A& E Departments: Staffing

Jim Shannon Excerpts

Monday 23rd March 2020 Commons Chamber

[Chris Bryant]

That is a brilliant moment, and of course I celebrate it. When I was a vicar, I used to be there for quite a lot of births, giving blessings for babies in the special care baby unit. That is a vital part of the business, as it were, of accident and emergency departments.

[Jim Shannon (Strangford) (DUP)]

I am conscious that the A&E close to me at Ulster Hospital in Dundonald is one where there has been an increase in the number of violent attacks on staff. Does the hon. Gentleman agree that we must protect staff by not only providing them with protective gear but having CCTV and police available?

[Chris Bryant]

My heart wants to sink every time I hear of any assaults on emergency workers. That is why I brought forward a private Member’s Bill a few years ago, which I know the hon. Member supported, and I wish the prosecuting authorities used it more frequently. Any attack on our emergency workers is an attack on all of us, because they are there to save our lives and protect us in our most difficult moments.

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[The Minister for Care (Helen Whately)]

I thank the hon. Member for Rhondda (Chris Bryant) for calling this debate and for leading us in that tribute to the NHS workforce.

As we stand here, our NHS faces daunting challenges, as it will continue to do for weeks and months to come. I, too, want to take a moment this evening to thank each and every one of our health and care staff and their individual families for all they are doing for our country at this most challenging of times. I know they are making incredible sacrifices, selflessly working at the frontline in looking after our families in our hour of need, while their families are at home concerned for their safety and welfare. They are there on the frontline around the clock, tackling this head-on. As a country, we will be eternally grateful to them, and from us all, thank you.

I will also pause, if I may, to mention some of the heart-warming gestures across our communities, such as small businesses and large multinationals offering staff hot drinks and hot food, supermarkets making specific opening times for NHS and social care staff, and hotels and chains making beds available to staff to use. Thank you to each and every one of you. You do our country proud.

I want to assure everyone this evening and, most importantly, all our NHS staff that we are here to support them, and we will not let them down. First, we know the NHS needs more people to fill the gaps when staff have to stay home and to cope with the particular needs of patients with coronavirus. We have made a call to arms to those who have left the healthcare professions in the last three years. The healthcare regulators have been contacting doctors, nurses, pharmacists, paramedics and others to ask them to return to practise to support the coronavirus response, and the response from the workforce has been amazing. At noon today, 1,930 doctors and 5,630 nurses had responded by indicating that they were willing to return to the NHS. They will help the NHS not only to treat coronavirus patients, but to continue other emergency healthcare, including urgent operations and cancer treatments. We are also working with professional leaders across nursing, midwifery and allied healthcare professionals to see how students in their final year of study can provide support at the frontline. Our nursing leaders, staff representatives and university bodies will put out a joint statement on that tomorrow.

As we welcome so many doctors, nurses and allied healthcare professionals back to the NHS, we must look after them and all those who work in our health service. I know that staff at the frontline are worried and need assurances that there is sufficient personal protective equipment for everyone who should be using it. The safety of those on the frontline is of paramount importance. We have stocks of PPE nationally and NHS England is working to make sure that the NHS frontline has the equipment it needs. I know there have been problems with distribution in some places, but that is now being resolved by NHS England, which has restructured its logistics operations so that equipment should now be getting to those at the frontline who need it.

[Jim Shannon]

There is some indication in the news today that some of the personal protection equipment and material available is not up to standard. Will the Minister confirm that everything the Government are sourcing is of a standard suitable for the needs of staff at the frontline?

Supermarkets’ Role in Tackling Childhood Obesity

Jim Shannon Excerpts

Wednesday 18th March 2020 Westminster Hall

[Steve McCabe (Birmingham, Selly Oak) (Lab)]

I beg to move,

That this House has considered the role of supermarkets in tackling childhood obesity.

It is a pleasure to serve under your chairmanship, Mr Robertson. Even as we struggle with the threat of covid-19, I want to stress the importance of this debate, because childhood obesity is a subject whose importance cannot be overestimated. It is without doubt the time bomb that will increasingly affect the lives and wellbeing of our society in the years ahead. We need clear steps to address it. The report, “Healthy Families: The present and future role of the supermarket”, from the all-party parliamentary group on a fit and healthy childhood, sets out to contribute to the debate. It does not seek to cast supermarkets as the villains of the piece; rather, it recognises the influence that they have and how that influence can be used positively to help tackle health issues.

Supermarkets have always occupied a special place in our psyche. It was J. K. Galbraith who told us:

“A person buying ordinary products in a supermarket is in touch with his deepest emotions”,

and Jonathan Sacks who suggested:

“A Martian would think that the English worship at supermarkets, not in churches.”

Supermarkets are now widespread in many countries. This country’s development trailed behind that of the USA. Indeed, by 1947 our self-service sector consisted of a mere 10 shops, but by 1969 supermarkets numbered about 3,500 and were well and truly established as part of our shopping experience. Store layout, daily promotions and sensory cues are all part of a formidable arsenal designed to encourage customer purchases, often regardless of the nutritional value of the product.

Price promotion is a key element in the strategy. A Cancer Research UK report in 2019 argued that three in 10 food and drink purchases are determined by price. The households making the greatest use of price promotion bought more products high in fat, salt and sugar. The upper quartile of promotional purchasers are 43% more likely to be overweight than the lower quartile, irrespective of income and age demographics.

[Jim Shannon (Strangford) (DUP)]

I suspect that the hon. Gentleman shares my concern that supermarkets place chocolates just in front of the tills, so that there is almost a wish to buy them as people make their purchases. Does he feel that supermarkets should move them away from the tills, so that there is not that temptation for mothers and children as they come to pay for goods?

[Steve McCabe]

I certainly agree. There is quite a lot of research to show that children, almost irrespective of their age, are influenced by that, and that the placement of products influences purchases.

The Obesity Health Alliance’s 2018 report “Out of Place” focused on the prime locations in stores for selling particular goods—exactly the point that the hon. Member for Strangford (Jim Shannon) has just made. It found that 43% of all food and drink promotions situated in prominent places, such as entrances, checkouts, aisle ends and so on, were for sugary food and drink. Fruit and vegetables amounted to less than 1% of products promoted in high-profile locations.

Diabetes UK reports that one in three children in primary schools in England currently suffer from excess weight, increasing their risk of type 2 diabetes. Excess weight or obesity accounts for up to 85% of someone’s overall risk of developing the condition. The Obesity Health Alliance makes a similar point: as well as causing type 2 diabetes, obesity can lead to cancer, heart and liver disease, and associated mental health problems.

[Jim Shannon]

I think it is wise to reflect on diabetics. I declare an interest, as I have been a type 2 diabetic for almost 15 years. There are 5 million diabetics in the United Kingdom, and the number is rising. It is one of the greatest health problems for future generations. Does the hon. Gentleman agree that there should be a campaign to address the issue across the whole United Kingdom of Great Britain and Northern Ireland?

[Steve McCabe]

I do, because we have to educate people who could avoid this condition about to how to do so, not least because, as the Obesity Health Alliance points out, the annual cost of overweight and obesity-related ill health to the NHS is £6.1 billion.

Like other organisations, Diabetes UK acknowledges that products high in sugar are more likely to be promoted through price promotions. It argues that we must have a rebalancing of price promotions to favour healthier products, which would make healthier options cheaper and encourage people to buy such products. Polling conducted by Diabetes UK shows that 82% of adults favour front-of-pack traffic light labelling to help them make a more informed choice. As Britain negotiates new trade arrangements following our EU exit, there is an obvious opportunity to ensure that the UK can introduce legislation to mandate such labelling.

