Health Services (North-West London)

Jane Ellison Excerpts

Tuesday 15th October 2013 Westminster Hall

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

This is the first time I have served under your chairmanship, Mrs Riordan—in fact, under anyone’s chairmanship, because it is my first Westminster Hall debate. It is good to start off with such a straightforward and easy subject.

I congratulate the hon. Member for Westminster North (Ms Buck) on securing the debate. I am a London MP and I know that this matter is important to her and her constituents, to the constituents of her hon. Friends the Members for Ealing North (Stephen Pound) and for Hammersmith (Mr Slaughter) as well as to those of other MPs who are not here today.

Before I turn to the issues raised, I put on record my thanks to the staff of the NHS for their commitment and dedication in providing a first-class service, particularly as they enter a period of change. We know that that is sometimes not easy, but they are maintaining a first-class commitment to patients throughout.

The debate around aspects of the north-west London reconfiguration has been going on for some time, but it is fair to say that the hon. Lady discussed a slightly new feature of it. Today is the first time I have heard in detail directly from her about these important issues. I will give her a response, but I will look at the detail of what she said, reflect on it and come back to her more fully after the debate. It is not possible to do that instantly, because until now I had not heard directly from her about some of the problems on communication and so on in the past year that she said illustrate some wider issues.

My understanding is that the joint committee of primary care trusts agreed in February this year that further work was needed to bring about improvements to services at both Charing Cross and Central Middlesex hospitals. I am aware that Imperial College Healthcare is developing its clinical and site strategy based on the principles set out in “Shaping a healthier future”. The trust has put forward a case for some elective surgery to be carried out at the Charing Cross site and has developed a vision for each of its three main sites becoming centres of excellence for the service they provide.

It is right that hon. Members and local authorities should expect openness and transparency when discussing local health issues and changes, and the hon. Lady has vividly put across that she does not feel that that has happened. It is regrettable that she feels she has encountered, in her dealings with Imperial, a lack of clarity around its clinical and site strategy and, in particular, around planned care and elective surgery.

The hon. Lady rightly stressed the need for partnership working through periods of difficult change such as these. Her comments on the overall exercise and the expressed clinical priorities were balanced, and I take seriously what she said about wishing to work in partnership and her point that we can clearly do a lot better. I have been assured by NHS England that a real effort will be made by the new leadership team at the trust and the local clinical commissioning group to engage more fully with her, other local MPs, local councillors and the local NHS as the site strategy is developed.

I am aware that the hon. Lady met the chief officer and the GP chair of the central London CCG to discuss her concerns about the changes to planned care and surgery in north-west London. As a result, she will know that under “Shaping a healthier future”, St Mary’s will continue to provide out-patient services, diagnostics, therapies and appropriate follow-up. I understand that work is under way to agree the best locations across north-west London for planned care surgery services.

[Mr Slaughter]

I hear what the Minister is saying—it is reasonable and I know that she is sincere—but we constantly meet these people and they are, frankly, hopeless. The issue is now becoming political. So far, we have had political unity across the board and we now know that the issue is on the Secretary of State’s desk. I implore the Minister to talk to him about these proposals—in the interests of her party, if none other.

So far, apart from Hammersmith and Fulham council, which is supporting the closures, everyone across west London is united on this: it does not matter what party they are or what position they hold. This issue is moving from the local to the national. Will the Minister please look—it is in her interest as well as ours—at what is going wrong in north-west London before we take steps in closing hospitals that we will not be able to correct?

[Jane Ellison]

I am not sure that describing NHS colleagues as “hopeless” is a particularly helpful contribution to future partnership working, but the hon. Gentleman has chosen his words in his own style, as he always does. He is right to say that the matter is on the Secretary of State’s desk. I will report back to the Secretary of State after this debate, specifically on the new concerns expressed by the hon. Lady on the dialogue and the relationship she has had. Beyond that, I cannot comment further on the reconfiguration, because of its status.

