Wuhan Coronavirus

Jim Shannon Excerpts

Tuesday 11th February 2020 Commons Chamber

[Matt Hancock]

This will be new money to those NHS organisations bidding for it, and we have not put a cap on it. We are inviting bids from NHS organisations and will very rapidly assess those bids.

[Jim Shannon (Strangford) (DUP)]

With universities in Northern Ireland cancelling trips to China individually, can the Secretary of State outline whether the Government intend to issue guidelines to stop travel between and to infected areas? Further, is there any intention to do routine tests on anyone recently returned from the infected areas?

[Matt Hancock]

We have enhanced monitoring in place on flights from the areas I mentioned, which is important, and of course we keep all options under review, because the most important thing is to follow the scientific advice wherever possible and to keep people in this country safe.

GP Provision: Pilsley

Jim Shannon Excerpts

Monday 10th February 2020 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

The hon. Gentleman is illustrating an issue that is apparent in not only his constituency but across the United Kingdom, including in my constituency. The availability of GP appointments is fast becoming a nationwide crisis, which is adding to pressure on minor injuries units and A&E departments. Does he agree that there must be direct funding to encourage medical students to commit to a five-year placement in a GP practice, in exchange for student loans, Province-wide and UK-wide? That may be a possibility.

[Mark Fletcher]

It is a delight to receive an intervention from the hon. Gentleman. As I understand it, he is slightly notorious for doing so. He strayed slightly from what I wish to speak about this evening, but I thank him for his support, as do the people of Pilsley.

As I was saying, on the face of it, this is about difficulties in recruiting and retaining GPs. That is why this Government have committed to recruiting 6,000 more GPs and 26,000 primary care staff other than GPs. We know that there is a particular issue with meeting increased demand at GP surgeries, and we are addressing that challenge head-on with a three-pronged approach: recruiting more GPs; recruiting other staff such as nurses and pharmacists, who can often deal with more routine appointments; and finding new ways of working, such as telephone appointments. That is why I wrote to the Secretary of State asking for a meeting with myself and Staffa Health, to discuss alternative ways of working—a meeting that I believe he is happy to arrange.

But if I were being a cynical man, I would suggest that the top line about GP recruitment is a cover for other reasons why Staffa Health wishes to go ahead with this closure. In the frequently asked questions section of the consultation letter, there was a section headed,

“How would it help Staffa Health by closing the Pilsley surgery?”

Five reasons are given. The first is, as previously covered:

“Enabling us to review and improve access to GP appointments without having to spread staff thinly over four sites”.

The second is:

“Allowing us to redesign the way we provide some aspects of the service. We plan to improve access to same day urgent care, telephone and online consultations”.

I am at a bit of a loss as to why the closure of a surgery is required for that to happen. The third reason stated is:

“Reducing some of the activities that are duplicated across multiple sites, providing greater efficiency”.

I suspect that that might be the most important reason. I think that the finances of the closure may be a considerable factor in this proposal, and if I am right, I wish that Staffa Health would come out and say so, rather than hiding behind other factors.

The fourth and fifth reasons given are:

“Giving the Practice a greater ability to support doctors, nurses and pharmacists in training by supervising them on fewer sites”

and

“Making the practice a more attractive place to work due to a more supportive, less stressful and less isolated working environment”.

What both those points skirt over is the impact that this will have on residents in Pilsley, who are unanimously against this closure. Of course it is important to think about the morale of staff and the quality of their training, but if doing so results in the plummeting morale of patients, is that a good decision? There are serious concerns about the impact the closure will have on the residents of Pilsley, especially those who cannot drive or suffer mobility issues. The village has a higher proportion of elderly residents than most of my constituency, and there are three major issues that I want to raise today.

The first is public transport. The consultation document points out that the other Staffa Health surgeries are only a couple of miles away from the Pilsley surgery, and that there are two public transport routes to them. My inbox and postbags are full of residents’ communications presenting a very different picture. As one email from a Pilsley resident stated:

“Our village has lost one bus service and what is left is erratic and unreliable. I am 72 and currently drive but wonder what will happen in the years to come.”

Do we really want our elderly patients who cannot drive waiting in the freezing cold in bus shelters for a once-an-hour service that is far from reliable? Will this improve their health, or would we prefer them to shell out for a return taxi that will cost about £20, or are we to rely on a commitment to home visits that will surely put considerably more strain on the workforce?

The consultation document says that the practice

“recognises that not all patients would be able or willing to travel to one of the other surgeries. Any patients who may choose not to remain registered with Staffa Health would be fully supported and offered advice on how to re-register with a different Practice.”

However, this is far from adequate. It knows that it is the only surgery available, and those wanting a local doctor will have no alternative. That was the one part of the consultation I was somewhat offended by.

The second issue is the new housing being built in the village. Because it is a fantastic place to live, Pilsley is popular for new housing developments. The Pilsley surgery has 2,800 patients registered at the practice, which has increased by 500 patients since 2017 due to new housing in the area. Other developments, such as the Rockliffe housing development on Green Lane and a site on Gladstone Lane, have been identified for more housing. It is perverse to build new housing in a village while at the same time losing vital infrastructure. We need to have a much more joined-up approach between the local authority, the CCG and Staffa Health, and I suggest that some of the developers building in Pilsley should be contributing financially to local services such as the GP practice.

The new houses will create more demand, and we are going to end up in a position in a few years’ time where we will need to reopen this practice, so let us just cut out this closure. I was particularly amused to read that, because of concerns over parking at one of the other surgeries—in Tibshelf—the plan was to close the Pilsley surgery to patients, who will then have to travel to Tibshelf, but to move administrative staff from Tibshelf to the now closed Pilsley service so as to free up car parking space in the short term at Pilsley. It brought to mind the episode of “Yes Minister” when Jim Hacker visits a new hospital that has no patients, and Sir Humphrey proudly tells him that it is one of the best performing hospitals in the country on many measures.

