Hormone Pregnancy Tests
Baroness Laing of Elderslie Excerpts(9 years, 3 months ago)
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Yasmin Qureshi
My right hon. Friend is right. It is amazing how other countries reacted to the evidence. The medical association in the UK was first alerted by Dr Isabel Gal in 1967, a paediatrician who said that her research showed that there was a link between women who had taken the drug and deformities in babies. Her letters and her research were dismissed out of hand by Dr Inman, who headed the regulatory authority. In a letter the authority referred to her in a derogatory manner as a “pathetic eastern European woman”, completely ignoring what she had to say.
We know that other information was available. For example, in February 1969 a committee received a letter from a Dr Dean of the Royal College of General Practitioners, who stated that
“Primodos should be withdrawn from use”.
However, the chief scientist of that committee, Dr Inman, refused to support that and instead wrote to the manufacturer of the drug, Schering, stating that
“the opinion expressed by Dr Dean that Primodos should be withdrawn should not be taken into account. Some women deliberately use excessive doses of Primodos with the intention of ridding themselves of an unwanted pregnancy”.
We have heard that Norway and Sweden banned the drug in 1970.
Again the Committee on Safety of Medicines took no action. Similar notices were issued in Finland, Germany, the USA, Australia, Ireland and the Netherlands, but again the committee took no action. In fact, in 1974 a letter from Schering—from PGT Bye—stated that
“after discussion with the Committee on Safety of Medicines we agreed some time ago not to recommend for the use of pregnancy diagnosis. It is not recommended for early pregnancy since the possibility of virilisation of the female foetus cannot be excluded with certainty”.
Yet still the committee issued no warning.
A further letter stated that
“side effects cannot be reliably excluded”
and that
“Primodos should no longer be recommended for the diagnosis of pregnancy.”
Again the committee said nothing. There are countless such documents. One of our concerns is that panels should have sight of those documents and be given sufficient time to read them, because they must be looked at properly and not ignored.
In 1975 the Committee on Safety of Medicines issued its first warning, stating:
“A number of studies have shown a possible association between Hormone Pregnancy Tests and an increased incidence of congenital abnormalities.”
On 15 October 1975, 41 years ago, Dr Inman wrote:
“We are defenceless in the matter of the eight-year delay”.
In November 1977, eight years after the committee had first been alerted, an adverse reaction leaflet was issued to the medical profession, stating:
“Further results have now been published and the association is confirmed.”
I want to refer briefly to some of the documents, many of which were archived in Berlin and at Kew. Marie Lyon, who chairs the victims association, has painstakingly gathered the documents, and the panel has been informed of them. I want to pay particular tribute to Marie Lyon, who has been doing a considerable amount of work over the past five years. She has spent months and months working on the documents, travelling the length and breadth of the United Kingdom and visiting Germany. She has effectively been working alone, with no support from Government bodies or local authorities. She and the victims association have been on their own. The only support they have had has been from members of the all-party parliamentary group and the Members in the Chamber today who have been fighting their cause. I also want to thank Jason Farrell of Sky News, who has been instrumental in getting some of the documents from Berlin and having them translated.
Translation of the documents is another issue, because many of those that came from Berlin are in German, as is to be expected. I want to know whether all those documents will be translated into English for the panel, because clearly it cannot carry out the inquiry if they are in a different language. We need to know whether all the documents that the victims association has gathered will be looked at and presented to the panel and, if so, in what format? When I used to prepare a large case with thousands of pages, there was a way of presenting the evidence so that the jury could understand it. Will that be done for the inquiry? If not, why not?
The reason we are asking these questions is that I have tried to contact the chair of the panel, Dr Ailsa Gebbie, and written letters to her, asking her to answer numerous questions, and, to be honest, we have not received a satisfactory answer to any of them. If anything, Marie Lyon, who has observer status on the panel, has been put under what I would call a gagging clause, which means she cannot talk about anything, because if she did she would be criminally prosecuted.
One of the things I remember from our discussion with the Minister was that the purpose of the inquiry was to have transparency and openness. We accept that there is obviously a need for a degree of confidentiality when evidence is presented, but we need to know what is going on. We need transparency, because without it, what is the purpose of this?
One thing the Minister promised was that the inquiry would have the victims at its heart. Yet, how have the victims been treated in this inquiry, which has been going for over a year now? I got a letter from one of the victims who turned up, and it is so distressing. The victims were told they could come and speak for a few minutes. Some travelled for five or six hours across the country to get to the hearing. They were promised at least 15-minute slots, but some were given three minutes or five minutes. Nobody even spoke to them properly; they were just asked to get on with it and to say what they had to say.
