Government Action on Suicide Prevention

Kerry McCarthy Excerpts

Wednesday 8th June 2022 Westminster Hall

[Kerry McCarthy (Bristol East) (Lab)]

I beg to move,

That this House has considered Government action on suicide prevention.

As always, it is a pleasure to see you in the Chair, Mr Bone.

Three weeks ago today, I hosted an event on mental health and suicide prevention in Speaker’s House. We heard from two members of the band Joy Division/New Order because the event took place on the 42nd anniversary of the death by suicide of the singer, Ian Curtis. I want to take this opportunity to thank Stephen and Bernard from the band for coming along, because if it had been just me speaking about this subject, not as many people would have listened, although I am sure a mass audience is hanging on to my every word today.

At the event, we also heard from Simon Gunning, chief executive officer of Campaign Against Living Miserably, or CALM, whom I thank for meeting me yesterday in advance of the debate. I also thank Mr Speaker, who spoke movingly about his daughter’s suicide and the recent loss of his brother-in-law. We also heard from the leader of the Labour party and the Minister. I thank the Minister for speaking at the event, but I hope she will forgive me for seizing the opportunity of securing today’s debate to press her further on some of the issues we discussed then. It is good to talk, but it is even better to see action.

I am sure the Minister will remind us that the Government are consulting on their 10-year mental health plan, which will also be used to inform a refreshed national suicide prevention plan—the previous one is 10 years old. I am a little concerned that the issue is being bundled up within the one consultation and that there are only passing references to suicide in the consultation overview, which is what most people will read. In fact, suicide is not mentioned at all in the chapter on crisis, which is where I would most expect to find it, and people have to go to the mental health and wellbeing plan discussion paper to find any detail. I hope that that does not mean that suicide is being treated as an afterthought.

We are told that the details of the suicide prevention plan will be set out in due course, but given that suicidality is recognised by the Government as needing its own separate strategy, I do not understand why it does not warrant its own consultation. The latest coroners’ statistics show that deaths by suicide are at a record high, and it is obvious that the Government have not met their target of reducing suicide by 10%. Clearly, a better strategy is needed.

I accept that setting any kind of target is complex. We saw a spike in suicides after the 2008 financial crash; we are now emerging from a pandemic that has taken a terrible toll on people’s mental health and the cost of living crisis is starting to bite. A lot of factors are not in the Minister’s control, but as is often said, what is measured is what gets done, so there has to be something to aim for. To help us to get there, several organisations have raised with me the need for real-time data. The Government are developing a national real-time suicide surveillance system, so perhaps the Minister will update us on progress with that.

As the British Psychological Society has explained, suicidal behaviour cannot be understood from any one perspective alone. Suicidality is best explained as a complex interplay between risk factors across domains. Not everyone who experiences bereavement or relationship breakdown, or who is under massive pressure at work or is struggling financially, will feel suicidal. There is often an accumulation of pressures and events, sometimes stretching back to adverse childhood experiences and exacerbated by adult trauma, although sometimes it is just that something bad has happened.

It is difficult to unpick all that, but Professor Louis Appleby has suggested some priority areas for the suicide prevention plan: where rates are high, such as among middle-aged men; where rates are rising, even if they are quite low, which relates to children and young people; where there is proximity to prevention, such as among current mental health patients; and where there is public concern, such as for university students. Professor Appleby also suggests, for political reasons, that the north should be a priority. That might also be because he is based at Manchester University and he is perhaps pushing his home turf, but as part of levelling up. Economic aspects such as poverty and unemployment can be big factors.

[Paul Blomfield (Sheffield Central) (Lab)]

In 2017, my constituent Jack Ritchie took his life at the age of 24 as a result of gambling addiction. I am pleased that his mother and father are in the Gallery with us today. It is estimated that there are more than 400 gambling-related suicides each year. The national suicide prevention strategy recognises high-risk groups, and my hon. Friend has highlighted the comments from Professor Appleby. Does she agree that as gambling-related suicides account for almost 8% of all suicides that group should be recognised in future strategies as high risk?

[Kerry McCarthy]

I thank my hon. Friend for his intervention. I know there was a very good debate in this Chamber yesterday morning, which unfortunately I could not attend, where such issues were raised. There are some discrete areas where a specific intervention suggests itself, such as gambling addiction, alcohol abuse, post-natal depression, or veterans’ mental health. I certainly feel that such risk factors ought to be reflected in the suicide prevention plan.

A quick win would be to obstruct people from accessing the means to die by suicide, with obstacles placed in their way. A lot of suicides are opportunistic. For example, the British Transport Police is very good in terms of how it polices stations and watches out for signs that somebody might be thinking of jumping in front of a train, and helplines can be flagged up at places such as the Humber bridge and the Clifton suspension bridge, but there are also physical measures that would make suicide more difficult. People might say, “Well, perhaps people will just go somewhere else,” but it does not always happen like that. If the moment is lost, there is a good chance a life will be saved.

Will the Minister tell us a little bit about the plans for the revised suicide prevention plan? Will it have clear priorities, with an evidence-based, tailored plan in each case for how we will bring rates down, and then targets set on that basis? One organisation described the current approach as very much a “throw everything at the wall and hope something sticks” approach. We need a far more tailored approach.

Will the Minister also tell us where the boundary falls between what is in the remit of the Department of Health and Social Care and work that requires action by other Departments? We have already talked about gambling, and the debate yesterday was answered by the Under-Secretary of State for Digital, Culture, Media and Sport, the hon. Member for Mid Worcestershire (Nigel Huddleston). The Online Safety Bill is another example of where another Department is taking the lead, and I am worried that the Government will not fully seize that opportunity to crack down on sites promoting suicide and self-harm. I gather there is a bit of a difference of opinion between the two Departments, which is particularly disappointing given that the current Secretary of State for Digital, Culture, Media and Sport, the right hon. Member for Mid Bedfordshire (Ms Dorries), was the first Minister for Suicide Prevention. Does the Minister agree that we need to strengthen the Bill’s provisions on this issue, or has she lost the battle with the Secretary of State for Health and Social Care? I hope not, and I hope that, if the Bill is not strengthened in Committee, we can improve it on Report.

The review of special educational needs and disability is another potential missed opportunity. It is meant to be a joint effort by the Department for Education and the Department of Health and Social Care—there is a joint foreword—but there is very little in it on child and adolescent mental health services. Given the overlap between children struggling at school who cannot get the right diagnosis and cannot get a timely education, health and care plan and children who end up in the mental health system, joint working is really important.

Obviously, it is not just children with SEND who struggle. One in six children are now said to have a probable mental health condition, up from one in nine in 2017. More than 400,000 under-18s were referred for specialist mental health care between April and October last year. These are children at the more severe end of the spectrum—those who presented with suicidal thoughts, self-harming or eating disorders. The number of attendances at A&E by young people with a diagnosed psychiatric condition has tripled since 2010.

We know that CAMHS is at breaking point. There are huge waiting lists, and severely mentally ill children are being cared for in inappropriate settings or being sent hundreds of miles away from home for treatment. It is said that half of all mental health problems are established by the age of 14, rising to 75% by the age of 24. If we do not want today’s children to be tomorrow’s suicide statistics, we need to do much more, much faster, to help them now, and I just do not see that sense of urgency from the Government. This consultation is all wrapped up in a 10-year plan, but we need a 10-day plan. We need action now.

