Dementia Care in Hospital

Debate between Helen Whately and Jim Shannon

Wednesday 6th March 2024 Commons Chamber

[The Minister for Social Care (Helen Whately)]

I sincerely thank my right hon. Friend the Member for Chipping Barnet (Theresa Villiers) for securing this Adjournment debate, and for her powerful speech. She really brought the subject to life through the examples from her constituency of people’s experiences in hospital. They were very difficult stories to hear, and I am very sorry to hear of times when it sounds like the care for people’s loved ones has fallen short.

My right hon. Friend made some powerful points that I want to address, starting with the fact that, as she said, there are many thousands of people living with dementia, and the number is only expected to increase; indeed, there will be more than a million by 2025. Many people with dementia will also be living with other health conditions. At the moment, it is estimated that around a quarter of the beds in hospitals are being used by patients with dementia, so ensuring that people receive the right care when they are in hospital with dementia is really important, as is doing our utmost to avoid unnecessary admissions and ensuring that people are discharged from hospital on a timely basis.

It is really worth emphasising the point that my right hon. Friend made about dignity, and the fact that every single person counts, at whatever stage of their life. There are challenges to ensure that people living with dementia have that dignity, particularly when they are in hospital. I, too, pay tribute to the many unpaid carers who are looking after their loved ones with dementia. I know what a huge burden and challenge that can be. However much someone loves somebody, there is a huge demand on them when they are caring for somebody with dementia. It can be very difficult, very distressing and absolutely relentless, however much they love them. I pay tribute to all carers who are doing that.

My right hon. Friend spoke first about Lisa Rutter, who very sadly lost her mother, who was living with dementia, during the pandemic—in hospital, if I heard my right hon. Friend correctly. I thank Lisa Rutter for the work that she is doing as the founder of Dementia Club UK. It is fabulous to be supporting other people to look after loved ones with dementia, or indeed those with dementia themselves. My right hon. Friend talked about the time Lisa’s mother spent in hospital, and how, for instance, Lisa knew what her mother needed but felt that she was not listened to, and that it may have contributed to her mother’s death. My right hon. Friend also talked about the visiting restrictions during the pandemic. I will talk about those in a moment.

My right hon. Friend talked about another constituent, whose wife was in hospital. She rightly talked about the importance of mobilising somebody with dementia, and how her constituent’s wife was nearly given the wrong medication, which could have been fatal. She spoke about the importance of his intervention. She also spoke about a constituent who was a carer for their father, and the importance of mobilisation, and some of the communication challenges for somebody with dementia.

My right hon. Friend talked about one person who had been screaming all night, as described by the staff. Actually, the family member who knew them understood that they were calling for help, as they needed to go to the toilet. That brings to life how difficult it can be when somebody has dementia and is not necessarily able to articulate their needs and what they want. Those who know them well will often know what they are trying to say or communicate, but that can be difficult in hospital when they may be being looked after by staff who simply do not know them well enough to know what they mean.

My right hon. Friend talked about food being left uneaten. If somebody is not eating in hospital, clearly they are likely to lose weight and their condition may deteriorate. She also talked about medication being stopped, and she talked particularly about somebody whose partner had early onset dementia, and had been coping fairly well at home. He walked into A&E, and that was very sadly the last time he walked. That emphasises the challenge of keeping people moving and maintaining their ability to be mobile during a hospital stay. She also described the fight to visit outside visiting hours.

I very much hear my right hon. Friend’s asks on visitor access, volunteers being trained in dementia care, as well as staff training, and avoiding discharge delays, among other things. I will pick up on some of those.

First, on the challenge of caring for people with dementia when in hospital, many hospitals have worked hard to do better for patients with dementia, for example creating dementia-friendly environments by changing the colour and lay-out, ensuring that staff are trained in dementia, and having dementia leads and dementia-lead nurses, as well as having training for volunteers. Standard training in caring for people with dementia is available through NHS England for staff and volunteers.

Clearly, my right hon. Friend the Member for Chipping Barnet described examples where care fell short. I have no doubt that across the NHS, with the work already taking place, we can go further. I will raise the points that she made about secondary care with my colleague, the Minister for Health and Secondary Care, so that we can work together on ensuring that care is right in hospitals. He also has oversight of workforce, and we should focus on whether the training that I know is available is being taken up by enough staff, considering the number of people in hospital with dementia.

On visiting, my right hon. Friend spoke about a subject that is close to my heart. Having been involved in some of the decisions about social care visiting restrictions during the pandemic and knowing how hard those decisions were—weighing up the infection control concerns and ensuring people could spend time with loved ones—we have been putting in place changes to Care Quality Commission regulation to make visiting a fundamental right, a fundamental part of care and a fundamental standard of care to ensure better access for loved ones to their family members in care homes and in hospitals. I know in particular how important that is for people with dementia, among others. The CQC is consulting on the implementation of the regulatory change, which will be live shortly. I believe we have taken a significant step to address concerns expressed about visiting.

Another thing my right hon. Friend spoke about was faster discharge. I am very alert to the risk of patients deconditioning in hospital, particularly patients with dementia. That is why over the past year or so, we have worked hard with the NHS to get better at identifying patients at greater risk of deconditioning, in particular those with dementia, on their admission to hospital. We have done earlier discharge planning and have been getting care transfer hubs established all across the country, which will do the work on more complex discharges. Often someone with dementia may need more access to social care. We may need to increase the access to, availability and supply of social care, so that it is there for those who will need it when they leave hospital. We have made some real progress on that over the past year.

[Jim Shannon]

Will the Minister give way?

[Helen Whately]

I have very little time, so I am afraid I will not give way.

My right hon. Friend the Member for Chipping Barnet talked about the social care workforce, another subject close to my heart. We have a strategy for the care workforce. We are building care as a career, in particular to boost recruitment and retention among our home-grown workforce. We recently published the first ever national career structure for care workers, and we are launching a new national qualification to boost the supply of care workers.

Avoiding admission is another priority for me. Clearly, some people should be—absolutely must be—in hospital for the treatment they need, but we know that patients with dementia in particular can deteriorate in hospitals, so we are doing more work with the national health service and social care to avoid admission when it is not truly necessary by putting in place alternatives or, at the other end, supporting earlier discharge through the roll-out of the Hospital at Home initiative, or virtual wards, under which we committed to at least 10,000 hospital-at-home beds or equivalent as part of emergency care recovery plans. The NHS has over-delivered on that, so we now have more than 11,000 Hospital at Home beds, which help people who would otherwise be in hospital receiving acute care. They receive that care and are able to recuperate at home, avoiding the risk of a longer hospital stay and deconditioning.

My right hon. Friend talked about dementia research and the new treatments coming onstream. The Government have committed to doubling our investment in dementia research during this Parliament, and we are on track to do that with our dementia mission. We are also working very closely with NHS England to be ready for the breakthrough treatments lecanemab and donanemab coming onstream. I should be clear that we know very well—I have received clinical advice on this—that those treatments have quite significant side effects, so they will not be suitable for everybody and I put a note of caution there. We are waiting to hear whether they are approved by the Medicines and Healthcare products Regulatory Agency and the National Institute for Health and Care Excellence. In the event of approval, NHS England is taking steps to be ready to put in place the levels of diagnosis required to be able to support those treatments.

That goes hand in hand with the work that we are doing with NHS England to improve the diagnosis rate for dementia. We have a target dementia diagnosis rate of 66.7%. That dropped during the pandemic because dementia services and assessment had to be closed, but it has been gradually building up, and I expect NHS England to get back up to that level during the course of this year. That is really important, because having a diagnosis helps people—the individual with dementia and their carers, for example—to access the support and back-up that they should be receiving.

I am conscious of the clock ticking, so I have tried cover some of the territory that my right hon. Friend set out in her speech, which I thought was very powerful in raising these significant issues for those with dementia receiving care in hospital, their carers and loved ones. I completely agree about the importance of dignified treatment and treating those with dementia with dignity at all times. I know that that can be particularly challenging in hospital, but we have to ensure that that is the case.

We will ensure that we get all the necessary care in place outside hospital, which avoids unnecessary admissions; support people to be discharged from hospital quicker; get ready for the arrival of new dementia treatments; and raise awareness about the significant proportion of dementia cases that can be prevented or at least delayed by looking after our health. In fact, the risk factors for dementia are similar to those for heart disease and other things, and there is relatively low awareness of that. We will see more people with dementia in the years ahead, but we can do more to raise awareness of how people can maintain their health and stave it off.

Oral Answers to Questions

Debate between Helen Whately and Jim Shannon

Tuesday 5th March 2024 Commons Chamber

[Helen Whately]

Across the country, ambulance response times have come down by a third. We have worked very hard, particularly with areas that face greater challenges, including Shropshire. I have spoken to leaders in the local health system about the ongoing challenges. We are learning lessons about what has worked over the past year, and from where we have not made so much progress, to ensure that we do better in areas such as the hon. Lady’s over the year ahead.

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for her positive answers; they are really appreciated. Bearing in mind the pressure that GPs are under, which is leading to more pressure on emergency provision, what steps are being taken to provide greater incentives for medical students to take on positions in GP surgeries? That would make a big difference.

[Helen Whately]

The hon. Gentleman is absolutely right to talk about the whole health system. One thing we are doing as part of our work on urgent and emergency care is preventing people from being admitted to hospital unnecessarily, or from being brought to A&E in the first place. Primary care is part of that. In our investment in expanding medical school places, we are particularly encouraging medical schools, such as the new Kent and Canterbury Medical School near me, to train students to work more outside hospitals, including in primary care.

Patients with Rare Diseases

Debate between Helen Whately and Jim Shannon

Thursday 9th March 2023 Westminster Hall

[The Minister for Social Care (Helen Whately)]

I thank the hon. Member for Strangford (Jim Shannon) for securing today’s important debate on rare diseases; it is always a great pleasure to debate these issues with him. He is so good at raising health issues that otherwise might not be talked about in this place. As he often does, he covered a huge range of things in his speech and very effectively brought the situation to life with personal stories of people he knows and patients. When he says to me that there is no pressure, I am not sure that he entirely means what he says, but he does it in an extremely friendly way.

As the Minister with oversight of rare diseases, among other things, in the Department for Health and Social Care, I welcome the pressure and the interest that the hon. Gentleman and other Members of Parliament have shown in this issue. He made the point, as did others, that rare diseases are rare but collectively common, especially among children, which, very sadly, leads to short lives for some. During the course of my speech I will mention many of the things that he raised this afternoon.

It was good to hear too from the hon. Member for Blaydon (Liz Twist), who is very effective in her role as chair of the APPG on rare, genetic and undiagnosed conditions. She spoke about some of the problems for people with rare diseases, including potentially waiting a long time for a diagnosis, the difficulty in accessing treatments, mental health challenges, and difficulties with co-ordination of care. She also mentioned the importance of the screening of research, and she spoke about access to the innovative medicines fund. Again, I shall pick up on several of those points this afternoon.

Just last week, on 28 February, we marked Rare Disease Day. On that day, we heard first-hand stories of the huge impact of rare diseases on people’s lives, and many of those stories have been echoed today. Some of the challenges facing people with rare diseases are unique and personal, but many others are shared by the 3.5 million people across the UK who make up this diverse and resilient community. The Government are committed to overcoming the challenges in order to secure a better future for all of those living with rare diseases.

The 2021 UK rare diseases framework embodies our commitment to this issue. The framework sets out our vision of how to improve the lives of people with rare diseases through four vital priorities: helping patients get a final diagnosis more quickly, increasing awareness among healthcare professionals, better co-ordination of care, and improving access to specialist care, treatments and drugs—many of the things that have been mentioned during the course of the debate.

The framework was established thanks to the National Conversation on Rare Diseases survey, which received thousands of responses from the rare diseases community about the issues that matter most—the same issues that we have heard about today. These continue to drive forward our focus on UK-wide improvements, putting patients’ voices at the heart of decision making and the policy development underpinning all our work.