Supermarkets are showing that they have the capacity to reach out to different segments of our society and to play an important social role. In 2014 Sainsbury’s introduced a disability-friendly trolley, designed in conjunction with parents of disabled children. In 2018 Morrisons introduced a quiet hours scheme, with dim lighting and music switched off to help parents with autistic children. There is widespread agreement that the biggest driver of food poverty is lack of money, and that low-income families are therefore nudged by economic factors towards a diet characterised by highly processed, calorie-dependent foods with less fibre and less vitamin and mineral content. The consequent long-term health risks of such a diet can include heart disease, type 2 diabetes and cardiovascular illnesses.

Supermarkets are the sole largest food source for families in England and could support disadvantaged households in making healthy choices. There are good examples in other countries. Denmark, Norway and Sweden use a keyhole label to facilitate healthy choices. Since 2000 there has been a requirement in Finland for a “healthy heart choice” symbol to be displayed on over 11,000 products. In Israel, co-operatives sponsor community physical activity, as does Sainsbury’s in this country—it has helped raise over £186 million for sports equipment through its Active Kids scheme. In the United States, we have seen experiments with stocking healthier products at checkouts. In New York, 170 supermarkets participated in a study that found that displaying low-calorie drinks at eye level increased sales. In Australia, a study found that healthy signs on shopping baskets influence purchases. In New Zealand, supermarkets have co-operated on a health star rating and on programmes to encourage healthy eating.

Supermarkets have a major role to play in the drive to improve the nation’s health, but their potential is as yet untapped. In order to support families to make healthier choices, supermarkets must address the current retail environment by ensuring that healthy foods are available and conveniently located in stores. Snacks are popular across all income groups but tend to comprise a higher proportion of all food consumed by those on lower incomes. Major retailers could improve the availability of higher-quality snacks to low-income families by developing their own brand lines and diverting surplus waste food towards the production of affordable, healthy snacks. They could agree to place high-fat, salt and sugar products alongside like items, rather than supporting out-of-context promotions. Healthy products should be in prime locations, such as the end of aisles, at eye level on shelves and at checkouts.

I acknowledge the good that is done. Tesco’s free fruit for kids and “helpful little swaps” are welcome, as is Sainsbury’s investment in reducing the cost of fruit and vegetables and its measures to end multi-buy promotions. However, we need supermarkets to agree that all customers should have access to clear, accurate nutritional and value-for-money information on all products. Fruit, vegetables and other healthy foods should be positioned in prominent places. Price discounts and multi-buy promotions should be discouraged, or offered on healthy foods.

I do not want the Government to bludgeon supermarkets; I want supermarkets to be partners in this exercise. I want the Government to provide more information, in the context of health and education campaigns, about the psychology of shopping and the importance of lists and meal planning, but I also want the Government to consider legislative measures on price and multi-buy promotions. We can make a real difference here. I want supermarkets to use their influence to play their full part in helping us tackle the problem of childhood obesity.

Alcohol Harm

Jim Shannon Excerpts

Tuesday 17th March 2020 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a real pleasure to serve under your chairmanship, Mr Paisley, and to debate this matter with the hon. Member for Congleton (Fiona Bruce). I am always inspired by her compassion and her devotion to doing all she can to make her constituency and the nation a better place to live. That always encourages me and encourages all of us.

I am also pleased to stand with the hon. Lady on many things; I do not think there is anything that she and I disagree on—not that I am aware of anyway. We are kindred spirits across political parties. We may have different opinions on the politics, but not on the constitutional issues and certainly not on what we want for society.

I am a great believer in all things in moderation. Since becoming a type 2 diabetic I have realised that the key to my continued health lies in my ability to eat in moderation. It took me many years to realise that. The issue with alcohol is that many people struggle for moderation, just as I used to struggle with sweet food—two bottles of Coca-Cola with a Chinese takeaway from Davy Lee’s in Newtownards, five nights a week. In addition to that, there was the stress issue. I was probably Davy Lee’s best customer. Now I have a meal from there once in three months, at most, and it is “no Coke here”. I have no sweet drinks whatsoever.

The issue of alcohol-related harm is not ring-fenced for people with alcoholism, or any specific age group. It is a UK-wide problem across classes, genders and race, and we need a better way to address it. We look to the Minister for a helpful response. I concur with the comments of those who have spoken—and probably those who will speak after me—in that we need to address the issue not only in England but in Scotland, Wales and Northern Ireland, from where I have got my statistics and information.

Across the United Kingdom, 80 people a day die because of alcohol, and that statistic has to change. In Northern Ireland there were more than 11,000 hospital admissions due to alcohol in 2016-17. Across the UK 33 people a day are diagnosed with an alcohol-related cancer. There is a high cost to those numbers, and it is not only medical and physical; it is emotional and affects families. Healthcare costs associated with alcohol in Northern Ireland are estimated at £122 million, and alcohol is strongly linked to health inequalities there. We can see that it is, in our offices and advice centres. The rate of alcohol-specific deaths is more than three times higher in Northern Ireland’s most deprived areas than in its least deprived areas. I see that in my office every day, as I am sure you do, Mr Paisley. I see families who are broken by alcohol, by verbal and physical exchanges, by the effect on children, by abuse, marriage break-up, despair and sadness.

Shockingly, alcohol is involved in 40% of violent crime in Northern Ireland. I understand that the relationship between alcohol and domestic violence is complex, but research finds that between 25% and 50% of perpetrators of domestic abuse have been drinking at the time of the assault. The figure is as high as 73% in some studies. I concur with what my hon. Friend the Member for East Londonderry (Mr Campbell) said in reference to the coronavirus and the steps that the Government have taken. I welcome what the Government have done and urge everyone everywhere to focus on the directions and rules laid down by the Prime Minister and the Government. As my hon. Friend said, if there is no sport or social interaction during the coronavirus outbreak, people will be at home—perhaps for 24 hours a day, if they are struck down with the virus. There is potential for all sorts of problems and, let us be honest, people will probably go to the off-licence—or someone will go for them—and buy drink in. They will consume alcohol at home. I am not a prophet, nor the son of a prophet, but I can see great potential for issues to arise from that.

It is for that reason that I support the calls by the Alcohol Health Alliance UK for minimum pricing. In its words:

“The cheaper alcohol is, the more people drink, and the more harm is caused. One of the reasons why alcohol harm has been rising is because alcohol has become much more affordable over the last few decades. It is possible to buy a bottle of…cider, containing the same amount of alcohol as 19 shots of vodka, for as little as £3.70.”

That is someone’s high for under a fiver. The alliance states:

“The most effective policy to tackle such cheap high-strength drinks is minimum unit pricing (MUP). By setting a floor price linked to the amount of alcohol in a product, MUP targets the cheapest drinks which are linked to the most harm, while having minimal impact on moderate drinkers or on pub and restaurant prices.

MUP was introduced in Scotland in 2018 and in Wales in March 2020. The early evidence from Scotland is very encouraging”.

I often look to Scotland for the direction it is taking on health issues. Particularly in this case it has shown what the rest of us can do. The alliance says that

“off-trade alcohol sales fell by 3.6% in the year following MUP; in England and Wales, they rose by 3.2% over the same time. The minister of health in the Republic of Ireland has recently written to the Northern Irish executive regarding implementing MUP on both sides of the border”.

I fully support that, and I urge the Northern Assembly to take that action and to do it as soon as possible.

