Oral Answers to Questions

Debate between Lindsay Hoyle and Maria Caulfield

Wednesday 15th May 2024 Commons Chamber

[Maria Caulfield]

As usual, this Government have already done all of that work. In England we have the Wellbeing of Women pledge, which the NHS, the civil service and this Parliament have signed. We will take no lectures from Labour on women’s health. While we have had a women’s health strategy for two years, Labour-run Wales has no health plan for women.

[Mr Speaker]

I call the shadow Minister.

Oral Answers to Questions

Debate between Lindsay Hoyle and Maria Caulfield

Wednesday 20th March 2024 Commons Chamber

[Maria Caulfield]

Actually, the results from our gender pay gap reporting are slightly different: it is in higher-paid professions that the gender pay gap seems to exist, but that is because women are often in low-paid work. The hon. Member is absolutely right to raise the issue. Next month, we are introducing a pay rise of 10% for the lowest paid through an increase to the national living wage. After the national insurance cut, added on to the cut in January, people will be almost £900 better off in work.

[Mr Speaker]

I call the Chair of the Women and Equalities Committee.

Oral Answers to Questions

Debate between Lindsay Hoyle and Maria Caulfield

Wednesday 7th February 2024 Commons Chamber

[Maria Caulfield]

I would respectfully say to the hon. Gentleman that God gave us two ears and a mouth for a reason, and I would encourage him to put his listening ears on to hear about the track record of this Government. We have, for instance, improved payments for carers, introduced groundbreaking legislation to allow flexible working from day one, and legislated for parental leave including shared parental leave and paternity leave. The kinship care strategy was launched in December to provide a funding model for kinship carers. We have gone further than any Government with our plan to improve the lives of carers and value the work that they do.

[Mr Speaker]

I call the Scottish National party spokesperson.

Oral Answers to Questions

Debate between Lindsay Hoyle and Maria Caulfield

Tuesday 23rd January 2024 Commons Chamber

[Mr Speaker]

It is going to be a long year.

[Maria Caulfield]

I have news for the hon. Gentleman, because we have a plan and it is working. Our investment of £143 million into crisis support is showing early evidence of reducing admissions—admissions are 8% lower. With the crisis telephone services, which are available 24/7, we have admissions down 12%. More importantly, detentions under the Mental Health Act are 15% lower. We have a plan, and it is working.

Measles

Debate between Lindsay Hoyle and Maria Caulfield

Monday 22nd January 2024 Commons Chamber

[Maria Caulfield]

I remind the hon. Lady that health is a devolved matter across the United Kingdom. When she refers to the United Kingdom’s lower MMR vaccination rate, does she include Labour-run Wales? Wales has also not met the WHO threshold, and neither has Scotland, Northern Ireland or England. It is a real shame to play politics with this issue. This is an issue of the utmost importance.

As I have set out, this Government have been working over the past 12 months to get vaccination rates up in England, and we have seen a 10% increase. There are a range of reasons why we are seeing certain parts of the country and some communities not coming forward. The hon. Lady touched on the concerns of the Jewish and Muslim communities that a wide range of MMR vaccines are porcine vaccines. We do have non-porcine vaccines available. Priorix is not just available on request; following a meeting that we had with west midlands MPs, we proactively pushed Priorix out to communities. The help of local MPs to get that message out to communities would be extremely valuable. There is also a halal vaccine available. Again, we need to get that message out, so that people do not have to request it; it would be routinely offered to them.

We are also undoing much of the damage done to the Wakefield cohort of young adults, who were born between 1998 and 2004, when Dr Andrew Wakefield’s discredited paper on the risks of MMR led to a drop in the numbers coming forward for the vaccine. Those young adults are eligible for vaccines right now to try to prevent the spread of measles.

We also know that covid disrupted the routine vaccination programme. Again, that is a key reason why all four nations of the United Kingdom are not meeting the WHO recommended coverage. As I have set out, letters are going out to the parents of unvaccinated children, because we recognise that rates have been lower than we would wish. One million have gone out across London and the west midlands. Of all parts of the United Kingdom, it is the west midlands that we are most concerned about.

To give the House some context, last year there were more than 209 laboratory-confirmed measles cases in England, over three quarters of which were from the west midlands, predominantly Birmingham and Coventry, so there is a particular push in the west midlands. That is why nearly two weeks ago we gave a briefing to local MPs and local directors of public health, who are doing an outstanding job at the coalface, rolling out pop-up clinics in schools and going out on community buses to reach communities that may struggle to be reached through traditional routes. GPs are putting on extra clinics, but we have to get the message out. It is not through a lack of vaccines or a lack of messaging, but we still have vaccine hesitancy. We all have a role to play in getting communities to come forward.

[Mr Speaker]

I call the Chair of the Health and Social Care Committee.

--- Later in debate ---

[Mr Speaker]

I think that was the Adjournment debate on measles. [Laughter.]

