Puberty-suppressing Hormones

Julian Lewis Excerpts

Wednesday 11th December 2024 Commons Chamber

[Wes Streeting]

Very heavy consideration—of all the considerations, it is the one that has weighed most heavily. As I said in my statement, trans people too often find themselves at the wrong end of the statistics on mental ill health, self-harm and suicide. I take those issues very seriously indeed.

What I would say to my hon. Friend, Members of this House, and campaigners—particularly online actors—is that a number of claims have been made about the data that are not borne out by the facts. In fact, I asked Professor Louis Appleby, the Government’s suicide prevention adviser, to examine the evidence for some of the claims made that there has been a large rise in suicide. His paper, published on 19 July, concluded as follows:

“The data do not support the claim that there has been a large rise in suicide in young gender dysphoria patients at the Tavistock.

The way that this issue has been discussed on social media has been insensitive, distressing and dangerous, and goes against guidance on safe reporting of suicide.

The claims that have been placed in the public domain do not meet basic standards for statistical evidence.

There is a need to move away from the perception that puberty-blocking drugs are the main marker of non-judgemental acceptance in this area of health care.

We need to ensure high quality data in which everyone has confidence, as the basis of improved safety”.

I would add that it is important that we make sure that these children and young people have access to good-quality mental health support, and I am working with NHS England to make sure that this is the case. This area is one in which all Members should tread carefully when engaging in debate.

[Sir Julian Lewis (New Forest East) (Con)]

I do not think anyone who has listened to the Secretary of State today could be in the slightest doubt about the responsibility that he has borne and the personal empathy that he has injected into his handling of this very difficult question. I personally thank him for it.

I was told a long time ago that one should never ask a question in the House to which one does not already know the answer, but I think I will break the rule this time. What about surgical procedures? One hears about irrevocable steps such as so-called top surgery—the removal of healthy breast tissue from young females. Where does the law stand on that issue at the current time?

[Wes Streeting]

The only thing worse than a Member not knowing the answer to their own question is the Minister not knowing the answer. Happily, in this case, I can say that surgical intervention for trans people does not apply to children and young people.

Cumberlege Review: Pelvic Mesh

Julian Lewis Excerpts

Thursday 5th December 2024 Westminster Hall

[Chris Vince]

I thank the right hon. Gentleman for that useful intervention. Following my meeting with Debbie, two further Harlow residents have come forward who have also been part of this scandal. I have spoken to Members across the House who have constituents with the same issue. More than 600 women came forward to be part of the Cumberlege review and the subsequent Hughes review. This is a huge issue that affects many people.

As many Members will be aware, on 21 February 2018, the then Secretary of State, the right hon. Member for Godalming and Ash (Jeremy Hunt), called for an inquiry. The independent medicines and medical devices safety review, chaired by Baroness Julia Cumberlege, who I am delighted to see here today and whose support I am delighted to have, published the “First Do No Harm” report in July 2020. The report considered two medications and one medical device, but I will focus on pelvic mesh implants, which were used in the surgical repair of pelvic organ prolapse and to manage stress urinary incontinence. It was hugely emotional to hear Debbie’s story—to hear at first hand the huge impact that this issue has had on her life.

In her report, Baroness Cumberlege described the accounts of women who had been affected by this issue as “harrowing”. I think we can all agree that that is absolutely the case. I will not go through the whole review, because that would take too long, but I will just highlight a couple of things said by women who came forward and spoke about the impact that the procedure had had on them.

The women said that there was a

“lack of awareness of who to complain to and how to report adverse events”

and reported

“breakdown of family life; loss of jobs, financial support and sometimes housing”.

However, the situation is even worse than that. The women also spoke about a

“loss of identity and self-worth”.

Sometimes, we fail to recognise the massive connection between physical health, including a physical procedure such as this one, and people’s mental health and wellbeing. The women also reported

“a persistent feeling of guilt”.

