Hospice Services: Support

Ellie Reeves Excerpts

Wednesday 14th June 2023 Westminster Hall

[Paul Holmes]

I pay tribute to Rowans Hospice and to all the hospices that we will no doubt hear about this morning, given the number of people attending this debate.

As I say, I had the pleasure of meeting the CEO of Mountbatten hospice. Its work does not come without cost, but, as a charity, its services are provided free of charge to all who need them, thanks to the generosity of its amazing community and incredible volunteers, who give their time to support the best possible care for local people during the last years and months of their lives. Mountbatten currently supports around 1,000 families every day, and demand for its services is predicted to rise by 40% in the next 18 months. It costs £11.5 million a year to keep the services running, and the hospice relies on charitable support to fund its 24/7, 365 days a year services to people who need them.

[Ellie Reeves (Lewisham West and Penge) (Lab)]

St Christopher’s Hospice in my constituency is widely regarded as the first modern hospice, and it is still pioneering today, but it has to fundraise £15 million a year. The cost of living crisis means that its costs are going up and its donations are at risk of going down. Does the hon. Member agree that the Government must review the current funding model?

[Paul Holmes]

The hon. Lady tempts me to come to content that I will cover later in my speech, but for now she can take it that I wholeheartedly agree, as do many Members here, I suspect.

No one will contest that our health and care staff deserve to be well paid for the incredible work they do, and in an ideal world we would see our life savers and carers never have to worry about their finances and pay, but it would be deeply irresponsible to facilitate pay rises without giving due consideration to the dramatic impact that rising wage costs have on these essential services. To give some specific context, Mountbatten Hampshire took over management of the hospice from the NHS in 2019. It has a contract with the NHS for roughly 35% of its costs, of which about £3.8 million comes from the local NHS commissioners in the form of an outcome-based contract. The hospice follows the NHS pay award each year to remain competitive and to retain and hire staff for its services, which means that the hospice has seen a 4.8% rise in costs this year and will see a further 5% next year, with no corresponding change in its NHS contract, leaving an increasing and worrying financial gap that the charity will find very hard to reconcile without public funding.

Oral Answers to Questions

Ellie Reeves Excerpts

Tuesday 6th June 2023 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

I thank my hon. Friend for his question. I feel that we had a very productive meeting yesterday with the all-party parliamentary group on covid-19 vaccine damage about the vaccines for covid and the issue of the MHRA. He raised a number of important points during that meeting, including that on the MHRA, and I will be responding to him shortly.

[Ellie Reeves (Lewisham West and Penge) (Lab)]

T7. One of my constituents with complex health needs has struggled to get GP appointments for years now. On one occasion when they could not get an appointment, they had to resort to taking out-of-date medicine. Last week, they phoned every morning at 8 am, before finally getting just a telephone appointment. When will the Government finally fix the crisis in primary care and make sure that everyone gets access to a GP appointment?

[Steve Barclay]

As the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Harborough, said earlier, through the primary care recovery plan we have specific measures to tackle things such as the pressure at 8 am, particularly on a Monday morning. There is the investment in digital telephony, with call-back features, and online booking, as well as the channel shift to enable pharmacists to do more and to prescribe more, the use of the NHS app and the review of 111. There is a range of initiatives that we are taking to address the increased demand. Ultimately, GPs are seeing more patients—up to 10% more patients—but there is more demand, and that is how we are meeting it.

Oral Answers to Questions

Ellie Reeves Excerpts

Tuesday 24th January 2023 Commons Chamber

[Steve Barclay]

It is slightly odd for the hon. Lady to talk about a plan when she does not agree with the plan of the shadow Health Secretary, the hon. Member for Ilford North (Wes Streeting). He plans to use the private sector, which he describes as “effective and popular,” whereas the hon. Lady said:

“In my own brief in mental health we have use of the private sector, which ultimately often lets patients down.”

First, the hon. Lady does not agree with the shadow Secretary of State. [Interruption.] The hon. Lady chunters, but she asked about a plan when she does not agree with her own Secretary of State.