The third concern I want to raise is the consultation, a lot of which was done online. Not all residents are online and not all residents in Pilsley feel they have been kept up to date on the process. Two brilliant ladies, Sheila Baldwin and Wendy Hardwick, took matters into their own hands and organised a petition against the closure, collecting 600 signatures in three weeks. I applaud their efforts, particularly as Sheila is not online, yet she has galvanised Pilsley into action. She is one of a number of people who have tried calling the surgery in recent weeks only to discover that the options system for the practice automatically transfers them to the test results option. This has added to the confusion and Chinese whispers that are inevitable in a situation of high anxiety.

I brought the consultation up in business questions a few weeks ago, and I know that the CCG is of the opinion that the consultation process for the proposed closure was satisfactory, but I question whether it has explored more than the papers put in front of it. It is clear from speaking to residents in Pilsley that they feel very unsure about who is making decisions, when they are coming, and what impact they will have. We are far too reliant on websites for this sort of thing, and it annoys me that those of us who are tech-savvy gloss over the discrimination this presents to those who are not computer-literate. On behalf of all residents in Pilsley, I thank Sheila and Wendy for all that they have done.

I appreciate that the Government do not have control over this decision: responsibility lies with the CCG. Reportedly—this has not been confirmed to me in writing—a decision will be made at its next meeting on 26 February, although no time or location has yet been provided to me. Equally, I appreciate that a lot of this happened before I was elected. I also wish to state again that I have no ill will towards those who work for Staffa Health, who I am sure wish to do their very best to make their patients’ lives better; I disagree with them on this matter, but I do not question their passion for what they do. But it seems to me that the rationale for this proposed closure is short-sighted. It will adversely impact many vulnerable and elderly patients. It is deeply unpopular, and the best approach would be for us to find a way of keeping this surgery, such a vital part of the Pilsley community, open.

I also fear that the closure of the surgery could see a reduction in services or a potential closure of the local pharmacy, creating a real health blackspot in one of the finest parts of Derbyshire. I know the Minister is particularly passionate about pharmacies, and she knows how vital to communities these local businesses are.

I hope Staffa Health and the Derbyshire CCG will pause this proposal, meet me and the Secretary of State to discuss their issues and reassess what can be done. If any confirmation of the importance of this issue were needed, I might add that when I spoke to Sheila earlier today she told me that a last minute notice had gone out in the community because ITV’s “Calendar”—I am sure you are a big fan, Madam Deputy Speaker—was filming in the local area and wanted people to come out; at incredibly short notice 30 people made themselves available. This is a vitally important issue for the residents of Pilsley and I look forward to the Minister’s response.

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

I congratulate my hon. Friend the Member for Bolsover (Mark Fletcher) on securing this debate about GP provision in Pilsley. We know that general practice is the lifeblood of the NHS, and we understand the essential role that local practices play in their community, and this is particularly the case in rural areas such as Pilsley.

Before I address the specific issue of the proposed closure of the Pilsley branch surgery, I would like to mention the local work that is being done in Derbyshire that partly explains some of the things that my hon. Friend was talking about. First, Derby and Derbyshire CCG has been active in working with NHS England to expand the local workforce, and I am very pleased that three new GPs have been recruited in Derbyshire, one of them indeed by Staffa Healthcare. Secondly, the CCG has made progress in ensuring that GPs remain in the NHS and within general practice in particular, An example of that progress is the “GP Aspire” programme launched by the GP taskforce in Derbyshire. The programme started as a pilot back in 2018 and now provides support to all GPs across Derbyshire at any stage of their career. That includes, among other things, one-to-one careers guidance, signposting for wellbeing, mentoring, leadership and mental health advice. Since its launch, the programme has had some 116 individual contacts from Derbyshire GPs.

Retaining experienced GPs and encouraging more into the profession is the way we will be able to deliver more services across the nation and get more appointments into primary care, so people can get the right care from the right healthcare professional. On that, I add that I understand my hon. Friend’s point about pharmacies because the right appointment with the right healthcare professional for individuals will be hugely important as we begin to understand how to better work with the national health service across all the different healthcare professions.

I turn to the proposed closure of Pilsley branch surgery. As my hon. Friend outlined, the closure of a GP surgery is considered and decided by the local CCG, following the application from a GP provider. Such a decision understandably stirs up strong emotions within the local community, as he explained so well.

An application to close Pilsley branch surgery was submitted by Staffa Health in 2019. On the recommendation of the CCG, the public consultation was launched on 24 June. Staffa Health employed a wide range of feedback approaches during the 60-day period, including: meetings with staff; meetings with stakeholders and the patient participation group; issuing a letter, a “frequently asked questions” sheet and a questionnaire to all registered patients; text-message alerts to raise awareness of the consultation; and three face-to-face drop-in sessions. However, I understand what my hon. Friend said about the use of modern technology and how that may not always cover all patients who access local surgeries.

In addition to the consultation, the local petition calling for the closure to be halted, which got 592 individual signatures, was presented, and I join my hon. Friend in paying tribute to Sheila Baldwin and Wendy Hardwick, who organised it. I commit here and now to ensuring that my officials write to the CCG to ask it to set out how it has fully taken on board the views of the ladies and the broader petition and the action that it intends to take in response. Those local views can often help to deliver the most sensible solutions for everybody.

Following the conclusion of the consultation, Staffa Health decided to continue with its application to close the Pilsley branch to ensure the long-term sustainability of its whole practice across the three other local settings. A report was compiled and submitted to the CCG engagement committee for review on 8 January, and it commended the consultation for being “robust”. The report was also submitted to Derbyshire County Council’s improvement and scrutiny committee, and the final decision regarding the future of the Pilsley surgery will now be made by Derby and Derbyshire CCG’s primary care co-commissioning committee. The committee has been asked by Staffa Health to approve the closure, but to postpone it for a year from the date that approval is given. That postponement is to allow time to increase the number of consultation rooms at the neighbouring Tibshelf surgery and to address car parking issues. Those specific concerns have been raised through the consultation to date.

