Mental Health Treatment and Support

Holly Lynch Excerpts

Wednesday 7th June 2023 Commons Chamber

[Holly Lynch (Halifax) (Lab)]

The Metropolitan police recently announced that it would stop attending mental health calls unless there was a risk to life. That has rightly generated much debate about the role of policing. However, it has not generated much debate so far on how, if we all believe in the right care, right person principles, we got into the position where the police are playing such a primary role, and where our mental health services are in that conversation. We know that the police are stretched. For all the Home Secretary’s talk of increased police numbers, the Government are only restoring the officers they have been cutting since 2010. Alongside those cuts, years of austerity have hammered other public services. West Yorkshire police tell me that mental health-related demand increased by 60% between 2012 and 2022. We have allowed policing to become the one-stop-shop that we ask to pick up the pieces when everything else falls apart. Mental health practitioners are also undeniably stretched, but mental health specialists are the right people to provide mental health support, especially when somebody is in crisis.

I am in no doubt that the police will have tried various other ways of encouraging their colleagues in mental health trusts to recognise the leadership role they are required to play in the response to a mental health issue. I know that because I also spend a great deal of time locally in Halifax trying to do the same, and secure specialist support for people who need serious and urgent help. When someone is in real distress with their mental health or approaching a crisis, too often West Yorkshire police, Calderdale Council, charities and other partners—even the hospital trust—work together with my team and I to do what we can. Yet I am afraid that too often it has proved incredibly difficult to bring qualified mental health specialists into the team to even be a part of the conversation. That results in the wrong care for people at their most vulnerable.

As my hon. Friend the Member for Manchester, Withington (Jeff Smith) said, that is a false economy, because it falls to all the other services and partners to try to provide a degree of care that they are not qualified to provide. We should not criminalise people who are unwell out of necessity. The police are right to take a step back. The question is what will it take for mental health trusts and professionals to be able to step forward?

As our motion sets out, patients suffering with mental health issues waited more than 5.4 million hours in accident and emergency last year and we have nearly 400,000 children currently waiting for treatment. If we are proactive about mental health, it will, as has been outlined, be cost-effective in the long term and we can prevent more people from being in a crisis situation. A Labour Government would recruit thousands of mental health staff to expand access to treatment, provide access to specialist mental health support in every school, establish open access mental health hubs for children and young people, and bring in the first ever long-term, whole-Government plan to improve outcomes for people with mental health needs.

I read the Government’s amendment to our motion. Does any MP who does their casework properly and is truly grounded in their constituency really recognise the picture it paints? The Government pat themselves on the back for hitting the target for interventions in psychosis. I checked what the target was. The standard is that 60% of people experiencing their first episode of psychosis will have access to a NICE-approved care package within two weeks of referral. We have all experienced supporting people in a psychotic episode. How long does it take to even get an assessment for that person to then hope that they are in the 60% of people who should get care within two weeks? It is not good enough. We need a Labour plan to deliver much more.

NHS: Long-term Strategy

Holly Lynch Excerpts

Wednesday 11th January 2023 Commons Chamber

[Holly Lynch (Halifax) (Lab)]

I want to start by sharing the experiences of my own office manager. He has two children who are one and four. They both became increasingly unwell on a weekend. They had temperatures just below 40°C and were becoming lethargic, with the four-year-old complaining of a sore throat and the younger having spots on her tongue.

Concerned as all parents are about the tragic fatal cases of children with strep A, and with the GP closed, they decided to call 111. They waited one and a half hours for someone to answer the call, and were told that the symptoms were such that they required a call back from a GP within six hours. Shortly after ending the call, my office manager received a text:

“Dear Parent/Guardian, due to unprecedented numbers of calls, we are unable to provide a call back at this time, and your case has been closed.”

As the children’s condition worsened, into the evening and on a weekend, the parents became increasingly concerned for their children and felt that they had no choice other than to take them to A&E. After an eight-hour wait in A&E, into the early hours, an exhausted doctor came to the waiting room and told patients that he was incredibly sorry but there was no way they could see everyone, and that anyone who could possibly leave should do so. My office manager was faced with the decision reluctantly to take his children home.

In his speech to the nation, the Prime Minister asked people to judge him on his results, saying,

“judge us on the effort we put in and the results we achieve.”

He is not seeking to be in government; he is the Prime Minister from a party that has been in government for 13 years. We are judging him by the results. During his interview at the weekend, he repeatedly refused to say whether he uses private healthcare, insisting it is not really relevant. I know he clarified that point at Prime Minister’s questions today, but the Government’s response to the crisis so far has not reflected the sheer panic and hopelessness that people, and parents in particular, feel if their loved ones and children are seriously unwell, and the NHS is so broken that they cannot get any help.