It is essential that Northern Ireland, the part of the United Kingdom with the second highest rate of alcohol-specific deaths, is not left behind. I want to see minimum unit pricing in Northern Ireland. For the protection of health in my country, I stand by these calls, Mr Paisley, as I know you will, too, and I urge the Minister to consider how we can help to minimise alcohol harm without adversely affecting our hospitality sector, which is vital. If people drink in moderation, that is okay, but we are talking about those people who do not do it in moderation. That is why this debate is so important.

I look forward to hearing the Minister’s response and I thank the hon. Member for Congleton again for bringing this matter forward. Her desire to help to make homes and communities stronger and happier by reducing the harm caused by alcohol is something that is close to my heart, close to my chest and close to the person that I am.

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[Patricia Gibson (North Ayrshire and Arran) (SNP)]

I am pleased to be participating in this debate. I begin by paying tribute to the hon. Member for Congleton (Fiona Bruce) for giving us a very thoughtful and comprehensive opening to the debate. I begin also by saying that people have mentioned the effect of being isolated at home because of the coronavirus and that it is worth bearing in mind, as we go through this crisis, that drinking alcohol lowers the body’s immunity.

We have heard a lot today about the damage of alcohol over-consumption. The cost to our families, our communities and ourselves is almost incalculable. It cannot be counted in pounds and pence, although very often we are forced to do that, for practical reasons. Alcohol abuse leads people to lose their homes, families and jobs. There is a cost in hospital admissions, perhaps on numerous occasions, and people may even end up encountering the criminal justice system. Victims of alcohol abuse become economically inactive. They often become absent parents. The damage to mental health and physical and emotional wellbeing is profound.

I remember standing in this Chamber a couple of years ago to speak on alcohol abuse. A number of us involved in that debate were willing to admit that we came from homes with an alcoholic parent. My father was by all accounts an alcoholic, although I never knew him, as he died when I was 15 months old—he was very much helped on his way by alcohol. The damage to my family was not insignificant. My husband’s father was also an alcoholic and died because of the demon drink. These stories are not unusual; in fact, they are far too common. Almost every person we meet has a family member or knows someone who is an alcoholic. That is very sad, but it is a fact of life. However, that does not mean that we cannot turn things around. It does not mean there are not measures that we can take and, in Scotland’s case, have already taken to combat this problem. There is no silver bullet, but much can be done to mitigate the harmful grip that alcohol has on our communities. In the round, a number of measures can be taken.

In Scotland, 686 hospital admissions and 22 deaths every week are due to alcohol. In 2018, the figure for alcohol-specific deaths was 1,136. In 2018-19, there were 35,685 alcohol-related hospital admissions in general acute hospitals. Worryingly, hospital admissions are still more than four times higher than the level seen in the 1980s. Clearly, in Scotland, we could not simply shrug our shoulders and tolerate that. We tried to turn the situation around. I am pleased that the SNP Government chose to use the powers at their disposal to tackle the level of alcohol harm suffered by our communities, at great cost to those communities, on every single measure.

The hon. Member for Congleton pointed out the need for England to have a revised or updated alcohol strategy, and she is correct to say so, as the current one is out of date. Indeed, the Scottish Government updated their own alcohol strategy in 2018.

I could stand here today and talk about the fact that the Scottish Government have invested almost £800 million to tackle alcohol harm and drug use since 2008 and will allocate a further £95 million next year to reduce the harms caused by alcohol and drugs. I could mention—indeed, I have already alluded to—the Scottish Government’s alcohol framework setting out 20 actions that build on existing measures to change Scotland’s relationship with alcohol. I could even mention the legislation introduced by the Scottish Government to ban irresponsible alcohol promotions, such as the multi-buy discounts in supermarkets.

[Jim Shannon]

Will the hon. Lady give way?

[Patricia Gibson]

I am worried about time, so I will press on, if that is okay.

That legislation was associated with a 2.6% reduction in consumption in the 12-month period following its introduction from October 2011. The hon. Member for Henley (John Howell) might be interested to know that in 2014 Scotland reduced the legal alcohol limit for drivers from 80 mg to 50 mg in every 100 ml of blood. That reduction has not been made in the rest of the UK, which, apart from Scotland, currently has the joint highest levels in Europe that are permitted for driving. I could mention a whole range of measures—

[Patricia Gibson]

Okay. I will give way briefly.

[Jim Shannon]

I compliment the hon. Lady and particularly the Scottish Parliament on what they are doing. The hon. Lady has outlined a blueprint for the whole of the United Kingdom of Great Britain and Northern Ireland. We should all take note of it and let it be our blueprint for Northern Ireland, Wales and England.

[Patricia Gibson]

I thank the hon. Gentleman for his comments. As I will go on to say, there is no room for complacency in any part of the United Kingdom. There are things that work that every part of the United Kingdom should implement, and the UK should continue to review them to see how the measures can be improved.

All the measures that have been taken, on their own merits and collectively, represent real action and commitment to dealing with the scourge of alcohol on our communities. Many of them were set out by my hon. Friend the Member for East Lothian (Kenny MacAskill), who has significant insight into the issue from his role as Cabinet Secretary for Justice in the Scottish Government. There has been broad agreement today that minimum unit pricing for alcohol is the single most significant action that can be taken to tackle alcohol harm, as we have seen in Scotland, but it is not a silver bullet. Nothing is, and nothing ever will be. As my hon. Friend the Member for East Lothian reminded us, it is part of a package of measures and must be seen in that context. I urge the Minister to emulate that measure in England in order to benefit the communities that many Members in this Chamber represent.

When it comes to the strongest drinks on the market, in England we can buy cider for 18p, lager for 23p, vodka for 36p and wine for 38p—I am talking about units, not bottles. Minimum unit pricing was introduced in 2018 in Scotland. Shamefully, the policy was delayed for several years as the alcohol industry dragged it through every court it could find to stop it or delay its implementation for as long as possible. Studies indicated that there would be around 121 fewer deaths a year as a result, and there would be a fall in hospital admissions of just over 2,000 a year by the end of year 20 of the policy.

It gives me no pleasure to say that the initiative sadly met more blocks during its passage through the Scottish Parliament, as opposition parties opposed it purely on the basis that nothing the SNP Government introduced could ever be supported. Although that is the usual response to any SNP policy in the Scottish Parliament, eventually the Tories abandoned their absurd opposition. Labour, however, simply could not bring itself to do so because it was an SNP initiative. The Labour party argued and argued against it and grew more ridiculous with every word. In the end, unable to support it even in the face of overwhelming evidence that it would be a key weapon in the battle against alcohol harm, Labour contented itself with abstaining on the issue. I know that many Labour MPs from other parts of the UK looked on at their Labour colleagues with bewilderment at what was going on—not for the first time, and probably not for the last. Willingness to put narrow party politics before public health is one of several reasons why the Labour party in Scotland is completely adrift. Some issues go far beyond party political lines.

The evaluation of the first year of alcohol minimum pricing has been very promising. As the first country in the world to introduce such a measure, we saw off-trade sales per adult in Scotland fall by 3.6% in the first year after implementation. In the same period in England, there was a rise of 3.2%. There was an 18.6% fall in off-trade cider sales per adult in Scotland in the year following minimum pricing, and an 8.2% rise in sales in England and Wales. There is still more to do, and there can be absolutely no complacency.