Nobody who is a victim of medical negligence should feel guilty about that fact.

[Sir Julian Lewis (New Forest East) (Con)]

I think that often the reason people feel guilt is because they feel that they were not given the necessary information at the beginning and they did not ask for it, but if they had only known, they would not have touched this debatable and deplorable procedure with a bargepole.

[Chris Vince]

I thank the right hon. Gentleman for his intervention and I could not agree more. In the case of Debbie, who I have spoken about, she did not even need the procedure in the first place, but clearly that information was not provided correctly to her. Many women absolutely would not have gone through with the procedure if they had known about the dangers—and, as I say, in Debbie’s case she did not need to go through with it.

The Cumberlege review made a number of recommendations. First, it recommended establishing a separate redress scheme to meet the cost of care and support for people who have experienced avoidable harm caused by the pelvic mesh. It also recommended:

“Networks of specialist centres should be set up to provide comprehensive treatment, care and advice for those affected by implanted mesh”,

and that a database should be created of all patients who received an implant of medical devices, including the pelvic mesh.

The previous Government published their response to those recommendations in July 2021. They did not accept the report’s recommendations about redress. However, in December 2022 they announced that they had asked the Patient Safety Commissioner to explore options for redress, and that project began in the summer of 2023.

On 7 February 2024, the Hughes report was published, setting out recommendations for redress for those harmed by sodium valproate—a medicine used to treat epilepsy—and pelvic mesh. The report calls for the establishment of an independent, two-stage redress scheme to provide both financial and non-financial redress for affected patients.

I realise that I have been talking for quite a long time, Mr Stringer, but I think you appreciate the importance of this subject. I will quickly go through the recommendations of the Hughes report, so the Minister is aware of them. There are quite a few recommendations and they are as follows:

“The government has a responsibility to create an ex-gratia redress scheme providing financial and non-financial redress for those harmed by…pelvic mesh. This scheme should be based on the principles of restorative practice and be co-designed with harmed patients.”

We have seen that throughout this process patients have not had a voice and it is hugely important that they have a voice in finding the solution.

The Hughes report’s recommendations also said:

“Redress should provide all those harmed by pelvic mesh or valproate”—

the other medicine I mentioned—

“with access to non-financial redress. To deliver this, the government should work with other government departments, the healthcare system and local authorities to measurably improve harmed patients’ access to, and experience of, public services.”

Another recommendation was:

“The government should create a two-stage financial redress scheme comprising an Interim Scheme and a Main Scheme… The Interim Scheme should award directly harmed patients a fixed sum by way of financial redress… The Interim Scheme should be followed by a Main Scheme. This would offer more bespoke financial support to directly harmed patients based on their individual circumstances and…those indirectly harmed”.

--- Later in debate ---

[Sir Julian Lewis (New Forest East) (Con)]

Listening to the heartfelt contributions of so many new colleagues, I get the impression that most if not all of them had, like me, never heard of this problem until a constituent walked into their surgery and told them of the terrible experience that they had had.

I have a practical suggestion: at the end of this debate, which will no doubt follow in the footsteps of several previous debates that were equally well informed, passionate and horrifying, we should perhaps put our names to a joint letter to a man called Nick Wallis. He is a freelance journalist who did a wonderful thing: he researched the Post Office Horizon system disaster and wrote a book called “The Great Post Office Scandal”. If I remember correctly, it was serialised for a week on Radio 4, and subsequently he was the consultant to the remarkable production, “Mr Bates vs. The Post Office”. We can have these debates regularly, as we have been doing, and we can upset and horrify each other by recounting our constituents’ pain and the appalling negligence that led to these terrible outcomes, but until the issue grasps the public imagination, I do not think people will get anywhere.

Interestingly, one point that has not been mentioned is the possible responsibility and liability of the large pharmaceutical company that manufactured the mesh in the first place. What research did it undertake? What responsibility does it have? What help can the Government give people who have been irreparably harmed to go after that company for compensation?

