Healthcare (International Arrangements) Bill

Lady Hermon Excerpts

3rd reading: House of Commons & Report stage: House of Commons
Monday 21st January 2019 Commons Chamber

[The Minister for Health (Stephen Hammond)]

It is a great pleasure to bring the Bill to its Report stage tonight. Before I address new clause 1 and amendment 1, it might help the House if I set out with clarity what the Bill actually does. It provides the powers to fund and arrange payments for healthcare for UK residents, or indeed former residents, outside the UK as well as to share the necessary data to facilitate this. In a deal scenario, the Bill’s powers would support the Government’s attempts and motivation to implement a future relationship with the EU from 2021 and bilateral arrangements with individual member states, should the EU agreement fall short. In a no-deal scenario, the powers would ensure that the UK was prepared for any outcome. This could include implementing any negotiated reciprocal healthcare arrangements, which might differ from the current EU arrangements, or making unilateral arrangements for UK nationals in order to assist with accessing healthcare abroad in exceptional circumstances.

I am grateful to the hon. Member for Ellesmere Port and Neston (Justin Madders) for tabling new clause 1, because it gives me the opportunity to reiterate what I said in Committee about the important issue of financial reporting and facilitating parliamentary scrutiny. I note that, in Committee, the hon. Member for Burnley (Julie Cooper) tabled exactly the same provision as new clause 1, and that it was defeated. I said at the time that I recognised the new clause as a device that Oppositions always used. That does not make it any less relevant, but I explained that the Government were committed to openness when it came to the managing of public money. Expenditure by the Department of Health and Social Care relating to EU reciprocal healthcare arrangements is currently published in this place in the form of annual resource accounts, and will continue to be so. However, given that we do not know the provisions and administrative processes of future reciprocal agreements, the Government are once again unable to accept the proposal. As now, the Department’s future expenditure on reciprocal healthcare would be subject to the existing Government reporting requirements.

However, the hon. Gentleman’s new clause asks the Government to place a statutory duty on future Administrations to collect and report on data, which we have not yet agreed to exchange with other countries. This cannot be appropriate. The frequency and detailed content of a financial report should and could be determined only when reciprocal healthcare agreements have been reached. Currently, the UK and other EU member states are able to collect data and report both nationally and at EU level, as provided for in the relevant EU regulations. Spending on EU healthcare is reported as part of the Department of Health and Social Care annual report and accounts laid before this place.

My Department is currently working to ensure that UK nationals can continue to access healthcare in the EU in exactly the same way as they do now, either through an agreement at EU level or through agreements with the relevant member states. In either case, we will have to agree how eligibility is evidenced, the way in which and frequency with which that information is exchanged and, of course, the reimbursement mechanisms that will govern the new agreements.

[Lady Hermon (North Down) (Ind)]

I have listened closely to what the Minister has said. It would be helpful if he could offer some reassurance to Irish citizens living in Northern Ireland who, under the terms of the Good Friday/Belfast agreement, are entitled to regard themselves as Irish citizens, British citizens or indeed both. I presume that their rights will continue unchanged in Northern Ireland after Brexit. Am I right?

[Stephen Hammond]

The hon. Lady is completely correct. We explored that in Committee, and discussed the purposes of the common travel area. Indeed, there was an explicit debate in Committee on the arrangements for Northern Ireland. I am happy to confirm that to her.

Each of the agreements that we are seeking to strike could differ from country to country. Such agreements will have to take into account the operational possibilities and limitations of each contracting party, to ensure the smooth operation of reciprocal healthcare arrangements. This should include how NHS trusts in the UK can evidence eligibility for the treatment of non-UK citizens in the most efficient and least burdensome manner. Only when these technical details are known will the Government be able to speak confidently to the specific measures that we can report on for each country. Regardless of the specifics of any arrangements entered into, and as with all departmental expenditure, reciprocal healthcare costs are and will continue to be authorised by the Treasury supply process and to be included in the Department’s annual estimates, as well as being included in the annual resource accounts, which are audited by the Comptroller and Auditor General. I said in Committee that I hoped that the hon. Member for Ellesmere Port and Neston would be satisfied by that commitment to transparency, and I give that commitment again tonight. With that, I hope that he will feel able to withdraw new clause 1.

Turning to amendment 1, the hon. Member for Ellesmere Port and Neston again raised the important issue of appropriate levels of parliamentary scrutiny. The Government clearly recognise the importance of such scrutiny for this Bill and for secondary legislation made under it. The hallmarks of an effective and responsible parliamentary system are the processes by which we draft, consider and test legislation, and the appropriate parliamentary procedure for the scrutiny of regulations made under this Bill is the negative resolution procedure. The exception to that is where provision within regulations is needed to make consequential changes to amend, repeal or revoke primary legislation. Consequently, the Government are once again resisting that amendment.