A 50p per unit price provides a proportionate response to tackle higher-risk alcohol use. We know there is a proven link between consumption and harm, and that minimum unit pricing is the most effective and efficient way to tackle the cheap, high-strength alcohol that causes so much harm. Going back to the comments made by my hon. Friend the Member for East Lothian, the World Health Organisation said that tobacco education was not, and could not be, as effective as regulation and Government action. We need to remember that when we seek to tackle alcohol harm.

People in Scotland still buy 9% more alcohol per head than those in England and Wales, but that gap is closing because of growing sales of alcohol in England and Wales last year. A 50p minimum unit price is no longer sufficient, because after it was brought in in 2012, the implementation of the policy was delayed by court action for years after the 50p level was set. It is time to explore raising that unit price to 60p, because it has to be set at a level where it is effective; it is not there for some kind of virtue signalling. A 60p minimum unit price seems reasonable to me.

I urge the Minister to carefully examine the action that has been taken in Scotland to tackle alcohol harm. It is a basic economic fact that if the price goes up, consumption goes down, and if the price goes down, consumption goes up; it is not rocket science. There are no silver bullets for tackling this issue, but there is some good practice in Scotland. Scotland, as well as England, has to build on what we already know and what we are already doing. I urge the Minister to emulate this practice for the good of the families and the communities who live with this scourge every day, and who need action.

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[Helen Whately]

I thank the hon. Lady for her contribution and I take her point. It is important that we continue to look at the evidence and that is the approach we will follow. I thank everyone here today for their contributions to this important debate and for having this conversation.

[Jim Shannon]

I urge the Minister to contact each of the regional devolved Administrations, in Scotland, Northern Ireland and Wales. It would be a good idea for interaction with those three regional Administrations, to gauge a universal policy for the whole of the United Kingdom of Great Britain and Northern Ireland and to take all the evidence from other parts of the United Kingdom, which could gel a strategy that we could all agree on. That would be a substantial way forward.

[Helen Whately]

The hon. Gentleman makes an important point about working together, and the UK Government working with the devolved Administrations, drawing on the lessons that we have all learned and the evidence we all have. I do not think I will make a commitment to do that immediately in the light of the current public health situation, but he does make a very good point.

The Government absolutely are taking action and we are determined to do more to support people who are most vulnerable from alcohol misuse.

Covid-19

Jim Shannon Excerpts

Monday 16th March 2020 Commons Chamber

[Mr Speaker]

The last but certainly not the least, Jim Shannon.

[Jim Shannon (Strangford) (DUP)]

Thank you, Mr Speaker. I have the strongest legs in the Chamber.

What discussions has the Secretary of State had with banks and lenders regarding mortgage payments? In answering for every Department today, can he tell us whether there will be a three-month freeze on mortgage payments, which would be extremely helpful? After all, banks and building societies have a role to play.

[Matt Hancock]

My right hon. Friend the Chancellor of the Exchequer is in constant dialogue with the Governor of the Bank of England and the banks themselves. There were active discussions over the weekend about what further measures can be brought forward. The hon. Gentleman is right to ask that question of a different Government Department of me. We are working incredibly hard right across Government to address that concern and, indeed, every concern that Members across the House have rightly raised this evening.

Mr Speaker, I am grateful to you for allowing me to make this statement at an unusual time, and I will commit to come before the House whenever necessary to answer each and every concern.

Coronavirus

Jim Shannon Excerpts

Wednesday 11th March 2020 Commons Chamber

[Matt Hancock]

Yes. I entirely agree with the hon. Gentleman, and he is very wise to raise that point. That strand of work is being led by the Communities Secretary.

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for his dedication and for the vital role he has played in this House. History has taught us many lessons. In the pandemic of 1919, secondary schools stayed open, as did churches—it was normal life, with precautions in place for all. Is that the message the Health Minister is sending out to people tonight?

[Matt Hancock]

I hope that the decision to keep Parliament open makes it clear that the institutions that are fundamental to our way of life in this country will continue through this virus. We will get through it as a nation, and then we will take this nation forward. This is going to be a difficult and challenging time for many, many people. It will be a national effort, but that national effort will prevail, and we will get through.

Oral Answers to Questions

Jim Shannon Excerpts

Tuesday 10th March 2020 Commons Chamber

[Helen Whately]

I thank my right hon. Friend for his question. I am well aware of concerns in the social care sector, particularly in areas where there are higher vacancy rates. It is important that employers make sure that they are taking the steps they can take to make sure that social care jobs are attractive and, of course, well paid, as they should be. I recognise as well a role for Government in this, supporting the role of working in social care, and overall making sure that we come together and fix the social care crisis.

[Jim Shannon (Strangford) (DUP)]

7. What recent estimate he has made of the number of GP practices that have adopted the care for young carers package.

[The Minister for Care (Helen Whately)]

NHS England outlined the care for young carers offer in GP surgeries in June 2019. The offer includes a package of practical plans and actions to help young carers. Uptake will be monitored at a regional level in England through integrated care systems.

[Jim Shannon]

I am grateful for the Minister’s response. However, can she further break down the number of surgeries that have offered priority appointments for carers for home visits and additional mental health checks, and double appointments for the carer and those they provide for? What is she doing to see this rolled out in every GP surgery throughout the nation, bearing in mind that 40% of carers struggle with their own mental health?

[Helen Whately]

My hon. Friend makes a really important point about support for carers and young carers. I cannot answer on the details of his question right now, but I will take it away, talk to the Under-Secretary of State, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), who is responsible for primary care, and the Under-Secretary of State, my hon. Friend the Member for Mid Bedfordshire (Ms Dorries), who is responsible for mental health, and come up with a better answer for him.

Coronavirus

Jim Shannon Excerpts

Monday 9th March 2020 Commons Chamber

[Matt Hancock]

Yes, of course. This is a lead for the Education Secretary, but he and the Schools Minister are working very hard on it.

[Jim Shannon (Strangford) (DUP)]

Churches in my constituency took precautions yesterday. Those who need to self-isolate are having food supplies delivered, and are receiving regular phone contact to stave off the feeling of being alone. Does the Minister accept that the ability for churches to meet for fellowship and prayer is essential for a lot of people’s mental health and spiritual welfare, and that churches remaining open for as long as possible is as essential as schools remaining open?

[Matt Hancock]

I emphatically agree. I should, of course, have added churches and other religious groups to the long list of organisations that can—and I hope will—participate in this national effort, so that the country can get through this situation as well as possible.

Eating Disorders Awareness Week

Jim Shannon Excerpts

Thursday 5th March 2020 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I thank the right hon. Member for Knowsley (Sir George Howarth) for bringing the debate forward. I am pleased to participate in it. I, too, have had constituents who have had eating disorders over the years, so this is an opportunity to highlight those issues and look to the Minister for a positive response—no doubt we will get one. It is good to follow the hon. Member for Broxbourne (Sir Charles Walker), and I thank him for his contribution. Until the right hon. Member for Knowsley told me about it some time ago, I was not aware of the issue of eating disorders among people with diabetes.

It is good to have the opportunity to speak about eating disorders, which are serious mental illnesses that deserve to be dealt with in that vein. My interest in the issue came from sitting with a friend of mine—a father who was at his wits’ end trying to get his daughter, who was suffering from an eating disorder, the help she needed. That was way back when I first came here, between 2010 and 2012. He did not give up. Neither did I—and neither did the Minister responsible for health back in Northern Ireland or the Health Minister here. It was a combination of both that brought about the success that we had hoped for. The Minister in Northern Ireland managed to make changes to how things were approached there. The result of that was that we—not me, but the Minister at the time—made legislative changes and changes to the provision of in-patient care specifically for those suffering from eating disorders.

