Oral Answers to Questions

Gavin Shuker Excerpts

Tuesday 22nd March 2016 Commons Chamber

[Alistair Burt]

Two things: the first set of waiting time standards—the first ever by a Government—are already in place from April 2015, with 50% of people experiencing an episode of psychosis treated within two weeks and improved waiting times for talking therapies; and, secondly, we have to get the database right. The right hon. Gentleman will know that we are doing an extensive and much greater data trawl to find a base on which those waiting times can be set, but it remains our determination to get them introduced by 2020.

[Mr Gavin Shuker (Luton South) (Lab/Co-op)]

8. What improvements have been made to child and adolescent mental health services since the publication of the Government’s strategy, “Future in mind”, in March 2015.

[The Minister for Community and Social Care (Alistair Burt)]

Progress has been made on many of the key ambitions set out in “Future in mind”. Of greatest significance is the development of local transformation plans that cover the full spectrum of children and young people’s mental health issues, from prevention to intervention for emerging or existing mental health problems, for every clinical commissioning group in the country.

[Mr Shuker]

This month, the Mental Health Network, representing NHS providers, said that very little, if any, of the money promised for child and adolescent mental health has yet materialised and that some services are experiencing cuts in-year. The Minister must accept, despite his assurances to my hon. Friend the Member for Liverpool, Wavertree (Luciana Berger), that the Department’s efforts in getting this money out the door has been woeful. What will he change?

[Alistair Burt]

I do not necessarily, despite the energy of the hon. Member for Liverpool, Wavertree, accept everything that she says. I gave a list of where the money is being spent. However, I think I can help both the hon. Gentleman and the hon. Lady. Much more is being done to ensure that CCGs deliver what they need to deliver in relation to mental health. This year’s figures will show that, whereas there has been a 3.7% uplift for CCGs, there has been an uplift of 5.4% in mental health spending. With more transparency and more determination by the NHS on CCG spending, hopefully what people are saying and feeling will become less justified in the future.

A and E (Major Incidents)

Gavin Shuker Excerpts

Wednesday 7th January 2015 Commons Chamber

[Mr Hunt]

Indeed. I pass on my best wishes for the new year to Mrs Bone. Like many people, she has benefited from superb NHS care. A million more people are having operations every year under this Government, and 700,000 more people are being seen within four hours at A and E under this Government.

[Gavin Shuker (Luton South) (Lab/Co-op)]

The NHS is a system, which is why cuts to social care and other parts of the system affect A and E. With that in mind, and with 14 hospitals in a state of emergency, will the Secretary of State review the plans that are in place should a winter crisis of cold weather come along at this very vulnerable point?

[Mr Hunt]

It is interesting that the hon. Gentleman did not want to talk to the House about his own local hospital, which is performing extremely well for A and E. It would be good if more of those on the Opposition Benches talked about the good things that are happening in the NHS, including nine out of 10 people who go to A and E being seen within four hours.

NHS Services (Access)

Gavin Shuker Excerpts

Wednesday 15th October 2014 Commons Chamber

[Mr Andy Slaughter (Hammersmith) (Lab)]

I make no apologies for addressing my comments to the latest developments in the “Shaping a healthier future” programme, the comprehensive reorganisation of health services that is affecting 2 million people in west and north-west London. It constitutes the biggest hospital services closure programme in the history of the NHS, and I believe that it will be the prototype for similarly draconian cuts if the current Government are, by some misfortune, re-elected.

The programme was two years in planning—in secret—and was announced in June 2012. It involves the closure of four of the nine accident and emergency departments in the area, and the closure, effectively, of two major hospitals. It affects both A and Es in my constituency and, indeed, the complete demolition of Charing Cross hospital, one of London’s major hospitals. At the time, all but 3% of the land on which that hospital stood was to be sold off.

There followed two years of confusion, phoney consultation, buck passing and false information, and decisions were taken by primary care trusts that were then abolished the following month. The original scheme was so incompetent that the business case was delayed for more than a year. It emerged last month, and now requires 50% of the Charing Cross land to be sold, as well as 50% of the land at St Mary’s, Paddington. However, it still requires £400 million of borrowing to be approved by the Treasury, despite the fact that the trust—Imperial College Healthcare NHS Trust—cannot manage its finances from one month to the next.

Exactly a year ago, the Secretary of State announced in the House that the Hammersmith hospital and Central Middlesex hospital A and Es should close as soon as was practicable, and that in fact happened on 10 September this year. Two A and E departments closed in one day, with people who attended them being told to go to Northwick Park and St Mary’s hospitals. Four days later, The Mail on Sunday reported in relation to Northwick Park:

“An accident and emergency unit criticised in an official report for being unsafe and unable to cope with demand is set to be swamped with thousands of extra patients—thanks to emergency department closures elsewhere. The Chief Inspector of Hospitals painted a picture of chaos at ‘very busy’ Northwick Park Hospital in Harrow, North-West London, after a recent visit. But its A&E will soon have to deal with at least 8,000 more patients a year due to the controversial closure of two London units last week.”