As I have said previously, the powers in this Bill provide the Government with both the flexibility and the capacity to implement detailed and complex arrangements concerning healthcare access abroad. The remit of our regulation-making powers is tightly focused. They can be used only to give effect to healthcare agreements or arrange, provide for or fund healthcare abroad. Therefore, the subject matter to which the regulations relate is narrow. I say again that when regulations amend, repeal or revoke primary legislation, they will of course be subject to the affirmative resolution procedure, which is the appropriate level of scrutiny for such powers. However, where statutory instruments do not make changes to primary legislation, and deal with procedural, administrative or technical provisions, they should be subject to the negative resolution procedure, and that is reflected in our approach to this Bill.

We have been clear about our intentions for reciprocal healthcare in the context of exiting the EU. In the short term, our policy is to maintain the current system of reciprocal healthcare with the EU on a transitional basis until the end of 2020. That would happen automatically if there is an implementation period, and it is something that we are seeking to agree individually with member states in the event of no deal.

Access to Orkambi

Lady Hermon Excerpts

Tuesday 17th July 2018 Commons Chamber

[Lady Hermon (North Down) (Ind)]

Will the hon. Gentleman give way?

[Mr Lewis]

I am going to make progress, if I may, but I will perhaps give way once more later on.

--- Later in debate ---

[Mr Lewis]

I agree entirely with my hon. Friend, and I will develop his argument as I continue my speech.

A quote from Emma, Alex’s mum, sums up many of the frustrations of the constituents represented here today. She says, very movingly:

“Alex has a real love for life and all she wants to do is live a long and happy live without having to fight to breathe.”

That powerful statement says it all.

Since March, when we last debated this issue, NHS England and Vertex have met on four occasions. I welcome the fact that, during those negotiations, NHS England accepted the principle of a funding agreement that supports a portfolio approach to current and future drugs. That is undoubtedly a step forward and a positive response to the contributions parliamentarians made in the initial debate, but it is clear that these negotiations have not produced an agreement that is acceptable to both parties. Indeed, the public recrimination suggests that the negotiations had all but broken down. It remains to be seen whether NHS England’s written offer, made on the eve of this debate, is a basis for progress, but the early indications are not encouraging.

It would be inappropriate for anyone to make judgments about the validity of either party’s case without having full access to the information, which remains confidential for reasons of commercial sensitivity. I know I speak for all parliamentarians when I express concern about the fact that, as my hon. Friend the Member for Dudley North said, NHS England described its offer as “final”. It could lead to a stalemate that once again lets down patients and their families. To be clear, I respect the need for an objective process that delivers appropriate medication and value for money for the taxpayer. If NICE did not exist, it would have to be invented, but—this point has been made time and again tonight—the shortcomings of the current assessment processes are well documented. That is why NHS England’s involvement in this instance is to be welcomed.

Equally, Vertex has the right to seek financial remuneration at a level that maintains its viability and supports the development of the company. Sadly, I am unconvinced that more of the same will lead to an agreement that will enable Orkambi and successor drugs to be made available to people with cystic fibrosis. Consequently—my hon. Friend the Member for Bury North suggested this—I urge the Secretary of State for Health and Social Care to facilitate an urgent meeting with the chief executive officers of NHS England and Vertex. In that meeting, they should seek to resolve any outstanding differences, and agree a rapid timescale for the roll-out of Orkambi across the country and an approach for other relevant drugs. People with cystic fibrosis have been waiting far too long.

[Lady Hermon]

The hon. Gentleman is well aware that health is a devolved matter in Northern Ireland, but we do not have a Health Minister because we have not had a functioning Assembly for 18 months. Will he join me in urging the Minister to liaise with the permanent secretary in the Department of Health in Northern Ireland to reassure the many cystic fibrosis suffers and their families, who are desperately anxious, that we have a drug available? The health service must enter into final discussions to reach the outcome we all want.

[Mr Lewis]

I agree entirely. The absence of a functioning Executive is a source of continued regret to those of us how care passionately about Northern Ireland. Progress has been made, but there is now a stalemate. It is incredibly important that, in the absence of an Executive, Ministers ensure that any solution that is reached also benefits people with cystic fibrosis in Northern Ireland.