One issue we discussed at the event in Speaker’s House was how schools could better nurture children’s creativity and give them an outlet for their emotions through music and art. We also talked about whether the current trajectory of education, with schools very focused on grades—someone described them as “exam factories”—places undue pressure on children. I agree with that to a large extent and worry about cuts to things like music education, which mean that creatively inclined children do not have that outlet. It is not plain sailing for the other 50%, the academic ones, either. Just because a child does well in education does not mean that they are set up for success in the wider world, whether that means higher education or the world of work.

I am sad to say, as a Bristol MP, that Bristol University has become known for the number of student suicides in recent years. It is obviously not the only university to have experienced this, but it has come to particular attention. There needs to be a constant process of reflection and review. We have just had the court ruling in the tragic case of Natasha Abrahart. She was a very able student at Bristol University, but she suffered terribly from social anxiety and just could not handle the oral side of her course and having to do presentations. Rather than trying to force all young people into one model of what success and achievement look like, institutions need to adapt to them. I hope that Natasha’s parents will be able to pursue their campaign to ensure that that happens in the future.

I have also spoken to various groups about data sharing, which I appreciate is a complicated area. When should parents of university students, who are adults, after all, be informed? What are the boundaries of patient confidentiality? Some students might be deterred from speaking to mental health services at uni if they think that their parents might be told, particularly if they are grappling with something like their sexuality or if they have become involved with drugs. There are all sorts of things that young people would not want their parents to know about. Some might come from abusive family backgrounds and their parents would not be helpful or supportive, but in many cases the parents would have desperately wanted to know that their child was struggling to the extent that they were.

Steve Mallen from the Zero Suicide Alliance thinks that more could be done within data protection laws to protect students, and I hope that that is under active consideration.

[Dan Carden (Liverpool, Walton) (Lab)]

I was at the Speaker’s House reception, and one of the most shocking things I heard was that two thirds of people who commit suicide have never sought any support for their mental health. What does my hon. Friend think are the consequences of that, and how should we be trying to deal with it? I think that we need to ensure that we have a holistic approach that offers support, because we all have mental health needs; we all need support. What does she think?

[Kerry McCarthy]

I thank my hon. Friend and agree with him, but I have some reservations about going down that path. A lot of the conversation about mental health in recent years has focused on the importance of getting people to open up and talk about their problems, and an obstacle in the way of doing that is that it can be very difficult for people to access GP appointments or to get the help that they need. I very much support Labour’s policy of publicly accessible mental health hubs in every community, as well as mental health support in every school. There needs to be swift and easy access to talking therapies or even to something less formal—just to someone who will sit there and be prepared to talk to the person. There is also campaigning to try to get people just to ask others how they are feeling, and that would help. I am a bit worried because there is a danger that we will focus totally on the softer end of things and talk a lot less about the more difficult areas, where people are well past the point where a nice cup of tea and a friendly chat would make a difference. At the moment, there certainly seems to be a huge problem where people are considered to be past the point where talking therapies would help. It might be that they are too high risk or too unwell to benefit from primary mental health services but not quite ill enough to access secondary services, such as the community mental health teams; they are not totally at crisis point. Often, they are left to fester somewhere in the middle, and when they reach crisis point, they finally get help, but that is too late in many cases to actually turn their mental health around. Too many people fall by the wayside because the right pathway is not available.

Currently, 40% of patients waiting for mental health treatment are forced to contact emergency or crisis services before they receive treatment. One in 10 of them ends up in A&E, and I have real concerns about whether A&E is appropriate, particularly if someone has experienced psychotic episodes. I cannot think of anything worse for them than being in an A&E department, with the sirens, flashing lights and people who have probably turned up there because they have drunk far too much or are off their heads on something or other and have got into fights on a Saturday night. Some hospital trusts are experimenting with trying to triage people very quickly away to mental health provision in A&E, which I think is a very good move.

We have waited a long time for the Government to bring forward the mental health reforms outlined in the Queen’s Speech. We are right to be concerned about the misuse of powers under the Mental Health Act 1983. We have heard terrible stories of people with autism being detained long term against their will, and the disproportionate use of those powers against people from ethnic minority backgrounds, particularly young black men. I hope that, as part of that debate, we can also talk about how the system fails people who do need to be in hospital, whether by voluntary admission or being sectioned, because a lot of people would benefit.

We see people on the streets talking to themselves, heads bowed, and everybody side-steps them. Sitting on public transport next to someone who is clearly unwell can be uncomfortable. If people have physical health problems, the expectation is that the health service is there to treat them. I know there is a question of capacity and whether people consent to treatment, but I feel we write people off when their mental health reaches a certain state, unless it gets so bad that they are a danger to themselves or others. The system needs to gear up to help people who are broken to that extent. It might not be possible to fix them, but their lives could be made better.

The number of beds in NHS mental health hospitals has fallen by a quarter since 2010, with almost 6,000 beds lost in England alone, despite big increases in the number of people needing mental health support, and cases where people are sectioned under the Mental Health Act. Figures obtained through freedom of information requests show that on a single day in February this year, all of England’s high and medium-security hospitals were operating above the Royal College of Psychiatrists’ maximum bed occupancy rate of 85%. The NHS pays £2 billion a year to private hospitals for mental health beds because it does not have enough of its own. Nine out of 10 mental health beds run by private operators are occupied by NHS patients.

It was also revealed last month, again through FOI requests, that over a five-year period from 2016 to 2021, more than half of the 5,403 prisoners in England assessed by prison-based psychiatrists as requiring hospitalisation were not transferred from prison to hospital. Those were not people with what might be called run-of-the-mill mental health concerns; they had major psychotic illnesses or chronic personality disorders. They needed to be in hospital, not in prison, but they did not get those transfers. We can only speculate on the problems that might store up for the future.

Where there are hospital beds, the pressures on the wards and staff are immense. There are way too many tragic stories of patients being discharged too soon, being wrongly assessed as low risk, and not getting the help they needed, with inevitable results. For example, 22-year-old Zoe Wilson died at Callington Road hospital in my constituency in 2019. She was put on a low-risk ward, despite ongoing psychosis. In January this year, the inquest jury returned a narrative conclusion, having found that multiple failings contributed to her death. The prevention of future deaths reports—the regulation 28 reports—published with the latest coroners’ statistics, make very grim reading. So many of the reports point to failings such as those noted in Zoe Wilson’s case.

I am not convinced that lessons will be learned from these reports, because what is required in many cases is not actions by individual hospital trusts. I should explain what happens. The coroner notes that an institution—a university, or any organisation that might have had contact with the person prior to their death—should learn a lesson and do something in future to try to save a life. Those comments are usually directed at a hospital trust or another organisation, but I would like to know what notice the Government take. Patterns showing where there are failings in the system emerge in these reports. I would be reassured if I felt that, rather than just informing the actions of an individual institution, the reports also informed future suicide-prevention strategy. I am sure the Minister will tell us how much more is being devoted to mental health spending, but we need to acknowledge the simple fact that, despite any figures she might produce today, our mental health services are drastically underfunded, under-resourced and under-staffed, which is why they are at crisis point.