The committee met on 22 January and decided at the meeting to defer its decision to the next meeting on 26 February, which I understand will be after my hon. Friend has met the Secretary of State with Staffa Health. In the run-up to and following the PCCC’s decision, the CCG and Staffa Health are urged to continue to listen to the concerns that have been raised and to ensure that appropriate action is taken to reduce the impact on the community, which my hon. Friend laid out so eloquently.

As I stated, improving access to general practice is a leading priority for our Government and, consequently, I have asked that I be kept informed about developments regarding the future of Pilsley branch surgery. I understand that workforce shortages have been cited as a reason behind the application to close, as my hon. Friend said, and I appreciate how challenging the situation is for GP surgeries across the country. As the hon. Member for Strangford (Jim Shannon) outlined, it affects all of us, north to south, east to west, and particularly those trying to deliver across large rural areas and multiple sites, where delivery is extremely challenging. As such, I reassure my hon. Friend that tackling this issue lies at the heart of our determination to strengthen general practice and support those who work in it. We are committed to increasing the workforce, providing about 6,000 more doctors and 6,000 more primary care professionals such as physiotherapists, pharmacists and physician associates, on top of the 20,000 primary care professionals to whose funding NHS England is contributing.

[Jim Shannon]

Earlier, I referred to the possibility of a scheme allowing student doctors to commit themselves to five years in a general practice and thereby offset some of their student fees. Would the Department be prepared at least to consider that?

[Jo Churchill]

As the hon. Gentleman knows, we are always prepared to consider anything that will help to sustain the viability of the entire workforce. Offering appropriate career development, for instance, is important to ensuring that we retain doctors, nurses and other healthcare professionals. We do not just want to train them; we want to keep them as well.

Last year Health Education England recruited the largest ever number of GP trainees—some 3,540—but the system is under significant strain, and more trainees will be required to meet our target of 6,000 general practitioners. The five medical schools that are currently coming onstream will be to central to that objective. However, training new staff is only one piece of the jigsaw. As I have said, retention is just as important. The GP contract recognises that, and sets out an ambitious programme of initiatives which, by 2023-24, will support existing doctors. As well as introducing those workforce measures, we intend over the next 12 months to reduce the unnecessary burden of bureaucracy that often restricts GPs.

Our review has been agreed as part of this year’s contract, and will begin with a ministerial round table that will seek input from our partners across Government and general practice. Our aim is to free up valuable time for doctors and primary care professionals, while also ensuring that Government agencies, departments and patients have the necessary access to information. By recruiting and retaining more doctors in primary care, covering a wider range of specialisms, we will reduce the burden of bureaucracy placed on them and create additional capacity over the next five years. However, this is also about delivering care in the most appropriate setting as we strengthen general practice, and at the heart of each and every one of those settings is the patient. That can only work if we listen to the concerns and views of all involved in general practice, both staff and patients.

I commend my hon. Friend’s tenacity. He has lobbied both the Secretary of State and me to ensure that we know about the challenges at the Pilsley surgery, and that we listen and then continue a conversation that involves me but also, most importantly, the Secretary of State when he and my hon. Friend meet Staffa Health shortly. We will act on what we are hearing.

Question put and agreed to.

Historical Stillbirth Burials and Cremations

Jim Shannon Excerpts

Thursday 6th February 2020 Commons Chamber

[Ms Dorries]

I will. If my hon. Friend drops me an email at my departmental address, we will look into that, and the officials will take it away. I am grateful to him for raising that, because I was not aware of it.

I do not think I have missed out anyone who made a speech. We have heard today how important it is to many parents to find the final resting place of their stillborn children’s remains. Unfortunately, that is not always easy or possible, and I have explained that such records are not currently held by the Government. Rather, they are held by local hospitals that arranged for burials or cremations with local funeral directors or crematoriums. In some cases, records no longer exist, or they may not contain enough detail to be helpful.

Nevertheless, I reiterate that the Department of Health and Social Care expects all hospitals to provide as much information as they have available to them to any parents who inquire about what happened to their stillborn babies, no matter how long ago they died. I would like to praise the 800 parents who have attempted to find out where their babies’ remains are, because they have helped to raise the profile of this issue. As the hon. Member for Swansea East said, only by raising the profile do we manage to get something done. We need to continue to do that, because that is how we will make progress.

We have also heard today about the new regulations and systems to ensure that parents are involved, as they want to be, in the burial or cremation arrangements for their stillborn children. Parents are required by law to register a stillbirth, and once registration has been completed the registrar provides parents with all the certification they need to organise their babies’ burial or cremation, and a funeral service if they so wish. The required burial and cremation forms ensure that the wishes of parents are recorded and respected. Many NHS hospitals still do make arrangements for funeral services and support parents to consider various options and to make the decisions that are right for them. Some parents may wish to arrange a private burial or cremation with a funeral director. Most funeral directors do not charge for their services for stillborn babies. Thanks to the hon. Lady’s efforts, the new children’s funeral fund supports parents, as I said in my opening speech.

A funeral can sometimes be a catalyst for people to begin processing a deeply profound loss. At such a time, parents mourning their stillborn baby need as much emotional support, compassion and understanding as possible. However, the quality of support can vary from one maternity service to another. This is why the Government have funded Sands, the stillbirth and neonatal death charity, to work with other baby loss charities and the royal colleges to produce a national bereavement care pathway. The pathway covers a range of circumstances of baby loss, including miscarriage, stillbirth, termination of a pregnancy for medical reasons, neonatal death and sudden infant death syndrome. The NBCP is now embedded in 43 sites, and a further 59 sites have formally expressed their interest in joining the programme.

I would like to talk a little bit about mental health support. The hon. Member for Kingston upon Hull North is a campaigner on this, and she raised mental health during her speech. A couple of weeks ago, I visited nurses who are delivering perinatal mental health care support. As part of the new approach to and new funding for mental health, there are now specialist perinatal mental health community services in all 44 local NHS areas in England, and further developments are planned. Just in 2018-19, this has enabled over 13,000 additional women to receive support from specialist perinatal mental health services, against a target of 9,000.