NHS Workforce

Holly Lynch Excerpts

Tuesday 6th December 2022 Commons Chamber

[Holly Lynch (Halifax) (Lab)]

It is a pleasure to follow my hon. Friend the Member for Salford and Eccles (Rebecca Long Bailey), who made an incredibly powerful speech.

I do not think I am being dramatic when I say that a genuine sense of fear has set in across the country about being in a position of needing to use the NHS. Almost every family now have a story about how they or, even worse, a loved one have needed to access care and have had a very difficult experience. People’s experiences range from waiting at A&E to waiting for an ambulance, from being unable to get a dentist appointment when they were in pain and urgently needed one to facing a wait years long to see a specialist. One member of my team called up on 25 November and was told, “You’re in luck: there’s been a cancellation at the GP’s, so they’ll book you an appointment—but it’s for a telephone consultation on 20 December.” The chronic pressures in staffing across the board are affecting healthcare in every part of the country.

[Margaret Greenwood]

This afternoon we have heard some horrendous stories about people waiting for ambulances: hideous delays of 16 hours or more for people in pain and sometimes truly tragic circumstances. Does my hon. Friend agree that that shows the abject failure of this Government to provide a health service that we can all be proud of?

[Holly Lynch]

My hon. Friend is absolutely right. Not only is there a massive impact on patient safety and care, with detrimental outcomes for patients, but there is a loss of service to others: while paramedics and ambulances wait outside A&E, there is an impact on care for all the other people who need that provision. My hon. Friend makes a really powerful point.

I want to focus on some key areas of the NHS workforce, starting with midwifery. The chief executive of the Royal College of Midwives, Gill Walton, has told the Health and Social Care Committee that England is more than 2,000 midwives short of the numbers it needs, and the situation is getting worse. The RCM’s analysis shows that midwife numbers fell by a further 331 in the year to November 2022. We need a plan because, as other hon. Members have said, the staffing shortages are driving further staffing shortages. More than half of all midwives surveyed by the RCM said that they were considering leaving their job, with 57% saying that they would leave the NHS in the next year.

In November last year, I joined a March with Midwives rally in Halifax, where midwives held up signs that they had made themselves and that said things like, “I’m a physically and mentally exhausted midwife”, and, “I can’t keep saying sorry for no beds, no midwives, no support and no time”. What really brought home how it is not just about the impact of short staffing on patients and patient safety was the signs that midwives’ children had made themselves. One sign said, “My Mum falls asleep on the driveway after work”. It was made by a girl who told me that she had come out of the house one morning ready for school, only to find that her mum had driven home after a nightshift, pulled on to the driveway and fallen asleep in the car because she was so exhausted. A younger child had made a sign that simply said, “Mummy being late from work equals me being a lonely kid”.

Case studies conducted by the Royal College of Midwives highlighted not just the strain on the service, but the strain in the workforce and their families. A midwife called Julia said:

“We’re reducing the time we give to women, having to close facilities, reduce antenatal education, postnatal visits cut to a minimum. Stretched physically is one thing, you can rest your body eventually when home, but the mind, the mind does not have an easy off switch. The constant unrealistic expectations on maternity staff is damaging their mental health, it’s impacting on the wider service and it’s putting women, babies and families hopes and dreams in danger.”

This is why a Labour Government with a commitment to train 10,000 additional nurses and midwives every year cannot come fast enough.

[Karin Smyth]

My hon. Friend is making some excellent points, particularly about the impact of those exhaustion levels on families. In my speech I spoke about the recruitment of families who looked forward to their jobs and were proud of working in the NHS. That is important to bringing future generations into the health service, and giving encouragement to young people in schools. It is still a fantastic career, but does my hon. Friend agree that helping young people not to be deterred by that negative publicity and helping them through training routes is a crucial way of solving the current workforce problems?

[Holly Lynch]

We have all told stories about the NHS heroes in our constituencies today, but my hon. Friend is right about the need to transform that into an attractive skills plan. Some of the midwives and their children whom I met were extremely proud to be in NHS families. Every member of those families is affected by that shared sense of pride, but also by that shared sense of exhaustion, and there are problems for the whole family when there are problems for the NHS worker. My hon. Friend has made a powerful point.

[Emma Hardy]

As I pointed out in my speech when I was talking about radiotherapy, the reason people are leaving the profession is to do with the work-life balance. It is not just a question of the number of people who are leaving midwifery, but a question of the number of people in midwifery who are reducing their hours to try to achieve that balance. Does my hon. Friend agree that something is seriously amiss when people have not fallen out of love with the job, but are simply finding that they cannot do the job while also maintaining the home life that they need?

[Holly Lynch]

Once again, my hon. Friend is absolutely right, as I know when I meet those children of NHS staff who hold up signs saying, “When my mummy is late home it means that I am a lonely kid”. As other Members have pointed out, when NHS workers are exhausted at the end of a shift but find that the cavalry is not arriving and there is no one to take over, they cannot walk out of their jobs as other people might be able to. They have to stay and deliver patient safety, rather than leaving those patients at risk. Questions about the life-work balance and childcare—who will feed the kids when they get home?—are not easy questions for workers in that position to answer.