How that can be said to be a practicable and safe decision, I do not know. At the trust’s annual general meeting two weeks later, the chief executive—newly arrived from Australia—told people that they should not rely so much on A and E departments. Well, they do not have a great deal of choice in my constituency.

Is closing two neighbouring A and E departments enough? Clearly not, despite the fact that GP and community services are also being cut—I wish I had the time to go into that in more detail—because the closure of Charing Cross hospital A and E is being persisted with. That hospital is still due for demolition and downgrading. The current plan is for it to lose all but 24 of its 360 in-patient beds, its emergency surgery unit, its intensive therapy unit, its stroke unit and of course its A and E, which will leave only primary care treatment and day surgery on site.

[Gavin Shuker (Luton South) (Lab/Co-op)]

My hon. Friend, alongside his local party, has mounted a truly impressive campaign to protect those services. Government Members say that they are the defenders of the NHS. What action has been taken locally by other political parties to support him?

[Mr Slaughter]

The Conservative party fully supports the closures of the A and E departments. When it ran the local authority—fortunately, it no longer does so—it simply put out disinformation about whether the service closures would or would not take place. It is only because of the actions of local residents that my constituents know exactly what is happening.

Worse than that, on 15 May the Prime Minister came to my constituency for one purpose and one purpose only—to go into the basement of the Conservative party offices and give an interview to a local journalist, in which he said that Charing Cross hospital would retain its A and E and other services, and he then left. That was of course one week before the local elections. On 7 September, The Mail on Sunday, which I now regard as the paper of record on this issue and which has fought a strong campaign on behalf of A and E departments, reported the following:

“A casualty unit that David Cameron personally promised would stay open is due to be closed, The Mail on Sunday can reveal. Days before council elections in May, the Prime Minister visited Hammersmith in London and stated that Charing Cross Hospital in nearby Fulham ‘will retain its A&E and services’. But the organisation that runs the hospital intends to close the department and replace it with an ‘urgent care centre’, NHS papers show. Urgent care centres can be run by GPs and nurses rather than A&E consultants, and have far fewer facilities to care for the seriously ill or injured.”

I do not think that I need to explain that any more. The Prime Minister, for the purely party political reason of supporting a Conservative local authority that he has described as his favourite, did not say what was factually correct.

If they were not so disingenuous and incompetent, I might have some sympathy for those at the trust because, under instruction from their political masters, they have to argue against themselves. On 7 October, they came to answer questions from the scrutiny committee of the local council. They were asked about Charing Cross hospital and said that, in future, it will have

“emergency services appropriate for a local hospital”.

They were cross-examined on that issue and could not amplify their position, so we are none the wiser. However, we do know that a hospital that has only primary care and treatment services cannot sustain an A and E department. In the interests of safety, as well as honesty, it would be better if that was admitted to my constituents.

I will end with the beginning of a letter that is in the Evening Standard today. It is from Anne Drinkell, who is the admirable secretary of the “Save our hospitals” campaign in Hammersmith and a former community matron. She says:

“You highlight the pressures that closing A&Es at Hammersmith and Central Middlesex hospitals put on surrounding emergency departments. God help us if plans to close Charing Cross A&E go ahead. Imperial NHS Trust’s management seems in chaos, with leaked internal memos detailing cuts in acute beds and a mounting deficit. It has been unable to provide a clear description of what future ‘emergency’ care at these sites would look like. A notice on the back door at Hammersmith still advises patients to take sick kids to the now-closed Central Middlesex A&E”.

She ends by saying:

“We ask North West London NHS for a moratorium on closures until they consult on plans for change based on clinical need, not budget cuts.”

Is that an unreasonable request?

--- Later in debate ---

[Gavin Shuker (Luton South) (Lab/Co-op)]

Many hon. Members on both sides of the House have talked about their personal experiences of the NHS, and movingly about the care that they and others have received. It might not have escaped the House’s notice, but I am statistically one of the least likely Members to access NHS services, being under the age of 40—[Interruption.] I hear disparaging remarks about my size coming from my left, but I will ignore them.

I was extremely grateful to receive incredible care for my wife and child when Ruby, my daughter, was born last year, and got to see, incredibly and movingly, the dedication of NHS midwives, doctors and other staff as well.

I am hugely moved as well by the fact that locally in the seat I represent in Luton we receive fantastic NHS care. We have Luton and Dunstable hospital, and we were pleased to welcome the Darlington mums who had marched down to Whitehall to protest about the changes to the NHS when they came through Luton. They made many of the points I want to make today. They, as members of the general public, were able to articulate what I do not believe many Members across this House could: the depth of passion people feel for the NHS.