I spoke to the nurses about the perinatal services that are being delivered, and in that particular trust they have helped 700 women who previously had no assistance whatsoever. It was incredible to hear the stories of how that assistance—the mental health support—is now being given to women. As I have said, all trusts now have in place those perinatal support services, which were never there before. Again, that is a huge step on the path towards delivering services that are focused on women and their needs.

Via maternity outreach clinics, we are also providing targeted assessment and intervention for women identified with moderate or complex mental health needs arising from or related to their maternity experience who would benefit from specialist support, but where it may not be appropriate or helpful for them to accept specialist perinatal mental health services, so we are even thinking further than that. In those services we are also assisting partners and families, so it is not just for the women, but for their partners and families.

A huge amount of work is being done in this area. I am not saying that we have finished—there is more to be done—but we are making progress. This actually fits in very well with our women’s agenda in the Department of Health and Social Care. The women’s agenda is not just about periods and menopause; it is about so many things. The particular area we are discussing today is a huge part of that.

Hon. Members present for the Baby Loss Awareness Week debate last October may recall that I undertook to write to Professor Jacqueline Dunkley-Bent, the chief midwifery officer in England, to ask if those bereaved by baby death could be included in the NHS long-term plan commitment to develop maternity outreach clinics that will integrate maternity, reproductive health and psychological therapy support for women with mental health difficulties arising from or related to the maternity experience. I am delighted to tell the House that I recently received a letter from the chief midwifery officer confirming that access to these services is available to women and their partners who are experiencing moderate or complex/severe issues, so we have listened and we have addressed that need. At this point, I should pay tribute to Professor Jacqueline Dunkley-Bent for her understanding of and support for my role in helping to deliver better services to women.

As I have said, a funeral can often be a catalyst for helping people to deal with death and stillbirth death, and I believe that that is so important today. It used to be about protecting women or just not holding them in high enough esteem to inform them about what happened, but we now know that actually the opposite is true. As my hon. Friend the Member for East Worthing and Shoreham mentioned, it is important to be involved not just in the death, but in what happened before, during and just afterwards. The question parents have at a time like this is: why? That question needs to be answered, and it does not get answered in a sentence or in a minute. Parents need to know and women need to know. They can only feel as though they have fulfilled their own responsibility to their child when they have explored every avenue and know every detail of what happened.

[Jim Shannon (Strangford) (DUP)]

This debate has been specific to England, Scotland and Wales, and not necessarily about Northern Ireland. I congratulate everyone who has made a speech on their very valuable contributions. After this debate, could the decisions, conclusions and the way forward on the strategy be conveyed to Northern Ireland, where this is a devolved matter, so that we can all work together to help everyone?

[Ms Dorries]

The hon. Member is quite right that this is a devolved matter. However, this is an issue that affects all women in the United Kingdom. He is quite right, so I will ask my officials what discussions take place with the devolved Assemblies and come back to him.

The stillbirth rate in England is falling. As I am sure the hon. Member for Swansea East knows, it was our intention to reduce the 2010 rate of stillbirths by half by 2025. I am delighted to report that we are ahead of that target: in January 2020, we were already ahead of what we are trying to achieve. Since my appointment as the Minister with responsibility for both maternity and patient safety, I have seen for myself how NHS maternity services in England are working hard to ensure that the care they provide is safe and personalised to women’s individual needs.

Many measures have been introduced in maternity services that are achieving this reduction in the rate of stillbirths, and the issues raised in debates such as this on baby loss also make a contribution. We all know that applying pressure and raising the issue pushes the agenda further along.

The efforts have resulted in a 20% decrease in the stillbirth rate between 2010 and 2018. Between 2016 and 2018, there were 760 fewer stillbirths in England than in 2015. That is an enormous achievement, and something that we should be very proud of. There are 760 fewer families who have to go through the painful experience of planning a funeral for a much-loved and wanted child. I think we all know that there is nothing more painful for a woman or a couple than to go into hospital to have their baby and to leave with empty arms and broken hearts. The fact that 760 fewer families are doing that now, as a result of the measures that have been introduced, is a huge achievement.

In closing, I pay tribute to the initiatives that have been stimulated by Members of this House to improve support for families experiencing a stillbirth. These include the national bereavement care pathway, the children’s funeral fund and the Parental Bereavement (Leave and Pay) Act 2018, which provides for at least two weeks’ leave for employees following the loss of a child under the age of 18 or a stillbirth after 24 weeks of pregnancy.

I also pay tribute to the clinical professionals and support staff working in acute and community maternity services. They work incredibly hard. I visit these maternity units and meet amazing midwives who dedicate their lives to being in that room at that moment when a baby is born, to ensure a safe delivery. Through their efforts, many more women and babies are being supported to have a healthy pregnancy, labour and birth. They will be supported nationally by the maternity transformation programme, which will continue to oversee the implementation of maternity safety initiatives, including those published in the NHS long-term plan and the new NHS patient safety strategy, published last July.

I would like to conclude by thanking the hon. Member for Swansea East yet again—we are truly in her debt for the issues she raises in this place—and my right hon. Friend the Member for South Holland and The Deepings for supporting her, or for being her acolyte, as he described himself.

Question put and agreed to.

Resolved,

That this House has considered historical stillbirth burials and cremations.

Children’s Mental Health Week

Jim Shannon Excerpts

Thursday 6th February 2020 Commons Chamber

[Preet Kaur Gill]

The right hon. Gentleman makes that point very well. A lot of research has been done on this by the Royal Society for Public Health. It is a contributing factor—one of which there are so many.

Looking after our children and young people requires children’s and young people’s mental health services to be properly resourced. At the moment, this is simply not happening. Almost a quarter of NHS child and adolescent mental health wards were rated as inadequate or requiring improvement by the Care Quality Commission in 2019. We also know that we have a huge shortage of mental health professionals, with a workforce that has hardly grown since 2010. According to the Royal College of Psychiatrists, we need an additional 4,370 consultant psychiatrists to meet current Government commitments. A recent British Medical Association survey revealed that almost two thirds of nurses said that on their last shift there was a shortage of one or more nursing staff. So can the Minister tell me how these shortages will be addressed?