The UK Government need to commit to a proactive role to help secure a deal as soon as possible that will ensure access to these new treatments. They must fulfil their own stated ambition for NHS patients to be

“among the first in the world to get life-changing treatments.”

Vertex, the pharmaceutical company, must be fair and responsible with pricing to ensure that a deal on access to new treatments can be agreed—and agreed rapidly. The Government must consider looking towards the future pipeline of treatments for cystic fibrosis to ensure that a robust and fair system is in place for appraising high-cost new medicines to avoid similar issues about access to medicines with other companies and drugs in the future. The time for words is over; on behalf of our constituents, tonight we demand action.

Breast Cancer Screening

Lady Hermon Excerpts

Wednesday 2nd May 2018 Commons Chamber

[Mr Hunt]

That is a very good point. The original issue—or the original potential issue—was identified by people working on the AgeX trial for Oxford University, who then brought it to the attention of Public Health England in early January. One of the issues seems to have been the confusion about whether the scans stopped when someone turned 70 or whether they should carry on until their 71st birthday. That is why we think the original coding error happened, but obviously this is a matter for the review, and we need to learn everything from it.

[Lady Hermon (North Down) (Ind)]

This is a hugely upsetting and serious issue, and I commend the Secretary of State for the great compassion and sensitivity with which he has delivered this very bad news for women throughout the United Kingdom. He mentioned the fact that the Northern Ireland breast screening scheme was slightly different, but he will appreciate that he absolutely must say more to reassure women in Northern Ireland at this time because we have no Health Minister. May we please have more reassurance for women in Northern Ireland?

[Mr Hunt]

I thank the hon. Lady for making that fair and important point. I will make a special effort in the case of Northern Ireland to understand what the situation is and to ensure that it is publicised to the people of Northern Ireland. Absent politicians are able to do that.

Bowel Cancer Screening

Lady Hermon Excerpts

Tuesday 1st May 2018 Westminster Hall

[Nick Thomas-Symonds]

I am grateful for that kind offer, Sir Roger. I am delighted to hear that we can continue for an extra six minutes.

The hon. Member for Eastbourne (Stephen Lloyd) is absolutely right. This is a cross-party issue. I believe that his predecessor spoke in favour of the system that he proposes, and the hon. Member for Hexham (Guy Opperman) contacted me to draw attention to the debate that he led back in 2011. There is broad cross-party consensus for looking at the screening age and at more accurate screening methods, which I will come on to.

Participation rates remain an issue. We should send a very simple message to people: “Please do not ignore your bowel cancer screening kit, which could save your life.” There is no doubt that we must also do more to raise awareness of symptoms. Bowel cancer is often mistaken for other conditions, such as irritable bowel syndrome. That only reinforces the point that a number of hon. Members have made about the importance of highly accurate screening.

Previously, the standard screening test was considered to be the faecal occult blood test—the FOB test, as it is known—and all men and women between 60 and 74 received a home test kit, but that has been changing across the country. The best available test is now the faecal immunochemical test—the FIT—which can detect more cancers and can be set to different sensitivity levels, enabling any traces of human blood that are found to be investigated. The Royal College of Pathologists sent me a useful briefing, in which it indicates that it would expect a 45% increase in demand on pathology if the test were set at one level, but a 480% increase if it were set at a more sensitive level. That sensitivity level is important.

The Welsh Government are introducing the FIT from March 2019. I believe that it was due to be introduced in England in April. I hope that the Minister can update the House on when that will happen. I hope that there will be a decision for Northern Ireland soon. Of course, Scotland already screens people using the FIT at age 50.

[Lady Hermon (North Down) (Ind)]

As ever, it is lovely to have you in the Chair, Sir Roger. We forgive you, of course.

My youngest sister had bowel cancer. Mercifully, she had an early diagnosis because she had a wonderful GP. The hon. Gentleman mentioned Northern Ireland. In the continued absence of a functioning Northern Ireland Assembly, will he and his colleagues, and colleagues from other parties, please support the very active campaigners in Northern Ireland who, like me, wish to see the screening age for bowel cancer reduced to 50?

[Nick Thomas-Symonds]

I am pleased to hear the good news that the hon. Lady’s sister was able to recover well. Of course Members across the House should look to support those campaigners. I am in favour of consistency across the UK. One of the great things about devolution is learning from best practice in different parts of the United Kingdom, and people in Northern Ireland absolutely should benefit too.

There are other differences in testing. In England and Scotland, people aged over 75 can obtain a screening test by calling a free bowel cancer helpline. In England, a one-off bowel scope screening is promised for those aged 55, but only around half of areas currently offer that. Will the Minister update us on how progress towards all areas being covered can be sped up?