I would just say this. A number of different contributors today have talked at length about statistics and churned out figures, but for me there is one stand-out statistic from this Parliament: the level of patient satisfaction in the NHS. We can talk until we are blue in the face about which target should be met and which target should be missed, but it speaks volumes to me that the highest ever level of patient satisfaction was in 2010 when this Government came to power and it has dropped since then. That should cause us to ask profound questions, because we understand that a new top-down reorganisation of the NHS can only do one thing, which is distract from patient care. That is the experience in this Parliament.

People forget that the NHS is not a series of services that can easily be bolted together. It is more a network or a system, and just as Beeching wielded his axe and chopped up different parts, compartmentalising and fragmenting the railways, so we must be aware of the lessons of history when it comes to fragmentation in our NHS system. It is the role of us in this Parliament not just to protect our own local services or seek to move forward with the amazing new treatments that exist now, but to protect the legacy of the NHS over the last 70 or 75 years.

Will this Government talk about the massive error that was the reorganisation of the NHS in this Parliament and allude to two others? The starvation of funds by the Tories in the ’80s and ’90s that had to be put right by a Labour Government in 1997, who saved the NHS, is the second, and opposing its creation in the first place was the Tories’ original sin on the NHS, but they seem not to have learned that lesson. They continue to make this mistake, and it has led to 440 new organisations in the NHS, tying up hospitals in competition law, with 4,000 staff laid off and then rehired. Is this not the waste we have talked about in our system—the waste that could be repurposed for better patient care, and a rise in patient satisfaction as well?

We need a clear plan for putting this system back on track, because of the many shortages and the rationing we have seen in the system. The first plank of that plan, advocated by my right hon. Friend the Member for Leigh (Andy Burnham), is to be clear about our plans to repeal this damaging Tory NHS Act that has done so much damage in this Parliament. I am glad to hear that in five weeks each of us in this Parliament will be asked to cast our votes for the repeal of the most damaging aspects of this legislation, and I pledge to my constituents that I will not be found wanting when that comes. We must also exempt the NHS from the transatlantic trade and investment partnership, make sure the extension of competition law that has led to a massive acceleration in privatisation is curbed, increase NHS spending by £2.5 billion a year in a sustainable way to make sure the NHS has time to care, and hire 36,000 new nurses, doctors and midwives.

That is the expectation that will fall to us in the next Parliament, but in this Parliament there is also something that needs to be done. Government Members must admit publicly, not just privately, their error in going about this reorganisation, and commit to the funding that is going to be required. We all accept that there are no easy solutions, and politicians can sometimes get wound up in all sorts of knots trying to defend services that should be reconfigured. I fully accept that. But, fundamentally, we are the custodians and the guardians of the greatest mechanism against social inequality and the greatest mechanism to attack health inequality head on. The national health service is an institution rightly held in high regard by the people who believe they own it, not those who are asked to be its custodians. It is the crowning achievement of the 1945 Labour Government. It needs to be rescued by successive Labour Governments after Tory Administrations. The NHS demands nothing less.

Residential Home Closures

Gavin Shuker Excerpts

Thursday 10th July 2014 Commons Chamber

[Gavin Shuker (Luton South) (Lab/Co-op)]

Social care is changing. All parties in this House are rightly committed to giving disabled people more choice and control over where and how they live.

If I were to acquire a serious disability, I would hope to spend as long as possible in my own home. I hope that the care system would provide me with high quality care that allowed me to enjoy a good quality of life close to my friends and family. That is an increasingly normal model, but it has not always been that way.

For decades, it was conventional for most severely disabled people to move into a residential home. Today, some disabled people prefer to live in a residential home where they can be part of a community of staff, relatives and other residents. There will always be some people whose condition is severe enough to rule out other options of care.

Residential home closures, whatever the motivation behind them, pull apart existing communities. They are people’s homes. It may be that many disabled people wish to move from their existing setting, but others do not.

Robert Holmes is 39. I met his mother, Grace, two months ago when out knocking on doors in my constituency. She told me about the excellent quality of care that Robert, who has cerebral palsy, receives at Scope’s residential home, Hampton House in Northampton.

--- Later in debate ---

Motion made, and Question proposed, That this House do now adjourn.—(Anne Milton.)

[Gavin Shuker]

Grace also told me of Scope’s proposals to close Hampton House and relocate the residents apart from one another. She said:

“All of the residents there are like brothers and sisters to Robert—and some have been there for 39 years. The staff are brilliant. Even when residents go to hospital they have a staff member with them 24-7…I felt happy knowing that if anything happened to me Robert was in a place where he was loved and cared for, but now I worry constantly about it.”

