(2 years, 9 months ago)
Commons ChamberI have given way a number of times and I want to make some progress. I will be winding up the debate, so hon. Members will have the opportunity to come back in then.
I would like to move on to ICBs and ICSs, but I suspect that, assuming there is time, my right hon. Friend, who chairs the Treasury Committee, may have the opportunity to intervene during my winding up, or to give a speech during the course of the debate.
Currently, the NIS regulations cover NHS providers in England, rather than commissioners. Government amendment 30 allows us to mitigate cyber-risk in a wider sense, making cyber-security a responsibility for organisations that have duties across the system, and to drive forward a shared and collaborative effort towards reducing the risk to patients. I hope that Government amendments 29 and 30 will be uncontentious and supported on both sides of the House.
Is the Minister absolutely sure about what he said in response to the hon. Member for Thirsk and Malton (Kevin Hollinrake)—that everybody would be better off under new clause 49 than they are now? Is it not the case, as illustrated by the Health Foundation, that people with very modest homes, worth less than £106,000, will never hit the cap and therefore will not be better off under the Government’s proposed system than they are now?
I make the point to the hon. Lady that I made in my opening remarks; I said that no one would be worse off and the majority would be better off. That is the point that I make to her: people would not be worse off. If she looks at Hansard, she will see that those were my original remarks when I opened this debate.
(2 years, 9 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
It is a pleasure to serve under your chairmanship, Ms Bardell. I congratulate the hon. Member for South Leicestershire (Alberto Costa) on securing this important debate. We have worked together over many years on health issues, and he has done very important work alongside my hon. Friend the Member for Gower (Tonia Antoniazzi) through the all-party parliamentary group on medical cannabis under prescription.
I start by saying to those who have spoken in the debate and those watching elsewhere that I cannot begin to imagine how difficult it must be to be the parent of a child with serious epilepsy. The fear that they go through every day, and the difficulties that they experience, must be beyond terrifying. I also recognise the huge financial burdens that many parents face, and the anxiety of parents who want access to these prescriptions, but are still denied it.
As the hon. Member for South Leicestershire said, it has been three years since the then Home Secretary, now Health Secretary, changed the law on this very important issue. As we all know, that change came about after a number of very high-profile campaigns in utterly heartbreaking cases of children suffering from epilepsy, including Billy Caldwell and Alfie Dingley. I pay tribute to the families who campaigned relentlessly on these issues. It gave hope to people that things would change. Yet three years later, we do not seem to be very much further forward. As the hon. Member for South Leicestershire said, the law has changed, but the practice has not.
I will focus on three things that need to happen to put this right. The first, which many hon. Members have spoken about, is the desperate need for more research and evidence. One of the barriers to clinicians prescribing is that they feel they lack knowledge, or are not really sure about the evidence on both the benefits and the risks. That point has been made time and again over the last three years. It was made during the original review, back in 2018, particularly by the Advisory Council on the Misuse of Drugs. It was repeated by the Health and Social Care Committee in its review of why things had not changed, back in 2019. Six of its 11 recommendations were about providing more research and evidence. Indeed, that was called for by the then chief scientific adviser, now chief medical officer, Professor Chris Whitty, and in the NHS England review commissioned by the last Health Secretary, the right hon. Member for West Suffolk (Matt Hancock).
I hope that the Minister will say where we have got to on that issue, and particularly on the point about more research and evidence from clinical trials being needed. However, that last point absolutely cannot mean taking children off these products if they are on them; that would be completely wrong. How will she make progress on all those issues?
Secondly, what other steps are being taken to improve access? I will focus briefly on three of the 10 recommendations made by NHS England. One was that the national medical director and chief pharmaceutical officer for England should write to doctors and pharmacists, reminding them of the guidance on prescribing, how they can access a cannabis education package produced by Health Education England, and how to get the message out about what can happen at present. NHS England also recommended much clearer information for patients, and that a specialist clinical network be established, so that everybody is aware of the real evidence. Could the Minister comment on what further action the Government have taken on that?