That story is very poignant. I will not mention any names, but that young lady had severe eating disorders. Unfortunately, she had hidden much of it from her parents, whom I knew extremely well; they both were in an occupation that I had a particular interest in. They had approached the Department of Health back home but had not really got the response they wanted, so I met Edwin Poots, who was Health Minister at that time. Ultimately, through our contact with him and the Health Minister here, we were able to get that young lady over from Northern Ireland, where there did not seem to be anything in place to help, to St Thomas’s Hospital just across the way from where we are now. Ultimately, the medical care it was able to offer saved that young girl’s life. It is as simple, as graphic and as honest as that. I would like to put on the record my thanks to the Minister at that time and to St Thomas’s for giving that family the treatment and help they needed.

The wonderful thing about that story—again, I will mention no names—is that that young girl is now married. She is still one of my constituents, as indeed are her mum and dad, and she has two young children. I had not seen her for a few years, but before the election I knocked her door. She came to the door looking extremely well, and she reminded me of that story. I wanted to tell it today to add to the interactions described by the hon. Member for Broxbourne and the right hon. Member for Knowsley. Things can be changed if the right measures are in place to make that happen.

I asked the Minister back in January how many people were recorded as having had eating disorders over the past five years. The answer was not straightforward. That moves us to the crux of the issue: the differing diagnostic processes. The Minister’s response read:

“The following tables show the number of people referred to specialist secondary mental health services with a primary diagnosis of eating disorders from 2014/15 to 2015/16, and the number of people referred to specialist secondary mental health services with a primary reason for referral of eating disorders from 2016/17 to 2018/19.”

The figure was 4,513 in 2014-15 and 3,895 in 2015-16. The source for those two years is the NHS Digital mental health and learning disabilities dataset. In 2016-17, the figure jumped to 11,207, and in 2017-18 it increased to 18,224. In 2018-19, there was a massive jump of more than 4,000, to 22,336.

The Minister’s answer continued:

“There are two matters to consider when looking at the MHSDS data:

Diagnosis recording is known to be low. Of the people in contact with these services on 31 October 2018, for example, a diagnosis was recorded for only 22.3% of people. Therefore, the number of people with a primary reason for referral of ‘eating disorders’ for 2016/17, 2017/18 and 2018/19 is provided, rather a count of people diagnosed with an eating disorder.”

That probably means that in 2014-15 and 2015-16 a large number of people had similar problems but were not referred. That is what the Minister acknowledged in her response. If we have a problem even counting how many people have a disorder, how on earth do we find them the help they need?

The charities that work with those struggling with their eating are a little clearer about how they work things out. The right hon. Member for Knowsley referred to Beat—I thank both it and the Library for the information they sent us—which estimates that there are some 1.25 million people in the UK with an eating disorder. That is not in any way reflected in the Government’s figure of 22,000. If it is anywhere near the truth, Beat’s figure cannot be ignored.

Beat stated:

“The most common age of onset is 15-25 years old, during a developmentally sensitive time. Anorexia has the highest mortality rate of any mental illness, and the mortality rates of the other eating disorders are also high. People with eating disorders typically develop severe physical health problems and overall quality of life has been estimated to be as low as in symptomatic coronary heart disease or severe depression.”

That demonstrates the magnitude and severity of the issue. Beat continued:

“Without early intervention, many become unable to participate in education or employment.”

Some 1.25 million people in the UK currently live with an eating disorder, while 10% of people affected by an eating disorder suffer from anorexia and 40% suffer from bulimia. The rest of sufferers, including those with binge eating disorders, fall into the “other specified feeding or eating disorders” category. There are some very complex examples of those problems.

Research suggests that the earlier treatment is sought, the better the sufferer’s chance of recovery. That is the case with almost every disease: early diagnosis always helps to address something early, solve problems and raise awareness. Some 50% of eating disorder sufferers go on to recover. That is encouraging, but it tells us that 50% continue to have problems. Only 30% improve, and 20% remain in a chronic condition; many continue to suffer way beyond their alarming early conditions. Those high figures highlight the serious issues with the availability of holistic treatment.

I wholeheartedly support the Dump the Scales campaign, which would bin the GP regulations enforcing a minimum weight or BMI before a diagnosis can be given. Indeed, I support calls for GP retraining on this issue. I am very respectful of our GPs, who are wonderful people. They do great work, but sometimes we need a better understanding of eating disorders. We should not insist on certain categories in relation to eating disorders or insist that people get on the scales. I think it is important to address that.

I am a type 2 diabetic. Whenever I go down to the doctor, he weighs me and refers to my BMI, and he tells me whether I am on the right or wrong side of it. Thank goodness, this last while I have been on the right side of it. I try to keep careful control of what I eat and how much I eat.

When a parent, a carer or a sufferer themselves realises that all is not okay with their mindset towards food, palming them off with a little leaflet or a referral—I mean this respectfully—to yoga classes, as sometimes happens, is not enough. I am not saying that yoga is not good to do—I have never done it and have no knowledge of it—but to say that that is a way to solve someone’s eating disorder is a wee bit crass, to say the least. We must get on with early diagnosis and intervention, rather than effectively saying to people, “You aren’t skinny enough yet to merit help,” because they are.

The starting point must be the first realisation that there is a problem. When the parents of the young girl I mentioned earlier realised that their daughter had a problem, they addressed it early on. A doctor has never asked me to be tired for six months before checking the iron in my blood. He carries out a test to ensure that nothing is wrong. We start at the beginning and do not waste six months to see what it is. Why must we wait until someone is dangerously underweight before we offer them help when, in some cases, that is just too late?

I am fortunate to have two granddaughters who are extremely beautiful, not like their grandfather—and they will be glad to hear that; they have their grandmother’s and mother’s good looks—but never do I want them not to see what I see when I look at them. If, God forbid, there was a problem, I would want to know that the NHS had not simply the finance but, more importantly, the understanding of how and when to intervene. That is not simply when the scales show the correct small number.

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)]

It is a pleasure to serve under your chairmanship, Mr Rosindell. I thank the right hon. Member for Knowsley (Sir George Howarth) for introducing the debate, particularly in Eating Disorders Awareness Week, on such an important issue that is often overlooked because it is hidden. He was fastidious in detailing so many of the crucial aspects of eating disorders and how our popular culture impacts on so many. I think it will go on to affect more young people as it grows under the social media stresses and pressures put on them.

I was thinking back to when I first started to think about appearances, which was probably when I was in my mid-teens, but my daughter, aged 11, is already looking on Instagram and so aware of how she looks and how many friends she has on social media. Those are not what I would call actual friendships, but these days it is all about social perception, and the pressures and stresses we put on young people through social media, which remains largely unregulated, are astronomical. We are creating a mental health catastrophe that is coming down the line for our young people. It will impact on men, who are not immune, but it impacts significantly on young women. I see that in young children of primary school age: my daughter and her friends very much relate to pictures of one another online and how they look. A societal image of perfectionism is being created that is very unhealthy for people’s mental health.

Eating Disorders Awareness Week is running this month, raising awareness of a disorder that, as has been said, affects 1.25 million people across the UK. When I worked as a psychologist in mental health services, I was aware how even then it was not a key focus in our training. Mental health professionals could benefit from much more in-depth training in eating disorders. When I was at Glasgow University, we benefited from the psychologist who came to train us having a specialist interest in the area. He is long retired and I do not know if anyone has taken his place, but training was very much dependent on individuals who had developed specialist expertise coming and lending that expertise, because those in training may not meet or have clinical experience of treating people with eating disorders unless they go on to do a specialist placement. Many of the professionals we are bringing through across the United Kingdom will not necessarily feel that they have sufficient expertise to treat eating disorders. We need to address that, particularly because, as has been said, it is not the kind of difficulty where people often come forward and say, “I have an eating disorder.” Clinicians, trying to form a picture on presentation of someone who might come with a diagnosis of depression or trauma, may notice a larger clinical picture not in the referral, but they require that expertise to pick up those symptoms early on. We know that earlier intervention creates a much better outcome for those with these conditions.