Ann and Richard Fensome are also my constituents in Luton South. Their daughter, Joanne, is also 39. Ann and Richard report that Joanne, who has cerebral palsy and is severely disabled, does not wish to move from Wakes Hall in Essex—another Scope home earmarked for closure. They are not alone, and I thank the families who have taken time to contact my office to share their personal and emotional experiences of support for their loved ones at this time.

Scope has proposed to close eight residential homes and modify another three in the coming years, but it is not alone in pursuing such proposals. We are seeing the same thing happen with the Guinness Partnership, Home Farm Trust and other smaller charities who feel that residential homes are no longer in step with the Government’s decision and direction on care provision. This debate is important because we must ask: what about the voice of those disabled people who wish to live in such facilities, but who lose that right because of home closures? What happens when these homes no longer provide the same kind of care they would once have done? Who ultimately steps in?

I do not have one of the proposed home closures in my constituency, but I easily found families who will be profoundly affected by Scope’s decision, and in that sense I suspect that every Member in this place will be affected in some way. The two families I spoke of earlier came to Parliament last month to lobby MPs along with Labour’s parliamentary candidate for Northampton North and former Member of this House, Sally Keeble. She has been tireless in her work on this issue, but she has not been alone. Indeed, I have spoken to a number of Members from across the House who have raised their concerns directly with me.

The hon. Member for Northampton North (Michael Ellis), who is in his place, has challenged the decision to consult on shutting Hampton House in his constituency. The hon. Member for Witham (Priti Patel) has shared her concerns with me about the decision to consult on the closure of Wakes Hall in the nearby constituency of the hon. Member for Harwich and North Essex (Mr Jenkin), and I know that she spoke at a lobby on that issue last month. The hon. Member for Ribble Valley (Mr Evans) and former Deputy Speaker spoke with me about his concerns for the residents affected. In my constituency office in Luton, Grace Holmes and the Fensomes highly praised Scope’s approach to care. They spoke of the quality of support that their children receive, and the relationships that they have built with the staff over the years. As an example of their gratitude for the charity’s work, they shared how they have actively supported Scope for a number of years. Perhaps that is why they are so disappointed by Scope’s proposals. They raised concerns with me about the consultation process, the upset it was causing residents, and a number of process issues. At the core of their argument, however, was the issue of choice.

Peter Walker, Scope’s regional director, recently told a local newspaper that the charity was looking to close care homes such as these,

“because we don’t think this kind of old-fashioned care home offers disabled people the kind of say that everyone else has over where they live, who they live with and how their money is spent”.

Scope states that the closures are necessary in order to comply with the direction of Government policy, which is to encourage those with physical and learning difficulties to enjoy independent living and choice about the care they receive. I have no reason to doubt that assertion, and that Scope’s desire is to give future service users an experience that reflects their expectations. I am fully supportive of the move towards more independent living for those who believe that they will be able to lead better lives in that way. My hon. Friend the Member for Leicester West (Liz Kendall), the shadow Minister for care and older people, has similarly expressed her support for those laudable aims in correspondence with Scope’s chief executive, but for Joanne and Robert, who do not wish to move, their choice is not being enhanced; it is being taken away. I understand that they are among the most vulnerable of Scope’s clients. They are the people that the charity was set up to care for. For them, round-the-clock care does not come towards the end of their lives, and they will continue to need such care for decades to come.

The Department of Health website looks towards a new system under the Care Act 2014 that will be

“built around each person—what they need, how they can best be cared for, and what they want.”

The tone is very purposely set to encourage patients to have more confidence in the choices available to them, yet the most important expression of choice is that of my constituents—their choice is to stay in the home that they know and love, and they want their families to be assured that their loved ones continue to receive good quality care by those whom they trust.

Scope has made efforts to bring residents on board with its new strategy. Hampton House residents have had the opportunity to visit the type of independent housing that Scope envisages—small clusters of individual properties. Although that will appeal to some, the overwhelming feedback was concern. They fear that the move will result in the residents becoming more isolated, and in a loss of the easy mobility and companionship that they currently enjoy. The move will appeal to some, but we should take note of that overwhelming feedback.

I would appreciate the following response from the Minister. First, I should like him to review that broad issue and report to the House. The review should set out what work the Government have done on the changing culture—the shift from residential care home settings for disabled people while at the same time preserving the rights and choices of people such as Joanne and Robert to stay in residential home settings.

If the care home residents were tenants in the housing market, they would have tenure rights, exercisable through the courts. As customers of a business or clients of a charity, they can lose their homes on the whim of a change in strategy by the organisation. That could happen even in the case of Hampton House, where one resident has lived for some 39 years.

The review should examine the issue of choice. Questions have been raised about the working of the Mental Capacity Act 2005, and about the exercising of choice by people who have profound learning difficulties. Who is best able to interpret and assist in their choices: the charity that provides their accommodation or their family members?

