Dangerous Waste and Body Parts Disposal: NHS

Kevin Foster Excerpts

Tuesday 9th October 2018 Commons Chamber

[Stephen Barclay]

The hon. Lady raises several points. On the 350 tonnes of waste, I clarified the flow of that waste in my comments to the right hon. Member for Normanton, Pontefract and Castleford (Yvette Cooper) and I said that not all of it is clinical. I was not personally told on 31 July. I set out in my written statement when the NHS and then Ministers were told.

The question about whether there is any cost to NHS trusts is a very valid one for all constituency MPs who wish to understand the situation. The contingency cost—for example, from the additional capacity being put in place at trusts—will be borne centrally by the NHS family, and the cost of processing clinical waste will be borne by NHS trusts, as it has been to date.

[Kevin Foster (Torbay) (Con)]

I welcome the action the Minister has taken to terminate the contracts with this company, given its clear breaches and failure to deliver what it said it would. In his statement, he referred to the capacity for clinical waste incineration. Can he give us further detail about how he satisfied himself that there is capacity in each region? Clearly, these are specialist facilities, and having to transport waste could have a knock-on effect.

[Stephen Barclay]

I should clarify that it is not me personally who has terminated these contracts. These contracts with HES are held by the trusts themselves, and therefore it is a decision taken by those trusts.

As I said earlier, there is significant additional capacity within the incinerator landscape to process the waste generated by this contract, and therefore the suggestion in some quarters that this is an issue of a lack of capacity is simply not valid. To be clear, HES produces 595 tonnes of waste a month that goes to incineration, and the NHS identified 2,269 tonnes of incineration capacity, so reports that there is a lack of capacity in the market are not valid.

Health and Social Care (National Data Guardian) Bill

Kevin Foster Excerpts

3rd reading: House of Commons & Report stage: House of Commons
Friday 6th July 2018 Commons Chamber

[Kevin Foster (Torbay) (Con)]

I am conscious of time so will be brief.

I welcome this Bill’s Third Reading and congratulate my hon. Friend the Member for Wellingborough (Mr Bone) on getting it this far—and, indeed, it is just the first of his private Member’s Bills on the Order Paper today. I pay tribute to my hon. Friend the Member for Bury St Edmunds (Jo Churchill) too; she has also played a huge role. I get to talk to her quite a lot in her current role, although, sadly, because of that post she cannot say anything about this Bill today.

I hope the Minister in her closing remarks will reflect a bit on how she sees the guardian being used as a champion of patients and of ensuring that their data are protected: given that this Bill covers some of the most sensitive data people have—their healthcare data—how we can make sure we get the benefits such new technologies offer to be able to analyse and find trends and patterns of disease we might never have found before; and how patients can be reassured that someone is acting as their advocate and champion in ensuring those data are used only for reasonable purposes, which we all want. It is right that we are looking to pass this law to enshrine such a role in statute; being the guardian of data, particularly across the NHS, is a key role, and I hope this Bill receives its Third Reading.

I took on board the explanation by the Bill’s promoter of why it says it covers England and Wales, even though it will cover only England, but I hope a relationship can be developed with the devolved health systems so that the data sharing benefits the entire UK. Given the time, however, and the fact that the Minister will wish to respond to the debate and other Members wish to speak, I will conclude by saying that I fully support the Bill.

Department of Health and Social Care and Ministry of Housing, Communities and Local Government

Kevin Foster Excerpts

Monday 2nd July 2018 Commons Chamber

[Dr Sarah Wollaston (Totnes) (Con)]

It is an honour to speak in this estimates day debate on the 70th anniversary of the NHS. I am privileged and proud to have worked in the NHS for 24 years before coming to this place, and I would like to start by saying thank you to all those who work in the NHS. The principle behind it is as strong now as it was on the day it first opened its doors: it should be free at the point of delivery, available to all, and based on need, not the ability to pay. That is as important now as it ever was; it is truly the thing that makes us most proud to be British. This is not just the anniversary of the NHS, however; it is also the 70th anniversary of the National Assistance Act 1948, which swept away the poor laws and introduced our system of social care, so it is absolutely right that we should be having this joint estimates day debate.