Fortunately, the victims who gave evidence were not subject to the gagging clause, so we were able to find out a little about what happened on the one day that seems to have been allocated for the victims. The panel heard from a few of them, but it did not ask them any questions. They were not cross-examined; they were not asked for anything—they just had three minutes. One lady said she was devastated; it had taken her five hours to drive there, and she was given three minutes. The victims said they were sitting so far from the panel, where the microphones were, that they were not even sure the panel was hearing what they had to say.
How can an inquiry that has victims at its heart not take more than a day to listen to them and, when they turn up, give them just three minutes? That is why we are having this debate. Given the way this inquiry is going, I do not think that any of the Members of Parliament who are supporting and assisting the victims have any confidence in it. As in the Hillsborough inquiry and the sexual abuse inquiry, everybody accepts that it is all about the victims; it is not about protecting regulatory bodies or the scientific community—it is about the people who have been affected.
There is another thing the Minister said. Obviously, it goes without saying that any inquiry must be independent—the panel members must be independent. When I raised that in a letter to Dr Ailsa Gebbie, the chair, she said, “Well, we got the expert panel members just to declare that they had nothing to declare.” There was no independent vetting or investigation into the background of any of these people. We have to understand this: people in the medical community, scientists and people in the pharmaceutical companies often work with each other. People have been advisers or consultants to somebody, or they have gone from the pharmaceutical companies into medicine or hospitals. There is a community of people who are linked.
We do not have the resources, but our basic research has shown that one of the panel members, Laura Yates, put on her social media that she does not think that Primodos caused any defect. How can this person be part of the panel? Then we have information about Doctor Schaefer. This man has worked with the company concerned, so he is directly linked with Schering—and he is still on the panel. That is two people, just from our basic inquiry. We want to know from the Minister whether the panel members will be properly vetted to see whether they are really independent and to find out about their connections. Again, without that, we will not have any faith in the inquiry.
We have asked the inquiry how long it will go on and how many sessions it will hold. There has been no response—nothing. We have tried to find out for well over a year, but nobody knows what on earth is going on with this inquiry. That leads to another question for the Minister. How long is the inquiry going to carry on? How many days have been set aside for it? How many hours have been spent on the inquiry to date?
In addition, how have the experts been chosen? We do not even know by what methodology they have been chosen. There are about 15 people on the panel, but does it need that many? Who are they, and how relevant is their experience to what they are looking at?
Madam Deputy Speaker (Mrs Eleanor Laing)
Order. I am sure the hon. Lady will soon be drawing her remarks to a close, in the knowledge that many other Members wish to speak this afternoon. She has vastly exceeded the guideline length of time, but I will allow her a peroration.
Yasmin Qureshi
I was just coming to the end of my speech, Madam Deputy Speaker.
Lastly, we are very grateful that the inquiry has been set up, but we have genuine concerns about what is happening with it and where it is going. As has been said, at the end of the day, there is no point in having the inquiry if it does not look at the things that matter, one of which must be to provide an explanation of the regulatory failures and the cover-ups in the 1960s and 1970s.
NHS Spending
Baroness Laing of Elderslie Excerpts(9 years, 7 months ago)
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Andrea Jenkyns (Morley and Outwood) (Con)
As somebody who was in the leave campaign, I think it is important that we remember that we worked across parties on it, whichever side we were on. In Yorkshire, I worked with colleagues from the Green party, the Labour party and UKIP, although I did not work with the SNP, obviously. It is the responsibility of both camps. I have seen “Project Fear” in both camps.
We need to move on from this now. It is pure economics. If we are pulling out of the EU, as the public have voted to do and as I am personally happy that we are doing, we must make sure that we start talking Britain up; otherwise we will talk ourselves into a recession. Members on both sides of the House need to pull together and talk Britain up. At the end of the day, both sides could have handled this better.
Madam Deputy Speaker (Mrs Eleanor Laing)
Order. Before the hon. Member for Central Ayrshire (Dr Whitford) answers the intervention, I must remind the House that this debate is not about the EU campaign. We are talking specifically about the NHS. I understand that the hon. Lady was—perfectly reasonably—using examples, but we must not stray any further.
Madam Deputy Speaker (Mrs Eleanor Laing)
Order. Before the hon. Gentleman gets into the body of his speech—I do not want to interrupt his argument—I want to thank him for the point he made and for his immediate action in removing the picture that he had tweeted. For the avoidance of doubt, it is simply not allowed, but as soon as he realised that he had done something that was not allowed, he acted immediately, and I thank him for doing so.
Mr Reed
That is greatly appreciated, Madam Deputy Speaker.
Despite the dedicated and incredible efforts of local NHS staff in my constituency, I see health inequalities on a daily basis, and many of my constituents experience profound access challenges to health services in my constituency and elsewhere across Cumbria, caused in part by our inadequate transport infrastructure, but also by a clearly insufficient profile of investment in local services. So far, I am afraid to say, my calls for improvement have fallen upon deaf ears.
