UK Rare Diseases Framework

Kevin Hollinrake Excerpts

Wednesday 24th March 2021 Westminster Hall

[Kevin Hollinrake (Thirsk and Malton) (Con) [V]]

It is a pleasure to speak with you in the Chair, Mrs Miller. I wish to speak about neurofibromatosis, which for obvious reasons is more commonly known as NF1. As far as rare diseases go, it is pretty common. It affects one in 2,700 people born today, and it is more common than cystic fibrosis, Duchenne muscular atrophy and Huntingdon’s disease put together. I particularly want to echo the words of the hon. Member for Blaydon (Liz Twist), who made an excellent opening speech, and I really appreciate the opportunity to speak on these issues.

My focus is on diagnosis and monitoring. I came across NF1 because the Watts family in my constituency had a son, Chris, who had the condition since he was born. He was 31 when he took his life, having managed to pursue a career and live independently. The thing about NF1 is that it can be mild, but then it can become quite severe. He had a tumour that started to grow and was painful, but he was nevertheless told, “Nothing to worry about; it’s cosmetic.” Sadly, it ended up being malignant and he passed away. I think this illustrates the fact that we have a divided approach to NF1. It is seen as either complex or non-complex. For non-complex, there is very little monitoring of what happens, even though it can become complex, and there is very little treatment for the complex conditions other than a couple of specialist treatment centres in London and Manchester. However, there is no clear pathway for one assessment—the non-complex to the complex.

I am very grateful to Vanessa Martin at the Childhood Tumour Trust. They have set up some simple changes they would like to see, and I urge the Minster to engage with them to implement those changes.

Social Care Reform

Kevin Hollinrake Excerpts

Thursday 18th March 2021 Westminster Hall

[Kevin Hollinrake (Thirsk and Malton) (Con)]

I am delighted to be so. It is a pleasure to speak in the debate with you in the Chair, Dr Huq.

I am going to speak, not for the first time, in favour of a German-style adult social care premium. All the speakers today have made good points about the need to resolve the problem, but we must address it with money. The need can be supported only by a financial solution.

There are three elements to getting anything done in the world: building a compelling case; building a coalition of people; and being very persistent. I am sure that the Minister would agree that we have been persistent on this topic and its solution. There is a compelling case for an adult social care premium, which I shall speak about in a second. I think that there is a cross-party coalition forming around it. My hon. Friend the Member for Northampton South (Andrew Lewer) referred to it, as have others, not least my right hon. Friend the Member for South West Surrey (Jeremy Hunt) and my friend the hon. Member for Sheffield South East (Mr Betts), under whose chairmanship I once served on the Housing, Communities and Local Government Committee. There is cross-party consensus that we can build on.

We have to find a financial solution. When we talk about a social care premium people say, “We have national insurance,” but that is obviously already in the tax system being used. There are huge demographic pressures that according to the Office for Budget Responsibility will drive debt to national income to 314% by 2060 unless we tackle the problems, including pensions and healthcare. All the solutions that we hear of generally involve a blank cheque from the taxpayer or the person in need of care, neither of which can be right.

The German-style system—Germany moved to it in 1995 from a local authority-provided system—means that everyone does what most people do, putting a small amount of income away every month, on a mandatory basis. It is roughly 2.4% of income, to save for later rainy days. It is a pay-as-you-go system, so everyone is covered from day one. It is done through insurance companies, so it is not taxation. They are not-for-profit insurance companies in Germany, and I would recommend going down that route as well. There is cover for people on low incomes, so that they do not have to contribute. There is also a cap for people on higher incomes so that it is fair to everyone. Germany delivered that on a cross-party basis. We have cross-party support, as I said earlier, and I worked on two cross-party Select Committee reports on the matter. The Health and Social Care Committee and the Housing, Communities and Local Government Committee recommended it as one of the solutions.

The key part of the solution is the social benefit, in that someone who is independently assessed as needing care can choose a service from a provider, or draw down the money personally and pay it to a friend or relative. That means that people can be cared for best by those who love them most. That is a great solution, and it is a solution for some of the capacity issues, too. It is simple, scalable and sustainable, and I heartily recommend it.

--- Later in debate ---

[Liz Kendall (Leicester West) (Lab)]

It is a pleasure to serve under your chairmanship, Dr Huq. As many others have done, I congratulate my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) on securing this debate. She has been a tireless, long-standing champion of these issues, and I really do pay tribute to her for her hard work.

I think that reforming social care—along with tackling climate change—is the challenge of our generation. If we cannot sort this issue out after the horror of the covid-19 pandemic, then frankly, as policy and law makers, we should pack up and go home, because this pandemic has brutally exposed the fundamental flaws in our system of social care, on which many people who have spoken today and many people who are watching this debate have campaigned for years.

First, despite all the rhetoric, social care is still not treated as equally important to the NHS. We have only to think about all the effort and focus that went into setting up the Nightingale hospitals and contrast that with what happened to care homes. Frankly, there was not a ring of steel around care homes; that was not the case. We can think about the examples of frontline care workers saying that their PPE was requisitioned for NHS staff. I want our NHS staff to have proper PPE, but to have it actually taken from people when they were caring for some of the most vulnerable in society was appalling.