The review should examine the accountability of charities and the private sector. If those homes were run in the public sector, there would be a statutory requirement for public consultation. The issues and information would be public, and the results would be open to legal challenge. In the case of Hampton House, Scope has said there will be a consultation, but it has told family members verbally that that is unlikely to change the decision to close the home. The decision is not open to scrutiny or challenge in the same way.

The review should also examine a national framework of safeguards. People with very complex needs require security in their housing and care arrangements throughout their lifetime, which may extend well beyond the lives of their parents or other close relatives. We know that age is a key factor in the argument. Some charities say that younger disabled people want to live independently and, anecdotally, I have been told that more independent living is a trend that is better reflected among some younger disabled people. However, that leaves us with a challenge, particularly for some older disabled people, such as those in their 40s or 50s. In some cases, the intentional communities in which they live have been their homes for all their adult lives. The Government should examine whether their sectoral needs are being well met, and what safeguards should be appropriately awarded to them.

Will the Minister review Scope’s proposed consultation and examine whether more can be done to protect the rights of disabled people who wish to live in these residential settings right now? Indeed, a number of families, accepting Scope’s position that it does not wish to continue actively supporting these institutions, ask whether facilities could be transferred to another charity to run. That would provide continuity of service. I understand that Scope’s position is that it is not an economic concern that has led it to take this route of consultation and closing homes, so it is credible to believe that another organisation could absorb them.

I do not doubt the Minister’s sincerity in seeking to move to a care system where disabled people have greater choice, voice and control over their own lives. It would, however, be the greatest of ironies if, in undertaking such a shift, we were to leave a generation or a group of severely disabled people behind.

Oral Answers to Questions

Gavin Shuker Excerpts

Tuesday 25th February 2014 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

I know that my hon. Friend is really concerned about this, but NICE is an independent body so it would not be appropriate for me to interfere in an ongoing appraisal. NICE has recommended a number of other treatments for advanced melanoma, and NHS commissioners are required to fund them where clinicians want to use them. I want to give her some encouragement: this spring a trial will begin of an awareness programme on melanoma in the south-west of England, working with Cancer Research UK.

[Gavin Shuker (Luton South) (Lab/Co-op)]

T7. I am grateful to the Minister for her previous answer on female genital mutilation. With that in mind, what action will she take regarding the three Tory MEPs Nirj Deva, Sajjad Karim and Timothy Kirkhope who voted against the motion, in the European Parliament on 11 December, strongly condemning the disgraceful practice of FGM?

[Jane Ellison]

I am aware of this case. The point made is rather unfair. My colleague Marina Yannakoudakis MEP has dealt with this issue in correspondence with other Members. The motion was a composite motion. All Conservative MEPs completely condemn FGM, but there was a technical reason why they voted in that way. It is clear that the Conservative party—along, I think, with all Members—absolutely condemns this practice. I am happy to give the hon. Gentleman the detail on that vote afterwards.

Oral Answers to Questions

Gavin Shuker Excerpts

Tuesday 22nd October 2013 Commons Chamber

The Secretary of State was asked—

[Gavin Shuker (Luton South) (Lab/Co-op)]

1. If he will bring forward legislative proposals to introduce standardised packaging of tobacco products.

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

As the hon. Gentleman knows, the Government have decided to wait before making a decision on standardised packaging, but the policy remains under active consideration. As he can imagine, I have spent much of the past two weeks, as I get to know my brief, looking at that carefully.

[Gavin Shuker]

I welcome the Minister to her new role. Stirling university’s systematic review of plain packaging concluded that it made cigarettes less attractive and health warnings more effective. Will she give me a straight answer: has she read the report, and if not, why not?

[Jane Ellison]

The straight answer is that I have not read the whole report, but I have read the summary, and it reaches some interesting conclusions. It is one of a number of interesting new pieces of information and evidence coming forward to support decision making in this policy area, and from work going on in countries right around the world as well as Australia.

Oral Answers to Questions

Gavin Shuker Excerpts

Tuesday 11th June 2013 Commons Chamber

[Paul Flynn (Newport West) (Lab)]

4. What his policy is on the introduction of standardised tobacco packaging; and if he will make a statement.

[Gavin Shuker (Luton South) (Lab/Co-op)]

9. When the Government plan to respond to their consultation on standardised packaging of tobacco products.

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

The Government have yet to make a decision. We are still considering the lengthy consultation, and in due course we will publish a report on that.

[Anna Soubry]

I certainly do not agree with the latter part of that. Just because something was not in the Queen’s Speech does not preclude us from introducing legislation should we take that decision. The hon. Gentleman makes some important points when he talks about the link between mortality and choices about how much alcohol one drinks or whether one chooses to smoke, but we await a decision from the Government.

[Gavin Shuker]

Many of my constituents, including Cancer Research UK ambassador, Elizabeth Bailey, are asking a simple question: why is it taking the Government so long to respond to this consultation? Is not the truth that they are caught up in interdepartmental squabbles while public health suffers?