In north and west as well as east Cumbria, we are currently subject to the ongoing success regime process. Funding for the important second phase of the West Cumberland hospital has not yet been released by the Government, and the communities I represent are gravely concerned about the uncertain future facing our local health services, including beds not just at the West Cumberland, but at our local community hospitals in Keswick, Millom, Maryport and elsewhere—and that is before we even consider the profound challenges to primary care, too.
In spite of the challenges that we face and the strength of feeling in my constituency, the Health Secretary, who is no longer in his place, has paid not one visit to the West Cumberland hospital, or any of our community hospitals on whose behalf I speak tonight, in the four years in which he has held his position. Moreover, he has refused my invitation to visit West Cumbria to see for himself the unique challenges that we face in our part of the world. Without visiting the hospital, experiencing the transport inadequacies and seeing the vital work of consultant-led accident and emergency, maternity and paediatric services that the West Cumberland hospital provides, the Health Secretary cannot and does not understand the necessity for his immediate intervention in our troubled health economy.
Most recently, owing to the fact that the Health Secretary would not come to us, my constituents and I—health campaigners from across the piece—decided to go to him. West Cumbrian health campaigners, including Mike Bulman, Mahesh Dhebar, Rachel Holliday, Siobhan Gearing and the fantastic Pamela McGowan from the News & Star newspaper, planned to make a 700 mile round trip to London to meet the Health Secretary, to outline the challenges that our health economy faces and to put our case to him. However, at short notice, but coincidentally on the day after he announced his ambition to stand as leader of the Conservative party, the Health Secretary cancelled the meeting. The decision to cancel that meeting was seen by my community as the calculated insult that I am afraid it surely was.
I led the local campaigners instead to the Department of Health to meet the gracious and approachable Under-Secretary responsible for care quality—the Minister in his place today. The delegation handed to him a confidential document containing the cases given to local campaigners by local mothers about babies who were likely to have suffered fatalities—and maternal fatalities, too—if consultant-led maternity services had been unavailable at the West Cumberland hospital in Whitehaven. The Government are well aware that consultant-led maternity services at that hospital are non-negotiable and absolutely essential—whatever the successor regime that comes forward in the immediate future. Any other option would compromise the safety of local mothers and their babies.
It is clear to me, to my community and to Simon Stevens, the chief executive of the NHS, who visited my constituency only a few months ago, that consultant-led services must be retained and improved at West Cumberland hospital. Removing those services from Whitehaven would be dangerous—
World Autism Awareness Week
Baroness Laing of Elderslie Excerpts(9 years, 9 months ago)
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Several hon. Members rose—
Madam Deputy Speaker (Mrs Eleanor Laing)
Order. A great many people still wish to speak, so I am afraid I have to reduce the time limit to five minutes.
Contaminated Blood
Baroness Laing of Elderslie Excerpts(9 years, 9 months ago)
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Several hon. Members rose—
Madam Deputy Speaker (Mrs Eleanor Laing)
Order. I hope that we can get through this debate without a formal time limit on speeches. The debate is not contentious, on one side of the House or the other, so I trust that Members will be courteous to each other by keeping their speeches to around seven minutes. That will allow everyone who has indicated that they wish to contribute to do so.
NHS: Learning from Mistakes
Baroness Laing of Elderslie Excerpts(9 years, 11 months ago)
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Heidi Alexander (Lewisham East) (Lab)
I thank the Secretary of State for his statement. The Opposition support any measures that will improve safety in our NHS and make it more open to learning from mistakes. However, we will also provide robust opposition and scrutiny when we think that the Secretary of State’s actions are having the reverse effect.
Let me start by setting out where we support the Government. On the independent medical examiners, the Secretary of State will know that that is a reform that the Opposition have long pushed for. The previous Labour Government legislated in 2009 for the introduction of medical examiners, following the inquiry into the crimes of Harold Shipman. The call to introduce medical examiners was then repeated in the Francis report and in the report of the Morecambe Bay investigation, chaired by Dr Bill Kirkup. Indeed, last year’s Kirkup report said:
“We cannot understand why this has not already been implemented in full”.
We welcome the implementation of the medical examiners system, but it is concerning that it appears to have been delayed until April 2018. Will the Secretary of State say why progress in that area is so slow? Will he reconsider the timetable for their introduction given that April 2018 is more than two years away? Will he say more about how the reform will be funded? Local government faces further cuts over the coming years and while I understand that local authorities will be reimbursed for set-up costs, they will have to collect fees to fund the service. How will that work in practice? Is the Secretary of State confident that local government, which is already having to do more for less, will be able to take on the role of administering this process?