Finally, a really difficult but important point: as we move forward with the research and evidence, and as we try to improve understanding among all professionals—GPs as well as specialists, because we can have a partnership approach—what will we do to support those parents who are paying such huge amounts of money? Have the Government considered what support might be made available to them?
Changing the law is essential, but getting that to work in practice—changing hearts and minds, as well as the law—is the only way we will make progress. I thank all right hon. and hon. Members who have spoken. I hope that the parents out there listening know that they have champions in this place, and that we will carry on doing our best to make sure we get the best results for their children.
Before I call the Minister, I say gently and kindly to her that I would expect her to finish by 5.44 pm, so that I may call the hon. Member for South Leicestershire (Alberto Costa) to sum up for two minutes.
(2 years, 10 months ago)
Commons ChamberIt is a privilege to speak in the debate, and to follow the right hon. Member for Romsey and Southampton North (Caroline Nokes) and the other Members who have spoken so far. I think that by speaking out about the menopause, Members on both sides of the House, women and men, will be giving a voice to 13 million menopausal and perimenopausal women in the country whose needs have been downplayed or ignored for too long.
I must begin by paying tribute to my hon. Friend the Member for Swansea East (Carolyn Harris), a phenomenal campaigner who is working across party lines, and with organisations up and down the country, to push this agenda, make a practical difference to women’s lives, and get the job done. I am very proud to stand alongside her today.
I feel that at this point I should make a personal declaration of interest in this topic, as many of my colleagues have already done today. To be honest, I am not really sure when the symptoms first started, but they have been building steadily over the last year—the truly terrifying sense of anxiety and panic that I had never experienced before; feeling completely exhausted, sore and aching all over, wondering in the evenings if I could make it up the stairs to go to bed, let alone do the exercise that has always been such an important part of my life; the itching, the hair loss, and just feeling downright low; and above all, what I can only describe as the catastrophically bad sleep, night after night. I would finally emerge in the morning drenched with sweat, thinking, “How on earth am I going to make it through the day?”
Like so many other women, I had absolutely no idea what was going on. I thought that there could be reasons for each of those symptoms individually, but together they felt overwhelming. 1t was only when a friend of mine recommended that I check out the MegsMenopause website that the penny finally dropped. This was something real, something really was happening, it had a name, and there was something that I could do about it that might start gradually getting the old me back.
I thank the hon. Lady for being so honest and open about this. She has just said that she did not know what was happening to her. Given that she is an intelligent, well-informed woman, does that not illustrate the importance of better education about this condition?
Absolutely. I must be honest: I was in a quandary about whether I was going to say anything today, but, like the hon. Lady, I thought, “If we in this place, with the power, influence and authority that we have, are too nervous to speak out, what does that say? “ We need to be leaders and champions, and I hope that we are all making a small contribution to that today.
I must say that I have had a very good experience with my GP. Two weeks ago, I did an online survey. A few days later, I had a phone consultation and I got my first HRT prescription last week—ironically, on the same day as the Backbench Business debate on World Menopause Awareness Month—but I know that millions of other women are nowhere near as lucky. Almost one in 10 women have to see their GP more than 10 times before they get proper help and advice. Two thirds of women suffering low mood or anxiety, like my hon. Friend the Member for Swansea East, are wrongly given antidepressants instead of HRT, often for many years. Around one in three women will end up having a hip fracture due to osteoporosis unless they take HRT, as was rightly mentioned by my hon. Friend the Member for Bradford South (Judith Cummins).
The objectives at the heart of this Bill—to raise awareness of the menopause, to make it easier for women to access HRT and to improve the education and training of health professionals—are absolutely essential. I hope when the Minister rises to speak, she will set out the steps her Government will take to make these goals a reality, because frankly, getting women the right diagnosis and the right treatment at the right time is a no-brainer. It is better for women and it is better for the taxpayer, because it will stop women having to have lots of unnecessary doctor’s appointments. It will stop them being put on the wrong medicines for years, leaving the real issue untreated and undiagnosed, and it will reduce the likelihood of women getting conditions such as osteoporosis when they do not need to, which can lead to much more serious and expensive NHS care, such as hip and other operations.
