Oral Answers to Questions
Helen Morgan Excerpts(2 months, 1 week ago)
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Helen Morgan (North Shropshire) (LD)
My constituent Mel Lycett has terminal cancer. After repeated visits to her GP, she was referred to a two-week urgent pathway in May. She was not diagnosed until the end of July, and she still has not started treatment. Every single target for her diagnosis and treatment was missed. That is not uncommon in Shropshire, and it is not uncommon in the rest of the country. Can the Secretary of State reassure me of what he is doing to deal with this terrible legacy left behind by the Conservative Government? How will he ensure that cancer patients are treated in a timely manner?
Wes Streeting
I welcome the hon. Lady to her role. I am afraid that this case is just one of countless stories of people whose lives might have been saved had the NHS been there for them when they needed it. It is bad enough when people receive a late diagnosis that equates to a death sentence; it is worse still when people in that position are not given the fighting chance of urgent, life-extending treatment.
The inheritance we have received is truly shameful. I assure the hon. Lady, as a cancer survivor myself—because the NHS was there for me when I needed it—that we will work tirelessly through a national cancer plan to make sure that we deliver the cancer waiting time standards that the last Labour Government met, and that are sorely needed today.
Helen Morgan (North Shropshire) (LD)
In England, 4.4 million children have not seen a dentist for at least a year. Meanwhile, in Shropshire, Telford and Wrekin integrated health board, £1 million of dental funding went unspent in 2022-23. The system is clearly broken. When can we expect the Secretary of State to fix it?
Wes Streeting
It is precisely because of the situation the hon. Member describes—the poor services and, ironically, the underspends in the dentistry budget—that we will work not only to stand up the 700,000 urgent and emergency dental appointments we promised, but to do the prevention work for children in our schools.
Maternity Services: Gloucestershire
Helen Morgan Excerpts(2 months, 2 weeks ago)
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Helen Morgan (North Shropshire) (LD)
It is a pleasure to serve with you in the Chair, Sir Christopher. I congratulate my hon. Friend the Member for Cheltenham (Max Wilkinson) on securing this important debate. Maternity services affect every single one of us at least once in our lives, so it is important that we protect them to ensure that, for all of us, that moment—obviously, many of us experience it more than once—is a safe one.
I will not mention all the hon. Members who have spoken, but I am pleased to see so many of my Liberal Democrat colleagues, who have all made excellent speeches and powerful points. I particularly thank my hon. Friend the Member for Thornbury and Yate (Claire Young) for sharing her experience, and the hon. Members for Gloucester (Alex McIntyre) and for Stroud (Dr Opher) and my hon. Friend the Member for Tewkesbury (Cameron Thomas) for sharing theirs. Obviously, the hon. Member for Stroud has his own medical expertise, which is very important. Finally, my hon. Friend the Member for Winchester (Dr Chambers) described his constituent’s shocking experience, which I think we were all upset to hear about.
This is not the first debate we have had on maternity services—not even the first in this Parliament—and the reason for that is the shocking under-investment in those services. On 19 September, during recess, the Care Quality Commission issued a report, and its contents are hugely disappointing if not surprising. As has been mentioned, it spoke of the risk of normalising avoidable harm, which is an unacceptable situation to be in.
Hon. Members might be aware that my interest in maternity care came about because I am from Shropshire—I represent North Shropshire—and my constituents Kayleigh and Colin Griffiths lost their daughter Pippa at Shrewsbury and Telford hospital NHS trust. They fought tooth and nail alongside Rhiannon Davies and her husband Richard Stanton to bring about the Ockenden review into the scandal that unfolded at the trust.
Since then we have had a report on East Kent, and there is a review going on in Nottingham. None of that is news to us, which is shocking. I sat on the all-party parliamentary group on birth trauma, which was brilliantly led by the former Member for Stafford, Theo Clarke, and on the baby loss APPG, and I am currently trying to reconstitute the maternity APPG. All those groups have found the same failings over and over again.