To deliver on our ambition, all four nations have now published rare diseases action plans, which set out how they will deliver the aims of the framework in ways that work for the specific populations and healthcare systems of each nation. I was pleased to be able to publish England’s second rare diseases action plan last week, on Rare Disease Day. This publication allowed us to reflect on some of the progress made during the last year.

The hon. Member for Strangford raised the case of his colleague who developed Miller Fisher syndrome and the experience she faced in receiving a diagnosis. It sounded unbelievably frightening for her—going into hospital with those symptoms and the several days she spent waiting for a diagnosis, hearing people around her talking about all the possible things she might have. I was very glad that she was diagnosed, and I hope she has made a good recovery. That case demonstrates the known problem that rare diseases can be hard to diagnose.

In our latest action plan, we report on some of the progress made on diagnosing rare diseases. Genomics England has developed a clinical research interface, which has helped identify over 1,000 new complex diagnoses for people with rare diseases. One illustration of the real-world impact of those developments is the 19 new diagnoses of Rett syndrome in 2022. Rett syndrome is a debilitating rare condition found in children that can be complex to diagnose. Those new diagnoses have helped to explain symptoms and enabled children and their families to access care.

The hon. Member for Strangford also highlighted the need for awareness of rare diseases among healthcare professionals to avoid delayed diagnosis and treatment. Over the last year, we have also made progress in increasing awareness of rare diseases. For example, Health Education England has developed GeNotes, a set of innovative educational resources on genomics and rare diseases, which will help put information at the fingertips of healthcare professionals. We continue to take steps towards improving co-ordination of care—addressing the point that the hon. Member for Blaydon made—through the roll-out of a toolkit for virtual healthcare consultations. This helps people with complex, multi-system rare diseases access multiple specialists on one call without needing to travel.

On treatment, significant progress has been made in improving access to specialist care, treatment and drugs. The hon. Member for Strangford rightly highlighted the emerging potential of cell and gene therapies for treating some rare diseases. The innovative medicines fund was launched by NHS England and NICE, to fast-track the most promising, cutting-edge medicines to NHS patients. Together with the early access to medicines scheme and the innovative licensing and access pathway, this will support early access to novel treatments. I assure the hon. Member for Enfield North (Feryal Clark), who asked about it, that the innovative medicine fund is open for applications for treatments for rare diseases. We also continue to monitor access to high-cost treatments for rare diseases across England, taking steps to ensure equal access to treatment across the country.

As the many stories shared today have highlighted, there is still much more to do. That is why England's second action plan sets out 13 new commitments to ensure everyone living with a rare disease gets the treatment, care and support they need. That includes a greater emphasis on co-ordinated access to specialist health and social care, including mental health and special educational support. Again, that addresses some of the points made by the hon. Member for Blaydon.

The hon. Member for Strangford raised the impressive research that has led to the development of the smart suit, helping young people with Duchenne muscular dystrophy maintain the use of their arms. It is truly an exciting and wonderful thing to talk about. The 2023 action plan also emphasises the importance of research to translate scientific breakthroughs into cutting-edge diagnostics and treatments. In August, we announced £12 million of funding to support the UK rare disease research platform, which will accelerate the understanding, diagnosis and treatment of rare diseases. A £790 million investment from the National Institute for Health and Care Research in biomedical research centres will also support rare disease research.

[Jim Shannon]

I am very conscious, Minister, that my knowledge of that smart suit simply comes from watching BBC 1 before I left the hotel one morning. It was a mum who, on behalf of her 13 or 14-year-old son, managed to get lottery funding of £1.25 million. She was the lady who developed the smart suit; she is not just a mum, but obviously much more, as she was able to do that. The Minister may not know, but could she come back to us on whether, now that it has been developed and the plans for the smart suit are there, it is possible that other people with Duchenne muscular dystrophy could also take advantage of it?

[Helen Whately]

As the hon. Member described, it is fantastic that a mum who saw the problem and the opportunity came up with a way of helping. I will have to write to him to answer his question. I assure him, and everyone present, that we will take further steps to make it easier for the rare diseases community to participate in research. That is exactly the point. It is very important that those most affected—the individuals and their families—are involved in research and innovations, such as the one the hon. Gentleman described. We will continue to improve the use of securely held national datasets in research.

Our new plan seeks to reduce the health inequalities experienced by people living with rare conditions. The hon. Member for Strangford spoke of pemphigus vulgaris and its greater prevalence among some ethnic groups. That is one aspect of health disparities, but health disparities can be faced by all people living with a rare disease when they seek to access the services they need, and we aim to address that. Through NHS England’s Core20PLUS5 framework, we will help integrated care systems to address the health inequalities faced by people living with rare conditions.

Similar efforts are under way in all four nations of the UK. Although each nation is taking a distinct approach through its action plan to best meet the needs of its healthcare system and population, we continue to work closely across the four nations to ensure that we learn from each other.

I assure the hon. Member for Strangford that I share his views about the importance of co-operation across the UK on rare diseases. The rare diseases advisory group at NHS England has membership from all devolved nations to ensure that it identifies and seizes opportunities for collaboration. Patients can move between parts of the UK to access specialist services.

The hon. Member for Blaydon mentioned the newborn heel prick, or newborn blood spot screening programme, and asked whether we could screen for more conditions, specifically spinal muscular atrophy, or SMA. We test for more than 30 rare conditions during pregnancy and the newborn period, and nine conditions via newborn blood spot screening. There is a good reason why we screen for fewer conditions in the UK than in other countries: it is because we believe that we have a more rigorous approach to evaluating the benefits, and also potential harms, of screening than other countries.

The 2022 rare diseases action plan committed us to establishing a blood spot task group to further develop the evidence base for newborn blood spot screening. The UK National Screening Committee has since established the blood spot task group, which is working to improve the evidence available to the screening committee when considering the screening programmes to be added to the blood spot.

Oral Answers to Questions

Debate between Helen Whately and Jim Shannon

Tuesday 7th March 2023 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

T3. Recent analysis from Macmillan Cancer Support shows that 2022 was the worst year on record for cancer waiting times. Will the Minister consider the introduction of an urgent support package for UK cancer services in the upcoming Budget to support our hard-working staff and to ensure that there is additional capacity to deal with the current pressures on the system?

[Helen Whately]

It is indeed a worrying experience for people to be waiting to know whether they have cancer or, having received a diagnosis, to be waiting for treatment. However, I can assure the hon. Gentleman that more people are currently coming forward for cancer checks, more people are being treated for cancer, and the NHS is reducing some of the backlogs following the pandemic.

Covid Pandemic: Testing of Care Home Residents

Debate between Helen Whately and Jim Shannon

Wednesday 1st March 2023 Commons Chamber

[Helen Whately]

As the hon. Lady says, care workers were among those on the frontline during the pandemic and they had some incredibly difficult experiences. They took the risk of catching covid and, very sadly, some care workers and NHS workers were among those who lost their lives. Others have long covid. The question of compensation is currently with the Department for Work and Pensions. The Minister for Disabled People, Health and Work, my hon. Friend the Member for Corby (Tom Pursglove), is in his place on the Front Bench: his Department is looking at this and will respond in due course.

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for her answers. Everyone’s thoughts and prayers are with those who lost loved ones. The impact of the covid lockdown on mental health was felt most keenly in care homes. To see what the elderly people were put through, and learn that the full protections were not in place and they could not see loved ones at the end of life, is totally unacceptable. What would the Minister offer to those who lost precious hours with those they loved and adored on hearing this tragic news today?

[Helen Whately]

I reiterate to those living in care homes and their loved ones and families that the Government took every step throughout the pandemic to protect those we knew were vulnerable. For instance, we prioritised testing with more than 180 million tests going to care homes during the pandemic, and we prioritised vaccinations. I remember talking to residents in care homes at the time, and vaccination was a huge moment for them because it was the first time they had felt really protected from that cruel virus. I know how hard it was for families that they could not see loved ones in care homes, and that was one reason we put out guidance about visiting, saying that if someone was close to end of life they should be able to receive visitors. I will continue to do my utmost as Minister for Social Care to make sure that we do our very best for those living in care homes.

Cystic Fibrosis: Living Costs

Debate between Helen Whately and Jim Shannon

Thursday 2nd February 2023 Westminster Hall

[Helen Whately]

I absolutely hear the hon. Member’s argument, and similar points were made during the debate. As the Minister with oversight of major conditions, cystic fibrosis is not the only condition about which I have received letters, parliamentary questions and lobbying in general asking for exemptions to prescription charges. We cannot just look at cystic fibrosis in isolation; a similar argument could be made in relation to a number of other conditions. As I have set out, the way the system works is specifically designed to help people on low incomes with the cost of prescriptions and make it more affordable for people who have to get a lot of prescriptions during the course of a year.

[Jim Shannon]

I want to follow on from what the hon. Member for Bristol East (Kerry McCarthy) said. I think I referred in my contribution to the 1968 legislation. The perception at the time was that children who had CF were not going to survive, and that therefore there was no need to include CF, but today there are more adults who have CF than ever. The point that I am making is that things have changed. Will the Minister convey that information to the DWP in as strong a fashion as we have in this Chamber, and ask the DWP to look at that? I know it is not the Minister’s responsibility to look at that, but if that is agreeable to her, it would be helpful.

[Helen Whately]

As ever, the hon. Member is extremely persuasive. I will be happy to take that up with ministerial colleagues who are responsible for prescription charges, but I do say that this is the case not just for cystic fibrosis. We should be aware that we would be similarly lobbied on behalf of other conditions, so we need to be aware of the breadth of the issue raised. However, I shall be happy to take up the matter with ministerial colleagues.

I want to pick up on the cost of attending medical appointments, which was also raised. To help people to get to appointments, the NHS healthcare travel costs scheme provides financial assistance to eligible patients who need assistance with their travel costs. That includes patients in receipt of a qualifying benefit and those on the NHS low-income scheme.

Another way to alleviate the cost pressures of medical appointments for people with cystic fibrosis—I stress that this is only where appropriate; I do not want to be misconstrued—is for appointments to be virtual. NHS England is supporting NHS providers to embed and spread the use video consultations innovatively, where that is the right thing for a patient, and in discussion with the patient in respect of their individual needs. For some patients, that is helpful in reducing the number of journeys they make to appointments—but I am clear, and I know very well, that some appointments should and have to be in person, particularly whenever anybody wants that.

[Jim Shannon]

I tried to illustrate this point earlier, but although I understand that, with the restructuring of hospitals, not every hospital can specifically respond to everything—hence the centralisation of medication and healthcare—when it comes to cystic fibrosis and getting an appointment with a consultant, physio or whoever it might be, one factor is the distance that a great many patients have to travel, especially those in rural areas. The Minister has said that those on benefits can qualify for travel costs, but for some people it is not the cost alone; it is the travel itself. I am sorry for going on a wee bit, Ms Harris, but as I said earlier, for most people with CF that means two to five hours every day of their lives, so the impact on them is greater. The Minister has talked about the physical and mental health aspects, but there are wider aspects, which include the long distances that people have to travel just to get the treatment they are after.

[Helen Whately]

The hon. Gentleman makes an important point about having to travel further for appointments and treatment, which affects people in rural areas generally. Those costs will clearly affect those who have to travel regularly and frequently, such as patients with cystic fibrosis who need many appointments. I am very happy to take away the point he raises and to look at whether we should do something different or specific for those living further away from wherever they need to go for treatment.

I want to pick up on the point about hospital parking, which is clearly another cost that might be affecting people. The Government committed to introducing free hospital car parking for those in great need, including frequent out-patient attenders, as part of our election manifesto. NHS trusts and NHS foundation trusts are required to comply where applicable with NHS car parking guidance, which outlines that disabled patients and visitors should receive free parking for the duration of their attendance at, or visit to, hospital. It also makes it clear that parking will be provided free to all out-patients who attend hospital for an appointment at least three times in a month and for an overall period of at least three months. Importantly for parents of children with cystic fibrosis, parents of children who are admitted as an in-patient overnight should receive free parking between the hours of 7.30 pm and 8 am while visiting their child. I was glad to hear from my hon. Friend the Member for Ashfield that, as I have heard in other places, there is indeed free parking for the patients with cystic fibrosis he mentioned and their families.

