Holly Lynch debates with Department of Health and Social Care

There have been 6 exchanges between Holly Lynch and Department of Health and Social Care

Tue 8th September 2020 Covid-19 Update 3 interactions (117 words)
Mon 13th July 2020 Independent Pharmacies 3 interactions (132 words)
Mon 7th October 2019 Hypermobility Syndromes: Healthwatch Calderdale’s Report 5 interactions (123 words)
Wed 2nd October 2019 Community Pharmacies (Westminster Hall) 4 interactions (1,714 words)
Tue 25th June 2019 Living with Dementia (Westminster Hall) 3 interactions (1,095 words)
Wed 28th June 2017 Health, Social Care and Security 3 interactions (783 words)

Covid-19 Update

Holly Lynch Excerpts
Tuesday 8th September 2020

(1 week, 4 days ago)

Commons Chamber
Read Full debate Read Hansard Text
Department of Health and Social Care
Matt Hancock Portrait Matt Hancock - Hansard

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 Portrait Holly Lynch (Halifax) (Lab) - Hansard

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 Portrait Matt Hancock - Hansard

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

(2 months, 1 week ago)

Commons Chamber
Read Full debate Read Hansard Text
Department of Health and Social Care
Bob Seely Portrait Bob Seely (Isle of Wight) (Con) - Hansard
13 Jul 2020, 12:02 a.m.

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 Portrait Holly Lynch (Halifax) (Lab) - Hansard

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 Portrait Bob Seely - Hansard

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.

Hypermobility Syndromes: Healthwatch Calderdale’s Report

Holly Lynch Excerpts
Monday 7th October 2019

(11 months, 2 weeks ago)

Commons Chamber
Read Full debate Read Hansard Text
Department of Health and Social Care
Craig Whittaker Portrait Craig Whittaker - Hansard
7 Oct 2019, 9:20 p.m.

The hon. Gentleman is right in a lot of what he says, but the thing about hypermobility syndromes is that they are incredibly complex. As I said earlier, things like the digestive system, the immune system and teeth can all be factors. It is not like when someone goes to hospital with a broken leg, and we know what the problem is. There are multiple complexities around this disorder, so it is difficult from a professional point of view, which I will speak about later, but he is right in much of what he says.

From the Healthwatch work on the subject, it is clear that many people—specifically those with hypermobile Ehlers-Danlos syndrome or hypermobility spectrum disorder—are not receiving the appropriate NHS care, as the hon. Member for Strangford (Jim Shannon) indicated. It is not clear how many people in the United Kingdom are affected by hypermobility syndromes. Hypermobility is often misdiagnosed as fibromyalgia, osteoarthritis, seronegative arthropathy, psychogenic rheumatism, depression or chronic fatigue syndrome. I do not know about you, Madam Deputy Speaker, but after that description, I need to lie down in a darkened room. So imagine how patients with hypermobility-related problems feel when they have to battle alone with immense health problems, often for years before obtaining a diagnosis, only then to face immense difficulties in accessing appropriate NHS healthcare to manage their complex and multi-system disorders and conditions. These patients describe feelings of being let down by the system, as well as huge frustration at both the widespread lack of understanding about their condition from medical professionals and the lack of appropriate care for their condition.

Holly Lynch Portrait Holly Lynch (Halifax) (Lab) - Hansard
7 Oct 2019, 9:20 p.m.

Will the hon. Gentleman give way?

Craig Whittaker Portrait Craig Whittaker - Hansard
7 Oct 2019, 9:20 p.m.

It would be an honour to give way to my neighbour.

Holly Lynch Portrait Holly Lynch - Hansard

I am grateful to my neighbour for giving way. I thank him for securing the debate and congratulate him on articulating a number of those medical conditions incredibly well. I have two constituents I am aware of who have a diagnosis of Ehlers-Danlos syndrome. I was incredibly disappointed earlier this year when the clinical commissioning group informed me that Manchester Royal Infirmary, which had been delivering a degree of care for those with hypermobility, was going to have to stop accepting tertiary referrals for that support. Not only are people struggling to get a diagnosis after years, but regional specialist care is then not available once they have received a diagnosis. We really need to address that.

Craig Whittaker Portrait Craig Whittaker - Hansard
7 Oct 2019, 9:20 p.m.

My hon. Friend and neighbour is right. Because there is a lack of understanding about this syndrome and because, not only at GP level but in some specialist areas, areas that do particularly well on this issue are now having to close the list to outsiders because they are becoming over-subscribed. She is absolutely right; that is one of the issues. When I get to the end of my speech, one of my recommendations, which the Minister can hopefully address, is having a regional centre for this condition.