The CQC report tells us what we already know: 40% of maternity services are rated as requiring improvement and 18% are rated inadequate. That means that less than half are rated as acceptable, which is not excusable, particularly given that we have had so many high-profile scandals and so many commitments—I believe they were made in good faith—from the Dispatch Box that these things will not happen again, but they are happening every single day.
We know from all those reports that unsafe staffing is at the root of most of the problems and that it is pushing hard-working midwives, in particular, to the brink. They work their socks off to share in what should be the most joyful moment of each individual’s life. When I had my baby nearly 16 years ago in an emergency situation, the midwife, who had been with me all afternoon, stayed on at the end of her shift to make sure that I and my baby were okay. We received excellent care and were both fine in the end, thank goodness. However, we have all relied so much on the good will of those individuals that they are experiencing burnout at an alarming rate.
I was canvassing in my constituency during the general election when a midwife came running across the road in her dressing gown and slippers to tell me that she was emigrating because she had had enough and that two other midwives she knew in the county were taking the same step because they had experienced burnout on such a shocking level. Any workforce plan needs to deal urgently with that problem.
Staffing is one problem, but unsuitable buildings are another. In the shocking inquiry into the Lucy Letby case at the Countess of Chester hospital, which is slightly unrelated, I read that sewage was coming up into the hospital’s sinks. How can we control infection when there is literally raw sewage in the building? It is unacceptable. We need to ensure that this Budget invests not just in the GPs, healthcare workers and midwives we so urgently need, but in the fabric of our hospitals.
We have repeatedly heard that there is a failure to learn when things go wrong and that hospitals focus too much on protecting their reputation rather than on learning from terrible mistakes that might have happened—and that will inevitably happen on occasion, even with the best staff in the world, because sometimes things go wrong. Hospitals must learn from those mistakes.
Finally, there is a failure among hospitals to have an open culture, so staff who have concerns are unable to raise them. The duty of candour law, to which the Government have committed, is so important, and I urge the Minister to ensure that the people to whom workers in hospitals can speak up are independent of the hospital manager and the clinical director. If workers are reporting to the person responsible for giving them their jobs, that is not a safe process. We must have independent whistleblowing procedures for people raising clinical concerns. I am sure my constituents share my anger that we have to return to this topic again and again, when we should be looking at how far we have come since the Ockenden review over two years ago.
I want to touch on the point made by my hon. Friend the Member for Carshalton and Wallington (Bobby Dean) about outcomes. Black and Asian women and their babies have a far worse probability of surviving birth than white women. If that was happening in a single trust, we would have another big, important review, but because it is spread out across the country, it is being lost, so we must return to it. It is not acceptable in this country in the 21st century that ethnic or socioeconomic background is a determinant of whether having a baby is safe. We are not on track to meet our 2025 targets for reducing stillbirth and neonatal death, and those targets have not been renewed. I urge the Minister to renew them and to ensure that there is a plan in place to meet them.
Finally, my hon. Friend the Member for Winchester made the critical point that spending more on medical negligence than maternity services is totally unacceptable. This country cannot afford for that to continue. We must make maternity services safe, because it is better for the mothers, better for the babies and better for the taxpayer. I look forward to hearing the Minister’s response.
NHS Performance: Darzi Investigation
Helen Morgan Excerpts(2 months, 2 weeks ago)
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Helen Morgan (North Shropshire) (LD)
The findings in Lord Darzi’s report are shocking, but Liberal Democrats—there are many of us here today—find that they echo the hundreds of thousands of conversations we had with people on the doorstep across the country throughout the election campaign. In too many ways, the NHS just is not working as it should, and that is a tragedy, because we all cherish the NHS and want it to succeed. It is one of our country’s greatest inventions and a great Liberal idea. It is one of the things that makes us proud to be British.
We all owe so much to the NHS and the incredible hard-working staff who have kept it going under the most intense pressure imaginable. Despite their heroic efforts, there is no doubt that we have a major crisis in the NHS. Let us not forget, because it is so important—these things are intrinsically linked—that we also have a major crisis in care. The message that the British people sent at the general election in July was clear: fixing the health and care crisis must be this Government’s No. 1 priority.
