Access to Primary Healthcare

Joy Morrissey Excerpts

Wednesday 16th October 2024 Commons Chamber

[Luke Taylor (Sutton and Cheam) (LD)]

I am in general agreement with others about the state of the NHS. The NHS was a Liberal idea, delivered by the Labour party, then broken by the Conservatives. The attendance among Conservative Members at today’s debate shows just how much interest they have in trying to fix it. The Liberal Democrats will act as a responsible, constructive Opposition and work with the Government to fix the NHS’s many problems.

[Joy Morrissey (Beaconsfield) (Con)]

On that point, will the hon. Member give way?

[Luke Taylor]

No, I will not.

Solving the crisis in access to primary care matters not just to patients facing traumatic situations, but to our GP surgeries, which are striving to do their best under the most difficult of circumstances. Our hard-working GPs dedicate years to training and work hard at what they do because they are passionate about being there for their patients. For too long they have been let down, and it is our job now to give them the means to continue doing their remarkable job.

We know the difficulties. Too often, appointments are not available, and patients and staff experience frustration and conflicting priorities when attempting to access services. For patients, that often means resorting to dialling 111, or even 999, and attending A&E when issues escalate. That puts further pressure on our already overstretched NHS emergency facilities, which too often have to deal with issues that could have been fixed by preventive primary care if patients could have accessed it in a timely way.

GPs in Sutton and Cheam tell me that requests for appointments are triaged because of the level of demand. Decisions have to be made to prioritise patients with increasingly complex needs, often with very little information available. Unsurprisingly, that is affecting GPs’ mental health and making it increasingly difficult to retain experienced staff, further eroding the ability of practices to keep up with demand.

The ask from GPs in my constituency is simple: the Minister must act quickly to increase their budgets, and offer certainty to allow them to plan ahead financially after a sustained period of real terms cuts in funding. That will allow them to hire and retain more staff at competitive wages during this cost of living crisis, lower the collective workload and treat more patients more effectively.

It is not enough to simply offer more training places, or incentives to train, if surgeries cannot employ the GPs who are already qualified and available. That is a particular problem in my constituency. If the NHS cannot compete with the private sector on pay, or with overseas Governments, who attract our doctors with improved conditions, a lower workload and possibly even better weather conditions—legend has it that there are places that have even more sunshine than Bournemouth —then it cannot hope to retain GPs. We must make it easier for foreign students who have studied and qualified in the UK to get the right to remain after their course, should they wish to do so.

As the new Government search for ways to boost growth, I say that it is here in front of them. There is no better investment in our future growth than good-quality primary healthcare, keeping patients healthy, able to provide for themselves and their families, and living healthy and fulfilling lives.

Health and Social Care

Joy Morrissey Excerpts

Friday 3rd December 2021 Commons Chamber

[Edward Argar]

My hon. Friend is right. The key words are “where necessary”, and that is a clinical judgment. I have highlighted the improvements that we are seeing in terms of the number of face-to-face appointments going up in primary care. Equally, we do not want to lose the benefits of telephone appointments or other appointments for those who wish to interact in that way. It is about trying to craft the system around the patient and taking those clinical judgments into account.

[Joy Morrissey (Beaconsfield) (Con)]

Will my hon. Friend allocate a portion of the enhanced winter discharge funding to mental health support for young people? I have had another secondary school student take their own life—that is my crisis. We need more mental health support and out-of-hospital provision for young people.

[Edward Argar]

My hon. Friend highlights the hugely important point that over winter we face challenges not just in physical health but in mental health, particularly as we come through the pandemic. One reason that we are investing £500 million in mental health catch-up is that we know how vital it is that we do not just talk about parity of esteem but recognise it in the resources that we put in.

GP Appointment Availability

Joy Morrissey Excerpts

Tuesday 26th October 2021 Westminster Hall

[Mr Laurence Robertson (in the Chair)]

Before we begin, I encourage Members to wear masks when they are not speaking, in line with current Government guidance and that of the House of Commons Commission. Please give each other and members of staff space when seated, and when entering and leaving the room.