[Ms Buck]

The Minister is kindly referring to my sense of the communication problems. To reinforce the point, I should say that at the heart of this problem is a local authority that is meant to be a statutory partner. It has a duty to be consulted and that has clearly not happened. That is what matters, because it is through that consultation that decisions are made on how a local authority performs its role on supporting care. I want that message to go back to the Secretary of State. It is not a matter of opinion; it is a matter of absolute fact that the local authority has been ignored by Imperial for probably two years.

[Jane Ellison]

I hear that. I believe in the role that local authorities have to play in shaping health outcomes for their residents; as the public health Minister, one of my jobs is to champion their role. Like Members of Parliament, they care so deeply for the health of their local population and are so close to them that they are well placed to shape the future of health care in their area, and we take that seriously. I will take the hon. Lady’s concern back, reflect on it and talk to the Secretary of State about it.

There is a limit on what more I can say on the detail that the hon. Lady has given me. We have a lot to look at and talk to health partners about. I can only assure her that I take it seriously. The role of hon. Members in periods of enormous change such as this is critical, as it is for key local authority partners, too. That message is fully taken on board.

I will use my remaining time to give a little background on the reconfiguration. I know hon. Members will be familiar with it, but it is worth putting on the record. The reconfiguration of NHS services is a matter on which the local NHS is taking the lead, hence the importance of engaging local partners. The hon. Lady has already made reference to the fact that we do not believe that these things can be shaped only in Whitehall. They have to be influenced by enormous local input. I cannot agree with the description of the service as “hollowed out”, which is neither accurate nor fair.

Individual health overview and scrutiny committees, and the joint overview and scrutiny committees, made up of democratically elected members of all the councils concerned, have the power to refer the reconfiguration to the Secretary of State if they believe that the consultation has not been conducted appropriately, or that proposed changes are deemed to be not in the best interests of the local health service. We know that one council has exercised that power.

As the hon. Lady is aware, the proposals were referred to the Secretary of State by Ealing borough council in March this year; the hon. Member for Ealing North referred to that. The Secretary of State has sought and received advice on that referral from the Independent Reconfiguration Panel. I fully understand the importance of the Secretary of State’s decision to the hon. Members present and to others who have been prominent in this debate. The Secretary of State is actively considering the panel’s report and that decision will be made public shortly. Although I have not been pressed on when that might be, it is imminent. I cannot say anything further about the IRP’s report.

The one thing I want to stress is that all the changes are being driven by clinical need and a desire to get better outcomes for patients. They are not driven by a desire to save money. In that regard, I reject the comments made by the hon. Member for Hammersmith. The hon. Lady acknowledged that the driving force behind the reconfigurations is looking at whether we can get better outcomes for all our constituents through greater specialism.

[Ms Buck]

rose—

[Jane Ellison]

If the hon. Lady wants to intervene again, she is welcome.

[Ms Buck]

The Minister is being generous. She refers to decisions made by Ealing council and Hammersmith and Fulham council, but Westminster council was not even told about some of these changes, so it could not exercise its powers on overview and scrutiny in this case. While that is absolutely true, I do not think that anyone is setting out to change these things deliberately. They are, however, doing it without telling anybody.

[Jane Ellison]

As I said, I have heard the hon. Lady’s points. All relevant CCGs and trusts supported the overall shape of the reconfiguration. Local authorities have been key partners in that as well. She has rightly made specific points on some specific aspects that affect her constituents. We will reflect on those points and come back to her.

Children’s Heart Surgery

Jane Ellison Excerpts

Wednesday 12th June 2013 Commons Chamber

[Mr Hunt]

On the hon. Gentleman’s second point, we need to be very careful about how we use any mortality data, particularly on specialist services where distortions can be based on just one or two operations. I know that he will agree, however, that we have a responsibility to act if we have genuine concerns. That is what happened and the process over Easter was very difficult. One lesson we have learned in the NHS is that in Bristol it took a very long time—years—before anything was done about the higher mortality rates and we do not want to make that mistake again. I take on board the hon. Gentleman’s other point, too.

