Civil Proceedings

James Cartlidge Excerpts

Tuesday 29th March 2022 Commons Chamber

[The Parliamentary Under-Secretary of State for Justice (James Cartlidge)]

We have had an interesting debate on these important measures. I am grateful to all colleagues who have contributed. Like the hon. Member for St Albans (Daisy Cooper), I thank all the workers in the NHS, and in social care, who put in such a shift over the pandemic. As a Justice Minister, I would say the same about all those working in the courts, particularly the clerks and others who had to go into work in the spring of 2020, when there was fear across society about the consequences of working face to face with others. They did that to keep justice going, and we owe them a great debt.

The hon. Lady asked about emergency legislation. Of course we want to learn lessons from covid-19, and we continue to review the effectiveness of our legal framework, and the lessons learned from our response to covid-19, as part of our preparedness for future pandemics and other health emergencies.

The hon. Member for Bradford East (Imran Hussain) movingly discussed an important subject that matters a great deal to him, and to his constituents, and I pay tribute to him for speaking up for his constituents. These are very important matters. I can confirm that the general register office measures on death registration have been replaced in permanent legislation, except for the provisions for telephone death registration. We are trying to identify a legislative vehicle through which to put those provisions in place.

There were a number of comments on the immunosuppressed. I understand the concerns on the subject; it is one that my colleagues in the Department of Health and Social Care take seriously. I remind colleagues that those who are immunosuppressed are eligible for three primary vaccine doses and a booster, and will be called forward for a spring booster when appropriate. We made 5 million doses of antivirals available for the immunosuppressed.

[Ms Lyn Brown]

Does the Minister agree with my GP that expansion of the use of antivirals might be a necessary tool in our campaign to keep people safe, as we learn to live with covid?

[James Cartlidge]

I am a Justice Minister, but I am happy to pass on from my health colleagues that they keep that issue under review. The hon. Lady raised a point about tests; from 1 April, free tests will be available for those in certain groups most at risk from the virus. More details will be set out shortly; I cannot say more than that at this stage, I am afraid.

The hon. Member for Denton and Reddish (Andrew Gwynne) is absolutely right—the hon. Member for Chesterfield (Mr Perkins) made a similar point—that we went through matters relating to remote hearings in detail when the Judicial Review and Courts Bill was in Committee. That was my first Bill as a Minister. We went through in great detail the support for vulnerable users, but let me restate this for the hon. Member for Denton and Reddish: remote technology has a huge role to play in our courts, and we should not underestimate the extent to which its use kept justice going, which was very positive for vulnerable users. He is right, however, that there must be measures in place, and we have set them out in detail. Only recently, we awarded a new contract that provides for a technical support line to assist remote hearing users, and to enable them to access their hearing in the most appropriate fashion. Of course, the type of hearing held is always up to judicial discretion, and dependent on the circumstances.

On the point about the backlog, the hon. Member for Denton and Reddish said—I address this to the hon. Member for Chesterfield, too—that we want to forget about the pandemic, but also that the backlog is entirely the result of Government incompetence. Let us be clear: before we went into lockdown, the backlog was smaller than when Labour was last in power. When we went into lockdown, the courts closed. The Crown Court’s output collapsed. That should not be a surprise; we did not have jury trials because of social distancing.

My right hon. and learned Friend the Member for South Swindon (Sir Robert Buckland), then Lord Chancellor, who has just emerged into the Chamber—he is probably out of sight to most Members—put in an extraordinary shift, together with the Lord Chief Justice and others in our courts, to get courts reopened, and to get jury trials going again in this country, but there was a consequence: a huge bottleneck of cases. That is why we had this record backlog. The good news is that the number of cases in the backlog is falling; it has gone from a peak of around 61,000 last June to around 59,000. However, we recognise that we have to go further, which is why court recovery is a priority for this Government.

The measures that we propose extending through the statutory instrument that is before us are helping to ensure that courts and tribunals have the resources necessary to deal with these outstanding cases. To be clear, sections 53 to 55 of the Coronavirus Act 2020 enable thousands of hearings to be conducted online—currently around 11,000 per week—so that courts and tribunals can be reserved for hearings, such as trials, that must be heard in court. Without section 30, the backlogs in our coroners courts would have been larger, which would have further increased the demand on local authority-funded coroner services. These temporary measures are in fact so important to court recovery that we intend to make them permanent, but we cannot afford any gap in provision while we wait for that legislation to complete its passage through Parliament. If courts were unable to continue to use these provisions, even for a few months, there would be a significant impact on our court recovery programme. That would mean defendants waiting longer than necessary for trial, more victims waiting longer than necessary for justice, and the bereaved waiting longer than necessary for inquests.

I express my thanks to all those who work in our courts for the sterling work that they did to keep the courts running during the pandemic. I hope that Members agree with me that, by extending the four provisions of the Coronavirus Act 2020 that are under consideration for a maximum of six months, we can continue to build on the progress that we have made in managing the virus, and in ensuring that our courts and tribunals can recover as quickly as possible from the effects of the pandemic. I reassure the House—this is crucial—that the four provisions will be expired under the Act once new legislation comes into force.

As was noted by the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Erewash (Maggie Throup), who has responsibility for vaccines, statutory sick pay is a transferred matter, and the Government are simply facilitating an extension of the provision relating to it, following a formal request by the Department for Communities in Northern Ireland.

Question put and agreed to.

Resolved,

That the Coronavirus Act 2020 (Delay in Expiry: Inquests, Courts and Tribunals, and Statutory Sick Pay) (England and Wales and Northern Ireland) Regulations 2022 (SI, 2022, No. 362), dated 23 March 2022, a copy of which was laid before this House on 23 March, be approved.

Coronavirus Act 2020 (Review of Temporary Provisions) (No. 4)

Resolved,

That the temporary provisions of the Coronavirus Act 2020 should not yet expire.—(James Cartlidge.)

Covid-19: Contracts and Public Inquiry

James Cartlidge Excerpts

Wednesday 7th July 2021 Commons Chamber

[Ian Blackford (Ross, Skye and Lochaber) (SNP)]

I beg to move,

That this House believes the Government has failed to give full details of the process behind the issuing of emergency covid-19 contracts; and therefore calls on the Government immediately to commence the covid-19 public inquiry, announced by the Prime Minister on 12 May 2021.

There have been many instances during this covid-19 pandemic when we have seen the very best in our society, from our frontline workers keeping food on supermarket shelves, to our extraordinary scientific community who have produced life-saving vaccines, to, of course, our NHS heroes who have been so deserving of the George Cross. The pandemic has also led to opportunism, greed, and covid profits being put above accountability. This Tory Government are guilty of funnelling covid cash from the frontline into the pockets of their rich friends. We are talking about endemic cronyism during a global pandemic, the misuse of funds, and covid profiteers raking in billions of pounds for services that have often been too substandard or irrelevant in the fight against the virus. Yes, Mr Speaker, it is billions of pounds that we are talking about—billions of pounds while millions in our society have been excluded from any help from the Government.

Today, the SNP is saying enough, no more dodgy dealings, no more undeclared meetings, and no more billion-pound contracts to friends. The Prime Minister promised an inquiry into the UK Government’s handling of the pandemic; it must start right now.

[James Cartlidge (South Suffolk) (Con)]

I have the greatest respect for the right hon. Gentleman and I understand why he is bringing this debate forward, but he must realise that we have just had a week where his own country’s newspapers are full of headlines saying that Scotland is becoming the covid capital of Europe. Who is responsible for that?

[Ian Blackford]

We really should not be playing political football—[Laughter.] I have to say, Mr Speaker, that says it all. [Laughter.] They should just keep going, because, friends, we are talking about people who are getting a serious illness, we are talking about people who are getting long covid, we are talking about people who are going on ventilators, we are talking about people who are losing their lives, and that is the behaviour that we get from the Conservatives. They ought to be utterly, utterly ashamed of themselves.

When it comes to the covid numbers in Scotland, let me give those Members a reality check. The reason that covid numbers are rising so dramatically right across the United Kingdom—and we have seen the projections this morning of what is going to happen here over the coming weeks—is largely down to what has happened with the delta variant. My Government in Edinburgh told the Government in London that we had to lock the door on the delta variant. It is the UK Government who have been asleep at the wheel, so we take no lectures about our responsibilities when there is a Prime Minister who talks about letting the bodies pile high. We know where the blame lies and the blame lies at the door of No.10 Downing Street.

[James Cartlidge]

rose—

[Ian Blackford]

Last week, I raised an urgent question in this House on the misuse of covid funds—[Interruption.]

--- Later in debate ---

[Jo Churchill]

Thank you very much, Mr Speaker.

I agree that we have seen, totally, the best of people—our frontline workers and our NHS workers. They have really stepped up. They need to know that we did everything we could in exceptional circumstances. I remember the weekend I went to Liverpool to meet the plane that flew back from Wuhan with those very first individuals who were carrying the virus. We knew nothing of it at the time, so how far have we come?

The other point on which I would agree with the right hon. Member is that very pithy sentence, “Those of us on these Benches know Scotland can do better.” As he will appreciate, covid-19 has presented this country with one of the most unprecedented challenges we have ever faced. It has been imperative for us to work together closely throughout this pandemic. In particular, the Government recognise the key role devolved Administrations have played in this, and I have been incredibly grateful for the meetings I have had with my counterparts not only on issues relating to the pandemic but on other issues—there was a meeting last week in which we spoke about how we might address the challenge of those going through the journey of cancer. We are very grateful for that.

It is thanks to that close collaboration and co-ordination that we have been able as a United Kingdom to achieve success in our vaccine roll-out programme. Over three quarters of adults in the UK have received at least one dose and well over half have received both doses. Our job was to protect the weakest and most vulnerable, and that goes for all of us.

Had we remained in the EU scheme, which has not performed as well as ours, we would not be here at this point, and I am proud of the work of the vaccines taskforce and proud of the leadership that Kate Bingham showed. I seem to remember these debates revolving around that at one time; I do not see anybody now denying and saying, “No, don’t give me a vaccine.” That work was led and driven by Kate Bingham and her team, who worked ceaselessly—longer days for longer weeks for longer months—to find our pathway out of this.

[James Cartlidge]

I am grateful to my hon. Friend for giving way, and totally share in the point she just made about the vaccine. As she will have seen, when I intervened on the SNP spokesperson earlier I raised the point that Scotland has been described recently as the covid capital of Europe, and the SNP is refusing to take responsibility, and indeed is blaming the UK Government because of the delta variant. But is it not the case that since it became identified as a variant of concern, England played Scotland and the Scottish Government could have stopped thousands of Scots travelling south of the border? There was nothing to stop them doing that; they must take some responsibility for the fact that there are so many covid cases in Scotland.

[Jo Churchill]

I thank my hon. Friend and constituency neighbour. The right hon. Member for Ross, Skye and Lochaber referred to his leader, who early on in the pandemic spoke about elimination, yet now the World Health Organisation says six out of 10 of the highest rates across Europe are currently in Scotland. That is why I think that if selective lines are picked out, and people are used as battering rams against each other rather than us looking sensibly at the facts, that means that we do not get the perspective we need to make sure that we come through this and that we stand shoulder to shoulder with the population and deliver the vaccine programme.