I absolutely welcome the uplift in funding announced by the Prime Minister, but I would like to talk about how we will get the most from those funds, and also how we will pay for this. One of the key challenges that we have long faced is that although the NHS is free at the point of delivery, social care has been means-tested from the outset. That has created a huge challenge in bringing the systems together and providing the integration that patients expect but often find, to their surprise, is not there. Moving towards more integration would have great benefits for patients, and would create savings and a much more logical, patient-centred approach for both systems. I urge the Minister to look closely at the report of both Committees into social care, in which we touched on that issue and made recommendations, which I will talk more about later.

[Kevin Foster (Torbay) (Con)]

My hon. Friend is providing an excellent introduction to this debate. Does she agree that both Front-Bench teams could look at the example of Torbay Council—the local authority we share—which now has an integrated care organisation that brings together adult social care and the NHS for the benefit of our local residents?

[Dr Wollaston]

Indeed; Torbay has led the way. When the Health and Social Care Committee visited Norway and Denmark, we were shown slides from Torbay, because its approach, referring to a Mrs Smith and actually trying to envisage how everything would work around the patient, has been hugely influential abroad as well as at home.

Childhood Obesity Strategy: Chapter 2

Kevin Foster Excerpts

Monday 25th June 2018 Commons Chamber

[Kevin Foster (Torbay) (Con)]

Community sports clubs, such as the Cary Park tennis club in Torquay, play a large role in making children active and encouraging them to participate in activity. Will the Minister confirm that looking at these sorts of groups will be part of the strategy—to get people active, not just to tackle what they are eating?

[Steve Brine]

Yes, that is part of the strategy, in so much as we want local authorities to be involved, and upper tier authorities in England are all now public health authorities in their own right. There is absolutely no reason why sports clubs, which are plentiful in all of our constituencies, should not be a key part of the active lives agenda. Not just children need to do more activity in our country; all of us do.

Oral Answers to Questions

Kevin Foster Excerpts

Tuesday 19th June 2018 Commons Chamber

[Sir Roger Gale (North Thanet) (Con)]

10. What funding his Department has recently allocated to capital investment projects in the NHS.

[Kevin Foster (Torbay) (Con)]

23. What funding his Department has recently allocated to capital investment projects in the NHS.

[The Secretary of State for Health and Social Care (Mr Jeremy Hunt)]

In the Budget we announced £3.9 billion of additional capital funding, and 77 projects have conditional approval.

[Mr Hunt]

I hope it will have a positive impact. We are asking NHS trusts to get their proposals in during July. We are also delighted that there is a new medical school in Canterbury and we hope that this will be the start of a transformation of NHS services.

[Kevin Foster]

Earlier this year, Torbay and South Devon NHS Foundation Trust was allocated £13.3 million of capital funding for improved urgent care and a new emergency department at Torbay Hospital. Will my right hon. Friend confirm what progress is being made to get those major construction projects under way?

[Mr Hunt]

I think it will be brilliant not just for patients at Torbay Hospital but for patients living in Newton Abbot and Torquay. My understanding is that this project is on track, and my hon. Friend should be very proud, because he campaigned hard.

Mental Health Units (Use of Force) Bill

Kevin Foster Excerpts

Report stage: House of Commons
Friday 15th June 2018 Commons Chamber

[Kevin Foster (Torbay) (Con)]

I am listening with some interest to my hon. Friend’s speech. The purpose of his amendments, as he has said, is to replace the word “force” with “restraint”, and he has just given quite a strong list of things that could be restraint. However, surely the whole purpose of this Bill is to focus on force as we see it defined in other legislation. I know from his doughtiness on issues such as nanny state and cotton wool-style politics that the prospect of talking to people with smiles, which he says could be restraint, is the last thing that we want in this type of Bill.

[Philip Davies]

I understand the points that my hon. Friend makes, and I will come on to some of them later on, as they probably sit better with other amendments that have been tabled. I certainly accept his point, and as always, he makes it well.

I am also concerned that using the word “force” might worry people who are thinking about seeking treatment for mental health conditions. If they see that, it might scare them into wondering what may happen to them in some mental health settings. My view is that the word “force” in this case is not appropriate, not sensible and not actually what is generally used. Of course an element of force is used at times to carry out some methods of restraint, but common sense would suggest that the terminology used in the Bill should be what the sector uses.