Secondly, social care and the NHS are still not seen as inextricably linked. We saw that with the discharges from hospitals into care homes without covid-19 tests, and we saw it with many care homes feeling abandoned and feeling as though they did not get the support that they needed and deserved from the NHS at the start of the pandemic.

Thirdly, our frontline care workers are chronically undervalued and underpaid. The Minister will know that of the infection control fund that went to care homes, the vast bulk went towards ensuring that frontline care workers were paid enough so that they could self-isolate if they had to have time off sick, and so that they did not have to have several jobs between care homes. Quite frankly, that should not be additional, extra funding; it should be embedded in the bottom line of funding for our frontline care workers.

Finally, the families who do the bulk of caring in this country get precious little help and support in return. Unpaid family carers have come to my constituency office absolutely broken by the pressure from the extra hours of caring that they have had to do. They tell me that they just have nothing more to give. We have to do more to support families in the longer term. I also think that the pandemic has entrenched the misperceptions about social care: that it is about only care homes, not care in people’s own homes, and that it is about only elderly people, not working-age adults with disabilities, who make up a third of the users and half the social care budget.

Of course, the immediate cause of those problems is the 10 years of cuts to local authority budgets. Local authorities have had £8 billion removed, which has meant fewer people getting help and not enough people getting the type and quality of help that they need. We know that there are longer-term problems, too. Social care was never included in the initial creation of our NHS and welfare state. Any politician who has tried to solve that problem has risked being obliterated by their political opponents. We saw that in 2010, with accusations of a Labour death tax, and we saw it with Theresa May’s Government and the accusations of a dementia tax. In the end, however, it is not politicians who suffer, but the users of social care and their families.

There is another issue that has not been touched on so far in the debate: one reason why this issue has not been grasped is that caring work is predominantly done by women and is not valued in the same way as medical care provided by the NHS. We desperately need a new settlement of investment, yes, but we also need one of reform, because putting more money into a system that is not working is not the right approach.

We need a system that works for older people and for disabled people. I want to pick up on a point that several hon. Members have made: ensuring that people do not have to sell their homes to pay for their care is an issue—an important one—but it is not the issue, because for working-age adults with disabilities, that is not the fundamental problem in the social care system. We need a system that works for both.

We need a real shift in the focus of services and support towards prevention and early intervention. I think we should have a “home first” principle and more options between care at home and care in a home. Other parts of the world have lots of different examples of housing and care being brought together, and that is what we need in this country.

We need a system that is fully joined up with, but not run by, the NHS. One thing that care users will say is that they have to tell their stories time and again to lots of different services. We cannot have that in future, because people do not see a health need over here and a care need over there; they have just one set of needs. We should design services around users, rather than getting them to fit into different parts of the system. We need to put the principle of choice and control at the heart of the system, enabling older and disabled people to live the lives that they choose, with a radically transformed, paid care workforce, and radically transformed support for families, too.

[Kevin Hollinrake]

I agree with virtually everything the hon. Lady has said. A funding solution is key, because in order to expand capacity there has to be more money. Does she have a funding solution for that? Would she consider a German-style system, which has cross-party support, or would she at least be willing to sit down with a number of people who support that system to engage with the idea?

[Liz Kendall]

The hon. Gentleman may know that I have been calling for cross-party work on this issue for the past five years. The principles are clear—we should not leave the costs to individuals alone. We should pool our resources and share risks. That is essential for the future. I do not think any sort of private insurance system works. One issue around the cap on care costs was that the Government thought a private insurance market would spring up. That was not the case, and it will not be the right solution for the future.

The Prime Minister stood on the steps of Downing Street 19 months ago and said he would fix the crisis in social care with a plan that he “had” developed—that he had it already. It is still nowhere to be seen. Lord Bethell recently said that now is not the time to have fundamental reforms, because we are busy dealing with the covid crisis. I argue that now is precisely the time for reforms to give people hope that, after the horrors they have been through, there is a better system for the future. That is why I was disappointed not to see anything in the Budget about social care reform.

Yesterday, there was an unprecedented statement from social care leaders, who called on the Government to end years of inaction and fix the system. They said that as well as emergency funding, we need longer-term plans to make social care a cornerstone of the modern welfare state. The crucial point is the potential for social care not only to transform the lives of millions of older people, disabled people and families who use care, but to create jobs and drive economic recovery.

In the remaining minutes, I will focus on this point. We often talk about the costs of reform, but the costs of not reforming the system are just as important. First, social care has huge potential to create good quality, valued jobs in this country. We need 520,000 more frontline care workers just to meet growing demand by 2030. The Resolution Foundation rightly argues that if we want to create jobs immediately in every community—that is what we need to do to level up all parts of the country—social care is the place we should start, and I completely agree.