[Maria Caulfield]

The hon. Gentleman is absolutely right and I want to work with all four corners of the United Kingdom, because none of us is meeting the World Health Organisation coverage for MMR. Northern Ireland has similar rates to England at 89%. A joined-up approach, so that we have better coverage for MMR across the UK and can get back on top of breakouts and eradicate measles once again, would be very welcome.

Oral Answers to Questions

Debate between Lindsay Hoyle and Maria Caulfield

Tuesday 17th October 2023 Commons Chamber

[Maria Caulfield]

I was going to pay tribute to the hon. Lady for her work on mental health campaigning, and she will know we have done a huge amount. The suicide prevention strategy is a cross-Government piece of work, which makes sure suicide is everyone’s business, not just that of health and social care. Whether by supporting families bereaved by suicide or rolling out mental health support schemes in schools, it is this Government who are delivering on mental health services.

[Mr Speaker]

I call the shadow Minister.

Oral Answers to Questions

Debate between Lindsay Hoyle and Maria Caulfield

Tuesday 11th July 2023 Commons Chamber

[Maria Caulfield]

I thank my hon. Friend for raising that issue. There were many recommendations during pre-legislative scrutiny. We are working through those and we hope to be able to respond fully shortly after the summer recess.

[Mr Speaker]

I call the shadow Minister.

Oral Answers to Questions

Debate between Lindsay Hoyle and Maria Caulfield

Wednesday 7th June 2023 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

I thank my hon. Friend for campaigning on this issue. Having inclusive transport is important. He is right that the inclusive transport strategy is integral to our ambition to make transport fully accessible by 2030. My colleagues in the Department for Transport are committed to delivering that strategy to make real practical differences from accessible platforms through to accessible buses. We will be able to update him shortly with more progress.

[Mr Speaker]

I call the SNP spokesperson.

--- Later in debate ---

[Maria Caulfield]

My hon. Friend is correct. We have made great progress in getting young girls to take STEM subjects—the numbers are up 31%—but the challenge is to get them into work. The FTSE women leaders review has set a target of 40% of FTSE 350 companies having women on their board. The STEM Returners programme is key to getting experienced women back into the workplace and on to those boards.

[Mr Speaker]

May I make an announcement? I want to tell the House about the success last night of the House of Commons teams in the tug-of-war. We beat the House of Lords 4-0.

Oral Answers to Questions

Debate between Lindsay Hoyle and Maria Caulfield

Tuesday 6th June 2023 Commons Chamber

[Maria Caulfield]

I thank the hon. Lady for her question, and let me also pay tribute to the hon. Member for West Ham (Ms Brown), who has campaigned hard in this space. I met a group of women to discuss painful hysteroscopies just a few weeks ago. This is a priority in the women’s health strategy, as the hon. Member for Luton North (Sarah Owen) said. We are working with the royal college to update its guidelines, because a lot of these issues are associated with women’s consent, the provision of information before these procedures, and women knowing that they can have them under a local or general anaesthetic and can also ask for pain control. This is not working in practice, which is why it is a priority in the women’s health strategy.

[Mr Speaker]

I call the Chair of the Select Committee.

--- Later in debate ---

[Maria Caulfield]

I thank my hon. Friend, who does a huge amount of work supporting her local midwives in Stroud. I can give her encouraging news: not only have we spent £190 million on midwifery services, but we are seeing an increased number of midwives coming through midwifery training. Excitingly, we have a nurse conversion course, which takes 18 months, with NHS England paying the tuition fees for nurses to convert to being midwives. We have had 300 in training this year and we are expanding that to 500 in the next academic year. We have encouraging retention rates too, which show that midwives are not only joining the profession, but staying in it.

[Mr Speaker]

I call the shadow Minister.

Oral Answers to Questions

Debate between Lindsay Hoyle and Maria Caulfield

Wednesday 26th April 2023 Commons Chamber

[Maria Caulfield]

I can reassure my hon. Friend: we are spending £7 million to ensure that 75% of black, Asian and minority ethnic women are being cared for by the same midwife during their pregnancies, because we know that continuity of carer improves outcomes for those women.

[Mr Speaker]

I call the shadow Secretary of State.

Oral Answers

Debate between Lindsay Hoyle and Maria Caulfield

Tuesday 25th April 2023 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

Successfully containing antimicrobial resistance requires co-ordinated action across all sectors. That is why the UK takes a “one health” national approach to AMR across humans, animals, food and the environment. Since 2014, the UK has reduced sales of veterinary antibiotics by 55% and has seen a decrease in antimicrobial resistance as a result.

[Mr Speaker]

I call the SNP spokesperson.

