteed jobs and progression into consultant roles or general practice—have steadily eroded. We have far too much doctor unemployment and far too many specialty bottlenecks. We have what I think is a really unreasonable set of behaviours towards resident doctors in terms of placements, rotations and the ability to take time off work to attend weddings and other important life moments. The tragedy of the position we find ourselves in is that I recognise that and I want to address it. We can do that together without the need for strike action, and those are not reasons for strikes. Worse still, especially at a time when I am prioritising dealing with doctor unemployment, they are inflicting further costs on the NHS, patients and the taxpayer. That makes my freedom and flexibility and my resources to deal with those issues more limited—that is the tragedy of their tactics.
(2 weeks, 6 days ago)
Commons ChamberI thank my hon. Friend for that question. On whether people feel cautious optimism or quiet scepticism based on the experience that he describes, I have heard the same thing so many times. “I love AI, genomics and machine learning—yep, great. But can you just give me the basic technology that works?” Well, I can confirm that in 2026-27 we will make sure that we create a single log-on for staff. I am not holding my breath for that to be the front-page splash tomorrow, but that one thing, as well as saving loads of staff time, will give them confidence that genuine change is coming.
As always, the Secretary of State makes a good fist of an impossible job, but I think we all know in our heart of hearts that this model, which takes 38% of public funding, is unsustainable in the long term. He mentions the Australian outback; I have been a voice in the wilderness, urging him to replicate the excellent Australian system, which is a mix of public and private. I will not do that again now, but may I ask him to at least look at Australia’s pharmaceutical benefits scheme, which ensures national procurement of medicines, so that people who have a medical card there get their medicines cheaper than people here?
I am always willing to search the world for ways to spend taxpayers’ money more effectively, and the right hon. Gentleman makes some good arguments on making sure that we get a good deal on medicines pricing, and on using the real procurement power of the single payer model—but therein lies the answer to the other part of his challenge. It is the single payer model, created in 1948, that makes the NHS ideally placed to get much better value in procurement, and to harness and lead the revolution in AI, machine learning, genomics and big data, in a way that many insurance-based systems struggle with. I assure him that if there were a better way of funding the NHS, I would have the political courage to make the argument, but we looked at other systems of funding and concluded that that is really not the problem. It is not the model of funding; it is the model of care, and that is what we are going to sort out.
(1 month, 1 week ago)
Commons ChamberOur spending on the NHS is now as much as the entire GDP of Portugal. We used to be a country with an NHS attached to it, but we are almost becoming an NHS with a country attached to it. Of course we would welcome this spending if we got the same outcomes that people get in civilised countries, like the Netherlands or Australia, but every time I mention fundamental reform, I am dismissed as wanting to bring in privatisation, so it is hardly worth raising that issue. Australia has an extremely successful pharmaceutical benefits scheme; I know that the Secretary of State for Health and Social Care went out there, and I have talked to Australian doctors about it. Will the Minister at least look at the successful outcomes, including some of the highest life expectancies in the world, that are being delivered in countries like Australia and the Netherlands, to see how we can deliver better outcomes? There is no point spending more money if people’s only right is to join the back of a queue.
I was expecting the right hon. Gentleman to talk about the funding model, and I am disappointed that he did not; it is something that he has talked about for many years. I do not know the details of the Australian model, but will ensure that he gets a proper answer. I am always happy, as is my right hon. Friend the Secretary the State, to look at models from across the world. We want to learn from the best, and we want to deliver the best in the NHS.
The Conservatives seem to have an obsession with input into the health service. It is true that the last Government put more money in, but it went into a leaky bucket and they got nothing out. This Government have taken a different approach. We are not just taking money from the Treasury, handing it out and then coming back for more. We are being very clear with providers and the system more generally. My right hon. Friend the Secretary of State is talking at the NHS Confederation conference this afternoon; we are working with them to ensure that we look not just at the inputs, but at what goes on in the system. We want to ensure value for taxpayers’ money in all our constituencies. There are outstanding examples of both financial and operational good practice across the country. We want to take the best to the rest, and make the best of every taxpayer pound.
(2 months, 3 weeks ago)
Commons ChamberI beg to move,
That this House has considered Parkinson’s awareness month.
I extend my gratitude to the Backbench Business Committee for granting me this debate, and I thank hon. Members for attending, especially given that local elections are taking place across some parts of the country—I know the pull of the doorsteps is strong for politicians, as can be the power of persuasion from party bosses and headquarters.