I want to finish today by paying tribute to people who have spoken up about their own family experiences, as Mr Speaker did at the event in Parliament. He spoke so powerfully, because he was clearly very upset about what had happened. I, too, lost someone to suicide last year, as many other people will have, including people who are listening today. I started off by talking about how Bernard and Stephen from Joy Division/New Order came to speak about how, even 42 years later, they are still affected by the death of their singer Ian Curtis. Another musical genius and a musical hero of mine, David Berman, took his own life a few years ago. His last album, “Purple Mountains”, was basically a suicide note. He can be very funny at times—he has this real lyrical genius—but listening back to the album now, you can see where he is going. He suffered from depression for a long time, and he has this song, “Nights That Won’t Happen”, which says,

“The dead know what they’re doing when they leave this world behind…

When the dying’s finally done and the suffering subsides

All the suffering gets done by the ones we leave behind.”

I will finish on that note, because that is very true. He felt that he was escaping from something. He escaped from it, but I hope that support services for people who have recently been bereaved by suicide is at the top of the Minister’s agenda, because those are the people who really need it.

--- Later in debate ---

[Gillian Keegan]

The hon. Gentleman has my assurance that I will definitely work cross-Government, with the Under-Secretary of State for Digital, Culture, Media and Sport, my hon. Friend the Member for Mid Worcestershire (Nigel Huddleston) who actually sits in the office next door to me—he finds it very difficult to escape. I think that answers the questions from the hon. Member for Bristol East about whether there are ongoing conversations, which will also continue into the future.

I am happy to visit Paul’s Place. As the hon. Member for Liverpool, Walton (Dan Carden) knows, I am often back in Liverpool, visiting my parents and friends. The first visit I made in this role was actually to James’ Place, also in Liverpool, which was set up by a constituent of mine, Clare Milford Haven, who set up the charity after the tragic death of her son, James. We met in Liverpool, but she was a constituent of mine down in Chichester. Every time I go to one of these places, I learn—every time. There are so many families trying to help the next family avoid the tragedy of losing a loved one.

I also met Tim, Mike and Andy—the 3 Dads Walking. They have done a fantastic job, walking round the whole country. They came to tell me the stories of their three daughters, Sophie, Beth and Emily, who all tragically died by suicide. They told me about the number of people who came out to take part as they walked around the country. There is that saying, “Walk a mile in someone’s shoes.” They were walking a mile together, talking about their experiences. They said that many people had never spoken about their experiences before, because they still felt there was some stigma attached to it. One of the fantastic things about having these conversations is the de-stigmatisation of not only suicide, but mental health conditions in general.

One of the things I have learned as Minister for Mental Health is that anybody can have a mental health issue at any point in their lives. One, two or three things happen that they were not expecting, and anybody can be in that situation, but everybody can recover and manage their mental health. If I can achieve one thing in my role it would be for everybody to really understand that and for us to put the services in place to address it—that is what I hope to do.

I recognise that the last two years have been exceptionally difficult. They have impacted on the mental health and wellbeing of many people, and many will have experienced harmful or suicidal thoughts. The shadow Minister for Mental Health, the hon. Member for Tooting (Dr Allin-Khan), raised the concern that too many people are having to resort to A&E in a crisis. That is why mental health service providers worked across the country at pace during the pandemic to establish a 24/7 urgent mental health helplines for anybody of any age in crisis. Those services are now operational in every area of England, handling 230,000 to 250,000 calls each month. That service was not there before the pandemic; we have tried to respond and to respond quickly.

The long-term plan also committed to increasing the forms of provision for those in crisis, including safe havens and crisis cafés, providing a more suitable alternative to A&E. We know we need to do that. There are some excellent examples throughout the country, including the Evening Sanctuary at the Mosaic club in Lambeth.

[Kerry McCarthy]

In the case of my friend Ric, we learned at the inquest last week that he had phoned a mental health crisis helpline. In that conversation, he revealed that he was in the middle of a psychotic episode. When he later went to A&E at the suggestion of the helpline and spoke to a mental health nurse, he did not reveal that. In the prevention of future deaths report, the inquest recorded that there should have been real-time updating of his medical records, because the people at the hospital would not have let him leave A&E that night if they had realised that part of the problem was psychosis. I talked about taking note of what is said at inquests, and I hope that we can pick up the recommendation on real-time updating.

[Gillian Keegan]

Absolutely. I read all the prevention of future deaths reports, which come to me, and I take them very seriously. There is always so much to learn from them, and I agree with the hon. Lady. Sharing data between services sounds easy and trips off the tongue, but it is actually quite difficult to ensure that data is there in real time. That does not mean that we do not have the desire to achieve that; we absolutely do.

Talking therapies were mentioned by the hon. Member for Blaydon (Liz Twist), and we are improving access to those. I remind people that they can self-refer, rather than going through a GP. I am sure that many people are not aware of that. We are building up mental health support teams in schools. They will really help by providing our young people with first-level support in school, but we realise that we have to invest more in mental health. That is why we have £2.3 billion more to invest in mental health services in 2023-24. We need to build up the workforce, which is a challenge, because it takes a long time to train people for many of these roles. In fact, I had another meeting on this issue earlier this morning.

I want to address the use of risk assessment tools. I am running out of time, but I am happy to respond on the situation; it is important, and I definitely want to take the time to do so, particularly as Mr Pirie is in the Public Gallery. The guidelines published by the National Institute for Health and Care Excellence in 2011 make it clear that risk assessment tools should not be used to predict future suicide or repetition of self-harm, or to determine who should or should not be offered treatment, as the hon. Member for Bristol East said. We would expect health professionals to have regard to that, but it is clear that further work is needed, and discussions are under way right now to find out what further actions are necessary to achieve this.

I acknowledge the valuable role of the voluntary sector in complementing all the things we do. We have given more money—£5.4 million—to voluntary and community organisations. That money has supported 113 organisations, which do a fantastic job at helping people who are struggling. They are in lots of areas, and have often been set up by families who have lived experience. We have also provided funding to support the Hub of Hope, which was set up by a charity in Liverpool, and which is crucial in signposting people to services locally. For people who are at risk, we now have a fantastic opportunity with the call for evidence on mental health and the updated suicide prevention plan.

We have learned a lot more, and we know that there are a lot of things that we need to fix. We have mentioned debt, drugs and alcohol, and men’s sheds—I have visited those, and they are fantastic. Our LGBT expert advisory group is meeting tomorrow to discuss suicide prevention, and to see what more we need to do. I know that Members present are genuinely committed to working with me on situations that it is difficult to prevent, and we are absolutely convinced that we can do a lot better. We will work with colleagues across the Department for Education—we have mentioned the SEND review—and DCMS. It is vital that we work cross-sector, cross-Department and cross-party, because everybody has a role to play in suicide prevention. It is not just my job—if it was, it would be overwhelming. We all have a role to play.