Oral Answers to Questions

Debate between Lindsay Hoyle and Maria Caulfield

Wednesday 8th March 2023 Commons Chamber

[Maria Caulfield]

Absolutely. It is this Conservative Government who, in 2017, introduced the world-leading regulations that have ensured that we are able to record the gender pay gap and the progress that we are making. We are also committed to the childcare aspect, which is difficult for many women. That is why we have announced additional funding of £160 million this year, £180 million next year, and £170 million the year after for local authorities to increase the hourly rates to pay for childcare, which is so important to women.

[Mr Speaker]

I call the shadow Minister.

--- Later in debate ---

[Maria Caulfield]

I am pleased that the Labour party is getting with the programme—that it can actually define what a woman is, for a start. We will not take any lectures from the Labour party; perhaps it needs to get its own house in order before lecturing the rest of the country, because according to The Daily Telegraph in January, the Labour party paid its black workers 9% less than its white workers. It absolutely needs to get its own house in order.

[Mr Speaker]

I call the shadow SNP spokesperson.

--- Later in debate ---

[Maria Caulfield]

The hon. Gentleman makes a very good point and that is exactly why mental health is part of the major conditions strategy. People with mental health and learning disabilities do suffer from poorer physical health, and that is why it is crucial that we do not see—[Interruption.] If he listened to me, he would have heard that I said “learning disabilities”. It is crucial that we do not see people with a learning disability in isolation, and that we look after their physical health, as well as the conditions they suffer from.

[Mr Speaker]

I call the shadow Minister.

--- Later in debate ---

[Chris Stephens]

The Minister will be aware of a legal agreement under the Equalities Act between McDonald’s and the Equality and Human Rights Commission over the handling of complaints of sexual harassment. Does the Minister believe that that is solely an issue of a toxic culture at McDonald’s, and will she look at whether women working on zero-hours contracts across the economy are at increased risk of experiencing sexual harassment because of depending on male managers for future shifts?

[Maria Caulfield]

We take sexual harassment in the workplace very seriously—[Interruption.] Oh, to be shouted down for the entrance of a man.

[Mr Speaker]

Order. Minister, nobody was shouted down. It happens every time, and when the Prime Minister comes it will happen again. Don’t worry—come on.

--- Later in debate ---

[Maria Caulfield]

The Labour party is once again late to the party, because the Conservative Government are already delivering on this. We have set up the high-growth enterprise taskforce to get more women into setting up high-growth businesses and to end the disparity in venture capital whereby, for every pound that is given, 89p currently goes to men’s businesses and only a penny to women’s.

[Mr Speaker]

Before we come to Prime Minister’s questions, I would like to point out that live subtitles and a British Sign Language interpretation of proceedings are available to watch on parliamentlive.tv.

Oral Answers to Questions

Debate between Lindsay Hoyle and Maria Caulfield

Tuesday 7th March 2023 Commons Chamber

[Maria Caulfield]

I remind the hon. Lady that about 60% of women in England who are on hormone replacement therapy are already exempt from prescription charges, but we are reducing the cost by hundreds of pounds a year for the remaining women who do pay. We respect the Scottish Government’s decision to provide free prescriptions, but it would cost us in England £651 million a year to provide free paracetamol to millionaires and we do not think that is the best use of taxpayer money.

[Mr Speaker]

I call the shadow Minister.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

I thank my hon. Friend for raising this important issue. We are launching a prevention of suicide strategy, and male suicide will be a particular focus, as it is a high-risk group. The debate next week will be answered by a Minister in the Department for Education, because it relates specifically to the national curriculum, but I am very happy to meet my hon. Friend and his constituent.

[Mr Speaker]

I call the SNP spokesperson.

Oral Answers to Questions

Debate between Lindsay Hoyle and Maria Caulfield

Wednesday 25th January 2023 Commons Chamber

[Maria Caulfield]

I thank the hon. Lady for her work in this space. I recognise that while we have set up nine specialist mesh centres to tackle mesh removal and seen a number of women come forward and receive their surgery, there are still a number on the waiting list. I am meeting some of the campaigners on mesh removal next week. We were at the Health and Social Care Committee hearing just a few weeks ago, and I heard some of their concerns then. I recognise that there is still progress to be made in this space.

[Mr Speaker]

We now come to the shadow Minister, Anneliese Dodds.

Oral Answers to Questions

Debate between Lindsay Hoyle and Maria Caulfield

Tuesday 24th January 2023 Commons Chamber

[Maria Caulfield]

I thank my hon. Friend, who has always been campaigning for better health services in Kettering. Let me reiterate what he has just said: that announcement followed the announcement last week of £10 million for NHS breast screening services, to provide 29 new mobile units and static breast care units across England.

[Mr Speaker]

I call the shadow Minister.