Before I turn to the Government’s plans, it is worth reminding ourselves of the scale and urgency of the challenge. Far too many people wait weeks to see a GP or NHS dentist, if they can find one. Far too many wait months or even years to start vital treatment for serious conditions. Far too many wait for hours in pain and distress for an ambulance to arrive. I recently spoke to a constituent, Emma, whose 11-year-old daughter Charlotte suffers from a medical condition that means she is red-flagged, or a category 1 priority patient, in the case of a medical emergency. Unfortunately, Emma and Charlotte were recently involved in a car crash. Charlotte urgently needed an ambulance, but after two hours of waiting, her father decided to take her to hospital in the back of his car. She starts her journey to senior school this autumn. Her family have had to devise their own response network to keep her safe and secure, and to allow her to attend school in confidence. Our ambulance service failed Charlotte and her family when they were in crisis, and we cannot let that continue.
The problems do not stop there. Across the country, almost 6.5 million people are stuck on hospital waiting lists. That is one in every nine people in England. Two million of them have been waiting for more than six months. Over the past year, more than 100,000 people have waited more than two months to start cancer treatment after an urgent referral. In my constituency of North Shropshire, almost 20% of urgent referrals took more than 43 days and 10% took more than 62 days. The target is 28 days. It is truly heartbreaking. We know that every day counts when patients are battling cancer.
Young people needing help with their mental health are waiting months and even years to access child and adolescent mental health services. There is no help for them until they are in crisis. As if all that was not bad enough, we have hospitals that are literally crumbling. There is a maintenance backlog of £11.6 billion. Buildings are decades past their use-by date. It is shocking but, as my Liberal Democrat colleagues and I know, far from exceptional. Most of these problems go back decades. The truth is that Governments of all parties have failed to put enough capital investment into the NHS. They have failed to face up to the challenge of an ageing population and, crucially, they have failed to tackle the care crisis, with one honourable exception: the Care Act 2014 was passed by Liberal Democrat Ministers a decade ago, with cross-party support. Sadly, it was ripped up by the Conservative Government after 2015.
The failure and neglect of the Conservative Government left the NHS teetering on the brink. There were so many grand promises—6,000 more GPs, 40 new hospitals and cross-party talks on social care—but they were all fantasies. In Shropshire—which is not an outlier—the Royal College of General Practitioners found that the average GP is seeing 475 more patients than they were in 2016. Patients and their loved ones have been let down so badly.
When the scale of challenges across health and social care is so enormous, it would be easy to succumb to pessimism and defeatism—doom and gloom—but we cannot afford to do that. The patients of today and tomorrow cannot afford for us to do that. This moment demands the same urgency, ambition and vision that drove the creation of the NHS all those years ago. We very much hope that the Government will show that ambition. I welcome the Secretary of State’s recognition of the fundamental importance of shifting more focus to primary care—to GPs, dentists, mental health practitioners and community pharmacists—for our young people.
Dr Danny Chambers (Winchester) (LD)
As the newly appointed Liberal Democrat spokesperson on mental health, I was really concerned to see in the report that mental health is about 20% of the NHS’s burden yet receives only 10% of its funding. Certainly in Winchester—it will be the same for nearly all hon. Members in the Chamber—mental health, and especially the mental health of children, is one of the most commonly brought up subjects.
I know that the Secretary of State agrees that mental health and physical health need to be treated with the same level of importance, but I urge us to recognise that we cannot treat it with the same level of importance if the level of funding does not accord with the demand it is putting on the service. It is not just about funding; it is about making sure that the mental health support that is needed is there in schools, in social care and for people struggling with debt. So many non-medical factors contribute to mental health that we need a cross-departmental look at how we support people’s mental health.
Helen Morgan
My hon. Friend is exactly right, and we put mental health and access to primary care and health prevention front and centre of our manifesto for that very reason. I encourage the Secretary of State to take our plans where they are complementary to his and run with them. We are happy to have our ideas plagiarised—we will welcome it.