Secondly, the hon. Lady talked about shiny new equipment. I am delighted that she allows me to draw the House’s attention to yesterday’s announcement of a fleet of 100 new mental health ambulances, which will relieve pressure on A&E. I am delighted that she gave me an open door to highlight that investment, which is part of our £2.3 billion investment in mental health.

[Ellie Reeves (Lewisham West and Penge) (Lab)]

3. What recent steps he has taken to implement the women’s health strategy for England.

[Alex Davies-Jones (Pontypridd) (Lab)]

22. What recent steps he has taken to implement the women’s health strategy for England.

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

Last summer we published the first Government-led women’s health strategy for England, which sets out our 10-year ambition to boost the health and wellbeing of women and girls and to improve how the health and care system listens to them. I am pleased that we have set out the first eight priorities for the first year of the women’s health strategy, and that we are already delivering on many of them.

[Ellie Reeves]

After 13 years of Conservative Government, more than half of maternity units now consistently fail to meet safety standards. Almost 40,000 women now wait over a year for gynaecological treatment, up from just 15 women 10 years ago. Women in the poorest areas are dying earlier than the average female in almost every comparable country. At every stage of a woman’s life, her health is being compromised. When will these failures be reversed, and when will we see real investment in the NHS workforce and in women’s health?

[Maria Caulfield]

I am sorry that the hon. Lady does not welcome our announcement of this country’s first women’s health strategy, which is putting women as a priority at the heart of the health service.

We have eight priorities for this year. We are rolling out women’s health hubs around the country as a one-stop shop to make healthcare more accessible to women. We are improving women’s health provision by setting out a women’s health area, with reliable information, on the NHS website. We are working with the Department for Work and Pensions to support women’s health in the workplace. We are recognising pregnancy loss by developing the first ever pregnancy loss certificate for babies who are born and lost before 24 weeks. We are improving and standardising access to in vitro fertilisation for same-sex couples around the country. And we are launching the first ever hormone replacement therapy prepayment certificate in April. That is some of the work we are doing, and I am disappointed the hon. Lady does not recognise that effort.

Children and Young People’s Mental Health

Ellie Reeves Excerpts

Wednesday 16th June 2021 Westminster Hall

[Ellie Reeves (Lewisham West and Penge) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Gary, and I thank the hon. Member for Twickenham (Munira Wilson) for having secured this incredibly important debate. We know that half of mental health illnesses develop before the age of 14, and it is therefore essential that everyone has access to mental health services from an early age. I have spoken many times in this House about the inadequacies of CAMHS provision, including unacceptably long waiting times for referrals and the incredibly high threshold for treatment. However, today, I want to focus my remarks on infant mental health.

Worryingly, reports have demonstrated that there is a baby blind spot in our mental health service when it comes to the very youngest, and while children and young people’s mental health services are aimed at those aged 0 to 19, research has shown that there is inadequate provision for our youngest children. In 2019, 42% of clinical commissioning groups in England reported that their mental health services would not take a referral for a child aged two or under. The Parent-Infant Foundation recently surveyed professionals working in children’s mental health, and found that only 9% of those surveyed believed that sufficient provision was available for infants whose mental health was at risk.

Just like us, babies and toddlers can experience stress, anxiety and trauma. This impacts on their emotional wellbeing and development, but by failing to provide infants with access to mental health support, we enable mental health problems to build up. Given that thousands of babies have been born during lockdown with limited access to health visitors, peer support, playgroups and children’s centres, it is really urgent that we tackle these issues. Early intervention can have long-lasting benefits for mental wellbeing, benefiting not only the infant, but also reducing demands on mental health services in the future if it is tackled early on.

It is clear that we need action to address this blind spot. We need to invest in the provision of infant mental health services. We must also develop a strategy to ensure that there are enough qualified professionals to deliver it, so I urge the Government to address this baby blind spot and ensure that babies are not forgotten in mental health policies, strategies and services.