[Feryal Clark (Enfield North) (Lab)]

The women’s health strategy was an opportunity to fundamentally change the inequalities women face. Women were promised a clinical women’s health lead in the NHS, yet a former Health Minister, the hon. Member for Sleaford and North Hykeham (Dr Johnson), admitted that there has not even been a discussion about establishing the role. Women in east Kent were promised change after the damning review of local maternity services, yet the Care Quality Commission is now threatening the trust there with enforcement action. Time after time, women’s voices are at best being ignored and at worst being silenced. So I ask the Minister: when will this Government stop letting women down with empty promises? Is the women’s health strategy worth the paper it was written on?

[Maria Caulfield]

Perhaps the shadow Minister will reflect on her comments when she receives the “Dear colleague” letter later today outlining the eight priorities areas for our first year of the strategy, with work such as the prepayment certificate for hormone replace treatment being done already; it is launching in April and saving women hundreds of pounds on the cost of HRT. May I say that I am gobsmacked by the Labour party’s position on this? Not only does it struggle most days to define what a woman actually is—for reference, it is a female adult human—but it cannot stand up for women either. There was no greater example of that than what we saw in this Chamber last week, when Labour Members were heckling the hon. Member for Canterbury (Rosie Duffield) and intimidating my hon. Friend the Member for Penistone and Stocksbridge (Miriam Cates). Come back to us when the Labour party is reflecting on the behaviour of its own MPs before dictating to us.

[Mr Speaker]

Let me just remind people: these are questions to the Government.

--- Later in debate ---

[Maria Caulfield]

I am happy to write to the hon. Gentleman with that information. However, I must be clear that we planned for an increase in admissions this winter. That is why we got on and delivered on our plans for 7,000 extra beds, and why we brought forward our flu and covid vaccination programme and lowered the age of eligibility. There are a number of factors, and they are the same factors that have driven excess deaths across the United Kingdom and across Europe.

[Mr Speaker]

I call the shadow Minister.

Strep A Treatments: Supply

Debate between Lindsay Hoyle and Maria Caulfield

Monday 19th December 2022 Commons Chamber

[Maria Caulfield]

My hon. Friend is right to advise people to take their flu vaccination. What I was trying to say, but the Opposition did not really want to hear, was that strep A occurs in all age groups. Actually, the highest number of deaths we see are in over-65s. It is important to get the message out that this issue does not just affect children. My hon. Friend is right. The flu vaccine is something that should always be recommended for winter. He is also right that the alternative antibiotics that I read out have been recommended by UKHSA, and we have taken its clinical advice.

[Mr Speaker]

We now come to the shadow Secretary of State.

--- Later in debate ---

[Maria Caulfield]

My hon. Friend makes a valid point. While we do not have a shortage, there are, as I have clearly outlined, supply issues. When deliveries are made to pharmacies, those pharmacies very quickly run out because of the sheer scale of demand. I say to parents that the new SSPs issued on Friday will allow pharmacists to replace the prescription antibiotic with a number of antibiotics. If they go in with a prescription for penicillin B and are given amoxicillin, clarithromycin, flucloxacillin, cephalexin, co-amoxiclav or erythromycin, for example, that is because they are recommended as alternative antibiotics that can adequately treat strep A.

[Mr Speaker]

I call Jim Shannon.

Abuse and Deaths in Secure Mental Health Units

Debate between Lindsay Hoyle and Maria Caulfield

Thursday 3rd November 2022 Commons Chamber

[Maria Caulfield]

I will not stand at the Dispatch Box and deny any of the instances that we have seen, their consequences or the failings that have been identified. I apologised in my opening remarks for the care that failed the most vulnerable patients in our system. I commit to right hon. and hon. Members from the Dispatch Box that we are urgently looking not just at these cases but across all mental health in-patient services, and not just at adult mental health, but at offenders and other users of mental health facilities.

We have brought in a number of measures. We introduced new legislation, which was enacted in March, on the use of force and restraint. We are identifying best practice and trying to get that rolled out across the country. We are looking at putting in place a number of measures to improve safety and to support staff in units where staff shortages have been identified as a cause of the problems.

With regard to the hon. Lady writing to the Secretary of State, I signed off a letter to her early on Tuesday, which she should receive any day now. I apologise that she did not previously get responses in a timely manner.

NHS England has commissioned a system-wide investigation into the safety and quality of services across the board, particularly around children and adolescent mental health services. I am pushing for those investigations to be as swift as possible.

On the issue of a public inquiry, I am not necessarily saying that there will not be one, but it needs to be national, not on an individual trust basis. As we have seen in maternity services, when we repeat these inquiries, they often produce the same information and we need to learn systemically how to reduce such failings. My issue with public inquiries is that they are not timely and can take many years, and we clearly have cases that need to be urgently reviewed and to have some urgent action taken on them now. I will look at the hon. Lady’s request but, as I said, the Secretary of State and I are taking urgent advice, because we take this issue extremely seriously. One death from a failing of care is one death too many.

[Mr Speaker]

I call the Father of the House, Sir Peter.