Welcome as that focus is, some of what we have heard gives me cause for concern. First, some weeks ago the Prime Minister suggested that investment can come only after reform. I warn the Secretary of State that I do not think that that will work. The reforms that our NHS needs cannot be done on the cheap. Improving access to primary care means investing in more GPs, more NHS dentists and more community pharmacists. Boosting productivity means investing in better IT systems and bringing hospitals up to date with the new facilities they need. I agree that it cannot be just more investment without reforms, but nor can it be just reform without more investment. We need that investment now. The reports that we have heard of potential cuts to spending in the Budget are deeply concerning. I urge the Secretary of State to guarantee today that they will not happen.
Finally, I am afraid that there still seems to be nowhere near enough focus or urgency when it comes to care. We simply cannot fix the crisis in the NHS without fixing the crisis in care. Right now, more than 12,000 people in hospital are ready and well enough to go home but stuck there because the care they need is not available. That is awful for them and their families, and it is awful for the NHS that 12,000 beds that should be getting used by patients who need them and allowing better patient flow through hospitals are being held up because the care system is in crisis. I urge the Secretary of State again not to put this off any longer but to set up a cross-party commission now so that we can agree a long-term solution to ensure that people get the care they need, when and where they need it, and that carers are properly supported, too.
Mr Richard Holden (Basildon and Billericay) (Con)
I support what the hon. Lady is saying about a having cross-party group look at social care, which is a sensible long-term thing that we need to do, and discharges from hospital are an important part of that. Does she agree that discharges from mental health units are also an important part of that? On a recent visit to Basildon hospital, I saw that discharges were not happening in mental health units. That is perhaps as much of an issue in mental health social care as it is in older people’s social care, which the House is more attuned to.
Helen Morgan
I thank the right hon. Gentleman for his intervention. There is a general problem with care in the community of all types not being there for people. We have people in places where they will not get better as quickly—in some cases, their situation may be deteriorating—because that care is not available. Mental health provision in my constituency is absolutely appalling. People register with a doctor over the border just to access better mental health care. I could not agree with him more.
In conclusion, the Darzi report is shocking, but it is not surprising based on the experience of my constituents. Poor access to primary care—whether that is GPs, dentists or early mental health intervention—is leaving people in pain and distress. Long waiting lists and crumbling hospitals are leaving people unable to get back to work, with their situation deteriorating, and the crisis in social care—the elephant in the room—is depriving people of their independence and leaving them in hospital when they could be at home. The new Government must make fixing the NHS and care their No. 1 priority. Liberal Democrats will be here to provide constructive opposition to ensure that they do.
Madam Deputy Speaker (Ms Nusrat Ghani)
I call Ben Goldsborough to make his maiden speech.
Preventable Baby Loss
Helen Morgan Excerpts(3 months, 2 weeks ago)
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This information is provided by Parallel Parliament and does not comprise part of the offical record
Helen Morgan (North Shropshire) (LD)
The hon. Gentleman is making a powerful speech. It is good to hear the story of Agnes, and I hope that he will agree with me that sympathising with our constituents who have suffered such awful circumstances and telling their stories in Parliament is a good way to ensure that they are heard in the future.
Jim Shannon
I thank the hon. Lady for that. The story of Agnes’s son is this: her stillborn son was born sleeping in the early ’70s and was buried. Agnes came to see me over 50 years later.
Helen Morgan (North Shropshire) (LD)
It is a pleasure to serve with you in the Chair, Mr Dowd. I start by thanking the hon. Member for Ashfield (Lee Anderson) for securing this important debate. Sadly, we have revisited this issue a number of times, even in the short period since I was elected in 2021.
Members’ speeches today have been excellent, and I will touch on them briefly. I thank the hon. Member for Ashfield for telling the stories of his constituents who have come along today, and I thank them for sharing their stories, which were very moving. It is tragic that they have been through such experiences.
The hon. Member for Clacton (Nigel Farage) addressed the fact that the subject is taboo and that we need to get over that if we are to support families properly. The hon. Member for Morecambe and Lunesdale (Lizzi Collinge), who I welcome to this place, stressed the importance of providing support for bereaved families and of the groups in her constituency that do that. The hon. Member for Strangford (Jim Shannon) told us the moving story of his constituent Agnes, who felt her loss for the rest of her life.