Secondly, investing in social care is essential if we want all families to be able to balance their work and caring responsibilities. In today’s world, with our ageing population, social care is as important a part of our economic infrastructure as the roads and the railways. When one in three unpaid family carers have to give up work or reduce their hours because they cannot get the support they need to help their loved ones, it is bad for them, because they lose their job and income; it is bad for business, because they lose their skills; and it is bad for the economy.

Finally, investing in social care is vital to make the best use of taxpayers’ money. We should not be paying more for elderly people to be stuck in hospital when they could be cared for in the community and at home. As we seek to get our public finances back on a more sustainable footing, value for taxpayers’ money is essential. This issue is the biggest challenge of our generation. I hope the Minister will tell us when the Government will introduce their reforms, because reforming social care is not just a matter of social justice, but an economic necessity.

--- Later in debate ---

[The Minister for Care (Helen Whately)]

It is a pleasure to speak under your chairmanship, Dr Huq. I thank the hon. Member for Worsley and Eccles South (Barbara Keeley) and her co-sponsor, my right hon. Friend the Member for South West Surrey (Jeremy Hunt), the Chair of the Health and Social Care Committee, for securing this debate on the important and interconnected subjects of social care reform and the social care workforce.

The 1.5 million people who make up the paid social care workforce, and the 5.4 million unpaid carers, do the most wonderful thing—caring for people, whose lives depend on what they do. It is a service not just to those individuals, but to the whole country, and never has that been more true than during this cruel pandemic. Yes, our social care system needs reform. It has needed it for decades, and my party committed to that in our election manifesto. The pandemic gives us a moment in time; if not now, when? The pandemic has delayed our work, but I reiterate the Government’s commitment to bringing forward plans for social care reform this year.

This has been a really good debate, with many well-informed contributions from across the parties. I will mention just a few of them. The hon. Member for Worsley and Eccles South talked about the long-term nature of the problems with social care; the fact that the system is as important for those of working age as it is for older people; and the importance of unpaid carers.

The Chair of the Health and Social Care Committee, my right hon. Friend the Member for South West Surrey, talked about the catastrophic costs faced by one in 10 people, who end up spending over £100,000—using their life savings—on their care, and about the problem of high turnover in the care workforce. I thank him for his recognition of my personal commitment and the work I am doing, largely behind the scenes, on social care reform.

My hon. Friend the Member for Northampton South (Andrew Lewer) drew on his experience in local government, going back around 20 years, if my maths is right. He spoke about the need for closely integrated health and social care. My hon. Friend the Member for Peterborough (Paul Bristow) draw on his personal knowledge, as I have heard him do with great value before. I very much look forward to reading the report on supported housing that he mentioned, and I will look it up. This debate would have been missing something if my hon. Friend the Member for Thirsk and Malton (Kevin Hollinrake) had not mentioned the German system as one for us to consider as we work on proposals for reform.

I will set out some of the support we have given to social care and the social care workforce over the last year, because it really is quite different from anything that has been done by Government for social care before. I also want to pick up on several points that hon. Members made during the debate.

At the start of the pandemic, we identified carers, both paid and unpaid, as essential workers or key workers. That was in recognition of how crucial they are, but also so that they could access support, such as places at school for their children when schools were closed, or priority slots at supermarkets. We made it clear, in guidance and communications to care providers and local authorities, that care staff should receive full wages if required to self-isolate because of covid. That has been one of the uses allowed for the infection control fund, which to date has amounted to £1.4 billion in ring-fenced funding for social care.

To the point made by the hon. Member for Luton North (Sarah Owen), who spoke about care workers being told to work despite having symptoms, that absolutely should not have happened. I have heard of a small number of cases and have investigated, and work has been done to stop that happening. It has been made very clear to care providers that nobody should come into work with symptoms. The Government’s funding was provided specifically so that care workers would not have to worry about lost earnings in the event that they were either covid-positive themselves, or required to isolate as a contact. In addition to that, in January we provided a further £120 million to boost the social care workforce and help providers that faced staff shortages, particularly as a result of staff sickness and self-isolation.

During the pandemic we have also provided free PPE, which runs through to June. We have provided millions of tests to identify covid cases in social care, protecting staff and those who receive care. I was disappointed to hear the shadow Minister, the hon. Member for Leicester West (Liz Kendall), suggesting that there was some form of requisitioning of PPE from social care by the NHS. When I heard stories about that, they were investigated, and the investigations simply did not bear that suggestion out.

On vaccinations, as we started the herculean task of rolling out vaccinations across the country, we put care home residents and staff in the highest priority group. Thanks to the dedication and hard work of so many people, by the end of January we were able to offer vaccinations to all residents in over 10,000 care homes for older people. More than 90% of residents and over 70% of staff have now been vaccinated.