Healthwatch’s report was published in July this year, and it focuses primarily on patient experiences. It presents the overwhelming negative NHS experiences of adults with hypermobility syndromes, and it makes for challenging reading. It is 70-odd pages, and it is not a pleasant read at all. The report took evidence from 252 people via focus groups and a questionnaire. Approximately 86% of the participants had a diagnosis of hypermobile Ehlers-Danlos syndrome, or what would now be termed hypermobility spectrum disorder. A further 13% had other diagnoses linked to hypermobility syndromes. It is precisely those people who are presently excluded from NHS specialised rheumatology services, and it is those people on whom I would like to focus this evening.

The report identifies problems with NHS care in many different areas. It highlights that people are experiencing difficulties obtaining a diagnosis: 76% of respondents indicated that obtaining a diagnosis had been challenging; 22% described the process as difficult; and a staggering 54% stated that it had been very difficult. Frequently, people described the diagnostic process as leaving them feeling depressed, alone and isolated as a consequence of the lack of understanding that appeared to be the norm among professionals. This and the level of disbelief by professionals, as the hon. Member for Strangford pointed out, have led to people doubting themselves, despite their symptoms and, of course, their experiences.

Common terms used to describe how the diagnostic process made people feel included being angry, belittled, desperate, and feeling like a liar or a fraud, and some even said they were feeling as though they were going a little crazy. By contrast, obtaining a diagnosis generated feelings of hope and reassurance, and the feeling that they had been vindicated or were relieved at having an explanation of their difficulties.

On the road to diagnosis, many tests and procedures were commonly performed—sometimes repeatedly, sometimes in isolation and sometimes in conjunction with others. Many people reported that they had had many blood tests, scans and X-rays. A number of respondents spoke of being tested exhaustively over many years. For some people, this extensive testing was a route to an eventual diagnosis and, in some cases, supported interventions, but for others, this resulted in delaying the diagnosis, misdiagnosis and delayed support. A pathway would not only be beneficial to patients, but would also reduce the costs and associated wastage to the NHS of all the unnecessary tests, which are often carried out on a repetitive basis, as they are not giving the anticipated results at the time.

Participants reported that between one and six health professionals were involved in the diagnosis. One significant theme of the responses generally was the failure of medical professionals to link together the variety of symptoms and health issues being reported and a focus on the presenting symptom only. Perhaps unsurprisingly, many participants said that they had received other diagnoses, rather than a diagnosis of hypermobility syndrome. Altogether, a staggering 62 other conditions were named during the process.

The complex and diverse symptoms resulting from hypermobility syndromes have led to many people being misdiagnosed. They were told, for example, that their symptoms were related to mental health issues or mental illness, such as depression, anxiety or stress, and this resulted in subsequent referrals to mental health services, as health professionals could not find a physical cause of the symptoms. People also reported that health professionals had ascribed the symptoms to excess weight, clumsiness or lack of physical exercise. Misdiagnosis, partial diagnosis or stereotyping left people feeling upset and patronised by health officials and led to feelings of anger, frustration, rejection and defeat.

Inadequate knowledge among health professionals was another key theme of the report, and that also emerged from the data. The majority of the respondents referred to health professionals as not aware of, not knowing about or not believing in the wide-ranging symptoms and the health and life impact of hypermobility syndromes on the patients. GPs were specifically mentioned in this regard, and rheumatologists and physiotherapists also received mixed feedback about their knowledge. Some people who had a diagnosis also talked of medical professionals disbelieving the conditions, with some being told, “It’s all in your head,” or assuming that people were just after drugs, rather than genuinely being in pain, despite the diagnosis.

Another key theme that emerges from the data is poor communication between health professionals, both between departments in the same service and between one medical facility and another. Communication between professionals is by no means consistent. Communication failures occur frequently and conversations are repeated at consultation. Again, this experience is described as exhausting and demoralising. A number of participants also reported difficulties in persuading GPs to refer them to consultants. Most people who responded to the survey said that they had either no NHS care or inadequate NHS care. The life impact of these difficult NHS experiences is significant, with people having to give up work, experiencing difficulties in education, having problems with social relationships, the breakdown of families and financial problems, too.

Community Pharmacies

Holly Lynch Excerpts
Wednesday 2nd October 2019

(11 months, 3 weeks ago)

Westminster Hall
Read Full debate Read Hansard Text
Department of Health and Social Care
Holly Lynch Portrait Holly Lynch (Halifax) (Lab) - Hansard
2 Oct 2019, 9:29 a.m.

I beg to move,

That this House has considered the role of community pharmacies.

May I say what a pleasure it is, Sir David, to serve under your chairship this morning, and to have you join us for this important debate?