There has been one great positive development, which has been referred to several times, and that is the magnificent work of Baroness Cumberlege, who certainly did the whole community of damaged women the best possible service in conducting that excellent review. The question is to what extent will her recommendations be implemented?

I pay tribute in particular to my right hon. Friend the Member for Wetherby and Easingwold (Sir Alec Shelbrooke), who spoke earlier, and the hon. Member for Washington and Gateshead South (Mrs Hodgson), from whom we are about to hear, for their exemplary leadership of the all-party parliamentary group on this terrible disaster and for keeping the flame burning all these years. I say “all these years” because it has been a long time. Looking back on my own website to check my contributions, I see that this is now the fourth full- scale debate in which my colleagues and I have gone over the same ground. If anybody is interested, the dates of the previous three debates, which were packed with testimony and interesting information, were 19 April 2018 —slightly longer ago from now than the entire duration of the second world war—8 July 2021 and 3 February 2022. It would not be appropriate for me to go over in detail what has been said previously, as it is all there on the record, but it is important to recognise that we are talking about thousands and thousands of damaged women—10,000 at the very least, and as we have heard, some estimates put the number as high as 40,000.

Treatment centres have been mentioned, but there is a particular question about who has the skill to practise in the treatment centres. Who will put themselves forward as being appropriately skilled? It will be the very people who inserted the mesh in the first place.

In one of the earlier debates, I cited a constituent who was 35 when she was given what was described to her as “routine surgery”, 16 years before the debate in question took place. I said then:

“She was initially told that it was her fault that her body was rejecting the two mesh implants. She then went through a cycle of implants, the removal of protrusions and eroded segments and seven bouts of surgery. Three TVTs—trans-vaginal tapes—are still inside her, she suffers chronic pain from orbital nerve damage, constantly needs painkillers and has had constant side effects, indifferent treatment and a refusal to admit fault or to refer her to an out-of-area specialist in mesh removal.”—[Official Report, 19 April 2018; Vol. 639, c. 508.]

[Sir Alec Shelbrooke]

My right hon. Friend has just made an important point. He spoke about the removal of protrusions and seven surgeries. That almost puts a gloss on what has happened. We have all heard from women who have had the surgery and the experience of many of them is that they have been butchered. It is important to make that clear in this debate, especially for new Members, because we have discussed this in Parliament before: when we think of surgery, we think of any other normal surgery, but this surgery leaves huge amounts of scar tissue and has butchered women in ways that I will not go into now. That must be recognised when we describe some of the remedials that have happened, mainly because those carrying them out do not really know what they are doing at this stage.

[Sir Julian Lewis]

Exactly right. That is why my constituent said at the time, “I do not want anyone from the hospital coming near me ever again. I have lost complete faith in them. I have been lied to and told repeatedly that it was my body rejecting the mesh. But unbelievably they kept putting more in.”

Over this period of six or more years I have probably tabled about 12 or 15 questions for written answer, obviously to a previous Government. I will quote three, which were all in the aftermath of the Cumberlege report. In June 2021—for the benefit of Hansard it was question 16777—I asked the Secretary of State for Health and Social Care

“what checks his Department carried out to ensure that surgeons awarded NHS contracts for the removal of failed vaginal mesh implants had not previously been responsible for (a) originally implanting them, and subsequently (b) denying that anything had gone wrong with them; and whether any personnel awarded NHS contracts to work at mesh remediation specialist centres are known by his Department to be currently facing legal proceedings for implanting mesh which injured women who are now seeking its removal at such centres.”

The answer, which came from the then Minister of State, read:

“It is the responsibility of the employing organisations”—

presumably the NHS—

“to ensure that the staff undertaking mesh implantation and/or dealing with mesh complications are qualified and competent to do so. NHS England’s procurement process to identify the specialist centres to deal with the complications of mesh considered a range of clinical and service quality issues. No assessment was undertaken regarding National Health Service contracts or staff facing legal proceedings.”