More widely, I am concerned by reports that find that one in six children now have a probable mental health condition. Demand for support is rising; there was a 35% increase in referrals to children’s mental health services in 2019-20. The Children’s Commissioner has warned that the pandemic will have a profound impact on children’s mental health going forward, putting already struggling mental health services under more pressure.

It is clear that urgent action is needed to support CAMHS. The postcode lottery in service provision has only worsened during the pandemic. There is huge disparity in the length of waiting lists, in the number of children accessing treatment and in the number of children being turned away. It is not acceptable that the availability of support can be based on where someone lives. The ability to access mental health services is so important, and this needs to be addressed.

I am concerned that the current expansion of mental health services is not fast enough to meet increased demand, and the Government must urgently address this. We need full and sustainable funding to support expansion, and we need a plan to address the shortage of specialist staff in the sector. Greater emphasis needs to be put on prevention and early intervention to ease demand, with properly funded mental health support in every single school across the country. After the extremely difficult year that our children, infants and young people have had, we owe it to them to put their mental health at the top of the agenda.

Covid-19 Update

Ellie Reeves Excerpts

Monday 19th April 2021 Commons Chamber

[Matt Hancock]

The hon. Lady is right to raise this issue. We have maintained access to urgent dental treatment throughout the pandemic. We put in place dental centres to be able to do that in the first peak and dentistry was not closed in the second peak—indeed, we have put in place an incentive to get dental practices really motoring. Of course there is infection prevention and control that needs to be updated as the prevalence of the disease comes down, but making sure that we have those check-ups is incredibly important, because it is one of the most important preventive measures there is, especially for children. Given her interest in and enthusiasm for this subject, I hope she will support the proposals for much more widespread fluoridation of water, which we are proposing to put into legislation when parliamentary time allows and which was part of the White Paper we published in February, because that is one of the biggest steps we can take to protect dental health.

[Ellie Reeves (Lewisham West and Penge) (Lab) [V]]

The NHS has had its busiest and most crucial year ever, fighting the pandemic and delivering the vaccine roll-out, and all while continuing to provide routine care and treatment. We owe our NHS workers so much, yet this Government are proposing just a 1% pay increase, not even the 2.1% previously promised. Can the Secretary of State not see that after the year we have had, this is an insult to their heroic efforts? Will he commit to getting a pay rise for staff that truly reflects the value of their work?

[Matt Hancock]

The admiration in which I hold NHS staff holds no bounds. The question of pay is rightly one for the independent pay review body, and I look forward to its publication.

Maternal Mental Health

Ellie Reeves Excerpts

Wednesday 10th March 2021 Westminster Hall

[Ellie Reeves (Lewisham West and Penge) (Lab) [V]]

I thank the hon. Member for Richmond Park (Sarah Olney) for securing this important debate today.

Maternal mental health problems are prevalent and are not talked about often enough. One in five women will develop some form of mental health problem during their pregnancy or in the year after giving birth, and research suggests that as many as seven in 10 mothers will underplay the severity of their feelings, due to stigma surrounding mental health.

Sadly, all of this has been exacerbated by the impact of the pandemic. As someone who has spoken in the House about prenatal depression while pregnant with my first child, this is an extremely important issue for me.

From a personal perspective, my second child was only four months old when we went into the first lockdown. My plans for baby yoga, music classes and meeting other mums for coffee to get through the sleep deprivation were suddenly out the window. Instead, the ensuing weeks were spent with him mostly in a sling while I home-schooled the eldest. With much of his little life spent in lockdown, his one-year check was done on the phone, he has not been weighed since he was six weeks old, and I cannot remember the last time he saw a health visitor.

Yet I feel lucky: lucky that he was born just before the pandemic hit, so my husband was able to be there the whole time I was in labour; lucky that he was my second child, so at least I had a vague idea about what I was doing; and lucky that we had those four months together before going into lockdown. For many of my constituents, having a baby during lockdown has been incredibly challenging. One of my constituents, Nina, wrote to me last autumn:

“I was pregnant for the entirety of the first lockdown and had to attend all scans for the twins I was carrying alone. This was bearable when I looked around and saw everyone making huge sacrifices.