[Jane Ellison (Battersea) (Con)]

I know that many of the staff and patients at the Royal Brompton hospital will very much welcome my right hon. Friend’s statement today. Although the hospital is not in my constituency, many of the staff live in my constituency and other hon. Members have been extremely active in making the Royal Brompton’s case over recent months. There was particular concern about the possible impact on other specialisms of any decision to withdraw children’s heart surgery, so can my constituents be assured that such concern will be taken into account in any future process?

[Mr Hunt]

The IRP report says that we must consider the broader impact of any changes beyond the narrow question of children’s heart surgery, so I am sure that that is one of the lessons that will be learned.

Oral Answers to Questions

Jane Ellison Excerpts

Tuesday 11th June 2013 Commons Chamber

[Mr Hunt]

Yes I do, which is why we have published a website today that gives much more detail than there ever has been before about health inequalities. it is why, nationally, the Government have been responsible for a huge amount of initiatives to boost public health, including calorie labelling in restaurants, action on point of sale display tobacco advertising, alcohol unit labelling and a range of other things. We will play our part.

[Jane Ellison (Battersea) (Con)]

In April, the BBC’s “Casualty” programme highlighted the vital role that health professionals have in spotting young girls at risk of being taken abroad or of having female genital mutilation carried out on them in this country. We are approaching the most difficult time of the year over the long summer holidays, when girls are most at risk. Will Ministers do all they can to draw the attention of health professionals to the vital role that they have in these critical next two months?

[Anna Soubry]

Absolutely, and I pay tribute to my hon. Friend and to other hon. Members on both sides of the Chamber for the great work that they have done on FGM. I am really proud that the Government have produced the FGM passport, which is available to many young women. It does—I hope that it will continue to do so—protect women, especially younger women who are going abroad for this appalling abuse to be carried out upon them. We have done great work already with health professionals who increasingly realise, first, that they must be aware of it; secondly, that they must report it; and thirdly, that they must take action to prevent this appalling abuse of women, especially young women.

Mental Health

Jane Ellison Excerpts

Thursday 16th May 2013 Commons Chamber

[Jane Ellison (Battersea) (Con)]

Thank you, Madam Deputy Speaker, for allowing me to speak in this debate. I had not planned to do so, but I realised earlier today that I wanted to address an aspect of female genital mutilation, which I have discussed often in the House. When I listened to the opening speeches, I realised that I have never talked about an issue that many of the campaigners I work with discuss a lot, namely the mental health aspects of both acute and, in particular, chronic FGM.

I just want to put the issue on the record for the Minister to think about; I do not expect any instant answers. As many Members have said, it is hard enough to talk about mental health, but raising the issue of the mental health problems of the victims of a secret, taboo and illegal practice that we have never successfully prosecuted adds several layers of difficulty to an already difficult situation. We know enough, however, for the matter to be put on the record so that somebody at the Department of Health can at least think about it. We should be worried about it.

Female genital mutilation is practised in many countries around the world, but it is predominantly an African practice. In this country, it is practised predominantly by communities from east and sub-Saharan Africa. Most professionals in the field think that the largest diaspora groups in which FGM remains prevalent are probably from Kenya and Somalia; it is certainly heavily practised in those countries.

In the absence of a more up-to-date study, people work on the numbers given in a 2007 study by FORWARD—the Foundation for Women’s Health, Research and Development—which was itself based on the 2001 census. The study established that there are at least 66,000 women with FGM living in England and Wales and that about 21,000 more girls are at risk of becoming victims. Of course, given the substantial migratory trends of people from practising countries to the UK in recent years, the real figure is likely to be higher.

In 2004, the British Medical Association recorded that it believed that there were 9,032 births to women who had had FGM. It should be noted that not all hospitals are required or able to record FGM at birth, and I know that one of the Minister’s ministerial colleagues is looking at trying to get that right. Recent freedom of information requests by the press also show that hundreds of similar women are giving birth every year in hospitals in Leeds, London and elsewhere. We know that this is a problem and that the practice is not being abandoned at anywhere near our desired rate.