We also support the changes to the GMC and NMC guidance that the Health Secretary is announcing today, which will recognise the importance of an apology, but it is unclear how that is different from the guidance that came into effect last August. Indeed, the GMC first announced plans to change its guidance in this way more than a year ago, so can he say how his announcement today differs from the plans that were already in place?
On the learning from mistakes league, how will the 32 trusts that have a poor reporting culture be supported to improve? We know from listening to the testimonies of Sara Ryan, the mother of Connor Sparrowhawk, that the learning culture in some trusts just is not good enough. I know, from speaking to the small number of my constituents who have experienced failures of care, that the fight to get mistakes recognised is only part of the battle. They also want to know that the failures they have experienced will never happen to anyone else, yet all too often they are faced with a system that seems as though it simply struggles to learn.
Does the Secretary of State accept that he needs to do much more to develop a positive learning culture in our NHS? How in practical terms will he support clinicians and managers to improve services? Go to any health trust and we will find a director of finance and non-executive directors with financial expertise, but rarely will we see the same attention being paid to quality. Does the Health Secretary not agree that every trust board needs someone whose focus is not short-term firefighting, but co-ordinating and bringing together staff to drive improvements in quality?
I will always support sensible steps to improve safety and transparency in the delivery of health services, but what I cannot do is stand here today and pretend that other actions taken by this Government will not have a detrimental effect on patient care. The Health Secretary’s kamikaze approach to the junior doctor contract means that no matter how the dispute ends, he will have lost the good will of staff, on which the NHS survives. How can he stand here and talk about patient safety when it is him and him alone who is to blame for the current industrial action, for the destruction of staff morale and for the potential exodus of junior doctors to the southern hemisphere? [Interruption.]
Heidi Alexander
Thank you, Madam Deputy Speaker. I ask the Health Secretary: how can he stand here and say that he wants the NHS to deliver the highest-quality care in the world when the people he depends upon to deliver that care for patients have said, “Enough is enough”? How can he talk about patient safety when he knows that his £22 billion-worth of so-called “efficiency savings” in the next four years will lead to job cuts and will heap more pressure upon a service that is about to break?
I know the Health Secretary has been shy about visiting the NHS front line in the past few months, but if we speak to anyone who has any contact with the NHS, the message we will hear is clear: the financial crisis facing the NHS is putting patient care at risk. The independent King’s Fund recently said:
“Three years on from Robert Francis’s report into Mid Staffs, which emphasises that safe staffing was the key to maintaining quality of care, the financial meltdown in the NHS now means that the policy is being abandoned”.
That is simply not good enough. For those people who have experienced failures of care and for those staff working in environments so pressurised that they fear for the quality of care they are able to deliver, the Health Secretary needs to get his head out of the sand. I say this to him: measures to investigate and identify harm are all well and good but there needs to be action to prevent harm from happening in the first place—fund the NHS adequately, staff it properly and you might just give it a fighting chance.
Several hon. Members rose—
Madam Deputy Speaker (Mrs Eleanor Laing)
Order. Before the Secretary of State answers that important question, I remind the House that we have a lot of business to get through today. Shorter questions and correspondingly shorter answers would be welcomed by those who are waiting to take part in other debates.
Mr Hunt
As ever, I commend the right hon Gentleman’s interest in mental health. May I reassure him that this is very much about what happens in mental health and also the area of learning disabilities? In fact, some of the thoughts were prompted by what happened at Southern Health. It is absolutely vital that we investigate unexpected deaths in mental health as much as we do in physical health. The measures we take will go across those areas, and I am more than happy to meet him to discuss the very laudable aim of zero suicides.
Maria Caulfield (Lewes) (Con)
I congratulate the Secretary of State on his statement this afternoon, and welcome the culture change that he is introducing to the NHS. My experience of working in the NHS under a number of Governments over the past 20 years was that when mistakes happened, a scapegoat was identified and it was thought that the problem had been dealt with. That is why people were reluctant to report problems, but often it is not one individual but a system of failure. We need to learn from that, so I welcome the Secretary of State’s comments. Relatives and patients have said to me that they do not want just to identify the problem; they want to ensure that it never happens again, which is exactly what my right hon. Friend said. I chaired a primary care seminar this morning with GPs, doctors, nurses and pharmacists—
Madam Deputy Speaker (Mrs Eleanor Laing)
Order. I am sure that the hon. Lady will quickly come to her question, or we will run out of time.
Maria Caulfield
Thank you, Madam Deputy Speaker. People are fed up with the NHS being talked down by Labour Members, and there was a plea to showcase the good work that is taking place in our NHS today.
Paula Sherriff (Dewsbury) (Lab)
Last week I received an email that was frankly heartbreaking. My constituent’s 84-year-old father, a proud and dignified man, was admitted to hospital with symptoms of a stroke, and he had to wait 14 hours for a bed. She went to visit him later that day and found him in bed wearing clothes on only his top half. He needed the toilet, and she was given a bottle to help him urinate.