I want to mention the innovative work—which also touches on the virtual appointments that I mentioned a moment ago—that Royal Brompton and Harefield NHS Foundation Trust is doing in partnership with NuvoAir, whereby patients use spirometer devices at home to measure lung function and access the results on their phones or tablets via Bluetooth. The results can be shared with a specialist cystic fibrosis clinical team at the Royal Brompton Hospital during virtual consultations, saving the patients time and money while ensuring effective monitoring by the clinical team. There is a balance here, because although the many appointments mean extra journeys, we are doing things to improve the lives of people with cystic fibrosis and to help with the practicalities of the necessary extra treatment and care.

This debate has powerfully brought to life the extra challenges facing people living with cystic fibrosis and their families. It has been helpful to air the issues relating to extra costs and anxiety and the practical difficulties of living with the condition. I pay tribute to all those involved in supporting people with cystic fibrosis and all those living with it. The drive and determination to improve things is inspirational, and I hope that I have reassured everybody about the Government’s commitment to supporting patients with cystic fibrosis and their families.

Oral Answers to Questions

Debate between Helen Whately and Jim Shannon

Tuesday 24th January 2023 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

T8.   On World Cancer Day 2022, the then Secretary of State for Health and Social Care, the right hon. Member for Bromsgrove (Sajid Javid), announced a 10-year cancer plan to make us a world leader. Today, cancer services are buckling under immense pressure. Can the Minister confirm that the strategy will be fully resourced and will she commit to working with cancer charities to ensure that it is delivered?

[The Minister of State, Department of Health and Social Care (Helen Whately)]

Right now, we are seeing more people come forward for cancer diagnosis or to be given the all-clear. We are supporting services with an extra £8 billion for elective recovery. Cancer is an important part of our major conditions strategy, which the Secretary of State just announced, because we are determined to include patients’ cancer outcomes.

Aortic Dissection: Patient Pathways and Research Funding

Debate between Helen Whately and Jim Shannon

Tuesday 13th December 2022 Westminster Hall

[Jim Shannon]

I see more of the Minister than my wife.

[Helen Whately]

The third welcome I want to give is to Bob Harris, who is here today. He himself has suffered aortic dissection, and is working as an ambassador on this issue. It is very good to have him here with us.

We have heard during this debate about the sudden and heartbreaking impact that aortic dissection can have on families. That is why it is absolutely right that we should be talking about this issue today: we should be talking about how to raise awareness of the condition among medical professionals, about how to improve diagnosis so that aortic dissection is detected as quickly as possible, and about the research we need to make sure that more people survive. Sadly, around 4,000 people suffer from an aortic dissection in the UK each year, yet still many people have never heard of the condition. It is crucial that it is diagnosed and treated urgently, otherwise very sadly, it can be fatal. It need not be.

As we have heard today, diagnosing aortic dissection promptly is, unfortunately, not straightforward. The condition is relatively rare, which means medical professionals may be less familiar with its presentation. The symptoms of aortic dissection, such as chest pain, can be similar to other more common conditions, making it harder to accurately diagnose. Care pathways for aortic dissection vary across the country, meaning different patients often get different treatments.

I can reassure my hon. Friend the Member for Mid Derbyshire and other hon. Members here today that I am determined to improve the way the condition is diagnosed and treated. Earlier this year, NHS England launched its aortic dissection toolkit, which sets out the steps that commissioners, providers and clinicians should take to improve the care of patients with acute aortic dissection. The toolkit covers the pathway for aortic dissection, from recognition and diagnosis to treatment.

NHS England’s regional teams are currently implementing the toolkit within their local services, and we expect those improvements to significantly reduce delays to diagnosis and improve patient outcomes following treatment. NHS Digital has also made changes to NHS Pathways, which is a triage system used by NHS 111 and 999, to improve the recognition of chest pain likely to be associated with aortic dissection. However, I heard my hon. Friend say that the toolkit does not cover all the challenges that she is aware of in the pathway, so I will take that away and see how we can go further to make sure the toolkit is comprehensive or supplement it as necessary.

We have also heard today about the importance of raising awareness of aortic dissection among medical professionals. The Royal Colleges of Radiologists and Emergency Medicine published a best-practice guideline last year on the diagnosis of aortic dissection in the emergency department, in response to a report published by the Healthcare Safety Investigation Branch in 2021. I expect that to have a major impact on the prompt diagnosis of aortic dissection. The Royal College of Emergency Medicine, which sets standards of care in all emergency departments in the UK, has also developed guidance to support the timely diagnosis of aortic dissection. However, my hon. Friend told us that a freedom of information request showed that only some EDs are using the guidelines. Again, I will look into that, as guidance should be followed consistently across emergency departments.

Research is the piece of the puzzle that will drive forward progress and find the treatments of tomorrow. We need to understand better who is at risk of aortic dissection and how we should monitor them, we need to know how to most effectively detect and diagnose aortic dissection in emergency settings and how to improve treatment to make sure patients recover successfully. That is why the Department of Health and Social Care brought together a multidisciplinary group of experts and patient representatives in 2020 to consider research priorities for aortic dissection. That significant event identified research questions in diagnosis, treatment, care, awareness and education and, crucially, what matters most to people with aortic dissection and their families. In response to that event, the Department of Health and Social Care-funded National Institute for Health and Care Research launched a call for research on surgical treatment for aortic dissection. We await the outcome of the commissioning pool early in the new year.

The NIHR invests around £50 million a year on research into cardiovascular disease, including aortic dissection and other heart conditions. For example, the NIHR funded a major programme of work at Barts Health NHS Trust to develop and test a novel surgical treatment for aortic dissection, which is less invasive than routine care, allowing quicker procedure times and shorter hospital stays. It is also vital that we harness our understanding of risk to help prevent aortic dissection. UK Research and Innovation, which is funded by the Department for Business, Energy and Industrial Strategy, is supporting a study on how we can use genetic and other factors to predict aortic dissection and identify people at greater risk. That will pave the way for more preventive measures, such as blood pressure control, to be prescribed.

We know that there is interest in the academic community for a pipeline of research to improve outcomes for people at risk of and who have survived aortic dissection. I encourage researchers working in the field to harness the momentum building around aortic dissection research and to please come forward and make applications for funding.

My hon. Friend the Member for Mid Derbyshire also asked about data and called for more data on aortic dissection to be collected and made public. I will take that request away and raise it with NHS England, because she makes a really important point: the more data we collect, the more we know. Again, making it available more widely is one of the best things that we can do to improve understanding and support research into prevention, diagnosis and treatment. My hon. Friend also requested that we meet to discuss guidelines for genetic screening, which is another thing that I will take away and look into. I will get back to her on that.

This debate has made us all stop and reflect, and I will pause for a moment as well, because I think the hon. Member for Strangford is waiting to intervene on me.

[Jim Shannon]

I thank the Minister for her very helpful response. I always ask these questions, because it is important that we share the issues. In my contribution, I asked whether we could share information with Northern Ireland, Scotland and Wales, because we can all learn from it. We need to collaborate on research, because we can all benefit from it, wherever it may be—in Northern Ireland in my case, and in Scotland in the case of the hon. Member for Coatbridge, Chryston and Bellshill (Steven Bonnar). That might be helpful for us all.

[Helen Whately]

I completely agree with the hon. Member, and we can only do better if we share information across the whole United Kingdom and internationally, as work on this condition will be going on across the world.

This has been a really powerful debate, but it is not a patch on the pain that my hon. Friend the Member for Mid Derbyshire has been through. As she said so powerfully, each life lost to aortic dissection is not just one life affected. The condition affects the lives of all those around the person who is lost, be they mothers like her, fathers, husbands, wives, sons, daughters, grandchildren or friends—everyone who is affected when somebody is sadly lost too soon. I thank her again for her tireless work in raising awareness and campaigning, and I assure her that I will, in turn, do what I can in Government to support her efforts and to improve outcomes for all those affected by aortic dissection across the country.

Moles and Skin Tags: Testing for Cancer

Debate between Helen Whately and Jim Shannon

Monday 12th December 2022 Commons Chamber

[The Minister of State, Department of Health and Social Care (Helen Whately)]

I commend my hon. Friend the Member for Isle of Wight (Bob Seely) for securing this debate, and on telling us Zoe’s story so powerfully. It is a truly heartbreaking story of a young mum of just 26 with so much life ahead of her. It was harder still to hear because Zoe did the right thing and asked her GP about her mole, yet her skin cancer was not diagnosed until so late that she died just 55 days later. I pay tribute to Zoe’s family, including her mum, Eileen, who have campaigned to stop other people going through what they have gone through, and to Zoe herself. When I looked earlier this evening, more than 34,000 people had signed the petition.

Like Zoe’s family, as cancer Minister I want to stop people going through what they have been through. I want us to get better at preventing, diagnosing and treating cancer. Although we cannot remove the risk of skin cancer in its entirety, we can raise awareness of the things that increase the risk and help people take steps to protect themselves. Most skin cancers are caused by exposure to the sun. Getting sunburnt increases the risk—especially getting sunburnt as a child—as does using sunbeds. Those who have fair skin are at greater risk. As my hon. Friend told us, the lovely sunshine of the island he represents has its downsides, as does the healthy outdoor life that he describes.

As well as raising awareness of risks, we need to raise awareness of early signs and symptoms, and then what to do. We in Government are doing that. For instance, the NHS “Help Us, Help You” campaign has used TV advertising, social media and regional press to get the message out to people to get worrying signs checked out. We know that some people delay getting a check. That campaign has particularly sought to overcome those fears. If you are worried, it is always better to get checked out. Most people will get the all-clear, but the sooner you get a check, the better, because an early diagnosis improves the chances of successful treatment.

I know that Zoe did the right thing and asked her GP, which brings me to the importance of accurate diagnosis. For Zoe’s specific case there has been a full investigation locally, and I know the findings have been acted on. Specifically, teledermatology is now offered by all GPs on the Isle of Wight, and is increasingly available across the NHS. It involves a specialist medical photographer taking a detailed photograph of a skin lesion to check it for signs of cancer. That is a step on the path to more tests to confirm whether someone has cancer or is given the all-clear that no further tests are needed.

On the role of teledermatology, almost £1.5 million of our elective recovery funding has been allocated to seven cancer alliances to pilot self-referral for cancer symptoms, including skin cancer symptoms. I heard my hon. Friend’s argument for Zoe’s law to require all moles or skin tags removed to be tested for melanoma. I also heard him saying that he was not expecting an answer here and now, which I appreciate. I can assure him that I will take his argument away, look into it and then write to him with a full response on his proposal. I will also take away the suggestion from him and from other hon. Members about looking at the broader education of other people who might be able to spot something that might be an early sign of skin cancer. I recognise that people may not be able to see their back or the back of their head, for instance. Indeed, there may be opportunities to look at wider education. For sure, raising awareness overall of skin cancers and of what a person should do if they have a sign or a symptom will indeed mean that more people will know what to look out for.

[Jim Shannon]

I commend the Minister for her very positive answer and for what she said in relation to the nine centres across the United Kingdom, which is where the hotspots are. In an intervention on the hon. Member for Isle of Wight (Bob Seely), I referred to a pilot scheme in my trust area, the South Eastern Health And Social Care Trust, which seems to be having some good results. I always believe that the exchange of ideas is good for us all. It helps us to see what is being done here and it might help the Minister to know what we are doing back home.