Oral Answers to Questions

Debate between Lindsay Hoyle and Maria Caulfield

Tuesday 19th July 2022 Commons Chamber

[Maria Caulfield]

My hon. Friend is right; the delayed discharges and being able to free up those beds has a knock-on effect on A&E, which in turn has a knock-on effect on ambulances being able to unload. We have the £2 billion better care fund, which is supposed to be addressing just that, to help integrated care boards deliver and help patients get out of hospital. I have a meeting with all the integrated care boards tomorrow, so his is a timely question, but I am happy to meet him as well.

[Mr Speaker]

I call the shadow Minister, Dr Rosena Allin-Khan.

--- Later in debate ---

[Maria Caulfield]

To put this in context, I make no apologies for all the efforts that were made to secure PPE for frontline staff. We delivered more than 21.5 billion items of PPE to keep frontline staff safe during a time when we had a dangerous virus that no one knew anything about, we had no vaccine and there was a global push on the market resources. Those products that we procured that did not meet the standards for health and social care were used in other avenues. For example, we donated masks to transport operators and to schools, so that we could reopen the economy and to help them to keep safe.

[Mr Speaker]

I call SNP spokesperson, Martyn Day.

Ambulance Services and National Heatwave Emergency

Debate between Lindsay Hoyle and Maria Caulfield

Wednesday 13th July 2022 Commons Chamber

[Maria Caulfield]

I can reassure the right hon. Lady that I am the Minister responsible for ambulances, which is why I am standing here at the Dispatch Box. The Secretary of State has been out on visits this morning, meeting clinical teams; it is important that he hears at first hand from those who are on the frontline. I got into politics to make sure that those of us who work on the frontline—[Interruption.] The right hon. Lady rolls her eyes; maybe she does not have much respect for those of us who worked on the frontline. We are dealing with this situation, and will be supporting the ambulance service over the coming months. The right hon. Lady’s response is extremely disappointing.

[Mr Speaker]

I granted the urgent question because the shadow Secretary of State tabled it and normally we would expect a Secretary of State to come. I recognise that they may be busy in other areas, but it is something we ought to be aware of. More and more, we are seeing fewer Secretaries of State across all Departments, not just this one.

--- Later in debate ---

[Maria Caulfield]

The hon. Gentleman makes a very constructive suggestion—one of the first of the afternoon, if I may say so. There were lessons during covid that are being rolled out across emergency services. We are looking at best practice in those parts of the country where response times are better to see if we can share it. I am very keen to look at any option that relieves the pressure. We are investing in 111, which enables people to have alternative ways of getting urgent care directed to them. We are looking at 111 being able to make direct referrals as well, so there are a number of options. I am happy to take suggestions from any hon. Member if they are keen to see those happening in practice.

[Mr Speaker]

You have tempted me and I should not really, but it would be very helpful if you reopened Chorley A&E for 24 hours rather than 12 hours. It would reduce the number of ambulances queueing at Preston and Wigan, and we would have more ambulances on the road.

Oral Answers to Questions

Debate between Lindsay Hoyle and Maria Caulfield

Tuesday 14th June 2022 Commons Chamber

[Maria Caulfield]

My hon. Friend has been campaigning on this issue for a long time, particularly on the tragic case of his constituent, Vicky Clarke. I have met the all-party parliamentary group on medical cannabis under prescription and we have had debates on the issue in this place and in Westminster Hall. The key is to get those products licensed, and we have been in discussion with the Medicines and Healthcare products Regulatory Agency on how to do this. It is about gathering the evidence base. I am pleased to say that NHS England and the National Institute for Health and Care Research have recently announced two clinical randomised controlled trials to try to build that evidence base to get more of these products licensed.

[Mr Speaker]

We now come to the Scottish National party spokesperson, Martyn Day.

Oral Answers to Questions

Debate between Lindsay Hoyle and Maria Caulfield

Wednesday 8th June 2022 Commons Chamber

[Maria Caulfield]

The hon. Lady has campaigned very hard on IVF. I can say that IVF will be in the women’s health strategy; IVF services are commissioned at a local level, but there is disparity in how they are commissioned in local areas, and we want to see consistency of service offered to women and partners.

[Mr Speaker]

I call the Chair of the Women and Equalities Committee, Caroline Nokes.

North East Ambulance Service

Debate between Lindsay Hoyle and Maria Caulfield

Monday 23rd May 2022 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

Can I start by saying how horrified I was to read the concerns raised about the North East Ambulance Service in reports over the weekend? My thoughts are first and foremost with the families affected by the tragic events described. I cannot imagine the distress they are going through. It is hard enough to lose a loved one suddenly, but to have fears that mistakes were made that could have made a difference, and more than that, that the facts of what happened were not revealed in every case, goes further. They have my unreserved sympathy and support.