As I indicated in answer to the hon. Member for Eastbourne, there is cross-party support for reviewing the age at which testing starts. I ask the UK Government and all the devolved Governments to look at and keep under review the age at which screening begins—that is crucial—and the sensitivity of the tests that are used. It seems to me that reducing the screening age, which many Members have pointed out, and increasing the sensitivity of tests are the two uniting themes.

--- Later in debate ---

[Lady Hermon]

Northern Ireland has not had a Health Minister since January 2017. It would be enormously encouraging if the Minister would confirm that he has spoken to the permanent secretary for the Northern Ireland Department of Health about introducing the FIT technology in Northern Ireland, which is a part of the United Kingdom.

[Steve Brine]

I personally have not, but I will do so, as a takeaway from this debate. The hon. Member for Strangford (Jim Shannon), who is no longer in his place, has made the same point to me in other contexts. I shall speak to my officials and make sure that happens. I will keep the hon. Lady informed.

I have mentioned the bowel cancer charities. I have a regular roundtable with all the cancer charities—it is one of the great privileges of my position. They have worked on the narrative of needing, as they put it, to talk about poo. When mainstream drive time presenters talk, as they did on BBC Radio 5 Live last week, about looking at poo and “taking a look back” as the presenter put it, it shows how far we have come. Breaking down barriers and Members talking about their experience is important, as is the way in which charities approach the subject. We look forward to seeing what the new combined charity can do. It is an important part of changing the narrative and culture, in addition to the Government’s work with NHS England to change the testing regime and the other issues I have mentioned. The battle is long, as it always is with cancer, but with the support of “Team Cancer”, in which I count all hon. Members present, I think we are winning.

Question put and agreed to.

NHS Staff Pay

Lady Hermon Excerpts

Wednesday 21st March 2018 Commons Chamber

[Mr Hunt]

I thank my hon. Friend for making that point. He often raises difficult issues that need to be talked about in this place. We all know that the vast majority of patients are incredibly grateful for the care that they receive from NHS professionals, but occasionally that does not happen. Occasionally, people use services that they do not need to use, which creates pressures and denies other patients what they do need. My hon. Friend is absolutely right that as we start to expand NHS capacity, we need the public to understand their responsibilities as well.

[Lady Hermon (North Down) (Ind)]

I am happy to welcome the statement, but let me take a moment to remind the Secretary of State that we in Northern Ireland have not had a functioning Assembly for 14 months, and we have had no Health Minister for 14 months. How can the hard-working staff members of the NHS in Northern Ireland benefit from the new pay deal? Will the Secretary of State commit himself to speaking to the Secretary of State for Northern Ireland, whom I am delighted to see sitting on the Front Bench, to ensure that NHS staff in Northern Ireland see the benefits of the deal?

[Mr Hunt]

The hon. Lady speaks eloquently and my right hon. Friend the Secretary of State for Northern Ireland was listening to her comments. It is a matter of great sadness that nurses’ pay has fallen behind in Northern Ireland, not because the money was not available, but simply because the Administration were not in place to implement changes. I know that my right hon. Friend will do everything she can.

NHS Winter Crisis

Lady Hermon Excerpts

Wednesday 10th January 2018 Commons Chamber

[Mr Hunt]

I have said I will give way in a moment, but I want to make some progress, too.

Secondly, because many patients can be better seen by GPs, last year’s spring Budget allocated £100 million of capital to help hospitals to set up GP streaming services. In the year the shadow Secretary of State says the Government were sleepwalking, the number of type 1 trusts with GP streaming tripled to 91% of all such trusts across the country. At the same time, we made it massively easier for people to access GPs and nurses over the Christmas period. For the first time, people could get urgent GP appointments at their own surgery, or one nearby, from 8 to 8, seven days a week, except on Christmas day. The number of 111 calls dealt with by a clinician increased to nearly 40%—nearly double the figure in the year before. That, too, has massively reduced pressure on A&Es.

[Lady Hermon (North Down) (Ind)]

I draw to the Secretary of State’s attention the fact that we continue to have no Northern Ireland Executive and therefore no local Health Minister, meaning that there is a specific problem in Northern Ireland. The NHS staff there are absolutely superb, but they have also been under enormous pressure in recent weeks, as have the ambulance crews. It is terribly demoralising and wearisome for them. The Government must take some responsibility, given the continued absence of a Northern Ireland Executive. What recent discussions—and with whom—has the Secretary of State had in Northern Ireland about dealing with the crisis in the NHS and among ambulance crews in Northern Ireland?