Madam Deputy Speaker
Order. I am sure that the hon. Lady will quickly come to her question.
Paula Sherriff
That was no dignified way to treat that man. Will the Secretary of State agree to an urgent investigation into safe staffing levels at Mid Yorkshire Hospitals NHS Trust, because the nursing staff told my constituent that they did not have time to fulfil her father’s basic nursing needs?
Mr Hunt
My hon. Friend is absolutely right. I thank him for his work in this area. Maternity—stillbirths, neonatal deaths, neonatal injuries and maternal deaths—is the area where I hope we make the most rapid early progress in developing this new learning culture. There is so much to be gained. We can be the best in the world, but the truth is that we are a long way down international league tables in this area. None of us want that for the NHS. There is a real commitment to turn that around and I thank him for his support.
Madam Deputy Speaker (Mrs Eleanor Laing)
The prize for perseverance and patience goes to Mr Mark Spencer.
Mark Spencer (Sherwood) (Con)
I am grateful, Madam Deputy Speaker, even if my knees are not.
I congratulate the Secretary of State on providing a protected space for doctors, so they will be able to be honest and upfront when things go wrong, and on striking the right balance so that relatives and people who suffer wrongs in the NHS get to the bottom of what went wrong, why it went wrong and why it will not happen again.
NHS and Social Care Commission
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Norman Lamb
I am conscious that you may start to get slightly irritated with me, Madam Deputy Speaker —
Madam Deputy Speaker (Mrs Eleanor Laing)
On a point of clarification, the right hon. Gentleman is doing just fine on timing. I appreciate that he has taken a lot of interventions, and people who intervene know that, later in the debate, their speeches will be shorter as a result of their interventions. He is doing nothing wrong, and he may proceed.
Norman Lamb
I am relieved. I sensed that I might be getting into trouble. I will give way to the hon. Gentleman.
Chris Davies
May I say what respect around the House we have for you as Chair of the Health Committee? I would therefore be very interested to hear your view of the “Five Year Forward View”—
Madam Deputy Speaker (Mrs Eleanor Laing)
Order. I let the hon. Gentleman get away with it earlier, because I appreciate that he has not been in the House for very long, but when he uses the word “you”, he is addressing not the hon. Lady, but the Chair. I know he means his compliments not for the Chair, but for the hon. Lady, so he must refer to her as such.
Chris Davies
I apologise profusely, Madam Deputy Speaker. We of course have great respect for you, too.
The “Five Year Forward View” plan is already under way, led by the former Labour adviser Simon Stevens. It is looking at reforming heath and care services, and is backed by the funding that the NHS has already said it requires. Does my hon. Friend feel that setting up yet another body would benefit the NHS, or would it be a hindrance?
NHS (Charitable Trusts Etc) Bill
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Wendy Morton
Does my hon. Friend not agree, though, that funds donated to the NHS and put into these charities must be held separately from Exchequer funding provided by the taxpayer? Charities exist to support their beneficiaries, and there is a special relationship between the charities and the—
Madam Deputy Speaker (Mrs Eleanor Laing)
Order. I am trying to be helpful to the hon. Lady in saying that I know it is a great temptation to address her remarks to the hon. Gentleman and look at him to gauge his reaction—looking at him is always, of course, a very great pleasure—but if she turns her back on the rest of the House, it does not work. It is really important that she should face the Chair. She can still speak about the hon. Gentleman and imagine him in her mind as she does so.
Wendy Morton
Thank you, Madam Deputy Speaker. It is wonderful just to be able to imagine my hon. Friend in my mind. I have finished my intervention, but I am grateful for your advice and reminder.
Several hon. Members rose—
Madam Deputy Speaker (Mrs Eleanor Laing)
Order. I did not want to interrupt the excellent flow of the hon. Gentleman’s argument, but, for the sake of clarity and the avoidance of doubt, and because he referred to the numbering and order of amendments—he has not said anything wrong; I wish merely to educate the House—I wish to explain that the order in which amendments are numbered is that in which they are received in the Public Bill Office, but the order in which they appear on the amendment paper is that in which they relate to the Bill. It is actually very logical, but if one does not know why, it sometimes is not obvious.
Wendy Morton
As the Bill’s promoter, I rise to contribute to its Report stage.
We have listened to some interesting amendments from hon. Members, for whose submissions and contributions I am grateful, as they have enabled us to discuss, probe and question the Bill further, which is really important. It is worth reminding ourselves that, as of March 2015, there were about 206 NHS charities, with a combined income of £327 million. They do a terrific job and make a huge contribution to many patients, hospitals and NHS staff. Everyone will agree that the vast majority of them, like all charities, do fantastic work and that only occasionally does something go wrong. Sadly when it does, as has been said today, it always makes the headlines.