I thank hon. Members for supporting my application for the debate, including my hon. Friends the Members for Aldershot (Alex Baker), for Newcastle-under-Lyme (Adam Jogee), for Redditch (Chris Bloore) and for Weston-super-Mare (Dan Aldridge), who are sadly unable to be here but who I wanted to mention. I also thank the current and former chairs of the all-party parliamentary group on Parkinson’s, my hon. Friend the Member for Newcastle upon Tyne East and Wallsend (Mary Glindon) and Baroness Gale.
I found it surprising and, to be honest, a little shocking that there has never been a full debate in this Chamber on Parkinson’s, so I hope to lend my voice to the approximately 225 people in my constituency, and to the community of some 153,000 people across the UK, who are navigating life with Parkinson’s, along with their loved ones and the dedicated professionals who support them. Yesterday concluded Parkinson’s Awareness Month, but we must commit to doing much more than simply raising awareness; we must act. Awareness is not progress, and people with Parkinson’s can no longer afford to wait.
Parkinson’s is the fastest-growing neurological condition in the world, ironically due mainly to people living longer lives and being diagnosed in their later years. It is sometimes said that people do not die from Parkinson’s, but the condition is life-limiting, complex and relentless. It does not discriminate by postcode, profession, political affiliation or any other characteristic. It strips away not only physical ability, but voice, independence and identity. It affects not only those diagnosed, but their loved ones in profound and lasting ways. There is no cure, no treatment to slow or halt progress and no respite, yet there is hope. There is a path to change, and today I call on the Government and this House to walk that path with the urgency and compassion that the Parkinson’s community deserves.
When I was preparing for this debate, I was given a copy of a poem called “A Jump Too Far”, by Bobbie Coelho, a Parkinson’s UK campaigner who was diagnosed in 2002. I will read it out to put it on the record, because I feel that these words are important:
“I wish you could jump into my shoes for just an hour or so
To know just how I feel, for then you would know
The truth about PD, as far as it goes
I wish you could jump into my shoes when my face freezes
You can’t understand when I talk (I know it’s not easy)
To hear me called a miserable cow
How I wish I could talk happily as they’re doing now
I wish you could jump into my shoes when I can’t move across the floor.
How I admire your movements, so easy and so free
I just wish it could also be me
I wish you could jump into my shoes when I can’t walk down the street
And get stares from the people that I meet
I wish you could jump into my shoes when I can’t do anything at all
And, reluctantly, have to watch my husband do it all
I wish you could jump into my shoes to see a future I don’t want to see
With no cure in sight and I know there never will be
You hear about cancer there’s adverts all around
But awareness of PD there’s not a sound
If you could jump into my shoes
You would see how frightening PD can be”.
The hon. Gentleman must be congratulated on bringing forward this most important debate. The charity Parkinson’s UK organises voluntary support groups across the country—the nearest ones to Gainsborough are in Doncaster, Brigg and Scunthorpe. Does he think that the Government and local authorities can do more to encourage people to volunteer? Voluntary action across the country is quite uneven, so that might be one step forward.
The right hon. Gentleman has anticipated a point that I will make later, but I could not agree more about the need for volunteer support. Increasing the awareness of that volunteer support at the point of diagnosis is absolutely key, and I will refer to that later in my remarks. I thank him for the intervention.
I found Bobbie’s poem so moving because it reflects precisely what I heard in preparing for this debate, which I suspect colleagues in the Chamber also hear, from constituents living with Parkinson’s. I have been truly touched by the willingness and openness of those constituents, supported by Parkinson’s UK and Cure Parkinson’s, to share their experiences and stories. They do so in the hope that their voices combined will be greater than the sum of their parts, and that together they can improve the journey for those following in their footsteps.
The reality of living with Parkinson’s can be harsh. Although it is categorised as a movement disorder, it can affect movement, speech, swallowing and cognition. It can cause hallucinations, depression and pain. For many, their condition fluctuates unpredictably throughout the day, so what might seem like a good morning can spiral very deeply into a challenging afternoon, and too many people still wait too long for a diagnosis.
I draw the attention of the House to the Movers and Shakers, a group of people with Parkinson’s whose outstanding contribution and production have been a beacon of support for those with Parkinson’s. Some of them are in the Gallery and will be familiar to many in this House, including Gillian Lacey-Solymar, Rory Cellan-Jones, Mark Mardell and Sir Nicholas Mostyn. I thank them for being here today.