The other important issue I want to bring up is the Dump the Scales campaign, which I looked at while other hon. Members were talking. There may be more obvious signs of weight loss in individuals who present with anorexia, but those with bulimia are often bingeing and then purging, so there may not be noticeable weight loss. Such disorders can become extremely chronic before anyone picks up the symptoms. Certainly, one symptom of the disorders is denial and attributing difficulties elsewhere.

Dump the Scales is important, because my understanding is that BMI has to be at a certain level for a referral. We need to move on from that in clinical practice and look much more widely. I have just looked up the criteria in ICD-10 and, while they may have moved on, there are a number of symptoms and BMI is one of them. That needs to be considered, because, as I said, the person is not likely to come with a presentation of eating disorders in the first place and then, if some of the clinical symptoms are so stark that they cannot be referred on to appropriate services so quickly, that creates another barrier to getting the treatment they so desperately need.

Family support is another matter that we often overlook but need to focus on. We really need to get family members on board in order to have holistic treatment, particularly for young people’s mental health. It would be helpful to know more about what is being done in relation to family systems therapy and family therapy.

I was trained in the cognitive behavioural therapy model when I was practising, but it was very much a formulation-based model. I do not think eight sessions of CBT would necessarily be effective for people who have a long-standing chronic illness or perhaps other underlying issues such as trauma that need to be resolved. We need a flexible system to ensure that a person’s care pathway is at the level of service they need for the chronicity of their difficulties.

It has not passed me by that it is International Women’s Day this week, so it is apt to have this debate on eating disorders awareness, which an issue that is likely to affect so many young people—overwhelmingly women, but also men—who face this social pressure.

I will finish with a few things that the Scottish Government are trying to do. This is an area where we should share best practice and have much collaboration across the UK, and I would like to see that and be part of it. It is excellent for the way forward that an all-party parliamentary group has been reconstituted.

Last year, the Scottish Government created an online peer support tool specifically for this issue to allow young people to pair with a trained volunteer, who had themselves recovered from an eating disorder. That is important because peer-to-peer support can be extremely helpful, particularly for young people. At certain stages in life we may speak to our parents more or less readily, depending upon our stage of development, and for adolescents, among whom a higher percentage of eating disorders initially develop, peer-to-peer support will provide an excellent starting point for treatment.

The website caredscotland.co.uk is an information platform for parents and carers. We must ensure that parents and carers, who are, most often, going to be the ones who pick up the initial signs, have awareness, as well as the support they need. It is vital that parents and carers have that support because dealing with an eating disorder can take an enormous emotional toll upon an entire family. We need to look at people’s mental health in a holistic manner.

We need to do much more, right across the United Kingdom, in relation to access to treatment for those who have eating disorders. We have come some way, but we need to raise more awareness at different levels within the system. GP training has been mentioned. We also need a public awareness campaign, because often peers or families pick up the initial symptoms, and medical training for psychiatrists and those working in mental health. From my own training, I do not think those professionals have the level of training necessary to treat people in primary mental health care, which is often where an eating disorder might be picked up initially before it is referred on to secondary community mental health teams.

[Jim Shannon]

I am thinking about the dangers of social media and how it affects children and young people. Could the dangers of social media be made clear at an early stage, perhaps at school? The perfect body, clothes, hair and everything become things everyone wants, whereas the reality of getting them is quite different. For instance, in some photographs, models’ six packs or their weight are actually changed digitally. Social media has a lot to answer for.

[Dr Cameron]

The hon. Gentleman is entirely correct. Social media often creates a false world that none of us can ever live up to. That is why I welcome the Government’s work on social media, which is looking at potential regulation and other issues in relation to the impact on mental health.

This is an excellent pivotal debate, but it is not the finishing point. It is most definitely the starting point for taking these issues forward on a cross-party basis. I look forward to working with everyone who has an interest in this field, to support progress for those who have eating disorders across the United Kingdom.

--- Later in debate ---

[Ms Dorries]

My right hon. Friend makes an important point. That is why we invested £2.3 billion in mental health services, which, as I always say, is more than half the entire prison estate budget. We are focusing on young people and young women in this debate, but funding for mental health services is growing faster than the overall NHS budget. That funding and the development of community services is there to pick up exactly the cases she cites.

No mental health service, other than the very extreme, is better delivered in a hospital than in the community, whether for children, young people or adults. Despite that investment in community mental health services, our challenge is unprecedented, and our challenge is about workforce—it is about attracting people to work in this arena and to help us develop the community services that we need to provide treatment for adults and young people. That is the challenge we have taken on, and it is a challenge that we are meeting and moving forward with. It is our ambition and my absolute hope that children, young people and adults, regardless of their age—this illness is severe, whether in adults or children and young people—receive the treatment they require, when they require it.

[Jim Shannon]

These plans will require a close working relationship between the Department of Health and Social Care and the Department for Education. I am sure that that is what the Minister refers to, but will she confirm that that is the case?

[Ms Dorries]

Absolutely, and the Green Paper, which I am sure the hon. Gentleman will be aware of, references the mental health of young people in schools. However, it is also about the trailblazer schemes, peer support workers and other people who go into schools who specialise in how to identify this and pick it up. Teachers have a huge job, and I think if we were to say that they needed to pick up when someone is suffering from an eating disorder, they would probably throw their hands up, because it requires specialised training. It is a skill, and it takes careful handling when identifying someone who is suffering from an eating disorder. So yes, of course we work across Departments, but it is those specialised and trained mental health workers in schools who will pick this up.

Coronavirus

Jim Shannon Excerpts

Tuesday 3rd March 2020 Commons Chamber

[Matt Hancock]

No, we will be advised by the science. The point that has been raised many times is that timing is really important. There are downsides in terms of the destruction and medical downsides in terms of controlling the spread of this virus if things are done too soon. I am very happy to arrange a briefing for the hon. Gentleman —a briefing is available with the chief medical officer at 4.15 pm today for anybody who wants a private briefing—and to take him through some of that science.

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for his diligence. There are some 11.8 million elderly people, which is 18% of the population, and some 4 million diabetics, which is 6% of the population. I declare an interest as one of those. Those who have had the flu jab to protect them from the flu may feel that they are okay. Will the Minister give guidance to this section of people—those with chronic diseases and the elderly who have had the flu jab?

[Matt Hancock]

Yes, we are paying particular attention to vulnerable people—the elderly and those with other health conditions that may make them either more susceptible or more at risk should they get this virus—and there will be additional advice in due course, guided by science, as all of us should be in tackling this disease.

Nursing Workforce Shortage: England

Jim Shannon Excerpts

Tuesday 3rd March 2020 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Member for Bedford (Mohammad Yasin) on securing this debate. Although this debate is about nursing shortages in England and health is a devolved matter in Northern Ireland, I believe we are experiencing the same problems in Northern Ireland that exist in Wales, Scotland—as mentioned by the hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone)—and the whole of the United Kingdom. The solution must be UK-wide.