Oral Answers to Questions

Debate between Helen Whately and Jim Shannon

Tuesday 6th December 2022 Commons Chamber

[Helen Whately]

After hearing the hon. Member’s point, I should think that he therefore welcomes the fact that we have set up integrated care systems, which bring together health and social care. The £500 million discharge fund that I have mentioned is allocated to local areas to be pooled into the better care fund and spent jointly between local authorities and the NHS. Funding is an important part of this. In the autumn statement, social care received a historic funding settlement of £7.5 billion over the next two years. That is important, as well as ensuring that the NHS and local authorities work together hand in hand.

[Jim Shannon (Strangford) (DUP)]

5. When his Department will publish the 10-year cancer plan.

Pancreatic Cancer Awareness Month

Debate between Helen Whately and Jim Shannon

Tuesday 8th November 2022 Westminster Hall

[The Minister of State, Department of Health and Social Care (Helen Whately)]

I congratulate the hon. Member for Strangford (Jim Shannon) on securing this important debate, and for his work as chair of the APPG on pancreatic cancer. He is right: we should talk about pancreatic cancer; we should talk about how to improve survival rates and diagnosis rates; and we should talk about how we can raise awareness of pancreatic cancer. As we do so—including in this very debate—that in itself will make a difference, and if we do not debate this now, during Pancreatic Cancer Awareness Month, then when? I believe in seizing the moment.

I welcome the speeches from the hon. Members for Strangford, for East Dunbartonshire (Amy Callaghan) and for Upper Bann (Carla Lockhart) and my hon. Friends the Members for Stroud (Siobhan Baillie) and for Carshalton and Wallington (Elliot Colburn), who also seized this moment to speak about pancreatic cancer. The hon. Member for Strangford spoke movingly about Rebecca Buggs, whose children were just eight and nine years old at the time she had surgery. I am very glad that because she was diagnosed early, she was able to have surgery, but we know that, sadly, her experience is the exception not the rule.

The hon. Member spoke about the importance of raising awareness of symptoms such as stomach and back pain, indigestion, unexplained weight loss and jaundice, and the importance of getting those symptoms checked if there is no explanation. He also spoke about research as the key to earlier diagnosis. On one of his questions, I will answer straightaway that, yes, I would be delighted to join him for a meeting with Pancreatic Cancer UK. I will come to his other questions as I go through my speech.

My hon. Friend the Member for Stroud mentioned that she wants to help everybody and, knowing her well as a colleague, I know that that is absolutely true. She also mentioned the catchphrase, “The clue is in the loo,” as mentioned by other hon. Members. She spoke movingly about one of her constituents, a young woman who spent five years going to and from her GP with symptoms, including fatigue and bloating, which brought to life how hard this cancer is to detect. She also talked about the PERT treatment, which I will come to in a moment.

It is very good to see the hon. Member for East Dunbartonshire, a former chair of the APPG, here and to hear her speaking so eloquently in this debate. She spoke about Barbara, a PE teacher, and about the healthy life she lived. Barbara went many times to get a diagnosis, but it took almost 18 months to get one. Again, sadly, that brought to life how hard this cancer is to detect.

I thank my hon. Friend the Member for Carshalton and Wallington for acknowledging the work that the Government have done, particularly on raising awareness for pancreatic cancer. He talked about the importance of the workforce, which I will come to. He also asked me to visit the Royal Marsden, of which he is rightly proud, and which I would be delighted to do.

The hon. Member for Upper Bann spoke about the importance of access to GPs. She called for more funding into research, and said, rightly, that time matters.

I will come to many of the points that hon. Members have raised, but first, I believe in saying it as it is. Nearly 10,000 people a year are diagnosed with pancreatic cancer, and that figure has steadily increased since 2013. Diagnosis rates increase with age, and from the mid-40s onwards pancreatic cancer is more common in men than in women. Just under a quarter of pancreatic cancers are diagnosed at an early stage, so three quarters are not. About 40% of diagnoses follow an emergency presentation. The one-year survival rate is just 27% and the five-year survival rate is only 7.8%. Although those figures have improved in the past 10 years, they are still bleak for anyone who receives a diagnosis and for their loved ones. That is why it is right to talk about pancreatic cancer.

As with many other cancers, early diagnosis of pancreatic cancer is crucial so that there is the opportunity for successful treatment. One of the Government’s healthcare priorities is to improve early diagnosis of all cancers, and to achieve 75% diagnosis at stage 1 or stage 2 by 2028, compared with the current rate of about 50%. We have opened 91 community diagnostic centres, which have carried out 2 million extra scans, tests and checks, including cancer tests. We are rolling out non-specific symptom pathways so that people with symptoms such as weight loss or fatigue are either diagnosed or have cancer ruled out. We are encouraging people to go and get their symptoms checked. The NHS’s “Help Us, Help You” campaign tackles the barriers that prevent some people from getting their symptoms checked, such as fear about what might be found.

The hon. Member for Enfield North (Feryal Clark) talked about waiting times, and I assure her that we are tackling them. This August, more than 19,000 patients saw an upper gastrointestinal specialist, compared with 17,600 last August, and 17% more patients have seen a specialist within the two-week performance standard. That said, I recognise that the NHS is still not hitting the standard for enough people—it is currently 83%, compared with the 93% standard—so we will continue to support the NHS’s efforts to tackle waiting lists and backlogs.

On treatment, credit is due to hard-working NHS staff who have increased cancer treatment levels to 107%, compared with pre-pandemic levels. The cancer drugs fund has helped more than 80,000 patients, and we are investing £5.4 million in five new national clinical audits of cancer, one of which is focused on pancreatic cancer.

As several hon. Members said, the key to making a big leap forward in survival rates for diseases such as pancreatic cancer is research—research into tests that will achieve earlier diagnosis and research into treatments. The Government spend £1 billion a year on health research through the National Institute for Health and Care Research. The NIHR has funded seven research projects for pancreatic cancer since 2019, with a committed spend of about £3.6 million. That is about 5% of the NIHR’s total funding for cancer research, which is over £73.5 million.

[Jim Shannon]

I referred to the fact that Pancreatic Cancer UK has raised £10 million for research every year, and one of its requests is that the Government match that. I thank the Government very much for the £3.6 million that is going to pancreatic cancer, but is it possible for that extra bit of effort to be made and for the Government to match the charity’s £10 million? I do not want to put the Minister on the spot, but I really do think that is an important issue.

[Helen Whately]

I absolutely hear the hon. Gentleman’s request, which is for match funding for the funding contributed by Pancreatic Cancer UK. I will say two things about that. Another function of the NIHR is to support research where the funding comes from other organisations; it already does that. In fact, it has supported 70 pancreatic cancer-related studies that have been funded by others.

The other point, which the hon. Gentleman may be aware of, is that the NIHR does not actually ringfence funding for specific diseases. That is similar to his match funding point. The NIHR is ready to fund research. It looks at applications for funding from the research community and then allocates that funding by looking at the merits of the proposal. We should encourage more bids for funding for pancreatic cancer research and more bids to go into the NIHR, which would then enable it to allocate more funding. I am assured the NIHR stands ready to fund pancreatic cancer research; it is about getting those applications in to carry out that research. I could publish a highlight notice to flag to the research community the importance of pancreatic cancer, which may go some way to achieving what the hon. Gentleman seeks.

My hon. Friend the Member for Stroud spoke about PERT and asked why it is not prescribed for more people. National Institute for Health and Care Excellence guideline NG85 recommends that PERT be offered to patients with inoperable pancreatic cancer, and NICE includes PERT in its quality standard for pancreatic cancer. NICE guidelines do not replace clinical judgment. They are not mandatory; they are guidelines. However, it is clear that PERT should be discussed between a doctor and a patient so a clinical decision can be made. I heard what my hon. Friend called for and I will look into whether there is evidence that such discussions between doctor and patient are not happening.

My hon. Friend the Member for Carshalton and Wallington spoke about the importance of the workforce and, as the daughter of two NHS doctors and a former Minister for the NHS workforce, I agree with him. In essence, the NHS is its workforce, and I am proud that we are on track to achieve our ambition of 50,000 more nurses. Talking specifically about the cancer workforce, the workforce plan published in 2017 set an ambition to increase the workforce by 1,500 full-time equivalents by 2021. That has been achieved and, in fact, exceeded by 226 staff members.

Since then, Health Education England has been taking forward the priorities in the cancer workforce plan, with an additional £50 million of funding in the last financial year and this one. Also, a significant proportion of the elective recovery funding—£8 billion in the next two years—will be spent on workforce, both on capacity and skills. I assure my hon. Friend that, as the Minister with oversight of cancer care, I will look carefully at whether we have the necessary workforce coming on track now and in the future to achieve our ambitions and aspirations for cancer care.

The hon. Member for Strangford and several others asked about the 10-year cancer plan, and I know hon. Members are keen to hear about progress. More than 5,000 individuals and organisations responded to the Government’s call for evidence. The Government are considering the responses and the next steps, so I may have to disappoint some colleagues who may want to know more, because that is as far as I will go today. I assure hon. Members that I know how strongly they and their constituents feel about the matter.

I have welcomed this debate as a chance to talk about all the work going on to improve cancer diagnosis, treatment and survival rates, and crucially, to talk specifically about pancreatic cancer. Not least because raising awareness of pancreatic cancer is, in itself, an important step towards improving people’s chances of survival, raising awareness of the symptoms and, in turn, encouraging people to contact their GP and get themselves checked. I pay tribute to everyone involved in Pancreatic Cancer Awareness Month, particularly to Pancreatic Cancer UK and to everyone taking part, whether that is walking 30 km this month or doing their own thing to raise funds and awareness. I thank them all for what they are doing. In turn, I will do what I can in Government to support all those efforts and to improve the chances for anyone suffering from pancreatic cancer.

Cost of Living Increases

Debate between Helen Whately and Jim Shannon

Wednesday 16th March 2022 Commons Chamber

[Helen Whately]

If my right hon. Friend will give me a little time, I will come on to the importance of growth to our economy, which is the right answer for the longer term in ensuring that we improve people’s standard of living.

Pressures on household finances are not generally the consequence of one single price rise; they are typically affected by an amalgam of different factors. Remedying the pressure on households therefore requires taking action on a range of fronts, not just on energy bills. Again and again, that is what this Government have done and are doing. We are acting in dozens of ways to support working families. For instance, over the winter, the £500 million household support fund has helped vulnerable households with the cost of essentials such as food, clothing and utilities. Local authorities in England have allocated the lion’s share of that funding to ensuring that it reached those who needed it most, with 50% ring-fenced for households with children. Additional funding was allocated to the devolved Administrations, including the Scottish Government, in the usual way.

We have also reduced the universal credit taper rate and increased universal credit work allowances by £500 to ensure that work pays. This is essentially a £2 billion tax cut for the lowest paid in society. It is helping around 2 million households to keep an average of an extra £1,000 per annum in their pocket. Next month, the national living wage is increasing by 6.6% to £9.50 an hour, again benefiting more than 2 million workers and meaning an increase of over £1,000 in the annual earnings of a full-time worker on the national living wage. And we are committed to going further, so the national living wage will reach two thirds of median earnings for those over 21 by 2024, provided that economic conditions allow. We have supported working families in other ways too: doubling free childcare for eligible parents, which is worth around £5,000 per child every year, and introducing tax-free childcare, which will provide working parents with 20% support on childcare costs up to £10,000.

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for what she is saying, and I welcome the £400 million that is going to Northern Ireland under the Barnett consequentials. The Republic of Ireland has suspended VAT on fuel in the short term to try to address the issue now. Can I ask the Minister whether any discussions have taken place with the Chancellor to see whether that could be done for us here in this great United Kingdom?

[Helen Whately]

I am not sure I heard exactly the specifics of the hon. Gentleman’s question, but in general there is already a lower VAT rate on fuel. Overall, however, if the question is whether we should have no VAT on fuel, the Chancellor has spoken about how that would in fact disproportionately benefit wealthier households, so it simply cannot be the right thing to do when it is the less wealthy households who face the greatest challenges in paying their energy bills.

