Leaving the EU: NHS

Jamie Stone Excerpts

Thursday 22nd March 2018 Westminster Hall

[Mr Bradshaw]

My hon. Friend is absolutely right. The uncertainty not only bedevils business decisions, but is having a huge effect on the NHS, the pharmaceutical industry and the staff in all these sectors.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

I represent the most remote constituency on the UK mainland. The recruitment and retention of qualified staff is a huge issue in my constituency. Does the right hon. Gentleman agree that a crash out, and the problems he outlines, will be even more emphasised in the north of Scotland?

[Mr Bradshaw]

Coming from a peripheral region, I completely understand the challenges that the hon. Gentleman and his constituents face and the difficulty that our health and social care systems already have in recruiting and retaining staff.

I will give the example of midwives. EU midwives provide care for 40,000 mothers in England every year. The Royal College of Midwives has reported that the number of EU midwives registering to practise in the UK has fallen “off a cliff’ since the referendum, and that at the current rate of loss there will be

“no EU midwives left in the UK within a decade.”

We must have a clear assurance from the Government that, whatever the deal or no deal, the vital flow of EU medical and other staff to this country will not be affected. EU nationals already here also need an absolute assurance that their current status and that of their families will not change.

Thirdly, we would suffer the relocation of significant parts of our pharmaceutical industry—one of Britain’s most important and successful sectors—to the continent. Indeed, as part of our inquiry we were told by GlaxoSmithKline and other companies that they have already spent tens of millions of pounds moving research and medicines licensing work to other EU countries as part of their contingency planning for a hard Brexit. That money would otherwise be spent on medical research in this country. It is investment that they told us will not come back.

Fourthly, UK citizens visiting or living in the rest of the EU, including a large number of British pensioners, could lose their eligibility for reciprocal free health care. If they could not afford to pay, they would be forced to fall back on our health and social care system. The average cost to the UK of a British citizen being treated in the rest of the EU is £2,300. The cost of treating a pensioner in Britain is almost double that at £4,500.

Our report highlights a lot of other areas where there will be a serious impact if we get Brexit wrong: the potential loss of European Reference Networks, access to and participation in clinical trials, research funding, the mutual recognition of qualifications and data sharing. The loss or diminution of any or all those areas would damage Britain’s leading role as a medical research centre and the cross-fertilisation of knowledge and expertise that is so important for medical advances and patient safety.

I know that many other hon. Members want to speak, so I will bring my contribution to a close. Before I do, it is important to note that there are areas that the Health Committee’s latest report does not cover: concern that future trade deals with countries such as America could open up the NHS to wholesale privatisation; the possible impact of diverging from EU standards on the environment and food safety on public health, which the Committee plans to return to later this year; and, most significantly, the economic and fiscal impact of Brexit and the knock-on effect on health and social care funding as whole.

We know from the Government’s leaked impact studies that all Brexit options will hit Britain’s GDP over the next 15 years by between 2% and 8%—that is, 2% if we stay in the single market and customs union, 5% for the Government’s preferred option, and 8% in the case of a no-deal scenario. Unless the Government propose to significantly increase taxes or borrowing, or to cut other public services to move money to the NHS and social care, that can mean only that there will be less money available for health and social care, and not the extra that was promised on the side of that bus.

All in all, the next few months of Brexit negotiations will be absolutely critical for the future of our NHS for years to come. Our constituents expect us to hold the Government closely to account, and we will.

Acute and Community Health

Jamie Stone Excerpts

Thursday 8th February 2018 Commons Chamber

[Stephen Barclay]

My hon. Friend is absolutely right. That is why we are increasing the number of doctors we train by 25%. We are also looking into how we can increase the number of clinicians in leadership positions in trusts, and how we can reduce variance. That is one of the key issues. The NHS has some brilliant leaders, but the variance between trusts is far too wide.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

Given that health is devolved to the Scottish Government, Mr Speaker, you may wonder why I am asking this question. Will the Minister reassure me first that the report will be shared with NHS Scotland and the Scottish Government, and secondly that, as and when senior appointments are made, there will be an ongoing, constructive and informed dialogue across the border? Now you will see why I asked the question, Mr Speaker.

[Stephen Barclay]

I am happy to reassure the hon. Gentleman, but he has raised an important point. The question of people moving within the United Kingdom is not the only issue; another potential issue is the question of people moving to a charity or a private company that is providing services for the NHS, or taking up other roles in the healthcare landscape.