We have to transform the experiences of mothers and families using maternity services. Like almost every other parent who has had to use those services in recent years, I can say that it is a massive worry. You are told, “Once your waters have broken and your contractions are this regular, come to the hospital”, but even after that point I kept being asked not to come to the hospital, because there was only one bed left and it might be needed for someone else. That is the last thing you want to hear when you are in labour. Worrying about staffing and bed shortages compounds what is already one of the most stressful experiences that women—indeed, parents—can go through.

Let me now say something about paramedics, and all those working on the frontline of our ambulance services. I have worked closely with paramedics, in particular with the GMB’s union representative, Sarah Kelly, on the Protect the Protectors campaign, and I have spent a day out with paramedics, seeing just how relentless their days are. Analysis carried out by the GMB found that there were 7.9 million calls for an ambulance in 2010-11, but by 2021-22 that had risen to 14 million, a pretty staggering increase of 77%. The monthly handover delays report from the Association of Ambulance Chief Executives reveals that the performance of ambulance services fell to its lowest ever level in October. The report shows that, across the month, 169,000 hours of ambulance crew time were lost due to delays. That meant that paramedics could not answer over 135,000 calls for help. That number represented 23% of ambulance services’ total potential capacity to respond to 999 calls. All three of these metrics are the worst in the NHS’s history.

Staff have balloted for industrial action, and we can see how they do not feel listened to and that they are carrying so much responsibility. My hon. Friend the Member for Ilford North (Wes Streeting) has already made this point powerfully from the Dispatch Box. None of us here in the Chamber today has to face the reality multiple times a day of knowing that, no matter how hard we work, there could be fatal consequences for the vulnerable people we are looking after because the system in which we work is fundamentally failing. We do not carry that burden; we ask the paramedics, and all NHS staff, to carry it.

We know that, in addition to this, too many workers—after making such an exhausting contribution to the NHS—are facing financial hardship for their efforts. Like in midwifery and other areas of the NHS, research indicates that one in 1,000 ambulance workers have left since 2018 to seek a better work-life balance or better pay, or to take early retirement. It is not that workers are asking for more pay for the sake of it; it is because inflation is at 11%, energy bills have gone through the roof and the cost of fuel to enable them to get to work has shot up. The National Institute of Economic and Social Research has predicted that around 30,000 households could see their monthly mortgage repayments become greater than their monthly income in the months ahead. If the Government got a grip of these factors, they would not have so many workers being forced to ask for more pay just to make ends meet. I ask the Government to please speak to workers, to work with their trade unions and to work through their concerns, which are very real.

Turning to NHS dentistry, I presented a petition to the Government on 1 November on access to NHS dental care, signed by 549 people online as well as a number of signatures in hard copy—some are still coming into my office. Like all MPs, I have had so much casework in recent months where local people simply cannot see an NHS dentist. The British Dental Association says that more than 43 million dental appointments were lost between April 2020 and April 2022, including more than 13 million appointments for children.

Dentistry is now the No. 1 issue raised with HealthWatch, with almost 80% of the people who contact the organisation saying that they find it difficult to access dental care. The General Dental Council says that almost a quarter of the population—24%—report having experienced dental pain in the last 12 months. More locally, HealthWatch in Calderdale contacted every dental practice across Calderdale last year to establish whether they were willing to accept new NHS patients, whether they would register a child and whether they were offering routine appointments. Every dental practice told HealthWatch that it could not currently register a new NHS patient of any age. It is the same story.

Data from the British Dental Association reveals that 3,000 dentists in England have stopped providing NHS services since the start of the pandemic. For every dentist leaving the NHS entirely, 10 are reducing their NHS commitment by 25% on average. A BDA survey from May 2022 shows that 75% of dentists plan to reduce the amount of NHS work they do next year, with almost half planning to change career, seek early retirement or enter fully private practice. As in other areas of the NHS, the combination of pressures and remuneration is driving what remains of a depleted workforce away. It is a self-defeating cycle that the Government have to step in to break.

Other Members have made points today about the potential of community pharmacies. Having worked in a pharmacy when I was in the sixth form doing my A-levels, it became clear to me that this was often the longest standing and most trusted relationship that members of the community had with a healthcare professional. The pharmacy was the shopfront that was always open during the pandemic, where people could go and meet somebody who knew them and knew their circumstances. That really is the value of community pharmacies. We know they have the capacity to do so much more, and hon. Members on both sides of the House have spoken about unlocking that potential and relieving some of the pressure on A&E departments and GP surgeries by empowering community pharmacies to deliver the work they are best placed to deliver because of their deep roots in our communities.