The list of what we are doing in many different ways to help households goes on and on. Increasing fuel prices are indeed a global issue, not unique to the UK. The price of crude oil has increased sharply over the past year, increasing the price consumers pay at the pump. That is why we have taken action by freezing fuel duty; drivers are being protected by the 12th consecutive year of fuel duty freezes, with the average car driver paying around £15 less fuel duty per tank, saving them a cumulative £1,900 since 2011 compared with the pre-2010 fuel escalator.

On housing, the Government are maintaining the increase to local housing allowance rates for private renters on universal credit and housing benefit in cash terms. That increase was worth an extra £600 on average in 2020-21 for more than 1.5 million households. An additional £140 million has been provided this year for discretionary housing payments for those eligible for housing support who need extra help. All that is on top of existing support for families through the welfare system, which this year will add up to £240 billion of support, including £41 billion on universal credit and £105 billion through the state pension.

Turning specifically to Scotland, on top of our energy bill support scheme, which applies there, the council tax measure in England means the Scottish Government are receiving almost £300 million more than would otherwise be the case, which they can use towards cost of living interventions.

This Government will always do what we can to help those in need, and our actions speak for themselves, but we are also determined to help people to help themselves. The Government’s plan for jobs is helping people into work and giving them the skills they need to progress and earn more, which is the best approach to raising living standards. The Government are building on the success of the plan for jobs with a total of £6 billion on labour market support for the three years to 2024-25, providing targeted additional support to help at-risk groups find work, including younger and older age groups, the long-term unemployed and people with disabilities.

Why are we doing that? Because we know that work is the best way for people to get on, to improve their lives and support their families, and because households on universal credit are at least £6,000 a year better off in full-time work than out of work.

Rebated Fuel Rules: Construction Industry

Debate between Helen Whately and Jim Shannon

Wednesday 19th January 2022 Westminster Hall

[Helen Whately]

I will make a little more progress, and then I will be very happy to. I am keen to make sure I address hon. Members’ points, which I have listened to and noted down during the debate.

Despite diesel being one of the most polluting fuels that vehicles and machinery can use, red diesel benefits from a significant duty discount—a duty rate of around 11p compared with almost 68p per litre on standard diesel. That really is significant. As a consequence, businesses using red diesel pay far less for the harmful emissions they produce than individual car owners. The tax changes that we are introducing in April mean most current users of red diesel in the UK will instead be required to use diesel taxed at the standard fuel duty rate like motorists, which more fairly reflects the harmful impact of the emissions that are produced.

Importantly, the Government have also heard from developers of alternative technologies—cleaner alternatives to red diesel—that the low cost of running a diesel engine on red diesel currently acts as a barrier to entry for greener alternatives. This widespread use of red diesel is actually counterproductive in terms of our ambitions to tackle climate change, reduce emissions and reduce pollution overall.

[Jim Shannon]

I kindly put two issues to the Minister. First, all Members, including my hon. Friend the Member for Upper Bann, have said that there needs to be a staging of this process. Only then will the new technology come through. That is not being negative; we all wish to achieve these goals, but there is a practicality issue. The second point, which I raised in my contribution, is that if exemptions are being given to farmers—which I agree with—would it be possible to have exemptions for those who depend on the generator system? Minister, we are not agin ye—to use an Ulsterism—but we really do think that at this stage there should be some honesty and flexibility in the process.

[Helen Whately]

I heard the hon. Member’s point there. A number of colleagues, including the hon. Member for Upper Bann, talked about there being a cliff edge, and others have asked for a delay. This was first announced back in 2020 and was confirmed in the spring Budget of 2021 to be introduced this coming April, so I would say that there has been a substantial lead time into the introduction of this policy—it is simply not coming as a surprise.

There has been substantial consultation with industry and consideration of the cases that specific sectors have made about the challenges that the shift to paying tax at the same rate as standard diesel might mean for them. The Government have listened to those concerns and made specific exemptions where we can see very material impacts—for instance on the cost of goods and services to households. There is an exemption around some use of red diesel for the purposes of generating energy for those who are off-grid—there is a specific exemption relating to that.

Although the construction sector, and mining and quarrying, which my right hon. Friend the Member for East Yorkshire (Sir Greg Knight) mentioned, argued throughout the consultation process that they should be exempt, their case was simply not compelling against our overall objective to incentivise greener alternatives and greater fuel efficiency and to shift to a position, which can only make sense, where the appropriate level of tax is paid on such a polluting and harmful fuel to reflect the harm that using it causes. However, as I say, we did listen and consult substantially on this proposal; we heard among others from the construction sector and from business representatives in Northern Ireland. We did listen, but we had to make the decision that this is part of an overall direction of travel where we are committed to tackling climate change and the harmful effects of pollution.

NHS Update

Debate between Helen Whately and Jim Shannon

Wednesday 21st July 2021 Commons Chamber

[Helen Whately]

My hon. Friend makes a really important point. We have seen people not come forward for treatment during the pandemic and it is worth reiterating that if anyone is worried about their health, it is really important to seek that help and get a diagnosis or seek treatment. We are working to increase the number of appointments available in primary care. One thing we have also seen during the pandemic is that GPs have increased remote working and virtual appointments. We know that many people need to be able to see a GP in person, but there are also opportunities to combine GPs being able to offer services in person and virtually in a way that is good, hopefully, for GPs and patients.

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for the statement and what she spoke about earlier. I want to ask about the NHS wage increase, which is on my mind. On the TV screens this morning, a nurse gave her story—it was very heartfelt, for those who had the opportunity to hear it—about the difficulties of retaining staff and ensuring that they were able to cope through the process. There is a real need to respond positively on the wage increase. A petition on that has also been handed into Government. I believe in my heart that NHS staff should receive the 3% increase. Does the Minister agree that 3% is enough, given their tireless and admirable efforts in tackling covid-19, and can she confirm that NHS staff will receive the wage increase and that it will be a priority for her and the Government?

[Helen Whately]

The hon. Gentleman is asking me to pre-empt the Government’s response to the recommendations of the pay review body and I am afraid that I am not able to do that at the Dispatch Box today. What I can say is that we are considering its recommendations and we will make an announcement on pay for NHS staff as soon as we can.

National Health Service

Debate between Helen Whately and Jim Shannon

Tuesday 13th July 2021 Commons Chamber

[Helen Whately]

I may pre-empt my hon. Friend’s point. I know that hon. Friends have asked why the Government need to bring in the policy if some care homes are doing it themselves. The problem is that we could risk a situation in which someone fortunate enough to be living in a care home that has required vaccination for its workers is highly protected against the virus, but someone less fortunate, in a care home in which far fewer staff are vaccinated, is unfortunately at much greater risk. That is not an inequality that any of us should be comfortable with.

[Jim Shannon (Strangford) (DUP)]

If we take a vote tonight, it will set a trend, set down a marker and point the direction not just for this place, but for the whole United Kingdom; I mention Northern Ireland in particular. Before we make the decision, may I ask whether the Minister has had any opportunity to talk to the regional, devolved Minister, Robin Swann, to gauge his opinion on how the legislation will affect us?

[Helen Whately]

The hon. Member is right: I know that other parts of the United Kingdom are watching what we are doing here in England. There are regular conversations between the Department of Health and Social Care in England and the other Administrations. Also relevant is the international situation: other countries have either done what we are doing or are looking very hard at it. In fact, France has just announced that it will require vaccination for health and social care workers on a faster timeline than the one we propose.

Never again do we want to be back in the situation of having covid outbreaks across hundreds of care homes, with those who live and work in them losing their lives to this virus. Vaccination is a safe and effective way of preventing the spread of covid. The majority of care home workers have already taken up the vaccine, and it is essential that all care home workers who can have the vaccine do so in order to protect those in their care.

The original scope proposed in the consultation was to apply the policy only to care homes that look after older people, but following the consultation it became clear that there was a compelling case to extend the obligation to all care homes that provide care to the most vulnerable, for example young adults with learning disabilities. There was also significant support for broadening the scope of the policy to include all those who come into contact with residents, and there was support for including all those who enter care home residences in any capacity.

Covid-19: Effect on Retirement Communities

Debate between Helen Whately and Jim Shannon

Thursday 1st July 2021 Westminster Hall

[The Minister for Care (Helen Whately)]

It is a pleasure to serve under your chairmanship, Mr Efford. I thank the hon. Member for Strangford (Jim Shannon) for securing the debate and for his fantastic speech setting out both some of the challenges and the wonderful things that the sector has done during the pandemic, while looking ahead and setting the tone for the conversation about wider housing supply challenges and opportunities. I also congratulate the hon. Member for Airdrie and Shotts (Anum Qaisar-Javed) on her first Westminster Hall debate. She was extremely articulate speaking to us remotely.

The pandemic has clearly been a huge challenge across the whole of our society, but the sheltered retirement housing and housing with care sector has faced the challenges of the past 18 months and truly risen to them. Managers, support workers, carers and other staff have gone the extra mile for those they support, and I have heard personally how hard those providers and their staff have worked, supporting the wellbeing of residents during the pandemic. I thank all those organisations and their staff for their amazing work throughout the pandemic.

Sheltered retirement extra care housing provides a home to hundreds of thousands of—often vulnerable—older people across the country. Having the right housing options helps older people stay independent for longer, continuing to live as part of a wider community in their own home, with the care they need close at hand when needed, but still—as so many of us want for as long as we possibly can—living behind their own front door, as my right hon. Friend the Member for Staffordshire Moorlands (Karen Bradley) said, with their own furniture, for instance. These things make a difference to someone’s quality of life.

During the pandemic, the Government’s focus has been on ensuring that those most vulnerable to covid have had help and support to get through these difficult times, including specific help for those living in the residential settings that we are talking about.

The retirement and housing with care sector itself put in place tons of measures to protect the more vulnerable residents and to look after frontline staff, such as closing down communal facilities; suspending activities; restricting access in and out of communities; issuing PPE; restricting in-person visits; and often, regular and increased cleaning.

My right hon. Friend talked about the retirement village in her constituency, Bagnall Heights, which has done a fantastic job of job of protecting its residents from covid by controlling who came in and out; arranging the PPE they had; extra cleaning; going shopping for residents so they did not have to take the risk of leaving the area; supporting the vaccination effort; lots of testing; and organising some fantastic socially distanced activities to keep up morale, which has been so hard during this time. She says that staff worked all hours to do that. It was clearly a great job by manager Sue Clarke and owner David Vincent, whom she mentioned. I congratulate them and the many others I have heard of who have gone to those lengths to protect residents and to support them through such a difficult time.

As hon. Members mentioned, we have engaged regularly with the retirement housing sector over the past year or so, and all the intelligence we have received, as was particularly mentioned by the hon. Member for Strangford, is that infection and death rates related to covid in that housing sector have thankfully been lower than we might have feared considering the relatively older and more vulnerable residents living in the sector. The measures we have put in place have clearly been effective in protecting those more vulnerable residents. However, as we have recognised today, there has also been a downside: the impact on the overall health and wellbeing of older people of, for instance, limits to socialising and communal activities; restrictions on visits; and not being able to get out and about as usual. In fact, a serious thing that happened, particularly earlier on, was residents sometimes not having access to healthcare or doctors as normal. As the hon. Gentleman said, life was completely different. As we have talked about, retirement housing providers worked really hard to get that balance between protecting their residents from infection, trying to maintain as much of the quality of life of their residents as possible and trying to maintain social contact.

The hon. Gentleman talked about technology being part of that, as did the hon. Member for Airdrie and Shotts, and about how Zoom calls have replaced visits for some; some people have actually found that they see more of their family via Zoom than when a long trip is required. We all agree that there is no way that a Zoom call actually replaces being physically together with people; it is not the same as coming together for a meal or a cup of tea and having a hug. However, it has been better than nothing. We all want things to get more back to normal, and we welcome the fact that that is happening.