Male Suicide

Jamie Stone Excerpts

Wednesday 13th December 2017 Westminster Hall

[Ged Killen]

My hon. Friend is absolutely right and I hope that the Minister will touch on that. I note that suicide is treated as a health matter.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

The hon. Gentleman is quite correct to raise this hugely important subject. Sometimes, suicide is not any respecter of wealth. A much-loved local general practitioner in my constituency committed suicide, and there is a very moving memorial to him in my home town of Tain. The hon. Gentleman mentioned health, but does he feel that the education system might have a useful role in getting men to talk from an early age?

[Ged Killen]

I absolutely agree. I keep making the point that there are many different factors that influence suicidal behaviour, but certainly, if we can take the opportunity as early as possible in school, or even before, to look at mental health in general, we will go a long way in tackling the issue across the board.

Scotland, England, Wales and Northern Ireland pursue their own suicide prevention strategies, since it is a devolved matter, in line with devolution of health policy. This debate is important to raise awareness of male suicide. I hope that the Minister will talk about what the Government are doing to prevent suicide, particularly on the issues I have touched on, including inequality and perceptions of masculinity.

If those watching this debate—particularly men who are watching—take one thing away, I hope that it is that as we approach what, for many people, can be a difficult time of year—for many others it is a very happy time—and as we battle the elements to pick up last-minute gifts, we please keep in mind those who might be fighting battles with their mental health. There are some things that money cannot buy, so for many of those people, some company and a chat might be all it takes to save their lives.

I ask the Minister to tell us of any initial evidence or representations that she has received regarding the roll-out of universal credit and the increased risk of suicidal behaviour associated with that. What consideration has her Department given to equalising the maximum limit of eight days to register a death, as is the case in Scotland? That has been called for by the Samaritans, to improve the reporting of suicide. What assessments has her Department made of the misclassification of suicides by coroners and the effects that that may have on official statistics? Could she update us on the Government’s strategies for tackling suicide among men in deprived areas?

Mental Health Provision: Children and Young People

Jamie Stone Excerpts

Tuesday 12th December 2017 Commons Chamber

[Luciana Berger]

The hon. Gentleman makes a really important point about co-ordination between various Departments to ultimately effect change and support young people across the country, and that is what I and so many others are really looking forward to. However, I am going to set out in the rest of my remarks why I think the opportunity has been missed.

We have seen programmes such as Channel 4’s “Kids in Crisis”, which have brought many of the issues I have set out to a broader audience. That has included the scandal of too many young people having to travel hundreds of miles from their homes to receive treatment and support—and that is if they get in at all.

We know that the younger generation, coming into adulthood, are prone to a range of mental health conditions: depression, anxiety, eating disorders, self-harm, suicidal thoughts, phobias and other challenges. Those destroy confidence, blight education, training and employment opportunities, alienate young people from society, and, in some cases, drive families to tearful despair.

There is a social justice aspect to this too. Children from the poorest fifth of households in our country are four times more likely to have a mental health difficulty than those from the wealthiest fifth. Health inequalities in our country persist as strongly in mental health as in physical health.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

Would the hon. Lady agree that, in my vast and far-flung constituency—the second biggest geographically in the UK—what she says about distance is an extraordinarily pertinent and very worrying issue for my constituents?

[Luciana Berger]

I thank the hon. Gentleman for his intervention. We have heard from many Members on both sides of the House about families having to travel hundreds of miles to access treatment. Just last week, I heard of one young person being sent to Scotland to access in-patient treatment for eating disorders, because there was not a bed available for her in England. In certain parts of the country, it is certainly the case that people have to cross boundaries and to go north and south to access services, in a way that we would not accept if this was for physical health services.

Given this growing and what I can only describe as desperate demand for services for young people, I and many others eagerly awaited the Green Paper. I have read it many times, but it was—and I hate to say this—a disappointment. I believe that Ministers have failed to meet the scale of the challenge. The £300 million outlined for mental health support in schools sounds really impressive—until we read the detail and we realise that Ministers aim to reach just a fifth of schools over the next six years, with eight out of 10 schools remaining without the extra support until 2029. It really is a drop in the ocean. Ministers intend to roll out services over the next decade as though there was no urgency or imperative for action. I hardly need to point out that this means that most eight-year-olds today will see no benefit from these proposals throughout their entire childhood and adolescence.

--- Later in debate ---

[Jamie Stone]

I appreciate the sincerity of the Minister’s remarks. All that I can say, given my earlier intervention about my vast and remote constituency the other side of the border, is that I would be grateful if she could share her Department’s expertise with the Scottish Government, because the same issues could be tackled in the same way north of the border.