Labour has a plan for the NHS. It is costed, comprehensive and will save the NHS. In today’s debate, the Government have not had the humility even to acknowledge that there is a problem in the NHS, never mind having a plan of action. That is why a Labour Government cannot come soon enough.

Access to GP Services and NHS Dentistry

Holly Lynch Excerpts

Tuesday 21st June 2022 Commons Chamber

[Holly Lynch (Halifax) (Lab)]

In the time that I have this afternoon, I will focus on the incredible difficulties my constituents have had in accessing NHS dentistry. As others have said, the pandemic has intensified problems in our dental healthcare system, but the architecture for those problems was in place long before the pandemic. We have heard from the British Dental Association that more than 43 million dental appointments were lost between April 2020 and April 2022, including more than 13 million appointments for children.

Helen Hunter, chief executive of Healthwatch Calderdale, which serves my constituency, has argued that the pandemic has made

“a significant problem even worse”.

At a national level, dentistry is now the No. 1 issue raised with Healthwatch. Almost 80% of people who get in contact with the organisation say that they find it difficult to access dental care, with the General Dental Council saying that almost a quarter of the population—24%—report having experienced dental pain in the last 12 months.

Healthwatch Calderdale has been relentless in its campaigning on this issue. In August last year, it contacted every dental practice across Calderdale to establish whether it was willing to accept new NHS patients, whether it would register a child and whether it was offering routine appointments. Every dental practice told Healthwatch that it could not currently register a new NHS patient of any age. When neighbouring Healthwatch Kirklees did the same, it had the same outcome.

As others have said, having people get in touch with us, as MPs, because they cannot find a dentist is one of the most difficult issues that we are asked to contend with from a local casework perspective. As things stand, there is simply nothing we can do to help people. We speak to the CCG, we call the dentists, we speak to NHS England and we write to Ministers, but the capacity is not there because the system is so broken, and no amount of pleading from local MPs can fix it for someone in need.

One constituent rang more than 30 dental practices, each of which told them that it was not accepting new NHS patients. My constituent could find no available practices in Halifax and none across Calder Valley. There was not even a dental practice available in Huddersfield or Bradford. We have already heard a passionate argument from my neighbour, my hon. Friend the Member for Bradford East (Imran Hussain). People are encouraged to look further afield, but those practices are overwhelmed with their local demand, so going further afield does not solve the problem. When we have made representations on behalf of patients in Halifax, we have been advised to search for practices in Leeds, Barnsley and Wakefield. Members can imagine making that kind of journey to get to a dentist. Parents of children, for example, are asked to book appointments that do not impact on the school day. For them to be asked to travel 20 miles to try to speculatively get an appointment is just not good enough.

I recently met Rachel Dilley, chief operating officer of Town Hall Dental, which has dental practices in Calderdale, to gain a better understanding of the problems that they are experiencing. Town Hall Dental has had to set up a charity alongside its private and NHS work to help to fund dental treatment, check-ups and the vital oral cancer checks that dentists undertake. That is all necessary, but it goes underfunded. I commend Town Hall Dental for its charitable and fundraising work, but that should not be necessary.

In my desperation to get Government to act, I started a petition on my website for constituents, calling on the Government to improve NHS dental care provision in Halifax, so that residents can access care easily and locally. The petition has more than 500 signatories, and I will be presenting it in the Chamber in the days to come.

One local parent said to me:

“I have been making weekly phone calls to all Calderdale dentists in an attempt to (at the very least) get my children into a dentist as I value oral health greatly. However, I am yet to be successful in my goal which is becoming quite time consuming, as I now have a three year old daughter that has never even visited a dentist and 4 other children who have been without a check up in 5 years. That is half a decade with zero dental care.”

Another constituent got in touch to tell me that, since they had had no luck finding a nearby practice that would take NHS patients, they were forced to make a five-hour round trip to the Berkshire dentist that they had been registered with prior to moving to Halifax.

Such long waiting periods are also undermining what is functioning within the system. One constituent had to wait five years just for braces. When they finally got their braces, the orthodontist informed my constituent that they would need four teeth taken out. Having tried everywhere to find a dentist, my constituent told me,

“if I don’t find one, I won’t be able to keep my braces on.”

It is just madness. Another of my constituents, who was already dealing with mental health challenges, had been in pain and needed urgent medical treatment. Her friend got in touch to tell me that she was sent to A&E and advised she needed to see a dentist. She ended up seeing an NHS dentist in Elland for treatment, but they would not see her on the NHS and told her she had to pay for private treatment. Her friend could not believe that that could be allowed to happen, saying:

“How can this be the case when a young lady with mental health issues and no savings, in a medical emergency, needs to seek help from me, her friend to pay for urgent dental treatment”?