When I gave birth to the twins in August, continued restrictive rules meant that my husband could not be with me on the labour ward. Add to the mix a fast-moving induction and I ended up giving birth to my babies with only midwives I’d never seen before in the room.



My husband simply wasn’t able to make it in time. If he’d been able to stay on the ward I would have had his much needed support through labour. As it was, I have had to recover mentally from a fairly traumatic experience.

And yet...I brought the twins home while everyone was still ‘eating out to help out’. How can this be right? Why do women’s and particularly mothers’ needs fall so far down the Government’s priority list?”

Nina’s story and many others show the profound impact that the pandemic has had. In September, the Government allowed families with a child under one to form a support bubble and the NHS now allows the birth partner to be present during labour and the birth, but for many families those changes came too late. The Government must be ambitious in their plans to support the babies born in lockdown and their families. That will be a huge task. For example, if health visitors are to catch up with the huge backlog in missed face-to-face appointments and provide a full service, proper funding will be needed. They provide an amazing service and invaluable support to parents, but about one in five were lost between 2015 and 2019 due to public health budget cuts.

As a result, in February, before the pandemic hit, almost a third of health visitors reported that they were responsible for between 500 and 1,000 children. The Institute of Health Visiting considers the optimal maximum for the work to be fully effective to be 250 children. Similarly, since 2010, cuts of 66% have led to the loss of over 1,000 Sure Start and children’s centres, which provide huge support to families, particularly those who are vulnerable or hard to reach. Funding needs to be restored, so that there is a one-stop shop for parents to get support for themselves and their children.



Early years and nursery providers provide huge support for parents, but according to the Institute for Fiscal Studies, they ran at a significant loss during the first lockdown, receiving less than £4 of income for every £5 of costs. In addition, playgroups and baby activities are often run by small businesses, and restrictions mean that their doors have largely been shut. I would like the Government to look urgently at sector-specific grant funding for early years, to maintain the viability of the sector as we come out of the pandemic.

It is clear that the added stresses of lockdown and the pandemic have exacerbated maternal mental health problems. A recent UK-wide study published in the Journal of Psychiatric Research found that during the first lockdown, 43% of new mothers met the criteria for clinically relevant depression and 61% met the criteria for anxiety. Given the consistent evidence that shows that postnatal depression and anxiety are linked to a range of negative outcomes for children’s health, development and behaviour, it is imperative that the Government do everything they can to protect maternal mental wellbeing.

That begins with many of the measures that I have outlined, but also by improving and maintaining access to perinatal mental healthcare. Although NHS resources and staff are under huge strain, investment is needed to ensure that mental health interventions can be timely and effective to prevent the escalation of symptoms and the formation of a larger burden on the NHS and other public services. That is not beyond our capabilities, and we owe it to the babies born in lockdown and their families to put that at the top of the agenda.

[Sir Edward Leigh in the Chair]

Oral Answers to Questions

Ellie Reeves Excerpts

Tuesday 12th January 2021 Commons Chamber

[Dr Rupa Huq (Ealing Central and Acton) (Lab)]

What recent assessment he has made of the effect of the covid-19 outbreak on bed capacity throughout the NHS.

[Ellie Reeves (Lewisham West and Penge) (Lab)]

What recent assessment he has made of the effect of the covid-19 outbreak on bed capacity throughout the NHS.

--- Later in debate ---

[Edward Argar]

I can reassure the hon. Lady that beds and increased capacity, where we put them in place, are allocated on the basis of where they are needed. She is right to highlight the pressure that her local hospital trust, London North West University Healthcare NHS Trust, is under. The team there, as across the NHS, are doing an amazing job, but the critical care bed occupancy rate in her trust was 98.7% on the latest figures I have. That is extremely significant pressure, but I can give her the reassurance that we look to ensure that all areas receive the resources they need.

[Ellie Reeves [V]]

London has declared a state of emergency and the stark reality is that at this rate we will run out of beds for patients in the next couple of weeks. At least two NHS hospitals in the capital have already postponed urgent cancer surgery and figures show that treatment levels are failing to keep pace with demand. Will the Minister therefore commit to fully opening the London Nightingale hospital, secure the use of London’s private hospitals for cancer treatment, and invest in the number of beds in our NHS for the long term?

