Health and Care Bill

Jess Phillips Excerpts

Consideration of Lords amendments
Wednesday 30th March 2022 Commons Chamber

[Jess Phillips (Birmingham, Yardley) (Lab)]

Will the hon. Lady give way?

--- Later in debate ---

[Jess Phillips]

I had not intended to be here at all today. Sadly, my mother-in-law died of a heart attack very suddenly on Friday, so women’s health and how we treat it is at the very top of how I am feeling at the moment. My mother-in-law, much like my own mother, who sadly died as well, sent her children to women’s liberation playgroup. She would not have forgiven me for not turning up for the opportunity of a free vote, so here I stand. Her name was Diana, and I feel that days like this are often dedicated to the Dianas of this world.

I want to respond to some of what has been said about coercion and control. I respect the hon. Member for Congleton (Fiona Bruce) and her firmly held views, and I would go down fighting for her right to hold those views. Had she allowed me to intervene on her earlier, I would have asked her whether she could tell me which expert agency that deals with violence against women and girls agrees with her. I represent the entirely alternative view. Maybe she and I could just both be honest and say that, largely, the detail in front of us does not necessarily matter: she thinks one way and I think another, and we should just be honest about the reality of that situation.

There is no evidence that coercion will be a concern any more than it already is. That is not my experience, from years of working with victims of sexual violence, sexual exploitation and abuse. The problem is not usually that they are forced to have abortions but the alternative: they are forced to go to term. They are scared. I worked with a beautiful woman called Natasha who was killed when her violent ex-partner found out that she had had an abortion. He murdered her. That is the normal pattern.

[Sir Peter Bottomley]

The evidence that has been given to me is that virtually every group concerned with violence against women and girls supports the use of telemedicine, as do Dame Clare Gerada and Dame Lesley Regan, who are leading doctors, gynaecologists and obstetricians. Lastly, with telemedicine consultations, the period of time before an abortion has been halved, not increased.

[Jess Phillips]

I agree 100% with every word that the Father of the House has just said. There is no expert opinion group that agrees with the view put forward by the hon. Member for Congleton, who cited the secretariat of a pro-life group. By the way, I am pro-life: I am pro the people who live being able to make choices. I am incredibly pro-life—I am just also pro-choice. I hate the terminology that suggests somehow one side is pro-life; what is the alternative?

[Alec Shelbrooke]

First, may I offer my condolences for what must be a very difficult time for the hon. Lady and her family?

There has been a lot of conversation in which people have said, “You’ve got no way of knowing that it is going to be less than nine weeks and six days.” Will the hon. Lady address that particular point, which is very important to how people have been trying to frame the debate?

[Jess Phillips]

I have heard similar framing, with some saying people will take the pills after 10 weeks. If we look at the actual data, we see it shows that the change increased from 25% to 40% the proportion of abortions happening before six weeks. Telemedicine has dramatically reduced the gestational period, making it much less. I am afraid to say that these are not a good faith arguments. They are based not on fact, but on the idea that women will lie. Women are concerned about their health. They are frightened about their health. We do not make decisions about our health in the hope that we will be harmed; we do what is best. We should not be treated like children; we should be treated like adults.

[Mrs Maria Miller (Basingstoke) (Con)]

I thank the hon. Lady for giving way and add my condolences to those of others for her sad loss.

The hon. Lady is right when she says that these issues can be entrenched and people have entrenched points of view. When we have that situation as a House, we look at the facts and at what the experts say. The experts who support Government amendment (a) in lieu of Baroness Sugg’s Lords amendment 92 include the vast majority of professionals: the Royal College of General Practitioners, the Royal College of Obstetricians and Gynaecologists, the Royal College of Midwives, the British Medical Association; and the Academy of Medical Royal Colleges. Does the hon. Lady agree that, when it comes to trying to find a way forward through entrenched views, we should look at the experts, and the experts are giving us a very clear way forward, followed by my hon. Friend the Minister?

[Jess Phillips]

I absolutely agree. It is difficult to be dispassionate. I have never been accused of being dispassionate about anything. I am passionate about what I eat for my breakfast. I am just not a dispassionate sort, but the right hon. Lady is absolutely right that we must look at column A and column B in this instance. Column A is full of experts—medical experts, women’s rights experts, and women themselves—and a huge amount of evidence.

[Dame Diana Johnson (Kingston upon Hull North) (Lab)]

I just wanted to add to the list that the right hon. Member for Basingstoke (Mrs Miller) just read out the World Health Organisation, which also says that telemedicine is safe, and the National Institute for Health and Care Excellence, based in the United Kingdom, which made a recommendation in 2019 about the safety of telemedicine for abortion.

[Jess Phillips]

I totally agree with my right hon. Friend. Actually, if people are against telemedicine for abortion, they might have very strongly held views about not liking telemedicine for anything. By that virtue, they should be against it for everything. For all the people who are desperately worried about vulnerable women—victims of domestic abuse and victims of sexual violence—not being able to access healthcare, I say come on and join me. They are absolutely right: there is zero availability of most mental health support. There is zero chance of getting a GP appointment any time soon, but somehow, people are against telemedicine only on this issue.

Often in debates, we do not stand up to seek to convince others. That only happens when there is a free vote—when actually the debate is really important. To people who are unsure, I say that I understand it—I totally get it—especially if they do not necessarily have so much skin in the game have but a huge load of emails in their inbox. The reality is that if they are not sure, they should either try to be convinced by the debate and the evidence, or they should simply abstain on the issue.

This is not particularly difficult for me. As I have said, I am not a dispassionate sort. I have stood in this House before and said that I have had an abortion. I do not feel devastated by that fact. I think we need to be clear about this. In this place, we only deal in hard cases, because they tell the argument much better. One thing I would say about when I had an abortion is that the worst process of having an abortion is the waiting. I had made the decision about what I was going to do with my body. I had made it the second that I saw I was pregnant on a pregnancy test, because I am an adult woman, completely capable of handling my own body and knowing my own mind, and that is how we should treat every woman in this country.