During the pandemic, I organised a roundtable discussion with local dentists, who shared with me the perverse ways in which NHS contracts are broken down into units of dental activity. The UDA system is just not functioning. If we needed any further confirmation, data from the BDA reveals that around 3,000 dentists in England have stopped providing NHS services since the start of the pandemic. Perhaps even more worryingly, for every dentist leaving the NHS entirely, 10 are reducing their NHS commitment by 25% on average. A BDA survey from May 2022 shows that 75% of dentists plan to reduce the amount of NHS work they do next year, with almost half planning to change career, seek early retirement or enter fully private practice.

That is where the current, broken contract system has got us. I urge the Minister, if she believes in being able to see a dentist on the NHS, to scrap the current system, start again and find a way to make the contracts work. One third of people see a dentist privately, but 71% of those people say they do not do so through choice. As the cost of living crisis continues to affect families, more and more people will be priced out of private treatment by inflation and rising bills and living costs.

My hon. Friend the Member for Washington and Sunderland West (Mrs Hodgson) earlier described this as an existential crisis, and it very much is. I say to the Minister, “Please, please fix it.”

--- Later in debate ---

[Maria Caulfield]

No, I will not.

We are also delivering zero tolerance to abuse through the Police, Crime, Sentencing and Courts Act 2022. Labour talk the talk, but it was those of us on the Government Benches who voted to double the maximum sentence for those who abuse our emergency care workers. Labour actually voted against giving the Bill a Third Reading. That tells us all we need to know.

With the time I have left—

[Holly Lynch]

Will the Minister give way?

[Maria Caulfield]

I will not give way. Members did not—

Covid-19 Update

Holly Lynch Excerpts

Thursday 13th January 2022 Commons Chamber

[Sajid Javid]

I thank my hon. Friend for his support. I will ensure that the website is updated in the way he suggests as soon as possible.

[Holly Lynch (Halifax) (Lab)]

Recent data suggest that just 4% of teachers say that readings on classroom carbon dioxide monitors are above the safe threshold set by the Department for Education. The Secretary of State will be aware that ventilation is becoming a massive challenge in schools, and in primary schools in particular. What conversations is he having with his colleagues at the Department for Education to ensure that children can continue to learn in classrooms, but can do so as safely as possible, protecting them and the wider community?

[Sajid Javid]

The hon. Lady raises an important issue: ensuring we do all we can as a Government to work with schools to protect schoolchildren so they can stay in school. No one wants to see what happened before with the lockdowns and children not being able to attend school in the usual way. That is why I hope she welcomes the recent announcement by my right hon. Friend the Education Secretary on a huge new investment in ventilation. My right hon. Friend takes this issue incredibly seriously, working with schools up and down the country, and seeing what more can be done.

Covid-19: Community Pharmacies

Holly Lynch Excerpts

Thursday 11th March 2021 Westminster Hall

[Holly Lynch (Halifax) (Lab) [V]]

It is a pleasure to serve under your chairmanship, Sir Graham. I feel there will be a great deal of consensus over the course of this debate.

I have shared my experiences of my first job working in my uncle’s community pharmacy on numerous occasions in Parliament. Indeed, I secured a Westminster Hall debate on the role of community pharmacies in October 2019. I spoke of how there was never a dull moment in a pharmacy. I recalled the time a frantic mother handed me dead headlice taped to a piece of cardboard, and someone asking me to run a pregnancy test on a bottle of cough medicine before discreetly letting me know it was actually a urine sample and the bottle was the most secure way that she could think of getting it to the shop.

The lighter moments aside, what has always stayed with me from my time working evenings and weekends in a local chemist shop was that so often, particularly for older people, someone’s relationship with the pharmacist was the longest standing and most trusted relationship they had with any clinical professional. When we think about the pandemic, we think what an invaluable community asset pharmacies are, and I take this opportunity to thank all those who have worked so hard to keep pharmacy doors open during the most difficult times of this crisis.

Prior to the crisis, pharmacies had their budgets cut back in 2016, with a reduction from £2.8 billion in 2015-16 to £2.59 billion in 2017-18. That represented a 4% reduction in funding in 2016-17 and a further 3.4% reduction in 2017-18. When inflation is factored in, as well as all the services that pharmacies already offer free of charge—costs that they absorb—it dealt an almost fatal blow to pharmacies. The then Minister told the all-party parliamentary pharmacy group that he expected between 1,000 and 3,000 pharmacies to close as a result, because they would simply no longer be viable, with multiples and chains of pharmacies best placed to weather the cuts, and independent and more rural chemists left at a disadvantage.

That was in 2016 and it set the landscape going into the pandemic. When the pandemic started, these already underfunded pharmacies were called on to be a crucial element of the UK’s frontline response, dealing with a 20% rise in demand for medicines and a 35% increase in required prescriptions. They experienced a doubling in demand for home deliveries of medication and a tripling in calls from the public. According to the PSNC pharmacy advice audit, pharmacies have been providing healthcare advice to more than 600,000 people every week. We owe a great debt to these underfunded and overworked pharmacies and their teams, who went above and beyond to relieve pressures on our NHS.

