Internationally Recruited Health and Social Care Staff: Employment Practices

Kwasi Kwarteng Excerpts

Wednesday 31st January 2024 Westminster Hall

[Kwasi Kwarteng (Spelthorne) (Con)]

I beg to move,

That this House has considered employment practices for internationally recruited health and social care staff.

I am very pleased to introduce this very important debate on a very important issue, which in the hubbub of the emotional conversation around immigration has not, as far as I am aware, been thoroughly discussed or even addressed; it relates to the critical work undertaken by people in the health service and particularly in social care. What I have noticed, and what has been brought to my attention, is that because of high levels of immigration, we have brought in people who are recruited to work in our health and social care system who have often, though not always, been badly treated and poorly paid.

We all know that the health and care worker visa has been exempted from the increase in the earnings threshold for skilled workers, so a lot of the people underpinning our social care and healthcare earn very little income; they are also often very vulnerable and not particularly fluent in English. Given the concern felt by everyone in the House about human trafficking and modern slavery, there is also a real concern that a large number of healthcare and social care workers are being exploited in a way that none of us wants to see.

There is a particular issue with regard to workers who leave their contract before an agreed period. The code of practice allows for this, but there has to be a reasonable expectation; fees owed as a result of workers leaving their contracts early should be reasonable. I have heard reports of fees in excess of £10,000. That is completely unacceptable. In that situation, the contracted employee is being exploited—and it very much has the look and feel almost of extortion. I am sure that the Minister is very concerned about this issue. In the midst of a very charged debate around immigration, it is something about which any Government professing humanity, and looking after our people, should be concerned.

On top of all the exploitation, and in the context of staff who are often highly vulnerable, there are reports that rogue international recruitment agencies have extorted —that is a word I use with some degree of caution, but they have extracted payments—from people. That is really a form, dare I say it, of trafficking. Often when the workers find themselves in the UK, perhaps because of language barriers or a lack of knowledge, they find themselves with no recourse; their employment conditions are often deplorable, but they cannot find a way to push back against some of the more extreme demands. I mentioned repayment clauses, and anecdotally I hear that there is often a lack of understanding of what exactly people are signing up to.

We all understand that we need people who can operate in our social care system and support us in maintaining the health of an ageing population, but that employment needs to be regulated. One statistic that particularly horrified me was that between January and September last year there were something like 76 reports and referrals with modern slavery and human trafficking indicators in the care sector alone. That is a couple a week, and of course that could be just the tip of the iceberg. I am very pleased to be able to have this debate, and I look forward to hearing what the Front Benchers—particularly the Minister—have to say.

I have spoken about the problem and outlined the situation broadly. I think we all feel a measure of concern about it, but we have to look forward and think about ways we can improve the situation. I have spoken to friends, and liaised with people I know at the Royal College of Nursing and some of its officials, and a lot of what they say is eminently sensible: there should obviously be standards for induction; the Department of Health and Social Care needs to establish pastoral and professional support; and there needs to be some sort of structure by which we can monitor potential exploitation and even trafficking in this area.

From what I have heard, we know very little about this phenomenon: we know very little about the number of people whose lives are blighted by exploitative practices. We talk all the time—in this House and outside—about immigration. We talk about the scale of immigration, but we rarely talk about the types of immigration that we are seeing, and I am not aware that we have dealt with this specific issue.

There is a code of practice for the international recruitment of health and social care personnel in England, which was last updated in August 2023, but what is a code of practice? It seems to me that it is really only a start in investigating the seriousness of what is being alleged. Publicly available hard evidence is difficult to come by, but we all know of reports; in my constituency, I have heard pretty hair-raising stories about the conditions in which many such workers find themselves.

I think there is a question about the code of practice. We should always be trying to get the best standards. I am sure that the Minister is fully aware of that, given her experience. We must always be interrogating ourselves, and ensuring that our guidelines and codes of practice are fit for purpose and up to the job. Given reports of rising numbers of exploitation cases, there is a broader question about whether the code of practice for international recruitment is really up to scratch. I know that colleagues and friends in the RCN have questioned whether the current code is really doing its job.

I am afraid to say that the issue of human trafficking and modern slavery will always be associated with immigration and bringing people into the UK. It is a very negative side-effect of seeing huge numbers of people coming into the UK about whom we know very little. I appreciate that the Minister is here today to represent the Department of Health and Social Care, but it is an issue not just for that Department; there are wider agencies of Government and more Departments involved. I will be very interested to hear what she says and, if at all possible, about the work that her Department is doing across Whitehall, with Treasury and Home Office colleagues, to get a better measure and a firmer grip of this chronic and increasing problem.