The hon. Member for Central Ayrshire (Dr Whitford) talked about how the pandemic had affected social care workers, including how some social care workers have been bereaved by the sad loss of those they cared for. She is absolutely right about that being a hard part of the experience of the care workforce. I have talked to many care workers over the last year and knowing that they have been facing that during the pandemic has been a real concern to me. I have spoken to employers about this, and many care providers have put in resources—access to counselling and mental health support, for instance—to support their staff to cope with what they have been going through. In government, we have worked alongside the NHS and brilliant organisations such as the Samaritans, Hospice UK, and Shout to provide a package of emotional, psychological and practical resources for the workforce, which includes support helplines and guidance and specific support for registered managers in care homes.

I want social care to have a stronger voice in our health and care system and more visible leadership. That is why, in December last year, we appointed Deborah Sturdy as the first chief nurse for social care. Deborah is providing that leadership. She is already a galvanising force, particularly in supporting infection prevention and control, which must continue, even with the high levels of vaccination that we have.

Hon. Members spoke about vacancies in the care sector and the problem of staff turnover. I am well aware of the challenges for social care employers and how some do struggle to recruit and retain the staff they need in both care homes and the domiciliary care sector. We are and have been supporting the sector with a national recruitment campaign across broadcast, digital and social media, highlighting the vital role that the social care workforce has played during the pandemic, along with the longer-term opportunities of working in care. We are working with the Department for Work and Pensions, and I am working with ministerial colleagues in that Department to promote adult social care careers to jobseekers. I am hearing directly from care providers that they are seeing people taking up those jobs in care and discovering the rewards of care work. However, I am clear that that alone is not the solution to the challenges of having the workforce we need in social care and that, as part of our reforms, we must also focus on what is needed to develop and support the social care workforce.

I turn to social care reform. The Government are absolutely committed to the reform of the adult social care system. As I have said, we will bring forward proposals this year. Despite the challenges of the pandemic, we have been gearing up for the reform so that, as we build back better, we have a system that is fairer and fitter for the future. I assure hon. Members that the work has already begun. In fact, our White Paper, published last month, sets out plans for a health and care Bill that will both further integrate health and social care services and improve the oversight of how social care is commissioned and delivered for people. The Bill will also allow us to get better data on what is going on at a local level so that we can follow the evidence about what works.

The enhanced assurance framework set out in the White Paper will introduce an independent voice through the CQC, with clear and consistent oversight of adult social care, supporting local authorities to improve the outcomes and experience of people and their families in accessing high-quality care and support. That is only the beginning. For the long term, we want a sustainable adult social care system that meets people’s needs and aspirations and gives them the care and support that they need to live life to the full. We want to empower recipients of care and support people to live independently in their own homes and communities for as long as possible. We also want to improve the information provided to the public about the social care system, enabling people to plan for their care and make more informed choices. A stable and well-qualified workforce is central to our ambitions for social care.

[Kevin Hollinrake]

The Minister is doing a fantastic job on this issue, which is one of the biggest issues that faces us. If this is not going to be a blank cheque for the taxpayer or for the recipient of the care, does the Minister agree, as I think the shadow Minister, the hon. Member for Leicester West (Liz Kendall) did, that there has to be a pooled solution, perhaps like the German-style system of social care premiums?

[Helen Whately]

My hon. Friend makes an important point. I will not be drawn into further detail about the system at this point. The questions about funding lie with the Treasury rather than with the Department of Health and Social Care. We want to tackle the problem of the catastrophic costs of care that a minority of people face, as mentioned by my right hon. Friend the Chair of the Select Committee. I emphasise that we have made the commitment that no one who needs care should be forced to sell their home to pay for it. How we do that is indeed part of the reform work.

As we emerge from the pandemic, we will continue talking to stakeholders, pivoting the many conversations that we have been having about covid to more conversations about reform. Our reforms will be informed by a wide range of voices, not only colleagues and experts in the sector but also care providers, the workforce and those with lived experience of the care sector.

I thank all right hon. and hon. Members who have contributed to this important debate. I know that everyone who has spoken is deeply committed to their support of the social care workforce and reforming social care. The Government are on the case to make that happen. I take this final opportunity to thank all of those on the frontline providing care—people who go the extra mile to care for our loved ones, day in and day out. Carers have been truly remarkable throughout this pandemic. It is for them and the people they care for that we must move forward with the much bigger plans for the reform of social care.

NHS Staff Pay

Kevin Hollinrake Excerpts

Monday 8th March 2021 Commons Chamber

[Helen Whately]

I must remind the hon. Gentleman of the difficult times that we are living in: many thousands of people have, sadly, lost their jobs through covid and others have had pay cuts. We are in times of great economic uncertainty, and against that backdrop the Government have to make very difficult decisions. They have made the decision that there will be a pay freeze for much of the public sector, exempting those on the lowest pay and the NHS from that pay freeze—so the NHS workforce will get a pay rise.

[Kevin Hollinrake (Thirsk and Malton) (Con) [V]]

Every 1% increase will cost the taxpayer £750 million, but I did not hear the shadow Health Secretary say by how much he would increase pay or indeed which taxes he would increase to pay for that. Does my hon. Friend the Minister agree that one way to increase resources for health and social care and remuneration for our care workers is by means of a German-style social care premium?