The Minister has responsibility for England, but I want to refer to things that are happening in Northern Ireland, which I believe the UK Government can change to the benefit of the devolved Administrations. We are currently facing a crisis in nursing care. Although nurses in Northern Ireland have received a pay increase, which they deserve, that does not ease the conditions in which we are asking them to work. Those conditions are the same as in England, Scotland and Wales.

During the election, nursing was perhaps the largest issue I was confronted with on the doorstep, along with the dysfunction of the Northern Ireland Assembly, which, although we are not directly responsible for it, people still wanted to talk to us about. When we got past the misinformation that had been fed to people in a deliberate attempt to skew the vote, it was clear from speaking to nurses that, although the pay issue had been an insult to them, they had genuine concerns about staffing levels—the subject of this debate. The concerns I heard on the doorstep were clear to me, as I am sure they were to all hon. Members from across the United Kingdom of Great Britain and Northern Ireland. There was a genuine concern that the everyday nurse felt guilty about taking annual leave; they felt that they were letting people down by having their hard-earned time off. That should not be so.

The health service in Northern Ireland has a registered nurse vacancy rate of 11.6%, equating to precisely 2,103 empty posts, as well as a shortage of 421 nursing assistants. The cost of employing nurses via agencies has increased from £10 million in 2012-13 to £32 million in 2017-18. I know that the last few years, with a non-functioning Assembly, were an issue regarding the employment of agency staff.

I had a meeting with the Royal College of Nursing some six weeks ago in my office, and I welcome the fact that the Northern Ireland Assembly is up and running. I also welcome the fact that the Minister who has responsibility for the Health Department in Northern Ireland, Robin Swann, has committed to recruiting more nurses. I understand that 700 nurses will be recruited, which will go a long way to addressing some of the empty posts. However, that will still be only a third of the way to filling all the vacancies that exist; the other two thirds of vacancies also have to be filled.

[Jamie Stone]

The hon. Member makes an extremely interesting point. At the last election, constituents and voters said to me on the doors that they would prefer that nurses were employed by the public purse—by the Government—rather than via an agency, which, by definition, makes a profit on the salaries for those nurses. I suggest that the general public does not like that and, if I am reading him correctly, he does not like it either.

[Jim Shannon]

I thank the hon. Gentleman for his intervention, and that is exactly what I am saying. I know that the Health Department in Westminster does not have responsibility for recruiting nurses in Northern Ireland. The Minister in Northern Ireland now has, and he has made the first step towards addressing that issue. It is hoped that over the next couple of years the number of vacancies—over 2,100 nursing posts, as well as 400-odd nursing assistant posts, making about 2,500 vacancies in total—will be addressed. We hope that the cost of agency staff and the extra financial burden created by the fact that agencies are profit-making organisations—this is how they make their money—will be addressed in a way that helps to reduce the shortcomings.

This situation means that nurses cannot simply work their 37.5-hour working week. They are called in on days off and asked, “Can you do the twilight shift? Can you give me a couple of hours?” That is not the fault of the ward sisters; they need the floors covered and are under pressure. It is simply that we do not have enough full-time working nurses in the NHS. That means that conscientious nurses, who do not want to leave the ward or the district short, are working additional hours themselves, and not in the short term to save money for a holiday or a renovation of their house. Instead, they are consistently working overtime to help on the wards, and so they are not getting their family time, their social time and—more importantly—their rest time

I have had glimpses of this situation. Some 6,500 nurses live in my constituency, so I have regular contact with them. I got a brief glimpse of the work of a nurse during my surgery and was in awe of how they stayed on their feet, and remained both sharp and compassionate —as they do. Doing all that with no rest is simply unsustainable. So, for a better system and a better caring system with better nurses, who are more able to work within that system, we need to address the shortage of nurses.

It used to be the case that bank nurses were only used in an emergency, but now they are used ever more frequently and their use is becoming the norm. They are no longer just used in the emergency. Using them is now just the fall-back position: “Let’s just do it”. That is not good either for morale or for finances—the current finances clearly indicate that it is not. It is more costly to have agency staff in than it is to have nurses on full-time pay.

I will give another example, of a nurse who approached me in my office and asked me to clear up rumours about nurses, their employment and so on. She is a young nurse in her early 20s who has been working at the Ulster Hospital in Dundonald—the main hospital in my constituency—but she has been left as a staff nurse in charge at night on numerous occasions. What she said to me was simple; she just said to me, “Jim, keep the pay rise and please give me an extra nurse per shift.” That was her initial reaction, because she can feel the pressures of delivering this system, and was saying, “I physically can’t do it all for much longer”.

This is a lovely young girl who is dedicated and good at her job, but who knows that when she has kids she will not be able to work 60 hours a week. She is asking me to do something about that, and today I am on the path towards doing something; I am highlighting this issue. I am very happy to do so.

[Scott Mann]

The hon. Gentleman is making an excellent point about that young lady. There is one way that the NHS might be able to support her. NHS Property Services owns huge amounts of land around the country on the public estate, and I know that the Government are putting together a key worker policy, for there to be a 30% discount for local people in the housing policy, like a local homes discount. Does he think that if we included nurses within that category that we might be able to address some of the challenges that we face, by giving people discounts and getting them into the profession?

[Jim Shannon]

I thank the hon. Gentleman for that intervention. I was not aware of that proposal until now, but it certainly seems like a way of incentivising people—for some people. Let us be honest; it will not suit everybody’s circumstances, but it will suit some people’s. Whatever we can do to incentivise nurses to stay in the profession is good. I will give a third example, if I may, of the reasons why nurses are not staying in the profession, but some of the things that the hon. Gentleman referred to would be helpful.

I met one woman in her 30s in my office who wanted to go into nursing, but she could not do so because her tax credits would not allow to stop work while she got her national vocational qualifications and other qualifications. So, reluctantly, she gave up and we lost her. She is not the only one we have lost; we have lost many more than that.

I know that in Northern Ireland this issue is not the responsibility of the Minister who is here today, the Minister for Care, the hon. Member for Faversham and Mid Kent (Helen Whately); I understand that. However, will she ask the Minister who has the portfolio for tax credits to review the circumstances around tax credits and the circumstances of those nurses who are trying to get their NVQs, and have to stop work to do so? If we are losing nurses because of an anomaly in the system, let us try to address that anomaly, to allow us to retain the nurses who want to be retained.

My mother was a nurse. That was a long time ago; my mother is coming up to 89 now. I know that for her nursing was a vocation, as it is for many other people. In today’s busy life, it is important that we try to help those who want to be in nursing for the rest of their lives to retain their position. However, that was a young girl in her thirties in my office who wanted to go into nursing and unfortunately we lost her.

We lost someone who wanted to train as an intensive care unit nurse, because the current system could not work with her and her four children. Can we do better in helping mature people to come out of retail and enter education, while still having their children cared for? There are many such people across the nation and across my constituency. There are also a great many people who are former nurses, and we should try to recruit them back into the system as well. There comes a time in their life, perhaps when their children are a bit older and they find themselves with a bit more time on their hands, so what are we doing to attract the more mature nurse into the profession that they once wished they were in?

There must be a way of doing that. I believe that it is up to us in this House to address these two issues, which are so closely linked: getting more nurses; and making a clear way forward to allow mature people to choose nursing, not simply as their job but as their vocation and their calling.

--- Later in debate ---

[The Minister for Care (Helen Whately)]

I congratulate the hon. Member for Bedford (Mohammad Yasin) on securing this debate. I thank him for his tone and his constructive approach to the challenges. I also thank him for giving me this opportunity to speak about a subject that I am truly delighted to have as my responsibility as a new Minister in the Department of Health and Social Care, and about which I feel very strongly—namely, the NHS workforce.