The Government targeted our support at the sector; we have broadly worked hard for the last 18 months to support the social care sector. It is a hugely diverse sector, as hon. Members have talked about today, ranging from care homes and nursing homes to extra care housing, retirement housing, shared lives and shared accommodation. So there is huge diversity in the sector, which we have sought to support in different ways.

The shadow Minister talked about guidance. We have worked to provide guidance for the range of settings in the sector, but it has not always been easy, simply because of the diversity and the different circumstances that exist. Nevertheless, our support has included the provision of testing, which my right hon. Friend the Member for Staffordshire Moorlands said was clearly being used regularly by Bagnall Heights, and that was good to hear. There has also been access to PPE and all the particular support to settings that are more like care homes, where residents live in closer proximity and receive more care than in other settings.

Also, this year frontline health and social care workers, including those providing care in retirement communities and extra care housing, were prioritised for the vaccine by the Joint Committee on Vaccination and Immunisation in cohort 2. We are now in a great place, where the vast majority of people in those settings—both residents and the staff working there—have had not just one vaccination but two.

We continue to listen to and work with the sector, and to work with local authorities as well, on how we can support this part of society as we come through the pandemic. Although life is getting closer to being back to normal, as the shadow Minister rightly said, there have been long-term consequences from the relative isolation that people have lived in, and from their not being able to get out and about to participate in normal activities. We do not know all the consequences yet, but we know that getting back to normal brings its own challenges, too.

I will pick up on a particular question from the hon. Member for Strangford about future pandemic readiness. He made a really good point that we have seen that this kind of accommodation helps people to be protected from the risk of an infectious disease, for example because of separate housing units and that sort of set-up.

Looking ahead, however, we know that there will be opportunities to look back, to reflect upon and to learn the lessons of the whole experience of the pandemic. Of course we learn as we go, but actually taking the time to reflect is something that is still ahead of us. The Prime Minister has committed that there will be an independent inquiry established on a statutory basis, and that will begin its work next spring. I have no doubt that it will lead us to making sure that we are ready for future pandemics, looking across the wide range of settings where people are more vulnerable to infectious diseases.

This debate has also been a really rich conversation about housing provision more broadly for older people and the sort of provision that we want to have across the country. Housing will be part of our social care reform proposals, which, as hon. Members know, we have committed to bringing forward later this year. It is totally right that housing is so much a part of that work. The homes that we live in, and the environments and communities around us, have a huge impact on our health, wellbeing and quality of life. I want people to be able to live in the home of their choosing for as long as possible and as independently as their age and their health condition will allow.

We know that living in a home that is safe, so that it allows someone to keep living independently, not only improves someone’s quality of life but helps to prevent them from having an early admission to hospital and helps them to be transferred back out of hospital to go home. For many people, it can mean that they may never need to move into a residential care home setting, or at least delay it. However, we should all be clear that care homes and nursing homes are an important part of the mix of accommodation, and there is absolutely a time and a place when that setting is the right thing for people.

[Jim Shannon]

The right hon. Member for Staffordshire Moorlands (Karen Bradley) asked a question, Minister, which I will repeat. How can the health and social care reform work in partnership with the retirement communities, so that they can devise a strategy? I ask that because there are two Departments involved. The right hon. Lady made the point, and I just reiterate and reinforce it, because she and I both want to see that happening.

[Helen Whately]

I thank the hon. Member for his point. I completely agree. I will come to that, if he will just bear with me. I will continue, but I will pick up on exactly that.

As a Government, we know that we need to review housing holistically, looking at existing stock, which is clearly the vast majority of the housing in the country, as well as new builds, and looking at the wide range of housing options that we want to be available to meet all the health and care needs of our population—the growing number of people who are living longer and what that means for us. Whether people are living with or without home care support, it is important that we remember that not everyone will want or be able to stay in their current, lifelong home. That means that we need to think very broadly about having the right specialist housing options, including those with extra levels of care and support.

In England, both my Department and the Ministry of Housing, Communities and Local Government provide capital grant subsidy to assist with delivery of specialist and supported housing for older and other more vulnerable people with care and support needs. Speaking for my own Department, we provide funding to build specialised housing, through the care and support specialised housing fund, for older people and adults with learning and physical disabilities and mental ill health, and £71 million has been provided for that fund in 2021-22. Furthermore, 10% of delivery under MHCLG’s £11.5 billion affordable homes programme will be used to increase the supply of much-needed specialist and supported housing for a range of people with care needs, including older people.

That is what we are doing now, but I think that we are in agreement in this debate that we need to do more and we need to increase the supply of retirement housing and extra care housing and have a broad range of the kind of housing that helps people to live with their own front door—in their own home—for longer. Therefore I am working with MHCLG Ministers, and my officials are working with those officials, on how we can best achieve that. We are working across Government and also working with stakeholders, with the sector, on how we can achieve it. We are indeed considering the proposal for a taskforce, which was referred to by my right hon. Friend the Member for Staffordshire Moorlands. Yes, the partnership approach is absolutely one on the table.

I will come to a conclusion, but I want to say that one highlight of this debate for me has been hearing about the mother of the hon. Member for Strangford. It is a highlight because it is a reminder to all of us that this is about people. It is about real people and about their homes, which matter so much. I have been to brilliant homes; I have been to wonderful specialist retirement communities. I have been to housing and care settings and everything in-between. We need a mix of provision, and we need that mix so that individuals like the hon. Member’s mother, family members of all of us, whether it is grans, grandads, mothers, fathers, brothers or sisters, and, in due course, we ourselves have the homes that we need where we can live the best possible life and live our life to the full for as long as we can.

Social Care Reform

Debate between Helen Whately and Jim Shannon

Wednesday 23rd June 2021 Commons Chamber

[Helen Whately]

My hon. Friend is clearly having conversations in his constituency, and he makes an important point about the scale and number of people who have involvement in the care system. There are over 1.4 million people who receive care, over 1.6 million people in the care workforce, and over 5 million unpaid or family carers. The scale is huge and is growing as more people need care. My hon. Friend is absolutely right that this is not a party political issue; we need to come together and build a consensus across Parliament, but also across society as a whole—and, yes, we will bring forward proposals for reform later this year.

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for her statement today on social care reform. An issue close to my heart is support for carers in the form of respite; in particular we have generations of young carers who need a break after the isolation of the pandemic. Will the Minister commit to making funding available specifically to provide respite overnights for carers who carry out their activities 24/7 and need support more than ever right now?

[Helen Whately]

The hon. Gentleman makes a really important point about respite for carers. Being a carer is hard and back-up support and respite services help make it more possible, but frustratingly, during the pandemic many of those services have not been able to function as normal. I am currently working with Ministry of Housing, Communities and Local Government Ministers to help local authorities across England ensure that day services and respite care are fully restarted as that is very important, and I would like to see that across the whole of the UK.

Dementia Action Week

Debate between Helen Whately and Jim Shannon

Thursday 27th May 2021 Commons Chamber

[The Minister for Care (Helen Whately)]

I beg to move,

That this House has considered Dementia Action Week.

I congratulate the hon. Member for Oldham East and Saddleworth (Debbie Abrahams) on securing this debate to mark Dementia Action Week. I pay particular tribute to her work as co-chair of the all-party parliamentary group on dementia, and to the charities that she and I both work with, including the Alzheimer’s Society.

I know how hard the last 12 months have been for those living with dementia and their families. Living with dementia is hard in normal times, but harder still during a pandemic. It has been an incredibly difficult year. I know that, and I have seen that. There are more than 850,000 people living with dementia and around 670,000 carers looking after them. I thank everyone who is caring for someone with dementia.

While many thousands of people have dementia, we must not, and I do not, see it as an inevitable part of ageing. Although one in six of those over 80 have dementia, five in six do not. Around a third of dementia cases are estimated to be preventable. I am ambitious—ambitious about preventing dementia, ambitious about developing treatments, and ambitious about one day developing a cure. However, first I will update the House on what we have been doing under the umbrella of the challenge on dementia 2020 and in response to the pandemic.

Last year, we assessed delivery of the 2020 challenge, which showed that we now have more than 3 million dementia friends, thanks to the Alzheimer’s Society. We have 437 areas across England and Wales signed up as dementia-friendly communities. We have 137 trusts signed up to the dementia-friendly hospital charter and, thanks to Skills for Care and Health Education England, more than a million care workers and another million NHS workers have received dementia awareness training. Added to that, our commitment to spend £300 million on dementia research over five years was delivered a year early, with £344 million spent over four years.

Timely diagnosis of dementia is really important to help people to understand what is going on, find out what support is available and get advice on what happens next. Since 2016, we have consistently met the challenge on dementia target of two thirds of people living with dementia receiving a formal diagnosis. However, at the start of the pandemic many memory assessment services had to close, and the dementia diagnosis rate has dropped below the national ambition for the first time since 2016.

While we have supported remote or virtual memory assessment services, I recognise that that is not for everyone. I want to see in-person services fully functional as soon as possible, because a diagnosis can make such a difference, allowing people to access the support that they need.

[Jim Shannon (Strangford) (DUP)]

The charity Music for Dementia says that those who have started to sing or listen to music on a daily basis have

“more than doubled their quality of life…whilst halving their depressive symptoms.”

Could that charity be introduced to the Government’s strategy?

[Helen Whately]

The hon. Member makes a really important point: music is one of the things that is known to really help people who are living with dementia. It helps to improve the quality of their lives, and it has been one of things that has been hard to access during the pandemic. I am determined that we see that kind of support restarted, and develop further support along those lines in the months and years ahead.

We have allocated £17 million of funding to NHS England to get the diagnosis rate that I was talking about back up to where it should be, to support the needs of those waiting for a diagnosis and to help those who have been unable to access support due to the pandemic. Everyone with dementia should receive meaningful personalised care, from diagnosis to end of life, to help them to live with the condition and to live the fullest possible life for as long as possible.

It is imperative that we support those—often husbands, wives, partners, sons and daughters—who care for loved ones with dementia. They take on a huge burden of care, both practically and emotionally. Since the Care Act 2014, every carer for someone with dementia should have their needs assessed by their local authority and should then receive the support that they need, whether that is support with caring or respite, time out for themselves or sometimes help with extra costs. That is crucial, not only because carers are so important to the person with dementia they care for, but because they need to have a life alongside caring.

Throughout the past year, we have worked with the Alzheimer’s Society, Age UK, Carers UK, other charities, care providers, local authorities and the NHS to work out how best to support people with dementia and their carers during the pandemic and put that support in place. We have provided more than £500,000 in funding to the Alzheimer’s Society for its Dementia Connect programme, £500,000 to the Carers Trust for its support to unpaid carers, £122,000 to Carers UK to extend its helpline opening hours and £480,000 to the Race Equality Foundation.

We have provided free personal protective equipment for carers where they live separately from the people they care for, in line with clinical advice. We have given carers priority to vaccines in line with Joint Committee on Vaccination and Immunisation prioritisation, considered them time and again in guidance, worked to better identify them and supported local authorities in the restoration of day and respite services, including with nearly £12 million in funding from the infection control fund.

As we come out of the pandemic, we want not only to ensure that we restore and improve early diagnosis and support for people living with dementia and their carers, but to go further: to prevent people from getting dementia in the first place, support research to develop effective treatments and, ultimately, find a cure. The National Institute for Health Research is right now supporting several studies on dementia.

The 2019 Conservative party manifesto committed to doubling funding for dementia research and delivering a moonshot of ambitious goals. The moonshot will expand the UK’s internationally leading research effort to understand the mechanisms underlying the development and progression of dementia, develop new therapies and help to prevent the condition. We are working right now on developing a new dementia strategy to boost dementia awareness, diagnosis, care, support and research in England. As everyone knows, we are committed to wider reform of social care; we will bring forward proposals for that later this year.