[Fiona Bruce]

On that point about adult women, and the point about the number of professional organisations that have been quoted, as if there were universal support for the continuation of telemedicine, I will mention two organisations, with particular reference to young people. The National Network of Designated Healthcare Professionals for Children, NHS doctors and nurses who work in the area of children’s safeguarding, has welcomed the Government’s decision to end the provision, and the Royal College of Paediatrics and Child Health recently released a statement:

“Children and young people under the age of 18 and Looked after Children up to the age of 25 must be offered and actively encouraged to take up a face-to-face appointment to assess gestation, support their holistic needs and assess any safeguarding issues as part of the pathway for early medical abortions.”

[Jess Phillips]

I could not agree more. People should absolutely be able to access a face-to-face appointment where they want and need one, and there is not a single thing in the legislation that would prevent that. I go back to this idea: “If you don’t like abortion, don’t have one. No one’s forcing you.” This is exactly the same. No one is forcing anybody to take through the procedure at home; it is a choice that we should allow adult women to make.

When I made that choice, after I made it I had to wait another eight weeks. It was some time ago, long before the pill was even necessarily widely available. I had made the decision, and I did not feel sad about it. I did not feel bad about it. I had made the decision on behalf of my son, who had only just been born—although, actually, I do not even need an excuse. I did not want to have a baby, having just had one, and it is perfectly well within my gift to make that decision. The argument is often made about all the children who have been lost because of women like me, but my younger son, Danny, would not exist if that baby had been born, so we end up equal, and he is a cracker of a kid.

The reality is that I had to wait, and I started to feel pregnant. I started to feel unwell, I started to feel tired and it started to affect my work. That was horrendous for me, knowing that I was not going to go ahead with it—not horrendous because of guilt, but because it made me feel sick and it made me feel that people had expectations of me. I had to hide it. I could not tell people I was pregnant; I had to hide that fact from people at work and other places, because I had to wait. Had I been able, at the four-week point when I found out I was pregnant, to just stay in my house and ring up, it would have been a far better situation for me.

People do not want to think about me, but rather obsess about the difficult cases, not the vast majority who are adult women and should be trusted to take medication in their own homes. We are treating those women as if they are going to get a methadone allowance from a surgery, as if they cannot be trusted when they say, “Actually, I’d prefer to stay at home and not maybe have a miscarriage on the bus on the way home because I live in a rural community.”

If people want to hear about the hard cases, I am currently handling one. It is the case of a young woman who has been sexually exploited since she was 13 years old. She is 23 now. She has had 10 years of being raped repeatedly, pretty much every weekend of her life, by multiple men, and it continues. Obviously, she falls pregnant—well, she does not fall pregnant; she is raped and then she gets pregnant. She has very little trust in agencies and in the police, and she is right to have so little trust. She has been failed time and again. Without the opportunity of telemedical abortion, I have no idea how she would cope. It is a vital service for people who really need it.

I ask hon. Members to vote Aye on Government amendment (a) in lieu of Lords amendment 92, or, if they are not sure, to abstain. Adult women can be trusted to decide what they want to do with their health, and any other vote would suggest otherwise.

--- Later in debate ---

[Dr Johnson]

With respect, the right hon. Lady makes my point for me, because that is right: there is nothing to stop that happening, and it may be that the doctor would say that they wanted to see the patient, but they do not have to do so. We know that abortions are being prescribed by telemedicine to children under the age of 18. If this measure had been looked at properly by the House as a single issue, rather than as this amendment to something else, we would have stipulated that children under the age of 18 should not be receiving abortions over the telephone without proper appointments, as I think they should and as the right hon. Lady, if I understand her correctly, also seems to be saying that they should.

We know that sometimes women and girls can be coerced into having abortions that they do not want, perhaps because the baby is of a gender or sex that the father does not want, perhaps because they are being abused, or perhaps they are being trafficked or sexually assaulted. It is very difficult for a woman to tell someone about that over the telephone, whereas if a woman is seen in clinic, she has that one-to-one opportunity.

[Jess Phillips]

Will the hon. Lady give way?

[Dr Johnson]

I am going to finish my point. In person, the woman has a one-to-one opportunity with that clinician and a chance to say, “Please can you help me?” Clinicians are alert to that opportunity to provide that help. It is true that if the woman receives the abortion by post, the problem of her being pregnant is solved, but the problem of her being abused is not. That is what can continue.

[Jess Phillips]

Will the hon. Lady give way?

[Dr Johnson]

No, I am going to continue. The other problem with giving tablets—[Interruption.] The hon. Lady spoke for 16 minutes, which is considerably more than a fair share, given the number of Members who want to speak, so I will keep going.

The other problem is who will take the tablets. If someone is prescribed something of such severity over the telephone, the clinician does not know who will take the tablets. Will they be taken by the woman speaking to the clinician on the telephone? Will they be given to somebody else? Are they going to be sold to somebody else? Is somebody else going to be forced to take them? The reality is that we do not know and we cannot know, and that is another safety issue.

I will summarise my concern by saying, as a woman— I have not had an abortion, but I guess in the future I could become pregnant and not want to be—if I were having an abortion, I would rather have the inconvenience of having to go to a clinic than the worry of knowing that some women are having abortions without going to a clinic. Essentially, for me this is an issue of whether we want to make things more convenient for the majority of women, or we want to protect the women who are the most vulnerable, the most marginalised and the most at risk.

Children’s Mental Health

Jess Phillips Excerpts

Tuesday 8th February 2022 Commons Chamber

[Jess Phillips (Birmingham, Yardley) (Lab)]

What I am going to talk about will surprise no one. We have heard a lot about the causes and whether it was lockdown or social media, but I am going to talk about the thousands of children I have met who have been victims of sexual violence and have lived in domestic abuse circumstances.