Somebody in the process of suing a surgeon but still needing ongoing care may have no other option but to go to a mesh centre headed up by—guess who?—the surgeon who she is suing because he damaged her in the first place.

The second written question I will refer to was in July 2021—question No. 31274—which read:

“To ask the Secretary of State for Health and Social Care, with reference to the debate on the Independent Medicines and Medical Devices Safety Review on 8 July 2021…what steps he plans to take to research new and improved techniques for removal of eroded surgical mesh implants.”

As we have heard, it is intolerably difficult to remove this stuff. One would think that the very least the NHS could do would be to make a dedicated effort to develop new techniques for doing it. The description of it being like removing hair from chewing gum is vivid. I have sometimes speculated—I am not in any way qualified to do so—that maybe the answer to this might be to develop some sort of technique that could harmlessly dissolve the material and let it be gradually flushed away, rather than physically trying to disentangle it with the risk of doing more damage. That may be completely and utterly impracticable, but my point is that we do not know because no proper national effort is being made to find a way in which this disaster can be, to some extent, effectively rectified without harming the victims further.

[Anna Dixon]

I think the right hon. Gentleman makes a very valid point. Obviously, from my professional background, I see myself as fairly well-informed, but the scale of the damage done by this particular implant—the pelvic mesh—is also a shock to me. It is really timely that new Members are made aware of this issue. Hopefully, we can support any efforts to continue to raise it, and I commend Members who have been in this place for longer on their work to date.

I hope that the Minister will reflect on the specific point about research. As someone with a research background, I absolutely agree with you—I am sorry, Mr Stringer; I meant the right hon. Gentleman—that more effort needs to be put into research, not only on how we might treat such cases in future, but on the remedial effect.

[Graham Stringer (in the Chair)]

I thank the hon. Lady for correcting herself and acknowledging that “you” refers to the Chair. I also remind all hon. Members that interventions should be brief and to the point.

[Sir Julian Lewis]

That being said, Mr Stringer, I am absolutely delighted that the hon. Lady made that intervention. When someone of her expertise and experience says that even she had not realised the scale of this issue, it shows the magnitude of the task that faces us. This is every bit as bad as we heard in the excellent introduction from the hon. Member for Harlow (Chris Vince)—I apologise for not paying tribute to him earlier. He has done us all a great service by bringing this debate to Westminster Hall. This is on a level with the infected blood disaster, and it deserves the same level of treatment and remediation in so far as that is possible.

Reverting to the written question I asked, the Minister of the State at the time answered:

“There are no current studies specifically relating to new and improved techniques for the removal of eroded surgical mesh. However, there are five studies ongoing on surgical mesh implants and the National Institute for Health Research welcomes funding applications for research into any aspect of human health, including on the removal or implantation of vaginal mesh. There are currently no plans to establish a unit in order to train mesh removal specialists.”

I want to quote a third and final written question of those 15. Question 124936, from February 2022, stated:

“To ask the Secretary of State for Health and Social Care, what recent progress has been made in establishing the South East Regional specialist centre for the treatment of women damaged by mesh implants; and whether checks will be carried out to ensure that such women, when seeking remedial treatment from that specialist centre, are not placed in the hands of surgeons who were responsible for (a) implanting the mesh originally, (b) denying that anything had gone wrong with the implants and (c) claiming that women reporting extreme physical pain from the implants were imagining it.”

After a fairly long paragraph in reply, the answer concluded:

“Patients can discuss their choice of surgeon with the multi-disciplinary team if they have concerns regarding a specific clinician and can also discuss a referral to a surgeon in another specialist mesh centre.”

Think of the conversation that would require. A patient would have to explain to the person who had—to quote my right hon. Friend the Member for Wetherby and Easingwold—“butchered” them that, because they did not want to have his or her ministrations any further, they wanted to be referred to somebody else a long way away. Good luck with all that.