[Helen Whately]

I thank my hon. Friend for his question. I am smiling, because it is not the first time that he has mentioned to me a German-style social care system. I absolutely appreciate the work he has done to look into that and say to him, as I have before, that we will bring forward proposals for social care reform. He is absolutely right that we also need to look at the whole health and social care system as we consider these difficult questions.

Oral Answers to Questions

Kevin Hollinrake Excerpts

Tuesday 23rd February 2021 Commons Chamber

[Nadhim Zahawi]

We are working very closely with the Welsh Government and the other devolved Administrations to ensure that vaccines are allocated as per the Barnett formula. The Secretary of State has quite rightly reassured all the devolved Administrations that they will receive the vaccines to be able to deliver on the targets that we have set. It is great to see that over 860,000 people have received their first dose in Wales. The pace of our vaccination programme means that we have administered more vaccines than any other European country.

[Kevin Hollinrake (Thirsk and Malton) (Con)]

What steps his Department is taking to increase funding for adult social care.

[The Minister for Care (Helen Whately)]

During the pandemic, the Government have provided over £1.1 billion for infection control, £149 million for rapid testing costs and £120 million to boost the workforce in adult social care, and that is in addition to £4.6 billion to local authorities. For 2021-22, we are meeting our commitment to an annual uplift of £1 billion for social care and will provide councils with access to an additional £1 billion.

[Kevin Hollinrake [V]]

Does my hon. Friend agree that the best long-term funding solution for adult social care is a German-style social care premium?

[Helen Whately]

I agree that we need a sustainably funded social care system. I know that my hon. Friend is very well informed of the options. We are committed to taking forward social care reform, and will be publishing proposals later this year.

Public Health

Kevin Hollinrake Excerpts

Wednesday 30th December 2020 Commons Chamber

[Kevin Hollinrake (Thirsk and Malton) (Con)]

I am very supportive of this legislation and the principle of tiers, but the counterpart to legislation is, of course, implementation, which could perhaps be improved by the taking of a more localised approach and by giving local responsibility to our excellent local resilience forum. Will our excellent Minister consider making the North Yorkshire local resilience forum a pilot scheme for a more localised implementation process?

I have listened carefully to many of the speeches in this debate, and I quite understand the concerns about a Government who restrict freedoms. In particular, our Government—a Conservative Government—should be the guardian of our freedoms. We are the party of business and should at all costs keep the economy open, so I can understand the concerns. Having said that, we are also the party that is responsible for running the NHS, and it would not be me or other Back Benchers who have spoken in this debate who would have to answer to the press, to other parliamentarians and to the public if the NHS was overrun by covid, so I quite understand that we need these restrictions.

Today, North Yorkshire has gone into tier 3, which I support—other areas have gone into tier 3 at a similar level of infections—but North Yorkshire is a huge place: our districts are the size of counties in other parts of the country. As you probably know, Mr Deputy Speaker, it takes two and a half hours to drive from one side of the constituency in the west to the east side—and that is not in my car; that is in a good car on a good day. Putting a huge county such as North Yorkshire into one tier masks huge differences in the infection rate among districts. Some districts have an infection rate that is two or three times that in other districts, so it is possible that some of our districts should be in a higher tier and some in a lower tier. We should consider that.

My other concern about tier 3, as I understand it, is that lots of areas have gone into tier 3 and not seen infection rates fall. That may well be because of what we have seen in North Yorkshire: we saw lots of people from other parts of the country that were in higher tiers travel down into York and North Yorkshire because of our greater freedoms. There are a number of things that our local resilience forum might try in York and North Yorkshire—for example, using districts for tiers because of the huge geographical differences and the differences in infection rates, and taking a different approach to solving problems. Our resilience forum identified that the problem in one part of the county was not with hospitality but with household mixing. It introduced an excellent process to speak to households and inform them, which has seen rates falling in one district of the county very successfully.

We might try a shorter, sharper shock, which I would support from a business point of view; I declare my interest in that regard. We may feel that schools should close for a longer period, to try to bring infection rates down more quickly to a level that will enable us to go into a lower tier. I speak as the parent of a child who is doing their A-level exams this year, so I do not say that lightly. We would definitely want to move travel restrictions from guidance to being an offence. That would prevent a lot of the travel we are seeing, with many people moving from different parts of the country into our area, which is increasing infection rates. Whatever the Minister decides, I ask her to take that away. When the police have used their powers in terms of mixing within hospitality venues or households, that has been very effective, and the word has gone round quickly. It would have a similar effect if we started to fine people for travelling without good cause.

We also need to look at the financial side of things now that we are in a higher tier. The monthly grants should be increased for businesses that are required to close and those that can stay open but are affected by covid, and the job retention scheme does not allow those who were employed after 30 October to access it, so I ask the Treasury to look at that.