I used to run a counselling service—funnily enough, it was one of the first things that went in the cuts and then had to be paid for by the lottery—for children who had been raped. That lifeline was taken away. I want to remove this from what we can do in an educational or even an NHS setting and say that we need specialist trauma counselling for children who have been a victim of sexual abuse, violence and exploitation. Bear in mind that, this year, we are at the highest level ever of children suffering from exploitation. That went up by 10% last year—British children trafficked around the UK—and it is at the highest it has ever been, all while conviction and charging rates are falling. Each one of those children, many of whom I meet, are without any counselling or specialist support while they wait four to five years for justice to be served, for their child abusers to face any sort of justice.

I will speak briefly about my constituent, who I make come and see me every Friday because I am worried she is going to kill herself. She is 19. She was abused from the age of 10 and she first came forward to police forces when she was 14. She is awaiting the trial after coming forward at 14—she is 19, so that is five years she has been awaiting the trial. She is currently housed—this relates to the point that my hon. Friend the Member for Bristol East (Kerry McCarthy) made—in unregulated, exempt accommodation for homeless women and bear in mind, she is a rape victim, a child abuse victim.

Suddenly, all the Ministers care about child abuse, one notes, this week. This child abuse victim has been housed with three men, two of whom are being released from prison. I have written to the Levelling Up Minister to say, “What would this do to your mental health, if you were a rape victim waiting five years for trial?” No counselling service was available to her when I tried to get it. Basically, I am going to pay for it myself, because there is nothing available to her—nothing. I might as well—I was going to swear then, Madam Deputy Speaker, but I will not—do something in the wind, trying to get her on to a waiting list. We are housing her in dangerous circumstances. When I asked the Minister to regulate that, they said we do not have the parliamentary time.

Health and Care Bill

Jess Phillips Excerpts

Report stage
Monday 22nd November 2021 Commons Chamber

[Dame Andrea Leadsom (South Northamptonshire) (Con)]

This Bill can really help support giving every baby the best start for life.

First, new clause 55, in the name of my hon. Friend the Member for Ruislip, Northwood and Pinner (David Simmonds), would require the Secretary of State to publish guidance on how integrated care systems should meet the needs specifically of babies. “The Best Start for Life” report, published in March, calls for every local area to publish a seamless start for life offer for every new family. That must include midwifery, health visiting, mental health support and targeted services such as couple counselling, debt advice and smoking cessation. Each of these services is currently provided from silos within the public, private and civic sectors, so properly integrating them is no small task. I urge my hon. Friend the Minister to ensure there is very clear guidance to every local area on how it should co-ordinate its support for babies.

I also want to support amendments 91 and 92, in the name of my hon. Friend the Member for Broxbourne (Sir Charles Walker), which call for parity of esteem between mental and physical health. Mental health support for families who are struggling in that critical early period is vital. The London School of Economics has assessed that perinatal depression, anxiety and psychosis carry a total long-term cost to society of about £8.1 billion for each one-year cohort of births in the UK. Prevention is not only kinder but so much cheaper than cure.

Finally, I would like to support amendment 102, from my right hon. Friend the Member for Basingstoke (Mrs Miller), which calls for integrated care boards to provide clarity about their plans to tackle domestic violence. I am delighted that the Minister has already agreed to accept it. Analysis by the WAVE Trust indicates that up to 30% of domestic violence begins during pregnancy. The WAVE Trust highlights the crucial nature of experiences in the period of conception to the age of three in the formation of seriously violent personalities, largely because of the sensitive nature of the infant brain in those formative years. Domestic violence within a family is incredibly damaging to the emotional development of a baby, and I encourage my hon. Friend the Minister to ensure that plans for tackling domestic violence cover not just relations between partners, but reducing the impact on babies.

Madam Deputy Speaker, you may have heard me speak in this place before about giving every baby the best start for life, and I keep doing so because I am convinced that, if we invest in the 1,001 critical days, we really will transform our society for the better. It is in the period from conception to the age of two that the building blocks for lifelong physical and emotional health are laid down.

[Jess Phillips (Birmingham, Yardley) (Lab)]

I was not expecting to be called, Madam Deputy Speaker, but here we are. I want to tell a little story about my dad. My dad often rings me and tells me the things I should say in Parliament—I am not entirely sure any of you are quite ready for it, but I want to tell a story about my dad. He was born in the war, and they were given a council house by the Attlee Government—my dad could lecture us on it for weeks! He was given a council house, which his very Conservative parents bought in the 1980s. My granny, unbelievably—a lovely, generous woman—was a massive Thatcherite. She bought her council house in the 1980s, and that council house stands in my constituency. It is worth around £120,000.

My dad went on to get an education—a free education—and he moved into an area of Birmingham that was not very trendy at the time. He stayed there, I was born there, and my brothers lived there. All through our lives we watched that area get a little bit trendier, and the price of my dad’s house, which he bought for £30,000, went up and up and up. He didn’t particularly do much work—he likes to woodwork in his garage, but he has not done much. His house is probably worth around £700,000 now, and it was £30,000 when he bought it.

If my dad were here today, what he would say to hon. Members, and what he will almost certainly say to me, because he watches it all, lurking on Twitter, is that he does not deserve to keep his wealth for his children at any greater rate than the people who live in the council house that his parents bought on Frodesley Road in Sheldon. Yet today, the people who live in my constituency and the council house that my granny bought, to try to get a better life, will subsidise the care of my father, who has a £700,000 house that I do not need to inherit. I’m all right. I’ve got quite a good job. It is totally unacceptable that that is the situation we are putting almost all my constituents in, compared with constituents in Chipping Norton, for example, or the constituents of other hon. Members who have stood up and spoken. My constituents will largely be left with nothing. They will not be grateful.

[Edward Argar]

I am conscious of time, Madam Deputy Speaker, so I will try to cover some of the main themes that have emerged from today’s debate. I am grateful for the debate we have had today. The vast majority of what is contained in the Bill is exactly what the NHS said that it wanted and needed, and it is the right legislation being brought forward at the right time, to drive forward those priorities highlighted by the NHS in its 2019 consultation. The Bill drives forward integration not only within the local NHS within a region, but also greater integration with a local authority. It provides the foundations on which we can continue to build, as we move forward with greater integration of health and social care services that are designed to work around the individual, rather than in institutional silos.