The vast majority of NHS charities use the corporate trustee model, whereby the Secretary of State does not appoint the trustees.
Conception to Age 2: The First 1001 Days
Baroness Laing of Elderslie Excerpts(10 years, 1 month ago)
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Mr Graham Allen (Nottingham North) (Lab)
First, I declare an interest as the founder of the Early Intervention Foundation, and take this probably unique opportunity to put on record my thanks to its chief executive, Carey Oppenheim, its director of evidence, Professor Leon Feinstein, its director of policy, Donna Molloy, and all the fantastic staff there.
Secondly, I pay tribute to colleagues who secured this debate. If I may say so, the inspiration behind a lot of this comes from the hon. Member for South Northamptonshire (Andrea Leadsom). I do not suppose that she is allowed to contribute today, but we are getting thought beams from her as our speeches progress and drawing great inspiration from that.
Madam Deputy Speaker (Mrs Eleanor Laing)
Order. The hon. Member for South Northamptonshire (Andrea Leadsom) may, on this unusual occasion, acknowledge the praise being heaped on her, and rightly so, from around the House.
Mr Allen
I would gladly give way to the hon. Lady if it did not break all sorts of precedents.
I come to this issue as a constituency Member of Parliament representing the fifth most deprived constituency in the United Kingdom who is learning how to resolve some of the intergenerational problems that start with the very youngest in our communities—indeed, as “The 1001 Critical Days” implies, before birth. Trying to break some of these cycles is my own personal learning curve. I share that, surprisingly but very importantly, with the right hon. Member for Chingford and Woodford Green (Mr Duncan Smith), who has been on a similar journey to mine, in very different circumstances. I hope that those two strange bedfellows, he and I, have demonstrated that we must have an all-party view on this. As with the previous debate on the sexual abuse of 16 and 17-year-olds, we will make no progress unless we agree across the House, in all parties, because getting something from one Government only for it to fall under the next is no progress at all. The problems we tackle are intergenerational and long-running. They require us to invest in individuals, whether with love or with money, and take a very long-term approach. We must all unite across the House to make sure that this moves forward.
Mental Health
Baroness Laing of Elderslie Excerpts(10 years, 2 months ago)
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Madam Deputy Speaker (Mrs Eleanor Laing)
Order. Before the Secretary of State answers the intervention, let me say that long interventions are not appropriate on a day when so many Members wish to speak. If Members wish to make a speech, they may do so, but an intervention has to be short.
Mr Hunt
If the hon. Gentleman has listened to what I have been saying, he will know that I have been very honest about the problems and about the gap between what we want to deliver and what we are delivering. I shall come on to talk about some solutions, but it is important that Opposition Members recognise that we have had a real and specific focus on mental health over the last five years, during which very important progress has been made. If we continue to broaden out our focus, we hope we can make progress in other areas as well.
Let me talk openly about where more progress needs to be made. First, we have far too much variation in the quality of services across the country, and opacity about where services are good and where they are unsatisfactory. It is wrong that I, as the person responsible for the health service, cannot tell people in simple terms the relative quality of mental health provision in North Shropshire versus South Shropshire or in Cirencester versus Sheffield. We need to know that. We know from other areas of the health service that once we can be transparent about the variations in care, people will measure themselves against their peers and huge improvement can be made.
Madam Deputy Speaker (Mrs Eleanor Laing)
Order. The House will be aware that a great many Members wish to speak, so I will now have to impose a five-minute time limit on Back-Bench speeches.
Several hon. Members rose—
Madam Deputy Speaker (Mrs Eleanor Laing)
Order. We have less than an hour for Back-Bench contributions in this debate, so I will have to reduce the time limit to three minutes, which makes life a little difficult for Mr Julian Sturdy.
Heidi Allen
That is fundamental and there should be no alternative. The right hon. Gentleman is absolutely right.
Nobody doubts the need to improve mental health care or the fact that money does not grow on trees. Investment is increasing, but I fear that the scale of the problem is far greater than any Government cheque book. It is so much bigger than that, but the good news is that we are capable of being bigger than that, too. Let us cast aside party politics and make this our issue, not just the Government’s issue.
In South Cambridgeshire, we are pooling together the resources of schools, world-leading academics, mental health charities, business, local authorities, politicians and parents—everyone—to do things differently. With Steve and the memory of his son, Edward, at the helm, we want to roll out a timetabled early intervention and prevention programme in every single one of our schools. We are trialling and developing it, and in March next year we will launch it at an international conference in Cambridge, which Alistair Burt has kindly committed to attend.
Madam Deputy Speaker (Mrs Eleanor Laing)
Order. The hon. Lady must refer to Members by their constituency name. Twice now she has referred to people by their names. It is simply not done in this Chamber.