[Mr Hunt]

The hon. Lady will understand that because I am the Health Secretary for England, I have not been having an enormous number of discussions about the terribly challenging political situation in Northern Ireland, but I agree that it is incredibly unhelpful for the NHS in Northern Ireland if there is not an Executive. The former Northern Ireland Secretary—I know that the whole House wishes him well with his medical challenges—was very engaged in trying to address that issue, and I know that the new Northern Ireland Secretary will make it her top priority, too, precisely because it matters so much for public services.

Stroke Services

Lady Hermon Excerpts

Tuesday 5th December 2017 Commons Chamber

[Sir David Amess]

If I did not know better, I would have assumed that the hon. Gentleman had read my speech, because I was just about to say that in the past three years there has been a rise in compliance with standards for physiotherapy from 53% to 79%, and from 24% to 47% for speech and language therapy. I know that similar progress has been made in Scotland. With all that in mind, it is essential that the NHS continues to lead from the front. We must utilise some of the newest technologies to improve the effectiveness of stroke treatment, to allow patients to live fuller lives, and to decrease the burden of ill health after someone has suffered a stroke.

Two out of three stroke survivors currently leave hospital with a long-term disability at a cost of £1.7 billion, as I said. The provision of healthcare to people who have had a stroke accounts for approximately 3% to 5% of all healthcare expenditure, which is a vast amount. The cost of stroke treatment will rise to £43 billion in 2025 and £75 billion in 2035. If I remember rightly, I think the husband of the hon. Member for North Down (Lady Hermon) suffered strokes during his illness.

[Lady Hermon (North Down) (Ind)]

It is very kind of the hon. Gentleman to mention my late husband. He did not actually suffer from a stroke; he suffered from Alzheimer’s, which was unfortunately the cause of his death. While I am on my feet, however, may I encourage the hon. Gentleman to put on record his appreciation for all the wonderful charities that work with stroke victims, and that support them and their families after what is a devastating health incident?

[Sir David Amess]

I absolutely join the hon. Lady in celebrating the work of all those charities.

The European Stroke Journal found that improving access to thrombolysis and early supported discharge services alone can contribute to reducing the financial burden of stroke on health and social care services. When the benefits of treatments such as mechanical thrombectomy are included, the costs can be lowered significantly. What measures are the Government taking to address the rising costs associated with strokes in England? I very much hope the Government are considering the widespread use of mechanical thrombectomy, which is a new and effective way of treating some of the most serious strokes caused by a blood clot.

Mental Health: Pharmacists

Lady Hermon Excerpts

Wednesday 25th October 2017 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Jackie Doyle-Price)]

I thank the hon. Member for North Durham (Mr Jones) for bringing this debate before the House tonight. I am especially gratified to see so many hon. Members in attendance. This illustrates the very real concern that we have for suicide as an issue, and I welcome their participation here. I know that the hon. Gentleman has been deeply concerned by this incident, and my thoughts also go out to Alison’s family, friends and colleagues. This must be an extremely difficult episode for them. He has described a young woman of great talent and potential, and with timely support she could still have been with us today. I am truly sorry that we have had to hold this debate at all, but in doing so we must learn the appropriate lessons from this case.

Every death by suicide is a tragedy. As the Minister responsible for mental health, I hear from families bereaved by suicide about the devastating impact it has on them. That is why I am determined to drive forward the action we are taking at national level and within local communities to reduce suicides. I am encouraged that suicide numbers have fallen in recent years but they still remain too high. I am aware that the north-east of England has the highest suicide rate in England, and that Durham has one of the highest suicide rates in the region. Really, however, this debate is about Alison Stamps. I am aware that she was a pharmacist, and the hon. Gentleman has raised the issue of suicide risk among pharmacists. He has also put on record his concerns about Boots as an employer. Alison clearly had support in the workplace, but her colleagues did not know how best to help her, and that is not satisfactory.

The hon. Gentleman might be aware that the Office for National Statistics has published research on the suicide risk in occupational groups. While the research did not find a high risk in pharmacists specifically, there is a heightened risk of suicide among health professionals generally. I understand that Alison’s family raised concerns with the coroner about the awareness of mental health issues in the workplace and the ability of employers to support people who experience problems. This is an important concern and one that the Government are addressing.