[Anna Soubry]

No, it certainly is not, and I have given my views. The hon. Gentleman will know that like many decisions on public health, these are complicated matters. Most importantly, it is vital that we take the public with us. I have said before that I welcome a debate, and perhaps he and the hon. Member for Newport West (Paul Flynn) might come to you, Mr Speaker, and ask for a debate in this Chamber or in Westminster Hall. Let us have the debate, because taking the public with us is always important when we make these sorts of difficult and controversial decisions.

--- Later in debate ---

[Gavin Shuker (Luton South) (Lab/Co-op)]

T4. An enormous number of people—largely women—involved in on-street prostitution are caught in a cycle of drug and alcohol abuse, and are working to feed their habit, but at the same time, beyond managing drug dependency, many drug and alcohol services do not offer any practical pathways out of prostitution or even ask whether the client wishes to exit prostitution. Will Ministers look into this issue, consider issuing guidance and write to me?

[Anna Soubry]

Absolutely yes on all those very important points. The hon. Gentleman makes an extremely important point to which I absolutely subscribe. I have regular meetings on this matter, and I hope that our sexual health strategy addressed exactly those points, but I am more than happy not only to write, but to meet him to discuss the matter further. If I might say, I think that all Members, whatever the party political divide, could do far more both here and locally to reduce the number of women who find themselves working on the streets as prostitutes. I have long taken the view that these are some of the most vulnerable people in our society, and without exception I have never met a prostitute—I used to represent many of them—who has not herself been abused, usually as a child. They are vulnerable people and we should recognise them for that.

Oral Answers to Questions

Gavin Shuker Excerpts

Tuesday 27th March 2012 Commons Chamber

[Mr David Crausby (Bolton North East) (Lab)]

2. What his most recent estimate is of the cost of NHS reorganisation.

[Gavin Shuker (Luton South) (Lab/Co-op)]

7. What his most recent estimate is of the cost of NHS reorganisation.

[The Minister of State, Department of Health (Mr Simon Burns)]

The cost of the NHS modernisation is estimated to be between £1.2 billion and £1.3 billion. It will save £4.5 billion over the rest of this Parliament and £1.5 billion a year to 2020. We will reinvest every penny saved in the NHS in front-line services.

[Mr Burns]

No, I do not believe it is. The administration figure that has been announced for CCGs throughout the country is £25 a patient, but if a CCG is more effective and efficient in providing administration and bureaucracy and makes savings, those savings can be transferred and reinvested in funding the care of their patients. That is an incentive for them to be streamlined and to ensure that that happens.

[Gavin Shuker]

The Minister speaks of reinvesting every single penny in the NHS budget. How does that fit with the £500 million raid on the NHS budget spoken of this week?

[Mr Burns]

If I could explain this to the hon. Gentleman, the £500 million that he is talking about was part of the savings made through renegotiating the IT contract. It is a perfectly normal procedure, because as the right hon. Member for Leigh (Andy Burnham) will know, the average figure for previous years was £850 million, and one year when he was a Minister at the Department of Health, it was £2.3 billion.

Pregnancy Counselling

Gavin Shuker Excerpts

Monday 12th December 2011 Commons Chamber

[Gavin Shuker (Luton South) (Lab/Co-op)]

I am extremely grateful to you, Mr Speaker, for granting this Adjournment debate. Three months ago, during our debates on the Health and Social Care Bill, an amendment upholding a notion supported by 78% of the British public, that

“a woman should have a right to independent counselling when considering having an abortion, from a source that has no financial interest in her decision”

was put to the vote. It was voted down by a majority of three to one. I know this all too well because I intervened in the debate to say why I hoped it would not go to a Division. It felt misplaced in the legislation and followed a fractious debate that had been conducted in the papers and the media. It descended, as all such debates seem to, into a political bun fight. Indeed, one of the few voices of moderation—hon. Members might be surprised to hear me say this—was the Under-Secretary of State for Health, the hon. Member for Guildford (Anne Milton), who is in her place tonight.

The Government are rightly engaging in a consultation process to see how best to improve pregnancy counselling services. It is in that context that I sought this Adjournment debate. I hope that we can show, as a House, that we have the maturity to ask a simple question without descending into accusations either of betrayal or of compromise. The question we must ask is this: do the present arrangements for pregnancy counselling, when a woman is deciding whether to undergo a termination procedure or to make arrangements for seeing her pregnancy through, serve us well?

I should like to quote a few women who have spoken about their experiences of the pregnancy counselling system as it is currently constituted. All these women received taxpayer-funded counselling; they really are the most important voices we could hear from this evening. A woman called Jennie had a bad experience. She said,

“I felt this counsellor was disinterested. I actually told her to pay attention because this was important to me that I had this counselling. It was like she was thinking about her shopping and I was just choosing a handbag.”