Despite misleading claims by campaigners—and, indeed, by some Opposition Members—the Bill does not privatise the NHS. The NHS will always be free at the point of delivery. It has been in the hands of the Conservative party longer than it has been in the hands of any other party, and the Conservative party has put in place record investment in terms of resources in our NHS. What we propose in the Bill continues to build on that. Government Amendment 25 on ICBs is clear: ICBs are NHS bodies. They have always been NHS bodies in our proposals, and we have put in place provisions regarding conflicts of interest. Just to make sure, and given the misleading claims about private involvement, new clause 25 puts beyond doubt that ICBs are NHS bodies and must act in the best interests of the NHS. It is an amendment that is much stronger and much more effectively drafted than the alternatives put forward by the Opposition, because we believe in putting this question beyond doubt.

On the ICBs and ICPs, we have sought to be permissive rather than prescriptive, giving those local systems, within a national framework, the flexibility to deliver what they need to deliver for their local areas, which they know best.

I have been happy to accept amendments 102 and 114. I will continue to reflect on the points made by my hon. Friend the Member for Broxbourne (Sir Charles Walker); in the nicest possible way, I suspect that—rightly—he will not go away. The former Secretary of State, my right hon. Friend the Member for South West Surrey (Jeremy Hunt), set out very clearly the case for his amendment 114, which I was happy to accept, and the importance it places on patient safety.

My right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom) has done a huge amount of work in this space—I pay tribute to her—and she is right: we will look very carefully in the statutory guidance at how we can emphasise that. I fear that my hon. Friend the Member for Newton Abbot (Anne Marie Morris) was not in her seat when I paid tribute to the work that she had done previously, but I put that on the record too.

On new clause 49, my hon. Friend the Member for Gosport (Caroline Dinenage), a distinguished former Care Minister, made the point extremely well that this is a significant improvement and step forward on where we currently are in respect of tackling the social care challenge.

Baby Loss Awareness Week

Jess Phillips Excerpts

Thursday 23rd September 2021 Commons Chamber

[Maria Caulfield]

I take the hon. Lady’s point. There was a lot of misinformation earlier in the year that made pregnant women reluctant to come forward, and there is a lot of work we can do to improve that communication.

[Jess Phillips (Birmingham, Yardley) (Lab)]

I wish to raise a specific point about covid that I learned of from an obstetric consultant: the number of preemie births dramatically dropped during covid because women were at home. It was a doctor from Reading who told me this. He had to be dispatched somewhere else in the NHS because his services in dealing with premature babies were no longer needed as the number had dropped so greatly because women were at home. Will that form part of the strategy, to make sure that in terms of baby loss we are looking after women throughout their pregnancies?

[Maria Caulfield]

The hon. Lady makes an excellent point. We need to be guided by clinical evidence and practice, and we will look back and reflect on some of the lessons that can be learned from the period of covid.

Many hon. Members mentioned the staff who look after women and families who have lost a baby. It is incredibly important that we support those staff, because the impact is huge. May I put on the record my thanks to every one of those maternity staff who look after women and families, because the toll on them is sometimes greatly underestimated? It is assumed that because they go into that speciality they can cope with this, but it is extremely difficult for them. Like my hon. Friend the Member for Cities of London and Westminster (Nickie Aiken), may I too welcome Jane Scott and her colleague, one of the midwives from St Mary’s Hospital, who have set up the UK National Bereavement Midwife Forum? I would be delighted to visit them and learn from their experience, because we are committed to supporting staff and making sure that they are able to undertake the special work that they do.

In conclusion, there are multiple and complex issues associated with baby loss and we need to do more not only to support families through such a difficult experience, but to reduce the numbers of people experiencing baby loss in the first place. Crucially, as I said in my opening remarks, we have made some good progress on our national maternity safety plans. We have seen a 25% reduction in the stillbirth rate since 2010 and a 29% reduction in the neonatal mortality rate for babies over 24 weeks’ gestation. That means hundreds more mothers and families are going home with a live and healthy baby each year, but, as this debate has ably demonstrated, there is still much more to be done. I hope to return to the Chamber next year during Baby Loss Awareness Week to be able to show the further progress we have made on this important issue.

Health and Care Bill

Jess Phillips Excerpts

2nd reading
Wednesday 14th July 2021 Commons Chamber

[Joy Morrissey (Beaconsfield) (Con)]

May I thank Neil from Buckinghamshire Healthcare NHS Trust, Buckinghamshire County Council, the local Bucks clinical commissioning group, local GP surgeries, REACH care homes and care workers across South Buckinghamshire, Thames Hospice and Jayne from the Care Campaign for the Vulnerable? They are all already modelling integrated care, which is promised and promoted through this Bill, and I just want to thank them for their tireless service.

I also need to declare an interest: I am now a carer for a very disabled relative, who became disabled through the pandemic and now requires 24-hour care. So I am fully aware of how broken the care pathways are. I want to speak on behalf of disabled adults and their access to care, and the carers who struggle with the demands of finding ways of advocating for their loved one in the current system. I welcome any changes to integrated care because of that. I want to share examples from my personal experience, not because it is important; it just chimes with what I keep hearing from patient advocacy groups, Age Concern, Mencap and other charities. The problem we see is: when a patient is discharged from hospital, who then takes up the duty of care? I have countless examples of my relative being discharged with open bleeding wounds or bed sores, of waiting four days for a nurse to come to attend to them, of being given the wrong medication, of being unable to access—

[Jess Phillips (Birmingham, Yardley) (Lab)]

I just wanted to give the hon. Lady a bit more time. Does she agree that we would want to see more in this Bill on how social care is going to be accounted for? Currently, I feel that is lacking.