Between the ages of 14 and 18 I worked in a local chemist shop two evenings a week and some Saturday mornings. There were the usual first job responsibilities: restocking shelves, cleaning, and meeting and greeting customers and patients who were not always well, for a variety of reasons. I loved it, because there is never a dull moment in a pharmacy. I remember a frantic mother handing 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 that it was actually a urine sample rather than cough medicine and that that was the only secure way she could find of transporting it to the chemist shop.

The shop was exactly what it said on the tin. It was a community pharmacy, and the whole community would walk through those doors for advice, medication and reassurance. I remember the older people, whose relationship with the pharmacist was the longest-standing and most trusted relationship they had with a clinical professional. I remember a long-term recovering addict, who would bring his daughter with him every day. We watched her grow up, and supported him as he worked hard to stay the course on his journey to recovery.

That is why community pharmacies matter, and it is why they work. However, it appears from the community pharmacy contractual framework announced in October 2016 that that was not appreciated. There was a reduction from £2.8 billion in 2015-16 to £2.68 billion in 2016-17 and £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 and whose costs they absorb, that was a near fatal blow to the service nationwide. The then Minister, the right hon. Member for North East Bedfordshire (Alistair Burt), told the all-party parliamentary group on pharmacy that he expected between 1,000 and 3,000 pharmacies to close, as they would no longer be viable in the face of the cuts, with multiples and chains of pharmacies best placed to survive, and independent and more rural chemists left at a disadvantage.

In March this year the Pharmaceutical Services Negotiating Committee found that 233 community pharmacies have closed in England since the Government funding cuts were introduced. Sixty-nine were independent pharmacies and a further 22 were independent multiples. The number of closures anticipated by the right hon. Member for North East Bedfordshire has not yet been reached. However, I have spoken to people in pharmacies, and others contacted me ahead of the debate, and many are operating at a loss, clinging to the hope that the funding arrangements will improve, but with a business model that, as the right hon. Gentleman predicted, is not viable.

The impact that the funding cuts have had on patients is really difficult to justify. The cost of delivering prescriptions to those who find it hard to leave the house was previously absorbed by local chemists, but that is no longer possible. Boots was the last of the big four chain pharmacies to start charging for delivery over the summer, with all patients having to pay £5 for delivery, or £55 for a 12-month delivery subscription, by the end of the year. All have some exemptions for particularly vulnerable customers, but Boots, LloydsPharmacy, Rowlands Pharmacy and Well have all reduced free deliveries, or started charging for delivery.

There is no funding for arranging drugs in trays. When I worked in a pharmacy, it was a big undertaking to arrange medicines in trays by time and day, predominantly for older people who needed that degree of support if they were to live well for longer by taking their medication at the right time and in the right doses. Pharmacies were delivering a degree of invaluable social care, and that is no longer possible in the present financial climate. We can all see what the consequences will be. Ultimately the result will be more costly clinical interventions.

In addition to the financial pressures that pharmacies face, drugs shortages are now becoming debilitatingly resource-intensive across the NHS. Pharmacies have no ability to absorb the costly hours spent sourcing drugs or speaking to GPs about possible alternatives. A Bristol GP, Zara Aziz, recently wrote in The Guardian of her experience of medicines shortages. She explained that EpiPen users in Bristol are now being told to use their old EpiPens up to four months after the expiry date. She also tells the story of a patient in acute distress from arthritis pain when a commonly used anti-inflammatory, Naproxen, suddenly became unavailable. Eventually, a very small quantity was found, but the patient was forced to use it sparingly, not as she had been prescribed, as none of the alternative anti-inflammatories would have been suitable for her.

My hon. Friend the Member for Redcar (Anna Turley) shared with me a photo of a poster from Pharmacy Magazine, which has gone up in her local hospital. It says, “Please don’t blame us for the NHS medicine shortages. It is a nationwide problem. Please ask your local MP to help.” The poster included contact details of local MPs handwritten on the bottom. We very much hear those concerns, and we are here to ask the Minister to get a grip on this problem.

Shortages are caused by a combination of different issues. The implications of Brexit are inevitably a factor that will play out over the coming weeks and months. However, we know that the NHS and the UK are potentially losing out to more profitable and attractive markets. In addition, the stockpiling, as a precaution, of certain drugs that are harder to source, coupled with the deliberate and more alarming manipulation of the markets by some wholesalers to deliberately push up prices, is having a detrimental effect. New regulations are also having an impact on manufacturing processes.

On top of that, cash flow is a massive challenge in community pharmacies. Community pharmacies pay out for drugs and are reimbursed by the Government the following month. The situation is made even tougher still, however, because they are not always reimbursed what they have paid out for drugs, particularly for drugs that are in short supply. By law, pharmacies have to do everything in their power to source a drug and dispense it, even where prices have become inflated due to a shortage. Let us take Naproxen as an example. One of my local pharmacies tells me that earlier this year the cost of a box shot up from about 26p to about £15. The tariff price paid by the Government to reimburse pharmacies for Naproxen peaked around February, at £12.50 a box. The medicines shortage is having the perverse effect of forcing pharmacies to dispense at a loss. In previous budgets, there might have been just enough for the pharmacy to absorb this cost. Those days are long gone. The system is clearly no longer fit for purpose.