Heidi Allen
Forgive me, Madam Deputy Speaker—I was genuinely unaware of that.
I have no doubt of the personal dedication of our Ministers, for they have proved it to me and, more importantly, to Steve Mallen. If Members are undertaking similar work in their constituencies, or if they want to join our project, I urge them to talk to me. If we have learned one thing about mental health, it is that we need to talk about it. The answer is simply not about cash; it is about partnership working, and I urge every Member of this House to join in this fight together. Let us take the responsibility.
Madam Deputy Speaker
Order. If hon. Members wish to be kind to their fellow Members, they will now take three minutes or less and no interventions. If that does not happen, several people will not get to speak at all. It is up to Members how they wish to behave.
Several hon. Members rose—
Madam Deputy Speaker (Mrs Eleanor Laing)
Order. If every speaker is to get in and we are to finish the debate on time, we must now have a limit of two minutes.
Cities and Local Government Devolution Bill [Lords]
Baroness Laing of Elderslie Excerpts(10 years, 2 months ago)
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Mr Allen
To an extent, their voices have to be captured by those who seek elected office, whether in this House or in the locality. Devolution is just one part of a broader democratic settlement. It is essential that it is not just the great and the good who are involved. As I outline in new clauses 1 to 4, there has to be the most tremendous unprecedented outreach. A citizens convention must go way beyond even what we saw in Scotland, either in the referendum campaign or in its own citizens convention, and use all the modern techniques of social media, technology and electronic polling, so that people can feel ownership. My hon. Friend is absolutely right that unless we build that in, and unless people feel that a proper debate has been had, the process could be stressed and fractured when people feel that the right thing has not been done. I would argue, therefore, as with new clauses 1 to 4, that we will need a broad-based exercise involving an unprecedented level of public participation in order to settle our democracy not just for the next four years but so that it holds for 100 years after that. That cannot be done on the back of us alone making these decisions.
Madam Deputy Speaker, I seek your advice on a matter of order, although I do not know if I am entitled to do so in the middle of a speech. There are amendments on health. Should we talk about those matters now or wait for a natural break?
Madam Deputy Speaker (Mrs Eleanor Laing)
The hon. Gentleman asks a perfectly reasonable question, and, just for once, it is a question that the Chair can answer. The answer is no. The matters relating to health are in the next group, of which the lead amendment is new clause 9. We should discuss health at that point.
Mr Allen
That is very helpful, Madam Deputy Speaker. In that case, I will limit my final remarks to a brief consideration of manuscript amendment (a) to amendment 56, which bears my name. Amendment 56, which I wish well, seeks to provide some welcome flexibility to allow for the organic growth and development of our devolution proposals. The Secretary of State, who needs to be reassured that the process will not drag on forever, has proposed a manuscript amendment that puts an end date on discussion. Colleagues and local authorities will have an opportunity, a gateway, a window—whatever metaphor we wish to use—in which to make representations. That process will not drag on forever, but there will be a lot of time to make those representations, which seems very appropriate. On that basis, I am pleased to have added my name to amendment 56.
This large group of amendments covers many other areas, including issues on which I could speak at some length, such as votes for 16 and 17-year-olds and a governance review. The latter will be very important. I believe that there are now 34 or so devolution deals. As we develop those, there will be much best practice, which, by definition, we cannot learn from mid-process, around what has been devolved and how, and around how local authorities can use their powers. It will all be at different levels and different speeds—because, again, devolution means people doing their own thing, not taking a one-size-fits-all approach—but there will be a place for a gathering and sharing of best practice by local government so that the next set of deals, building on the pre-existing deals, can be done in the best way.
We do not currently have an institution that can do that. Despite the excellence of the officials in the Department, we do not have what local government might regard as an independent institution to take that forward. It makes a lot of sense, therefore, to have a review at an appropriate time. It might not look that way to the Secretary of State, who is battling through a set of deals with lots of interested individuals—and that can only be his main priority—but, when the dust settles, it will make sense to have an adjunct to the Local Government Association, or whatever local and central Government come up with, to make sure that all the learning from the first set of proposals is carried over to the next set.
With that, I shall draw my remarks to a close. We now have a set of devolution deals, and the boulder is rolling forward. We need to keep the momentum going, so I hope that everyone will wish the Bill well.
James Wharton
My right hon. Friend tempts me to go further than I can in the specific context of the Bill, but I think he has been above averagely consistent on that point and very clear about his position. He has put it clearly on the record today, as he has before, and the fact that he has done so is welcome.
I look to the Chair, Madam Deputy Speaker, for advice on whether you would like me to comment on the other amendments in the group, which I would be happy to do, although I have not yet heard the comments of hon. Members on them.
Madam Deputy Speaker (Mrs Eleanor Laing)
If the Minister would like to wait until the end of the debate, I shall, with the leave of the House, call him again.