As I said, I am proud of the work that the UK Government have done in driving the vaccine. At the beginning of the pandemic we were told this would be a 10-year process; we got there in a year. That is utterly phenomenal, and there were great academics from Scotland who joined in; there were academics from across the world. We can deliver this, and the NHS is getting on with the job of vaccinating and allowing us that road to freedom.

--- Later in debate ---

[James Cartlidge]

How much does the hon. Lady think the investigation into the former Mayor of Liverpool will cost?

[Fleur Anderson]

I do not know how much further investigations will cost, but that does not preclude from needing to investigate this point. We cannot deflect by looking at other investigations; we need to have an investigation into this point.

Hundreds of millions of pounds have been spent on masks that have been mothballed and on gowns that could not be used because the contracts were not good enough. At a time of public emergency, we need the Government to be excellent in their competence in contracting, and not to throw the rules out of the window and end up with these failed contracts.

Question 12: why, despite all the evidence uncovered this year, will the Government still not commit to ensuring these contracts are in the public inquiry? I hope to hear confirmation that this will happen.

--- Later in debate ---

[Angela Richardson]

I thank the hon. Gentleman for his intervention, but I think he is being a little bit too narrow in his focus by saying that we only got one thing right. The way we invested in that scheme was replicated across many areas. We rightly hold that up as the absolute beacon of success, but there are many other areas where we used similar sorts of processes and where we had successes. We need to keep that in mind. Our diagnostic capacity has been excellent at identifying new strains, and we have to discuss that as well.

[James Cartlidge]

Is it not true that our brilliant scientists also developed groundbreaking treatments such as dexamethasone that, in the long run, will be the most crucial to ensuring that those who are seriously ill recover?

[Angela Richardson]

My hon. Friend is absolutely right. Those therapeutics have made a huge difference to people who are unfortunately hospitalised. In my local hospital, the Royal Surrey, the doctor who led the covid ward was seconded from treating cancer, and he has learned many things by being involved in running that ward that will be beneficial not only for the pandemic but for anything coming down the line.

The right hon. Member for Ross, Skye and Lochaber (Ian Blackford) is no longer in his place, but in his speech he gave several examples of companies that had no previous experience in the production of something but had turned their hand to helping us to source things that we needed for the pandemic. I would ask the right hon. Member, if he were in his place, what he would say to all the whisky distilleries in Scotland that turned their hand to making hand sanitiser. What message is he giving to them today? I would like to take this opportunity to thank all the gin distilleries in my constituency and neighbouring constituencies that got in touch with me. They had made hand sanitiser and wanted a contact to speak to at my local hospital so that they could gift that hand sanitiser to it.

The Opposition would like us to take a trip down memory lane. Well, I am quite happy to do that. I was newly elected in December 2019, and I still have my training wheels on. I think a lot of us still feel like that. I had barely given my maiden speech before we were locked down and put into this situation. When you start as a new MP, you build your team from scratch. It is not there already waiting for you. At the most difficult time, I had about 1,500 emails a day coming into my inbox, and there were three of us dealing with them. We were trying to triage them and help as many people as we could. At the same time, I was receiving emails from people I had never met. I am an immigrant, and I went to a state school, so I am not connected in the way that the Opposition like to suggest about Conservative Members. It is a complete farce to talk like that, especially about a lot of those who have come in in the new intake—

--- Later in debate ---

[James Cartlidge (South Suffolk) (Con)]

It is kind of a pleasure to follow the hon. Member for Inverclyde (Ronnie Cowan). His tieless, sedentary, relaxed demeanour contrasted somewhat with the demeanour of the right hon. Member for Ross, Skye and Lochaber (Ian Blackford), who I admire and respect, because when I intervened on him and raised the issue of the very widespread levels of covid currently pertaining in Scotland, it is fair to say that he did not react with what I would describe as calm statesmanship.

Only two days ago, The Scotsman, no less, had as one of its headlines the question, “Why does Scotland have the highest covid rates in Europe?” That is a fundamental question.

[Owen Thompson (Midlothian) (SNP)]

indicated dissent.

[James Cartlidge]

If the hon. Gentleman wishes to intervene and defend that, he is more than welcome to the chance. He will not defend it; well, there is a surprise. [Interruption.] Come on then, why does Scotland have the highest rates in Europe?

[Owen Thompson]

Of course, The Scotsman is well known to be a great supporter of the Scottish National party; the hon. Gentleman might want to have a look at that. The Scottish Government do not have control of our borders. The delta variant has come in and has created so many of these cases. That is outwith the control of the Scottish Government, who are doing everything they possibly can to bring them down.

[James Cartlidge]

That is unbelievable. Scotland has the highest covid rates in Europe. The SNP is governing in Scotland and it will take not a shred of responsibility for this situation.

[Owen Thompson]

rose—

[James Cartlidge]

I might give the hon. Gentleman another turn, but let us just put some facts on the table.

In June, 2,000 people in Scotland who tested positive for covid had attended a Euro 2021 event. I am no killjoy. I am quite happy that they attended. I will be attending a Euro 2021 event tonight to watch England vs Denmark. I am quite happy that many thousands of Scots made the journey to London to watch that game, in which their team performed admirably—far better than we did. The idea that the Scottish Government had no power in this matter is ludicrous. If they really thought that this variant was such a concern and that we should have closed the borders, they should not have allowed people to come down in their thousands. The evidence shows that those people are now super-spreaders of covid in Scotland. The hon. Gentleman should not pretend that the Scottish Government had no power in this matter.

Having said all that, I am grateful to the right hon. Member for Ross, Skye and Lochaber, who has now returned to the Chamber, for introducing this debate about covid contracts, because it gives me the opportunity to talk about two covid contracts that are far more important than all the other guff we have heard today. Those contracts are, first, the contract that this Government—indeed, my right hon. Friend and neighbour the Member for West Suffolk (Matt Hancock)—signed with AstraZeneca to procure a vaccine, along with all the other ones that we took a risk on procuring before the rest of the EU. That has brought liberty to millions and saved the lives of thousands, for which we should all be grateful.

The second contract is one that we will not find a copy of, and there was no procurement for it, but again it is of fundamental importance: it is the social contract that exists between the Government and the governed on the basis of when we are expected to give up our precious rights because an emergency exists and when—the key question for me—those rights should be returned because the emergency has passed: a fundamental point given the Prime Minister’s statement on Monday.

The first contract was the generic process through which the UK Department of Health and Social Care negotiated contracts for those vaccines and delivered them in a way exceeding almost all other major nations, delivering millions and millions of doses. I am grateful to the hon. Member for Angus (Dave Doogan) for saying in his intervention that that was the one thing the Government got right, but, boy, that one thing is more important than anything else: it is the way out of the mess; it is the way we get out of lockdown; it is the ways we save millions of lives. And it is not just lives in the United Kingdom that are being saved; it is not just lives in every corner of this precious Union. The AstraZeneca vaccine contract was negotiated so it would be produced at cost. The significance of that enormous contractual point is that the vaccine has been spread around the developing world. We have seen 400 million Oxford-AstraZeneca vaccines go into the arms of the poorest in the world. We should be incredibly proud of that. This Government have an incredibly honourable record in what has passed.

Covid was one of the greatest crises the world has faced; it was completely unprecedented, and every time we have had to make a choice we have been between a rock and a hard place, but the only way out of it, as we all knew, was through vaccines, and we made the right call at the right time, which no other Government in Europe made at that point, and we should be proud of that contract, and it is far more important than all the other stuff mentioned today.

On the second point, the social contract, this is my first opportunity to respond to the enormous announcement we heard on Monday—one I am so grateful for—that we will be returning to normal, restoring our precious freedoms. I believe in the social contract; it is implicit—we all have our own interpretation of it—but at its heart must be the idea that Government have certain powers but they can only use them in exceptional circumstances, if those circumstances are truly an emergency.

Tonight, as I said, thousands—millions—of people around part of the Union will be going to watch a football match. They will be crowded in pubs. The idea that we are still in an emergency is for the birds, and that is because of medical science, and I am profoundly grateful; it is because of the first part of the contract that I spoke about, but because of that we must start taking decisions that restore freedom and return this country back to normal.

I understand that some people are nervous, because I have had emails from constituents who voted in all ways for all parties—and in all ways in the referendum, in case anyone tries to make that link. Some people are still nervous; they worry and think we should still have to wear masks after 19 July and that the Government should still keep measures on. I have no idea where the Labour party stands on this; as far as I can see, they want us to remain in lockdown, but, as the Prime Minister said, if not now, when? Let me answer that: if not now, it is never, because the whole point of the social contract is that if we allow the state to keep that power for too long, it will not come back. The default disposition of the state must be that its citizens are free and that they are only not free in exceptional circumstances, and I believe those circumstances have now passed, and that is because of the vaccine; there are still high numbers of cases, but they are generally not resulting in significant ill health, and because of that we can unlock this lock- down.

[Mr Carmichael]

For the record, I agree with a lot of what the hon. Gentleman says with regard to the social contract, but if his analysis is that we are genuinely out of the end of the emergency period, then surely the same question—if not now, when?—should be applied in respect of the start of the inquiry?

[James Cartlidge]

I have great respect for the right hon. Gentleman and that is a fair question. My own view is that to most of my constituents the question of how soon the time comes when, for instance, they can sing in a choir in a church or go to a nightclub or gather inside with family and friends and loved ones without fearing that they are breaking the law, is more important than how soon the Westminster bubble can get excited about something that will take months and months and months and be pored over by legal people and many others.

[Alec Shelbrooke]

rose—

[James Cartlidge]

I was going to conclude, but I cannot resist my right hon. Friend; he spoke so well earlier, so as a prize I will let him intervene on me.

[Alec Shelbrooke]

Well there you go—everybody is a winner. Just to expand on the point that the right hon. Member for Orkney and Shetland (Mr Carmichael) has just made, I entirely agree with my hon. Friend that now is the time that we should come out of the restrictions, and things are moving to a close, but they are not over yet, because we have to get the autumn booster programme right. I would rather that that was properly in place before we move on to inquiries.

[James Cartlidge]

My right hon. Friend makes an excellent point. I hope he will be writing to our brilliant new Health Secretary to make that point to him.

Let me conclude by saying this. We ask ourselves when those freedoms will return and when the Government will do their part of the social contract and say, “The worst has passed, so it’s fair that you should now be able to do those things you used to do in normal life.” The answer is when those first contracts have delivered—the ones we signed with those companies, such as AstraZeneca and Pfizer, that have delivered this amazing vaccine programme that has benefited every part of the UK and every part of the world.

Every country in the UK has played a role in that. It has been a true feat of the Union, and we should be proud of it, because we are stronger together as a Union. Instead of falling back on narrow nationalism and bitterness, we stand together with a positive agenda. We have done the right thing. We have delivered an amazing vaccine programme. We have brought freedom, we have brought hope, and we look forward to better times ahead.