I will briefly touch on some points raised by people in the community of damaged women. I have been told about difficulties regarding personal independence payment applications. It has been suggested that staff managing PIP applications and renewals need better training and understanding of mesh injury. There has been some progress, apparently, in the gradual acceptance that many women had not given informed consent at the beginning, and this is perhaps beginning to make itself felt in relation to the legal actions that some people are undertaking. Just imagine being in constant pain and having the burden of undertaking those legal actions.

There is concern that mesh removal centres do not seem to have the same approach across the board for treatment or surgery. There are also very lengthy waiting lists if someone opts for a second opinion, for the reason I have already explained or any other reason. Mental health support and counselling is not readily available, which is another gap. We have already heard an excellent contribution by the hon. Member for Shipley (Anna Dixon) noting that the 10-year limitation for legal action on medical devices needs to be reviewed, because by the time some women have confirmation that the mesh is the problem, the 10 years could well have passed.

I have already mentioned that the Government ought to be looking to assist the legal cases against the pharmaceutical company or companies. It would be interesting to know whether the Government are making any progress on the subject of interim payments, which I believe the Cumberlege report recommended prior to any more bespoke payments based on individual circumstances. Will the Government encourage the yellow card Medicines and Healthcare products Regulatory Agency reporting to be made mandatory? If people are not reporting in when these things go wrong, how can we be sure of the scale of the problem? Finally, it is noted that there is a clear need for transparency for the public to be aware of exactly what payments medical professionals in the health sector receive from the pharmaceutical industry when they recommend these “routine procedures” that so often go wrong.

I conclude with a case that I have deliberately anonymised. Nothing should be drawn from where I happen to represent as to which surgeon in which mesh centre I might be referring to. This is what one victim has said about someone I will call surgeon X. He

“operated on me in 2009 to insert the mesh, which was described as a simple procedure that would solve my problems. Mesh was eroding through the vaginal wall immediately, and I had seven further ‘repair’ surgeries, which did not solve the erosion problem. In 2016, he advised me he could remove the mesh, so I paid privately for the surgery. During the surgery, nerves were damaged, causing severe pain and limitations, and the mesh was not all removed. I am left with the pain and limitations permanently, and have been told by another surgeon that full removal is now not possible. This surgeon is the clinical lead of the mesh centre”

local to her. She concludes:

“No surgeon should ever be allowed to cause damage to multiple patients, yet not only continue to perform the same surgeries, but to be head of the very centre which should be helping women. I feel sick at the thought of passing him in the street, let alone needing to see him as a health professional. I am sure we all feel the same.”

Tobacco and Vapes Bill

Julian Lewis Excerpts

2nd reading
Tuesday 26th November 2024 Commons Chamber

[Wes Streeting]

We want to work in a genuinely collaborative and cross-party way, and I know that is true right across the House. As I look at the Opposition Benches, including Conservative Benches, I see long-standing campaigners for action on smoking and vaping. We want to listen and engage.

I feel strongly about the matter, as does the Prime Minister. In our manifesto, we set out Labour’s mission to improve the health of the nation. We will be far better served as a country if this is a truly national mission, and if we come together in common cause for action on public health.

[Sir Julian Lewis (New Forest East) (Con)]

rose—

[Wes Streeting]

In that spirit, I will give way to the hon. Gentleman—and then to some of my hon. Friends.

[Sir Julian Lewis (New Forest East) (Con)]

Can the Secretary of State tell us if there is any place for vapes as a step-down, in the context of the addictive aspects of tobacco? I seem to remember that when vaping first came along, it was heralded as a way to help wean people from their tobacco addictions. Sadly, it has turned into something else, as he describes, and starts children on the road towards nicotine addiction, but does it have a role as a step-down?