There have been a lot of significant steps since the national suicide prevention strategy was published in 2012. Professor Louis Appleby is mentioned a lot in these circles and has put a lot of work and effort into this endeavour. Real-time surveillance is on the agenda, and the National Suicide Prevention Strategy Advisory Group will continue to work towards making things better. We have made a lot of progress, but everybody accepts that there is more to come. We have recently launched a call for evidence, and we have had about 2,500 people respond so far, but I would like a lot more to do so—particularly those from marginalised groups, or groups that find it harder to talk about these subjects. We need to hear their perspectives and get hon. Members’ help in making sure that everybody responds to the call for evidence, which is an opportunity. I am serious about this, as is the Secretary of State. I thank everybody for their contributions.

[Kerry McCarthy]

I think I have just about time to thank everybody for coming, and I hope that this debate continues. I am sure that it will.

Question put and agreed to.

Resolved,

That this House has considered Government action on suicide prevention.

Integration White Paper

Kerry McCarthy Excerpts

Wednesday 9th February 2022 Commons Chamber

[Edward Argar]

The hon. Lady will know from the debates on the Health and Care Bill that we are moving forward with opportunities for local authorities to be engaged not just at partnership level, as some are already, but more directly with the NHS at the ICB level. Health and wellbeing boards will continue to be a hugely important part of that.

[Kerry McCarthy (Bristol East) (Lab)]

There is a lot of what, to me, seems to be rather mind-numbing jargon in the statement, but only one mention of nurses. Could the Minister tell me—ideally without the jargon—about the impact of the statement on the nursing profession?

[Edward Argar]

As I mentioned in my earlier answers, this White Paper needs to be taken in conjunction with what we announced yesterday in respect of waiting list recovery, the September social care White Paper and, more broadly, our approach to growing our nursing profession, through increasing the skills and numbers in that profession. We are already well on target for 50,000 more nurses in the profession.

This White Paper looks at the specific aspect of the integration of social care and health and permissive ways for local areas to come up with their most effective place-based arrangements, many of which are already in development. It is, quite rightly, not specific about any individual profession, nor do we believe it should be, because it is for local places to develop their own local plans to reflect their local needs.

Special Educational Needs and Children’s Mental Health Services

Kerry McCarthy Excerpts

Wednesday 9th February 2022 Westminster Hall

[Kerry McCarthy (Bristol East) (Lab)]

It is, as always, a pleasure to see you in the Chair, Ms Fovargue. I congratulate the hon. Member for Newbury (Laura Farris) on securing the debate. I also pay tribute to my hon. Friend the Member for Sheffield, Hallam (Olivia Blake). I have a friend who was diagnosed with ADHD in his 50s. He is a very talented musician but he really struggled at school and with the basic things in life. He, too, says that the medication has made a huge difference.

As we have heard, life is a never-ending battle for many parents of children with SEND. They have to deal with their child’s physical and mental health needs, trying to get the right diagnosis and all sorts of things on top of that: hospital appointments, physiotherapy, daily meds, vulnerability to viruses, communication issues, issues with trying to get their child to eat properly, and behavioural problems. They face all those things at home, and then they have to battle with bureaucracy, and they often feel that they are at war with the very people who are meant to be there to help them. They feel that the system is stacked against them and that sometimes people would rather they went away and stopped being such a nuisance—what the hon. Member for Newbury said about CAMHS in that context very much resonated with me.

The first battle that parents often face is to get the right diagnosis for their child. Then there is a battle to get the EHCPs. Then the councils say they do not really have the power to enforce them. If a child develops mental health problems, it is often a battle to get support from CAMHS, and parents of neurodivergent children, in particular, sometimes find that they are being bounced around between CAMHS and SEND provision, with nobody stepping in to help them.

In 2019, it was estimated that 6.8% of children in Bristol had special educational needs or disabilities, and it is true that Bristol City Council has struggled to meet the needs of those children—as we have heard, that seems to be case with many councils. We had a pretty damning Ofsted report in 2019, and the council says it is now absolutely committed to trying to do better with its Belonging strategy and a three-year, £6.1 million education transformation programme. There are concerns about getting schools to buy into that, and some parents have said that a significant number of schools are batting away struggling pupils even though they have a legal duty to meet the needs of SEND children.

Children should never be put in the “too difficult” box, but I have heard many examples of children being out of school without any support or just having part-time schooling or perhaps hospital school tutoring—if a child has to go into hospital because of their underlying physical disabilities or illness, they will have education there, but not when they are at home. Parents complain about schools having a one-size-fits-all approach to dealing with children with additional needs, while there are complaints from schools that they can no longer afford teaching assistants, who are so valuable in providing children with the one-to-one attention they need.

Delay can make a huge difference to children’s wellbeing and future attainment, as we have heard. We know that half of all mental health problems are established by the age of 14. Tragically, in some cases, young lives will be lost if we do not intervene early. In 2017, suicide was the most common cause of death for both boys and girls aged between five and 19.

I would like the Minister to commit to provide mental health support in every school, early interventions so that we can spot the signs—otherwise, problems will increase in severity—and respect for a child’s individuality. I know that that costs more and needs more resources, but the problem with these pathways—the hon. Member for Newbury talked about fixed, predetermined interventions—is that it does not help to refer a child with autism for counselling based on cognitive behavioural therapy, because their minds just do not work like that. Finally, we also need better in-patient services, because sending children hundreds of miles away from home, when they need intensive support, is absolutely unconscionable.

Children’s Mental Health

Kerry McCarthy Excerpts

Tuesday 8th February 2022 Commons Chamber

[Kerry McCarthy (Bristol East) (Lab)]

I will focus on a few key points. On in-patient treatment for children in severe mental health crisis, the Health and Social Care Committee’s report last year found that

“there are too many children and young people in inpatient units subject to inappropriate care: far from home, without adequate understanding of their rights, and subject to restrictive interventions.”

Being far from home is a particular issue—so many children are being sent out of county and too far away for their families to visit. That is a particular problem for young people with eating disorders, because the beds are commissioned nationally, so even those who are clinically high priority may be sent out of county and isolated from their support networks. A recent BBC investigation found that children struggling with mental health problems during the pandemic faced agonisingly long waits for treatment, with more than one in five waiting more than 12 weeks, and doctors reported that distressed children ended up in A&E as they had nowhere else to go.

Another point that I want to make to the Minister—I know he is not a Health Minister, but I hope he will pass it on to his colleagues—is about the suitability of A&E for people presenting in mental health crisis. The number of A&E attendances by young people aged 18 or under with a recorded diagnosis of a psychiatric condition has tripled since 2010.

In Bristol we have a pilot of a separate room for autistic children who come to A&E, which is a hideous place to be, as hon. Members can imagine, even if someone has just burned their hand or something. There are bright lights, sirens and people rushing around—it is a whole sensory overload—especially at times when we know that A&E is full of people who are drunk, aggressive or violent. That can really add to a child’s distress.

Bristol is piloting a scheme where children are put in a separate place, but I would argue that A&E is not an appropriate place for anyone having a mental health crisis. For example, someone having a psychotic episode should not be sitting in A&E. I hope that the Government will look at that—I think Oxford is thinking about how it can separate that out. Connected to that, youngsters are often being treated for mental health conditions on general wards, because the beds are not available, but obviously they do not get the specialist support that they need there.