--- Later in debate ---

[Stephen Flynn]

My right hon. Friend makes an important point, because there have been opportunities, not just last week but throughout our debate today, for Conservative Members to stand up and clarify exactly why it happened, but they have failed to do so. It is incumbent upon the Minister to do so when she follows me in this debate.

But if the Conservatives are unwilling to do that, they should be willing to do one other thing: finally agree that a public inquiry must take place. [Interruption.] The hon. Member for Macclesfield (David Rutley) says that it is. When is it happening? Is it happening now? It should happen now. Some Conservative Members argue that it is not happening now because we are still in the middle of the pandemic, but one of them said today that the emergency is over. So if not now, then when? The hon. Member for Macclesfield is wearing his mask; in two weeks, he will not have to. We will be told that the pandemic is almost over at that point. Yet the Government will not start a public inquiry because they are afraid of accountability, transparency and the consequences for them in the polls.

Ultimately, the people are watching—in particular, the people of Scotland. We will be at a crossroads once again in the not-too-distant future in relation to the constitutional settlement on these islands. The people of Scotland will have the opportunity to decide their future once again. Is this incompetent, sleazy and corrupt Government the limit of their ambitions? Absolutely not, and when they have the opportunity to decide, they will choose to take a different path. The hon. Member for Montgomeryshire (Craig Williams) shakes his head. If he is not in agreement, he can get his Prime Minister to go to the polls any day, any time, and the people of Scotland will show him an alternative way.

It is not just about the cronyism; it is also about the handling of the pandemic. I have been appalled by some of the remarks from Government Members in relation to the situation in Scotland at the moment. We even had a Member at the back blaming it on Scotland fans going to the football. Of course, the only people who were not allowed to travel in the UK were football fans. I find the remarks that we have heard appalling.

[James Cartlidge]

rose—

[Stephen Flynn]

The hon. Member had the opportunity to say what he said earlier, and he can reflect upon it. The truth of the matter is that the situation in Scotland is as it is because Government Members let the Johnson variant in. They brought the delta variant to our shores. They could have closed the door, and they chose not to.

[James Cartlidge]

On a point of order, Mr Deputy Speaker. Could you advise me, as you did my hon. Friend the Member for West Aberdeenshire and Kincardine (Andrew Bowie), how I correct the record? I did not at all blame Scottish fans. I said that personally I was happy for them to travel and to celebrate. The point I made, sir, was that SNP Members were saying that it was our fault that Scotland now has the highest rate of covid in Europe, but had they wanted to do something they could have stopped fans travelling.

[Mr Deputy Speaker (Mr Nigel Evans)]

That is not a point of order for the Chair, and I hope that this device will not be abused.

A Plan for the NHS and Social Care

James Cartlidge Excerpts

Wednesday 19th May 2021 Commons Chamber

[Jonathan Ashworth]

The hon. Gentleman is spot-on. I will come on to cancer in a few moments. He is a great champion for improving cancer care, and I thank him for reminding the House that Leicester City won the FA cup on Saturday. It is a reminder that even when the odds are stacked against them, a small team can still beat a well-funded, complacent opposition.

I will now move on to elective waiting lists. Where is the plan in this Queen’s Speech to bring down the rocketing waiting lists for treatment and surgery? Where is the plan to roll out technology such as in ophthalmology, for the thousands in our constituencies awaiting cataract operations? There are already 81,762 of our constituents waiting over 12 months for orthopaedic surgery. Where is the plan to get on with the hip replacements and knee replacements that many of our constituents will be raising with us in our surgeries, and how much longer will they have to wait? Where is the plan for the 24,407 of our constituents who are now waiting over 12 months for gynaecological surgery? How much longer will they have to wait?

Everyone understands that there has been a pandemic and that that has meant a disruption in care pathways, but the NHS was forced into this unprecedented position because we went into the crisis on the back of 10 years of Tory underfunding and cutbacks. We went into this crisis on the back of a 6% reduction in bed numbers between 2010 and 2019. That is why, at the beginning of 2020 when we debated the last Gracious Speech, 4.5 million people were on the waiting list for treatment. The target of 92% of patients beginning treatment within 18 weeks of referral from their GP had not been met for five years. We need a resourced plan now because the queues are set to lengthen further, as those who may have delayed seeking treatment for fear of covid infection will begin to emerge once again. Even though the NHS is dealing with significantly fewer covid patients, it is still operating at a much-reduced capacity and is unable to treat everyone in need of care.

Infection control measures meant that the number of beds fell by 9% in the first quarter of last year. It has only partially recovered in the past three months, but the number is still 6% lower than the previous year. What that means when we look at the most recent figures is that, on average, there are almost 4,000 fewer patients in NHS general and acute beds than the equivalent pre-covid period.

The Prime Minister has delayed the review of social distancing for entirely understandable reasons, but we must have a plan to drive up this capacity in the NHS. The solution to these capacity issues in the NHS cannot be a multi-billion pound deal with the private sector. The loss of capacity in terms of beds in the NHS is actually far larger than the whole capacity offered by the private sector. In order to reopen those closed and empty general and acute beds in the NHS, we need more capital investment. This investment needs to be built up now, so that the NHS can get on with the routine surgery that it will clearly have to confront in the coming years. I am afraid that, both the Queen’s Speech and, indeed, the Budget from a few weeks ago, failed to deliver that.

[James Cartlidge (South Suffolk) (Con)]

Is the hon. Gentleman saying that under no circumstances would he use the independent sector to reduce the pressure on elective surgery waiting lists?

[Jonathan Ashworth]

If the hon. Gentleman thinks that the answer to driving up capacity is just a four-year £10 billion deal with the private sector, then we will not be in a position to reopen the beds over the coming years in the NHS. That is the issue. It undermines capacity in the NHS. We need capital investment in the NHS, so that we can drive up capacity.

[James Cartlidge]

Let me repeat the question: is the hon. Gentleman explicitly ruling out using the independent sector at all to drive down that backlog?

[Jonathan Ashworth]

The independent sector is not the answer to this. The answer is investing in capital in the NHS. In the hon. Gentleman’s local area, there are 8,485 patients waiting for diagnostic tests—that is 25% when the operational standard is supposed to be 1% or less. He should be arguing for capital investment in the NHS, but he is not, and he is not sticking up for his constituents.

[James Cartlidge]

Will the hon. Gentleman give way?

[Jonathan Ashworth]

I want to make a bit of progress. If the hon. Gentleman wanted more beds in the NHS and greater diagnostic capacity, he would have been arguing for capital investment in the NHS, which we did not get in the Budget and we did not get in the Queen’s Speech.

That brings me to diagnostic capacity—I have just given the hon. Gentleman his local diagnostic figures. [Interruption.] This is not about new hospitals; this is about diagnostic capacity. The Secretary of State knows that we still have some of the lowest numbers of computerised tomography scanners and magnetic resonance imaging scanners per capita in the OECD. We still have only average amounts of RTE radiotherapy machines. We need investment in this technology, which we are not getting in sufficient amounts. That is why, in the past year or so, we have seen 4.6 million fewer diagnostic tests for cancer. Some 46,000 fewer people are starting cancer treatment. We should not have to choose between covid care and cancer care, but, for too many, that has been the reality of the past year, and it means that 4,500 additional avoidable cancer deaths are expected in the next 12 months. It means that progress in survival rates for colorectal cancer, breast cancer and lung cancer is expected to be undone. The proportion of cancers diagnosed while still highly curable has dropped from 44% to 41%.

The long-term plan, on which the Secretary of State fought the election, promised rapid action on cardiovascular disease. Experts now predict the highest cardiovascular mortality in a decade, and they predict 12,000 additional heart attacks and strokes over the next five years. The Queen’s Speech needed to include proposals to expand access to the appropriate cardiovascular healthcare facilities, but it also needed to include real interventions to tackle smoking and alcohol rates, and to reduce salt intake. Yes, there is a commitment to a tobacco control plan, but will there be a reversal of the 17% cuts to smoking cessation services? Given that 7,400 people died last year from alcohol abuse—a record number—will the Secretary of State reverse the cuts to drug and alcohol addiction services, with budgets being cut by 15% over the past three years?

We have been promised action, again, on banning junk food advertising, but when? I have heard the Secretary of State—and, to be fair, his predecessor—make that promise at the Dispatch Box many, many times, but when will we have the ban? When will he reverse the cuts to public health weight-management services?

Narrowing health inequalities should be at the heart of every Government policy, but there can be no levelling up while life expectancy advances stall for the poorest in society. Levelling up and tackling inequalities apply to mental health outcomes as well. More people suffer from depression in the poorest areas of the country than the richest. We know that the mental health problems are prevalent among certain minority ethnic communities —black men, in particular, are more likely to be detained under the Mental Health Act 1983, more likely to be subjected to seclusion or restraint, and less likely to access psychological therapies. We therefore welcome the commitment to reform the Mental Health Act, as we welcomed it last year, and I look forward to working constructively with the Secretary of State on reforming the Act. I would like to put on record my thanks to Sir Simon Wessely for his pioneering work on this front. Simon is a committed Chelsea fan, so I dare say that he will be more responsive to my felicitations this morning than he might have been on Saturday evening.

We face a crisis in mental health now, and we need action now. Two hundred and thirty five thousand fewer people have been referred for psychological therapies; eating disorder referrals for children have doubled; and the pandemic—again, because of infection control measures —has meant a reduction of almost 11% in beds occupied, which is equivalent to 1,700 fewer patients over the past three months compared with a year earlier. When will the Government implement their promise of significant increases in staff and resources for mental health, to ensure that mental healthcare is genuinely given parity of esteem with acute services?

That brings me to staffing more generally. Given that we are short of 200,000 staff across the health and social care sector, why was there nothing new in the Queen’s Speech to recruit more doctors, nurses and social care staff? Why was there no plan to give our NHS staff the pay rise that they deserve? NHS staff, including nurses who have cared for those with covid on wards, and district nurses who, in the first wave, cared for those who were discharged from hospital earlier than planned so that they could stay at home safely, have gone above and beyond, yet they feel that the 1% pay rise, which could well turn out to be a real-terms cut because of inflation, is a kick in the teeth. Is it any wonder that nurses are leaving the profession, including the nurse who cared for the Prime Minister, blasting Ministers for treating NHS workers with a total lack of respect? It is simply not fair. Our NHS staff deserve better.

The gaping hole in the Queen’s Speech is the plan for social care. Two years ago, the Prime Minister stood on the steps of Downing Street and said he had a plan to fix social care. He said:

“we will fix the crisis in social care once and for all with a clear plan we have prepared to give every older person the dignity and security they deserve.”

It was not a plan to be developed, or work in progress; no, this was a plan that was already done—oven-ready, you might say, Madam Deputy Speaker. But two years on, where is it? Has the Health Secretary seen it? What do we need to do to see it—perhaps we could pay for some cushions in the Downing Street flat? The Government promised us cross-party talks. They now brief that cross-party talks have taken place, but when—did they forget to send the Zoom link?