[Joy Morrissey]

I thank the hon. Lady for the point she has raised. I have had reassurances from the Minister that we are going to address the social care issues, but I agree that we need parity of esteem between health and adult social care. We need to see those who are delivering those care pathways—local authorities—given the parity of esteem that the NHS and other care providers now have. I hope that we will look at this further as the Bill progresses.

Parity of esteem is very important because there is a difficulty with collaboration and co-ordination of care, and it is the major driver of health inequality and avoidable deaths for people with learning disabilities. Many people with learning disabilities have very complex health needs that require healthcare professionals to collaborate and to co-ordinate interventions. On top of that, healthcare staff need to work together to deliver the healthcare that those vulnerable patients need, which requires effective communication and understanding, as well as resource. How those funding streams are co-ordinated and improved in future is something that should be looked at.

I have seen at first hand, particularly with stroke victims who leave hospital with varying levels of cognitive and physical impairment, the need for critical rehabilitation services to be co-ordinated and put in place the moment people leave hospital, but that is often difficult. Many Members have raised the issue of workforce capability—I echo that. We need to look at how we can work together collaboratively to put patients first and deliver the vital services that many disabled adults need. We have an ageing population, and we face a crisis in adult social care that will eclipse all other things in healthcare. If we work to deliver solutions now—I welcome what is in the Bill—to the hard problems that we face in integrated social care, we can find the solutions that we need for the future.

--- Later in debate ---

[Rob Roberts (Delyn) (Ind)]

Today’s Bill will help our healthcare system to become more accountable and less bureaucratic, allowing our brilliant healthcare professionals to focus on their job of providing world-renowned care to patients, rather than filling in unnecessary paperwork. It allows our healthcare system to be flexible, adapting to meet future and local needs.

As my hon. Friend the Member for Meriden (Saqib Bhatti) said earlier, a one-size-fits-all approach is rarely the most effective, and today’s Bill will mean local areas can develop practices that best suit their needs.

[Jess Phillips]

Will the hon. Gentleman give way?

[Rob Roberts]

No.

This is something we are acutely aware of in Delyn, as we have a much higher proportion of over-65s than the national average. Sadly, the Welsh Government’s funding to the north Wales health board is significantly lower per capita than that enjoyed by the health board in south-east Wales, but that is a debate for another time and place.

[Jess Phillips]

Will the hon. Gentleman give way?

[Rob Roberts]

No.

Sadly, one of the major elements of today’s Bill that should be praised falls a little short for my constituents in Wales. The Bill will lead to greater collaboration and integration between the NHS, local authorities and care providers in England, and ultimately this will deliver more joined-up working and the best outcomes for patients, yet this move towards greater collaboration needs to go further. We need to see collaboration in healthcare across all the constituent parts of the United Kingdom.

The NHS is not limited to one part of our country; it is nationwide. When someone is treated in their local hospital, they are treated by the NHS—not NHS England, or NHS Wales but the national health service. People do not see that there should be a difference and, frankly, they do not care.

Just as we should be united in our response to covid-19, it is now time for our healthcare system to work together across borders for the good of all UK residents. Despite holidaying within the same country, as so many people are doing this year, if a constituent from Delyn holidays in Cornwall and needs NHS treatment, their medical records will not be on file and will be difficult to access. Without immediate access to those medical records, I cannot help but worry that it could affect the outcome and care they receive, demonstrating the need to share records between all four nations. This issue is one of many that could be resolved through greater collaboration between the UK Government and the devolved Administrations on healthcare, just as we saw with the fantastic vaccine roll-out.

I urge the Government to remember that they are the Government of the whole United Kingdom, which should come with an overarching responsibility to care for and look after all their UK citizens, regardless of the nation in which they reside. As this Bill progresses through the House, I hope the Government draw on the lessons they learned from working together on the covid-19 vaccine programme to consider how greater collaboration in healthcare can be achieved between all four constituent parts of the UK to tackle the public health issues that we collectively face.

Covid-19

Jess Phillips Excerpts

Monday 16th March 2020 Commons Chamber

[Matt Hancock]

Yes, that is a very good suggestion. It is one for the Secretary of State for Environment, Food and Rural Affairs and the supermarkets, of course, but is an example of people pulling together to help the most vulnerable.

[Jess Phillips (Birmingham, Yardley) (Lab)]

In answer to the question from my hon. Friend the Member for Leeds West (Rachel Reeves), the Secretary of State stated that people had to take it through the benefits system, unlike maternity allowance, just as an example. I wish to speak for a moment about the benefits system. My own brother, who is a universal credit claimant and an agency worker, has likely lost his job because he had to self-isolate for a period and it will not be kept open for him. Given the lag of universal credit, he will not get anything until early May. The Secretary of State needs to tell us now when he will come before us with a package of financial benefits for business and people, because it is getting too late.

[Matt Hancock]

We changed the law on Friday to take into account the need to make sure that payments are made from day one, in some of the benefits. It is absolutely the case that statutory sick pay is paid by employers. For the self-employed, there is no employer. We cannot put in place, in the time that is necessary, a whole new system. We need to make sure that people use the benefits system that exists.

Mental Health and NHS Performance

Jess Phillips Excerpts

Monday 9th January 2017 Commons Chamber

[Mr Hunt]

My hon. Friend is absolutely right—obviously his role on the Select Committee gives him a particular insight—but we do not want to rush to a solution, which is why we have said that we will produce a Green Paper before the end of the year. It is a complex area. Other hon. Members have alluded to the risk of medicalising problems, given that, as we know, all young people at school experience periods of stress, anxiety and worry that are not necessarily diagnosable mental health conditions and which we would not want to make out to be such. This is about thinking through a smart way to improve resilience training and self-help and to educate schools so that they can spot when something is just a temporary thing in the run-up to exams, or whatever, and when it could be something a lot more serious, such as obsessive compulsive disorder, an eating disorder or something else that needs more immediate help. We have today started a big education programme with schools, but we want to go further.