[Joy Morrissey (Beaconsfield) (Con)]

I beg to move,

That this House has considered GP appointment availability.

It is a pleasure to serve under your chairmanship for the first time, Mr Robertson. The chances of misdiagnosis can increase dramatically if GPs rely on emails or telephone calls exclusively. I speak from experience: for days, my mother-in-law was misdiagnosed as having a urinary tract infection, when she had actually suffered a severe stroke. Precious time was lost, and terrible damage done, because she was not seen by a GP. For every 100 ailments that can be diagnosed safely without seeing a GP, there will be one that cannot—one that could prove to be fatal, which is not a price worth paying.

I thank NHS workers and GPs for working tirelessly throughout the pandemic. I was encouraged to apply for this debate by my constituents, who came to see me again and again about this issue. I wanted to make sure that their voice was heard. I will read out some of their actual cases, because it is important to hear from them about what they have been experiencing. I would say that they are divided into two categories. The first is those who are disabled and perhaps suffer from dementia or other cognitive impairments, who find talking on the phone very difficult, and who really need to see a GP in person. The second is those who are happy to speak over the phone when they need a GP appointment, but find that the IT systems in place in certain GP surgeries cause issues with access to GPs.

The first example is from Marlow. A lady wrote to me and asked for an appointment to see me. She said:

“When I got through to the surgery, we were told that we should have a telephone appointment first. The GPs have my daughter’s number, as she cares for her grandmother. I explained that we do not live with her and cannot sit at her house and wait for a call. Also, there was a phone for her to sit around all day, and no one answers. She isn’t good with IT and has trouble explaining and expressing herself and telling someone what is wrong over the phone. I understand we are in extremely unusual circumstances, but there has to be exceptions, and there must be a way for elderly, and in some cases disabled, people to be able to get an appointment. Many do not have the capability to use the internet, and even phones in some cases.”

That was particularly true in the case of my mother-in-law, who had had a stroke. Luckily, we had power of attorney, but many people do not. I appreciate that the Government have made great strides in this regard, but we need to look at how we can protect those who are disabled, who perhaps have cognitive impairments and who need to have a carer come with them to a GP surgery in order to express what is wrong and explain what condition they have. Greater attention should be paid to this in the future.

We also have the issue of general IT and phone challenges. A resident in Farnham Common wrote to me and said:

“We have difficulty making the initial contact with GP surgeries. Most GPs operate a system which requires the patient to telephone when the surgery opens at 7 am to seek a consultation for that day. In our collective experience, it is often extremely difficult to get through. It takes a very long period of repeated calling. One friend recorded 140 unsuccessful attempts to reach the GP surgery.”

Some of the GP surgeries in my constituency are excellent. They were excellent during the vaccine roll-out and through covid, but we have certain GP surgeries that have had challenges meeting residents, challenges with the vaccine roll-out, and challenges in general throughout the covid period. Quite a number of residents have written to me and spoken to me about Burnham Health Centre, so I want to share specifically the IT challenges that it seems to face consistently.

One resident, Colin, said that if you are lucky enough to be 29th in the queue that morning at 7 am, you may get a message that says no appointments are left for the day. You can hang on in silence, or you may get to speak to a person—you may get through to a human being. You are told that there are no appointments and that you need to use Patient Access. When you try to book an appointment via Patient Access, it gives you possible ways to book, but only for things like contraceptive appointments, and nothing else. When Colin tried to access Patient Access, he was given an electronic form which he completed several times. It kept coming back saying that it could not be processed. He tried dozens of times and finally gave up and decided that Patient Access was not working.