The hon. Member for Washington and Gateshead South (Mrs Hodgson) has been a pioneering campaigner on this issue. In particular, she has campaigned successfully on the issue of the birth and death certificate for a lost baby, and I am sure everybody is grateful to her for that. The importance of making memories for bereaved families is so important. The hon. Member for Rossendale and Darwen (Andy MacNae) pointed out the important statistics we need to consider and the importance of effective bereavement support. The hon. Member for Sheffield Hallam (Olivia Blake), who has also been an effective and tireless campaigner on the issue of miscarriage, made an excellent speech.
I became co-chair of the APPG on baby loss shortly after I was elected, because of the scandal at Shrewsbury and Telford hospital NHS trust and the Ockenden report, which was issued shortly afterwards. There have been similar incidents at Morecambe Bay and East Kent, and we suspect there is a similar issue emerging at Nottingham, with the review by Donna Ockenden currently under way. The fact that scandals have emerged across the country means that there are endemic failings that we need to address, rather than blaming individual trusts.
The reports on Morecambe Bay and East Kent were by Dr Bill Kirkup, while the Ockenden report was for Shrewsbury and Telford. They raised very similar issues, albeit in quite a different style. The first issue was the importance of safe staffing in ensuring that babies do not die unnecessarily on maternity wards. Sands and Tommy’s have also led a campaign on that, which the APPG supported. The former Government responded quite well in trying to improve midwife numbers and ensure that maternity units are safe places to be. Shrewsbury and Telford hospital NHS trust has achieved its targets on safe staffing. We need to keep the focus on that area, because safe staffing obviously needs to be maintained; it is not a one-off thing that we can do and then hope for the best for the future.
Other issues that came up include learning from mistakes, listening to mothers and their families, and doing a proper review when something goes wrong, as it inevitably occasionally will, to make sure that lessons are learned. It feels like that has not happened across the NHS as a whole. In every review, we have heard about a lack of openness and transparency with the families and about blame being passed on to mothers who have lost their babies. We have heard about a toxic environment in some hospital trusts and about a willingness to cover up what has gone wrong rather than be candid and learn from mistakes. Those issues have been highlighted time and again, and it is important that the three reports—we are expecting a fourth—do not just gather dust on a shelf somewhere. Action must be taken to ensure that those mistakes do not keep happening.
The hon. Member for Morecambe and Lunesdale raised the fact that there is an obsession with natural birth, and I feel that very strongly. After having an emergency C-section, I was asked by a midwife whether I felt like a failure for having been through that emergency medical procedure. The answer was, “No, not until you suggested that maybe I ought to,” but hon. Members can probably imagine the shame, guilt and depression that followed. We must get away from this obsession with natural childbirth. It is the best option for mothers with low-risk pregnancies, but it is not great for anybody who has a medical issue. We must not let ideology lead the evidence and science.
I am conscious of time, so I will not take too long. Shrewsbury and Telford hospital NHS trust has made great inroads in implementing the immediate and central actions that Donna Ockenden recommended, but I would welcome an update from the Minister on progress on the national actions. If the disparity for ethnic minority women—whether they are black, Asian or from another ethnic minority—was happening in an individual trust, we would be up in arms and would get in a professional to investigate what was going wrong. We must not lose sight of that disparity and inequality. We must deal with the terrible outcomes for some of these women, as well as with the wider situation in the NHS.
Independent whistleblowing is particularly important. In Shrewsbury and Telford hospital NHS trust, the freedom to speak up guardians report into hospital management, and people frequently report that they do not feel safe whistleblowing. I urge the Government to look at safe whistleblowing and to create an independent office of the whistleblower to ensure that when people raise medical concerns about safety, they are listened to, are not closed down and do not fear losing their jobs.
These scandals do not apply to a single hospital trust; there is huge variety in the quality of care across the country. I urge the Government to look at maternity care across the country and to ensure that getting safe care is not a postcode lottery but is consistent and fair for all women.