[Jess Phillips (Birmingham, Yardley) (Lab)]

I welcome the extra investment, if that is what it turns out to be, in mental health, but I want to press the Secretary of State on the question asked from the Dispatch Box by my hon. Friend the Member for Leicester South (Jonathan Ashworth) about educational psychology and how it will work. I speak as a mother of a child with SEN issues who has relied on clinical and educational psychology in schools. The school that my children currently attend is increasing class sizes from 30 to 33 and reducing the teaching staff—specifically those who engage with SEN children—because of changes to education funding. How does the Secretary of State think that will affect the mental health of pupils in my children’s school?

[Mr Hunt]

The hon. Lady raises a very important issue. Like her, I have had constituents who found it difficult to access educational psychologists and they have not been able to get approval for the plan that they need. We will consider these issues in the build-up to the Green Paper, and I encourage the hon. Lady to participate in that process.

Social Care Funding

Jess Phillips Excerpts

Monday 12th December 2016 Commons Chamber

[David Mowat]

I have made the point already, and I will make it again, that we acknowledge that the precept is uneven in the way that it was announced in the spending review. That is why the additional better care fund component is allocated on a basis that remedies that.

[Jess Phillips (Birmingham, Yardley) (Lab)]

Thank you, Mr Speaker; this is a timely moment to call me, given what the Minister says about remedies. I put in a freedom of information request about the adult residential weekly rate across every single council in the country. Buckinghamshire gets £615 a week, while Birmingham, including the home where my grandparents both died, gets £436 and has to make an additional charge of £55 per week on the residents who live there, who are no doubt poorer than those who live in Buckinghamshire. Does that sound like a discrepancy that is being solved by the Government’s system? Are nans and granddads in Buckinghamshire worth more than they are in Birmingham, Yardley?

[David Mowat]

In terms of quality in Buckinghamshire and Birmingham, we look at the CQC reports right across the system, and we are not finding a geographic variation based on those sorts of statistics. That is just the fact of the matter.

World Autism Awareness Week

Jess Phillips Excerpts

Thursday 28th April 2016 Commons Chamber

[John Woodcock (Barrow and Furness) (Lab/Co-op)]

I will try to reduce my speech to below five minutes to give others a chance to speak in this excellent debate, Madam Deputy Speaker.

[Jess Phillips (Birmingham, Yardley) (Lab)]

Thank you.

[John Woodcock]

You are welcome.

We have heard erudite contributions in the debate so far, and I just wish to make two main points. The first is on understanding the scale of the problem. People have talked at length about this, giving some excellent examples, but I want to go further on the fact that we are still far from seeing the true scale of the autism problem in our country. This is partly because although recognition is growing, it remains insufficient among members of the community. It is also because of the number of worrying ways in which the true extent of the lack of capacity in local services is being hidden, and I hope the Minister will take up that point; the extent to which people are being denied is also being masked. The hon. Member for Glasgow East (Natalie McGarry) talked about the long referral times, way beyond the recommended limits. In Cumbria, the time taken is even longer than the average, which shows the problems.

I wish to relate some of the concerns that parents of autistic children consistently raise in their local support group, and when talking with charities and directly to me. They suggest that even the acknowledged level of deficiency of the service does not reflect the true picture. They tell of their repeated frustration at contact just being ignored and how difficult it can be to get service practitioners even to pick up the phone. That is not properly documented. If people cannot even get on the waiting list to be seen, or they cannot get their request to be acknowledged because their contact is not being acknowledged, the problem is even bigger than is stated. Particularly worryingly, parents have a strong sense that people will tell them orally that the service is not sufficient for them but will refuse to put it in writing in a way that could allow them then to escalate it through the system. I would like the Minister to reflect on that and say whether he believes that that is a genuine problem and whether it is a wider problem.

My second point is about my pride in what my constituency has been able to contribute to the wider awareness debate. First, I should mention “The A Word”, which many hon. Members doubtless watch, as it is filmed in Broughton-in-Furness, in the north of my constituency. As Members will see from the programme, it is a fabulous place to go. I commend all involved in that programme for doing important work in a mainstream, prime-time BBC programme that is getting the message out in a really effective way.

I have delayed my congratulations to the right hon. Member for Chesham and Amersham (Mrs Gillan), but I thank her for the way in which she has engaged with my constituent Deborah Brownson, who has produced an excellent book. It is a children’s guide to autism called “He’s Not Naughty”, which she is trying to get into every school she can. I want to thank the Mayor of Barrow, who has financially facilitated, just yesterday, getting it to all the schools in the borough. Ministers on the Front Bench are asking for personal copies, and I would be delighted to help in doing that. I ask anybody listening to this debate who can contribute to her financial drive to get this illustrated book to other schools to do so—all we need is the postage and some of the printing costs covered. It is an excellent illustrated guide that will explain to children just what is going on in the minds of autistic—[Interruption.] I am afraid that I have completely failed in my task and I am on my last five seconds.

--- Later in debate ---

[Jess Phillips (Birmingham, Yardley) (Lab)]

I speak as a mother currently on the long waiting list for diagnosis. I thank everybody for their comments today.

I am delighted to speak in this debate. Like everybody else, I commend the right hon. Member for Chesham and Amersham (Mrs Gillan), who is a tireless campaigner on this issue—a subject incredibly close to my heart. So many misconceptions about autistic people get thrown around, such as “Everyone is somewhere on the spectrum”, which I am sure we hear a lot in this place, or my favourite, which is that people with people with autism have some sort of superpower or special gift. I can tell everyone now that they do not.

Last Friday, I watched the newly released DVD of “Star Wars: the Force Awakens” with my sons and their lovely autistic friend. Between us we decided that what appeared as the teenage tantrums of the new Dark Lord, Kylo Ren, was perhaps just him needing a bit of a “time out”. We concluded that perhaps he was autistic and just could not fit into the world he found himself in. Perhaps the new Death Star was just too noisy and made him feel stressed out. We thought he might wear the mask because he did not like eye contact. I am not sure that this was the film-maker’s intention, but it softened us to him. The group of people I was with “get” autism and ASD—they live with it every day—so they can see how a person’s behaviour might alter if things start to kick off. To all of us, it is not the person with autism who has the problem—it is the rest of the world. We have to think differently about people who think differently.