[Jackie Doyle-Price]

I thank the hon. Gentleman for his intervention. I am pleased to acknowledge that I have a very good dialogue with the Scottish Health Minister. It is fair to say that all four nations can learn from each other when it comes to delivering better health outcomes and sharing best practice.

We know that young people are sometimes still taken to police cells when they are in a mental health crisis. The hon. Member for Liverpool, Wavertree outlined the very distressing case of the young woman who had been restrained many times. The Under-Secretary of State for the Home Department, my hon. Friend the Member for Louth and Horncastle (Victoria Atkins), and I yesterday announced new police provisions that will finally put an end to this practice. We will ensure that children will always be taken to places of safety. The issue of prone restraint for children really needs to be examined.

The Green Paper will build on these foundations to build a new approach to supporting the mental health of our children and young people. With over £300 million of funding available, we will train a senior designated mental health lead in every school and college to improve prevention work—many schools have already made that commitment—and create brand new mental health support teams working directly with schools and colleges, and we anticipate that they might be working within multi-academy trusts or through local education authorities, and some might be provided through the NHS. Through the pilots we will discover what works, and it will not necessarily be a one-size-fits-all approach.

Autism Community: Mental Health and Suicide

Jamie Stone Excerpts

Thursday 30th November 2017 Commons Chamber

[David Linden (Glasgow East) (SNP)]

Thank you, Madam Deputy Speaker. On St Andrew’s day, may I say what a pleasure it is to serve under the chairmanship of a daughter of Elderslie?

I commend my hon. Friend the Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) for securing this debate, and it is a real pleasure to follow my hon. Friend the Member for North Ayrshire and Arran (Patricia Gibson), although I am beginning to be a bit disappointed that I do not have three communities in my constituency name. I welcome the opportunity to take part in this debate, and to sum up on behalf of the Scottish National party.

Today’s debate is on a very serious and important issue. It is important to address it for a multitude of reasons, but primarily because of the prevalence of poor mental health in those living with autism. About one in four people across the UK has a mental health problem, but the figure for autistic people is almost four out of every five. As the hon. Member for Blaydon (Liz Twist) mentioned, the autism research charity Autistica reports that up to two thirds of autistic adults have thought about committing suicide and, quite shockingly—this figure is utterly concerning—35% have attempted suicide. Although only about 1% of people in the UK are autistic, up to 15% of the people hospitalised after attempting suicide have a diagnosis of autism. These are very sobering statistics, which is why it is crucial that this issue is out in the open, and I am very glad that we have managed to bring this debate to the Floor of the House today.

Despite all this information, there is not much research to indicate why such a disparity exists, and I will come back to that point in a moment. That is why the research projects commissioned by Autistica—the ongoing work with the University of Nottingham on understanding suicide and autism—are to be commended. While we await the findings of this research, we must continue to do all we can.

Given that people with autism are more likely to be diagnosed with a mental health condition, early diagnosis and support are vital. Delays in diagnosis can hinder the implementation of effective support and intervention strategies. Members from other nations in the UK will no doubt know—indeed, they have highlighted this—where such delays are, but I would like to say a few words from a Scottish perspective. I will not, however, repeat what my hon. Friends the Members for East Kilbride, Strathaven and Lesmahagow and for North Ayrshire and Arran have said, for reasons of time.

The Scottish Government acknowledge that there is more we can do to improve waiting times, which is part of the strategy that was outlined by my hon. Friend for North Ayrshire and Arran. Surveys have shown that a positive diagnostic experience is associated with lower levels of stress and more effective coping strategies. Shorter waiting times for diagnosis can not only cut down on the time during which autistic people may feel misunderstood and isolated, but allow proper support to be given, which is very important. In addition to working towards faster diagnosis, the Scottish Government are investing record sums in mental health. The hon. Member for Liverpool, Wavertree (Luciana Berger) is no longer in her place, but I know that she has an interest in this. I commend what she has done in mental health. This financial year, investment in mental health for NHS Scotland will exceed £1 billion for the first time. This represents a huge increase on the £650 million spent in 2006-07, and it underlines the greater seriousness with which mental health in general is now being treated. I welcome that.

I am the son-in-law of someone who has recently retired from a medical practice in Stornoway. My mother-in-law would often say that about half the people who came through the door had mental health issues, but that was not necessarily how the funding had been distributed in recent years.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

I praise the SNP Government for their autism strategy. I can see the benefit of it in my constituency. The only slight point I would make is the tiniest wee niggle. Does the hon. Gentleman agree that the good work that the Scottish Government have done could perhaps be more widely advertised? There is still a slight gap between the Scottish general public’s understanding of it and the work that has been done. Perhaps via advertising or some sort of media campaign, it would be good to flag that.