Earlier this year, the Government introduced the serious shortage protocol in the Human Medicines (Amendment) Regulations 2019. It was intended to be a safety mechanism to help cope with any serious national shortage. It gives pharmacists the ability to dispense a reduced quantity, alternative dosage form or generic equivalent to that stated on the prescription. There would be a small payment to pharmacies for undertaking that process. Despite pharmacists and GPs feeling that they are spending unprecedented amounts of time sourcing medicines or researching alternatives, not a single drug has appeared on the list, which means that pharmacies and GPs do not get paid any extra to compensate them for the time they now have to dedicate to that element of dispensing.

Although there are no drugs on the serious shortage protocol, there is a separate concessions list, which acknowledges that, due to a shortage of a drug, the price has changed. At the end of September, there were 45 drugs on that concessions list. Again, inclusion on that list does not acknowledge the time involved in having to source the drugs, which is becoming the largest part of the pharmacist’s day. Nor is there any attempt to fund that work.

There was some hope for community pharmacies more broadly in the community pharmacy contractual framework published in July, which takes effect from October 2019 through to 2023-24. The five-year deal commits to not cutting the budget any further. However, when inflation is taken into account, it will still see pharmacies unable to meet costs, for all the reasons I have outlined.

Strangely enough, what the framework does do is realise the potential for pharmacies to alleviate pressures on the wider NHS, paving the way for a much more integrated approach. The 111 service is now able to refer a patient directly to a pharmacy for an appointment. The framework seeks to expand the delivery of clinical services in pharmacies. It is all great stuff, which is very welcome, but I return to the clear warning given by the then Minister back in 2016 that between 1,000 and 3,000 pharmacies will not be viable and will be forced to close if overall funding does not increase.

Mr Gregory Campbell (East Londonderry) (DUP) - Hansard

I congratulate the hon. Lady on securing the debate. Given the pressures all our A&Es and acute hospitals face, does she agree that the community pharmacies in many areas across the UK do a magnificent job—particularly those specialised pharmacists who relieve the pressure on A&Es? If community pharmacies are put at risk and we lose them, there will be even more pressure on our A&Es and acute hospitals at a most awkward time for our society.

Holly Lynch Portrait Holly Lynch - Hansard
2 Oct 2019, 9:40 a.m.

I could not agree more. I thank the hon. Gentleman for making that important point. It was very welcome that in the community pharmacy contractual framework—for the first time, I think—the Government really did understand that. However, the funding to allow pharmacies to survive long enough to deliver those services has not been forthcoming. For all its aspirations to deliver more clinical services, a pharmacy that has been forced to close can deliver diddly-squat. Does the Minister accept that community pharmacies’ potential will be realised only when they are funded to survive?

Like many colleagues, I am incredibly concerned about the impact of medicine shortages, both on the NHS and on patients themselves. It is contributing to the mix of factors that are piling unbearable financial pressure on our local chemist shops. I hope the Government have a plan to respond and keep our trusted, effective community pharmacies open.

Sir David Crausby (in the Chair) Hansard
2 Oct 2019, 9:41 a.m.

Order. I will call the three Front Benchers at 10.30 am. Several Back Benchers wish to speak. I will not put a time limit on speeches, but if hon. Members keep them to about seven minutes or less, everybody will get an opportunity to speak.

Living with Dementia

Holly Lynch Excerpts
Tuesday 25th June 2019

(1 year, 2 months ago)

Westminster Hall
Read Full debate Read Hansard Text
Department of Health and Social Care
Judith Cummins Portrait Judith Cummins (Bradford South) (Lab) - Hansard
25 Jun 2019, 10:18 a.m.

Thank you, Mr Paisley, for allowing me to speak in this important debate. It is a pleasure to serve under your chairmanship. I congratulate my hon. Friends the Members for Oldham East and Saddleworth (Debbie Abrahams) and for Cambridge (Daniel Zeichner) on securing this important debate, and commend their work on the all-party parliamentary group on dementia.

The scale of the challenge of dementia is well known, but it bears repeating. In the UK, some 850,000 people live with dementia. That is set to double by 2040. Of course, the figures do not capture the great many other people whose lives are touched by dementia, most obviously family, friends and carers. With so many people affected by dementia, we need a comprehensive and joined-up approach that supports people and their families as soon as they are diagnosed. This must involve health, social care, local government and voluntary organisations.