Adverse childhood experiences have been mentioned. We must look at prevention, whether that is children suffering abuse in the home, domestic violence, extreme poverty, neglect or abandonment—we have seen so many terrible stories recently. We need to recognise how traumatic that is for children and build that into our services.

I will give one example. When mothers and children are fleeing an abusive situation at home, they should not be put in temporary accommodation that they might share with people who are addicts or who have mental health problems and can be aggressive. We need to make sure that they have a safe place to stay.

[Several hon. Members rose—]

Cystic Fibrosis: Prescription Charge Exemption

Kerry McCarthy Excerpts

Wednesday 2nd February 2022 Westminster Hall

[Kerry McCarthy (Bristol East) (Lab)]

It is always a great pleasure to see you in the Chair, Mr Sharma, and I congratulate the hon. Member for Blackpool North and Cleveleys (Paul Maynard) on securing this debate.

As some Members might know, I have a personal interest in this issue, as my niece Maisie has cystic fibrosis. She was diagnosed when she was just a few weeks old. Actually, it was during that little period after Christmas: it was her mother’s birthday on 28 December and her dad’s birthday on the 30th, and she was taken to hospital because her progress had started to go backwards. One of the welcome developments since she was born is that there is now a heel prick test, so that newborn babies are screened for CF, which prevents people from having to go through a similar situation.

Maisie is one of those who is benefiting from access to the new drugs that have been developed recently, and at 17 she is doing really well. The same is true of one of my constituents, who is just a little older. His dad tells me that it is as if he had never had cystic fibrosis. That is great news and I congratulate all those who have been involved in developing these drugs—Kalydeco, Orkambi and its version for children, Symkevi, and Trikafta—and in making them freely available on the NHS. The former Health Secretary, the right hon. Member for West Suffolk (Matt Hancock), was obviously instrumental in that process and I thank him for it. Of course, I also thank the Cystic Fibrosis Trust for spearheading that campaign.

I also want us to remember those for whom these medical advances came too late. My constituent Lee Partridge tragically lost both his daughters to CF: Richelle at the age of 26 in 2015, and Lauren at the age of 19 just a few months later in January 2016. Perhaps if they had been born a decade later, the new drugs would have saved their lives. These medical developments happen so quickly. No sooner had the campaign paid off and Orkambi been approved than Trikafta was suddenly around the corner. I must admit that my sister, Maisie’s mother, did not even realise that there was another campaign to mount because it came so quickly afterwards.

I hope this means that cystic fibrosis will eventually become a condition that people live with to a normal age, rather than being something that they die from. We are here today because while it used to be the case that sufferers rarely survived into adulthood, life expectancy has increased almost fourfold since then and, as we have heard, there are now more adults than children with cystic fibrosis. If that had been the case back in 1968, when the list of exemptions from prescription charges was drawn up, there is no doubt that cystic fibrosis would have been on that list. It seems quite anomalous. We ought to treat conditions like for like, based on need. We cannot live in the past with this fixed state from 1968, which has become pretty meaningless.

Today I have received an answer to a written question requesting the figures for how many adults have to pay for cystic fibrosis prescriptions. I was told that those figures are not collected. We know that about 89% of all prescriptions are dispensed free of charge, but we do not know specifically what that means for adult patients with cystic fibrosis. The Cystic Fibrosis Trust estimates their number to be around 2,500 people in England.

Although the three drugs I have mentioned that target CF at its root cause are free to patients, which is obviously good, many patients often need to pay for additional medication to prevent lung and sinus infections, therapies to aid digestion, antibiotics and so on. Those who live in poorer areas are statistically more likely to contract severe lung infections, meaning that they are more likely to have to pick up the bill for antibiotic prescriptions. Having a lifelong condition incurs all sorts of hidden charges, including the cost of traveling to medical appointments or buying specific foods to cater to dietary needs. We are lucky in Bristol to have both an adult and a child cystic fibrosis unit, but someone living in Milton Keynes, as my niece does, has to travel to Oxford for their treatment. As the cost of living crisis escalates over the coming months, disabled people will face increasing energy bills and food costs, and many will experience the burden of stressful work capability assessments—we know that the Government are bringing in tougher sanctions on jobseekers. Shouldering the cost of a prescription-exempt chronic condition can mean a choice for some people between paying the bills and affording essential meds.

I was recently contacted by Martin, a constituent whose 19-year-old son James has cystic fibrosis. James works part time. Last year, his claim for disability allowance stopped when he reached adulthood, and his personal independence payment application was refused. Martin currently pays for James’s prepaid prescription certificate, but he worries that a change in his own financial situation would mean that he would not be able to foot the bill for his son’s prescription. What is ironic is that Martin himself has insulin-dependent diabetes, which entitles him to free NHS prescriptions. He cannot even begin to understand how he is deemed eligible while his son is not, meaning he does not pay for his own prescriptions but does pay for his son’s.

Martin is not alone in his opinion—96% of people who responded to a Cystic Fibrosis Trust survey described the prescription charges as unfair. It certainly gives rise to the question why CF patients should be treated differently from others with other lifelong conditions that exempt them. I asked the Health Secretary last year whether the Government plan to review the list of conditions exempt from prescription charges. A junior Minister responded to confirm that the Government did not plan to do so.

The former Liberal Democrat Member Bob Russell has been mentioned. I always use Bob Russell as an example of why early-day motions are perhaps not all they are cracked up to be. For years on years—it might have been two decades—Bob queued to be No. 1 on the early-day motion list so he could call for an exemption from prescription charges for cystic fibrosis patients. He always got lots of signatures, because his early-day motion was No.1 and first in the booklet, but we are still here debating the issue. When I am trying to explain to my constituents why my signing an early-day motion will not change the world, Bob is the example I use. It would be lovely if we could move on from having these debates and making the same points over and over again. There is no logical reason for it, other than the point that if the Government reopen the 1968 list they will have to review other conditions as well, because people are living longer due to medical advances. I do not think that is a very moral reason for not doing it.

We get told that patients who are not exempt from prescription charges can apply for a prepaid prescription certificate that costs £2 per week. However, that is £104 per year; everything adds up, and I have already mentioned increasing fuel bills and food prices. That is £104 per year that they should not be paying. Grants are available through charities such as the Cystic Fibrosis Trust to support those in urgent need, but they are in high demand. Between 2020 and 2021, one in 10 people with cystic fibrosis received an emergency grant from the trust; the majority of those grants went towards basic living costs.

There is a serious risk that cystic fibrosis patients who incur prescription charges may avoid taking essential medicines, especially if they are already in financial hardship. People living with chronic conditions in Wales do not have to face the same difficult choice between medication and heating their homes, as all NHS prescriptions are free there.

[Ruth Jones]

My hon. Friend is making a powerful speech. Would she agree with me that, for all of us living in Wales, the fact that all of our prescriptions are free means that people do not have to worry about not having the money to take life-saving medication?

--- Later in debate ---

[Kerry McCarthy]

That is certainly true. I know that some people would say that this would mean that Government money would be used to subsidise the 11% of people who pay for their prescriptions at the moment. However, the figures that we have talked about and the unfairness of the current situation seem totally wrong.