Emma said:

“I felt irritated with the counsellor because she presented my abortion options like it was a sweet shop; ‘So what would you prefer? The pills that will do this, this and this or you could have a surgical procedure.’ I was so angry; I just told her I didn’t care.”

Other women have reported that they felt pregnancy option counselling simply was not made available to them. A woman called Kerry said:

“They did not offer me counselling. I was crying and screaming as I went for the abortion but they still went through with it. I was pressurised by my boyfriend. It is the first thing I think about in the morning and the last thing at night.”

Patricia was not offered counselling either. She said:

“I was never given any options. When I took the second pill I was sent home to have the abortion. I have not stopped crying ever since.”

It is tempting to dismiss these experiences, but they are real. Any mature debate will, I hope, avoid the accusation that these women are in some way rewriting their own history. Surely we should do all we can as a society to ensure that women, regardless of their choice in such circumstances, do not have to live with regret, in many cases for the rest of their lives.

At the heart of the proposal that all women should access independent counselling where the source of that counselling does not have a financial interest in their decision is a concern about the current arrangements. At present the only available taxpayer- funded pregnancy counselling is given by those working for abortion providers. Some have suggested that this means that counsellors will act unprofessionally, in a directive fashion. I do not suggest that, but I do have a concern.

When a pregnancy counsellor also works for an organisation that provides abortions, there is an underlying direction of travel. The expectation, for both the organisation and the woman accessing the service, is that the normal process will conclude in the termination of a pregnancy.

[Andrew Selous (South West Bedfordshire) (Con)]

Given that the law gives a woman the right to choose, does the hon. Gentleman agree that a woman should also have the right to choose from where she gets her counselling? I have a wonderful lady in my constituency, Sarah Richards, who receives no funding for the women who come to her. She does not badger them in any direction. Would the hon. Gentleman like to see a woman such as Sarah Richards who provides such a service receiving the same payment as the British Pregnancy Advisory Service receives for the women it counsels?

[Gavin Shuker]

The hon. Gentleman makes an extremely good point about the experiences in his constituency. I will go on to talk about the system that I think might be able to facilitate something along those lines and address some of the concerns that, quite understandably, many people will have when they hear about those who are currently outside the system coming in as well.

It is reasonable to expect that women are offered, should they want it, counselling that does not have a connection and an underlying association with only one outcome.

[Kate Green (Stretford and Urmston) (Lab)]

My hon. Friend is making a very thoughtful case. Does he agree that we particularly want to avoid late terminations? They are stressful for women and they are obviously a cause of great concern. How would he be sure that directing women to sources of counselling outwith abortion providers would not cause delay?

[Gavin Shuker]

My hon. Friend makes an extremely good point. Where terminations are to occur, they should happen early. There is a concern that women who desire the kind of context in which they can make their own decision are provided for as well. There will always have to be a balance in any system, but there is an inherent risk in the system as it is currently constituted that women are not able to access that counselling.

It is reasonable that independent pregnancy counselling should be made available to all women who are considering their options. It might surprise the House to know that there is no legal guarantee that such counselling is available.

[Fiona Bruce (Congleton) (Con)]

I commend the hon. Gentleman for introducing this important debate. Does he also agree that where such counselling is offered, it should be provided by counsellors who have specialist training and experience in advising those who are in the situation he describes?

[Gavin Shuker]

The hon. Lady makes an extremely good point. I agree, and I will go on to say a few words about some of the criteria that we should look for in people providing such counselling in future.

I believe it is perfectly reasonable, in a debate as complex and fractious as this, to suggest that given the issues we have talked about, the most sensible thing the Government could do is take out of the equation the financial link between counselling and the procedure. I accept that there are opinions in all parts of the House, but one simple principle to enact—and one potentially complex thing to do—would be to take the financial link out of the process. Many would see it as wrong that pregnancy counselling is currently monopolised by those who are pro-choice. There is an imbalance in the system which means that, by and large, counselling is provided only by private abortion clinics. I encourage hon. Members, whatever their perspective on the issue, to consider this simple question: can it really be right that the only taxpayer-funded pregnancy counselling available is currently given by those working for abortion providers?

Counselling in this context should always be non-directive, client-centred and universally available, and the right to it should be legally protected, but I do not believe that it should be subject to a duopoly, as it is at present. If a provider can produce genuinely client-centred and non-directive counselling that is free from a financial link to any given procedure, I believe that the NHS should fund it. There are more than two such providers in the UK today.

In that light, I very much welcome the commitment that the Minister gave the House in September. She said:

“Whether women want to take up the offer of independent counselling will be a matter for them, but we are clear that the offer should be made.”—[Official Report, 7 September 2011; Vol. 532, c. 384.]