--- Later in debate ---

My point is that varying factors need to be taken into account in relation to the absence of a police video. I do not feel that they have been taken into account in the Bill. Stating that officers “must” take a video does not factor in the possibility of a scenario in which it is simply not possible to do that, or that there could be mitigating circumstances that will prevent them from doing it. Body-worn video has resulted in a marked improvement in reporting crime, and it has been rolled out to other services. Further to this, simple technology failures could make it difficult to produce a video. Making a police officer liable to criminal proceedings because they have not taken a video is excessive and absurd.

[Kevin Foster]

I thank my hon. Friend for giving way. It is always a pleasure to have an extended opportunity to hear him speak on a Bill. His amendment proposes to replace “must take” with “should consider taking”, when the words “if reasonably practical” are already in the Bill. Similarly, his amendment 19 would introduce the rather vague concept of trying to do something. Hon. Members are usually rather doughty in wanting to take vague provisions out of legislation, but in this case my hon. Friend wants to put some in.

[Philip Davies]

I understand the point that my hon. Friend is making. Equally, I am not keen on unnecessarily criminalising decent police officers. My fear, which I know my hon. Friend does not share, is that that could well happen. It could also be the case that the officer would be acquitted following a long disciplinary process and trial. That often happens to police officers, but we should not underestimate the hurt that results from their having to go through all that. I am trying to prevent unnecessary disciplinary and criminal proceedings being taken against police officers.

[Kevin Foster]

I thank my hon. Friend for giving way again. He gave the example of the pilot schemes, and body-worn cameras have led to a reduction in complaints against police of over 90%, which deals with the point he makes.

[Philip Davies]

I made it clear that I support and encourage the use of such cameras, but there may be occasions when, for whatever reason, they cannot be used, and the wording says “must”.

--- Later in debate ---

[Jackie Doyle-Price]

I am grateful to my hon. Friend for making that point. As he says, the longer the answers take, the more distressing and dehumanising it is for the bereaved. I will come to the timescales later in my remarks, but one of the real achievements of the Bill is that it places clear expectations on the authorities in regard to investigations.

As I was saying, a police investigation could be carried out at the same time, depending on the type of incident involved. That was the case when Seni died. NHS guidance now clearly states that, whenever feasible, serious incident investigations must continue in parallel with police investigations. That is an important point, because what happened in Seni’s case was that the police investigation basically put a brake on the NHS investigation. We are clear that these investigations should take place in parallel. That is possible because the terms of reference for the investigations are quite different, and where this eventuality arises, it should be considered in close consultation with the police so that they can be clear about the purpose of the healthcare-led investigation and how it will be managed.

If, following discussions or a formal request by the police, coroner or judge, an application is made to suspend the NHS investigation, it could be put on hold. However, the family must be very much involved in that decision, and the commissioner must ensure that they can agree a date for completion once the investigation can recommence. It is very much down to the commissioner to establish that timeframe. Whether an investigation is put on hold or not, it is absolutely central to our proposals that families should be kept engaged and informed of when the investigation will start up again, and when it will be completed. We also have national guidance on learning from deaths, which was published in March 2017. That now sets out clear expectations of NHS organisations for engaging with carers and families in these circumstances. Dialogue is absolutely central and underpins everything we are doing in this space.

I want to provide some details about what happens if a death follows police contact, when that contact may have caused or contributed to the death, as this is particularly relevant to the events that followed Seni’s death. In such circumstances, the police are under a duty to refer the matter as soon as possible to the Independent Office for Police Conduct. Following an investigation, a report is sent to the police force. The report provides the IOPC’s opinion about what should happen to those involved in the incident. For example, it might recommend further training, a misconduct meeting or a gross misconduct hearing. The police force will then provide its own view about what should happen. If the IOPC disagrees with the force, it has the power to recommend that it should take appropriate action, such as holding a misconduct meeting or hearing. Ultimately, the IOPC can direct the force to do that.

Under the scheduled reforms, this process will be further streamlined so that the IOPC will make the decision on whether there is a case to answer for misconduct or gross misconduct, and decide what form the disciplinary proceeding should take. The IOPC will provide a copy of the investigation report to the relevant police force, and to the complainants and the family of the person involved, as well as to the coroner and the Crown Prosecution Service, which will consider whether any further action should be undertaken.