Although I hope that cystic fibrosis becomes a condition people can live with, that drugs can manage the condition and that people do not suffer from too much, I would still not want to be in the situation of having it. It is still a condition where people have to have daily physiotherapy, take drugs such as Creon before eating any food, and make regular trips to the hospital. They have to be very careful to avoid infection and had to shield during covid. When people are paying that sort of price, giving them an exemption from prescription charges is not too much to ask. I hope that the Minister will finally commit to reopening the 1968 list, and make sure that cystic fibrosis patients do not have to pay this amount anymore.

--- Later in debate ---

[Edward Argar]

I am grateful to the hon. Gentleman for his spirited defence of early-day motions, of which he makes powerful use, as he does with every opportunity he has to speak in this place.

My right hon. Friend the Member for South Holland and The Deepings (Sir John Hayes) is no longer able to be here, but he made a valuable contribution, and I am grateful to you, Mr Sharma, for allowing him to speak—even if, as a former Minister, he should have known better the consequences of seeking to tempt me to make policy at the Dispatch Box without cross-Government agreement, which might have led to an early termination of my ministerial career. He made a powerful point, as all hon. and right hon. Members have done, and I will turn to some of those points in a moment.

Before I do so, I want to recognise the fantastic work undertaken by the Cystic Fibrosis Trust, which does a fantastic job on behalf of people living with cystic fibrosis and their families, and in bringing the condition and the needs of people with it to the attention of this House, and more widely. I also acknowledge the work of the Prescription Charges Coalition, of which the Cystic Fibrosis Trust is a member. It has worked tirelessly to raise awareness of the help available to patients with the cost of their prescriptions and campaigns on an issue that its members feel strongly about. In our democracy, whether or not we agree on the policy position, it is right that we recognise those who get out there, campaign and seek to drive change and policy. It is important to recognise those who are active in our democracy in that way.

As we have heard, cystic fibrosis is a life-limiting condition affecting many thousands of people in the UK. It is not only a life-limiting disease but, as we heard from my hon. Friend the Member for Ashfield, a disease that can impact on the quality of life and the life experiences of those affected and their families. While there is no cure for cystic fibrosis, there are treatments available on the NHS to help reduce the effect of symptoms and make it easier to live with.

It is not that long ago that conditions such as cystic fibrosis saw life expectancy so low that many were advised not to expect to live beyond their teens. Thanks to advancements in treatments, better care and the work of organisations such as the Cystic Fibrosis Trust, people with cystic fibrosis are now living for longer, with a better quality of life, with half of those with the condition living past the age of 40. Children born with cystic fibrosis today are likely to live longer than that. That is a positive story and a reflection on our medical and scientific advances.

I turn to the crux of the debate. When the medical exemption list was drawn up in 1968 in agreement with the British Medical Association, it was limited to readily identifiable, permanent medical conditions that automatically called for continuous, lifelong and, in most cases, replacement therapy without which the patient would become seriously ill or even die. As the shadow Minister, the hon. Member for Enfield North (Feryal Clark), alluded to, there has been a review since 1968—only one—which resulted in the addition of cancer in 2009.

When the exemption list was drawn up, decisions on which conditions to include were based on medical knowledge at the time—for instance, children with cystic fibrosis were not expected to live to see adulthood—and it is entirely understandable that, given advances in treatment and increases in life expectancy, those who are now living with cystic fibrosis for a lot longer should wish to pursue exemption from prescription charges to help them maintain their quality of life with the drugs that are essential to their quality of life. The issue of prescription charges was reviewed more broadly in the round in the 2010 Gilmore report, which did not recommend further changes at that stage.

As the hon. Member for Enfield North alluded to, I know that the answers that Ministers have given, stating that the Government have no immediate plans to review the list, will have caused disappointment to right hon. and hon. Members and to those with this condition. We do think it would not be right in this context to look at one condition in isolation, separate from other conditions, because others would rightly argue that their condition was potentially equally deserving of an exemption if it fitted the same criteria. My hon. Friend the Member for Blackpool North and Cleveleys has rightly advanced the case of cystic fibrosis, and I entirely understand why, but I know that he will also recognise that other conditions might qualify for consideration in the same way, or for the same case to be made for them by right hon. and hon. Members.

When the exemption list was first put in place in 1968, 42% of items on prescription were free; now 89% are free. There has been considerable change in that space, but to go to the heart of what right hon. and hon. Members have asked for today, were my right hon. Friend the Member for South Holland and The Deepings in his place, I would disappoint him by saying that, as he will appreciate, I cannot make policy standing at the Dispatch Box. It is important that everything is considered carefully. Although this is not my policy, I will continue to reflect on the points that have been made by right hon. and hon. Members today and by campaigners on this issue. I will also ensure that I will not only speak to my noble Friend, the Minister with portfolio responsibility for this issue, but draw to his attention the transcript of today’s debate.

[Kerry McCarthy]

I have just realised that it is groundhog day—I missed an ideal opportunity to weave that fact into my speech, as I think all of us would have done. Is there anything the Minister could say that does not makes us feel like we have been here many times before? He has said that he will reflect on these points, but is there not something a little bit more concrete that he can give us a commitment on, so that we feel that we are perhaps making some progress?

[Edward Argar]

I am grateful to the hon. Lady. She may or may not always agree with me, but I will always endeavour to be straight with the House, even when the message may not always be the one that Members want to hear. I cannot stand here now and say that there will be a review of that list; it is important for me to be honest with her. What I can say—which she may feel is insufficient, and I entirely respect her if she does—is that I will reflect on the points made today and the issues raised. I will discuss this issue with my noble Friend and ensure that the points that have been made in this debate are conveyed to him, but it would be wrong of me to commit to something that I am not in a position to commit to. The hon. Lady rightly presses her case, but I know that she will appreciate my position, and it is important that I am honest with the House in that respect.

I touched on the help with prescription costs previously, and the number of items. While I know that this is not at the heart of the point made by my hon. Friend the Member for Blackpool North and Cleveleys, it is still important that I put on record the point that I alluded to: when medical exemptions were introduced, only 42% of all NHS prescription items were dispensed free of charge. That figure is now around 89%, and around 60% of the English population do not pay prescription charges at all. Many people with medical conditions not on the exempt list already get free prescriptions on other grounds, as my hon. Friend the Member for Blackpool North and Cleveleys said, with current exemptions providing valuable help for those on the lowest incomes.

NHS Dentistry: Bristol and the South-west

Kerry McCarthy Excerpts

Monday 24th January 2022 Commons Chamber

[Darren Jones]

I agree, and I thank my right hon. Friend for raising the case in Exeter, which seems similar to the many other cases we are hearing about this evening.

When I surveyed my constituents, 79% of those who responded said that they did not feel that they could access a timely dental care appointment when they needed it, while 60% had not had any form of dental treatment during the past year. Twenty five per cent. detailed that they had contacted 11 or more dental practices to try to register for NHS treatment but were unable to do so.

Information compiled by the Association of Dental Groups puts those conclusions in context. The ADG highlights that 43% of patients across Bristol alone were unable to book an appointment when they wanted to do so. That figure increases to over 50% of patients when considering the south-west altogether.