We want a society where the public think and feel differently about dementia—where there is less fear, stigma and discrimination, and more understanding. We want to reduce the number of preventable cases of dementia. We are determined to support those who are living with dementia to live the fullest possible life for as long as possible, and to support those who care for them. We will lead the way in dementia research and innovation to find effective treatments and, ultimately, a cure.

Oral Answers to Questions

Debate between Helen Whately and Jim Shannon

Tuesday 13th April 2021 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

What plans the Government have to ensure an adequate number of nurses in the cancer workforce to deliver the targets for cancer set out in the NHS long-term plan.

[The Minister for Care (Helen Whately)]

Cancer diagnosis and treatment is a priority for this Government. I am working with the Minister for prevention and public health—the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Bury St Edmunds (Jo Churchill)—to ensure that we have the necessary workforce to deliver improved cancer care. Overall, we are increasing the number of nurses in the NHS, with over 10,000 more nurses in the NHS this January than a year ago. We are training 250 more cancer nurses and 100 more specialist chemotherapy nurses.

[Jim Shannon]

I thank the Minister for that encouraging response, but will she outline what steps have been taken to ensure that Northern Ireland students educated in UK mainland nursing schemes can easily transition to fill the needs in our cancer wards both in the UK mainland and in Northern Ireland?

[Helen Whately]

I thank the hon. Gentleman for his question, and if he will allow me, I will look into that and write to him.

NHS Staff Pay

Debate between Helen Whately and Jim Shannon

Monday 8th March 2021 Commons Chamber

[Helen Whately]

As my right hon. Friend says, most of the public sector—and that includes the police—is regrettably under a pay freeze for the coming year because of the challenging times we find ourselves in and in recognition that across the economy there are people who have lost their jobs and that we are having to spend a huge amount of money to support people’s incomes. It is against that backdrop that we are giving NHS staff a pay rise, but indeed these are difficult times that we are living through.

[Jim Shannon (Strangford) (DUP) [V]]

I have received literally hundreds of emails from constituents and from the Royal College of Nursing. The Democratic Unionist party and I support the campaign for a fair wage increase for NHS staff, because they have been at the forefront of the war against covid-19. They put their lives on the line day by day in defence of this great nation of the United Kingdom of Great Britain and Northern Ireland. Since 2010, average weekly pay in the private sector has grown by 22%, compared with only 17% in the public sector, so I ask the Minister, very gently and kindly, whether she will in the name of justice and for moral reasons consider reviewing the decision and deliver for NHS staff.

[Helen Whately]

The Government have submitted our evidence to the pay review body of what we can afford for NHS pay, but the review bodies will look at a wide range of evidence on what is the right level to set and will make recommendations over the spring.

Oral Answers to Questions

Debate between Helen Whately and Jim Shannon

Tuesday 1st September 2020 Commons Chamber

[Helen Whately]

I completely agree that nursing should be open to all men and women from diverse backgrounds. Our £5,000 grant to all nursing degree students, starting this autumn, will help students with the cost of that degree course. In addition to the apprenticeships route that I just mentioned, in January we are launching an online blended nursing degree to give another route into nursing.

[Jim Shannon (Strangford) (DUP)]

What recent assessment he has made of the effect of the covid-19 outbreak on diabetes screening.

A& E Departments: Staffing

Debate between Helen Whately and Jim Shannon

Monday 23rd March 2020 Commons Chamber

[The Minister for Care (Helen Whately)]

I thank the hon. Member for Rhondda (Chris Bryant) for calling this debate and for leading us in that tribute to the NHS workforce.

As we stand here, our NHS faces daunting challenges, as it will continue to do for weeks and months to come. I, too, want to take a moment this evening to thank each and every one of our health and care staff and their individual families for all they are doing for our country at this most challenging of times. I know they are making incredible sacrifices, selflessly working at the frontline in looking after our families in our hour of need, while their families are at home concerned for their safety and welfare. They are there on the frontline around the clock, tackling this head-on. As a country, we will be eternally grateful to them, and from us all, thank you.

I will also pause, if I may, to mention some of the heart-warming gestures across our communities, such as small businesses and large multinationals offering staff hot drinks and hot food, supermarkets making specific opening times for NHS and social care staff, and hotels and chains making beds available to staff to use. Thank you to each and every one of you. You do our country proud.

I want to assure everyone this evening and, most importantly, all our NHS staff that we are here to support them, and we will not let them down. First, we know the NHS needs more people to fill the gaps when staff have to stay home and to cope with the particular needs of patients with coronavirus. We have made a call to arms to those who have left the healthcare professions in the last three years. The healthcare regulators have been contacting doctors, nurses, pharmacists, paramedics and others to ask them to return to practise to support the coronavirus response, and the response from the workforce has been amazing. At noon today, 1,930 doctors and 5,630 nurses had responded by indicating that they were willing to return to the NHS. They will help the NHS not only to treat coronavirus patients, but to continue other emergency healthcare, including urgent operations and cancer treatments. We are also working with professional leaders across nursing, midwifery and allied healthcare professionals to see how students in their final year of study can provide support at the frontline. Our nursing leaders, staff representatives and university bodies will put out a joint statement on that tomorrow.

As we welcome so many doctors, nurses and allied healthcare professionals back to the NHS, we must look after them and all those who work in our health service. I know that staff at the frontline are worried and need assurances that there is sufficient personal protective equipment for everyone who should be using it. The safety of those on the frontline is of paramount importance. We have stocks of PPE nationally and NHS England is working to make sure that the NHS frontline has the equipment it needs. I know there have been problems with distribution in some places, but that is now being resolved by NHS England, which has restructured its logistics operations so that equipment should now be getting to those at the frontline who need it.

[Jim Shannon]

There is some indication in the news today that some of the personal protection equipment and material available is not up to standard. Will the Minister confirm that everything the Government are sourcing is of a standard suitable for the needs of staff at the frontline?

Alcohol Harm

Debate between Helen Whately and Jim Shannon

Tuesday 17th March 2020 Westminster Hall

[Helen Whately]

I thank the hon. Lady for her contribution and I take her point. It is important that we continue to look at the evidence and that is the approach we will follow. I thank everyone here today for their contributions to this important debate and for having this conversation.

[Jim Shannon]

I urge the Minister to contact each of the regional devolved Administrations, in Scotland, Northern Ireland and Wales. It would be a good idea for interaction with those three regional Administrations, to gauge a universal policy for the whole of the United Kingdom of Great Britain and Northern Ireland and to take all the evidence from other parts of the United Kingdom, which could gel a strategy that we could all agree on. That would be a substantial way forward.

[Helen Whately]

The hon. Gentleman makes an important point about working together, and the UK Government working with the devolved Administrations, drawing on the lessons that we have all learned and the evidence we all have. I do not think I will make a commitment to do that immediately in the light of the current public health situation, but he does make a very good point.

The Government absolutely are taking action and we are determined to do more to support people who are most vulnerable from alcohol misuse.

Oral Answers to Questions

Debate between Helen Whately and Jim Shannon

Tuesday 10th March 2020 Commons Chamber

[Helen Whately]

I thank my right hon. Friend for his question. I am well aware of concerns in the social care sector, particularly in areas where there are higher vacancy rates. It is important that employers make sure that they are taking the steps they can take to make sure that social care jobs are attractive and, of course, well paid, as they should be. I recognise as well a role for Government in this, supporting the role of working in social care, and overall making sure that we come together and fix the social care crisis.

[Jim Shannon (Strangford) (DUP)]

7. What recent estimate he has made of the number of GP practices that have adopted the care for young carers package.

[The Minister for Care (Helen Whately)]

NHS England outlined the care for young carers offer in GP surgeries in June 2019. The offer includes a package of practical plans and actions to help young carers. Uptake will be monitored at a regional level in England through integrated care systems.

[Jim Shannon]

I am grateful for the Minister’s response. However, can she further break down the number of surgeries that have offered priority appointments for carers for home visits and additional mental health checks, and double appointments for the carer and those they provide for? What is she doing to see this rolled out in every GP surgery throughout the nation, bearing in mind that 40% of carers struggle with their own mental health?

[Helen Whately]

My hon. Friend makes a really important point about support for carers and young carers. I cannot answer on the details of his question right now, but I will take it away, talk to the Under-Secretary of State, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), who is responsible for primary care, and the Under-Secretary of State, my hon. Friend the Member for Mid Bedfordshire (Ms Dorries), who is responsible for mental health, and come up with a better answer for him.

Nursing Workforce Shortage: England

Debate between Helen Whately and Jim Shannon

Tuesday 3rd March 2020 Westminster Hall

[The Minister for Care (Helen Whately)]

I congratulate the hon. Member for Bedford (Mohammad Yasin) on securing this debate. I thank him for his tone and his constructive approach to the challenges. I also thank him for giving me this opportunity to speak about a subject that I am truly delighted to have as my responsibility as a new Minister in the Department of Health and Social Care, and about which I feel very strongly—namely, the NHS workforce.

Our NHS is truly fantastic and we as a nation are proud of it. However, as we know, the NHS is really its people. The people of the NHS are the NHS—from the most senior doctor, to the newest healthcare assistant and everything in between. That is particularly true of nurses, who make up nearly one quarter of the NHS workforce, and good healthcare depends absolutely on good nurses.

The NHS should be looking after its nurses, but over many years visiting hospitals and community services—this goes back a long time—I have had too many conversations with nurses who feel that the NHS, or their employer, has not been looking after them. The biggest problem that comes up, going back over many years, is that of staff shortages.

I completely agree with the hon. Member for Bedford that the vacancy rates among NHS nursing teams are too high. They are particularly high for some specialties, such as mental health. There are variations across regions. For instance, in the north-east, Yorkshire and the north-west, the highest vacancies are in ambulance trusts. We also know that there are particular challenges in rural areas, as mentioned by my hon. Friend the Member for North Cornwall (Scott Mann), and across the nations of the UK. As we heard from the hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone), there are challenges in rural parts of Scotland. We heard from the hon. Member for Strangford (Jim Shannon) about the challenges in Northern Ireland, and there are also parts of Wales that are struggling. This is not just a problem in England, but nevertheless I recognise the problem in England. We need plans to address that, and we have plans, which I will come to.

The hon. Member for Bedford also flagged up the importance of safe staffing in the NHS. I absolutely agree that our first priority must be that the NHS is a safe place for patients, and that care is safe. As he will know, trusts call on bank and agency staff, to make sure that they have enough staff to make wards safe. We must appreciate the work of those staff, who do a really important job of stepping in, but, as I have heard from many a ward sister, although they welcome having agency staff to fill the gaps, that is not the same as having a fully staffed team. That is what we really want in the health service. It will make the NHS a great place to work and enable it to provide the best possible care for patients. That is why the Government have committed to 50,000 more nurses, so that staff shortages and those high vacancy rates will be a thing of the past.

Before I talk about how we will find thousands of new nurses, I want to discuss the most fundamental thing we have to do to succeed, which is to keep the nurses that we already have in the NHS. Some hospitals and teams do not have a problem with staff retention, and some have very low attrition rates. In others, we know that staff turnover is a real problem. There is no point in the NHS training up lots of new nurses if we cannot hang on to those who have already been trained.

In order to retain nurses, we need to make sure that each day is a good day. We need to look out for each and every nurse, which is the day-to-day job of the trusts that employ nurses. I want those trusts that are struggling with high attrition rates to adopt more of the good practices of successful trusts. The Government are also going to help.

First, as we have discussed today and as we have heard directly from nurses, more investment in ongoing training and continuous professional development would make a big difference. That is why the Government have committed to giving every NHS nurse a £1,000 training budget on top of the training that employers usually provide. That extra funding should help nurses to advance their careers, to move more easily between different roles and, of course, to provide better care to patients.