However, there is a consensus on social care, isn’t there? Care workers should be paid the living wage and proper sick pay. There should be a cap on costs, as this House legislated for. When the Institute for Public Policy Research, social care and older people’s charities and a House of Lords Committee, which, at the time, consisted of true-blue Thatcherites such as the noble Lords Lamont and Forsyth, have all called for reform of free personal care, why is the Secretary of State not engaging in that debate with us? To be frank, though, lack of cross-party talks is not an excuse for not getting on with reform. A Prime Minister with an 80-seat majority should be able to show some leadership and get on and fix social care.

If the Health Secretary wants to talk social care reform, I am free this afternoon. He knows where I am. I am happy to sit down with him at any time and discuss it. I think we would have very constructive conversations on this one, because it is true to say, as Members have detected, that we have developed something of a bond these past 12 months. The Health Secretary has been so friendly to me across the Dispatch Box that I am half expecting to win a lucrative PPE contract by the end of the day.

Because we have this new friendship, I have, as we say on the Labour Benches, some comradely advice for the Health Secretary. I know he is bringing forward a Bill to neuter the independence of the NHS chief executive and bring powers back to the Secretary of State. I have been around a long time and I remember when Tory MPs used to complain that the NHS needed independence, but we will leave that to one side. I just suggest that he ought to be careful what he wishes for, because I have been reading the Evening Standard, where Mr Tom Newton Dunn reveals not only that Simon Stevens, whom the Secretary of State is trying to neuter, was best man at the Prime Minister’s wedding, but that the Prime Minister is said to be about to appoint Simon Stevens—I beg your pardon, Lord Simon Stevens—to, yes, you guessed it, the newly empowered post of Secretary of State for Health and Social Care. It brings a whole new meaning to the phrase, “the best man for the job”, doesn’t it? But this is a Secretary of State who set up Test and Trace, who was responsible for PPE procurement and who failed to protect care homes. Dominic Cummings said the Department under his leadership was a “smoking ruin”—and now he wants more control.

The Queen’s Speech was remarkably unspecific in its description of the contents of the coming health and social care Bill, so perhaps the Secretary of State can reassure us today. Can he commit to ensuring that neither the NHS nor the partnership force to be set up in each integrated care system will permit the inclusion of private sector participants? Will he rule that out? Can he guarantee that as statutory bodies ICSs will meet in public, publish board papers and be subject to the Freedom of Information Act 2000? What guarantees can he give this House that the establishment of integrated care systems will not lead to more private corporations taking over GP practices, as has happened recently with Centene, or services currently delivered by NHS providers? I hope he can give us those very simple reassurances today.

With nearly 5 million people on the waiting lists and rising, ever-lengthening queues in our constituencies waiting for hip replacements and cataract removals, cancer survival rates worsening, mental healthcare in crisis, social care reform kicked into the long grass, and a costly, morale-sapping reorganisation on the way, we needed a fully resourced 10-year rescue plan for our NHS. I commend our amendment to the House.

--- Later in debate ---

[Matt Hancock]

I will absolutely consider that. The hon. Gentleman raises one example of the sort of backlog that has not yet presented itself in many cases to the NHS, and I know that he met the Minister for Health recently to discuss how we can tackle this further.

[James Cartlidge]

The Secretary of State heard the intervention I made on the right hon. Member for Leicester South (Jonathan Ashworth). Is he aware that, in January, Ipswich Hospital was able to more than double the number of intensive care unit beds it had available, from 11 to 25, precisely because it moved cancer patients to the Nuffield hospital in the independent sector? Does that not show the danger of ideologically ruling out the use of the independent sector, which immediately reduces the capacity of the NHS?

[Matt Hancock]

Yes, my hon. Friend is absolutely right. I thought that his exchanges with the right hon. Member for Leicester South were disappointing, because we know that the Opposition spokesman supports the use of the private sector in the NHS, because he was the guy behind the private finance initiative projects of the last Labour Government. Mr PFI there is a huge fan of the use of the private sector in the NHS, but he cannot admit it, because of the people sitting behind him, and the right hon. Member for Ashton-under-Lyne (Angela Rayner) sitting next to him, keeping watch over him from the hard left of the party.

--- Later in debate ---

[James Cartlidge (South Suffolk) (Con)]

It is a real pleasure to be called in this important debate on the NHS in the Queen’s Speech. I join others in paying tribute to the amazing effort of NHS and social care staff in South Suffolk: all the staff at Colchester, Ipswich and West Suffolk Hospitals, our care homes, and the community pharmacy and vaccine teams in primary care who performed such an extraordinary job. Finally, I would particularly like to mention those volunteers who were standing in the snow of winter when we started the vaccine roll-out to help us to achieve what is basically a miracle of delivery of the vaccine. It should make us all proud of the NHS and proud, frankly, to be British.

I just want to make one key substantive point today, given that we are talking about a Bill that will reorganise the NHS: however we do that, we must maintain diversity of provision. I will refer to three key areas. The first is community pharmacy. I am a great fan of community pharmacy. It does a huge amount already, but it has earnt its spurs during the pandemic, giving out over 3 million jabs to date—more than the entire population of Greater Manchester. I have seen in my constituency how community pharmacies can really make a difference. My constituents have chosen them as their preferred place to receive a jab and it shows what more they can do. We must give them a deeper role in the delivery of healthcare in this country.

The second part of this is the voluntary sector, and I am thinking in particular of mental health. In Norfolk and Suffolk we have a struggling mental health trust, but when constituents have come to me with mental health problems in my surgeries—this was pre-pandemic— and I have been able to refer them to local mental health charities, they have often achieved great improvement in their mental health. Ed Garratt, the brilliant head of our local clinical commissioning group, supports this. We should look at more of the funding that goes to our NHS trusts going directly to those charities so that they become part of mental health capacity.

Finally, we should talk about the independent sector, and on this point I come back to my two earlier interventions on the shadow Secretary of State, because it was extraordinary what we heard today. As I said, Ipswich Hospital was able to double the number of ICU beds it had by moving cancer patients to the local Nuffield hospital. If someone was ideological enough to say, “We won’t work with the independent sector,” they are literally denying that capacity to people who use the NHS and saying, “You can only pay for it.” That is an extraordinary political point and it shows that the Labour party has not moved on from the depths of its dogma. We should deliver the best possible outcomes within the universal NHS, and that means diversity of provision at the heart of its delivery.

Covid-19 Update

James Cartlidge Excerpts

Monday 17th May 2021 Commons Chamber

[Matt Hancock]

We have a PCR testing capacity in this country of many hundreds of thousands more than we use each day. The Leamington Spa project is incredibly important and the people working there are doing a magnificent job. Frankly, I do not think that the rest of the hon. Gentleman’s question deserves an answer.

[James Cartlidge (South Suffolk) (Con)]

I strongly share my right hon. Friend’s sentiment, which he expressed earlier, about his pride in the role that the United Kingdom has played in the global vaccine effort, through the Oxford-AstraZeneca vaccine. Of course, the Indian variant shows that we remain vulnerable while the virus is rampant abroad, so what further steps can we take in the global fight against covid?

[Matt Hancock]

My hon. Friend makes an incredibly important point that we cannot stress enough. We all, especially developed countries, have a role to play in making sure that we get the vaccines around the world. The UK approach is focused on outcomes and on getting as many people as possible vaccinated globally. The best way to do that is to allow the work that we have done here—the research and the proving of the Oxford-AstraZeneca vaccine—to be replicated and manufactured everywhere at cost. That is a better approach because it protects future intellectual property values and allows for the research money to go into new vaccines and variant vaccines. It does not undermine the system of intellectual property, which is the underpinning concept of all pharmaceutical development, yet at the same time it makes sure that we get people vaccinated around the world. This country should be incredibly proud that we have helped vaccinate over 400 million people, with many hundreds of millions more to come.

Deaths in Mental Health Care

James Cartlidge Excerpts

Monday 30th November 2020 Westminster Hall

[James Cartlidge (South Suffolk) (Con)]

Thank you, Mr Stringer; it is a great pleasure to serve under your chairmanship, and to follow the hon. Member for Hartlepool (Mike Hill) who introduced the debate on behalf of the Petitions Committee. He spoke of the case of Matthew Leahy. It is a terrible tragedy, and I pay a huge tribute to his mother, who has campaigned for years through the pain, which is without limit.

We all sympathise, I am sure, but as the hon. Gentleman said the case of Leahy is not the only one at the Linden Centre, Chelmsford. There have been several others, all tragic, including my constituent Richard Wade. I held an Adjournment debate on the case of Richard Wade in October. At the start of that debate, because the HSE case was live, a much stricter sub judice ruling was given, which meant there were things I could not say in the Adjournment debate that I feel able to say today.

I have a very short period of time and I do not have time to give the full details of Richard Wade’s case. The key point is that, on the day he was found hanging in the Linden Centre in Chelmsford, there is strong evidence that his parents have seen—not just documentary evidence, but other evidence that has come to them, including from people who have worked at the Linden Centre—that when his body was first discovered hanging, still alive, the clinicians who found it either panicked, or for some other inexplicable reason left it hanging, locked the door and allowed some minutes to pass before he was discovered a second time, this time with his parents nearby. At that point he was given resuscitation and urgent medical treatment. We do not know the impact of those crucial minutes on his eventual fate several days later, when he passed away. Essentially, his is a life that I believe could have been saved and a death that could have been avoided.

I will not repeat all the points I made about Richard Wade’s case in my Adjournment debate, other than to say that although he died in May 2015—in fact, I met him going to vote in Great Cornard in May 2015, a few days before I had the great privilege of being elected for the first time, and he was dead several days later—in February 2015 another man, who I believe was called Beecroft, also died by ligature in the Linden Centre in Chelmsford, in the very same bathroom where Richard Wade hanged himself that May. The extraordinary thing is that, when the trust reported on Richard Wade’s death in December that year, it never mentioned that there had been a hanging in the same bathroom three months earlier—as if it were a common occurrence or something. It is quite extraordinary.

When the Care Quality Commission came to investigate, because of course, by April 2015, it had taken over from HSE, I am afraid it did not handle the case well. The CQC did not investigate it initially, because, in the words of the report it issued to the Wades in July, the inspectors effectively did not realise that they had taken over statutory responsibility from HSE. It is a catalogue of failures; the Wade case alone would merit an independent inquiry, but there are also Beecroft, Leahy, Morris and potentially other cases.

At the end of my Adjournment debate my hon. Friend the Minister, who was being covered for at the time because she was isolating, announced an independent review into the deaths at the Linden Centre. I was very grateful for that, because I know she has taken huge interest in the matter and very sincerely so. I hope that that can be a full, robust, independent inquiry, like the one we had last week into the Dixon case, which can uncover the truth and can go into places that other mechanisms cannot.

[Kevin Hollinrake (Thirsk and Malton) (Con)]

These are terribly tragic cases; sometimes they cannot be avoided, of course, but at times they are due to the performance of the trust and perhaps of the management of that trust. Where that is the case, does my hon. Friend agree that the leadership of those organisations must be held to account for their performance?

[James Cartlidge]

My hon. Friend makes an excellent point, echoing the concluding remark from the hon. Member for Hartlepool, and he is absolutely right that there must be accountability. However, when we go into an independent inquiry, there is a danger of saying, “Well, it must be a statutory public inquiry,” and getting into the semantics of the mechanism we use.