In its 2021 “Great British Oral Health Report”, mydentist found that those in the south-west who have had a dental appointment in the last year lived, on average, over 5 miles away from their closest surgery. More concerningly, those who had not had a dental appointment in the last 12 months were twice as likely than the national average to live over 30 miles away from their closest surgery. That seems to suggest that there is a correlation between someone’s proximity to an NHS dentist and the amount of time that has elapsed since their last appointment, adding geographical inequality to income inequality in the often privatised dental care system—no doubt a levelling-up priority for the Government.

This is a growing problem, with increasing numbers of NHS dentists closing and a shortage of dentists available to do the work. For those familiar with the south-west’s regional news, Thursday’s BBC “Spotlight” reported that the number of NHS dentists practising across the south-west had fallen by more than 200 between 2017 and 2021. Across the country, 45% of patients have been forced to pay for private care due to the closure of a local NHS dentist.

The good news is that there are several actions that the Minister can take to address these issues. First, the Government should consider measures to reverse the decline in the number of dentists offering NHS services. Research from mydentist shows that nearly 1,000 dentists ceased providing NHS treatment in 2020-21, and in response to a survey, 47% of the British Dental Association’s membership said that they were considering reducing the provision of NHS dentistry due to the pressures being faced. I understand that the Government have announced a south-west dental reform programme. I would be grateful if the Minister could provide some detail as to how it could be deployed to increase dentistry numbers.

Secondly, the Government should look again at how they recognise international dentistry qualifications. The overseas registration examination has only 500 places available annually in the UK. The ADG has recommended that part of the examination could be taken in the candidate’s home country as a way of reducing some of the pressures, and that the overall number of places available should be increased. Furthermore, both the ADG and mydentist have recommended that the Government take swift action to reduce the impact that Brexit will have on those who have received their training in the European Union but whose qualifications are not recognised in the UK, and therefore on the number of dentistry providers in the UK. At present, the Government have agreed to recognise dentistry qualifications achieved in the EU until the end of the year, but given that 22% of dentistry care and treatment is provided by dentists from the European economic area, it is vital that certainty about the future is provided to those dentists and their patients as soon as possible. It is ridiculous that Ministers would prevent EU dentists from being able to work in the UK. I would be grateful if the Minister could update the House on that particular issue.

Finally, and most importantly, the Government need to bring forward long overdue reforms to the NHS dental contract, which was established in 2006. Local dentists in Bristol North West have contacted me to highlight their frustration with the current contract, which prevents them from seeing NHS patients when they need to be seen. They have explained that they have been expected to meet higher patient targets due to local closures, despite the need for covid-19 safety measures and without the full payment usually required to see those extra patients. Those pressures are in addition to the backlog from the pandemic, with more than 350,000 dental appointments lost in Bristol alone between April 2020 and November 2021. Reforming the NHS dental contract is vital to solving the underlying issues with access to NHS dentistry, and I would welcome an update from the Minister on the status of that work.

In the round, NHS dentistry is broken and the problems are getting worse. The system works only for those with dental emergencies—and that is if they are lucky—while everyone else is left largely to pay private fees in a private dental system that costs significant sums of money. The closure of so many NHS dentists is adding geographical inequalities to the income inequalities created by the private sector-led dentistry system, and the shortage of dentists in the country is being exacerbated by a failure to recognise European Union dentists and an unwillingness to make it easier to welcome dentists from other countries around the world.

From my experience with Ministers and officials, I get the sense that dentistry in this country is now nothing more than an afterthought, placed in the “too difficult for Government action” box.

[Kerry McCarthy (Bristol East) (Lab)]

I do not know whether my hon. Friend has written to Ministers about this. I have written to Ministers on behalf of constituents who are in pain and need emergency surgery, but cannot come up with thousands of pounds to pay for it. It is so frustrating when the response we get is a link to a site where they can check where their nearest NHS dentist is, or similarly useless bits of information. Does he share my concern that the Government are totally complacent about the crisis we face?

[Darren Jones]

I thank my hon. Friend for her contribution and I agree entirely. I know from my own experience of trying to get access to ministerial time following the closure of an NHS dental practice in Southmead that it took ages to get a response. I then had time with officials, who tried to be helpful but could not resolve the problem, and we had local briefings in Bristol where, I am afraid, the presentations and information were completely inadequate. That confirms my point that dentistry seems to be an afterthought, not a priority, for this Government.

Covid-19 Update

Kerry McCarthy Excerpts

Friday 26th November 2021 Commons Chamber

[Sajid Javid]

My hon. Friend is right to talk about ease of access to the booster programme. Of course we want to make it as easy as possible, and we are adding numerous sites day by day. I will absolutely see what we can do with regard to Kettering. The Vaccines Minister, the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Erewash (Maggie Throup), has heard what my hon. Friend has said. I suggest that they have a quick meet after this, as I am sure that she is eager to open up more access points in Kettering.

[Kerry McCarthy (Bristol East) (Lab)]

I echo the hon. Member for Kettering (Mr Hollobone). I have my booster on 18 December, which a few days ago was the first date being offered near me in Bristol. There is now a growing divide between people who will have had three jabs and people who will not have been jabbed at all. There are some hardcore vaccine refuseniks, but there are also quite a lot of people who think that they are now immune because they have had a mild dose of covid. However, we know that they could well be at risk, particularly with new variants coming on board. What more can we do to persuade those people who have not been jabbed at all that it is time to get jabbed?

Down Syndrome Bill

Kerry McCarthy Excerpts

Friday 26th November 2021 Commons Chamber

[Alex Norris (Nottingham North) (Lab/Co-op)]

I am grateful for the opportunity to speak for the Opposition on this very important Bill. I commend the right hon. Member for North Somerset (Dr Fox) for using his precious private Member’s Bill slot on this important matter, and I understand this is his first success in the ballot in 29 years, so roll on 2050 for the next one.

The right hon. Gentleman said plenty that will have moved people who are watching as well as Members in the Chamber, particularly the comment that I will reflect on now and over the weekend, too. This Bill is not about a condition: it is about people, and it is not about charity; it is about empowerment. That really struck me, and it is important.

We have heard that 47,000 people in this country, across every nation, region and constituency, are living with Down’s syndrome. They are people with hopes and dreams, who love and are loved, and they have a right to live full lives and to reach their potential. The right hon. Gentleman is taking a major step in that direction with this Bill.

We have had brilliant contributions from colleagues on both sides of the House, and I will try to group them into themes. As this Bill is human rights legislation, as the hon. Members for North Antrim (Ian Paisley) and for Stourbridge (Suzanne Webb) and my hon. Friend the Member for Hackney South and Shoreditch (Dame Meg Hillier) said, I share the enthusiasm of the hon. Members for Dunfermline and West Fife (Douglas Chapman) and for Berwickshire, Roxburgh and Selkirk (John Lamont) that there should be a four-nations approach in the years to come.

There were moving contributions from the hon. Members for Broxbourne (Sir Charles Walker), for Meon Valley (Mrs Drummond), for Buckingham (Greg Smith), for Carshalton and Wallington (Elliot Colburn) and for Don Valley (Nick Fletcher), who brought the debate to life by raising constituency cases. We can throw around the statistics about tens of thousands of people, but each one of them is an individual with different needs, different hopes and different dreams, and they should be treated in that way.