He was not the only resident in Burnham who complained about Burnham Health Centre and Patient Access; several more wrote to me about the same issue. One said:

“I do think it’s ridiculous that you cannot get an appointment when you call, I am happy to wait a day or two, if it is urgent, there is always 111. The practice of releasing a limited amount of appointments at a certain time is not fair and just causes a bun fight. I do think the staff would benefit from customer service training”—

for everyone’s benefit.

A set amount of appointments are on a first-come, first-served basis. This seems to be unique to this GP surgery, but it has become a very agitating issue for people in the area who already suffer from some health inequality. They perhaps do not have the financial ability to go privately. Many are older and vulnerable, and it is demoralising that they often cannot get hold of a GP for even a phone call and consultation. Just getting a phone call would be a positive step in certain cases in my patch.

[Margaret Greenwood (Wirral West) (Lab)]

The hon. Lady is making really good points on this massively important issue. She just remarked that it was unique to where she is. Not at all; I have similar issues and I am sure other Members will talk about their issues. It is so important. Does she agree that the difficulty people have in accessing GPs has a knock-on effect on the National Health Service in other areas? We see people going to A&E out of frustration, because they cannot see their GP. This is really a problem that needs to be tackled head on. I congratulate the hon. Lady on introducing the debate to put pressure on exactly that.

[Joy Morrissey]

I thank the hon. Lady for her contribution. I agree that the problem has a trickle-down effect throughout the NHS. We will see more people presenting at A&E and perhaps with more advanced stages of disease, because they have not been seen in person. Encouraging GPs or creating a covid incentive programme for them to see people in person will decrease the amount of hospital admissions and lead to earlier diagnosis for cancer and heart disease. These things can really only be done in person. If someone is healthy and just needs a phone appointment, that is fine, but certain things cannot be seen unless a person’s vitals—their heart pressure—can be physically checked. Only a GP can do that and really only in person. If we want to reduce the overall burden on the NHS this winter, finding a safe and secure way for more residents to see their GP will reduce the overall pressure long term on the NHS. I know we have an aging population, and that GPs are under huge amounts of pressure and strain, but I believe there is a way we can work together to find a solution.

[Rachael Maskell (York Central) (Lab/Co-op)]

The hon. Lady said that only a GP can check someone’s blood pressure. We know that many people can undertake many of the different clinical functions that a GP is asked to undertake. Is it not right, therefore, to look at a multidisciplinary clinical team and how to deploy it better, rather than just to focus on the GP?

[Joy Morrissey]

The hon. Lady is stealing my thunder, but I agree with that comment. With the multi-disciplinary approach, even nurse practitioners and others could be recruited into a GP surgery structure, to help with many of the ailments that people are presenting at A&E with or asking for an appointment about. There is a wide range of healthcare professionals who could help and support GPs, and I think this is an important issue that needs to be further discussed and debated.

When this matter came before the House in July, several relevant questions were raised. One of them was about NHS England and NHS Improvement, or NHSEI, which leads the programme of work support practices, using digital and online tools to widen access. I would just love to hear what progress has been made since this topic was debated in July. Also, what is the progress of NHSEI’s independent evaluation of GP appointments? Again, I would like to see whether we have had any progress on that independent evaluation. Finally, what is being done by the NHSEI access improvement programme to support practices where patients are experiencing the greatest access challenges, such as drops in appointment provision, long waiting times, poor patient experiences or difficulties in embedding new ways of working related to covid-19, such as remote consultations as part of triage? I would really welcome any updates on those questions.

We could perhaps discuss today how we can provide GPs and their surgeries with some kind of in-person patient incentive during covid. Perhaps that could come from existing regional funding streams. Perhaps each time a GP sees a patient in person, they could receive an extra payment, or they could receive an additional payment for visiting someone in their home. That would mitigate the additional cost of PPE and also the additional risk posed to the GP themselves by having to see people in person during covid or high levels of winter flu.

Some GP surgeries are already receiving additional funding for cervical cancer and diabetes screening, and we have seen uptake increased in those areas very successfully, so this type of programme has been modelled in the past. It would help to mitigate the risk and burden for GPs, while still getting as many of our constituents as possible into in-person appointments if they need them.