Coronavirus Vaccine

Kevin Hollinrake Excerpts

Wednesday 2nd December 2020 Commons Chamber

[Matt Hancock]

The hon. Lady asks two incredibly important questions, the first of which the hon. Member for Leicester South (Jonathan Ashworth) asked and I did not answer, for which I apologise. The speed at which we can continue this roll-out will be determined by the speed at which Pfizer can manufacture and whether the AstraZeneca Oxford vaccine, of which we have 100 million doses on order, is approved by the MHRA. I am afraid that I cannot answer the hon. Lady’s question on the timetable, or indeed the hon. Gentleman’s, because it is dependent on the approval of AstraZeneca and the manufacturing process of the Pfizer vaccine.

On the hon. Lady’s second question, I have completely forgotten what it was. [Hon. Members: “Next year.”] Next year, yes, and whether this vaccine is only short-term. One of the reasons we have 357 million doses from seven different vaccines is to be able to vaccinate with further doses if that is needed in due course, whether that is through re-procurement of one of the existing vaccines or by switching to a different vaccine if that is clinically appropriate. That is absolutely part of the potential future plans that we have under consideration, but it is too early to know the answer to that question as well.

[Kevin Hollinrake (Thirsk and Malton) (Con)]

It is wonderful news on the vaccine—many congratulations to all involved, including the Secretary of State. He will concede that it will be some months before restrictions can be lifted. North Yorkshire is the largest county in England by miles—it takes three hours to drive from one side of it to the other—and the variation in infection rates is considerable across the region. Will he consider, when he moves tiers around in two weeks’ time, moving one of the seven districts of North Yorkshire with low infection rates into tier 1?

[Matt Hancock]

As the Prime Minister said yesterday, we do look at the human geography and how the epidemiology shows the spread of the virus is occurring across the country, especially, but not limited to, the big rural counties. We have to be slightly careful in North Yorkshire. One of the challenged areas is Scarborough, where the case rates are elevated. I appreciate that that is a long way from my hon. Friend’s patch. We do look at it at that granular level and make decisions on that basis, but the decision to put the whole of North Yorkshire into tier 2 was taken looking at each part of North Yorkshire on its merits.

Deaths in Mental Health Care

Kevin Hollinrake Excerpts

Monday 30th November 2020 Westminster Hall

[James Cartlidge (South Suffolk) (Con)]

Thank you, Mr Stringer; it is a great pleasure to serve under your chairmanship, and to follow the hon. Member for Hartlepool (Mike Hill) who introduced the debate on behalf of the Petitions Committee. He spoke of the case of Matthew Leahy. It is a terrible tragedy, and I pay a huge tribute to his mother, who has campaigned for years through the pain, which is without limit.

We all sympathise, I am sure, but as the hon. Gentleman said the case of Leahy is not the only one at the Linden Centre, Chelmsford. There have been several others, all tragic, including my constituent Richard Wade. I held an Adjournment debate on the case of Richard Wade in October. At the start of that debate, because the HSE case was live, a much stricter sub judice ruling was given, which meant there were things I could not say in the Adjournment debate that I feel able to say today.

I have a very short period of time and I do not have time to give the full details of Richard Wade’s case. The key point is that, on the day he was found hanging in the Linden Centre in Chelmsford, there is strong evidence that his parents have seen—not just documentary evidence, but other evidence that has come to them, including from people who have worked at the Linden Centre—that when his body was first discovered hanging, still alive, the clinicians who found it either panicked, or for some other inexplicable reason left it hanging, locked the door and allowed some minutes to pass before he was discovered a second time, this time with his parents nearby. At that point he was given resuscitation and urgent medical treatment. We do not know the impact of those crucial minutes on his eventual fate several days later, when he passed away. Essentially, his is a life that I believe could have been saved and a death that could have been avoided.

I will not repeat all the points I made about Richard Wade’s case in my Adjournment debate, other than to say that although he died in May 2015—in fact, I met him going to vote in Great Cornard in May 2015, a few days before I had the great privilege of being elected for the first time, and he was dead several days later—in February 2015 another man, who I believe was called Beecroft, also died by ligature in the Linden Centre in Chelmsford, in the very same bathroom where Richard Wade hanged himself that May. The extraordinary thing is that, when the trust reported on Richard Wade’s death in December that year, it never mentioned that there had been a hanging in the same bathroom three months earlier—as if it were a common occurrence or something. It is quite extraordinary.

When the Care Quality Commission came to investigate, because of course, by April 2015, it had taken over from HSE, I am afraid it did not handle the case well. The CQC did not investigate it initially, because, in the words of the report it issued to the Wades in July, the inspectors effectively did not realise that they had taken over statutory responsibility from HSE. It is a catalogue of failures; the Wade case alone would merit an independent inquiry, but there are also Beecroft, Leahy, Morris and potentially other cases.

At the end of my Adjournment debate my hon. Friend the Minister, who was being covered for at the time because she was isolating, announced an independent review into the deaths at the Linden Centre. I was very grateful for that, because I know she has taken huge interest in the matter and very sincerely so. I hope that that can be a full, robust, independent inquiry, like the one we had last week into the Dixon case, which can uncover the truth and can go into places that other mechanisms cannot.