She also spoke of the difficulty in defining what was meant by “independent” in this context. For some it simply means non-directive, but for others it means independence from finance or independence of the organisational structure from the abortion provider. As I understand it, her Department has not yet given any assurance that the offer of independent counselling would by definition mean counselling by persons or bodies without any kind of vested interest in abortion provision. I ask her to reflect on this and reiterate her commitment that women will be offered independent counselling and that the way to ensure that is by creating a regulatory framework that recognises the provision of alternative sources of pregnancy counselling to those offered by the big two.

In this country we have more than 40,000 trained counsellors who are members of either the British Association for Counselling and Psychotherapy or the UK Council for Psychotherapy. I hope that the Department will liaise with both organisations and the Royal College of Psychiatrists in developing an entirely new approach to how pregnancy counselling is provided in this country.

I know I speak for many, both in the Chamber and outside, when I say that my preference would be for abortion clinics not to be provided in pregnancy options counselling, ensuring that every woman seeking such counselling would know that there is no financial relationship between counselling and the provision of a termination. However, I accept the Government’s position that the right way forward on this issue is through consultation that allows all parties to express their views. It seems entirely practical and plausible for the Government, using the resources currently available, to develop a system in which every woman considering her pregnancy is offered counselling, should she wish to have it.

Non-directive pregnancy options counsellors, who are excluded from the present state settlement, can offer practical advice and help for women who choose to take their pregnancy to full term and often an ongoing support relationship. The focus of existing providers, understandably, is whether to abort or not. Just as choices are wider than simply whether or not to have an abortion, so counselling should give recognition to and advice on adoption and fostering when a woman considers continuing with her pregnancy.

Let me turn to the inevitable charge that allowing counsellors who are pro-life in their personal lives into the system would be inherently damaging to women. It starts with an assumption that the present system is both neutral and independent and hinges on a prejudice about those who hold such convictions. Allow me humbly to disagree with this notion. First, if the debate this autumn taught us anything, it is that no one is neutral. On an issue of conscience, right-minded and well-meaning people will rightly disagree and end up on different sides of the debate, but they will hold a position of conscience that they feel strongly about, hence my suggestion that we do what we can do now, hence my call to break the financial link between counselling and the termination procedure, and hence my desire to ensure that there is no nagging doubt at the back of any woman’s mind about who is looking out for their interests.

Secondly, there is an assumption that people cannot park their personal convictions at the door. Every counsellor knows that pressure in any direction is counter-productive for a woman who wants to continue her pregnancy but needs the space to reach that conclusion herself. In a new system, every counsellor should know that, whether they are personally pro-choice or pro-life, any moves that depart from non-directive principles should endanger their ability to do such work in future.

Equally, I hope that being pro-choice would mean being pro-all-the-choices available to women and that some providers are more expert at providing additional choices to those currently available and funded within the present system. That is why I hope that providers who, as many Members have mentioned, are doing amazing work to support women who would otherwise have felt no option but to undergo an abortion will be welcomed into our present system.

As a House, we have always had the ability to bridge divides, overcome prejudices we see in one another and together find a better arrangement for those we are here to serve. I feel certain that there are women who are let down by the current arrangements. The right response for us is to come together in a spirit of respect, excluding no one or their views. The ongoing consultation by the Government is an opportunity for us to do so, and I hope that we will not be found lacking.

Health and Social Care (Re-committed) Bill

Gavin Shuker Excerpts

Wednesday 7th September 2011 Commons Chamber

[Nadine Dorries]

I thank my hon. Friend for that intervention, because I am coming to another interesting statistic that I have not yet included in my speech.

[Gavin Shuker (Luton South) (Lab/Co-op)]

rose—

[Nadine Dorries]

I will give way in a minute.

There is a huge disparity between the figures that show both where a woman received her counselling and her decision. In 2008, BPAS announced that the proportion of women who came to it and decided not to proceed with an abortion was as high as 20%. Unfortunately, freedom of information requests asking for the figures and the contracts with PCTs show that that is not true: the real figure is 8%, and sometimes even lower in some PCTs. I am not sure why an abortion organisation would say that its figures for women who do not proceed to an abortion are higher than they actually are.

[Gavin Shuker]

rose—

[Kate Green]

rose—

--- Later in debate ---

[Nadine Dorries]

I give way to the hon. Member for Luton South.

[Gavin Shuker]

The hon. Lady has rightly probed the relationship between counselling and abortion on behalf of those of us who feel uncomfortable about that relationship. However, does she agree that 90 minutes does not seem like a long time for us to debate the implications of what is going on? The Bill is substantively about the nature of the NHS, and not about abortion provision. In that light, I urge her to consider whether it is appropriate to divide the House on this issue.

[Nadine Dorries]

I do feel that it is appropriate to divide the House on this issue, because I would like the amendment to be part of the Bill.