In healthcare, a willingness to learn from mistakes can be the difference between life and death, and it is because of this that, as a Government, we place such a high value on a culture of openness and a commitment to learning across the NHS. That is why the allegations raised by The Sunday Times this weekend are so concerning. As was made abundantly clear by the Secretary of State’s predecessor almost a decade ago, non-disclosure agreements have no place in the NHS and reputation management is never more important than patient safety.

The Government are wholly supportive of the right of staff working in the NHS to raise their concerns. Speaking up is vital for ensuring that patient safety, and quality of services, improve, and it should be a routine part of the business of the NHS. That is why, over the last decade, substantial measures have been introduced to the NHS to reduce patient harm and improve the response to harmed patients, including legal protections for whistleblowers, the statutory duty of candour, the establishment of the Health Services Safety Investigations Body and the introduction of medical examiners. It is also why, in response to a recommendation of the Sir Robert Francis “Freedom to speak up” review in 2015, the Government established an independent national guardian to help to drive positive cultural change across the NHS so that speaking up becomes business as usual. However, when it comes to patient safety, we cannot afford to be complacent. It remains a top priority for the Government and we continue to place enormous emphasis on making our NHS as safe as possible.

I note the concerns raised in this weekend’s reports. They have been subject to a thorough review at trust level, including through an external investigation, and the trust’s coronial reporting is subject to ongoing independent external audit and quarterly review by an executive director. I also note that the Care Quality Commission has been closely involved. However, given the seriousness of the claims reported over the weekend, we will of course be investigating more thoroughly and will not hesitate to take any action necessary and appropriate to protect patients.

The Government are also committed to supporting the ambulance service to manage the pressures it is facing. We have made significant investments in the ambulance workforce, with the number of NHS ambulance and support staff increasing by 38% since 2010. Health Education England has mandated a target to train 3,000 paramedic graduates nationally per annum from 2021, further increasing the domestic paramedic workforce to meet future demands on the service, while 999 call handlers have been boosted to over 2,400, so we are very serious about improving resources for the service.

I fully appreciate the concerns of right hon. and hon. Members across this House, and we will be pleased to meet any who have constituents affected by the reports this weekend so we can look at the issue more fully.

[Mr Speaker]

Can I just say that it is three minutes—and that means three minutes, not three minutes and 40 seconds —and I am sure whoever writes these speeches can actually time them through? I say to those on both Front Benches that we have to think about Back Benchers, who need to get their hospitals mentioned and their ambulance trusts as well.

I call the shadow Secretary of State, who I am sure will stick to the allocated time.

[Wes Streeting]

I pay tribute to the courage of the whistleblowers, as well as The Sunday Times journalists David Collins, Hannah Al-Othman and Shaun Lintern, without whom none of this would have come to light. But with respect to the Minister, it should not have taken an urgent question to bring her to the House today. On what she said about the Department further investigating, what form will this investigation take, who will be involved and what assurance can she give the families that there will be both answers and accountability, which is what they deserve?

Peter Coates died after an ambulance did not reach him in time. An ambulance two minutes away could not be dispatched because the station door was faulty, and staff did not know about the manual override. The ambulance that was dispatched decided to stop at a service station, even though it had sufficient fuel. Information about these errors was then withheld by the service, statements were changed and staff were asked to withhold the mistakes from the coroner. Peter Coates’ family learned the full truth only when contacted by reporters last week. His is just one of what is thought to be 90 cases involving gross negligence, cover-ups and tens of thousands of pounds of taxpayers’ money offered in exchange for staff silence.

The Minister mentioned the CQC. Why did it fail to spot this, rating the service “good” in 2018? Why did it fail to spot the situation even after being tipped off in 2020? Why is taxpayers’ money still being offered to buy the silence of staff when non-disclosure agreements were supposedly banned in 2014? What role did under-resourcing and understaffing play in this scandal?

Record ambulance waits exist in every part of the country, with heart attack and stroke victims waiting longer than an hour for an ambulance. As for the North East Ambulance Service, it is advising the public to phone a friend or call a cab rather than wait, while presiding over gross negligence, cover-ups and taxpayer-funded gagging orders on staff. That is the record on its watch. It is a national disgrace. What are the Government doing about it?

[Maria Caulfield]

We take the patient safety element of this extremely seriously. To answer the hon. Gentleman’s questions on who we will be meeting, I am happy to meet all the families affected to hear their concerns and the actions that they want taken. We met with the CQC this morning on this specific example, but we will be meeting with the ambulance trust. I also want to meet the coroner, and we want to hear from the whistleblowers. I am very happy to meet any member of staff who wants to raise concerns so that we can get to the bottom of exactly what has happened.

This Government introduced the duty of candour. Mistakes will always happen, no matter how much money is put into the health service or how many staff it has, but when a mistake does happen the hospital trust or ambulance trust should be open and up front about it, start a proper investigation, and learn the lessons so that it never happens again.