First, we are looking at the issue of mental health first aid. In Alison’s case, this could have helped. Although general awareness has been raised, we recognise that there is further to go. That is why we have recently announced that we are investing £15 million to deliver an ambitious national mental health campaign to ensure that at least 1 million people receive mental health awareness training. That will be starting next year. Through innovative national programmes to engage the public and continuing to raise the importance of mental health in the same way that we do with physical health, we will increase awareness and knowledge, as well as challenging stigma.

The real concern that the hon. Gentleman has raised about the support—or rather, lack of it—provided to Alison by her employer is firmly at the top of the list in terms of what the Government are doing to address this issue. We recently commissioned Lord Dennis Stevenson and Paul Farmer to conduct a review of how people are supported in the workplace in relation to their mental health and wellbeing. I can advise the House that the outcome will be published shortly, and we will expect employers to step up to the plate as a result of what is in the review.

Pharmacists carry out important and precise work in dispensing medication, and the hon. Gentleman is right to point out that they are exposed to the very tools that can be used to take their own lives if they are minded to do so. I am aware that organisations such as the Pharmacist Support charity, which was set up by the Royal Pharmaceutical Society, do a tremendous amount to support pharmacists on a wide range of issues. That organisation also publishes information and resources about mental health support.

The hon. Gentleman has asked what more can be done, but from the Government’s perspective, the buck stops with the employers. It is they who must ensure that there is sufficient mental health support for their workers. There is much happening in this space, but change will not happen overnight. I am acutely aware that this has come too late for Alison Stamps and her family and is of little consolation, but I hope that improving mental health awareness and creating more mentally friendly and healthy workplaces will increase the likelihood that people will feel able to talk about their mental health problems at work and be assured they will get the understanding and support they need.

I am pleased to say that the profile of suicide prevention has never been so high, which is testament to the progress we are collectively making in tackling the stigma surrounding suicide and mental health problems more widely. I pay tribute to the hon. Gentleman for that. He has done much to raise awareness in this place of the impact of mental ill health. The Prime Minister has spoken about her commitment to tackling the burning injustices of people who experience mental ill health, and many well-known figures have helped to bring this vital issue into the national conversation. I am grateful to the hon. Member for Blaydon (Liz Twist) for mentioning the fantastic work of the Samaritans—what would we do without them? I am pleased to say that I met Ruth Sutherland just this week. The Samaritans is a key partner as we tackle the whole issue of suicide prevention.

Turning to Government action and the suicide prevention strategy, we are making a big step forward and responding to the calls of stakeholders. We need to ensure that locally managed suicide prevention plans are targeted, and we will provide support where plans are insufficient. We have done that because a previous suicide attempt is the strongest indicator of future risk of suicide, so local areas need to keep that intelligence and act upon it. We welcomed last year’s Health Committee inquiry into suicide prevention, which made a wide range of recommendations to reduce suicides. The Government published their response in July to set out how we are progressing many of those recommendations. We also welcomed the recommendation in the five year forward view for mental health to reduce suicides by 10% by 2020-21. The commitment is supported by an additional £25 million between 2018-19 and 2020-21, and we are working with NHS England and other stakeholders to identify the priorities for this funding in local areas.

Local areas are where real change will be delivered, and I am pleased to report that 98% of local areas have a suicide prevention plan in place or in development. I am also pleased that Durham County Council, which serves the constituency of the hon. Member for North Durham, is part of that 98%. Our aim is to reach 100% by the end of the year, but we need a qualitative assessment of the quality of the plans. We do not want this to be a box-ticking exercise, so we will work with local areas to ensure that their plans are high quality and to identify areas for improvement.

We remain committed to delivering the five year forward view for mental health and the Prime Minister’s mental health reforms. That work is supported by an additional £1 billion of funding up to 2020-21 to ensure that an additional 1 million people can access mental health services. We certainly do not want people like Alison Stamps to feel that they have nowhere to go. Much of that investment will directly impact suicide prevention, such as the £400 million we have invested in developing mental health crisis services in the community and the £250 million to implement liaison mental health teams in emergency departments to support people who present at general hospitals with mental health problems.

[Lady Hermon (North Down) (Ind)]

I am grateful to the Minister for giving way. In Northern Ireland, where health is devolved, we have not had an Assembly for 10 months and we do not have a Health Minister. May I urge the Minister to ensure that there is a suicide prevention strategy? She says that there is a national strategy. I love the word “national” because Northern Ireland is part of the United Kingdom, so will the Minister ensure that the permanent secretary for the Health Department in Northern Ireland is aware of the progress being made in the rest of the United Kingdom? I am encouraged by what she has said this evening.

[Jackie Doyle-Price]

The hon. Lady makes a fair point, and I will ensure that that is taken up with officials in Northern Ireland, because it is important that the situation is tackled locally.