James Wharton
Thank you, Madam Deputy Speaker. Given that we have had such a productive and healthy debate so far, it would be appropriate for me to respond later to the specific points that hon. Members raise. I therefore look forward to the opportunity to speak again as we progress through this stage of consideration.
Several hon. Members rose—
Madam Deputy Speaker (Mrs Eleanor Laing)
Order. Before I call the next speaker, I gently remind the hon. Member for Bolsover (Mr Skinner) that although I did not want to interrupt him when he was in such rhetorical form in his intervention, matters concerning the health service are in the next group of amendments. The House so much looks forward to hearing what he has to say then, but that will be after we have finished debating this group of amendments, having heard Sir Edward Leigh.
Sir Edward Leigh
It is of course a pleasure to follow my hon. Friend the Member for North East Somerset (Mr Rees-Mogg), with whom I normally agree. I quite understand his enthusiasm for referendums, which in one sense surprises me, because a traditionalist like him would normally have opposed the concept of referendums. He would have opposed them in the past because it was felt—this point has been made many times in the House of Commons—that they were a fundamentally unparliamentary device that has often been used by Governments who are dictatorships to impose extreme changes on society.
I understand where my hon. Friend is coming from, however, because in recent years referendums have been seen as a fundamentally conservative force. Generally, the people vote against change. I understand his arguments and I understand why the Government are wary of accepting any amendment promoting a referendum, because they have looked at what has happened in the past, particularly in the north-east, where people voted against change. The Government are determined to drive change forward and fear that if there is a proposal for a referendum, people will usually vote no. This is a very interesting argument.
I want to dwell on amendment 56, which was tabled by my hon. Friend—and indeed real friend—the Member for Cleethorpes (Martin Vickers). Normally I agree with him about most things, but on this occasion his amendment concerns me, and I want to make a few points about the situation in Lincolnshire and give the Minister the opportunity to reply.
My hon. Friend represents north-east Lincolnshire, and I represent Lincolnshire. Lincolnshire is a very conservative county. It is so conservative that the Gainsborough constituency—which I am proud to represent—has had only three MPs in 90 years, and all three have been Conservative. People do not like change in Lincolnshire, and they are wary of any device such as that in amendment 56. The Government appear to have accepted the amendment, albeit with a sunset clause, and it is quite unusual for a Back Bencher to table an amendment that the Government then accept.
People in Lincolnshire—and, I suspect, other rural counties—want to proceed by consent, which seems an admirably conservative point of view. Normally, proceeding by consent means dealing with the tried and tested, and taking things forward together. Many people are scarred—this has already been referred to—by the events of the 1970s, when ancient counties were swept away. There were different enthusiasms then. They may not have been in favour of elected mayors, referendums or unitary authorities, but everything was done on the basis of Heath-ite efficiency. We now know that that drive towards Heath-ite efficiency was fundamentally wrong and unpopular, and it imposed Whitehall centrist ideas on what local people wanted. I see that my hon. Friend the Member for Beverley and Holderness (Graham Stuart) is here. As a result of 1974, we created the ludicrous county of Humberside, destroying Lincolnshire, East Yorkshire—what madness. We know that is not the right approach.
Speaking as a Conservative—not just as a party politician, but as someone who tries to understand Conservative values—I appeal to the Minister to proceed with great caution and to take people with him on this matter. Now, elected mayors are all the rage, but a few years ago so were police and crime commissioners. We had a mixed history with that—low turnouts, lack of interest, and not necessarily democratic accountability.
Lincolnshire County Council is generally well run, popular, and has been in place for 130 years. The district councils have been in place for more than 40 years. It is not for me to speak for local councillors in Lincolnshire, but since they cannot speak in this place and have only me to say these things, I hope nobody minds if I say that we do not want a solution imposed on us. What worries me about the amendment—and the Government’s ready acceptance of it—is that, as the county council and district councils recognise, in terms of unitary authorities, elected mayors and devolution, we do not want a bruising battle over many years between district and county councils about which should be abolished.
We want to proceed by consent and to get together. We are happy with the idea of central Government devolving more powers to a county such as Lincolnshire, but we recognise that we are not Manchester, Birmingham or London. We are a large, quite poor county with a low rate base and a scattered population. There is no question that we could run the NHS or anything like that; we are not in the business of devo-max. We want to leave the present structure in place with district councils and county councils, and perhaps form a new body on which those will be represented. We would then accept new powers for that body. That is how we want to proceed by consent. Given many of our discussions so far, I am worried that in our rush for change and innovation, we may ride roughshod over what local people and councillors want. Being sensible people and knowing their area, they generally want to proceed slowly, cautiously, and by consent. With that, I feel that I have made my arguments and I will let others speak. I am sure they will be far more interesting than me.