[Edward Argar]

The hon. Lady is absolutely right to highlight the pressure that the NHS and critical care are under in London and, indeed, more broadly. I pay tribute again to all those who are working in the NHS, including my shadow, who I suspect has been on the frontline in recent days—I pay tribute to her, too. The best way we can thank them is by following the advice to stay at home and to follow the rules. In respect of her specific point, yes, we are involving independent sector capacity, Nightingale capacity and increasing NHS capacity—all those, alongside other measures—to ensure our NHS continues to be able to treat those who need this care at this time.

Covid-19 Update

Ellie Reeves Excerpts

Thursday 17th December 2020 Commons Chamber

[Matt Hancock]

Yes. We have to keep getting the case rate down. In Stockport it is still over 100. There is further to go. Right across Greater Manchester and the surrounding areas, I would urge people to do as they have been doing, because the case rates have come down really quite significantly. Right across Greater Manchester and in Stockport, people have been doing the right thing, but the pressures on the NHS remain, partly from people who are in hospital with covid from when the rates were really high. I hope that we can make the move as soon as possible, and in the meantime I hope that everybody has a happy, safe and careful Christmas in Stockport.

[Ellie Reeves (Lewisham West and Penge) (Lab) [V]]

UK and EU pharmaceutical companies have warned that no deal will lead to delays of up to six weeks in obtaining vital medicines. Given that the Pfizer vaccine is complex to move and distributed from Brussels at -70°, does the Health Secretary agree that no deal would be catastrophic and that everything should be done to get a deal to protect our access to vital medicines?

Oral Answers to Questions

Ellie Reeves Excerpts

Tuesday 17th November 2020 Commons Chamber

[Matt Hancock]

Yes, absolutely. A critical part of tackling disinformation is providing accurate, fair and objective positive information, and my hon. Friend is absolutely right about this point. The social media companies are working—and we are providing content for them—to ensure that proper, accurate information that the public can trust from the NHS about the effectiveness of vaccines can be promoted, as well as taking action to remove information that is not accurate and not correct.

[Ellie Reeves (Lewisham West and Penge) (Lab)]

What steps his Department is taking to help ensure that family members can safely visit relatives in care homes during the covid-19 outbreak.

[The Minister for Care (Helen Whately)]

Visits from loved ones are what makes life worth living for many care home residents, yet, sadly, these have been too few over the last few months. Unlike the first lockdown, during this period of national restrictions, we want visits to be able to continue. That is why we published new guidance on 5 November advising care homes of the steps that they can take to allow safe visiting while there are high rates of covid in the community. Yesterday, we launched our visitor testing trial and plan to offer visitor testing to care homes across the country by Christmas.

[Ellie Reeves [V]]

There are almost 2,000 people living with dementia in Lewisham and for those in residential care, a lack of social interaction through visits can cause their condition to deteriorate. Testing for family and friends is the way forward, but the Government’s pilot for this was launched only this week and just 20 care homes are included. With the festive period rapidly approaching, why was this not done months ago, and is it not just another example of the Government delivering too little, too late?

[Helen Whately]

We have been testing and have prioritised testing in care homes going back as far as May, and we have been carrying out whole care home testing. We are now testing over 500,000 staff and residents in care homes every week. Now, as testing capacity increases, we are launching the visitor testing trial with 20 care homes across Hampshire, Devon and Cornwall. We will use the lessons from that trial to roll out testing more widely across the country as fast as we possibly can.

Women’s Mental Health

Ellie Reeves Excerpts

Thursday 3rd October 2019 Commons Chamber

[Ellie Reeves (Lewisham West and Penge) (Lab)]

It is a pleasure to speak in this debate. I thank the hon. Member for Bath (Wera Hobhouse) for securing it.