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Lady for this absolutely superb Adjournment debate on a very critical issue. While there is, as she says, an onus on Government to respond, does she recognise that, as the health charity Place2Be says in early-day motion 137, tabled only this week by me and others—it also says that the theme of this year’s week is Find Your Brave—schools, churches and voluntary sector youth organisations also provide help to children at a time when they need it?

[Preet Kaur Gill]

The hon. Gentleman makes a really important point. Far too often, we do not recognise the work that schools are doing, and the charity sector, especially, has contributed significantly. Importantly, the Green Paper does not recognise that.

Today I want to focus on the public health approach, utilising early intervention and prevention. This is far too often overlooked, but it is a vital part of any attempts to tackle the crisis we are facing. Furthermore, if we fail to support children at an early stage, we will inevitably feel the impact further down the line when emergency services will be forced to step in. That is what we are seeing at the moment, and change clearly needs to happen.

So what am I talking about and what does it look like in practice? Let us take local government. Because of huge cuts by national Government, 60% of local authority areas have seen a real-terms spending drop on mental health services for children that come under the “low level” bracket, which includes early intervention for things like eating disorders and depression. Or let us look at our creaking and failing criminal justice system. Research by Revolving Doors found that children of offenders are three times more likely to have mental health problems or to engage in antisocial behaviour than their peers—and, as I said, almost all 15 to 21-year-olds in custody suffer from a mental health disorder. Reducing reoffending and the number of parents experiencing incarceration is not just a good in itself but may prevent their children from having mental health problems and reduce the likelihood that the child is involved in offending in the future. Will the Minister explain why, in answer to my written question, the Department for Health and Social Care admitted last week that it had

“not made a formal assessment of the adequacy of mental health services or mental health assessment in Young Offender Institutions”?

Let us take community-based mental health services. The Care Quality Commission, in its review of healthcare and adult social care in England in 2018-19, found that 21% and 10% of community-based mental health services for children and young people are rated as “requires improvement” or “inadequate” for the responsive key question.

Take schools, which the hon. Member for Strangford (Jim Shannon) mentioned. Schools in Birmingham are facing a funding shortfall of more than £90 million in 2020, but they are still working hard to fund their own mental health support or arranging peer mentors. Why are they doing that? One reason is that waiting times for referrals—if the referral is even granted—are far too long. Last year, I conducted a survey of schools in my constituency of Birmingham, Edgbaston and discovered that 90% had seen an increase in staff and students suffering from mental health problems. That is not sustainable without a substantial increase in support for our schools. Take looked-after children. According to Government data, they are nearly five times more likely to have a mental health disorder than their peers.

Take poverty. The TUC found that poverty in working households has increased by 800,000 since 2010. Poverty contributes to mental wellbeing. The Centre for Mental Health’s Commission for Equality in Mental Health found that children from the poorest 20% of households are four times more likely to have serious mental health difficulties by the age of 11 than those from the wealthiest 20%.

NHS Funding Bill

Jim Shannon Excerpts

2nd reading & 2nd reading: House of Commons
Monday 27th January 2020 Commons Chamber

[Matt Hancock]

Let me make a little progress, because so many people want to speak.

The purpose of the Bill is to set a minimum amount for the money going into the NHS. I want to set out what the funding in the Bill will be used for and what it will pay for, and also what we are adding on top of that, because the distinction is important.

[Jim Shannon (Strangford) (DUP)]

The Minister heard earlier from another Member about mental health issues, which do not just affect adults but also affect children—those from 10 to 12 or in their teenage years. A great number of children suffer from mental health issues at school. What has been done to help those schoolchildren to address those issues, which needs to happen early?

[Matt Hancock]

The hon. Gentleman is right to raise what is an incredibly important issue. We are rolling out support for mental health practitioners in schools across England. We have just given the new devolved Northern Ireland Government a big funding increase to enable them to roll out those services. Obviously this is a devolved issue, so exactly how they do that is up to them, but we will ensure that the roll-out continues across England and that children get the support they need.

Wuhan Coronavirus

Jim Shannon Excerpts

Thursday 23rd January 2020 Commons Chamber

[Matt Hancock]

Anybody with concerns, be they a student in Hull or elsewhere, should contact their doctor. As the first port of call, 24 hours a day, they can call NHS 111, which has clinical advice available around the clock. All the 111 contact centres have been updated and will be kept updated with the most appropriate advice.

[Jim Shannon (Strangford) (DUP)]

First, may I thank the Secretary of State for his statement and his clear commitment? Throughout the United Kingdom of Great Britain and Northern Ireland, people like you and me, Mr Speaker—you are a type 1 diabetic and I am a type 2 diabetic—have a chronic disease. Those who are diabetic and many others across the United Kingdom worry about the killer impact of this virus.

I note that the United States of America has diverted flights to specific screening areas. I am sure that the Minister and many others in the House saw the news this morning, as I did. On the flight that arrived this morning, there were three different opinions among those coming off the plane: one said that they had had no advice or discussion whatsoever; the second one got a leaflet; and the third one said that they had some tests done before they left China. So it seems that mixed messages are coming out. It is important that we have a clear policy and that everyone flying here and every person here feels assured.

[Matt Hancock]

The hon. Gentleman is absolutely right. We had a divert in place for that flight to ensure that it went to a part of Heathrow where there are the procedures and processes to be able to deal with this issue. There was enhanced monitoring of that flight— not all of that is immediately obvious to the passengers themselves. Crucially, we understand that the Chinese Government have stopped future flights. We will of course keep all that under review.

Adult Social Care in Shropshire: Government Funding

Jim Shannon Excerpts

Wednesday 22nd January 2020 Westminster Hall

[Daniel Kawczynski]

I thank my hon. Friend and neighbour for that intervention. I could not agree more.