[Wes Streeting]

The right hon. Member is right to make that distinction. As a stop-smoking tool, vaping has a part to play. For smokers, vaping is a better alternative—a route away from smoking. We do not want to throw the baby out with the bathwater. What we are interested in tackling is the scourge of youth vaping and the extent to which young people have been cynically addicted. It is important to say that we do not yet know the full extent of the harms caused by vaping, but we do know two things: first, it is better to vape than to smoke—that is why we are striking the balance in this legislation—and secondly, vapes are harmful. Ask any teacher in the country; they will talk about the signs of nicotine addiction that they see in their pupils, and about having to monitor school toilets to stop children congregating to vape. It is urgent and necessary to act today to protect this generation of kids from a new addiction, and that is exactly what we will do.

Infected Blood Inquiry

Julian Lewis Excerpts

Tuesday 19th November 2024 Commons Chamber

[Andrew Gwynne]

I can give my hon. Friend and Brendan the commitment that we will do just that, to reassure those who rightly have lost all trust in public authorities, and particularly in my Department, because of the dreadful actions that led to their infection. She has my assurance that we will do what we can to reassure Brendan and many others like him who rightly have no trust left in us that we will rebuild that trust.

[Sir Julian Lewis (New Forest East) (Con)]

I am sorry not to have been here for the opening speeches. Does the Minister recognise the fundamental similarity between the way in which the victims of this scandal and those of the Post Office scandal, and no doubt other terrible scandals, were treated by the state? Does the Government have any plan, possibly on a cross-departmental basis, to try to educate the bureaucracy that when terribly difficult and potentially expensive things like this crop up, they should not follow this well-worn path of denial and cover-up?

[Andrew Gwynne]

The right hon. Gentleman raises an important point. Indeed, it was acknowledged by my right hon. Friend the Paymaster General and Minister for the Cabinet Office in his opening speech that this is just one of a number of scandals that follow a similar pattern—when the scandal has been uncovered, rather than trying to protect the victim, the state has tried to protect itself. It is absolutely crucial that the state learns not just from each individual scandal, but collectively; that it is the same mindset that has led us to all these different scandals with similar outcomes for victims. That level of learning has to be genuinely across Government, and I know my right hon. Friend will lead on that in the Cabinet Office.

The Government will set out our formal response before the end of the year, but given that there is absolutely no time to waste, I want to take this opportunity to update the House on the work already under way to address some of the inquiry’s recommendations. To prevent future harm, the Department continues to explore options to enhance candour and openness across the national health service. To empower patient voices, the NHS is reviewing clinical audits related to haemophilia services to identify any gaps in patient involvement, alongside work on a new clinical service specification, which will set standards for services across England. To protect haemophiliacs, the NHS has convened an expert group to hear advice from the specialised blood disorders clinical reference group. A dedicated taskforce has been set up to consider its recommendations. The General Medical Council is working with NHS England and others to look at ways to ensure that lessons learned are reflected in training for doctors, nurses and other healthcare professionals.

Let me be clear to the House: the Government do not see this scandal in isolation. Sadly, repeated patient safety failings have eroded public confidence in our health and social care system, so we are taking steps to fix the culture of the national health service. My right hon. Friend the Secretary of State for Health and Social Care has been clear that we will not tolerate NHS managers who silence whistleblowers. Openness and honesty are vital to ensuring patient safety. NHS staff must have the confidence to speak out and come forward if they have concerns. There will be no more turning a blind eye to failure.

Our wider reforms to NHS performance will provide greater transparency for the public who pay for it. Measures will ensure that top talent is attracted to the most challenged areas, and persistently failing managers will be sacked. That is about ensuring that the right people are in post to lead our NHS with the resources they need to do their job. If we get that right, we will be able to look back on this moment as a turning point for patient safety and for leadership.

NHS Strikes

Julian Lewis Excerpts

Monday 17th April 2023 Commons Chamber

[Steve Barclay]

It perhaps will not surprise the House to hear that the hon. Gentleman disagrees with his party’s leader on that, because the Leader of the Opposition says:

“I don’t think 35% is affordable”.