The NHS claims that it would like more patients treated at home rather than having to stay in hospital for extended periods of time. This model could be enhanced if GPs were given the financial incentive to carry out in-home treatments for patients who traditionally would have remained in hospital. Obviously, this allocation would have to be set by the integrated care system in each region and it would be decided on within regional NHS structures, but it is worth considering.

In my own personal experience with my mother-in-law, she has been at home all the time 24/7. She is now completely disabled and needs 24-hour care, but the most difficult challenge was the out-of-hospital care provision—getting the GP, the hospital and the council to co-ordinate the care effectively. It is a full-time job for someone to co-ordinate that care. If we can make those pathways of care and co-ordination easier for everyone, then, as was said earlier in the debate, it would reduce the overall pressure on the NHS.

[Margaret Greenwood]

Does the hon. Lady share my concerns about the provision in the Health and Care Bill for the assessment of patients to take place after they have been discharged from hospital instead of before, as happens at the moment? I have very serious concerns about that issue. I tabled a couple of parliamentary questions, which were answered by a different Minister to the one who is here in Westminster Hall today. One question was about the fact that this discharge-to-assess approach has been going on under the Coronavirus Act; I asked how many patients had been discharged that way. The reply came back that 4 million patients had been discharged from hospital without having their assessment. I asked how many of those had been readmitted within 30 days; the Minister replied that the Government did not know because the information was not held nationally.

This is a very serious concern, because we are talking about vulnerable people. I know the hon. Member for Beaconsfield is talking about a particular relative. The idea that somebody with dementia, or early-stage dementia that has not been fully diagnosed yet, should be discharged before their needs are fully understood is very alarming. An independent review of this is going on at the moment, and I would be grateful if the Minister could give us an idea when that is going to be published. It is meant to be this autumn. I would like to raise this with the Minister as a very serious issue and wondered if she would like to comment on it.

[Mr Laurence Robertson (in the Chair)]

Order. I remind hon. Members that interventions need to be brief.

[Joy Morrissey]

I recall the Member speaking on this topic previously. I commented only because of my personal experience. The change is well intended, and I understand where it is coming from, but for a disabled person, and for someone who cannot advocate for their own care needs, having a care plan in place before leaving hospital helps with accountability and the structure of the care. From my own personal experience, as someone who has taken care of a very disabled relative who cannot advocate for herself, I can only say that having this agreed before she came out of hospital made it easier for our family to co-ordinate the care. It is difficult to know which funding pathway is linked to what care once someone leaves hospital; there is a statutory responsibility, but then there is the question of who picks up the care once that period out of hospital has finished. For someone who is disabled, has had a stroke or requires long-term rehabilitation, that is a very sticky issue because whichever organisation within the health structure picks up the statutory duty picks up a huge cost. I think it is a very nuanced issue and we need another debate on it to flesh out all the different challenges. However, I take on board the comments made by the hon. Member for Wirral West and recall supporting what she said when she spoke several months ago.

I understand that these are unprecedented times, and there are great challenges for everyone across the health sector. This is not to criticise anyone; it is just about how we can positively move forward into the new covid era in which we find ourselves, and into the winter months when there are more challenges. It is about how we can work together to find solutions, particularly for the vulnerable, the disabled and those who cannot advocate for their own care needs. I am very grateful that we have been given time to debate this topic.

[Kim Leadbeater (Batley and Spen) (Lab)]

I thank the hon. Lady for securing this important debate today. Like her, I have had communication from a number of constituents who are concerned about the lack of face-to-face appointments. It definitely is an issue. We have to be careful that we do not have a knee-jerk reaction. I also think there are benefits to a hybrid approach; I have a chronic health condition, but I would actually rather have a telephone conversation. The other important point is that a survey by the British Medical Association in August found that half of GPs had faced verbal abuse in the previous month alone, and most GPs had witnessed abuse directed at, in particular, reception staff. This is certainly borne out by the conversations I have had at surgeries in my constituency in Batley and Birkenshaw. Does the hon. Lady agree that this is extremely concerning and totally unacceptable, and that we must call out abuse directed at those in public service?