(3 months, 3 weeks ago)
Commons ChamberI think you may agree, Madam Deputy Speaker, that the longer we spend in this job, the more we realise that almost nothing is ever straightforward. Even the best intentions nearly always have unintended consequences, and there is absolutely no doubt that smoking, and specifically smoking tobacco, has done untold damage in my constituency and continues to do so. The health of my constituents has suffered as a result of the well-documented effects of regular smoking, and, moreover, smoking is a driver of social and economic inequality. Smokers earn, on average, 7% less than non-smokers. I could not believe that statistic when I first read it, but when I thought about it, I realised that it made complete sense. Those who take more time off work because of the inevitable ill-health effects of smoking, those who spend more of their disposable income on tobacco, and those who develop a dependency on a drug such as nicotine will obviously experience, over time, an impact on their earnings. Smoking is like an extra tax on the most disadvantaged communities, and I can see why this Government have maintained the last Government’s ambition to phase it out.
I agree with everything that my hon. Friend is saying about smoking, but the elephant in this room is the dramatic decline in legal tobacco sales. According to HMRC, they have declined by 44% since 2021, while the number of smokers has declined by only 0.5%. We are reaching a stage at which we are taxing cigarettes so heavily that we are fuelling the black market and criminality, and we have to be aware that, as my hon. Friend says, these are unintended consequences.
It is almost as if my right hon. Friend had read what is written next on my piece of paper. I was about to say that unfortunately we do not live in a perfect world, even our noblest ambitions have unintended consequences, and the Bill is not a silver bullet. There is already a thriving black market for tobacco in Gosport, and I am extremely concerned about the possibility that prohibition will exacerbate the problem. I am keen to hear from the Minister what action she plans to take, alongside the phased prohibition, to provide proper resources for the police forces in Hampshire and the rest of the country to ensure that the law is upheld, and what plan she has to take on the criminals who are already profiting, and who will only profit more as the age at which a person can legally buy tobacco rises.
Even without the Bill, smoking rates are falling across the UK as a result of a number of policy interventions, including education, smoking support and awareness campaigns. I recently visited a company in Gosport that provides innovative smoking cessation support. It is a vaping company, but it has a partnership with Mid and South Essex NHS foundation trust, which signposts smokers to its stores, where they are given continuing support to further enhance their shift away from tobacco. Hampshire county council has a similar Smokefree Hampshire scheme, which it says contributes to 500 quits per year. Interventions such as these have proven to be successful, so has the Minister weighed up their merits against the possible implications of the Bill?
(6 months ago)
Commons ChamberWill the Secretary of State forgive me if I give the House a few seconds’ respite from the blame game by trying to make a positive suggestion? Everyone accepts that the real problem facing our hospitals is the number of frail and elderly people who do not need to be in hospital and should be in some sort of care facility. Does the Secretary of State agree that while building brand-new, all-singing, all-dancing hospitals is very expensive, there is a future for smaller cottage hospitals such as the one in Gainsborough and a case for opening other facilities so we can move elderly, frail people out of those big hospitals into a caring environment and free up space?
I thank the right hon. Gentleman for a rare constructive contribution from the Conservative Benches—not rare from him, for he is regularly constructive; it is the rest of the Conservative party that we have a problem with. Let me reassure him that one thing we are determined to do is deliver a shift in the centre of gravity, out of hospitals and into communities, with care closer to home and indeed in people’s homes. As I saw on a visit to Carlisle over the new year, good intermediate step-down accommodation sometimes provides better-quality and more appropriate care and better value for the taxpayer. That intermediate care facility in Carlisle, funded through the NHS by a social care setting, was providing great-quality rehabilitation in a nicer environment at half the cost of the NHS beds up the road. This Government will deliver both better care and better value for taxpayers.
(6 months, 1 week ago)
Commons ChamberI will not focus on assisted dying/assisted suicide this evening, because as the hon. Member for Wimbledon (Mr Kohler) said in a good opening speech, we are all united in this place in our desire to see improvements in the palliative care system, but I feel compelled to make this simple point of fact. Studies and research show that in jurisdictions and countries around the world that have introduced an assisted dying/assisted suicide law, the investment in and the quality of palliative care has declined, relative to those that do not have an assisted dying/assisted suicide law. That is for reasons that are fairly comprehensible. That is a fact. I implore the House: let us fix our palliative care system before we consider opening up the law on assisted dying.