On every street I visit in Yardley, I meet families struggling with autism in adulthood or in their children. My postbag is full of heart-breaking cases of how much autistic people are struggling. In my constituency there is an amazing autism support group called Spectrum, where every meeting is packed with parents who want a break. This is not a minority issue—it is a growing issue, and we are not keeping pace with our provision, our awareness or our attitudes.

Today I want to focus on how the world needs to think differently about employment for people with autism. Only 15% of working-age people with autism are currently in work, according to the National Autistic Society. For any parent with a child with autism, this presents a heart-breaking and bleak future—but it does not need to be. Ambitious about Autism has identified that in fact 99% of young people with autism want to work.

So what can we do? The Department for Work and Pensions has made some impressive commitments over the past few years in saying that Jobcentre Plus will implement autism awareness and autism networks. I welcome all this, but in reality it is not what people in my constituency are experiencing. One constituent told me: “I do not blame the staff, but it comes down to a lack of understanding of autism. The support the jobcentre claim to be providing is not there. I was treated as though I had no disability and left to my own devices. That is the problem of having an invisible disability.”

[Melanie Onn (Great Grimsby) (Lab)]

At a meeting last week, somebody raised the issue of jobcentres specifically regarding the personal independence payment and self-assessment of people with autism or Asperger’s as being incredibly difficult. Why does that continue to be part of the process?

[Jess Phillips]

I could not agree more. Another of my constituents told me just this week how the jobcentre had failed to recognise the need for his mother to be able to attend meetings about his PIP arrangements and to change his benefits. That has resulted in frequent incidents of faltering benefits, which has made him incredibly vulnerable and left him with totally insecure finances.

On another occasion I heard of a mother who wanted to access a bus pass from the local authority for a home-to-school scheme, in order to get her son travel-ready for when he leaves school in a few years’ time so that he will be able to go on the bus on his own. She was given a “computer says no” answer and told to come back in the few years when it would actually matter. However, because she is a mum with an autistic child, she knows it is going to take time and training.

We have got to be bold and flexible. We have got to think differently about how we make our services and the world’s jobs available to people on the autistic spectrum. Although things are not perfect, we have come a long way from the days when a person in a wheelchair could not have a job because they could not access the building. Autistic people may not face a physical barrier like a staircase, but the barrier effect is exactly the same.

Not providing fair and equal access to these people is not only wrong; it is also illegal, and we have got to make sure that employers know that. We need employers to understand how an interview might feel to somebody with autism. It is terrifying enough for somebody who is neuro-typical, so I ask Members to imagine for a second that they do not want to look someone in the eye, find talking in front of strangers impossible, or find it impossible if two people speak over each other.

Ambitious about Autism has just launched its “Employ Autism” campaign to transform the employability of young people with autism. I ask everyone in this place to do as I have done and offer to provide work experience to young people with autism. I imagine that I will learn as much as my placement, possibly more. I also encourage Members to ask our local business improvement districts, chambers, local enterprise partnerships and businesses to offer tailored work placements and apprenticeships. That will help us all to think differently.

I want to stand here and say with confidence to every young person with autism and every parent with a child on the autistic spectrum: you can do anything. I want to say: your future is bright. I want to say it to myself, for my son. I want to say it to my son’s “Star Wars” fan friend. But I can’t. I don’t know what the future will be like for them. So let’s try to change it. Let’s think differently.

Student Nursing (Finance)

Jess Phillips Excerpts

Monday 14th December 2015 Commons Chamber

[Wes Streeting]

My hon. Friend speaks with great experience. The Government should heed the points she makes.

I will turn to the other questions I have for the Minister. How will clinical placements be funded under the student loans system? The Government talk about the number of places they can expand, but it is not like expanding a history undergraduate course because occupational placements need to be arranged. The Government should explain how they intend to fund them.

Given the number of mature applicants for nursing, midwifery and allied health subjects, what assessment have the Government made of the likely impact of the reforms on applications from mature students? Are the Government at all concerned that applications from mature students may fall, given the detrimental impact that the coalition Government’s student finance reforms had on mature and part-time student numbers? Given that many people choose healthcare as a second degree and may not be willing to take on more than £100,000 of debt, how will the Government ensure that this route is not closed to such students? Have the Government conducted any evaluation at all that might give us a clue as to the extent of the risk that these reforms pose to recruitment?

The Government suggested in the spending review that half of all applicants to nursing courses are turned away. Do they have any evidence of what stage they are turned away at? If it is really the case that people are flocking to these professions, will the Minister explain why my local NHS trust has been so reliant on temporary and agency staff, including nurses who have been flown over from Portugal, to address the recruitment and retention challenges facing the NHS?

Additional allowances are currently available for students with different circumstances. Will the Minister inform the House whether any changes will be made to additional allowances, such as the extra weeks allowance or the dependants allowance? If so, what are those planned changes and what assessment have the Government made of their potential impact?

Given the press speculation over the weekend that the Government plan to increase the overall cap on university tuition fees, what assurance can the Minister give the House that students studying nursing, midwifery and allied health subjects will not see their tuition fees and debts hiked up even further than is being suggested? Given that the Government seem content to shift the goalposts for existing students and graduates, does the Minister really expect current or future students to believe that the terms and conditions they sign up to will not be changed and applied retrospectively further down the line? At the very least, I hope the Minister will confirm this evening that the NHS will continue to fund the tuition fees for existing students for the remainder of their studies.

When the coalition Government chose to increase tuition fees in 2010, the move was subject to a debate and a vote in this House. Given the media speculation that Cabinet Office Ministers are busy trying to find ways to avoid proper debate and scrutiny of a possible increase in the overall cap on tuition fees, will the Minister give the House an assurance that we will have a full debate and a vote should the Government choose to extend tuition fees to nursing, midwifery and allied health subject courses? Many students have already written to Ministers in the Department of Health and are awaiting a reply. Will the Minister commit to meeting student representatives to discuss their concerns?