I think what my constituents the Wades want is the truth. They simply want to know the truth about what happened to their son. We now have a tangible offer from the Department of Health of a mechanism that all the families can use to get involved, to shape the terms of reference and to help us to deliver something in the public interest—as, again, the petitioners seek—to the benefit of the whole country in terms of wider mental health. Above all, that will bring some sense of accountability to all the families who have suffered so tragically at the Linden Centre in Chelmsford, including the Wades and the Leahys. I believe that the Minister will now act and I give her all my support in doing so.

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[Dr Rosena Allin-Khan (Tooting) (Lab)]

It is a real pleasure to serve under your chairmanship, Mr Stringer, and an honour to respond on behalf of the Opposition in this profoundly moving and powerful debate. I thank my hon. Friend the Member for Hartlepool (Mike Hill) for securing the debate, but it goes without saying that every contribution today has been extremely powerful. Everyone who has spoken has stood up for their constituents and represented the issues very well. The points have been made clearly and concisely, and hon. Members have done Melanie Leahy and the other families very proud.

We are here today because of a mother’s love for her son and her desire to receive some answers about his tragic and untimely death. It is fitting, then, that the debate should take place ahead of National Grief Awareness Week. Matthew Leahy was just 20 years old when he was admitted to the Linden Centre in November 2012 after being detained under the Mental Health Act 1983. While in the care of North Essex Partnership University Trust at the Linden Centre, Matthew phoned his parents on numerous occasions to express his unhappiness at being detained there. I know that I am speaking again of things that have already been mentioned, but it is important to give the details as many times as possible, to get what happened across as powerfully as is necessary to see the change we want.

Two days after being admitted, Matthew phoned his father to tell him that he had been drugged and raped on the ward. Following a 999 call made by Matthew, the Linden Centre staff gave assurances to the family that he was indeed safe in their care. Just days later, Matthew was found unresponsive and hanged, in his room. He was transferred to Broomfield Hospital, where he was pronounced dead. Matthew was in the Linden Centre for just seven days.

As a mother myself, I cannot comprehend what Melanie has had to contend with over the last eight years. Sadly for Melanie and the family, the struggle is not over. An inquest concluded with an open narrative verdict that Matthew was subject to multiple failings and missed opportunities over a prolonged period of time, by those entrusted with his care. Multiple investigations and reviews were carried out into the North Essex Partnership University NHS Foundation Trust, and into Matthew’s care, and they raised even more questions about the care that he received and the nature of his death. I want to raise some of the concerns that were found in the various reviews so that everyone here can get further understanding of the scale of the challenge that Melanie and her family have faced for the past eight years.

At post-mortem, traces of the drug GHB were found in Matthew’s system. He had bruises just above both ankles and four to five unexplained needle wounds in his groin. Matthew’s paperwork was incomplete and a key worker was not assigned to him. Staff at the Linden Centre had not issued Matthew with a care plan, but after his death they falsified one and backdated it. A number of ligature points in the Linden Centre previously identified for removal were still there. Essex police dropped a corporate manslaughter investigation into the deaths of 25 patients who were in the care of the North Essex partnership trust at nine separate establishments since 2000. The ombudsman investigated, and agreed that Matthew had not been responded to appropriately after reporting a rape, as well as that the Essex partnership’s investigation of Matthew’s death was inadequate. All this in eight years—the toll it has taken on this family. That is before we consider the prosecution of the Essex Partnership University NHS Foundation Trust by the Health and Safety Executive following the deaths of 11 patients in its care between 2004 and 2015.

The loss of multiple lives and the tearing apart of families were devastating and, most tragically, utterly preventable. We have to learn from those tragic losses so that no other families are affected. I ask the Minister if she will please work with Melanie Leahy on this matter directly, as her predecessor promised to do. I had the honour of speaking to Melanie ahead of the debate. This is her day, Matthew’s day and a day for all who are still seeking answers about their loved ones’ deaths.

The strength it takes to continue this fight after eight long years is commendable. My heart goes out to Melanie’s family and to all who have lost loved ones in similar circumstances, not just at the Linden Centre but in care settings across the country where they were meant to be safe. Many of those people have been mentioned in today’s debate, and I thank Members again for their contributions.

A system is not working properly if it takes so long to investigate such a tragedy, and yet answers are still not forthcoming. A grieving mother should not have to plead with people to sign a petition to get answers surrounding her son’s death. There should be no barriers to the truth. Inquiries and investigations should not be reserved for the most privileged and those who are most familiar with the system.

On the point about time, I highlight that it has taken over a year to have this debate following Melanie’s successful petition. We all understand the mitigating factors that this year has brought, but I would like everyone to consider how every step of the process has been slow. Barriers have been put in place for the family at every single turn.

[James Cartlidge]

Does the hon. Lady agree that, that being so, it would be very much in the interests of all stakeholders if the inquiry took place, ideally, as soon as possible?

[Dr Allin-Khan]

Yes, of course it would be in everyone’s best interests for the inquiry to take place as soon as possible. After all this time, Melanie deserves some answers. I support her call for a statutory public inquiry into Essex mental health services and for the appointment of an independent chair. It is crucial that lessons are learned from Matthew’s case.

I will take this moment to read a few words from Melanie about why a statutory public inquiry is so important to her:

“To come this far and then get fobbed off with a review or general inquiry…would simply take…us all back to square one.”

She goes on to ask that the Minister do something real and meaningful that paves the way for truth, justice, accountability and change. There is an opportunity here for the Minister to commit to providing a grieving mother with answers about her son’s death, and to learning lessons so that other families do not suffer in this way. We cannot, and must not, delay any further.

--- Later in debate ---

[Ms Dorries]

We will go through the processes that we have been through within the Department of Health and Social Care. They are set in law and abided by during every inquiry; that has included all the past inquiries such as the Dixon inquiry, the Paterson inquiry and the Morecambe Bay inquiry. The same protocols and the same process will be adhered to.[Official Report, 3 December 2020, Vol. 685, c. 4MC.]

[James Cartlidge]

I am grateful for what the Minister has said. I know that she has battled to get this through because she sincerely believes in the cause and in bringing justice. In my view, it is important that it happens quickly, as I said earlier. My worry is that a statutory inquiry would take months and months to set up. For my constituents the Wades, the key thing is time. The semantics do not matter, as long as what we do finds the truth and probes further. That is exactly what happened with the Dixon inquiry.

[Ms Dorries]

My hon. Friend is absolutely right that no stone was left unturned in the Dixon inquiry. It took 20 years to conclude, and the summary was devastating in terms of what happened. A nurse can no longer practise in this country, and it was revealed that the trust, doctors and medical staff had engaged in a cover-up for 20 years. It took 20 years of probing, but the inquiry happened. It might be thought that a public inquiry would find out more, but one of the advantages of an independent inquiry is that it can work much more closely with families and take their considerations into account by talking to them and involving them, whereas that would not happen with a public inquiry. As has been demonstrated by each one that has been conducted, an independent inquiry benefits from the relationship built with families and the information that families have been able to input. It is important that families’ stories are heard, because some of them are complex, painful and detailed.

Extending the inquiry from 2000 to 2020, as I have done this morning, incorporates both the former trust and the existing trust. A situation occurred recently within the new trust, and we are able to incorporate both trusts and even more families.

Covid-19 Update

James Cartlidge Excerpts

Tuesday 10th November 2020 Commons Chamber

[Matt Hancock]

Yes, of course. We are working with hospitals across Yorkshire and across the whole country to try to make sure that we have the most capacity available. It is true that the numbers going into hospitals across Yorkshire continue to be far too high, and there is an awful lot of work we need to do, but the most important thing is that we get this virus under control in order to bring that number of admissions down.

[James Cartlidge (South Suffolk) (Con)]

I join others in congratulating my right hon. Friend, my constituency neighbour, on ensuring that our country has its share of this very promising RNA vaccine. However, on the subject of the previous question and capacity, is not one of the key reasons for prioritising health and social care staff not just that we prioritise those who are protecting us, but that by ensuring they are first in line for the vaccine, should it come forward and be proved safe, we will help to boost hospital capacity at a crucial time of the year?

[Matt Hancock]

Yes, that is a really important point. Part of the challenge of, and the reason for, a second lockdown was NHS capacity. The more we protect those who work in the NHS, the fewer are unavailable to work, precisely as the right hon. Member for Normanton, Pontefract and Castleford (Yvette Cooper) said, and the more capacity we have in our NHS.

Care Quality Commission: Deaths in Mental Health Facilities

James Cartlidge Excerpts

Friday 16th October 2020 Commons Chamber

[James Cartlidge (South Suffolk) (Con)]

I am very grateful to you, Mr Deputy Speaker, for enabling this debate to come forward, and I will entirely abide by your guidance on the case that is ongoing. It highlights, frankly, that this is a very timely debate. Your guidance in relation to the case means that there are important points of substance that I am unable to make today, but the fundamentals are unchanged because, as you say, they relate to a death in May 2015 under the Care Quality Commission rather than the Health and Safety Executive.

The case in question is that of Richard Edward Wade of Great Cornard in South Suffolk, and the failure of the Care Quality Commission to investigate his death and provide his family with the justice and accountability that they have sought for so long. On the evening of 16 May 2015, Richard called the police as he was suffering from poor mental health and feared that he would hurt himself. The police assessed him and decided that the best course of action would be to admit him to the Linden Centre in Chelmsford to ensure his safety. I emphasise that Richard voluntarily called for assistance, he was not sectioned, and he was admitted to the Linden Centre on the basis that it would provide a place of care.

Just over 12 hours later, Richard was found to have attempted suicide by use of a ligature. Richard was transferred to the Broomfield Hospital next door, received treatment in the intensive care unit, and passed away on 21 May 2015. Richard, who had a PhD in political science and had published a book two years before, was just 30 years old when he died.

Before I set out my primary arguments about the CQC’s handling of the case, I would like to make three important points. First, I would like to take this opportunity to pay tribute to Richard’s parents, Linda and Robert Wade, who, despite their tragic loss, have shown remarkable resilience in their fight for justice. They have never given up pursuing the truth and I sincerely admire the way they have been able to maintain outer calm whenever describing to me and others, including the Minister, the traumatic details of their son’s last days.

The Minister I refer to is the Minister for Patient Safety, Mental Health and Suicide Prevention, my hon. Friend the Member for Mid Bedfordshire (Ms Dorries). She cannot be here today; the Minister for Health, my hon. Friend the Member for Charnwood (Edward Argar), is covering, but my second point is to pay tribute to my hon. Friend the Mental Health Minister, because she has shown huge personal interest in this case. Back in October, when she met the parents of Richard Wade, she was incredibly moved by what she heard. As the son of a nurse—my mother was a nurse for many decades—I would say that my hon. Friend’s background as a nurse shone through. She showed genuine empathy and sympathy with the Wades, and I know that she has been trying her best in the background to get proactive stuff done on the case.