[Joy Morrissey]

I thank the hon. Lady for her comment. In my constituency we have GPs who have worked tirelessly throughout the pandemic and have done so much to roll out the vaccine—I commend them for everything they have done in such an incredible way. This is not to disparage the wonderful work of the majority of GPs and GP’s surgeries. I am looking for the correct terminology. There are certain GP’s surgeries that have struggled to even respond to constituents with phone calls. Many would be satisfied with just a phone call, but they cannot even reach their GP to schedule a phone call appointment.

[Chris Green (Bolton West) (Con)]

Does my hon. Friend share the concern of many of my constituents that there is to some degree a postcode lottery in the national health service and the GP service? Different GP surgeries and different areas provide very different levels of service, whether that is face-to-face or there is a lack of that.

[Joy Morrissey]

I would agree with that. Some GP surgeries, in certain parts of my constituency, are excellent—they were excellent with the vaccine roll-out; they are excellent now; they have done everything in their power to see as many constituents as possible—and then there are certain others, in the Iver and Burnham areas, where we continually have complaints, where constituents come to me in desperation because they have nowhere else to go.

We need to find a way of giving health access to everyone in a fair and reasonable way. I promised my constituents that I would raise their concerns at the highest level, and I have done that today, both in Westminster Hall and with the Minister directly. I thank Members for their time today, and I hope that this issue will continue to be considered and debated within Parliament and by the Minister.

[Several hon. Members rose—]

--- Later in debate ---

[Joy Morrissey]

I thank hon. Members from across the House for their contributions. I thank the Minister for a very nuanced and positive response, and for taking so much time to explain the measures that the Government are taking. I think many of the GPs in my constituency would welcome those things. GPs need additional support and have perhaps not been able to ask for it because they are so overwhelmed with the backlog, so it is a wonderful and really positive step. I look forward to bringing more constituency issues directly to the Minister, and I thank her for opening up that pathway. Many of my constituents have never contacted their Member of Parliament before, and they just felt desperate. I know that many GPs are doing all that they can, but having additional support from the Government is very welcome indeed.

Question put and agreed to.

Resolved,

That this House has considered GP appointment availability.

Covid Vaccine Passports

Joy Morrissey Excerpts

Wednesday 8th September 2021 Commons Chamber

[Nadhim Zahawi]

I am grateful for my hon. Friend’s championing of the vaccination programme. He raises an important point. One of the issues around lateral flow tests is the risk of people fraudulently inputting their test result, but also those are for a single excursion whereas being double-vaccinated means that people can go and enjoy nightclubs as many times as they like.

[Joy Morrissey (Beaconsfield) (Con)]

May I, on bended knee, implore my hon. Friend to summon all his courage and say no to vaccine passports to protect our civil liberties? He has been so courageous in the vaccine roll-out, so will he please protect our civil liberties and say no to vaccine passports?

[Nadhim Zahawi]

I hope that when my hon. Friend pauses and reflects on what we will be bringing forward, she will see that it is that it is much better for the nightclub industry to be able to open sustainably while we get through the next few months. The winter months are going to be tough and challenging not just for covid but also for flu. It is a far better option to listen to the clinical advice of the CMOs and implement something that is difficult for me to do, and goes against everything I believe in, but nevertheless is the right thing to do.

Health and Care Bill

Joy Morrissey Excerpts

2nd reading
Wednesday 14th July 2021 Commons Chamber

[Jeremy Hunt]

There is a big issue, and my hon. Friend is aware from his time at the Department of Health that its root cause is capacity in the system. These capacity issues taken together are why the Health Foundation says that, in just over a decade, we risk a workforce gap in the NHS of about half a million people. That is why this is such a big issue. I urge the Secretary of State to think about that during the Bill’s passage.