I want to return to concerns about the quality of investigations, and to briefly explain the role of the Healthcare Safety Investigation Branch. The Lord Chancellor is looking at how we support people going through an investigation, and the hon. Member for Croydon North has also raised the issue of legal aid. It is important that we ensure that families have appropriate support as they navigate this process. This is not just about the process of walking through the contacts with the NHS investigating bodies, which can be quite formal; they could end up in a situation involving legal action or criminal proceedings, at which point they would need that support.

Much reference has been made this morning to the Dame Elish Angiolini review, in which she was clear that all deaths in custody should be treated on an equivalent basis, and I can confirm to the House that the Lord Chancellor’s review into legal aid for deaths in custody will consider deaths in mental health settings on the same basis as deaths in prisons and other forms of custody. I can also advise the House that the ministerial board on deaths in custody constantly reviews what we are doing and how we are implementing the recommendations of the Angiolini review, so the review of legal aid for inquests will consider how it can be applied to deaths in mental health settings, too.

[Kevin Foster]

The Minister is making some interesting points about the legal aid review. Will she confirm what groups she is considering talking to? I am thinking of third-sector groups, community groups and, potentially, law centres.

[Jackie Doyle-Price]

I thank my hon. Friend for that intervention. I hope that we will continue to consider everything that we can do to support people, and I welcome those suggestions. Ultimately, such people are facing massive injustice at the hands of the state, and we should never stop looking at what we can do to support people in those circumstances. The simple truth is that those people have put their trust in the institutes of the state, so there is double pain when they are failed by them, and we must ensure that we do everything possible.

I hope that what I have said about legal aid and the investigation process satisfies the hon. Member for Croydon North, so I hope that he will not press his amendments to a Division so that we can get the Bill into the other place and deliver the objectives that he and I both want.

To clarify something that I was saying about the Government amendments, we unwittingly included a loophole that would allow institutions not to provide patients with information, and I might have suggested that that was a matter of discretion. However, it is actually in the Bill that they must provide information unless “the patient refuses” to accept it. I just wanted to make that clear in case there was any misunderstanding. The remaining Government amendments are largely technical, linking the Bill with the Data Protection Act 2018, for example, and providing clearer definitions regarding mental health units. Those are very much drafting changes, and I hope that the House will approve them.

Turning to the amendments tabled by my hon. Friends the Member for Christchurch and for Shipley and the right hon. Member for North Norfolk, I have already discussed the Government’s view on such matters, but I will refer first to the right hon. Gentleman’s amendments in relation to threats and coercion. The Government’s main concern is that putting the use of threats of force and coercion on the face of the Bill might cause confusion for staff working in mental health units when we are trying to encourage them to use de-escalation techniques. We have the same objective as the right hon. Gentleman, which is to minimise restraint, but we are concerned that the amendments might act as an impediment to what we are trying to achieve.

NHS Outsourcing and Privatisation

Kevin Foster Excerpts

Wednesday 23rd May 2018 Commons Chamber

[Kevin Foster (Torbay) (Con)]

It is quite interesting to be following the speech we just heard. I will not dwell too much on it, but the hon. Member for Lincoln (Karen Lee) mentioned accountable care organisations. Supposedly, they will have “multiple benefits” and

“contrary to what some of the demonstrators suggest will make it easier for the NHS not to go down the private contracting route”.

Those are not my words, but the words of the right hon. Member for Exeter (Mr Bradshaw), a former Labour Health Minister.

I always welcome the chance to discuss the NHS on the Floor of the House and to consider some of the challenges in my constituency, in particular for social care, given that 9% of the entire population of one of my wards is aged over 85. That brings not only challenges around social care, but questions of how those with chronic conditions are cared for by the NHS.

I had hoped this afternoon’s debate would be constructive. To be fair, the hon. Member for Stockton South (Dr Williams), who is not in the Chamber, gave quite a constructive and thoughtful speech based on his own experience and his time serving on the Health and Social Care Committee. The debate, however, started off with what can best be described as a 40-minute partisan rant. It did include one positive and constructive offer of working with the Government on potential legislation but, other than that, it was quite bizarre to hear the Opposition spokesman running down every private contract given, except for those given by Labour Administrations. We heard an intervention by the leader of Plaid Cymru in Westminster about outsourcing in Wales, which is apparently okay because it is not wholesale, but just bringing in the private sector when it is the right thing to do. The Labour Front-Bench speech was a bizarre spectacle, although not surprising from a Member of the party responsible for 118 out of the 125 NHS PFI contracts.