During visits to schools in my constituency in recent months, I have asked questions about the issue—other Members may also have done so—but I have not received any satisfactory answers. Most recently, a headmistress who knew about the practice, which is unusual, had been told by a school community worker, “Don’t go there. Let’s not talk about that topic.” This is a problem; do not let anyone believe that it is a myth and that we do not have a problem in the UK.

A study cited by the World Health Organisation in the mid-2000s examined the effects of FGM on the mental health of women. The researchers concluded that FGM is

“likely to cause various emotional disturbances, forging the way to psychiatric disorders,”

especially post-traumatic stress disorder, possible memory dysfunction and other problems associated with trauma.

This issue was brought home to me by a Radio 5 programme I took part in recently after a two-part story on “Casualty”—they were two very powerful episodes—featured the acute health aspects of FGM. The story centred on an older sister who was trying to stop her younger sister being taken abroad to be mutilated, and on the impact of birth on the mother of the family, who had been infibulated.

One of the other guests on the Radio 5 discussion the following morning was a marvellous GP called Dr Abe from Slough, who told me that she sees two or three women a week who have chronic illnesses, some of which are mental-health related, associated with FGM. She asked me—the BMA stresses this and I will cite its guidance in a moment—to imagine the trauma experienced by a small girl who is being held down by people who are usually relatives or people she knows while a brutal procedure is carried out on her without anaesthetic. It is not difficult to imagine that such children will be troubled.

In case anyone thinks that such things do not really happen, let me point out that Dr Abe said that she regularly deals with children and young women whose bodies are contorted with pain and whose limbs are bruised, broken, battered and dislocated as a result of being held down by relatives. Few people who have that done to them by those who purport to be their loved ones will then go on to live with them as a family. I think we can all imagine the special and difficult mental health problem associated with that, and we are only beginning to understand it.

The BMA’s 2011 guidance acknowledged that little is documented about the psycho-sexual and psychological effects of FGM, but it does say:

“Long term consequences might also include behavioural disturbances as a result of the childhood trauma and possible loss of trust and confidence in carers who have permitted, or been involved in, a painful and distressing procedure”

and that

“women may have feelings of incompleteness, anxiety and depression, and suffer chronic irritability, frigidity, marital conflicts, or even psychosis.”

Many of the professionals and campaigners I work with stress the growing problem of anger, particularly among young women who suffered FGM before coming to this country. They are in a conflicted state, because the mentality of those who put them through FGM could not be more different from the mentality that they see around them in Britain. It is considered entirely normal in a sexualised society for magazines to invite young women to express their sexuality and have a fulfilled sex life. If someone has had a procedure carried out on them, the entire aim of which is to stop them wanting to have sex and to be a sexual person, and to restrict them and preserve their virginity—and everything else associated with the centuries-old tradition of FGM—that leads to conflict.

Both Efua Dorkenoo, who wrote the WHO guidelines, and campaigners such as Nimco Ali of Daughters of Eve talk about a growing pool of angry young women who are caught between those two very different worlds. It is also difficult for them to talk about it, because the subject is already taboo. Some Members may have read a recent article in The Sunday Times, which reported that Nimco Ali, who has been very bold in speaking out, has been threatened by people telling her that she should stop speaking out.

[Mark Hendrick (Preston) (Lab/Co-op)]

Is the hon. Lady saying that FGM is taking place in this country, or are parents taking their children abroad to have it done before coming back?

--- Later in debate ---

[Jane Ellison]

That does not relate strictly to the debate topic, but I will answer. We do not strictly know, but a growing body of evidence suggests that FGM does happen here. The girls I meet through some of the groups I work with will say off the record that it is happening here, but it is more difficult to get people to say so on the record and to point the police in the right direction. For example, women are re-presenting having being re-infibulated in hospital, which is also illegal. I think there is enough evidence now to suggest that FGM is happening here, but I think that the predominant view, and that of the police and the Crown Prosecution Service, is that girls being taken overseas is still the biggest problem. Since 2004, when a private Member’s Bill closed a loophole in the Prohibition of Female Circumcision Act 1985, such girls have also been covered by British law. The extraterritorial aspect of the law means that it is against the law to take a British resident or citizen abroad to perform FGM on them. Either way, that is covered. I think it is happening here, but we do not know.