[Mr Speaker]

I call the Chair of the Health and Social Care Committee.

Oral Answers to Questions

Debate between Lindsay Hoyle and Maria Caulfield

Tuesday 19th April 2022 Commons Chamber

[Mr Speaker]

Come on; we have got to get others in.

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

I thank the hon. Lady for her question, and we have met to discuss this previously. I am happy to discuss with Health Education England whether one of its centres for dentist development could be suitable for her constituency.

Nurse Staffing Levels

Debate between Lindsay Hoyle and Maria Caulfield

1st reading: House of Commons
Tuesday 8th October 2019 Commons Chamber

[Maria Caulfield (Lewes) (Con)]

I beg to move,

That leave be given to bring in a Bill to make provision about National Health Service bodies establishing nurse staffing levels.

I start by declaring an interest as a nurse and a member of the Royal College of Nursing, which is leading the campaign for safe and effective nurse staffing. Nursing is one of the most underestimated professions in the country, if not the world, because while everyone loves a nurse, with colloquial terms such as “angel”, “having a vocation”, “hero” and “caring or compassionate” being used to describe us, the true impact of nurses and nursing on the nation’s health has never been recognised. We are more than just a doctor’s assistant. Whether an experienced nurse who holds a patient’s hand as they die while assessing their level of pain or symptom management, or an advanced nurse practitioner in places such as the Royal Marsden Hospital’s clinical assessment unit who can treat patients with acute ascites and manage them by inserting a drain to deal with the symptoms or can look for the first sign of sepsis, nurses are truly saving lives.

There is increasing evidence that the right number of qualified nurses can improve patient outcomes in terms of mortality, morbidity and quality of care, and that, conversely, insufficient nurses can have a potentially life-threatening effect on patients. A study by Aiken et al reported in The BMJ looked at discharge data from hospitals for over 275,000 surgical patients in 188 hospitals across Europe, finding that a greater number of professional nurses was associated with lower odds of mortality. Likewise, Bridges et al also found in The BMJ only last year that the addition of qualified nurses makes a difference to patient outcomes—not simply the addition of healthcare workers, but qualified and experienced nurses. There is something in the skill and experience of qualified nurses that improves mortality rates, morbidity rates and quality of care.

Record numbers of nurses have joined the Nursing and Midwifery Council register, with 8,000 more nurses and midwives now registered to work in the UK, but over 43,000 nursing vacancies remain in England alone. The RCN staff survey in 2017 reported that that is having an impact on the ground, and nurses are reporting that care is going undone as a result. That is why, as a nurse and a member of the RCN, I am bringing this Bill forward to establish legally enforceable nursing staffing levels in the NHS in England, as was done in Wales in 2016 and in Scotland in June this year, when the Health and Care (Staffing) (Scotland) Act was passed.

The Bill has four main aims. First, we need to make the Government accountable for nursing levels in England. No one is accountable for nursing numbers, which is why we have such a high vacancy rate and a lack of strategic action to address the situation. How are we going to increase student nurse numbers via degree apprenticeships, which are working so well in places at the University of Brighton in my constituency, where student nurses earn while they learn in clinical placements? How are we to increase the numbers returning to practice when return-to-practice courses are difficult to access and expensive, with nurses often having to pay for them themselves? Nearly a third of our nurses in practice today are likely to retire in the next 10 years, so how are we to address early retirement? Without someone taking responsibility, none of those issues will be addressed. While individual trusts do their best to mitigate recruitment and retention challenges, no one is taking responsibility for the sheer scale of the issue across England.

That fits neatly into the second and third parts of the Bill, which relate to a fully costed workforce strategy and nursing numbers. There are currently no legally enforceable nursing numbers for any healthcare sector in England. In 2014, National Institute for Health and Care Excellence guidelines for adult wards stated that when nurse patient ratios reach eight patients to one nurse, that should act as a red flag that care is becoming unsafe. However, in the 2017 RCN staff survey, 71% of nurses report that they had cared for more than eight patients on their previous shift, with 26% reporting that they cared for more than 14 patients. We need legally enforceable numbers, so that nurses and patients can be protected from unsafe care and so that someone is held to account if that does not happen.

In England, each trust manages its own staffing numbers, and if money is tight, retention and recruitment just does not happen. To be fair to the trusts, they have no pool of nurses on which to draw, so what are they supposed to do? We need a nursing workforce strategy not only to meet short-term need, but to plan for the long-term healthcare needs of the nation. However, the Bill is about more than just ring fencing nursing numbers. It is about the skill mix, too. Having experienced qualified nurses is the key to improving patient outcomes.