People think PFI contracts are just about building hospitals, but they are not. I was deputy leader of Coventry City Council when University Hospital opened. The private sector did not just build the hospital; virtually all the facilities and services were privatised as a part of the PFI contract, which raised interesting issues with regard to amending it. Again, the idea that this was some sort of spot purchasing is absolute nonsense. This was a 25-year contract that even included guarantees about income from the car park, which ratcheted up the prices.

It is disappointing that the debate has not been more positive, with a consideration of some issues around health and social care. The other bizarre thing is that I have not yet heard one Labour Member talk about the motion or tell us why giving these papers to the Health and Social Care Committee would make much difference. What do they think the Committee would do with them? The terms of the Humble Address have not been talked about at all. It would be interesting to hear—I will be happy to take an intervention from a shadow Front Bencher—what discussions, if any, there were with the Chair of the Committee, my hon. Friend the Member for Totnes (Dr Wollaston), before the Labour party tabled the motion. It strikes me as bizarre that we have a motion stating that the papers are really crucial and should be given to the Committee, yet no one has talked once about why doing so would be sensible.

I will conclude by talking about the positives in my community. The recent announcement of investment in urgent care services in Torbay has been very welcome, and it will certainly make a difference to patients. This will be the first new A&E department for Torbay since the 1970s. It was also really satisfying this week to see the local trust rated as good in its latest CQC assessment. That is a real tribute to all those who work in the NHS locally, and it deserves to be recognised here in this House.

Learning Disabilities Mortality Review

Kevin Foster Excerpts

Tuesday 8th May 2018 Commons Chamber

[Caroline Dinenage]

The hon. Lady is right to raise that, but I will point out that we commissioned the review to examine the situation. We are not running away from our responsibilities; we are standing up and facing them. We are allowing them to be entirely transparent and out there in the public domain for people to judge. The deaths that the report covered come from the period starting July 2016, so they are historical, but it is important that they are examined. The hon. Lady is right to mention the issue of the commissioner, and I will look at that.

[Kevin Foster (Torbay) (Con)]

While the review’s conclusions make difficult reading in some ways, it is welcome that it happened, given that it is a world first and that it gives us the chance to have this discussion. What work will be done with councils and other third sector partners on taking away some of the lessons that can be learned from the review?

[Caroline Dinenage]

My hon. Friend is right to say that this is the first time in the world that such a review has been done. We are the first to have a learning from deaths programme and a Healthcare Safety Investigation Branch, so we take such things incredibly seriously. The whole point of the learning disabilities mortality reviews is that the information will be disseminated to local trusts so that they can make plans to avoid such disastrous, tragic incidents happening in the future.

Oral Answers to Questions

Kevin Foster Excerpts

Tuesday 8th May 2018 Commons Chamber

[Mr Hunt]

The hon. Lady is absolutely right. I have spoken to the social media companies. They are brilliant technologists, and they have a duty to their customers to make themselves part of the solution, not part of the problem, when these things happen.

[Kevin Foster (Torbay) (Con)]

Does the Secretary of State agree that some of this is about ensuring that parents use appropriate techniques—for example, having specific screen times and engaging with their children about what they see on social media—and giving them the tools to do so?

[Mr Hunt]

My hon. Friend is absolutely right. Parents play a vital role, but social media companies can make it easier for parents like us to do the right thing, and sometimes the tools that parents need to use are not readily available.

Breast Cancer Screening

Kevin Foster Excerpts

Wednesday 2nd May 2018 Commons Chamber

[Mr Hunt]

Anyone who has concerns as of today is welcome to call the helpline, but the women whom we know have been affected will be contacted by the end of the month. The first thing that many people will do is take action on receipt of a letter. If they are under 72, the letter will tell them that they will shortly be sent a date for a catch-up scan. If they are over 72, it will tell them how they can get advice as to whether that is appropriate for them.

[Kevin Foster (Torbay) (Con)]

I welcome the tone of the Secretary of State’s statement, even though its contents will be devastating for many people and families across my constituency. Will he confirm what engagement there will be with groups such as local health watches and support networks to ensure that the information that he has given is relayed to them and their users?

[Mr Hunt]

That is a good point. I can assure my hon. Friend that the Department will be leading a big consultation exercise so that everyone is informed about how their individual organisations will be affected.