[Mark Hendrick]

Have there been any prosecutions?

[Jane Ellison]

No; to the eternal shame of this country, in 25 years of this being an illegal act, there have been no prosecutions.

In recent times—I will return to the mental health aspects in a moment, Mr Deputy Speaker—we have had encouragement because Keir Starmer, the Director of Public Prosecutions, has been really good on this issue. He has a new action plan for the Crown Prosecution Service. It has reopened several old cases and is going through them with the police to see whether a prosecution is possible. It is also looking more imaginatively at prosecuting the aiders and the abetters, such as the people who set up the travel and those who supply the strong pain killers. If we wait for a seven-year-old girl to walk into a police station and report her parents, we will have a long wait. That is one reason why there have been no prosecutions. However, I am more optimistic now than ever that the police and the CPS are taking the matter seriously.

To return to the mental health aspects, a recent survey by the National Society for the Prevention of Cruelty to Children showed that 83% of teachers either do not know about FGM or have had no training on it. From memory, 16% of teachers thought that condemning FGM was culturally insensitive. That is extremely disturbing, given that it is an illegal act.

[Mr Charles Walker]

It is child abuse. There is no ambiguity. It is child abuse and it must be stopped.

[Jane Ellison]

I could not agree more.

My worry is about the 83% of teachers who just do not know about FGM or have not had the training. There are good guidelines, but they are not statutory. Not enough is filtering down. In my constituency, I have encountered people who say, “Don’t go there. It’s too difficult.” There is a role for Members of Parliament in pushing this matter at a constituency level. If teachers have no idea what FGM is or what the behavioural and psychological consequences might be, they will fail to understand why a young girl who has come back from being mutilated abroad is exhibiting naughty, disturbed or bad behaviour. It is therefore important to get more knowledge out there about the physical and psychological aspects of FGM so that we can understand and help children who present with signs of being disturbed.

In UK culture, women have an expectation that their sex life will be enjoyable and that they can have a normal expression of female sexuality. That is very much at odds with the mentality that leads to somebody being mutilated. Many of the women who are suffering the physical and mental complications of FGM do not speak English and live in socially isolated communities in which they are not encouraged to speak about it because it is entirely taboo. That is added to the taboo of speaking about mental health.

The lack of knowledge about FGM among teachers and medical professionals will increasingly be a problem as diaspora communities become scattered to places in the country where professionals do not see it as much. It is easier for a specialist in central London to know what they are looking for. Even if we stopped all FGM happening to young girls tomorrow—would that we could—we would still have to deal with the large number of women who are suffering the long-term consequences of it.

There is documentary evidence that some parents have second thoughts about having done this to their children. Some parents express regret. The Home Office had a good initiative last year, which we adopted from the Dutch, in which it provided girls and parents with a health passport to carry abroad with them to remind members of their extended family that the practice is illegal in the UK and that they must not do it, but must respect the rights of the child.

[Mrs Moon]

The hon. Lady is making some very interesting points, but the focus of this debate is mental health. Perhaps she could conclude by pointing out the mental health messages—

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. It is for the Chair to decide what is in order and what the debate is about. I need no help from the Back Benches, although it was very kind of the hon. Lady to intervene.

[Jane Ellison]

I have clearly outstayed my welcome, so I will conclude. I realise that time is short.

The point that I want to make is that there is a significant mental health aspect to FGM, but that it is not well documented. Not many of our front-line professionals have it at the front of their minds when trying to explain other problems. I just want to put that on the record so that the Minister and the Department of Health can reflect on it and so that it starts to become a normal thing for mental health professionals to talk about and think about, particularly when they see people from communities that practise FGM and who might have suffered it.