It is not hard to understand why the Government’s shift in policy is generating so much concern and anxiety. In recent days I have heard representations from, among others, Unison, the Royal College of Nursing, the National Union of Students, the University of Hertfordshire, the Royal College of Speech and Language Therapists, and the Chartered Society of Physiotherapy. I have been contacted by student nurses and midwives in my constituency, and received messages of support for this debate from those in the constituencies of other right hon. and hon. Members.

Before I conclude, I would like to share with the House some of the stories that I have heard, and I will finish by making a few points about nursing and midwifery students. These are exceptional people and their dedication to others is truly remarkable. They work long hours, often in difficult situations, and they take a direct role in caring for patients when they are at their most vulnerable. Nursing students have told me how immensely challenging their work can be. They hold the hands of patients in their final moments, and comfort them as they pass. They are the face of reassurance to patients, and a bedrock of support for families.

[Jess Phillips (Birmingham, Yardley) (Lab)]

My hon. Friend is making a powerful speech, and I wanted to share my thoughts as someone whose son’s life, and whose own life, was saved by a student midwife. Does he agree that making those people not just work for free but even pay to save the lives of people like me and my son, is simply despicable?

[Wes Streeting]

I wholeheartedly agree with my hon. Friend, and I am grateful to her for sharing her difficult personal experiences.

Nurses care for us in some of our darkest and most painful moments, and the weight of their responsibility carries with it a heavy physical and emotional load. The same is true for our nation’s midwives. One spoke of the difficulties that she faced when a baby was stillborn and she had to comfort the mother, while also taking hand and foot prints so that the parents would have memories of the baby they lost. She will never forget the shift when she spent 12 and a half hours with a mother who miscarried twins. She had five hours of rest, and then came back to do another 12 and a half hours with the same woman. She has supported the delivery of 10 babies, and she feels immense pride in being part of the wondrous moment of childbirth.

As the saying goes “Save one life and you’re a hero; save 100 lives and you’re a nurse.” These people are seeking to qualify into these difficult professions and form the NHS of tomorrow. They deserve our respect, admiration and support, as well as the right incentives to continue or even commence study in the first place. Ministers should listen to the students who are protesting, and to the nearly 150,000 people who have signed the petition to keep the NHS bursary. The Government owe it to patients and students to think their proposals through properly, and I ask them to pause this process. It would be a tragedy if the next Florence Nightingale or Edith Cavell were discouraged from the profession because of these changes. I look forward to the Minister’s response, and I hope that in the coming days, weeks and months, he will listen carefully to the voices of those who form the backbone of our national health service.

--- Later in debate ---

[Ben Gummer]

It is simply because I wish to see the same advantages that accrue to those already on the new finance system accruing to those who are not. I want to see an expansion in the number of places and I want to see the effects of the changes made by the Office for Fair Access to university admissions in the rest of the sector applied to nursing, so that we see not only an expansion in the numbers of nurses being trained, but a broadening of the backgrounds of those going into nursing, exactly as has happened in all other areas of higher education.

I want to explain, I hope quickly, how this change forms part of a wider reform we are making in student access to nursing. The hon. Member for Ilford North framed his entire speech, understandably so, around the university route into nursing, but he omitted to reflect on the fact that the Government have stated that we will introduce an apprenticeship route into nursing to degree level—level 6. That will provide an alternative route into nursing, whereby nurses will be able to earn while they learn from healthcare assistant level all the way to a full nursing qualification at degree level. It will be possible for them to do so as mature students, which means it might take a bit longer, but they will be able to earn all the way from an existing job to gaining a nursing qualification—an innovation that should be welcomed on both sides of the House and which will mark a real expansion of opportunity for the current NHS.

[Jess Phillips]

rose—

[Ben Gummer]

Before I give way to the hon. Lady, I should also explain that there are many people working as healthcare assistants at the moment who do not have the opportunity to progress to a nursing position unless they leave the workforce to do so. That puts many of them in an impossible position, because they have families to support and other duties and responsibilities. For the first time, we have been able to give that group of people an opportunity to progress, through the apprenticeship route, to a full nursing position. That will expand the whole area of career progression to include one of the larger cohorts in the NHS workforce, in a way that no Government have previously been able to do.

[Jess Phillips]

I wonder whether the Minister can clarify whether people will be paid for doing that apprenticeship and, if so, at what rates they would be paid. He rightly referred to getting mature students with families into work, so will he also say whether that cohort will fall foul of the rule that people must be doing 16 hours of work, and not be in training, to receive the Government’s 30 hours of free childcare? It was made clear in the Childcare Public Bill Committee that those nurses currently studying would not be able to access the 30 hours’ free childcare because that would not be considered work. When they saved my life, it looked like work.

[Ben Gummer]

The hon. Lady speaks with authority from her own personal experience—I have noticed that recently she has spoken her mind without holding back. We are in detailed discussions with the Nursing and Midwifery Council about precisely how the apprenticeship route will work. The council is the independent regulator and has to certify that the qualification matches the existing degree/university route. The qualification has to have complete equality of both esteem and rigour. Of course we envisage the apprentices earning a salary. We envisage opening the route to existing healthcare assistants to give them the opportunity to progress to a nursing grade while continuing at a similar salary point as an apprentice. However, because the hon. Lady’s question about maternity care pertains to student nurses rather than apprentices, I will ensure that I write to her in detail.

The hon. Lady clearly sees why this is an idea with strength, so I hope that in asking her question she realises that there will be two routes into nursing: the university route and the apprenticeship route. I think this is potentially one of the most exciting innovations in the workforce of the NHS for several decades, because it opens up nursing to a whole range of existing workers who have not had an opportunity before, and provides a wholly different route into nursing, but with the same rigour and robustness that the existing university degree route provides.