Members may also be aware that we launched the “Beyond Places of Safety” programme this month to provide £15 million of support for local community-based projects to ensure that there are more appropriate places of safety for people experiencing a mental health crisis and to avoid police custody or unnecessary hospital admissions. That builds on the £15 million we invested in the first phase of the programme.

The forthcoming children and young people Green Paper will set out a range of measures to improve access to services and support for young people. We will provide mental health first aid training to all state secondary schools by 2019, and we will expand that training to state primary schools. I hope hon. Members will agree that the Government’s continued investment and drive to improve mental health services will bring real change for people.

The death of Alison Stamps has been particularly tragic. Her case is a clear lesson that employers need to be alive to the mental health needs of their staff, and I make it clear that that is what we expect. There is political consensus that we must address issues such as suicide prevention, so now is the time for us all to take action to make change a reality for people and communities. We must be ambassadors in ensuring that employers step up to the plate.

As I have set out, this Government are committed to tackling the burning injustices experienced by people with mental health problems so that more people will feel able to speak out about their problems and feel confident that they will get support from those around them, including their employer. I was struck when the hon. Member for North Durham said that people are scared to speak out in case they end up being taken down a disciplinary process or losing their job. That is not acceptable, and employers need to ensure that employees realise that support will be forthcoming.

We have made huge strides on delivering parity of esteem between mental health and physical health, and on ensuring that more people have timely access to services when they need them, but there is still much more to do. We must not be complacent in pursuing those goals. We will be tireless in that pursuit, and I can tell from their interest that other hon. Members will be tireless, too. We must ensure that other families do not have to experience the grief and pain that Alison’s family are feeling now.

Question put and agreed to.

NHS Pay

Lady Hermon Excerpts

Wednesday 13th September 2017 Commons Chamber

[Jonathan Ashworth]

I did say I did not begrudge Northern Ireland the money; I was just making the point that the Government have found the money, when they keep telling us that there is no money for anything else. But we are grateful that the Democratic Unionist party has signed the early-day motion in the name of my hon. Friend the Member for St Helens North (Conor McGinn), and we are aware that the DUP has said consistently that it supports getting rid of the pay cap for public sector workers. We would be very happy for the party to join us in the Division Lobby this evening.

[Lady Hermon (North Down) (Ind)]

I am really pleased to hear what the hon. Member for North Antrim (Ian Paisley) has said today, but I want to put it on the record that DUP Members did have an earlier opportunity to support the removal of the pay cap but actually voted against that—all 10 of them—in the debate on the Queen’s Speech. An amendment was tabled by the colleagues of the hon. Member for Leicester South (Jonathan Ashworth), and the DUP voted it down, but we always welcome repentance.

[Jonathan Ashworth]

I am grateful to the hon. Lady and I am grateful that she also signed the early-day motion. This issue may be debated further as hon. Members make their speeches today.

As we know, according to the Office for National Statistics, many public sector workers regularly work an average of 7.8 hours’ unpaid overtime a week, worth £11 billion to the economy. With the pay cap, the Government have effectively been asking them to do more and more on less and less. That is unfair.

--- Later in debate ---

[Mr Hunt]

I will allow the Liberal Democrats to speak for themselves, but suffice it to say that even one MP is quite a large proportion of the Liberal Democrat parliamentary party and we are grateful that it does have some representation here this afternoon.

[Lady Hermon]

Will the Health Secretary take a few moments to address the serious issue of staff morale in the NHS? In Northern Ireland, we have no Assembly and, thus, no Health Minister, so there is no mechanism by which to give our nurses any pay increase. He needs to speak to the Secretary of State for Northern Ireland, as a start, and to address the crucial and concerning issue of staff morale, which is affected by low pay and the pay cap.

[Mr Hunt]

I will happily address those issues in some comments that I am coming on to, but I totally agree with the hon. Lady that this is crucial.

Contaminated Blood

Lady Hermon Excerpts

Tuesday 11th July 2017 Commons Chamber

[Mr Dunne]

I shall make a little progress on devolved matters before responding to other colleagues. Regardless of the style of the inquiry, our intention is that it should cover the whole of the UK, so we will be in direct contact with counterparts in Wales, Northern Ireland and Scotland to discuss that with them and to seek their views before determining those aspects of the inquiry.