[David Linden]

I am more than happy to agree with the hon. Gentleman on that. He brings considerable experience to the House; he is a former Member of the Scottish Parliament.

The additional funding for 800 additional mental health workers in key settings such as accident and emergency departments, GP surgeries, custody suites and prisons will reach £35 million by 2022. This local provision is crucial in ensuring that those with mental health problems get the help that they need when they need it. There is still much more to do, but we are moving in the right direction and clearly taking these matters seriously.

All these figures and actions might seem like hot air, but there is an understanding in this place that they can make the difference between life and death for some people. It is crucial that we get this right and learn from past mistakes if we are to prevent what are in essence preventable deaths.

It is clear from the shocking statistic that I gave earlier —that 35% of autistic people have attempted suicide—that much more can be done. There is a big challenge here and if we cannot collectively take responsibility and see that percentage fall, we will fail all those who live with autism.

I am conscious of the time and I want to make sure that my hon. Friend the Member for East Kilbride, Strathaven and Lesmahagow has a significant amount of time to wind up, but before I conclude I pay tribute to a few of the organisations that do fantastic work in Scotland such as the Autism Network Scotland and the National Autistic Society for Scotland. At this juncture I commend Bob MacBean of the National Autistic Society, a former Labour councillor in my constituency. Scottish Autism continues to do fantastic work, not least in conferences and children’s mental health. At a much more local level, in my constituency of Glasgow East, local families engaged with PACT for Autism came to visit me at one of my recent surgeries at Parkhead library. PACT is a friendly, parent carer-led support group that provides support, information and advice to all with a focus on autism spectrum disorders. I am sure that all hon. Members will have these kinds of groups in their constituencies. They provide wonderful support at a very local level, and the impact cannot be underestimated. There is a point to be made about the funding for such groups, which is probably a subject for another day.

Something as simple as one of PACT’s regular coffee mornings can be a lifeline for individuals and families in the east end of Glasgow. I commend that and I hope that the House will join me in recognising their work. We realise that such groups do an awful lot to help autistic people and their families to lead happy, healthy lives every single day.

I commend my hon. Friend, but we need to resolve in this place to do everything to ensure that people on the autistic spectrum can lead healthy, happy lives. I wish everyone a happy St Andrew’s day.

Oral Answers to Questions

Jamie Stone Excerpts

Tuesday 14th November 2017 Commons Chamber

[Steve Brine]

My hon. Friend is right to raise the issue. Local authorities, not Ministers in Whitehall, are best placed to take local spending decisions, but they must be accountable for their decisions. That is why we publish information at local authority level on smoking prevalence and quit numbers, so that local decision makers can be held to account. We also offer them expert support from Public Health England. I have a strong feeling that he will continue to hold those in Harrow to account.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

21. I am a reformed smoker—it was quite a battle. What proposals do Her Majesty’s Government have to enlist people like me to help other people to kick the weed? We know how to do it.

[Mr Speaker]

What a fine role model the hon. Gentleman is.

--- Later in debate ---

[Mr Hunt]

I am happy to do that. I had a very good visit to Medway recently, and Lesley Dwyer and her team are doing a fantastic job there. They had real challenges to turn the trust around, but they succeeded, and the staff did amazingly well. However, the truth is that we still have far too high levels of avoidable harm across the NHS. I want us to be the safest in the world. That is why, in the next few months, we will see campaigns to improve maternity safety, to deal with medication error and to improve transparency when there are avoidable deaths.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

T5. Could I raise the issue of mesh implants, which has been raised with me by constituents? A report in the United States indicates the associated pain—the headaches and the aches and pains in joints. Are Her Majesty’s Government looking at this issue? Rather than Ministers saying that this is merely a matter for the devolved Administrations, it would be instructive if they could give me an answer, because that would help inform the Scottish Government.

[The Parliamentary Under-Secretary of State for Health (Jackie Doyle-Price)]

The hon. Gentleman raises an issue that is of concern to many women up and down the country, and no one can fail to be moved by some of the horrendous injuries they experience. We now have 18 centres of specialist care that can treat those women. However, the advice we still receive is that, in some very narrow cases of stress incontinence, mesh remains the best possible treatment. The issue will be kept under review, and my noble Friend Lord O'Shaughnessy is due to meet the all-party group on surgical mesh implants to consider it in greater detail.