Secondly, there will be a new offer for all NHS staff. It will be released alongside the NHS people plan, which will set out the support each and every NHS staff member can expect from their employer, including for professional development and for more choice and control over shifts and working patterns. As several hon. Members have said, NHS staff want more control and flexibility. The hon. Member for Strangford mentioned the importance of flexibility. Nurses may have other caring responsibilities. Some trusts are doing well in this area, others not so well. We want all employers to do what they can to give staff more flexibility and control over their working hours.

[Jim Shannon]

I thank the Minister for her comprehensive response. I know that tax credits, NVQs and time out are not her responsibility, but would she be willing to speak to the Minister with that portfolio to see whether there is any flexibility in the system to enable nurses, especially those with young children, to continue?

[Helen Whately]

My understanding is that the system in Northern Ireland is different from that in England, so I do not have the answer at my fingertips. I am, however, happy to take up the hon. Gentleman’s question and get back him.

Thirdly, on improving the retention of staff in the NHS, we need to tackle the level of bullying and harassment. The recent NHS staff survey had some really positive results on how NHS staff feel about their work. The Secretary of State and I, however, are greatly concerned about ongoing reports of bullying and harassment that staff experience at the hands of other staff, patients and, sometimes, their families. That is simply not acceptable. We must send out a message, loud and clear, that we will not tolerate the bullying and harassment of staff, whether from other staff or from patients and their families. As a society, we should all be grateful to our NHS staff. Hand in hand with that, we absolutely will not tolerate racism, which is an ongoing problem in some parts of the NHS.

Fourthly, pay has never been the top thing brought up by nurses when I have spoken to them about their concerns, but clearly it is part of the picture. By April this year, we will have increased by 12% the starting salary for new nurses compared with three years ago. More than 200,000 nurses are benefiting from pay rises under the “Agenda for Change” pay deal. Nurses below the top of their pay band have been receiving increases of at least 9%, and those already at the top of their pay band are receiving a pay rise of 6.5% over the course of the “Agenda for Change” pay deal.

I just want to pick up on the point about returning to nursing. The issue of retention also applies to nurses who have, for many reasons, taken time out of nursing. We are very keen that more of those nurses return to work. We are supporting nurses who want to bring back their valuable experience to the NHS. I also want trusts to develop posts that will make the most of those nurses’ experience and to ensure that there is enough flexibility in their shift patterns and ways of working to fit any caring responsibilities they may have.

[Jim Shannon]

For that to happen and for them to return, there would need to be a database of all former nurses. I am mindful that there will be a statement later about the coronavirus, and a Health Minister has mentioned having a list of people who could come in and help in the event of a pandemic outbreak. If there is such a list, then there must also be a list of former nurses who have left the sector but wish to come back. Is there such a database?

[Helen Whately]

I am just digesting what the hon. Member said.

[Jim Shannon]

I talk very fast.

[Helen Whately]

I have not seen a database. The hon. Member refers to the coronavirus plans, which are very much on my mind as we talk about the immediate and longer-term plans to increase the number of nurses in the NHS. Clearly, we also have the short-term challenge of ensuring that the staff are there, and that work is absolutely in hand. Returners are an important part of it and we need to ensure that we make use of nurses who have already been trained, to boost the NHS workforce. All in all, we want to ensure that the NHS is a great place to work for nurses who return to it and for those working in it right now. The absolute foundation for ensuring that we no longer have nursing shortages is to look after the nurses that we currently have. On that foundation, we can seek to recruit and train new nurses.

--- Later in debate ---

[Jim Shannon]

The Minister has mentioned the Government’s commitment to increasing national health service funding. It is important to state for the record that we acknowledge the good things they have done.

[Helen Whately]

I thank the hon. Gentleman. As he says, I have spoken not only about how much we value the NHS workforce, but about our commitment to increasing NHS funding. The two go hand in hand.

A few Members have mentioned that the number of vacancies stands at well over 40,000. Although I absolutely recognise that those numbers are still far too high, the latest data shows a steady downward trend over the past year. I state for the record that as of the third quarter of 2019-20, the number of vacancies was under 39,000.

I will finish with one more piece of good news: the increasing number of nurses in the NHS. As of November 2019, the latest workforce data shows that we had 290,474 nurses in the NHS in England, which is an increase of 8,570, or 3%, since November 2018, and an increase of nearly 17,000, or 6%, since 2010. The numbers are going in the right direction. We have a long way to go but I am determined that we should get all the way to the extra 50,000 nurses in the NHS, so that nursing staff shortages will soon be a thing of the past.

Mental Capacity (Amendment) Bill [Lords]

Debate between Helen Whately and Jim Shannon

2nd reading: House of Commons & Money resolution: House of Commons & Programme motion: House of Commons & Ways and Means resolution: House of Commons
Tuesday 18th December 2018 Commons Chamber

[Helen Whately (Faversham and Mid Kent) (Con)]

It is a pleasure to follow the right hon. Member for North Norfolk (Norman Lamb), who has such expertise in this area and brought such valuable content to this debate as well as a valuable tone, which was very good to hear. I want to say a few things, first, in support of the Bill. As the right hon. Gentleman said, it is very important that we take a moment to reflect on the significance of getting this right.

Depriving someone of their liberty is a very significant act. Liberty is a fundamental right and freedom. We must take it seriously, and we must get this right. It is clear that the current system is not working. The fact that between 100,000 and 200,000 people are waiting because of an applications backlog is clearly unacceptable and cannot continue, given the consequences for individuals who have been deprived of the safeguards to which they are entitled, and the impact on their families and on care homes in which they may be residing.

[Jim Shannon (Strangford) (DUP)]

Earlier today I had a chance to speak about this matter to the Minister and some of her officials. Is it the hon. Lady’s understanding that the issue of human rights has been included in legislation that has been endorsed by Age UK, the Law Commission and Simon Wessely? If that is the case, the action that the Minister and the Government are taking this year is right, because it brings everyone together and ensures that there is legislation that everyone in the House can support.

[Helen Whately]

The hon. Gentleman has made a good point about the support for the Bill. Some Opposition Members have suggested that there is not much support for it, but it is, in fact, widely supported. Yes, there are concerns, with which I shall deal shortly, but, as the hon. Gentleman has said, there is widespread support for improvements in the current system. Those improvements include simplification—less bureaucracy and fewer administrative burdens—and the critically important representation of individuals through the independent mental capacity advocates, which will give them a voice. The frequency of assessments will become more appropriate; as my hon. Friend the Member for Berwick-upon-Tweed (Anne-Marie Trevelyan) said earlier, timings can be inappropriate and excessively burdensome. There is a better choice of language: the Bill removes the term “unsound mind”, which is very stigmatising and completely unnecessary. I am also pleased that the Government have listened to the concerns expressed by some of my constituents about, for instance, potential conflicts of interests for care home owners when a financial interest may be involved.

However, I have three outstanding concerns. First, there is the question of how the amended Act will work for people with severe mental illnesses. The Bill clearly focuses on those who lack capacity because of, for instance, dementia, learning difficulties, autism or brain injuries, but, if I understand it correctly, it could be applied to people with severe mental illnesses. Figures suggest that the current Act is applied to a significant number of people in such circumstances. We know that such illnesses—bipolar disorders, for example—are likely to fluctuate, and that as a result people’s capacity may also fluctuate. That could cause them to be detained and deprived of their liberty when, in fact, they have regained capacity. The Minister in the Lords, Lord O’ Shaughnessy, gave a commitment that that would be addressed in the code of practice, but may I press this Minister to ensure that there are sufficient safeguards in the Bill?

Lorry Parking

Debate between Helen Whately and Jim Shannon

Tuesday 30th January 2018 Commons Chamber

[Helen Whately (Faversham and Mid Kent) (Con)]

A few weeks ago, in the early hours of the morning, a car carrying four men crashed into a parked lorry on the edge of the A2 just south of Faversham. Three of the men were killed; the other was seriously injured. We might never know exactly what happened, and I am absolutely not blaming the lorry driver, but that stretch of the A2 is a well-known spot for what we call lorry fly-parking. Fly-parking is when lorries park in lay-bys or on slip roads, hard shoulders, pavements or verges, often at the edge of busy roads such as the A2, the A20 and the A249 in my constituency. Sometimes they also park up quiet country lanes or in industrial estates and housing estates. In general, these are places where lorries should not be parked for more than the few minutes that might be needed for a delivery or an unexpected stop. Sometimes they park legally, and sometimes illegally. Sometimes they park perfectly safely, albeit inconveniently, but at other times, unfortunately, they park dangerously.

This was not the first fatality in my constituency involving a parked lorry. A 74-year-old woman died after crashing into a lorry parked on the hard shoulder at junction 7 of the M20 a couple of years ago. Whatever the cause of the latest crash, this horrific accident should focus our minds on the problem, focus our attention on the need for more lorry parking spaces, and focus our energies on ending lorry fly-parking. Lorry fly-parking is dangerous. There is a danger to other motorists from lorries lined up, bumper to bumper, in lay-bys, sometimes jutting precariously out into the road. There is a danger to the police officers who risk their lives walking along the hard shoulder at night with hundreds of cars speeding by as they move alongside illegally parked trucks. There is also a danger to the lorry drivers themselves when they are in charge of a heavy goods vehicle but have not had a proper rest. A busy roadside with traffic thundering past is hardly a good place to get a proper night’s sleep.

The haulage industry is, rightly, tightly regulated. Drivers must record their hours on a tachograph and take breaks every four and a half hours. When the time comes to stop, they have to stop, but the roadside is not only a bad place to sleep, but a pretty bad place to stop off in general for a driver, as it has no security, no facilities, no showers and not even toilets. That is hardly helpful for an industry that would like to attract more women. From the point of view of most of my constituents —those who are not lorry drivers—they see extra litter and pretty disgusting other stuff on the roadside, and anyone who needs to pull into a lay-by on a main road can forget it, because they are already full.

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Lady for allowing me to intervene. Northern Ireland is heavily reliant on cargo being freighted by ship and then by lorry, so this issue concerns us greatly. We must ensure that there are safe and secure areas for lorry drivers to park, not only to enable them to stay within their hours under EU legislation, but to keep them and those who come into contact with them safe. Does she agree that we should look into providing parking facilities so that those living in residential areas do not have to listen to idling lorries and so that those who drive the lorries can be safe?

[Helen Whately]

I completely agree that this is about making things better for residents and ensuring that lorry drivers have the facilities that they need. I thank the hon. Gentleman very much for bringing a Northern Ireland perspective to the debate.

Lorry parking is not a new problem, but it is growing worse and it is time to fix it. So what is the answer? Everyone we speak to, including the Road Haulage Association, the Freight Transport Association, Highways England, local councillors and our constituents, will give the same common-sense answer: we must build more lorry parks. That seems deceptively simple. We know that there is demand for more truck stops. For instance, Kent County Council’s surveys show that we have around 900 lorries a night parking inappropriately. Lorry parks in Kent are turning lorries away. Ashford lorry park turned away 252 trucks in a single night last year, so the demand is clearly there. Kent County Council has been taking action by identifying possible locations for new truck stops and talking to lorry park operators to gauge their interest. Indeed, the Ashford lorry park just yesterday submitted a planning application to expand from 390 to 600 places. Those extra places will be helpful, but the number still falls far short of the 900 extra places needed in Kent. As freight volumes continue to grow with the growing economy, one can predict that that shortfall will only increase.

However, that prompts a question: given that commercial operators run service stations and lorry parks in the UK, why have more truck stops not stepped up to serve the demand? What can we do to ensure that the shortfall in parking places is met, and quickly? What conversations has the Minister had with lorry park operators about what is stopping them expanding? What investigations has he made to determine how we can encourage planning applications for truck stops that can make their way successfully and speedily through the planning system? I recognise that fast-forwarding planning for lorry parks is difficult, given the experience in Kent with the Operation Stack holding area, but when we get that vital lorry holding area, will the Government ensure that it can also be used for overnight lorry parking? I want lorry parking to be included in all major road improvements—specifically the lower Thames crossing—not just in Kent, but across the country.