My third point before I go into my main remarks is that I am very much aware that this is not the only death that has occurred by ligature at the Linden Centre Chelmsford. There are a number of cases with circumstances not dissimilar to those of Richard Wade. For example, Mr Deputy Speaker, you may be aware that the Petitions Committee has received a petition for a public inquiry into one such case that has now received more than 100,000 signatures. I believe that the case for a public inquiry or an independent inquiry is very strong, particularly in the case of Richard Wade, because, in demonstrating how the CQC failed to investigate his death, it prompts the following very simple question. Since that investigation timed out under its statutory time limit, if not an independent inquiry, what else can we offer the Wades in their search for the truth of what happened to their son?

Of course, primary responsibility for the handling of Richard’s clinical case in May 2015 rested with the trust in charge of the Linden Centre, then the North Essex Partnership NHS Foundation Trust and now the Essex Partnership University NHS Foundation Trust, which I will refer to from now on as “the trust”. In January 2016, following an internal investigation into Richard’s death, the Wades received a letter of apology from Andrew Geldard, the chief executive of the trust, stating that Richard’s death in the trust’s care “could have been avoided”. My primary concern today is not the role of the trust but that of the regulator charged by the Department of Health with the legal responsibility for holding the trust to account for its failings, the CQC.

The facts of timing are critical here. In April 2015, following recommendations in the Francis report, which came from the Mid Staffordshire scandal, prosecuting powers in relation to patient care passed from the Health and Safety Executive to the CQC. Richard died a month after the transfer of responsibilities, but, agonisingly for Richard’s parents, through a series of internal failures at the CQC the regulator failed to prosecute the trust within its three-year statutory limit. The main reason for the failure to prosecute is very hard to take, and is evidenced by the CQC’s own internal report into the handling of Richard’s case, published this July, which is the primary document to which I shall be referring.

The report states that the

“CQC did not undertake its own review or investigation of Richard’s death as staff, who acted as the relationship owner for this location, mistakenly believed that HSE retained primacy of the criminal investigation alongside Essex police”.

In short, the CQC did not investigate because it did not realise it was its responsibility to do so. What reason was given for this shortcoming? The report says that the CQC was “unprepared” for the changes of April 2015, stating:

“The implementation of new powers of criminal enforcement had been given to us at short notice”.

I repeat “short notice”, because that is simply not the case. In fact, these new powers were passed in the Commons in 2014 in the form of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, giving the CQC plenty of time to ensure that its staff were properly informed and trained in these new powers.

In February 2015, the CQC published its “Enforcement policy” document for its staff ahead of gaining the new powers in April 2015. This policy clearly states:

“CQC is the lead inspection and enforcement body for safety and quality of treatment and care matters involving patients and service users in receipt of health or adult social care service from a provider registered with CQC”.

I can also confirm that in the run-up to the CQC taking lead responsibility after April 2015, there was close working between the HSE and the CQC, which included not only a memorandum of understanding to clarify roles and responsibilities, but interim working arrangements and, crucially, training for CQC staff on criminal investigations. It is very hard to believe that CQC inspectors did not know of the new powers at the time of Richard Wade’s death. If it is true that they did not know, it represents gross negligence and a manifest failing on the part of senior CQC management for which nobody has been held to account to date.

The CQC did eventually hold a management review meeting about Richard’s case in May 2017, two years after his death, due to the impending coroner’s inquest, and in July 2017 a lawyer was finally allocated to the case. Over the next six months, because of “staffing continuity issues”, the lawyer changing three times and a lack of response from Essex constabulary, very little progress was made in Richard’s case. According to the report,

“by the time the police provided some evidence on 6 January 2018, the impending limitation date of 17 May 2018 left insufficient time for the case to be considered from a fully informed evidential position, with a view to a potential prosecution.”

Put simply, instead of using those final four months of the three-year time limit to commence the investigation, which, after all, was running late precisely because of mistakes made by the CQC, it would appear that at that stage the CQC simply gave up.

Last week the CQC announced that it would be prosecuting the East Kent Hospitals University NHS Foundation Trust, following complications that led to the death of a baby in its care in November 2017. This is the first time that the regulator has prosecuted an NHS trust over a safety failure in the clinical care of patients since it gained the powers in 2015. For Mr and Mrs Wade it has been a painful reminder of what might have been. As I said at the beginning, there have been a number of other cases at the Linden Centre not dissimilar to Richard Wade’s.

In addition to the failure to investigate within the statutory time limit, the other shocking aspect of the CQC’s handling of his death was its failure to see a wider pattern—surely this goes to the very purpose of the regulatory changes that followed the infamous Mid Staffs scandal. In February 2015, just three months before Richard died, another patient died from ligature compression to the neck in the Linden Centre. This occurred in the very same bathroom where Richard attempted to take his life on 17 May 2015. We know that the CQC first became aware of Richard’s case on 18 May 2015. On 20 May 2015, while Richard was in intensive care in Broomfield Hospital, the CQC published its report into the February incident. Richard was pronounced dead the next day. In that context, surely one would have expected alarm bells to be ringing and klaxons to be sounding. The CQC was suddenly aware of two similar deaths by ligature, not only in the same setting but in the same bathroom, but nothing happened—there was no investigation and no emergency investigation. Given the similarity of these cases, I find that extraordinary.

The trust carried out its own serious incident investigation into Richard’s death in December 2015, and the CQC report notes that

“it does not mention that a patient had used a ligature in the same bathroom three months before this accident, and subsequently died”.

Yet there was no challenge to this glaring omission from the CQC and its report states that

“there is no documentary evidence that CQC reviewed evidence and judged if the recommendations from the serious incident were embedded”.

Perhaps most worrying of all, the CQC inspection that occurred into the February 2015 death was a missed opportunity to prevent Richard’s own tragedy. The report on Richard’s death explains that there is no documentary evidence that the February 2015 inspectors gave verbal feedback to the trust about the actions that needed to be taken to prevent another death. Additionally, it states that they

“have no evidence in our records of any action the trust took following feedback from inspectors. After the 2015 inspection, the trust was asked to provide further information regarding environmental risk assessments and care plan reviews. However, there is no documentation of CQC formally reviewing this extra evidence that the trust submitted.”

At every turn, there was inaction by the CQC until it was too late.

That brings me to my final points. In October last year, the Public Administration and Constitutional Affairs Committee held an evidence session on the Parliamentary and Health Service Ombudsman’s report on missed opportunities at the trust. The report focused on the cases of two victims, who did not including Richard Wade, and Mr and Mrs Wade provided written evidence about Richard’s death. During the session, my hon. Friend the Minister for Patient Safety, Mental Health and Suicide Prevention explained that the Department’s position on the calls for a public inquiry was that such inquiries

“do not happen for individual cases; they tend to happen when there is a systemic problem or there are multiple cases. In this case, a public inquiry is not an appropriate response because we are talking about two cases.”

There are multiple cases. I believe there is strong evidence of systemic failure, and on top of that we now have regulatory failure. As such, I believe it is time for the Minister to consider the need for an independent inquiry into all similar deaths at the Linden Centre, including that of Ricard Wade.

A young man lost his life in the place where he had sought safety. Richard identified that he was a risk to himself and asked our mental health service for assistance. Due to multiple missed opportunities for existing problems to be rectified, he lost his life. Now, his family are being denied the justice that they deserve through patent failures by the CQC within the statutory time limit that has now closed. There is no statutory time limit on the grief of his parents. All they want is to know the truth. If that can come from an independent inquiry, that is the least we can do for them. My hon. Friend the Minister for Patient Safety, Mental Health and Suicide Prevention has been sympathetic and I know she is doing all she can in the background. I hope that today my hon. Friend the Minister for Health can give us some hope for the future.

[The Minister for Health (Edward Argar)]

I congratulate my hon. Friend the Member for South Suffolk (James Cartlidge) on securing this important debate and his dedication in representing his constituents. He is an old friend of mine and I know how committed he is to his constituents’ interests. Having spoken to him about this particular case, I know how much it matters to him. I was very sorry to hear about the tragic circumstances of this case.

I wish to put on record, at her request, the fact that the Minister for Patient Safety, Mental Health and Suicide Prevention would dearly love to have been in the Chamber today, given how closely she has been involved with this case and situation. However, as a contact of a recent positive covid case, she is doing the right thing, as always, and staying away. I know that she is watching this debate as we speak and that she will continue to keep very much in touch with developments. I am sure she will speak to my hon. Friend the Member for South Suffolk very soon.

I thank my hon. Friend for raising the concerns about the tragic circumstances around the care of his constituent, Richard Wade, at the Linden Centre, and the CQC’s role in investigating the events. As my hon. Friend set out, in May 2015, Richard tragically took his own life while under the care of the Linden Centre, a mental health facility in the Essex Partnership University NHS Foundation Trust. I put on record my heartfelt sympathies for and condolences to Richard’s family. I understand the devastating impact this must have had on their lives. The passage of time will do nothing to dim that, so I wanted to put that on the record.

As a Minister in the Department of Health and Social Care, I am fully committed to ensuring that we provide the highest standards of quality and safe services to patients, and that when there are failures in the delivery of those standards, we are transparent about how we are learning lessons. My hon. Friend raised important issues about the failings of the CQC in responding to the concerns of Mr Wade’s family following his death, and I have noted the CQC’s review of its handling of these matters. The CQC states that it decided not to use criminal enforcement powers to prosecute the trust—it states that this decision was taken after liaison with the Health and Safety Executive and Essex police—and instead to use civil enforcement powers against the trust after Mr Wade’s death. The CQC further states that there was, in its view, insufficient evidence to proceed to criminal enforcement as, according to the CQC, the evidence indicated that breaches were committed by a series of individuals whose actions lay outside the CQC’s prosecution powers. However, my hon. Friend has clearly set out his views on that and on the CQC’s actions. The CQC has unreservedly apologised to Mr Wade’s family for its handling of this case.

As my hon. Friend set out, the CQC review findings identified areas for improvement and organisational learning. The CQC has committed to internal learning for staff and to support providers to recognise ligature risks and improve safety for people who use mental health services. The regulator is providing mandatory training across all inspection teams on decision making and has strengthened its enforcement training for new inspectors. Importantly, the CQC works closely with families and ensures that their involvement and feedback is considered as an integral part of what the regulator does.

On the wider health system and learnings, last year the CQC wrote to all NHS providers of mental health services regarding concerns about the quality and safety of care provided on mental health wards. While progress has been made, there is still significant variation across the country, with a lack of improvement in some mental health settings. In July this year, the CQC wrote to all NHS providers of mental health services, highlighting that it will be looking at this in inspections of wards. Where insufficient improvements have been made, the CQC will take enforcement action.

In 2018, we launched a zero-suicide ambition for mental health in-patients, which means that every mental health trust now has a zero-suicide ambition plan in place. Those trusts will be supported by a new mental health safety improvement programme, which we committed to in the NHS long-term plan.

As my hon. Friend will be aware, the Parliamentary and Health Service Ombudsman laid a report before Parliament in June 2019 on a series of significant failings in the care and treatment of another two vulnerable young men who died shortly after being admitted to the Linden Centre: Matthew Leahy and Mr R. My thoughts are with the families of all those patients who died at the former North Essex Partnership University NHS Foundation Trust, and we are committed to learning lessons from those tragic events.