Many of the young girls and women who talk about FGM speak of a silent scream for help. All I wanted to do today was to give that scream a voice in the House of Commons.

Mid Staffordshire NHS Foundation Trust

Jane Ellison Excerpts

Tuesday 26th March 2013 Commons Chamber

[Mr Hunt]

I agree wholeheartedly. It is very important that we understand that the benefit of the new inspection regime will not just be that it identifies failing hospitals, but outstanding hospitals too, so that we have a good model of leadership in the system from which other managers can learn. Yes, it is really important to have the right relationships between managers and their staff, but we should not mandate or regulate that from the centre. We want to have a system where people can learn from each other.

[Jane Ellison (Battersea) (Con)]

I received a distressing piece of constituency casework yesterday that underlines the importance of the announcement my right hon. Friend has made today. Does he feel that his reforms will build more of a culture of compassion in nursing care?

[Mr Hunt]

That is at the heart of what the reforms intend to achieve. An organisation as complex and as large as the NHS needs corporate objectives and targets—for example, we need to do a lot better on dementia—and we do set system-wide objectives. However, we have to ensure that those objectives, set by whichever party happens to be in power, never compromise the fundamental care and compassion that needs to be at the heart of what the NHS does. We are putting in the safeguards that ensure that that cannot happen.

Health and Social Care Bill

Jane Ellison Excerpts

Tuesday 28th February 2012 Commons Chamber

[Mr Speaker]

Order. I would like to accommodate a few more questions, but from now on I really do require single-sentence questions without preamble and comparably pithy replies.

[Jane Ellison (Battersea) (Con)]

My constituency has considerable health inequalities, so I very much welcome the fact that tackling health inequalities is at the heart of the Bill. Does the Secretary of State share my surprise that the Opposition do not similarly welcome that?

[Mr Lansley]

I have to tell my hon. Friend that nothing much about the Opposition surprises me any more.

NHS (Private Sector)

Jane Ellison Excerpts

Monday 16th January 2012 Commons Chamber

[Jane Ellison (Battersea) (Con)]

We have heard much this evening from Opposition Front Benchers about celebrating the role of private providers, but the message that goes out from so many of the Back-Bench speeches is one of fear and alarm. It is the single message “public good, private bad”, and it tries to tarnish every private health care provider with that notion.

I want to use my brief remarks this evening to pay tribute to the staff of the newest NHS facility in my area who are working hard to tackle health inequalities and offering a great service to busy people in my constituency, but these hard-working health workers work for a private sector provider. When they are providing their service in an NHS facility, they must feel mystified and rather let down, I suspect, to be constantly criticised by the Labour party.

I agreed with the hon. Member for Leicester West (Liz Kendall), who is not in her place, when she said in 2008 that the private sector has much to offer in tackling health inequalities. That is what that NHS facility run by Care UK is doing in my constituency—tackling health inequalities, helping busy, highly mobile young people who cannot register with a GP to get the service that they need, and helping shift workers, migrant workers and those whose working day starts too early for them to get to the doctor during normal hours.

The Junction health centre in Clapham junction, a busy transport hub, opened in March 2010. It was commissioned in 2007-08 and provided by Care UK, a private sector provider but an NHS facility, working to agreed NHS standards. Yes, the Opposition should take pride in having commissioned it. Instead, we see them rowing back from that previous sensible pragmatic position. The facility in my constituency is an excellent example of partnership working, and it is providing care for my constituents. They judge it as an NHS facility. They do not worry about who is providing the care. They worry about the quality of the care and service being provided, and they are voting with their feet.

The target that the facility was set was 2,000 patients by March 2012. There are already well over 3,000. Many of them were not registered with a GP before. The facility is registering homeless patients. How much more universal a service can there be than that? It deals with unregistered walk-in patients—more than 30,000 last year, and in many cases people who would not otherwise have got to see a GP. This is all good. But what do we hear from Labour Members? They talk it down. A previously consensual position on private sector provision is now incredibly polarised around an ideological position that suits this Parliament. Alan Milburn was right when he said in 2009:

“Quality should be the only yardstick, not the type of provider.”