As already mentioned, there is a growing body of evidence to show the difference that experienced and qualified nurses can make to patient outcomes. In my 25 years’ nursing experience, nothing can beat the continuity of someone looking after the same patient over a period that only adequate staffing numbers allows for. An experienced nurse often gets to know their patient and can spot mild changes, such as mild confusion, that could indicate the start of sepsis. They can spot that someone is not taking their medication, is slightly dehydrated or has raised sugar levels. Something as simple as constipation can lead to abdominal pain, nausea and vomiting, dehydration and, ultimately, hospital admission.

Service managers who are driven to replace nurses with healthcare assistants take a penny wise and pound foolish approach, as a qualified nurse can prevent hospital admissions, reduce the length of stays and reduce readmissions simply by using their skill and experience. Any extra paid in higher wages would be offset by savings in the length of stays and acute adverse events.

Finally, the Bill would legislate to provide training and education for all nurses throughout their career. If we want nurses to take on more advanced roles, from nurse prescribing to chest drain insertion, the Government need to ensure the training happens both by paying for it and by allowing study leave. We cannot continue with nurses using their annual leave and their days off to undertake training vital to their role.

Other countries have realised the need for change and have made legislative changes to ensure safe staffing levels. That is why I support the RCN and Dame Donna Kinnair in promoting this Bill to create a legal framework that clarifies the roles and responsibilities and the accountability for the supply, recruitment and retention of nurses in England.

Question put and agreed to.

Ordered,

That Maria Caulfield, Alberto Costa, Kate Hoey, Stephen Lloyd, Andrea Jenkyns, Andrew Lewer, Andrew Griffiths, Lloyd Russell-Moyle, Charlie Elphicke and Eddie Hughes and present the Bill.

Maria Caulfield accordingly presented the Bill.

Bill read the First time; to be read a Second time tomorrow, and to be printed (Bill 439).

[Mr Deputy Speaker (Sir Lindsay Hoyle)]

I do not think there will be many here, but good luck.

Oral Answers to Questions

Debate between Lindsay Hoyle and Maria Caulfield

Wednesday 9th May 2018 Commons Chamber

[Maria Caulfield (Lewes) (Con)]

Q7. Does the Prime Minister think that it was the Labour party voting against the abolition of stamp duty for 69,000 first-time buyers, or the Labour party voting against 50,000 extra school children getting free school meals that convinced local voters in the elections last week to vote Conservative as the only party on their side? That is why the Conservatives retained control of Westminster and Wandsworth councils, and it is why they gained control in places such as Redditch, Basildon and Barnet.

[Mr Deputy Speaker (Sir Lindsay Hoyle)]

Order. The Prime Minister is not responsible for the Labour party, but I am sure that she will be able to respond appropriately.

NHS and Social Care Funding

Debate between Lindsay Hoyle and Maria Caulfield

Wednesday 11th January 2017 Commons Chamber

[Maria Caulfield]

I will not.

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. If the hon. Lady wants to give way, she will. Unfortunately, she is not, but Members cannot just stand there—two at once—shouting all the time. It is recognised that if a Member is to give way, they will, but it is up to them.

[Maria Caulfield]

These problems are not new. I have also worked in out-patient settings where A&E targets have had an impact on patients waiting for elective surgery. The sheer determination to meet those targets due to pressure from the Labour Government led to patients with breast cancer having their elective operations cancelled time after time owing to emergency admissions. I had to tell a young mum, whose mastectomy operation following breast cancer had been cancelled three times while her young family were waiting for Christmas, that the only bed we had left was in a post-natal ward, where she woke up and recovered from her operation next to young mums learning to breastfeed. That was in an attempt to meet four-hour targets, so do not tell me that services have reduced. Targets were met, but staff were put under severe pressure not with quality of care but with targets in mind. I make no apologies in making that clear.

I am a supporter of four-hour targets. I was enthusiastic when they were introduced as a way of monitoring performance and improving the service, but they became the absolute king, above everything else. I congratulate the Secretary of State on introducing the consideration of outcomes. What happens to a patient when they are admitted? If they have to stay for four and a half hours to avoid admission or to get full care, what is the problem with that? If they can leave within two hours because they have been adequately treated, fantastic, but we should not be held to account by an arbitrary four-hour rule that has no clinical significance. I support the four-hour rule, but there are other measures that we also need to be aware of and that should be treated with equal status to the four-hour target.

Of course money is important. As our ageing population and our ability to treat more patients grows, we will need more funding for both healthcare and social care. It is worth noting that the trusts either side of my constituency receive the same funding and look after the same types and numbers of people. One is in special measures, is unable to deal with its discharges, has queues and is unable to meet its four-hour targets; the other, five miles along the coast, is rated outstanding, does not have the same pressures or four-hour waits and is able to discharge its patients speedily. There is something about what happens to the money, as well as about how much the money amounts to.

Labour did put huge amounts of money into the NHS over the years, but much of it was squandered—£10 billion on a failed IT project that never saw the light of day, and PFI deals that are still costing the NHS £2 billion a year. How much could be done with that £2 billion?