There is a great deal of innovation and good practice. We must do all we can to ensure that it is shared as widely as possible, which is why I entirely agree with the Alzheimer’s Society that we need a national strategy on dementia. Of course, it is hugely important that the strategy is fully funded. I urge the Government to consider that in the upcoming spending review.

When thinking about a joined-up approach, we should look at the lessons from the integrated personal commissioning pilots. IPC, a partnership between the Local Government Association and NHS England, aims to integrate healthcare and education services around people rather than organisations. It focuses on an individual’s needs, along with the available community and peer support, to build their confidence and skills for self-managing long-term conditions such as dementia. It seeks to offer choice and control to patients by widening access to integrated personal budgets and developing more options to help people to achieve their goals.

An important point that the Alzheimer’s Society has raised is the need to ensure that people with dementia understand the information that they receive. What is told to people with dementia is not always the same as what they receive and understand. Given the nature of the condition, it is vital that medical professionals and others continually ensure that people are empowered by what they are told.

That point leads me on to the need for improved education about Alzheimer’s and dementia. I pay tribute to the Alzheimer’s Society’s Dementia Friends initiative, which has spread awareness and has seen 2.75 million people—including me and others in my office—become Dementia Friends. However, there is still poor knowledge among much of the public and some medical and care professionals about Alzheimer’s, dementia and what can be done to help people with the disease.

The Department of Health and Social Care should consider implementing a dementia awareness campaign to increase understanding of the symptoms of dementia and the interventions and treatments that can slow the progress of the disease, and to support people with dementia and their carers to lead independent lives for as long as is appropriate. The Government must do more to improve standards within the social care workforce to meet the needs of people with dementia, including by funding training to tier 2 of the dementia training standards framework for everyone who works in adult social care or interacts with people with dementia.

Finally, I turn to the support that we must provide for carers. I pay heartfelt tribute to the many thousands in this country who care for people with dementia and a whole range of other conditions. Out of love, they provide selfless care and deserve our utmost respect. Much more help must be given to those who care for people living with dementia. Carers need a wide range of practical, emotional and financial support. For instance, in its recent report on dementia and disability, the APPG on dementia found that carers need more support to know exactly what financial help they are entitled to, as well as how to make a successful claim. Carers are also time-poor and have little energy and—dare I say it?—headspace left after meeting the demands of caring for someone 24/7. The agencies involved need to take a more proactive approach to ensure that carers can claim the financial help they need, because they are entitled to support for the care they give their loved ones.

As we have heard, the Government’s aspiration to make the UK the best country in the world for dementia care and support is welcome, but it must be met with action and funding to make it a reality. I hope the Minister makes those commitments today.

Holly Lynch Portrait Holly Lynch (Halifax) (Lab) - Hansard
25 Jun 2019, 10:22 a.m.

As always, Mr Paisley, it is a pleasure to serve under your chairmanship. I join colleagues in paying tribute to my hon. Friend the Member for Oldham East and Saddleworth (Debbie Abrahams) for her leadership and for the compassion she shows in everything she does. I am a dementia friend because of her, having attended one of her workshops here in Westminster in 2016. I have since become a dementia champion and was asked by the Alzheimer’s Society to run its workshop for Dementia Friends at the 2016 Labour party conference to 80 colleagues and members, which was quite a challenge for my first workshop. I am incredibly proud to have played a very small role in training some of the UK’s 2.8 million Dementia Friends and sending them out into their communities to make them that bit more dementia-friendly. Once again, I pay tribute to my hon. Friend for her role in that.

This debate gives us an opportunity to evaluate where we are against the aspirations set out in the Government’s Challenge on Dementia 2020, but also to shine a spotlight on some of the good work that is being done at a grassroots level—not least in Halifax, thanks to some truly inspirational and passionate volunteers. As we have heard time and again, 850,000 people are living with dementia in the UK, a figure that is expected to double by 2040. One in 14 over-65s is living with dementia. If that is not an incentive to us all to do everything we can while we are able and empowered to do so, I do not know what is.

I recently wrote to older people in the Sowerby Bridge area of Halifax on behalf of the campaign to make Sowerby Bridge a dementia-friendly town, and invited them to a day of action to learn more and see the support available in their area. That campaign is driven by Shabir Hussain of Bluebird Care in Calderdale, who is a thoroughly committed community activist, along with Chris and June Harvey, who are truly dementia champions, and who run the wonderful Memory Lane Café for people with dementia and their carers. With their trustees and volunteers, Chris and June run pop-up cafés in churches and community centres in Sowerby Bridge and Halifax, with a dementia-friendly programme of games and crafts, information and support, cakes, music and conversation. Some 540,000 people in England alone care for those with dementia, and estimates suggest that one in three of us will be involved in caring for someone with dementia at some time in our lives, so a dementia-friendly environment that offers a thoroughly positive experience for all those involved in living well with dementia makes a massive difference to the regular attenders.