Although the issue of women’s mental health is wide-ranging, I will limit my contribution to maternal mental health, an issue that is close to my heart given that I am eight months pregnant with my second child. In response to a recent survey by the National Childbirth Trust, 50% of women reported that they experienced mental health or emotional difficulties at some time during their pregnancy or in the year after their child’s birth, yet many women are reluctant to admit to having difficulties. Society tells us that being pregnant and having a baby should be a wonderful, joyous time, but for many the reality can feel quite different. All too often, women do not discuss their problems because they feel embarrassed, ashamed or worried that health professionals would think they were not capable of looking after their baby.

I think it is important for me to say that I was one of those women. With my first son, I suffered from pre-natal depression, which led to an exacerbation of anxiety and obsessive compulsive disorder. At the time, I did not have enough knowledge of the condition to do anything about it. It is not something that gets talked about, so I did not know how to ask for help. This time around, I have been able to spot the triggers and deal with any problems before they escalate. I also had the confidence to tell my history to my GP, who was able to give me some options. At times, preventing the onset of pre-natal depression this time around has felt like a daily battle, but it is one that I am pleased to say I have won. However, for too many new mums, their mental health difficulties remain hidden, with research by the NCT showing that nearly half of new mothers’ mental health problems are not picked up by a health professional.

A simple solution would be to ensure that the six-week mandatory post-natal baby check included a mandatory maternal check. However, despite National Institute for Health and Care Excellence guidance, a six-week maternal check is not included in GPs’ contracts, which means there is no specific funding for it. As a result, the NCT found that a third of mothers had three minutes or less for their maternal six-week check; a fifth of mothers were not asked about their mental health at all at their six-week check; and half of mothers who wanted to discuss an emotional or mental health problem at their six-week check did not feel able to do so. With rushed appointments and without the right questions being asked, it is not really surprising that many women keep their problems hidden.

[Mr Kevan Jones (North Durham) (Lab)]

My hon. Friend is making a very good point. Does she agree that we need not just to look at GPs and that one visit, but to try to ensure that we embed in health visitors and other professionals who come into contact with new mothers the importance of looking for early signs of mental illness?

[Ellie Reeves]

That is absolutely right. Health visitors have a huge role to play, and we know from our constituency work that they are under a huge amount of strain and often the same issues apply. Health visits are often rushed, not through any fault of the health visitor, but because of the pressures and constraints they are under. The situation for both GPs and health visitors needs to be considered.

The NCT is currently running a campaign that I fully support. It seeks full funding for the six-week maternal post-natal check, so that GPs have time to give every new mother a full appointment. It also seeks to improve guidance for GPs on best practice around maternal health, with dedicated appointments for the six-week maternal check, and to encourage the disclosure of maternal mental health problems. Finally, it wishes the NHS to support GP education in maternal mental health. The consequences of not tackling maternal mental health are far reaching, with around 20 new or expectant mothers taking their own lives ever year. Maternal mental health problems are considered an adverse childhood experience, and urgent action really is needed.

I will end by championing some of the great support that is available to new and expectant mothers in my constituency, and which plays a fundamental role in maternal health and wellbeing. Bromley, Lewisham & Greenwich Mind offers a Mindful Mums course and a volunteer-led maternal befriending service. Our children’s centres offer drop-ins, mindfulness and breastfeeding support. Mytime Active offers a comprehensive pre and post-natal fitness programme in Bromley leisure centres, which I know has been instrumental in me not developing pre-natal depression this time around. Bromley Libraries offers free Baby Bounce and Rhyme and other activity sessions, and there are local NCT groups and baby cafes, to name but a few. I thank the dedicated staff and volunteers, without whom such services would simply not exist.

However, those organisations cannot do it alone, and their budgets are already stretched. Since 2010, 12 children’s centres in Bromley have shut. Bromley library staff have been on strike since June due to cuts to the service, and Mind is operating with waiting lists, such is the demand for its maternal services. Without proper investment in maternal health, and without breaking down the stigma surrounding pre and post-natal depression, women will continue to suffer alone. I hope that the Government are listening, and that this debate will be the start of much needed change.

[Several hon. Members rose—]