When we came into office, we of course had to rein in expenditure, and all Government Departments had to have cuts. The cuts to local government have, of course, adversely affected our council. I am pleased that the country’s annual deficit is now below £28 billion a year, down from the £152 billion a year that we inherited. However, now that we are getting the finances under control in a more sustainable way, I urge the Minister to take the message back to the Treasury that we need to increase public funding of our councils, so that they can start to meet the huge rise in demand for adult social care in our county. I will explain why Shropshire is uniquely affected.

[Jim Shannon (Strangford) (DUP)]

Although it is absolutely the case that adult social care is very important in Shropshire, and in other parts of the United Kingdom of Great Britain and Northern Ireland, does not the hon. Member agree that we need to attract more workers into adult social care, because there seems to be a dearth of them, and help them to understand how rewarding it can be to make a real difference to the life of a vulnerable person? Also, does the hon. Member believe that we can do anything in this place to encourage more adult workers to be involved?

[Daniel Kawczynski]

Yes, very much so, and I am sure that some of my colleagues from Shropshire will take up that point in interventions. However, I will make a few quick points before I take another intervention.

During the 2017 general election, we gave the impression to the electorate that somehow they would have to sell their homes in order to pay for their long-term care. I have to tell the Minister that I had never come across such levels of bewilderment, frustration and anger on the streets of Shrewsbury as I did following that announcement, and have not done so subsequently. Whoever came up with that policy for the then Conservative Government was really out of tune with the thinking of many of our natural voters.

Even my own beloved mother—this is the first time I have referenced her in 15 years—Halina, who is a staunch Conservative supporter, said to me, “I haven’t made sacrifices all of my life, I haven’t done the right thing, paid the right amount of tax and done all the right things, for you now to force me to sell my home to look after my long-term social care needs.” I think my mother exemplified the strength of feeling across the United Kingdom.

I am convinced that that policy lost us our majority at the 2017 general election; it was certainly a major contributory factor. I am therefore very pleased that the Prime Minister has indicated that in this Parliament a solution will be found. However, as my hon. Friend the Member for The Wrekin said, we need radical, innovative thinking that has the support of our voters.

Shropshire MPs meet the council on a regular basis. We Shropshire MPs work as a team and hunt as a pack, and one of our greatest strengths is the unity between us all. In fact, we are seeing our council this Friday, 24 January, which happens to be my 48th birthday. I am looking forward to a few bottles of beer from my colleagues during the meeting.

Stepping Hill Hospital

Jim Shannon Excerpts

Tuesday 21st January 2020 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

First, may I congratulate the hon. Gentleman on what he is doing? I have read some of the background, as I have already told him, and I commend him for his energetic efforts on behalf of his constituents and the hospital. My hospital, like his, has a specialist stroke unit and we want to keep it open, too. Time is of the essence. Does he agree that the retainment and enhancement of specialist services must be a priority in the NHS, no matter what direction it takes?

[Mr Wragg]

Naturally, I agree with the hon. Gentleman and commend him for his work, particularly in maintaining the stroke services at his local hospital. Indeed, I commend the work of all those who perform such vital roles at Stepping Hill.

In other parts of the country, especially in large cities, people have a number of options for where they can receive care for a range conditions, including as a result of accidents and minor injuries. That means that emergency departments just care for the sickest patients who need resuscitation or emergency care.

Surrogacy: Government Policy

Jim Shannon Excerpts

Tuesday 21st January 2020 Westminster Hall

[Andrew Percy (Brigg and Goole) (Con)]

I beg to move,

That this House has considered Government policy on surrogacy.

It is a pleasure to serve under your chairmanship, Sir David, and a delight to see my current favourite Minister and favourite shadow Minister in their places. Having flannelled them, I am sure that the debate will receive a very successful response.

Surrogacy is an issue that I came to by accident, having watched a documentary about people who were going overseas to partake in surrogacy arrangements, and some of the problems that that was causing, particularly when it came to the welfare of some of the surrogates. From that, I started to look at the issue of surrogacy in the UK a little more closely. Having become more interested in the subject, it quickly became clear that there is urgent need in this country for reform of surrogacy law. There is also an urgent need for Government to understand and appreciate the important role that surrogacy plays in creating families in this country, whether those families are heterosexual couples, same-sex couples, or single people who wish to create a family. It is a legitimate, valued and socially acceptable means of family building.

Apart from investigating the situation of surrogacy overseas, the only other thing I remember about surrogacy is the debate in the 1980s, when I was a kid growing up. That was when the legislation on which UK surrogacy is presently based came into being, in response to some of the stories and concerns about surrogacy at the time. The debate in the 1980s was very different from the debate we have now. We now understand that surrogacy in this country works, and that it is a legitimate and loving way in which families are created. I thank the previous Minister, my hon. Friend the Member for Thurrock (Jackie Doyle-Price), who is in the Chamber today. She was, I think, the first British Minister to publicly state in the House of Commons the positive role that surrogacy plays in this country. Although I do not wish to embarrass her, I will repeat what she said in July 2018 when she was a Minister in the Department of Health and Social Care:

“Surrogacy has an increasingly important role to play in our society, helping to create much-wanted new families for a range of people. The UK Government recognise the value of this in the 21st century where family structures, attitudes and lifestyles are much more diverse.”—[Official Report, 19 July 2018; Vol. 645, c. 38W.]

We could not disagree with a single word of that, and we thank her on behalf of the whole surrogacy community for the positive way in which she embraced surrogacy.

We in the surrogacy community also thank my hon. Friend for the guidance that was issued by her Department during her time as Minister, including “Care in Surrogacy”, which was guidance that the Department of Health and Social Care issued to healthcare providers across the country. It had the same simple aims that all of us in the surrogacy community want to achieve: to normalise surrogacy among healthcare professionals, and to avoid the embarrassments that sometimes occur when healthcare professionals do not understand how these arrangements are come to and just how normal they are. In the past, there have been car park handovers of children because healthcare professionals on maternity wards and in hospitals have not known how the legislation and these arrangements work. We all want to avoid those situations, so I thank my hon. Friend for that guidance, which was updated at the end of November last year. I also thank my hon. Friend for addling the brass, as we say in Yorkshire, to ensure that the Law Commissions’ review into the current legislation—a joint review by the Scottish Law Commission and the Law Commission for England and Wales—was a root and branch review. We are very grateful for that.