We also have a young onset dementia and Alzheimer’s group, or YODA for short, which was set up by Julie Hayden and provides support for younger people with dementia and for their carers and families. As we have heard, it is often overlooked that 42,000 people of working age live with dementia. Their requirements can be quite different. People diagnosed with dementia at that time of life usually present between the ages of 30 and 65 and are most likely in work, potentially with dependent children, older parents to care for or financial commitments such as a mortgage to consider. For that group, as other hon. Members have said, living well requires a different support package from that required for over-65s.

I would be remiss not to highlight the work of Inspector Neil Taylor of West Yorkshire police, who is a dementia champion and the chair of Dementia Friendly Todmorden. He has gone over and above in promoting best practice within West Yorkshire police and his local community—all credit to him. West Yorkshire police have introduced the Herbert protocol, named after George Herbert, a veteran of the Normandy landings who lived with dementia. The police and other agencies encourage family and carers to complete a form with useful information that could be used in the event of a vulnerable person going missing. The form includes vital details such as medication required, mobile numbers and places previously located, along with a recent photograph. In the event of a loved one going missing, the form can be handed quickly to the police to speed up the search and assist in supporting that person, who may be lost and confused when they are located. I recommend that all forces adopt such a protocol as soon as possible.

We are blessed with dedicated volunteers who have made Calderdale a better place to live with dementia, but what if Shabir, Chris and June, Julie, Neil and others like them were not there? The environment might be quite different without their leadership. How can we ensure that such work is supported and replicated elsewhere?

I give credit where it is due. David Cameron’s Government launched the dementia challenge in 2012, which sought to create dementia-friendly communities, with work led by the Alzheimer’s Society; drive improvements in health and care; and improve research, with a commitment that funding for dementia research be doubled to more than £66 million by 2015. Under Dementia Challenge 2020, as the programme was called when it relaunched in 2015, the Government committed to investing more than £300 million in dementia research and medical innovation.

It has been estimated that dementia costs the UK economy £23 billion a year, which is more than the costs of cancer, heart disease or stroke. With the numbers of people living with dementia expected to double by 2040, predicted costs are expected to treble alongside that increase. For anyone not yet won over by the human arguments for committing to research for dementia, the economic arguments speaks for themselves.

To be fair to David Cameron, I believe that he understood the issue. I hope the Minister can assure us that she will seek to make it a continuing priority for the incoming Prime Minister. However, there are still areas in which I would like to see things standardised across the UK to support people, particularly younger people, who live with dementia, as well as their families and carers. To have a dementia diagnosis in the workplace, with dependants or financial commitments, must be incredibly daunting, but with a renewed focus on that group, and with changes to our understanding of the support that those demographics need to live well, we can make a positive difference. I thank the APPG on dementia for its report “Hidden No More: Dementia and disability”, which calls, quite simply, for

“equality, non-discrimination, participation and inclusion.”

I wholeheartedly endorse those aims.

Ian Paisley Portrait Ian Paisley (in the Chair) - Hansard
25 Jun 2019, 10:29 a.m.

I thank colleagues for their immensely good self-imposed discipline, which will allow the Opposition spokespersons and the Minister 10 minutes each to speak.

Health, Social Care and Security

Holly Lynch Excerpts
Wednesday 28th June 2017

(3 years, 2 months ago)

Commons Chamber
Read Full debate Read Hansard Text
Department of Health and Social Care
Chris Elmore Portrait Chris Elmore (Ogmore) (Lab) - Hansard
28 Jun 2017, 5:56 p.m.

First, let me pay tribute to the hon. Member for South Antrim (Paul Girvan) for an eloquent maiden speech. He speaks with true pride for his constituency; it is clear that he is very proud of the community he comes from and now represents in this House. Secondly, I wish to thank my constituents for returning me as their Member of Parliament for the second time in 13 months. We are a little election-obsessed in my constituency, although I am hoping for a period of calm, as I am sure are my constituents. Serving in the House of Commons is the greatest honour imaginable, and I am extremely grateful to my constituents for returning me to this place.

In recent months, some of the most dreadful tragedies of modern times have been met with the resolve of those in our public services, who, through their bravery and skill, have surely saved far more lives than were lost. The emergency services in my constituency are world-class. Although they are often strained by the budgetary cuts of this Government, my constituents often remark on how hard-working and friendly our local police, fire and ambulance services are. They have my utmost gratitude and support for protecting our towns and villages, and I am proud to share the same community as them.