As my hon. Friend said, the Minister for Patient Safety, Mental Health and Suicide Prevention gave evidence to the Public Administration and Constitutional Affairs Committee last year. The Committee looked into missed opportunities and the recommendations made by the PHSO, and my Department is considering its response to the Committee’s report, which it looks forward to publishing in due course.

As you alluded to, Mr Deputy Speaker, the Health and Safety Executive has investigated the trust, and as a result of that investigation, the Health and Safety Executive has brought a prosecution against the Essex Partnership University NHS Foundation Trust. As Members will understand—and in line with your advice, Mr Deputy Speaker, and that of the Clerks—I am unable to go into any further details on the HSE investigation. However, it has advised that the first hearing in that case will take place in Chelmsford in November. I will say no more on the case than that, in line with your guidance, Mr Deputy Speaker. It is never acceptable for patients to be exposed to avoidable risks. When things do go wrong, clinicians need to be open, honest and able to learn from their mistakes.

I turn to one of the key points that my hon. Friend raised. I am very much aware, as is my hon. Friend the Member for Mid Bedfordshire, of the petition from families of patients who have died while under the care of NHS services in the Essex area, calling for a public inquiry into the deaths. I completely understand that they have concerns that they want to have heard in public. They want answers, and they want to know what happened. My hon. Friend the Member for Mid Bedfordshire has given careful consideration to the failures in care at the former North Essex Partnership University NHS Foundation Trust. On her behalf, I am announcing today that she has set out her intention to commission an independent review into the serious questions raised by a series of tragic deaths of patients at the Linden Centre between 2008 and 2015.

[James Cartlidge]

That will be incredibly welcome for all the families connected. Can the Minister confirm that it will include the case of Richard Wade? Does he appreciate that many other Members—particularly those representing Essex constituencies, and many of whom are Ministers and therefore cannot contribute—will be incredibly pleased to hear this announcement? Frankly, none of us expected it, even though we have waited for it for so long.

[Edward Argar]

I am grateful to my hon. Friend. Although the formal terms of reference of the independent review have yet to be fully agreed, the conditions relating to Mr Wade’s death and the date certainly appear pertinent to this review and are likely to be considered as part of it. I will turn to the details in just a second.

This review will build on the recommendations made in the 2019 Parliamentary and Health Service Ombudsman’s “Missed Opportunities” report. I emphasise again, because I know that my hon. Friend has argued for this powerfully, that it will be independent. He rightly alluded to the fact that, although he is raising Mr Wade’s case today, there is a broader context, and there are other hon. and right hon. Members who have constituents who have been in a similar position and families who have approached them about this. I know that they will want to be involved as well.

[James Cartlidge]

The Minister will appreciate that this is very significant news for many constituents because of the trauma they have experienced. He is right that the key word he has used is “independent”. Will he confirm that that means, basically, that what those constituents have been asking for will be granted, because it is the best chance they will have to learn the truth of what happened?

[Edward Argar]

I am grateful to my hon. Friend for his intervention. I am just coming on to the process that will be set in train now. I emphasise that although, for the reasons I set out, it is me announcing this to the House, the work has been done by my hon. Friend the Member for Mid Bedfordshire. I want it to be recognised just how much work she has put into this issue.

We have decided to start the process now, so that the lessons learned can benefit care across the wider NHS as quickly as possible. We will work with the HSE to ensure that the review does not in any way prejudice the legal action that is under way.

Turning to the specific issues that my hon. Friend raised, the Minister for Patient Safety, Mental Health and Suicide Prevention will also be seeking as swiftly as possible a meeting with the families affected by these events, as well as with my hon. Friend and other hon. Members who are involved with this issue, to understand what they would wish to see from this process as the terms of reference and scope are agreed. The Minister is very keen to fully involve them in understanding the scope and terms of reference that need to be set and how we can seek through this process to bring them at least some degree of resolution. She will provide further details on that in due course.

[James Cartlidge]

The Minister is right to stress the work of our hon. Friend the Minister for Patient Safety, Mental Health and Suicide Prevention, who cares passionately about this. I did say this in my earlier remarks, but I must stress that I know that when she met my constituents—the parents of Richard Wade—it cut to her heart. She has shown huge compassion, which is what has driven this. It is thanks to that that my hon. Friend has announced the news he has today.

[Edward Argar]

My hon. Friend is absolutely right, and I will turn briefly to that in a second. I hope that this announcement today to commission an independent review into issues at the former North Essex partnership trust shows the strength of our commitment and my hon. Friend’s commitment in addressing the concerns he and his constituents have raised and in listening to and working with the families involved in these tragedies. We are committed to learning lessons at a national level to improve services across the whole mental health system, so that no other family experiences the same devastating loss as Richard’s family and the families of other patients who died at the former North Essex partnership trust.

In the few minutes remaining, let me say that my hon. Friend is absolutely right in what he says: my hon. Friend the Member for Mid Bedfordshire brings compassion, decency and determination to her dealings not just on this issue, but across the field of suicide prevention, mental health and patient safety. She is absolutely passionate about it. She has not only a background in medical services, but a genuine passion. It is her energy that is driving this forward and I have to say that it is a privilege to be a colleague of hers and to work alongside her in the role that I hold in the Department.

I conclude by saying once again that, of course, my thoughts and those of colleagues in this House will remain very much with Richard Wade’s family and all the families who have lost loved ones in these circumstances.

Question put and agreed to.

Botulinum Toxin and Cosmetic Fillers (Children) Bill

James Cartlidge Excerpts

2nd reading & 2nd reading: House of Commons
Friday 16th October 2020 Commons Chamber

[Laura Trott]

My hon. Friend makes an excellent point. It is the NHS that has to pick up the bill for these problems, but it is not the NHS that will always pay for cosmetic surgery to fix them, so young people can be left with lifelong scars as a result of their surgeries, so he raises an excellent point.

The worst of it is that these risks are not theoretical or rare. I stress that this is an unregulated area, so instances of severe complications are not formally documented. However, thanks to brilliant campaigns by many Members of this House, the campaigning organisation, Save Face, and investigations carried out in the media, horrific stories have come to light. There were more than 1,600 complaints to Save Face last year, and it is estimated that 200 people have gone blind following these treatments, but it is the cases of the under-18s that have really stuck with me.

It is worth dwelling on a specific case study, which is representative of the countless stories I have heard. An under-18 female, who I will not name, booked a lip filler treatment after seeing a social media post promoting a discount. When she arrived at the clinic, she applied numbing cream herself to her lips. She was not asked her name. She was not asked details of her medical history. She was not even told what product was being used. She was not told of any possible side-effects. She was not consulted.

The treatment itself took less than 10 minutes. On completion, she was hurried out to pay the final balance. A few days later, she was experiencing significant pain and loss of sensation on the left side of her face. She contacted the person who treated her. She was ignored. Her symptoms became worse. She contacted her GP. She was told she should go and see another practitioner. When she eventually found a reputable local aesthetic healthcare professional, she reviewed her lips and concluded that the filler was compromising the blood flow to the tissue. She nearly lost her lips. This is an under-18 girl who nearly lost her lips through a procedure freely advertised and legally administered with no warnings or regulation whatever. Sadly, that example is not rare enough.

At the opening session of the all-party parliamentary group on beauty, aesthetics and wellbeing’s inquiry into the sector, Rachel Knappier appeared. She suffered from a botched filler, injected by a practitioner without any medical training, which resulted in her needing critical care. She told the APPG that there is

“nowhere for these people to turn to”

when things go wrong. She continued:

“Cheap adverts on social platforms are encouraging young impressionable people to seek an instant change to their appearance…to seek what is portrayed as the image of perfection.”

I could expound at length on the historical lack of oversight on women’s health issues. From PIP breast implants to vaginal mesh, we have simply not seen enough focus on these important issues by Governments over decades. This is a private Member’s Bill, however, and is necessarily limited in scope. I am pleased that the current Minister for Patient Safety, Mental Health and Suicide Prevention and her predecessor, my hon. Friend the Member for Thurrock (Jackie Doyle-Price), have started to change the trend.

[James Cartlidge (South Suffolk) (Con)]

My hon. Friend is making a brilliant speech. She is talking about the scope of the Bill, but will she clarify something? It is not clear to me whether it covers England, or England and Wales or the whole of mainland Great Britain.

[Laura Trott]

I thank my hon. Friend for his intervention. The scope of the Bill is England. It focuses specifically on the lack of protections for under-18s. The absence of a legal age limit for botox and for dermal fillers means that any 15-year-old could walk into a shop and get their lips injected by someone with no qualifications whatever. Despite the proven health risks and implications for psychological wellbeing, young people can legally access invasive cosmetic procedures on the commercial market or in their homes without any requirement for a medical or psychological assessment. Unregulated practitioners are not required to hold insurance and may not have the medical knowledge to manage complications. That cannot be allowed to continue.

The case for change is absolute. It is unacceptable that we allow children to be exposed to life-changing risky procedures with little to no regulation. My Bill would criminalise the administering in England of botox injections and cosmetic fillers to people under the age of 18. There are cases where medical conditions may require such treatment, such as migraines. These treatments could continue if carried out in accordance with the directions of a doctor. However, we must take action to bring fillers and botox procedures in line with other body modifications that carry similar health risks, such as tattoos. The Bill would impose a duty on businesses to ensure that they do not arrange or perform these procedures on under-18s unless approved by a doctor. We can no longer allow the unscrupulous actions of some people to impact on our children’s lives, and those administering the procedures must be held accountable. The most frequent reaction I have received in response to my Bill is, “Surely, that is illegal already.” I join in that disbelief, and this House must now put it right.

--- Later in debate ---

[James Cartlidge (South Suffolk) (Con)]

I am slightly surprised to be called so early when my hon. Friend the Member for Christchurch (Sir Christopher Chope) was ahead of me on the call list.

[Mr Speaker]

He may have been ahead, but if he is not here, you are certainly the winner!

[James Cartlidge]

The Bill is about fillers, and we could have had a filibuster—you never know.

I congratulate my hon. Friend the Member for Sevenoaks (Laura Trott) on her brilliant speech. This Bill is clearly well justified. She set out the scope of it and the key powers in it, and she has done herself immense credit.

I need to declare an interest. For many years, I have benefited from an artificial enhancement to my appearance. It may not be obvious to most people in the room, and before the speculation starts, it is not botox. It is made of something called hydrogels. I am, of course, referring to my contact lenses.

The point is a serious one. It is a good feature of the Bill that it will still be legal for children to have botox treatments where it is necessary for medical surgery. We talk about “enhanced appearance”. In my case, if I did not wear my lenses, whatever it did to my appearance, it would certainly affect everyone else’s, because my prescription is minus 7.5 in the left eye and minus 9 in the right eye, and I have a strong astigmatism. Without my lenses or glasses, I would not be able to see anything. I had glasses in secondary school that were so thick, it was like someone had attached two pint glasses to my head. When I got contact lenses, it helped with sport and many other things, and it gave a huge boost to my self-confidence and self-esteem. I will not comment on whatever it did to my appearance, because that is not the point. I understand and empathise with those who want to invest in procedures or enhancements that give them greater self-confidence about their appearance. It is an entirely reasonable thing to do, and millions of people do it up and down the country. I am not necessarily aware of the cases involving children, but many people use botox perfectly reasonably and are very happy with the results. It is a booming industry, and I suspect most procedures are successful.