--- Later in debate ---

[Kwasi Kwarteng]

We have had a wide-ranging and generally quite even-tempered discussion, although people have occasionally strayed into the political stuff. The point of these debates is to have a broad and tempered discussion, and the spirit with which we have debated this matter does the House proud.

This issue has not had the attention that it deserves, and it is clear that Members on both sides of the House and from all parties are concerned about it. It is also abundantly clear that, whoever the election decides will form the next Government, it will be even more important and critical that this issue has our focus, whether that Government is Conservative or Labour. I am delighted that the Minister spoke at length, showing her understanding and experience. This is only really the beginning, and I look forward to more debates in the future on this sensitive and difficult subject.

Question put and agreed to.

Resolved,

That this House has considered employment practices for internationally recruited health and social care staff.

Sudden Unexplained Death in Childhood

Kwasi Kwarteng Excerpts

Tuesday 17th January 2023 Westminster Hall

[Kwasi Kwarteng (Spelthorne) (Con)]

I beg to move,

That this House has considered sudden unexplained death in childhood.

It is a great honour for me to give my first speech as a Back Bencher in about six years on this vital subject. We are here to discuss something that is incredibly difficult to deal with, emotionally very taxing, and one of the most serious medical phenomena in our country—something that has not had the public attention it deserves: sudden unexplained death in childhood, or SUDC.

This vital subject was brought to my attention while I was still in Government. Julia and Christian Rogers came to see me at the beginning of October, when I was still Chancellor of the Exchequer. In that role, I would not have been able to raise this vital subject personally. I pay tribute to my constituency neighbour, my hon. Friend the Member for Runnymede and Weybridge (Dr Spencer), for his diligence in pursuing the subject while I was still in Government. Luckily, as a matter of privilege to me, I can now raise it myself. I cannot think of a better, more urgent subject to raise in my first Back-Bench debate for many years.

When Julia and Christian came to see me in October 2022, they told me the story of their son, Louis, who tragically passed away in 2021 before he reached the age of two. Julia and Christian lived with Louis in Shepperton in my constituency, and they loved their little boy with all their hearts. Of course, no occurrence is more tragic than the death of a small child. It was particularly disturbing that they knew very little about the illness that took away Louis’ life. One can only imagine the horror of discovering one’s child lifeless, and the sheer bewilderment of trying to understand the causes of that tragedy.

Julia and Christian introduced me to other bereaved parents who had gone through this heart-wrenching occurrence. The national charity SUDC UK does vital work to promote more understanding and sensitivity around a subject that, as I said, has drawn too little attention in the past. SUDC is among the leading categories of death in England and Wales for children aged between one and four. As a community, we have to engage more vigorously with this phenomenon.

Technically, SUDC is the sudden and unexpected death of a child between one and 18 years of age. Those deaths, by their definition of sudden and unexpected, often remain unexplained after a thorough investigation, including a post-mortem. This is one of those areas that modern medical science has still not really got to the bottom of, despite the great advances we have made.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

It is good that we can unite and collaborate to address some of the issues raised by SUDC. Christian’s aunt is my constituent, so I learned about Louis from her. Many of us here are parents, and this issue is deeply worrying. Like the hon. Member for Runnymede and Weybridge (Dr Spencer), I was a public health consultant and have come here from working in the NHS. This issue has not had the profile it needs—just 50 research papers, compared with 12,000 on sudden infant death syndrome. I hope we can do some joint working on the issue to raise the profile of risk factors and so on.

--- Later in debate ---

[Kwasi Kwarteng]

I am very pleased to join the hon. Lady in raising the profile of the condition. This category of death has never really gathered the attention it deserves. As far as I know, this is the first time it has been debated on the Floor of the House in this Parliament.

[Andy Carter (Warrington South) (Con)]

I pay tribute to my constituents, the Grogan family, in particular Sarah, a teacher at Cobbs Infant School in Appleton. She has been in touch with me to tell me about her experience with Frankie, her little boy, who died at the age of three. Sarah has helped to inform medical professionals, including GPs, through the videos she has made. I have learned a tremendous amount from her, and I am sure my right hon. Friend will join me in paying tribute to her for her work on this important topic.

[Kwasi Kwarteng]

I am delighted that my hon. Friend has made that contribution. I must press on to the end of my remarks and look forward to what other hon. Members have to say on this sensitive, moving and tragic subject. The silver lining is that we will be able to make more progress in the years ahead.