I was disappointed that the only mention of the emergency services in the Gracious Speech was in a vague allusion to police powers. We should not take our emergency services for granted, but under this Government I feel that has become the norm. Instead of heaping praise on the police, fire and ambulance services, and listening to their expert advice on how they could be better supported, this Government have cut to the bone at every opportunity. The fire service, whose heroics have been recognised again in the recent Grenfell fire, has seen 10,000 personnel and 41 stations cut since 2010. The police, to whom we personally owe our lives and health for keeping us safe during the Westminster attack just beyond our gates, have seen 20,000 officers cut in that same period. Our armed police, who during the London Bridge attacks neutralised the situation in minutes, have been reduced in number by 1,000.

We live in unprecedented times, and the first half of 2017 will be recorded in history as a time of tragedy for our country. I challenge any Member to stand before this House and say that they believe the Government have best supported our emergency services to tackle such events; the services themselves clearly believe they have not. The Police Federation has made it clear that the police are struggling under Government cuts, saying that there is no ignoring the fact that the police simply do not have the resources necessary in the light of recent events. Previously, as Home Secretary, the Prime Minister accused the Police Federation of “crying wolf” over the impact of the Government’s cuts. Clearly, the Government believe that they know better than the police.

The Fire Brigades Union has made it clear that firefighters do not have the resources that they need. It says that cuts have put the public at risk, which is evidenced by the increased number of fire deaths. It says that firefighters could soon lose their lives as a result of cutbacks, and that many no longer feel safe or supported. The Government believe that they know better than the fire service and have pressed on with austerity measures regardless.

In the Gracious Speech, there was no indication of increasing resources for emergency services. Instead, the Government signalled that there would be legislation to paper over the cracks with increased powers. I will wait until the Bill is debated before giving my further thoughts on increasing police powers, but I am concerned that yet again, this ignores the lack of funding and resources.

Only last week, the Home Secretary conceded to this House that police resources are very tight. Austerity may initially have been driven by ideology, but now that even the Home Secretary understands the strain, it is only dogma that continues to drive implementation of the cuts. It does not have to be like this, and under a Labour Government, it would not be. As long as the Government ignore our emergency services and their cries for increased resources, they cannot pretend to protect our country.

Holly Lynch Portrait Holly Lynch (Halifax) (Lab) - Hansard
28 Jun 2017, 6:01 p.m.

I am delighted to follow my good and hon. Friend the Member for Ogmore (Chris Elmore). It is a pleasure to make my first speech in the new Parliament. It is a privilege that I feared might elude me, going into the snap general election. I was trailing in the polls, and had a majority of just 428. The betting odds were 10:1 against me. Returning to Westminster, one of my so-called hon. Friends went so far as to call me Lazarus Lynch, returned from the dead, politically at least. Having increased my majority from 428 to 5,376, despite the odds, I would like to take this opportunity to thank the Prime Minister for carefully selecting Halifax as the place where she launched her manifesto. She parked her tanks firmly on my lawn; however, not only did those tanks misfire, but the engines seized up and the tracks completely fell off, giving me the chance to continue my work, standing up for the good people of Halifax.

With that in mind, there is a lot to do, and the Queen’s Speech failed to provide answers of any substance, but I wish to focus, in the short time that we have today, on our emergency services. My community, as well as those up and down the country, has never been so aware of the invaluable work that those services do. Over the past few weeks, with the terrorist atrocities in London and Manchester and the Grenfell Tower tragedy, we have seen the emergency services at their very best. It is a workforce of which we as parliamentarians, and as a country, can be incredibly proud, but it is a workforce that is tired and that we have let down.

The emergency service workers whom I know and whom I have spent time shadowing are pragmatic, and know just how vital their work is, so they get on with the job. However, there are fewer of them than ever before; they are asked to work harder and are stretched thinner, and as a result of the public sector pay cap they are paid less than they should be. It is surely time that we ended the public sector pay cap, which is demoralising our emergency services. The starting salary for a police constable is £19,700 in some forces, and £22,000 for a firefighter. The weight of the work that we ask them to undertake, and the risks that go with it, are not, I am afraid, reflected in their pay.

Emergency service workers face enough risks as a consequence of their job without a small group of shameful individuals making their job even harder by deliberately seeking to assault them. I launched my “Protect the Protectors” campaign last year, after having to call 999 while out shadowing the police. The lone officer I was out with found himself surrounded by an angry mob when a routine call very quickly escalated.

Many emergency service workers who have been subject to horrendous assaults while at work described feeling like they had suffered an injustice twice: first at the hands of the offender, and then again in court when sentences were unduly lenient. As the ballot for private Members’ Bills is taking place this week, I very much hope that I might be in a position to relaunch my ten-minute rule Bill from last year, which would seek to ensure that sentences for assaulting emergency service workers and NHS staff reflected the seriousness of the crime. I make this plea: if any hon. Members are drawn in the ballot and would like to discuss the Bill further, please let me know.