[Kevin Hollinrake (Thirsk and Malton) (Con)]

These are terribly tragic cases; sometimes they cannot be avoided, of course, but at times they are due to the performance of the trust and perhaps of the management of that trust. Where that is the case, does my hon. Friend agree that the leadership of those organisations must be held to account for their performance?

[James Cartlidge]

My hon. Friend makes an excellent point, echoing the concluding remark from the hon. Member for Hartlepool, and he is absolutely right that there must be accountability. However, when we go into an independent inquiry, there is a danger of saying, “Well, it must be a statutory public inquiry,” and getting into the semantics of the mechanism we use.

I think what my constituents the Wades want is the truth. They simply want to know the truth about what happened to their son. We now have a tangible offer from the Department of Health of a mechanism that all the families can use to get involved, to shape the terms of reference and to help us to deliver something in the public interest—as, again, the petitioners seek—to the benefit of the whole country in terms of wider mental health. Above all, that will bring some sense of accountability to all the families who have suffered so tragically at the Linden Centre in Chelmsford, including the Wades and the Leahys. I believe that the Minister will now act and I give her all my support in doing so.

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[Kevin Hollinrake (Thirsk and Malton) (Con)]

It is a pleasure to speak under your chairmanship, Mr Stringer. I pay tribute to all the speakers today; they have spoken very movingly, particularly the hon. Member for Hartlepool (Mike Hill) and even more particularly Ms Leahy, who sounds like an incredible person. All that she is dedicating her life to now is trying to make sure that lessons are learned and changes are made, and that individuals responsible for mismanagement or maladministration are held to account.

The case I allude to is one with which the Minister is familiar. One of my constituents, Andrew Bellerby, was under the care of the Sheffield Health and Social Care NHS Foundation Trust, so these issues do not just pertain to places like the Linden Centre, which sounds horrendous. He presented himself there one evening, having been referred there by his GP. He had a history of suicide attempts. He was seen by untrained nurses who used a triage assessment tool that was designed by the Sheffield trust. These nurses were not trained to use it. Through that tool, they rated him as presenting no risk of suicide. He was then released back into the community, and sadly that evening took his own life.

Mr and Mrs Bellerby, his parents, have championed the cause of trying to find truth and justice, and have been prevented at every turn by Sheffield Health and Social Care NHS Foundation Trust. The communications have been terrible. It has been denial after denial, lie after lie. Eventually, an inquest proved that the Bellerbys were right and that Andrew Bellerby’s suicide was preventable.

All that Mr and Mrs Bellerby wanted was an apology and an admission of the trust’s failure and mismanagement. Instead, there was denial and obfuscation. It cost in the order of £100,000 in legal costs, much of which fell to the taxpayer, although the actual compensation bill at the end was only £9,000. Incredibly, even after all that time and it having been demonstrated that Mr and Mrs Bellerby were right that their son had been poorly treated by the trust, there was no compassion, remorse or proper apology. It is simply unthinkable.

That was back in 2015. The CQC gave the trust a damning rating in 2016, and did another assessment in 2019. The most recent assessment showed that there were 47 breaches of the trust’s legal requirements. It was rated inadequate, and it is now in special measures. One of the things that runs through the report is constant reference to a lack of training. What had been learned in that four year period? Instead of the trust holding up its hands and saying, “Yes, we got this wrong. Yes, we are going to put it right,” which is what the Bellerbys wanted in the first place—I am sure that is what Ms Leahy wants too—the trust was in total denial.

Mr and Mrs Bellerby want to make sure that the assessment tools are prohibited and not used by the health service. They have stopped being used in the Sheffield trust, I am pleased to say, but there are 32 other trusts that may still be using them. The Minister has been great with this family and has met them personally, with me, and he is championing the cause of trying to improve best practice in this area. Questions remain about whether those lessons have been learned in other trusts around the country. Key to the matter, as hon. Members have alluded to in speeches today, is whether the leadership of the trust in question, and other trusts, has been held to account for the maladministration. Kevan Taylor was the CEO at the time, and the accountable officer. He has now left and a new chief executive has taken over. I would really like to know whether he left with a payment, and without any blemish on his track record, or whether he has been held to account or sacked for his underperformance. Demonstrably, for years there has been underperformance by the leadership of the trust. Unless we start to make sure that the individuals who run trusts are held to account if they get things wrong—many do a fine job, of course—such tragic cases will continue to happen.

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[Ms Dorries]

The hon. Lady is absolutely right, and we would hope for an interim report, but it would depend on the chair. Once we have appointed a chair and secretariat and have the ability to appoint a QC, as required for interviewing witnesses, we will have as a Department, as Ministers and as MPs—independent means independent. Nobody can have any influence on the inquiry, but we would ask for an interim report, particularly if there were findings. However, we have to be aware that findings could prejudice something that might come as a result of the inquiry. Learning is absolutely the key, which is why we have established the Healthcare Safety Investigation Branch.

