Building an NHS Fit for the Future

Jackie Doyle-Price Excerpts

Monday 13th November 2023 Commons Chamber

[Jackie Doyle-Price (Thurrock) (Con)]

My hon. Friend is making some compelling points. It strikes me that disposable vapes are often available at the point of sale where we used to find things such as chewing gum and packets of Polo mints. That makes it very easy for children to access them. Does she think that regulating point-of-sale products is a massive tool to tackle the problem? Let us remember that established tobacco companies have to have their multi-use vapes on sale behind the screens that tobacco is sold behind.

[Dr Johnson]

I completely agree that putting vapes where children can see them makes them more available and makes children want them more. That is why they need to be in plain colours and flavours and out of the sight and reach of children. My understanding is that that is part of the Government’s consultation, and I hope they legislate and make regulations as soon as they can.

Overall, the King’s Speech is a good one, and I am proud to support it.

--- Later in debate ---

[Jackie Doyle-Price (Thurrock) (Con)]

It is not really surprising that, having spent two years of this Parliament with large chunks of the economy and the NHS shut down while we fought a disease, we still face challenges coming out of that. When I listen to speeches from around the Chamber, with the constant wish lists for more and more money, I think we all ought to remind ourselves of that. We should also remind ourselves that lots of people who run businesses up and down the country are being taken for granted, with additional burdens being put on them. They are carrying the additional debt that we, the guardians of the taxpayer’s pound, have taken on, given what we have spent. In fighting the pandemic, we have taken on what is, in effect, a wartime debt. We must recognise that that has consequences. We would all have been much better off and could have afforded to be much more generous with taxpayers’ money had we not been through that.

Let me focus on some issues that were included in the King’s Speech and some that were not. One issue that was not included is reform of the Mental Health Act 1983. I add my voice to those around the Chamber who have expressed regret about that. I was the Minister who commenced that work five years ago, and it is particularly personal to me, because we raised expectations that we really were going to deliver parity of esteem by changing the Act. The Mental Health Act was passed in 1983, an era when we viewed people with severe mental health issues as a problem to be managed. We all wanted to look the other way; it was not something we wanted to deal with.

We have seen a sea change in public attitudes towards that issue, and it was finally being recognised in government. It was a privilege for me to sit down with a lot of campaigners, who told me of their experiences. What makes it personal to me is that I witnessed them reliving the trauma that they experienced under detention. I feel personally responsible for the fact that, having raised their expectations five years ago, we have let them down by not legislating.

My message to those on the Front Bench is that the legislation, although it was not in the King’s Speech, could still be brought forward. I encourage them to do that, because until we do, we are not genuinely delivering parity of esteem. It is all very well saying, “We are putting more resources into schools and we are tackling suicide prevention,” but they are two different things. We need a proper approach to dealing with severe mental ill health that will enhance the rights of people who are having to be treated.

There are occasions where people need to have their liberty taken away, but it is not an absolute; they still have ownership over what happens to them. When we hear stories about people in detention being constantly medicated by drugs, that is not something that I equate with our society. It is important that the Government’s first priority is to make sure that they do their best for the most vulnerable.

Another item of legislation long-promised that was not in the King’s Speech was the ban on conversion therapy. I issue a word of warning to the House. It is clear to me that there is a majority in this Chamber for a ban on conversion therapy. It is also clear to me that every one of us, I would hope, would wish to see abusive and coercive practices designed to cure people of their sexuality banned or outlawed. The thing that bothers me is that when we are talking about these abusive and coercive practices, we use the term “therapy.” Therapy is designed to alleviate distress. The practices we want to outlaw cannot in any way be described in such a manner.

I have been pleased by the engagement I have had with Government and campaigners on all sides about how we get the language on this right. We have moved a long way in the right direction, but we are looking at abusive practices designed to cause harm. I know that lots of discussion is happening, but I say to those Members perhaps thinking about bringing forward a private Member’s Bill to resurrect the ban on conversion therapy: can we just remove this term “therapy” from anything designed to change people’s sexuality? We know that ultimately therapy should be used only to describe processes designed to alleviate distress.

Turning to some more local issues, I want to talk about the national health service in south Essex. For a long time, we have had a challenging position in south Essex. We sit right next to London. We know there are much more attractive places to work for NHS professionals when there are the great teaching hospitals in London. We have always found it difficult to recruit the staff we need in south Essex. In fact, in Thurrock we have been without enough GPs for decades. When we have an NHS dealing with the backlog caused by the pandemic and waiting lists, we are seeing some acute problems. I was drawn to an article in the press just this weekend, where I read that along the Thames—just a little bit down the road in Southend—as many as one in five people are awaiting treatment on a waiting list. I am sad to say that was not a surprise to me.

Going back to 2015, the Ministers at the time gripped the challenge with the provision of health in south Essex. Great focus was put on it. There was a proposal for developing the integrated care system. We looked closely at what made the best health economy, and there was recognition that improving primary care in south Essex should be a priority, but we seem to have lost that focus. My challenge is this: what has happened to our commissioning system for that to happen? We thought that moving towards ICSs would give a better focus, but it seems to have fundamentally failed.

Six years ago, as part of the process, my local NHS brought forward a proposal to close what remained of Orsett Hospital in Thurrock. That hospital ceased to be a general hospital decades ago, but it retains a great deal of affection among my constituents, mainly because most of them were born there. I took it upon myself to support my local NHS when it said that it wanted to close what remained of that hospital and reinvest it in new services in the community. I was prepared to take the political flak. It is difficult to deliver that message to constituents, but I believed the local NHS when it said that it would bring new facilities—it promised me an urgent treatment centre in Grays in my constituency, and three new integrated medical centres—but I have not received any one of those things in six years.

I took the flak and persuaded my constituents that that was in their best interests, and now I look a fool. That is basically because there is a circular system in the NHS commissioning system whereby lots of papers get produced but there is no actual delivery. We really do need to get to grips with that. When we raise issues about the NHS, people think, “How dare they criticise our doctors and nurses.” Actually, we are not; we are criticising failings in how services are commissioned. Every time we look at this, we never see any improvements.

In Tilbury, I am looking at the hoardings around a site where we will build an integrated medical centre—they have been there for two years. We have cleared the site and it is ready, but we are still getting that circular conversation with the NHS in south Essex. That really needs to change.

I will use the last bit of my time to talk about the covid inquiry and what it tells us about how Government works and what we should be doing with our institutions. It is really not very pretty, is it, to see some of the film that is coming out? As we move on from the King’s Speech and we are having a new Government assembled in front of us, we should reflect on some of the really bad behaviours being highlighted as part of the inquiry. In the last few years we have seen some very bad behaviour here in Parliament, as well as in relationships between Ministers and civil servants in Whitehall.

We should remember that the impartiality of our civil service is to be valued. The way in which our Governments have operated has given us stable government for decades. We have seen a massive expansion in the number of special advisers, which has led to the marginalisation of junior Ministers in this place and a subsequent lack of accountability. Here is where the action should be. Ministers are responsible to Parliament for what happens in their Departments, and special advisers seem to be breeding apace but doing nothing to improve the quality of that government.