Crucially, we must restore numbers. The police and crime commissioner in West Yorkshire, Mark Burns Williamson, and Chief Constable Dee Collins last week joined the growing number of PCCs and chief constables taking the unprecedented step of admitting that reduced numbers are affecting frontline capabilities. West Yorkshire police has lost 1,200 officers since 2010, which is a 20% reduction of the force. The Home Secretary talks about an uplift in firearms officers to respond reactively to the threat of terrorism, but those officers just come from elsewhere in frontline policing, which again reduces the numbers in response policing, neighbourhood policing and policing elsewhere on the frontline, and makes proactively stopping terrorism even tougher. Chief Constable Dee Collins is extremely concerned about the impact that the loss of officers is having on neighbourhood policing in particular.

Finally, a police officer recently asked me why there is not an emergency services covenant, in the same spirit as the armed forces covenant. I very much hope that the Secretary of State will consider that request and respond to that officer in his reply to the debate.

Margaret Greenwood Portrait Margaret Greenwood (Wirral West) (Lab) - Hansard

I thank the people of Wirral West for returning me to this place.

We learn from this Queen’s Speech that the Government intend to do nothing to stop the fragmentation and undermining of the national health service that the last Conservative Government pursued with so much determination. In my constituency, many are very concerned about Cheshire and Merseyside sustainability and transformation plan’s shortfall of just under £1 billion and what that will mean for the service. The Government could have chosen to address that, but instead they have left services in Wirral and elsewhere across England to struggle to maintain levels of care. Board meeting papers of April 2017 show Wirral University Teaching Hospital NHS Foundation Trust with an operating deficit of £11.9 million in 2016-17. The effect is being felt by patients and staff, and targets for A&E waiting times, bed occupancy rates and GP referrals are being missed.

Staff morale is rock bottom across the NHS, bringing with it recruitment and retention problems. We have seen junior doctors striking and looking for work abroad. The Royal College of Nursing criticised the Prime Minister’s failure to scrap the public sector pay cap in the Queen’s Speech, and warned that failure to do so will result in an historic ballot of 270,000 nursing staff, signalling a summer of protests by nurses. But it is not only clinical staff who deserve fair pay. In my constituency, NHS administrators from the Wirral Community NHS Foundation Trust are seeing their roles downbanded from band 3 to band 2, which would mean they are paid below the Living Wage Foundation’s voluntary living wage for the first five years of employment. I recently met some of the women affected and they told me of how clinical staff, some on band 7, are being required to carry out some of their administrative tasks. That cannot be an efficient or effective way to run a service. It is an attack on the pay and conditions of administrative staff who play a vital role in the delivery of safe patient care. Hardworking clinicians should receive the full administrative support that they need to deliver care, from staff who should be valued for the important part that they play in the delivery of services in our NHS.

In addition to the cuts and rationing of the STP programme, the Government have quietly ushered in further initiatives, putting the squeeze on the national health service. The Naylor report recommends the accelerated sell-off of NHS land and buildings. The capped expenditure programme undermines the very founding principles of the NHS and requires senior health managers in 14 areas of England to think the unthinkable and impose strict spending limits in their areas. That will result in longer waiting times, closure or downgrading of services, job losses, ward closures and rationing of care. Essentially, the Government are no longer saying, “Do more with less.” They are just saying, “Do less.” Less care and fewer treatments will lead to poor health outcomes for our nation.

While the Tories’ NHS privatisation agenda has been clear for years now, their policy on adult social care, announced in the manifesto just a few weeks ago, demonstrates their approach to social security. Instead of pooling risk and developing a collective response to shared societal problems, they are replacing that approach with an ideology of, “Sort yourselves out. You’re on your own because this Government won’t help you.” Labour Members take a different view. We would restore and protect the national health service and establish a national care service of which we can all be proud.

During the general election I heard from hospital consultants from Arrowe Park hospital, the Royal Liverpool and Alder Hey, and their shocking testimony revealed a picture of overstretched staff in an under-resourced service. One consultant I spoke to said he felt that in future only the rich will have access to doctors. That is indeed a bleak vision for the future of the NHS from people on the frontline, and the Government must now take responsibility. I urge Conservative Members to change course, restore our NHS as a public service and give NHS staff the reward they truly deserve. Today we are asking colleagues to vote to end the public sector pay cap. In the light of all that public sector workers do for us, that is the very least they deserve. We owe it to them, but we also owe it to ourselves and the next generation. As we approach the 70th anniversary of the founding of the national health service, our finest social institution, let us cherish it, protect it and show how we value the staff who work in it.