As much as I welcome the Bill and believe that my hon. Friend the Member for Sevenoaks made a good case, we on the Government Benches in particular—there are not many on the Opposition Benches—should, by default, take the devil’s advocate position with respect to any regulation that will restrict what people can do, no matter how worthy. I feel I have to do that, given that my hon. Friend the Member for Christchurch, who was supposed to speak before me, probably would have examined that position in some detail.

These are heavily regulated times. I have a table booked in a restaurant in my constituency on Sunday for the six members of my family. Because Essex has gone into tier 2, I got a phone call to ask whether any of us are from Essex. At a time when we are regulating every aspect of daily life—which, of course, is for reasons beyond our control, because of covid—we must be extra careful in examining the case for all new regulations, even if it is morally very strong.

[Anthony Mangnall (Totnes) (Con)]

I thank my hon. Friend for the point he is making, because I agree that too much regulation could be a problem. This ties in with the ten-minute rule Bill presented a few weeks ago by my hon. Friend the Member for Bosworth (Dr Evans) about the impact of social media on people’s image. Does he agree that we must educate people about their image, how it is perceived and what social media companies are doing around that, so that we do not necessarily have to implement regulation all the time?

[James Cartlidge]

My hon. Friend makes an extremely good point, and that is, in many ways, what I am driving at. There is always a balance between whether we regulate and restrict or trust people’s judgment. There will even be people aged 16 or 17 who consider surgical enhancement procedures and are very rational and do not suffer from any form of mental health issues or self-confidence issues, for whom this sort of procedure would result in a satisfactory outcome. We have to remember that. The question in regulating is the traditional one of whether the benefit in protection of the vulnerable minority—we assume it is a minority; statistics are hard to come by—is worth while, given the impact it may have on a greater number who may not need that regulation but will now have a freedom stifled. That is the old chestnut.

I have heard what my hon. Friend the Member for Sevenoaks said—I thought it was a very good speech—and I have read all the notes and a lot of the research on the internet, and I am of the view that, definitively, this is a very necessary and justified Bill. It is necessary for the state to intervene and restrict the availability of these services, products and interventions for young people, because what outweighs the downside of regulating is the fact that we are protecting vulnerable people from an outcome that—in some cases, if not many cases—can be terrible or disfiguring, and they can go on to regret it for years to come, potentially at great expense. On that basis, it is certainly justified.

It is particularly justified in the context of children’s mental health, which I feel very strongly about. I have the Adjournment debate today on a very tragic suicide in my constituency. It reminds me that one of the very first traumatic constituency cases I had to deal with related to a young lady’s self-awareness issues—basically, an eating disorder—and although it was not fatal, there was an attempted suicide. It was a terrible case, and it really opened my eyes as a new MP to the issue of eating disorders.

Since then, I have had the pleasure to engage with the charity Beat. Its local spokesperson in my constituency is Laura Shah, an absolutely wonderful lady, who has explained the issues to me. In fact, given that my hon. Friend the Minister will be speaking later, I should put on record—he may not want to say this because of his naturally humble outlook—that he was once the parliamentary champion for the Beat charity, and he got its parliamentarian of the year award. I say that because I know he would not volunteer it himself. That is a noble achievement because it is a very good charity, and it underlines the fact that there are wider issues.

The other point—my hon. Friend the Member for Totnes (Anthony Mangnall) intervened on me about this—is about social media. I am profoundly worried about social media, its impact on young people and our inability to regulate it. It is not a failing; it is very difficult to regulate the sharing of media and the enhancement of media. Of course, we can imagine young people going to a practitioner to receive such surgery based on an image they have seen where the person has not actually had it, but has simply been artificially enhanced digitally.

[Duncan Baker (North Norfolk) (Con)]

My hon. Friend is talking about social media. I am a father to two young, good-looking, blonde-haired, blue-eyed girls—their looks come entirely from their mother. During lockdown, as I think every parent here would agree, our children probably watched far too much social media and YouTube content. My children watch hairdressing videos from America—something my hon. Friend would appreciate given his fine locks during lockdown. The serious point is that the content they are fed about what they should look like and what their body image should be should worry all parents. I warmly welcome the Bill brought forward by my hon. Friend the Member for Sevenoaks (Laura Trott), because it is so important that young people get to understand that they should have confidence whatever they look like. I warmly welcome what has been put forward today.

[James Cartlidge]

My hon. Friend is absolutely right. On my hairdressing expertise, all I will say is that I really am from Barnet. In fact, I used to live in New Barnet, and for some reason the hairdressers’ I used to go to in New Barnet was not called New Barnet Hairdressers. I never quite understood that one. He makes a very good extremely point. By the way, I think he is looking extremely dashing today, and he should not put himself down. I am sure his input into the beauty of his children was fair and proportionate—[Interruption]—yes, for Norfolk genes! [Hon. Members: “Move on!”] I will sit down now—but I am just going to say that there is a serious point here about social media and how on earth we regulate it, but here is the key: what we are talking about today is something that occurs in the physical world. These treatments are out there and are tangible, and we can and should regulate them for children.

I will finish with one important point. I asked my hon. Friend the Member for Sevenoaks about the issue of territorial application. This Bill covers England, as far as I am aware, although it does refer in the detailed clauses to the other parts of the United Kingdom. That obviously raises a question about people who, if it is illegal in England, might cross the border into Wales or Scotland, especially if they live nearby, and still receive these treatments. It would be interesting to hear from the Minister what expectation he has of these regulations being matched in the devolved Assemblies, because that could be an issue. Whether it would happen illegally anyway, even if we banned it, is another question, but if it is legitimate in other parts of United Kingdom but not in England, there is a potential issue we should think about. I am happy to wind up there, because I think this is a very good Bill and I will be supporting it today.

--- Later in debate ---

[Claire Coutinho]

That exactly underlines why this industry needs more regulation. We need to be worried not just about the potential for physical scarring but about the financial risk. A couple of Members have touched on the practitioners’ lack of insurance, which I hope can be considered when we introduce regulations. Their lack of public liability insurance means that the consumer often bears the financial risk of anything that goes wrong.

[James Cartlidge]

To go back to the point that my hon. Friend the Member for Bosworth (Dr Evans) made, having insurance in place might remove some of the cost that is falling on the NHS and therefore on the Exchequer.

[Claire Coutinho]

That is an excellent point.

We should not be allowing our young people to face these risks—not only the medical and financial risk, but the psychological risk. It is damaging for a person to go for a cosmetic procedure that they think will fundamentally change their life and then for something to go wrong or for them to realise that that was not the thing that was going to make them happy in the first place. I am very happy that we will hopefully be able to address all those things through this Bill.

There are medical procedures that young people need, such as cosmetic procedures because they have some sort of facial disfigurement, for example, or procedures for migraines, bladder dysfunction, face and eyelid twitching or excessive sweating. They would still be allowed under this Bill, so no one should be worried that they would not be able to get the medical help they need.

Returning to the point about social media, we have all seen the deeply worrying statistics showing how the young people of our age are different from our generation, when we were young. Young people now are more anxious and depressed and have a lower sense of self-worth, and that starts in their early teens because of how social media helps them to see themselves and their standing in the world. The availability of these procedures, particularly if they are unregulated, will make people question themselves more and think, “Maybe I should go and make a change. Maybe I should change my face, my jawline, my nose, my lips.” The ability to access unregulated procedures almost forces the question in a very damaging way.

People have talked about the effect on boys and girls—both sexes undergo these procedures. The unrealistic images on social media lead to a very damaging cycle by setting up a view of beauty that boys take on and girls then want to live up to. I have seen the results of scientific experiments in which young children are presented with a range of images and are asked which are the beautiful ones. They are now starting to pick out the ones that are cosmetically enhanced. That is incredibly damaging.

Oral Answers to Questions

James Cartlidge Excerpts

Tuesday 6th October 2020 Commons Chamber

The Secretary of State was asked—

[James Cartlidge (South Suffolk) (Con)]

What steps he is taking to improve cancer outcomes.

[Felicity Buchan (Kensington) (Con)]

What steps he is taking to improve cancer outcomes.

--- Later in debate ---

[The Secretary of State for Health and Social Care (Matt Hancock)]

The NHS’s recovery approach is restoring urgent cancer referrals and treatment to at least pre-pandemic levels and building capacity for the future. Latest data from July suggests that urgent two-week-wait GP referrals are back to over 80% of pre-pandemic levels.

[James Cartlidge]

I thank my right hon. Friend for that answer, but does he agree that if we are to deliver better outcomes in cancer and all areas of care, our clinicians need the best possible infrastructure? Is not that why it is so important that the Prime Minister confirmed last week that we will deliver our manifesto pledge of 40 new hospitals? Does my right hon. Friend share my delight at seeing on that list a new rebuild for West Suffolk Hospital, to deliver even better outcomes for our constituents?

[Matt Hancock]

Yes, I do. I share my hon. Friend and neighbour’s enthusiasm for the rebuild of the West Suffolk Hospital. For treating both patients with cancer and patients with all other conditions, the West Suffolk is a brilliant local hospital that is much loved in the community; however, its infrastructure is getting very old and it needs to be replaced. I am delighted, along with the Minister for primary care, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), in whose constituency the hospital is and will be rebuilt, that we are able to make the funding commitment and get this project going.

Covid-19 Update

James Cartlidge Excerpts

Tuesday 8th September 2020 Commons Chamber

[Matt Hancock]

It is incredibly important that people have the confidence to know that when workplaces are covid-secure, it is safe to go to them. Trying to get through this pandemic, protecting as much as possible the education of our young people and the livelihoods of people in work, while keeping the virus under control, is a difficult and challenging balance, but it is the right balance to be attempting to strike. The hon. Gentleman might note that both the actions of the Scottish Government and the actions that we are taking locally, for instance today in Bolton, have economic consequences, and I regret that, but they are targeted as much as possible on reducing the social activity, which is where we are increasingly seeing transmission.

[James Cartlidge (South Suffolk) (Con)]

We heard further evidence from Prostate Cancer UK today of how the original national lockdown impacted detrimentally on cancer referrals and other aspects of cancer care. I entirely accept that that was unavoidable because of the necessity of protecting the NHS through the peak of the pandemic in the spring, but as we move to a new phase of hopefully local rather than national lockdowns, can the Secretary of State assure me that the NHS will do everything possible to ensure that rising numbers do not again translate into a negative impact on those with other conditions that can, after all, also be fatal?

[Matt Hancock]

Yes, absolutely. My hon. Friend makes an incredibly important point with which I agree wholeheartedly. The backlog that was caused by the inevitable and, as he put it, unavoidable delays to treatment in the peak has more or less halved, which is good news. So there is progress. We have changed the NHS to be split, essentially, between sites that are covid-secure and sites where there may be covid. That will help us to protect cancer treatment, as we go forward, exactly as my hon. Friend asks.