[Joy Morrissey (Beaconsfield) (Con)]

Does my right hon. Friend agree that that is also the case for the rehabilitation services used by stroke victims? There is a vital link between occupational therapists and physios, but we do not have the proper workforce in place for at-home care after a stroke.

[Jeremy Hunt]

My hon. Friend is absolutely right. These issues are about not just doctors but all associated health professionals, allied health professionals and indeed the social care workforce. It is important to note that they predate the pandemic. That is why, when I was doing the job of my right hon. Friend the Secretary of State, I set up five new medical schools and increased the number of doctor, nurse and midwife training places by a quarter, but we need to go further.

When the number of clinicians we train is decided by haggling between the Department of Health and the Treasury in a spending round, there is always the risk that it will be eclipsed by more short-term considerations. The truth is that we have a short-term emergency with workforce burnout, so I urge my right hon. Friend to look at the simple and sensible solution proposed by the Health Foundation and all the royal colleges in The Times today to legislate for Health Education England to have a statutory responsibility to publish annual independent workforce projections across the health and care system for the next five, 10, 15 and 20 years. That would show how many training places are needed, which would start to tackle this problem and the obscenity of spending £6 billion every year on locum doctors and agency workers. That cannot be the best use of funds.

Frontline health and care workers are exhausted. They know that there is not an instant solution, because they know it takes three years to train a nurse and seven years to train a doctor, but we can at least give them the reassurance that there is a long-term plan in place. That is not in the Bill, but it needs to be. Given the dedication that we have seen from health and care staff over the last year, it is the very least that we owe them.

--- Later in debate ---

[Joy Morrissey (Beaconsfield) (Con)]

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

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

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

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

[Joy Morrissey]

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

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

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

Social Care Reform

Joy Morrissey Excerpts

Wednesday 23rd June 2021 Commons Chamber

[Helen Whately]

I remind the hon. Member about the unprecedented support we have given social care during the pandemic: extra funding of £1.8 billion, over 2 billion items of free PPE to providers, a new system of distributing PPE direct to care homes and other care providers across the country, distributing over 120 million covid tests to care providers, and vaccinating hundreds of thousands of care home residents and the care workforce. We have been supporting the social care sector to our utmost during the pandemic, and we will introduce our proposals for reform of social care.

[Joy Morrissey (Beaconsfield) (Con)]

May I reiterate the point made by the hon. Member for Wirral West (Margaret Greenwood) about the importance of hospital discharge and of assessment happening while someone remains in hospital? As one who has experienced this at first hand, I know that in taking care of a loved one it is important that accountability and pathway care structures remain in place. Does my hon. Friend agree that the time for action on adult social care reform is now, that we must be bold and courageous, and that we must put an end to the second-class service many disabled adults and elderly people are receiving right now?

[Helen Whately]

It is really important that discharge is carefully planned and that there is care and support at home for somebody when they are discharged from hospital, but it is also really important that we ensure that people are discharged when they are ready to leave. I saw that with my own grandmother, who ended up spending months in hospital owing to problems with her being discharged. Goodness, I wish that she had been discharged sooner—that would have been so much better for her. It is right that we support people to be discharged when they are ready to go home, and we should press ahead with doing that, although we must also ensure that support is there for people in their home.

Stroke: Aftercare

Joy Morrissey Excerpts

Wednesday 21st April 2021 Westminster Hall

[Joy Morrissey (Beaconsfield) (Con)]

I thank my hon. Friend the Member for Bromley and Chislehurst (Sir Robert Neill) for securing the debate and you, Sir Edward, for allowing me to speak. Many hon. Members have spoken so eloquently about the problems of rehabilitation and post-stroke care. I must declare an interest: a close family member had a severe stroke over the last lockdown, and I can only describe the post-rehabilitation care as a hell that I would not wish on anyone. As an educated person, I understand the pathways—we have someone there to advocate full time for this person who has had a severe and debilitating stroke—the care pathways out of hospital, however, are broken.