The United Kingdom is, of course, the birthplace of the hospice movement, and we have some of the best palliative care services and specialists in the world, but as we have heard this evening, our system simply is not working. We have demand for palliative care and hospice services on a scale that was never anticipated in the post-war years in which the NHS was developed. The challenges of growing demand have been sadly exacerbated by decisions that the Government have made, as we have heard.
On Friday, I went to St Barnabas hospice in Lincoln, our local hospice, which does wonderful work, and talked to its chief executive officer, who is tearing his hair out. Because of the national insurance increase, he is losing £300,000 a year. He pays his nurses less than the local hospital; he has to. He is literally funding the NHS and cutting his own service in the hospice. I beg the Government to think again about the national insurance increase on hospices.
My right hon. Friend makes absolutely the right point. It echoes the experience of hospices across the country. Prospect House, which is on the edge of Swindon and is in my constituency of East Wiltshire, receives only 23% of its funding from the taxpayer. It faced a significant deficit this year, so it took immense pains and steps to bridge its funding shortfall. There was a huge response to a public fundraising appeal, and it raised over £170,000 from the local community, but that was before the Budget. The effect of the national insurance increase alone on Prospect House is £170,000, so the public’s generosity has been entirely wiped away by the Chancellor, and Prospect House is back exactly where it was.
Julia’s House in Devizes is a children’s hospice, and the most wonderful, moving place that I have visited in my time as an MP. It has had a similar experience. It gets only 8% of its budget from the taxpayer. Its deficit has gone up from £900,000 before the Budget to £1.1 million now. We therefore desperately need a comprehensive review of palliative care.
I pay tribute to the hon. Member for York Central (Rachael Maskell), and to Baroness Finlay in the other place. They are leading a review of palliative care, with a view to coming forward soon with recommendations for the Government on how to improve the system. Indeed, thanks to Lady Finlay’s amendment to the last Government’s Health and Care Act 2022, integrated care boards are required to commission palliative care. Unfortunately, no money was attached to that amendment, and as we have heard, the way in which some ICBs commission care is not good enough. I regret, for instance, that the ICB in our area will not commission Julia’s House, the children’s hospice that I mentioned, so we need a better commissioning model.
I take issue with the point made by the hon. Member for Birmingham Erdington (Paulette Hamilton) that ICBs cannot find the money for these services in their budgets. They could if they did their job properly and commissioned services locally. They should be able to move budgets around. The fact is that if proper investment is made in palliative care, money is saved elsewhere in the NHS; that is the crucial point. Expensive bed stays in hospital would be reduced, as would demand on ambulances and other services. It should be possible to improve palliative care within the ICBs’ current envelope.
We do not want a system of enforced uniformity, or a great new national bureaucracy. I am concerned to hear some hon. Members suggest that we nationalise the system; I do not think that is right. We need to ensure that ICBs can do the job that they need to do, and that hospices can innovate as they want.
(6 months, 2 weeks ago)
Commons ChamberI welcome the consensual parts of the Secretary of State’s statement, but I wonder whether we have been entirely honest with the public about the sheer unaffordability of the cap proposed by Dilnot. I do not absolve my own Government from this: maybe we should start telling the truth to the public. Does the Secretary of State think we need a new social compact on bringing in social insurance so that people can plan for their entire life? They would know that they will have to pay more in taxes during their life for their old age, but at least they would have certain rights.
The right hon. Gentleman is right to say that we need a debate as a country about the balance of financial contribution between the individual, the family and the state. I well understand why David Cameron was so concerned about catastrophic care costs and people having to sell their homes to pay for their care and the problem he was trying to solve. With every Government since, the issue has been seen as less urgent than others, but that does not mean it does not matter or that we should not consider it as part of the Casey commission. We need to consider all these issues in the round and, as much as we can, build a consensus not just in this House, but throughout the country about the balance of financial contribution and what is fair, equitable and sustainable.
(8 months, 1 week ago)
Commons ChamberWe all know that a lot of the debate on assisted dying revolves around the lack of hospice places to help people pass in the best way possible. Similarly, much of the debate on the NHS is about the lack of care home spaces. Leaving aside the cross-party name-calling, may I beg the Minister to consider exempting hospices and care homes from this national insurance increase?