I commend the work of the all-party parliamentary pharmacy group under the leadership of the hon. Member for Thurrock (Jackie Doyle-Price) for its detailed work on this issue. I ask the Government to reflect on the ask within its recent flash inquiry report. We need pharmacists—that has to be the bottom line—so why are we putting these perverse financial barriers in their way? They are providing a great deal of care, as well as social care, to those who most need it. We have to find ways of looking after them into the future.

Covid-19 Vaccine Roll-out

Holly Lynch Excerpts

Tuesday 8th December 2020 Commons Chamber

[Matt Hancock]

Yes, if she can travel. When the NHS calls, my advice to my hon. Friend’s constituent is to get that card with that invitation and to phone up my hon. Friend, and he will give her a lift.

[Holly Lynch (Halifax) (Lab)]

This is incredibly welcome news today. Looking ahead to Christmas, I have been approached by a number of emergency service workers in the NHS, policing and other sectors who will miss out on the opportunity to see loved ones because of the window for household mixing—they will still be working on the frontline in the fight against the coronavirus crisis during that period. I appreciate that this is a difficult one to crack, but has the Secretary of State given any consideration to flexibility to ensure that those who really deserve a Christmas with their loved ones can still get it?

[Matt Hancock]

I have a huge amount of sympathy with what the hon. Lady says, and we have looked into this. We are not proposing to extend the Christmas bubbles, but we hope that NHS trusts and employers across the NHS can look compassionately at exactly this situation for all those brilliant colleagues who are working so hard and have had such a tough year.

Family Visits in Health and Social Care Settings: Covid-19

Holly Lynch Excerpts

Wednesday 11th November 2020 Westminster Hall

[Holly Lynch (Halifax) (Lab)]

It is a pleasure to serve under you as Chair in this important debate, Ms McVey. I thank the hon. Member for Beaconsfield (Joy Morrissey) for securing it and for sharing the harrowing story of Jamie from her constituency. It will stay with every single person who heard it.

I will begin my remarks, as others have done, by sharing a passage from a letter from a constituent called Penny Hutchinson. Her mother, Yvonne, is living with dementia in a care home in Halifax. She said: “Imagine that you had not seen your mum for eight months because she has been locked away in isolation with no meaningful family contact. Then imagine the huge feeling of relief and elation as restrictions are lifted and the vulnerable are told they no longer need to shield. Now imagine the feeling of complete desolation when you discover that those freedoms and privileges don’t apply to your mum and dad. Add to that the overwhelming feeling of guilt when you try to explain to your loved one why you can’t come in to see her, hold her hand or give her a hug, and that there is no end in sight.” I sent that letter on to the Secretary of State for Health and Social Care because it said more than I could have done on her behalf.

Like Penny’s mum, more than 70% of people living in care homes have a form of dementia. Visits from family members have a really important part to play in the cognitive state of those residents, but instead of being able to be close to loved ones at this anxious time, the best they can hope for is a socially distanced meeting behind plexiglass or outside in this weather. Although that is well intentioned, it can often cause confusion and distress.

Efforts to protect those who are older and clinically vulnerable by managing contact diligently will still of course have to be a priority in the coming weeks as we strive to avoid outbreaks in care homes and manage them where they have occurred. The Alzheimer’s Society has been keen to make it clear that for those with dementia, limiting visits in that way can lead to their symptoms increasing and their condition deteriorating more rapidly, ultimately leading to premature death, so a rebalancing of those risks is required.

I want to put on the record my thanks to Calderdale’s director of public health, Debs Harkins, who has worked tirelessly throughout the pandemic alongside her colleagues, including the director of adult services and wellbeing, Iain Baines. They have both met Penny and others to try to make progress.

Before I move on to the solutions, I want to point out that when I received a response to Penny’s letter from the Minister’s civil servants, it said: “The Government’s guidance for visiting arrangements for care homes published on 22 July allows for local decision making based on the assessment of the director of public health and the care provider. Further details can be found at the gov.uk website by searching for ‘visiting care homes during coronavirus’.”

I followed that link, and at the time it stressed that:

“For local areas with a high local COVID alert level (high risk or very high risk)”—

Halifax has been in tier 2 equivalent restrictions since July—

“visiting should be limited to exceptional circumstances only”,

such as end-of-life care. That gives no discretion for directors of public health, and puts them in an impossible position with family members desperate to see loved ones. Some clarity on decision making for visits would be incredibly welcome.

I imagine that everybody in this debate feels that the situation is far from acceptable—we have heard from many hon. Members already—so what would make a difference? I have been pleased to see news this week of mass testing, rapid testing and vaccines being developed at pace. We must ensure that residents of care homes, those working in care homes and designated family members are the first in line to access them as they become available. Treating designated family members as key workers would be a logical step. It would not overwhelm the system and would ease the distress of so many care home residents and their families.