I cannot praise enough the wonderful doctors and the nurses—Dr Joseph Kwan is an excellent stroke specialist—and I cannot say enough good things about the hospital care we now receive through the NHS and privately; it is wonderful. However, it breaks down in rehabilitation—the post-stroke care. As any doctor, OT or speech and language therapist will say, it is how intensive the rehabilitation efforts are in those crucial months after a stroke that will determine the outcome and recovery. In those first six months, a stroke patient will need intensive speech and language OT, physical therapy and perhaps the recovery of basic skills, depending on the severity of the stroke, but it breaks down as we simply do not have the workforce capacity to manage the needs of our population. It is not the fault of anyone. It is simply that we do not have the skillset at our disposal.

Will the Minister consider meeting me and a Department for Education representative to see whether we can have a strategic recruitment drive, perhaps starting in secondary schools, to encourage young people to go into professions such as occupational therapy, physical therapy and speech and language therapy or to become a district nurse, psychologist or neuro physical therapist? We need that specialist support in so many things, but we simply do not have the qualifications or the workforce available, and yet we have young people interested in science and interested in helping in their local community. What better way, as we are restructuring and bringing new changes to the NHS, to incorporate a recruitment drive that would allow young people to enter these specialist professions? We desperately need people in those professions, to help make the difference between someone dying a terrible and painful death in their home and having the additional support they need for a recovery to make their life liveable.

I praise and pay tribute to all the silent carers of covid, who have been helping their loved ones who have suffered a stroke, and who have had to negotiate through the care pathways alone. I thank them for everything they have done. I thank all the carers and health professionals who have done everything they possibly can during covid to help those who have been suffering in silence in their homes, in out-of-hospital care.

I ask that we look at strategic, long-term recruitment for these professions to meet the needs and demands of England, and that we look at how we can develop a much more joined-up and cohesive post-stroke recovery plan, because where the process also breaks down is where someone who is in a hospital in a local authority is discharged into another local authority, where the care pathway has to pass from one council to another and from one NHS trust to another. It is very difficult to maintain a pathway that delivers and communicates that, even to your GP, so those complex pathways tend to break down at the rehabilitation level. I ask that we look at having a stroke passport that those who have recovered might take with them—a physical copy that they can take to any healthcare professional, so that they can see their records and so that there is a clear understanding of where that survivor has come from. That would ease and speed the process of recovery as new carers take on the rehabilitation of that survivor.

I thank hon. Members for being here today and for considering the complex nature of the debate. I hope that we start an all-party parliamentary group—I would have to join as well—to continue raising this important issue in the House.

Oral Answers to Questions

Joy Morrissey Excerpts

Tuesday 23rd February 2021 Commons Chamber

[Matt Hancock]

We will need to draw many lessons from the pandemic. For instance, my brilliant team who have done all this procurement of PPE have also built an onshore PPE manufacturing capability. With regard to almost all items of PPE, 70% of it is now made onshore in the UK, up from about 2% before the pandemic—likewise for vaccines, where we did not have large-scale vaccine manufacture and we now do, and for a host of other areas, including some of those that the hon. Gentleman mentioned.

[Joy Morrissey (Beaconsfield) (Con) [V]]

With regard to the recent court ruling on the issuing of PPE contracts, will my right hon. Friend confirm that, as a result of the action taken by Health Department officials, NHS trusts did receive vital PPE, despite there being a global shortage?

[Matt Hancock]

My hon. Friend is absolutely right. The court ruling in question found that we were on average 17 days late with the paperwork, but it did not find against any of the individual contracts. My team worked so hard to deliver the PPE that was needed and so, as the National Audit Office has confirmed and as my hon. Friend set out, there was never a point at which there was a national shortage. There were, of course, localised challenges and we were in the situation of a huge increase in global demand, but I think that we should all thank the civil servants who did such a good job.