The hon. Member for Leeds East (Richard Burgon) is also wrong on the quantum, because the cost would be £2 billion, not £1 billion as he says. [Interruption.] Well, that has never been how departmental budgets operate—not when his party was in power, and certainly not now. He is wrong on the amount and wrong on the policy.

[Sir Julian Lewis (New Forest East) (Con)]

Given that the terms “emergency care” and “intensive care” imply that the life of those who need them is at risk, does my right hon. Friend share my dismay that people in that predicament are now clearly being targeted by strikers? Will he—and hopefully his Opposition counterpart—represent to the medical unions that whatever other strike action they take, they should not endanger the life of people in emergency or intensive care?

[Steve Barclay]

My right hon. Friend makes an extremely important point. Patient safety should come first for all parties in this dispute. That is why I urge the Royal College of Nursing to wait for the NHS Staff Council decision on the offer. Voting is still ongoing, and it would be premature to announce strike action ahead of that decision.

Urgent and Emergency Care Recovery Plan

Julian Lewis Excerpts

Monday 30th January 2023 Commons Chamber

[Steve Barclay]

As I said, we are not setting out that ambition in this statement, because the impact of the pandemic has been so severe. We need to set a target that is ambitious but achievable, which is what we have done. The president of the Royal College of Emergency Medicine said:

“This plan is a welcome and significant step on the road to recovery and we are pleased to see it released.”

It is about taking best practice from the areas that are working and ensuring that they are socialised across the piece. It is obviously concerning to hear about individual cases, such as the specific one that the hon. Lady mentioned, which are very traumatic for the families. That is why we have set out this plan and why we are putting in the extra funding.

[Sir Julian Lewis (New Forest East) (Con)]

From 2005 to 2006, there was a campaign within the NHS to close many in-patient beds in community hospitals. I was pleased by what the Secretary of State said earlier about beds in community hospitals having a role to play. In that connection, will he reconsider the future of the site of Fenwick Hospital in Lyndhurst in my constituency, where the in-patient beds were closed? The NHS is now proposing to sell it off, but I would have thought that, with a bit of imagination, such a site could increase capacity.

[Steve Barclay]

We are encouraging integrated care boards to take ownership of individual decisions, rather than trying to make all the decisions centrally from Westminster, so that those closer to the ground and to the issues are in power to make the trade-offs. I am sure my right hon. Friend will want to have those discussions with the chair and chief executive of his ICB. There is a wider issue of how we make greater use of community sites, not least given the workforce pressures and different staffing ratios that they have, and that is absolutely the way we help to get more people out of hospital who are fit to leave.

NHS Winter Pressures

Julian Lewis Excerpts

Monday 9th January 2023 Commons Chamber

[Steve Barclay]

That simply is not accurate. Let me give the hon. Lady some specific examples. Under the auxiliary contract with St John Ambulance, we invested an extra £150 million in the ambulance service, and we invested a further £50 million in additional capacity for call centres. Taxpayers spent £800 million on the new Royal Liverpool Hospital, and during 2018-19 a brand-new hospital was built at Aintree. However, this is not simply about investing in new hospitals; it is also about looking at the integration between health and care, and that was recognised in the autumn statement, which provided an additional £500 million. It is simply inaccurate to say that there were no measures in the summer. The St John Ambulance contract and the community first responders, and the service for frail and elderly people, will help with demand management and prevent people from going to emergency departments in the first place.

[Sir Julian Lewis (New Forest East) (Con)]

Do the Government recognise the danger of a major increase in pressure on the NHS as a result of any new variant of covid that may be imported from China? How quickly would we be able to identify such a variant and prepare a vaccine against it?

[Steve Barclay]

Let me first congratulate my right hon. Friend—along with the whole House, I am sure—on the knighthood that he received from His Majesty.