The thousands of people who have attended the Junction health centre in Battersea over the past two years are being well served by hard-working and dedicated health professionals. It might suit the Opposition for narrow party reasons to denigrate the efforts of those health workers who work on behalf of the NHS, but I want to pay tribute to them publicly and say how glad I am that they are providing this much needed and greatly appreciated NHS service, free at the point of delivery, to my constituents. I oppose the motion.

Social Care Funding

Jane Ellison Excerpts

Thursday 10th November 2011 Westminster Hall

[Kelvin Hopkins]

I agree absolutely about elevating the status, but we do that first by having the carers professionally trained, ensuring that we get the right people to begin with, having them properly paid and having staffing at the right level. If someone is looking after too many patients and cannot cope, either in a hospital or a care home, the patients do not get proper care. In most areas of life, as quality improves we want higher productivity, which means a lower level of labour intensity, but in this area we want more people working, with each care person or nurse looking after fewer patients, to ensure that everyone gets the care they need, rather than having one junior nurse looking after a large room full of elderly people and not being able to cope late at night.

In the past couple of weeks we have heard some distressing stories about elderly people in hospitals not getting the care they need. We will all be elderly one day, and some of us might finish up in care because we might not have extensive families to care for us. I do not like the idea of being in pain and suffering at night and not being able to get anyone to help. I am physically fit and doing well at the moment, but we shall all be old one day. People are suffering in that way now, and the only way to deal with it is to ensure that we put in sufficient resource. I think there are people around who want to do these kinds of jobs but they will not do them if they are going to be overworked, undertrained, underpaid, and treated badly by private companies or care managers in hospitals.

[Jane Ellison (Battersea) (Con)]

I am intrigued by what the hon. Gentleman has said about the barriers to entry into this work. I have been following the fortunes and recruitment patterns of a care home close to me in my constituency, which is struggling to get local youngsters to apply. We have talked through all the reasons for that, and the home thinks there are some cultural barriers. The hon. Gentleman made reference earlier to the different attitudes of people from different backgrounds and different parts of the world, and I think there is a cultural barrier to young people entering the workplace and spending their life giving care to older people. We have to admit that and address it.

[Kelvin Hopkins]

Possibly there is such a problem, but most of the care workers in the homes I was talking about were caring mature women. They had a genuine affection for the people they were looking after, which was wonderful to see. The residents liked being there, the care workers doted on them and the professionals who came in were full of admiration for what was going on. We have to replicate those conditions for all of us in one way or another. Perhaps we need to look at ways of recruiting people, but I believe there is compassion in humans and there are people who would do these jobs if they were treated with the appropriate respect and given the support, pay and conditions of employment we would expect. Unison has long been supportive of this kind of thing, campaigning against the privatisation of care and in favour of free long-term care.

Andrew Dilnot has gone a long way in the right direction and I applaud what he has done, but we have a lot more to do beyond what he has said. I hope that some of what I have said has rung a few bells, and that the Minister, and indeed the Opposition, start to take the issue much more seriously, and look after elderly people as they should be looked after.

Oral Answers to Questions

Jane Ellison Excerpts

Tuesday 8th March 2011 Commons Chamber

[Mr Lansley]

I am surprised, because the hon. Lady is on the Select Committee on Health and should know that responsibility for public health will lie both with Public Health England, inside the Department of Health, and with local authorities. The NHS commissioning board will have a responsibility for prevention, but the population health responsibility will lie with Public Health England, and I have absolute confidence that Dame Sally Davies, the newly appointed chief medical officer, will be a leader in public health delivery, through Public Health England.

[Jane Ellison (Battersea) (Con)]

I represent a constituency with a young and highly mobile population. Younger women are very much over-represented among those who do not respond to routine invitations to screenings. Will Ministers promote the increasing use of mobile communications in inviting women to routine screening services?

[Paul Burstow]

That is certainly one way in which we can improve access, and it is one of many that we outlined in the improving cancer outcomes strategy that we published in January.