Covid-19

Joy Morrissey Excerpts

Monday 22nd February 2021 Commons Chamber

[Joy Morrissey (Beaconsfield) (Con) [V]]

I welcome the Government’s decision to prioritise the reopening of schools on 8 March, and that should mean that every child is back in school. According to a study by Co-SPACE and the University of Oxford, there has been overwhelming harm to children from lockdown restrictions and school closures, particularly to their mental health. Child abuse reports to the NSPCC have risen by 79%, and anxiety and depression have increased substantially, as have self-harm, eating disorders and thoughts of suicide, according to the Royal College of Paediatrics, Ofsted and Reachwell. Even when the country was being bombed during world war two, schools remained open. We have no historical precedent for the damaging effect that school closures have had on our children’s education and future.

Since parents have had to shoulder much of the responsibility for teaching during the pandemic, please will the Government commit to consulting representatives of parents’ and children’s groups, as well as teachers and unions, to develop detailed plans for our children to catch up on a lost year of education? Only parents know the full extent of the damage that this lockdown has inflicted on our children, and parents’ voices and parental choice need to be prioritised. We need to be prepared to consider radical options, including summer learning camps and even giving parents the choice to allow their child to repeat the whole academic year.

I urge all MPs to meet parents’ groups—including, for example, UsforThem—to hear about the damaging effects of lockdown and why it is essential for children to return to school. In that parent group, one parent in particular has shared her story with MPs, telling of the emotional and psychological effects the lockdown has had on all her children. She begged MPs to consider the long-term mental health consequences of the lockdown. One of her children developed Tourette’s syndrome in the first lockdown, and this weekend that same child tried to take their own life. They did not want to live in a world under lockdown any more, and at the A&E, the attending physician said that they were seeing an increase in children presenting with mental health disorders during this lockdown. She asked me to share her story today because it is important that parents speak out on behalf of their children and the effects that this lockdown has had.

Depending on the level of trauma, particularly for primary schoolchildren during the pandemic, some children will lose their speech and language ability altogether. We saw this during the first lockdown. Children from every background will be manifesting signs of extreme stress and anxiety upon their return to school, such as obsessive compulsive disorder, eating disorders, anger, aggression and self-harm. I urge that schools in England be given additional funds, ring-fenced, for mental health support for children and for increased levels of teaching staff to help to provide mental and emotional support for children.

Finally, every school I have spoken to during the pandemic has begged the Government and media to stop their negative reporting of the pandemic—

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. I have allowed the hon. Lady to exceed her time in the hope that she was going to conclude, but I am afraid that I have to stop her there.

Covid-19 Update

Joy Morrissey Excerpts

Tuesday 9th February 2021 Commons Chamber

[Joy Morrissey (Beaconsfield) (Con) [V]]

I know that my right hon. Friend is committed to securing our borders. Will he therefore consider commissioning and funding airlines and airports directly to run these new Department of Health and Social Care passenger and border restrictions? Airlines and airports such as BA and Heathrow have the experience, market innovation and incentive to deliver safe travel for Britain. Will my right hon. Friend meet me and representatives from the airline industry so that together we can deliver secure borders but a global Britain?

[Matt Hancock]

That is exactly our goal, and we have been working very hard with the carriers and airport operators to put this new scheme in place. There is further work to do in the days ahead, and no doubt after its initial introduction on Monday. What I would say very directly to my hon. Friend, the airline industry and the airports is that I know this is very difficult and tough. It is absolutely vital that we all work together constructively, positively and with the spirit of innovation that she describes to put in place a robust system that uses all possible technology to ensure that we have the basis of a future safe global travel arrangement. It is about both securing the borders now and ensuring that we can get global travel going for the long term.