I also want to say a big “thank you” to the Surrogacy UK working group on surrogacy law reform, which has done a brilliant job. Some of that group’s members are here today, although of course I am not allowed to refer to people in the Gallery. Particular thanks must go to my constituent, Sarah Jones, who serves as the chair of Surrogacy UK. When I got interested in this topic, I did not realise that one of my constituents was chair of Surrogacy UK; it was quite by accident. A big “thank you” is also due to Natalie Smith, and to Dr Kirsty Horsey from Kent University, who led and chaired the review working party within Surrogacy UK. We are really grateful that the funding is in place, and that this review has now happened. It is a three-year project which, if memory serves, we are about half way through.

Surrogacy in the UK has been regulated since 1985 by the Surrogacy Arrangements Act 1985, which came out of the 1984 Warnock committee report. That Act contains a number of provisions that make advertising for, or as, a surrogate illegal, criminalise for-profit surrogacy and render all surrogacy arrangements as they stand unenforceable in law. Since 1985, there has been plenty of legislation to change some of that Act’s provisions. The Human Fertilisation and Embryology Act 1990 established that in all forms of assisted reproduction, a woman who gives birth, and no other woman, is the legal mother at birth. The legal problem with the situation now is that a surrogate who is carrying a child who has no genetic link to them is, in law, the mother at birth, whereas the intended parents, who may have a 100% genetic connection to that child, are not.

The 1990 Act also determines that the partner of the surrogate is the legal father, even though he may have had absolutely no part in the surrogacy arrangements. That is why parental orders are being created that enable legal parenthood to be transferred after birth as long as certain conditions are met. However, that takes six to nine months at best, and in many cases takes much longer.

Surrogacy legislation has evolved and changed over time. Not so long ago, a remedial order was passed by Parliament in response to a human rights court case. That order now enables single individuals to take part in surrogacy, something that was previously outlawed. The key problem with the legislation, as I have highlighted, is the issue of parent orders. Despite the fact that surrogates, intended parents, and everybody involved in these arrangements have only one interest at heart, that of the child, the current legal situation sometimes works against the interest of the child. It is very rare in a surrogacy arrangement for the relationship between the surrogate and the intended parent to break down, but the current law means that if that does happen, a surrogate who, at birth, is the legal parent can prevent legal parenthood from ever transferring, even though the children could have no genetic relationship to the surrogate.

The relationship breaks down only in a very small number of cases. Most surrogates go into this for entirely altruistic reasons, and the relationships between the surrogate, the parents and the child are normally very strong and often life-enduring. However, when such a breakdown happens, as in the well-known case of Re AB (Surrogacy: Consent), it can result in legal parenthood never being transferred, resulting in a situation where the parent in law will always be different to the parents in reality. That is not in the best interest of the child, which is why we in the surrogacy community welcome the Law Commissions’ proposals on this issue. By outlawing the enforceability of surrogacy arrangements, the current situation is one in which people want to properly formalise an arrangement, but cannot then rely on that arrangement later on in law.

Most of us involved in the surrogacy debate would say that what does work in the current UK legislation is the principle of altruism.

[Jim Shannon (Strangford) (DUP)]

This is a complex issue, and the hon. Gentleman is setting the scene very well. However, does he agree that in all these things, sensitivity must be key? Does he also agree that we perhaps need to look to our neighbours across the pond in the United States of America, for instance, where large numbers of surrogacies are carried out, to see how their policies and guidelines have made the process safe for parents and surrogates alike?

[Andrew Percy]

I thank my hon. Friend for that intervention, and will come on to the issue of surrogacy arrangements in the United States. Nobody would question that surrogacy arrangements in that country operate in the best interest of the child, but they operate on a wholly different basis to surrogacy arrangements in the UK: they operate on a commercial basis, which many of us would not want to see here. It is fair to say that in this country, surrogacy arrangements work. There is no doubt that the welfare of the child is at the heart of surrogacy arrangements, and at the heart of the courts in this country. However, as the debate progresses, we can of course take examples of best practice from other jurisdictions, whether through legally enforceable surrogacy arrangements or whatever else.

[Andrew Percy]

I entirely agree. I will say more later, but there is a debate in the surrogacy community about the nature of payments and whether its basis should be altruistic or commercial. Throughout the process, the view of the all-party parliamentary group on surrogacy, which I formed with other hon. Members, has been that we must maintain the altruistic basis of surrogacy in the UK. There are others in the community who take a different view; I will say more about that in a moment.

The all-party parliamentary group undertook a number of hearings in response to the Law Commissions’ proposals. The principal purpose of the debate is to explain where we agree with them and where we do not, and I thank the Law Commissions for the way they have engaged with us. They have been proactive and positive in coming to APPG meetings and some of the hearings, and they have been open throughout the process. That view is shared by everybody across the surrogacy community.

We took evidence from a number of interested parties. We heard from surrogates, intended parents, parents who have created their families through surrogacy, and the legal community. We even took evidence from Tom Daley who, with his partner, chose to undertake their surrogacy arrangement in the UK, not in the United States, precisely because there are some big reasons why the US is not as attractive a jurisdiction—although it is perfectly safe—for such arrangements. Those sessions were really interesting and valuable. In response to the Law Commissions’ initial consultation, we have some clear views on what we would like to see.

[Jim Shannon]

There is something at the back of my mind, which I want to put on the record and get the hon. Gentleman’s thoughts on. With the rise of celebrities openly discussing their surrogacy journeys—he has mentioned one—does he agree that we need a clearly defined strategy to address the rise in the number of surrogacies and the complexity of the issue, which is difficult for people to understand without clear guidelines?