We all know that social care workers have been among the many heroes of this crisis. They have carried themselves with dignity, honour and respect in the face of unimaginable pressures. However, as they tell us, not even they can provide full care to their residents without the support of family members. For those with dementia, family visits are not privileges or luxuries but a vital part of their care and treatment. Therefore, it seems appropriate to consider measures such as this—the shadow Minister has also been calling for it—which would ease the considerable pressures that social care workers have been placed under and the mental anguish faced by separated families. We must work together to reach a better settlement for care home staff, residents and their family members.

When this is all over, we will bring the economy back from the brink, but there will be some opportunities that we will never get again. Let us not regret not doing everything possible when we had the chance.

Covid-19 Update

Holly Lynch Excerpts

Tuesday 8th September 2020 Commons Chamber

[Matt Hancock]

This is another important question about how we can provide support locally, especially in the west midlands, where it is so important, especially with cases rising, not only that we have the national response that we are discussing in this Chamber, but that we ensure that the local community, which my hon. Friend supports so effectively, can get the support it needs. I am happy to write to her with details of the extra funding that we have put into her area and to discuss with her what more might be done.

[Holly Lynch (Halifax) (Lab)]

I appreciate that we must keep a very close eye on infection rates and respond quickly and effectively. The Government say that they are listening to local leaders on the local restrictions, yet the very clear data-led recommendation from myself and Calderdale’s leaders last week was for the restrictions to be lifted in Halifax, with a continued focus on test and trace and the incredibly effective targeted community work that has been undertaken by Calderdale Council. Now that Calderdale has significantly lowered infection rates in areas that do not have the restrictions, can the Secretary of State tell me when Halifax will see those restrictions lifted and what else needs to happen to make that a reality?

[Matt Hancock]

We look at the issue of restrictions in Halifax every week. Calderdale has seen a fall in the number of cases; it is an example of a local lockdown being effective. I was really pleased that we were able to take some parts of the local authority area out of the restrictions 10 days or so ago now, and it was very good to be able to make that progress. I accept that we had to leave Halifax in the restrictions and I look forward to working with the council and with the hon. Lady and other local colleagues. We shall consider the matter again this Thursday.

Independent Pharmacies

Holly Lynch Excerpts

Monday 13th July 2020 Commons Chamber

[Bob Seely (Isle of Wight) (Con)]

It is a pleasure to open this debate, which was prompted by a letter from an independent pharmacist in my constituency, Mr Tim Gibbs, who runs the Yarmouth pharmacy. Those who know it will know that it is not far from our beautiful harbour in Yarmouth and just opposite Yarmouth castle. I am delighted that this Minister is on the Front Bench, as I know she is a great supporter of pharmacies, pharmacists and indeed independent pharmacists. I am aware that the Health Secretary spoke at the National Pharmacy Association today. He spoke eloquently on the need for a major winter flu vaccination programme, which, clearly, we would welcome.

I will not speak for too long, as I am aware that one or two others wish to speak and it is getting late in the day, but I wish to cover some of the issues of concern to not only pharmacists, but independent pharmacists, who are especially important in isolated and rural communities, as other Members here, including those from places such as Cornwall, will testify. I have six independent pharmacists in my patch and all are highly valued. They include Tim in Yarmouth, Freshwater, Seaview, Ryde and Regent, which covers both East Cowes and Shanklin. I am grateful to Gary for taking the time to chat last week about some of the issues that have faced him.

Although many healthcare providers closed their doors during the covid pandemic, pharmacists stayed open, often at risk to themselves and their staff. For many people in our communities, NHS pharmacies were the visible face of healthcare on the high street. It is to their great credit that they stayed open and continued to serve their patients, often delivering medicines, at their own cost, to the homes of vulnerable and at-risk patients to make sure that those patients had what they needed. Pharmacy staff saw patients in person and ensured that the public—particularly vulnerable patients—had a consistent and safe supply of medicine. In doing so, they took considerable pressure off other elements of the health service, including GPs, who were often answering calls on the phone, and A&E.

However, I know from talking to Tim, Gary and other pharmacists in my patch that they face considerable financial insecurity on top of all the other problems. That is worse for pharmacists such as Tim who have to rely on over-the-counter trade. In Yarmouth, where there are a lot of yachts at weekends, he can usually make up the decline of income in other areas by selling soap and all the other good things that chemists sell, but in the covid period those sales took a significant hit. The same has been true for the independent pharmacies and many of the chemists in my patch. They have incurred many thousands of pounds in additional monthly costs from staying open and serving the community, and some of my independent pharmacists have even relied on volunteers.

Pharmacies have paid for the costs of installing screens, buying PPE—although I think the Isle of Wight Council helped Tim out after he requested it on a couple of occasions—hiring locums, paying overtime and absorbing the increases in the wholesale prices of medicines, which pharmacists are not allowed to pass on to their customers. That has created serious cash-flow problems.