Alongside the 47,000 people, there are tens of thousands of families—mums, dads, sisters, brothers and cousins—who I know will have listened to the debate. My family is one of those tens of thousands, so I am especially grateful to the right hon. Member for North Somerset for giving us the opportunity to take a leap forward in the support available for people living with Down’s syndrome.

I was born in 1984, when life expectancy for a person with Down’s syndrome was about 25; it is now into the 60s. People with Down’s syndrome have basically gained a year every year for my entire life, which is wonderful and it shows the advances we can make when we prioritise the human rather than the condition, and when we are ambitious for everybody and do not define people by the challenges they live with. We know that, with appropriate support, people with Down’s syndrome can thrive at school, can work, can marry and can live full lives. We have to take every opportunity to remove all the barriers, to tackle stigma and to tackle the poverty of ambition that hold back progress in this area, and this Bill is a perfect opportunity to do so.

I note that the right hon. Gentleman has secured Government support for the Bill, so its passage is likely to be smooth. Clause 1(1) provides for the Secretary of State to publish guidance to relevant authorities to make sure they meet the needs of people with Down’s syndrome, which is a powerful tool and I look forward to hearing from the Minister about what she envisages being part of that.

Under clause 1(3) there is an expectation that the Secretary of State will consult. As other colleagues have said, that is important. It must start with individuals with lived experience, so they can tell us what change they need in their lives and what challenges they have had to negotiate. It must also apply to their families—the hon. Member for Carshalton and Wallington talked about it being a battle, which is a common theme in the stories of the families who I have spoken to and who we have heard about today. Beyond that, it is crucial that Ministers talk to clinicians, commissioners and decision makers. I am sure that the Minister will not want to be prescriptive about a consultation today, but she might set out some of its broader themes.

The schedule to the Bill highlights four areas in which the right hon. Member for North Somerset is seeking guidance to be made. I will touch on them briefly in turn. On the national health service, it is vital that healthcare services are responsive to and ambitious for people living with Down’s syndrome so that they get world-class healthcare. We can be proud of the progress made over the last few decades, but we must make sure that we are as ambitious about mental health as we are about physical health and that the progress in physical health can be matched in mental health. I hope that the Minister reflects on that in her closing remarks.

The Bill also references clinical commissioning groups. The Health and Care Bill is going through this place—we debated its remaining stages on Monday and Tuesday—so the commissioning landscape will change. Can the Minister tell us how the language will change to reflect the fact that the Bills are progressing at the same time?

[Kerry McCarthy (Bristol East) (Lab)]

To return to what my hon. Friend said about mental health concerns, when people with disabilities and conditions such as Down’s experience mental health problems that are not necessarily connected to their condition, treatment can be more difficult and it can be difficult to identify that they are developing mental health problems. Perhaps it is more a point for the Minister, but I hope that we can bear that in mind when we are looking at how we treat people with Down’s.

[Alex Norris]

I am grateful for that intervention. Members on both sides of the House share a commitment and an ambition to make significant advances in the mental health of the British people. We know that there are barriers for people with the most profound physical health conditions because, traditionally, we have not looked beyond those conditions to evaluate the mental health aspect. I hope that the Bill is a good opportunity to do that.

On housing, we know that with the right support, people with Down’s syndrome can live semi-independently, so we must make sure that the right type of housing, sensitive to need, is available and distributed across the country. Has the Minister made a baseline assessment of where we are and what we might need to do better?

Hon. Members have made important points about education. At the risk of repeating more of what the hon. Member for Carshalton and Wallington said, the points about education, health and care plans were well made and I hope that they were heard. I took from his contribution that they cannot be pro forma exercises; they must be individual exercises that meet individual needs. That is the purpose of having them.

Linked to that, on employment, only 6% of people with a learning disability in this country are in employment. We should aspire to do much better. Work gives purpose, independence and dignity, and is part of the collective investment that we make in each other. Our ambition is for everybody to be in work who can be, irrespective of their challenges. We need a full strategic plan on the active steps that we can take to show employers the benefits of hiring staff with learning disabilities and the support that can be offered to help to facilitate that. It is important to understand that it is a win-win because, as global studies show, workplaces hiring employees who live with Down’s syndrome are happy and productive.

The right hon. Member for North Somerset made the point about redress, which is an important and live conversation in this country. To read across, if I may, to the Cumberlege report and the impact of sodium valproate and Primodos on children who are born having been exposed to them, those families still cannot get redress—in many cases, many decades later—without an expensive, long and hard pursuit in the courts. That system is not working. The report recommended that a redress system be set up to avoid that, which has not happened as the Government have not accepted the recommendation. It should not be happening to them and it should not happen here, so I hope that, through the Bill, we can do better for people living with Down’s syndrome and for others.

Oral Answers to Questions

Kerry McCarthy Excerpts

Tuesday 13th July 2021 Commons Chamber

[Kerry McCarthy (Bristol East) (Lab)]

What support his Department is providing to young carers during the covid-19 outbreak.

[Mr Clive Betts (Sheffield South East) (Lab)]

What steps his Department is taking to ensure that unpaid carers can access the support they need to provide care to family members.

[The Minister for Care (Helen Whately)]

We recognise how much carers do and the huge demands that caring places on them. We have made carers a priority group for covid-19 testing and vaccination, funded carers’ organisations and asked local authorities to meet their duties to identify and support carers. We have also provided guidance and funding through the £1.5 billion infection control fund to support the reopening of day services.

[Kerry McCarthy]

I have been contacted by a Megan, a young carer in my constituency, and I have been in correspondence with the Minister about the lack of guidance for young carers on the gov.uk website. We got the Government to remove an outdated linked to a Barnardo’s service that had closed at the end of March, but they have not replaced it with anything, which has left a vacuum in where young carers can look for advice and support. Can the Minister ensure that there is adequate, up-to-date information on the gov.uk website and that young carers have somewhere to turn to when they need help and support?

[Helen Whately]

I thank the hon. Lady for her question and her correspondence on this. She makes a very important point and I will make sure of that.

Covid-19 Update

Kerry McCarthy Excerpts

Monday 19th April 2021 Commons Chamber

[Matt Hancock]

Yes, of course. We want to get back to normal for care home residents—of course we do. We are taking steps in the right direction in England. I cannot comment on the situation in Wales; that is rightly a responsibility for the Cardiff Administration. As we progress down the road map, I hope we will be able to make further progress.

[Kerry McCarthy (Bristol East) (Lab) [V]]

At today’s meeting of the all-party group on myalgic encephalomyelitis, we discussed the overlaps between ME and chronic fatigue syndrome and long covid. Obviously, there are some striking similarities. What assessment has the Secretary of State made of the impact that contracting covid can have on people with ME/CFS? Given their vulnerability, will he now do a bit of a U-turn and make them a priority for vaccination?

[Matt Hancock]

Of course, the prioritisation for vaccination when it comes to those who are vulnerable is clinically determined. I know that this question has been looked into. We are also looking into work on the links between ME and long covid, which share some similarities but are different conditions. It is an area that needs further work and further research—there is no doubt about that. If there is an update to the clinical advice on prioritisation and whether those with ME need to be in category 6 or category 4, I will update the hon. Lady. Thus far, however, we are following the clinical advice and that is the approach we have taken overall.