It is vital to get on the record an undertaking from the Minister and his Department to encourage consistent medical education and training—there is currently very little—to help prioritise research into this category of death. Our urgent, immediate request is an undertaking to increase public information about this tragic phenomenon. How will the Minister help to prioritise scientific research to better understand this phenomenon, and to work out ways we can prevent and reduce the tragic deaths such as those experienced among many of our friends and wider communities?

I have written to the chief executive of the NHS to ask for more and better public information. The website should be updated. I urge the Minister to engage with NHS officials and managers through a commonly agreed platform, on which we can progress.

The initial response to this debate has been incredibly heartwarming and impressive. In the last few days, dozens and dozens of people have written in. They have outlined their experiences and told us about their own tragedies and their families, which have been torn apart and devastated by this phenomenon. It would be invidious of me to talk about those responses individually, but common themes run through all the submissions in this overwhelming response—in all the evidence we have accumulated in the last few days.

The thing that comes out most tragically and vividly to me is the sense of utter bewilderment about the cause of death. Many of us in our lives have dealt with personal tragedy and the passing of loved ones. In most of those instances, we have understood the nature of the illness, and there has been a degree of timing and ability to adjust to an appalling series of events. But let us imagine the death of a child who has all of his or her life in front of them and it is suddenly ended. If we can imagine that for one of our own children, we get a sense of how tragic and difficult that occurrence is. I commend the many people here who have gone through that heart-wrenching experience, who have had the courage to reach out to come and speak to MPs, and who work incredibly hard to make sure this goes further up the agenda.

The other principal thing that I have noticed is that there is not only bewilderment and the initial horror and confusion around the event, but a marked degree of ignorance about this phenomenon among the wider public. People do not know about this. We used to read and hear about what was called cot death, which was technically applied to children under the age of one, but, for the age group between one and four and for older children, there was not even a word or a phrase to describe what happens. If this debate can start a wider conversation about SUDC, I will feel that we have done a bit of our job. This is not the end; this is just the beginning of a wider debate on a deeply tragic occurrence.

Finally, because we do not have much time, I want to thank Nikki Speed, the chief executive officer of SUDC UK, who is here, and Julia and Christian Rogers for bringing this important subject to my attention and enabling us to have a wider debate. As I have said, I think it is the first time that this has been discussed, certainly in my experience as an MP of 12 years, in these precincts. I hope we can continue to work together to find adequate solutions and improve outcomes for people in this country.

We have had successes on the phenomenon of cot death—we made huge strides with that—and it is vital now that we turn our attention and expertise to SUDC. I thank Members from across the House who have listened with real respect not to me, but to the gravity of the debate. I am very interested to hear what my hon. Friend the Minister will say in response to our speeches.

[Derek Twigg (in the Chair)]

May I remind Members that they should bob if they wish to be called in this debate? There are five standing, so I must limit speeches to five minutes or so to get everybody in. I am sure you will all work together to try to achieve that before the wind-ups. I call Tim Farron.

--- Later in debate ---

[Kwasi Kwarteng]

Thank you, Mr Twigg. We have heard some fabulous and heartfelt speeches from across the House. In many years in Parliament, both on the Front Bench and on the Back Benches, I have debated many issues of national importance, but I do not think that any of the issues I have ever spoken about has had such emotional impact on the people affected. I was particularly struck by the concordant note—the note of agreement—from Members of all parties. It seems to me that there are a number of things on which we all agree—a number of important issues where there is broad consensus, and on which we will be challenging the Minister and his colleagues to make progress.

Undoubtedly, research is the key element. We heard that there are something like 13,000 papers on SIDS, by contrast with 50 on SUDC. That balance has to shift somewhat if we are to get improved outcomes on SUDC. Clearly, public awareness has to be a big part of getting better results. Hon. Members have mentioned the NHS website, and I feel very strongly that it should be improved to incorporate many of the things we have discussed today.

Finally, it is really important that we continue to revisit this issue. On many occasions, I have had debates here in Westminster Hall or in the main Chamber where we have said lots of warm words, but we have had very little in the shape of follow-through. On an issue of this kind, which is so important and has touched everyone emotionally, we have to be able to follow through. I urge the Minister to meet Nikki, other families and people involved in SUDC UK’s vital work, so that we can have a dialogue and achieve much better outcomes than we are currently seeing today.

Question put and agreed to.

Resolved,

That this House has considered sudden unexplained death in childhood.

National Security and Investment Bill

Kwasi Kwarteng Excerpts

Report stage & 3rd reading & 3rd reading: House of Commons & Report stage: House of Commons
Wednesday 20th January 2021 Commons Chamber

[The Secretary of State for Business, Energy and Industrial Strategy (Kwasi Kwarteng)]

I beg to move, That the Bill be now read the Third time.