Our NHS is truly fantastic and we as a nation are proud of it. However, as we know, the NHS is really its people. The people of the NHS are the NHS—from the most senior doctor, to the newest healthcare assistant and everything in between. That is particularly true of nurses, who make up nearly one quarter of the NHS workforce, and good healthcare depends absolutely on good nurses.

The NHS should be looking after its nurses, but over many years visiting hospitals and community services—this goes back a long time—I have had too many conversations with nurses who feel that the NHS, or their employer, has not been looking after them. The biggest problem that comes up, going back over many years, is that of staff shortages.

I completely agree with the hon. Member for Bedford that the vacancy rates among NHS nursing teams are too high. They are particularly high for some specialties, such as mental health. There are variations across regions. For instance, in the north-east, Yorkshire and the north-west, the highest vacancies are in ambulance trusts. We also know that there are particular challenges in rural areas, as mentioned by my hon. Friend the Member for North Cornwall (Scott Mann), and across the nations of the UK. As we heard from the hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone), there are challenges in rural parts of Scotland. We heard from the hon. Member for Strangford (Jim Shannon) about the challenges in Northern Ireland, and there are also parts of Wales that are struggling. This is not just a problem in England, but nevertheless I recognise the problem in England. We need plans to address that, and we have plans, which I will come to.

The hon. Member for Bedford also flagged up the importance of safe staffing in the NHS. I absolutely agree that our first priority must be that the NHS is a safe place for patients, and that care is safe. As he will know, trusts call on bank and agency staff, to make sure that they have enough staff to make wards safe. We must appreciate the work of those staff, who do a really important job of stepping in, but, as I have heard from many a ward sister, although they welcome having agency staff to fill the gaps, that is not the same as having a fully staffed team. That is what we really want in the health service. It will make the NHS a great place to work and enable it to provide the best possible care for patients. That is why the Government have committed to 50,000 more nurses, so that staff shortages and those high vacancy rates will be a thing of the past.

Before I talk about how we will find thousands of new nurses, I want to discuss the most fundamental thing we have to do to succeed, which is to keep the nurses that we already have in the NHS. Some hospitals and teams do not have a problem with staff retention, and some have very low attrition rates. In others, we know that staff turnover is a real problem. There is no point in the NHS training up lots of new nurses if we cannot hang on to those who have already been trained.

In order to retain nurses, we need to make sure that each day is a good day. We need to look out for each and every nurse, which is the day-to-day job of the trusts that employ nurses. I want those trusts that are struggling with high attrition rates to adopt more of the good practices of successful trusts. The Government are also going to help.

First, as we have discussed today and as we have heard directly from nurses, more investment in ongoing training and continuous professional development would make a big difference. That is why the Government have committed to giving every NHS nurse a £1,000 training budget on top of the training that employers usually provide. That extra funding should help nurses to advance their careers, to move more easily between different roles and, of course, to provide better care to patients.

Secondly, there will be a new offer for all NHS staff. It will be released alongside the NHS people plan, which will set out the support each and every NHS staff member can expect from their employer, including for professional development and for more choice and control over shifts and working patterns. As several hon. Members have said, NHS staff want more control and flexibility. The hon. Member for Strangford mentioned the importance of flexibility. Nurses may have other caring responsibilities. Some trusts are doing well in this area, others not so well. We want all employers to do what they can to give staff more flexibility and control over their working hours.

[Jim Shannon]

I thank the Minister for her comprehensive response. I know that tax credits, NVQs and time out are not her responsibility, but would she be willing to speak to the Minister with that portfolio to see whether there is any flexibility in the system to enable nurses, especially those with young children, to continue?

[Helen Whately]

My understanding is that the system in Northern Ireland is different from that in England, so I do not have the answer at my fingertips. I am, however, happy to take up the hon. Gentleman’s question and get back him.

Thirdly, on improving the retention of staff in the NHS, we need to tackle the level of bullying and harassment. The recent NHS staff survey had some really positive results on how NHS staff feel about their work. The Secretary of State and I, however, are greatly concerned about ongoing reports of bullying and harassment that staff experience at the hands of other staff, patients and, sometimes, their families. That is simply not acceptable. We must send out a message, loud and clear, that we will not tolerate the bullying and harassment of staff, whether from other staff or from patients and their families. As a society, we should all be grateful to our NHS staff. Hand in hand with that, we absolutely will not tolerate racism, which is an ongoing problem in some parts of the NHS.

Fourthly, pay has never been the top thing brought up by nurses when I have spoken to them about their concerns, but clearly it is part of the picture. By April this year, we will have increased by 12% the starting salary for new nurses compared with three years ago. More than 200,000 nurses are benefiting from pay rises under the “Agenda for Change” pay deal. Nurses below the top of their pay band have been receiving increases of at least 9%, and those already at the top of their pay band are receiving a pay rise of 6.5% over the course of the “Agenda for Change” pay deal.

I just want to pick up on the point about returning to nursing. The issue of retention also applies to nurses who have, for many reasons, taken time out of nursing. We are very keen that more of those nurses return to work. We are supporting nurses who want to bring back their valuable experience to the NHS. I also want trusts to develop posts that will make the most of those nurses’ experience and to ensure that there is enough flexibility in their shift patterns and ways of working to fit any caring responsibilities they may have.

[Jim Shannon]

For that to happen and for them to return, there would need to be a database of all former nurses. I am mindful that there will be a statement later about the coronavirus, and a Health Minister has mentioned having a list of people who could come in and help in the event of a pandemic outbreak. If there is such a list, then there must also be a list of former nurses who have left the sector but wish to come back. Is there such a database?

[Helen Whately]

I am just digesting what the hon. Member said.

[Jim Shannon]

I talk very fast.

[Helen Whately]

I have not seen a database. The hon. Member refers to the coronavirus plans, which are very much on my mind as we talk about the immediate and longer-term plans to increase the number of nurses in the NHS. Clearly, we also have the short-term challenge of ensuring that the staff are there, and that work is absolutely in hand. Returners are an important part of it and we need to ensure that we make use of nurses who have already been trained, to boost the NHS workforce. All in all, we want to ensure that the NHS is a great place to work for nurses who return to it and for those working in it right now. The absolute foundation for ensuring that we no longer have nursing shortages is to look after the nurses that we currently have. On that foundation, we can seek to recruit and train new nurses.

--- Later in debate ---

[Jim Shannon]

The Minister has mentioned the Government’s commitment to increasing national health service funding. It is important to state for the record that we acknowledge the good things they have done.

[Helen Whately]

I thank the hon. Gentleman. As he says, I have spoken not only about how much we value the NHS workforce, but about our commitment to increasing NHS funding. The two go hand in hand.

A few Members have mentioned that the number of vacancies stands at well over 40,000. Although I absolutely recognise that those numbers are still far too high, the latest data shows a steady downward trend over the past year. I state for the record that as of the third quarter of 2019-20, the number of vacancies was under 39,000.

I will finish with one more piece of good news: the increasing number of nurses in the NHS. As of November 2019, the latest workforce data shows that we had 290,474 nurses in the NHS in England, which is an increase of 8,570, or 3%, since November 2018, and an increase of nearly 17,000, or 6%, since 2010. The numbers are going in the right direction. We have a long way to go but I am determined that we should get all the way to the extra 50,000 nurses in the NHS, so that nursing staff shortages will soon be a thing of the past.