[Lady Hermon (North Down) (Ind)]

First, I apologise to the House, the Minister and to you, Mr Speaker, for not being present at the beginning of this very, very important debate. The Minister said that he is going to consult on the inquiry, which will be UK-wide. He will know that we do not have an Assembly, and there is no corresponding Health Minister in Northern Ireland, which is absolutely disgraceful. There is no prospect of our having such a Minister before the autumn, so with whom will the Minister liaise in Northern Ireland in the Assembly’s absence?

[Mr Dunne]

We will ask the Northern Ireland Office to facilitate discussions with officials and representatives in Northern Ireland.

--- Later in debate ---

[Kevin Foster (Torbay) (Con)]

It was interesting to hear the reflections of the hon. Member for Newport East (Jessica Morden) and the personal stories she recounted. That was what brought me to this issue two years ago when I was first elected. Someone came into my office who was heavily disabled, but who should have been fit and healthy. They were relatively young—not much older than me—but their whole life had been dominated by a series of treatments they received back in the 1980s.

This is not an issue of someone having had a couple of opportunities taken away, having lost a couple of quid, or needing to work a little longer before finally being able to retire. This is about people who literally had their whole lives, which were going reasonably, taken away, with all opportunities removed. For many—about 2,500 people—literally the end of their life was caused by a treatment programme that should have helped to cure them.

I agree with the hon. Member for Central Ayrshire (Dr Whitford) that doctors in a hospital or an operating theatre would not be able to look at every single thing; they have to rely on the agencies that vet and certify things as safe. Clearly, in this instance, there was a huge failure.

I am pleased about the progress that has been made over the past couple of years. When I first spoke on this, I remarked that I suspected that my predecessor, at the time he was elected in 1997, would not have expected his successor in 2015 to still be talking about the issue. It is therefore very welcome that we will finally have a public inquiry to examine exactly what went wrong.

I was reassured to hear the Minister saying that there will be genuine consultation around the terms of reference, as they will be very important. If there is evidence of criminal wrongdoing, no aspect of the inquiry should prevent people from being held to account for any criminal liability in a court of law. It would be a great pity if the inquiry that finally brought about justice and answers also prevented people from being held to account in a criminal court.

I was reassured to hear the Minister’s reference to the Hillsborough inquiries— obviously charges have followed on from that, although I will not go into them—and I hope that the same pattern can be established for this inquiry if there is evidence to support it. I am sure that we would all join the calls that anyone with evidence should hand it over to the police immediately. People certainly should not be withholding anything that would be of interest to the police and might identify whether individuals need to be held to account.

It is right that there will be proper consultation on the form of the inquiry. It certainly will need to be able to compel people to take part and provide evidence. I was reassured to hear that the Minister is carefully considering those issues, because that could make quite a difference. If there is an awareness that criminal sanctions might be available but people can just choose not to take part, that might have a negative impact on getting to the truth of what has happened.

It is appropriate that there is some form of time limit on getting to the answers. We can all think of examples of public inquiries that took a long time and seemed to drag on forever. Although people have had to wait decades for this process, there is a limit to how much longer many of the victims—and, in many cases, the children and families of those who have already passed on—will be able to wait for the final answers about what happened.

[Lady Hermon]

The hon. Gentleman will be aware that the Prime Minister recently made the wise announcement that the Government would introduce an independent public advocate to help victims following disasters. Does he agree that it would be wholly appropriate for this independent public advocate to be appointed in time to represent bereaved families and victims right across the UK in this very sensitive and difficult case?

[Kevin Foster]

The hon. Lady makes a powerful point. I am sure that the Minister will have heard it and will wish to consider, as part of the consultation, how the inquiry is structured and how the victims are represented. I can imagine, given the victims’ experience over the past 30 years, that they might have strong views on whether they should be represented by a state-appointed person or someone they know themselves. It is important that the way in which they are represented should be determined through consultation. I am sure that all points will be carefully considered to ensure that these people are represented appropriately.

In my constituency, three ladies have raised this matter with me constantly: Jean Hill, Michelle Digby and Margaret Murray. They have been determined to pursue the matter, to find answers and to reach justice. Even while I have been in the House for the Minister’s speech, Margaret has been in touch to ask when the compensation payments will be made, given that the forms were sent out over 12 months ago. It is important that we resolve all these issues as well as finding the answers to what happened 30 years ago.

I welcome the Minister’s statement today, and I congratulate the hon. Member for Kingston upon Hull North (Diana Johnson) on her pursuit of this matter and on securing the debate. I also congratulate my hon. Friend the Member for Worthing West (Sir Peter Bottomley), who has been diligent in pursuing these cases. I hope that those who have suffered for too long can finally get the answers that they deserve and have an absolute right to receive.