First, I would like to pay tribute to my immediate predecessor, my right hon. Friend—my very good friend—the Member for Reading West (Alok Sharma), who took the Bill through on Second Reading. I pay tribute to him for being such a motivating force behind this Bill, and also for providing excellent leadership in our Department up to only a couple of weeks ago. I wish him well, and I am sure he will continue the excellent work that he has already started as president of COP26, which I am sure will be a brilliant and vital success.

I would like to return to the very core of why we need this Bill. As my right hon. Friend told this House, the UK remains

“open for business, but being open for business does not mean that we are open to exploitation. An open approach to international investment must also include”—

has to include—

“appropriate safeguards to protect our national security.”—[Official Report, 17 November 2020; Vol. 684, c. 205.]

This Bill provides those safeguards.

Subject to the debate in the other place and the views of the other place, the Government will be automatically informed of certain acquisitions in key sectors and will be able to scrutinise a range of others across the economy. The Government will also be able to look at deals involving assets, including intellectual property, whose acquisition might pose a national security concern. There will be no thresholds for intervention, as there are currently under the Enterprise Act 2002. This means that acquisitions involving emerging innovative businesses will also be covered by the Bill. All this adds up to a significant upgrade to our abilities and powers to reflect the sweeping technological, economic and geopolitical changes across the globe over the past 20 years.

I would like to make further acknowledgement of the work done so ably by those from across the House and in my Department that has got us to this point. I thank the Under-Secretary of State for Business, Energy and Industrial Strategy, my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi), and the Bill team for their fantastic work to date. He even managed to convince me. I know he is working flat out to ensure we can all return to normal before too long. I thank those who have ensured that the proceedings of this House continued without any disruption in the meantime. I therefore place on record, Mr Deputy Speaker, my thanks to you, to Madam Deputy Speaker, and to all the House staff who have ensured that today’s proceedings and previous stages of the Bill were undertaken with exemplary smoothness—no mean feat in the circumstances.

I also thank the members of the Public Bill Committee from across the House for their keen and diligent scrutiny of the Bill, and particularly its Chairs, the hon. Member for Halton (Derek Twigg) and my hon. Friend the Member for Altrincham and Sale West (Sir Graham Brady). I also thank all those who contributed to this very important debate. We heard from eminent Select Committee Chairs. My hon. Friend the Member for Tonbridge and Malling (Tom Tugendhat) is no longer in his place, but I have known him for a very long time, and I was very pleased to hear his able contribution to this debate. I thank my right hon. Friend the Member for New Forest East (Dr Lewis), the Chair of the Intelligence and Security Committee. His expertise is widely acknowledged across the House and was brought to bear in the proceedings.

In addition, we heard from Members from across the House, including my right hon. Friend the Member for South Holland and The Deepings (Sir John Hayes), and my hon. Friends the Members for Beckenham (Bob Stewart), for Isle of Wight (Bob Seely), for South Ribble (Katherine Fletcher) and for Arundel and South Downs (Andrew Griffith). The right hon. Member for North Durham (Mr Jones) is an acknowledged expert, and devotes himself to these highly important issues. There were also contributions I noted from the hon. Members for Aberavon (Stephen Kinnock), for Ilford South (Sam Tarry), for Liverpool, Riverside (Kim Johnson), for Warwick and Leamington (Matt Western), for Caithness, Sutherland and Easter Ross (Jamie Stone) and for Strangford (Jim Shannon). I thank all those right hon. and hon. Members for their important contributions.

Although there have been one or two differences, I have above all been struck by the broad consensus that has emerged across the House on the Bill, and by how important it is that we all agree that the Government should act in this area. There is a degree of debate about the details of the Bill. I thank the Opposition Front Benchers—the right hon. Member for Doncaster North (Edward Miliband) and the hon. Member for Newcastle upon Tyne Central (Chi Onwurah)—and the SNP spokesperson, the hon. Member for Dundee East (Stewart Hosie). All have acknowledged the need for this crucial legislation. Broadly, they have approached the Bill in a constructive manner. For that, my right hon. Friend the Member for Reading West and I are and have been extremely grateful.

Returning to what my right hon. Friend the Member for Reading West said on Second Reading, this country has always been a beacon for inward investment and a champion of free trade. The Bill does not change that. It does not turn its back on that history, but it feels very apposite for me to say that prosperity and security should go hand in hand. The Bill really captures that insight and represents a proportionate approach to the threats we face in today’s world. On that basis, I commend the Bill to the House.

[Mr Deputy Speaker (Mr Nigel Evans)]

As this is the first time I have been in the Chair since your promotion and appearance at the Dispatch Box, I congratulate you on your new role.