[Andrew Percy]

It is absolutely the case that we need updated legislation. We welcome the arrangement of Tom Daley and his partner, Dustin Lance Black—I have just remembered his name; I am not very good at remembering actors’ names—because they are two loving parents who have created a loving family. They are a good example, because they demonstrate better than anyone, or as well as anyone, how loving families can be created in a range of ways—through surrogacy, IVF, adoption or marriage—in the UK in 2020.

Dustin Lance Black also undertook an interesting set of radio programmes, one of which, following surrogacy arrangements in the US, explained why they chose the UK and felt that the system here was better. The hon. Member for Strangford (Jim Shannon) is spot on, however, that we need a well-regulated and updated framework for surrogacy in the United Kingdom.

We as an all-party parliamentary group are positive and pleased by the Law Commissions’ proposals. We recognise how progressive many of them are, and that they balance most of the concerns about safeguards, ethical surrogacy and the welfare of children—of course—that were raised by stakeholders throughout the process. We also welcome the fact that, unlike in previous reports, the lived experience is front and centre of all the proposals. We believe that the commissions have engaged positively with the whole surrogacy community and interested parties.

Where do we agree? As I said, we are happy that a full root and branch review is taking place. We are also pleased that there is no move towards allowing the commercial surrogacy that we see in the United States, because it would then become the preserve of the wealthy. That is not the case with the altruistic nature of the current system, although it is not without expense or challenge. We have a situation in the United States where some families are now going out of the United States to undertake surrogacy because they cannot afford it there.

Health and Social Care

Jim Shannon Excerpts

Thursday 16th January 2020 Commons Chamber

[James Brokenshire (Old Bexley and Sidcup) (Con)]

It is good to see you restored your place, Mr Deputy Speaker, and a particular privilege to take part in today’s debate on the Gracious Speech, with a particular focus on our precious NHS. It is also good to see the emphasis in the Government’s programme on funding, innovative medicines, safety and mental health, so that we can improve the services that our NHS delivers and improve the lives of those who needs its care.

The timing of today’s debate has some particular poignancy for me. I was struck by the comments of my right hon. Friend the Member for South West Surrey (Jeremy Hunt) about the ups and downs of politics. It is almost exactly two years to the day that I had surgery to remove the top part of my right lung and the cancerous tumour contained within it, but I am pleased to say that, in the immortal lyrics of Sir Elton John, “I’m still standing.” [Hon. Members: “Hear, hear.”] I count my blessings each day, and today provides me with a further opportunity to pay tribute to the incredible people in our NHS who saved my life and continue to save the lives of countless people up and down the country every single day.

I have learned so much over the past two years, and I am determined to use my experiences to act as an advocate for change, especially for less survivable cancers such as lung cancer. I have been heartened by the encouragement of colleagues across the House—even the colleague who upon my return to the Members’ Tea Room after surgery said, “Didn’t expect to see you back.” To this day, I am quite sure that the omission of the words “so speedily” was simply an unconscious oversight.

Over half of us will get cancer at some stage in our lives. That is why we need to be more open about and change the nature of the conversation around the disease. For many people, cancer is becoming the treatment of a chronic condition, and more and more people are living well with or beyond cancer.

[Jim Shannon (Strangford) (DUP)]

I thank the right hon. Gentleman for giving way. I was pleased to see him back after his operation, and he is making a clear case on cancer-related issues. Just this week, I met representatives from the Teenage Cancer Trust who indicated that, for young people and teenagers, cancer is not just about the operation and other physical activities, but mental anxiety, too. The Government have set aside money to ensure that that anxiety is addressed, but only 61% of such services are taken up in hospitals and just 40% of the available assistance and help is taken up afterwards. I am sure that the Government response will be positive, but does he agree that now is the time to address those shortcomings for those who experience mental health anxiety due to cancer?

[James Brokenshire]

I commend the hon. Gentleman for his point about mental health issues and some of the stresses and strains, and there is a need for greater focus and attention on teenage cancer patients. That leads me on to my next point, which is about the need to overcome the fear that a diagnosis can bring. I know what that can feel like. Early diagnosis and speedier treatment are key, not least to reduce the worry and sleepless nights that result from knowing something is wrong by getting something done about it. It is great that the NHS long-term plan recognises that. By 2028, the plan commits to improving cancer survival dramatically, increasing the proportion of cancers diagnosed early from a half to three quarters. That is why the NHS Funding Bill, with its commitment to an extra £33.9 billion a year for the NHS, is especially important.

There is, however, a question around how we turn the increased investment and that intent into the reality of improved outcomes. That is why we need to focus on what I term the “SAS”: better screening for the disease, greater awareness of the disease, and a breaking of the stigma attached to the disease. By doing that, we can make a real step change. I welcome the introduction of the targeted lung cancer screening programme, which I championed, and which is being rolled out as we speak. I commend the charities and the regular campaign events to highlight the symptoms and, yes, the importance of getting things checked out—especially for us blokes, who can be pretty rubbish at actually going to the doctors and doing something about it. The stigmas are linked to that, and we need to talk about the big C, because it is the disease that dare not speak its name. False judgments can be made, especially with something like lung cancer, because people may make wrongful assumptions that it must be perhaps the sufferer’s fault as they must have smoked. However, as one leading clinician said so effectively and succinctly at a recent conference I attended, “If you have got lungs, you can get lung cancer.”

All this needs to be looked at in context. We need the right workforce in place with the right equipment and the right systems and processes to back it all up. I welcome the Government’s commitment to increased investment in CT scanners and to increasing the overall number of nurses, but we need to recognise the particular role of specialist nurses and the incredible difference that they make. I look forward to the publication of Baroness Harding’s workforce planning review, and I hope that it sees this special group of nurses strengthened and supported and that their numbers will be increased.

There can be no doubt about the pressures that exist within the system and the increasing demands that our NHS has to meet, but the overwhelming experience of most people who use and rely on our NHS is positive, with a real appreciation of just how special it is. We need to continue to stand up for it, to champion it and to be positive about what more it can achieve. I have every confidence that we will and, in doing so, that we will help improve the lives of the people it serves and the people we are privileged to serve as Members of this House.