This is an important point at which to mention medical examiners. In April 2019, we introduced medical examiners into hospitals. If there is a death of a patient today, a medical examiner will examine the death certificate—the hon. Member for Tooting (Dr Allin-Khan) will know this, as she is a practising doctor—look into the circumstances of the death and liaise with the bereaved family. We would hope that the circumstances surrounding a death are already improved by the medical examiner system, which incorporates learning too.

It has been some considerable time since there has been any kind of inquiry into a mental health setting, so it is important that we have an inquiry in order to have a 20-year window. We can take those examples, look at the report and take away the learning. If that can be introduced in an interim report that we can take away, that would be excellent. I cannot guarantee that, however, because we do not know what the chair or secretariat will find once the inquiry begins.

I did not finish replying to an earlier intervention. I hope the inquiry will commence in the second week of February, but the chair and secretariat will be appointed before the December recess.

[Kevin Hollinrake]

Assuming that the independent inquiry finds that somebody is culpable within the management, will the Minister set out what sanctions might be available to her or to the inquiry to hold those people to account?

[Ms Dorries]

As a Minister, it is not my role to issue sanctions, but if the chair discovered anything even remotely untoward during the inquiry, it would be referred to the police. The inquiry does not cover up criminal activity—that is the case for any inquiry, not just this one. There would be accountability.

Oral Answers to Questions

Kevin Hollinrake Excerpts

Tuesday 17th November 2020 Commons Chamber

[Edward Argar]

I am delighted that my right hon. Friend the Secretary of State recently gave these plans the green light following independent advice from the IRP, and I am pleased that this will mean my hon. Friend’s constituents and, indeed, many others will benefit from a new state-of-the-art NHS hospital in Sutton. Patients and the public will now be engaged in shaping the detail of the new services; I encourage all local people to participate positively in that process and the council and others to get behind that scheme and that record investment by this Government in his area.

[Kevin Hollinrake (Thirsk and Malton) (Con)]

What recent discussions he has had with the Chancellor of the Exchequer on reducing the economic effect of the covid-19 outbreak.

[The Secretary of State for Health and Social Care (Matt Hancock)]

I have regular discussions with the Chancellor of the Exchequer and others. The best strategy for both health and the economy is to suppress the virus, supporting the NHS and the economy, until a vaccine can make us safe.

[Kevin Hollinrake]

The economic effect of the lockdown on the hospitality sector in particular is severe. In large constituencies such as Thirsk and Malton, the infection rate can vary significantly across different districts. When my right hon. Friend moves us back to a tiered system on 3 December, will he look at allocating tiers by district rather than by county to keep the economy as open as possible?

[Matt Hancock]

Throughout the process of the tiered system, we have always looked at a level of granular detail, whether at district council level or, indeed, ward level in some cases, to make sure that we have the appropriate measures in the appropriate places. While it is too early to say exactly how we will proceed from 3 December, that is a commitment that I can make to my hon. Friend.

Coronavirus Regulations: Assisted Deaths Abroad

Kevin Hollinrake Excerpts

Thursday 5th November 2020 Commons Chamber

[Matt Hancock]

The hon. Lady makes an important contribution to the debate in respect of how we should consider these issues.

[Kevin Hollinrake (Thirsk and Malton) (Con)]

I respect the views, which are all earnestly held, on either side of this issue. As my right hon. Friend has said, this is a matter of conscience. I am happy to put on the record that I am with the 80% of British people who think that to bring forward assisted dying with the proper checks and balances is the right thing to do. What are my right hon. Friend’s personal views on this issue, as the Member for West Suffolk?

[Mr Speaker]

I will be quite honest: I do not want to enter into personal arguments. I am not giving my view, and I do not think it is right to put the Secretary of State on the spot in that way.

Covid-19 Restrictions: South Yorkshire

Kevin Hollinrake Excerpts

Wednesday 21st October 2020 Commons Chamber

[Edward Argar]

I hope that the hon. Lady will forgive me; I did not see the evidence to the Select Committees, as I was preparing to come to the House. However, as she will be aware, the SAGE paper that was published recently, in referring to so-called local circuit-breaker lockdowns, did not say it was a one-off and would solve the problem. We are confident that we are taking a proportionate and effective approach on a regional and local basis that will, assuming that compliance is there, continue to drive down infection rates effectively, coupled with an effective economic and financial support package agreed with local leaders.

[Kevin Hollinrake (Thirsk and Malton) (Con)]

Although my thoughts are with the people of South Yorkshire and businesses in South Yorkshire, my primary responsibility is to people in North Yorkshire. Will my hon. Friend help to scotch any rumours that are circulating that North Yorkshire is about to go into tier 2 when its rate of infection is well below the national average? If there is any need to put us in a higher tier, will he look to do that on a district-wide level, where there is significant variation across North Yorkshire, rather than purely at county-wide level?

[Edward Argar]

If I recall correctly, I believe that my right hon. Friend the Secretary of State was able to offer my hon. Friend a reassurance relatively recently in the House in respect of the approach that he was looking to take in that context, and that still stands.