According to the analysis we have received, the variant in China is the same as the one in the United Kingdom. On the other hand, the data shared by China is often not as clear as we would like. That is why, over the Christmas period, my right hon. Friends the Prime Minister and the Secretary of State for Transport announced proportionate measures involving covid tests for travellers and, in particular, sequence variant testing for those coming into the UK, in order to identify any new variant quickly.

NHS Industrial Action: Government Preparations

Julian Lewis Excerpts

Monday 12th December 2022 Commons Chamber

[Will Quince]

The hon. Lady is right that this issue is about more than just pay. That is what the unions are telling us. It is about things such as staffing levels and working conditions. If that is indeed the case, let me repeat: my door is always open, and I would be happy, as would the Secretary of State, to discuss those issues with the unions at any point they would like.

[Dr Julian Lewis (New Forest East) (Con)]

Would there not be more money available for relatively poorly paid frontline NHS staff if there were fewer layers of management bureaucracy paid at substantially higher rates within the NHS?

[Will Quince]

I thank my right hon. Friend for that question. I am sometimes staggered by the number of people on six-figure salaries within our NHS, but in an organisation of its size, management is also important. It is about getting the balance right, but we always continue—[Interruption.] The hon. Member for Ilford North (Wes Streeting) chunters from a sedentary position. The balance may not be right, and we always continue to look at the ratio of management to frontline staff to make sure we are getting that right.

Urgent and Emergency Care

Julian Lewis Excerpts

Monday 5th September 2022 Commons Chamber

[Steve Barclay]

This obviously involves debates with Treasury colleagues about pay—not just on the social care side, but in respect of the NHS and the interplay with pensions—but it is not just about that; it is also about ensuring that we have the right data, and through the integrated care systems we are acquiring much better data to improve our ability to join up what is being spent on delayed discharge within the NHS with what is being done in the social care setting. I am sure Members will agree that not only is it often very damaging for frail elderly patients to spend a long time in hospital, but hospital is usually the most expensive place in the system for them to be. It is not just a question of having more money, although that is often the default; it is a question of thinking about how to get flow into the system in a way that will deliver not only patient care, but a more efficient service.

[Dr Julian Lewis (New Forest East) (Con)]

On checking my website, I saw that it was in late 2005—not a period of Conservative government—that my right hon. Friend the Member for New Forest West (Sir Desmond Swayne), the then Liberal Democrat Member of Parliament for Romsey and I were complaining about the closure of in-patient beds in small community hospitals. Does the Secretary of State accept that there is a role for such beds in enabling appropriate discharge from the larger hospitals, thus dealing with one of the main causes of people being stuck in ambulances without being able to be given a bed?

[Steve Barclay]

That, I think, relates to the point that I just made about the need for flow in the system and an appropriate step-down capacity. Sometimes patients are not yet ready to be discharged to their homes, but some additional physio or other support may enable them then to go home, which is where they usually want to be. This is all part of taking a much more integrated approach, and part of that must be improving the quality of data in relation to the activity that takes place within community settings.

North East Ambulance Service

Julian Lewis Excerpts

Monday 23rd May 2022 Commons Chamber

[Maria Caulfield]

I would like to hear more from the hon. Gentleman about his constituent’s case. I have concerns about what was reported in The Sunday Times. I am concerned that the process followed in investigating those concerns has not got to the bottom of some of the fundamental problems, so if he would like to meet me afterwards I would be very happy to take it further.

[Dr Julian Lewis (New Forest East) (Con)]

When senior managers and administrators are found to be directly involved in gross negligence and deliberate cover-ups, will they lose their jobs or will they be allowed to continue?

[Maria Caulfield]

A statutory duty of candour is in place. As I said, if a mistake happens—mistakes can always happen, even with the best prevention methods in the world—there is a statutory duty to reveal it to the family and the patient involved, and to have a full investigation and learn lessons from it. I am concerned that that may not have happened in this case.