I am very grateful, as we all are, that the Government provided £300 million in emergency loans to the sector at the outset of the crisis and have provided an additional £70 million since. Those are significant sums of money. The loans are, however, something of a sticking-plaster solution to cover the immediate covid costs that pharmacists have incurred and to make up for the longer-term shortfall. If pharmacists are left holding the bag for the costs that they have incurred through serving their communities in the past few months, many of them, including Tim, are worried that they will be forced to shut down in the next year or two. I believe that that would be a national shame. The ongoing uncertainty is an additional burden that pharmacists just do not need.

All pharmacists are valuable and they all play an important role. but because independent pharmacists are embedded in their community and represent a friendly, valued and, above all, trusted voice, they take pressure off A&E, GP surgeries and other areas of the NHS. On the Island, the number of GPs sits at roughly the average, but as the Minister well knows, we are struggling somewhat to make sure that there is an adequate supply of GPs to provide the primary care that this country needs.

I know that the Minister is a friend to pharmacists. Can she say something to reassure pharmacists—especially the independent ones—in my constituency and many others that the Government understand their valued and somewhat unique role, over and above chains of pharmacies, and that the Government wish to support them?

[Holly Lynch (Halifax) (Lab)]

I am grateful to the hon. Gentleman, who is making a powerful speech, and I congratulate him on securing this Adjournment debate. Having worked in an independent pharmacy while I was at school, I recognise the trusted relationship that he describes between the pharmacist and the community that they serve. When the funding formula for pharmacies changed in 2016, the then Minister told the then all-party group on pharmacy that between 1,000 and 3,000 pharmacies were expected to close because they would no longer be financially viable in the face of the cuts, so the outlook for pharmacies was already tough and bleak. A significant number of the pharmacies that have closed have been independent pharmacies. Does he agree that that is a real shame, and a real loss to those communities?

[Bob Seely]

I thank the hon. Member for making that point. I was just about to quote those statistics myself, but I thank her for teeing up the next bit of what I would like to say.

As I understand it, the budget for community pharmacies is £2.6 billion—a significant amount of money but quite a small proportion of the NHS’s total budget. It stretches to cover some 11,500 community pharmacies, serving the majority of the population of the United Kingdom—about 56 million people. On average, each one serves about 5,000 people per month and dispenses 7,300 prescriptions.

In the last four years, as the hon. Member says, the funding for pharmacies has shrunk by a significant amount; I am quoted a figure of approximately £200 million. Tim and other pharmacists in my patch are concerned that there is now going to be significant additional pressure, and we have seen statistics to suggest that up to 3,000 pharmacies could close for good. That has not happened yet; these are threats. Some have closed, but the majority are still struggling on.

I believe that would be short-sighted in the extreme. I am sure the Minister agrees that a sustainable pharmacy sector is a critical part of the NHS network in this country because, as I said, it takes pressure off both A&E and GPs. We badly need it. Having used an independent community pharmacy myself, I know the added value of having somebody trusted to talk to, whether about a bunged-up ear because I swim too much—well, not at the moment—or about more serious concerns.

NHS pharmacies are ready and willing to support the test and trace programme—something I have knowledge of in my patch due to our experience trialling the app, which sadly was not taken further. They could help to ensure support for test and trace, for home testing kits, and certainly for the winter vaccination programme, which is likely to be of increased significance this year because of the potential for phase 2 of covid, which clearly we all hope does not happen.

There is strong public support for community pharmacies. A recent opinion poll showed that 81% hold a favourable view of pharmacies, 78% value a face-to-face relationship—I wish Members of this House had those sorts of approval ratings; we live in hope—and more than half want to see emergency covid funding turned into a permanent grant versus the significantly smaller amount who want to see it repaid.

Crucially, the public are ahead of the health bureaucracy in seeing the benefit of having this network of highly trained healthcare professionals in many communities in Britain; 84% say that the NHS should do more to make use of pharmacists’ skills. It does seem to be a bit of a wasted resource when we have people with so much skill and ability in dispensing medicine and in being the first port of call for many when they are feeling under the weather.

Some 71% of people think pharmacies should be able to expand their offering to take pressure off the NHS. I completely agree. I wonder how we can work towards that betterment, which is certainly in all our interests considering the relatively small amount of money compared with the overall NHS budget that goes towards pharmacies, specifically community pharmacies.

I will round up and let other Members speak, but may I tempt the Minister to talk about how she can support community pharmacies—the six in my patch but also the 11,500 across Britain? What can she say to reassure us that the financial support will be there? Losing independent pharmacies would be much more expensive in the long run than providing modest additional sums to ensure that we help keep their pharmacy businesses viable, especially during the covid period, when other elements of their business—the cash trade of the chemist—have clearly been declining. I very much look forward to her response.