There is lots more I could say on that issue, but I want to use the remaining time I have to talk about the impact of menopause in the workplace, an issue rightly raised and championed by the right hon. Member for Romsey and Southampton North. There are currently more than 4.3 million working women aged 50 to 64. We are the fastest growing group in the UK workforce, often at the peak of our experience, with all the skills and talent that that brings, but 80% of women say that the menopause has affected their working lives.
Around 14 million days are lost at work every year due to menopause, and a quarter of menopausal women at work find the symptoms so debilitating that they are considering reducing their hours, changing their working patterns or leaving the workplace altogether. Women lose their income and careers, businesses lose their talent and the Treasury loses their taxes. Where on earth is the sense in that?
The fundamental problem is that the vast majority of women are too embarrassed, worried or frightened to speak out or discuss the issue with their bosses or line managers. I think the reason for that is the double whammy of sexism and ageism. If a quarter of men in their 50s were considering quitting work or reducing their hours, you can bet your bottom dollar that it would be at the top of the workplace agenda and a solution would pretty quickly be found. Women should not have to suffer in silence. We have to remove the ignorance and stigma about the menopause. It is not a women’s issue or a private matter, let alone a joking matter; it is a mainstream, no excuses, no ifs or buts workplace issue, and it must be addressed. Again, I hope when the Minister rises, she will set out the steps her Government intend to take on this vital issue.
In conclusion, Members will know that I have never been one for revolutions, but on this issue I make an exception.
I think every word that the hon. Lady has said will resonate with millions of people across the country for exactly the reasons she set out. It is powerful to hear from her about her personal experience, and I hope, especially after this day and going forward, that the whole House can co-operate and do much to help with this. I welcome her comments.
That is very kind of the right hon. Gentleman, and very much appreciated by me, my colleagues and women across the country. I am very proud to join my hon. Friend the Member for Swansea East, all the other women and men in the Chamber today, women outside this place and the organisations who are campaigning on the issue and calling for a menopause revolution. As she said on the radio this morning, let us make women wonderful again. Who on earth could disagree with that? Millions of women across the country deserve nothing less.
(2 years, 10 months ago)
General CommitteesIt is a pleasure to serve under your chairmanship, Mr Hosie. I appreciate your repeating the advice about mask wearing in the Committee, and I thank some Members on the Government side for following it.
As the Minister said, the main thing that the SI does is extend by six months the requirement to self-isolate for people who have been in contact with someone who has tested positive but who are not double-vaccinated, as well as for anyone who has tested positive. I absolutely accept and support the need to extend the powers, but they need to come alongside some other measures. First, we need to turbocharge the vaccination programme, particularly the booster jabs and jabs for children, and I shall make what I hope are some constructive suggestions about how the Government might go about doing that. We also need to deal with the fundamental, long-standing problems that we have had with supporting people to self-isolate during the pandemic—namely, the need to give proper financial support and sick pay in order to help people do the right thing, drawing on the lessons I have learned in my constituency over these issues, and to put in place the other measures that we need to get on top of the virus, to deal with the growing pressures on the NHS, and to keep children in school, parents in work and our economy open for business. Plan A, plan B or whatever we call it—we need a plan.
Our NHS has done a fantastic job so far on the vaccination programme. We know that being double-vaccinated and having a booster jab is absolutely essential for continuing the fight against the virus and stopping people having to self-isolate in the first place, which is what the regulations are about. However, I am really concerned that the roll-out is stalling, especially on the booster jabs and on children’s vaccinations. The Minister and I have talked about this issue before. In the city that I represent, only 40% of over-50s have so far had the booster jab. Nationally, 2 million people have not even been invited for the jab, which is really worrying for people who are immunocompromised and have serious conditions such as blood cancer and kidney problems. We also know from surveys done by charities that 55% to 60% of people with those conditions still have not been invited to get the third injection, which is important for people whose immune systems have been compromised.
The Minister will know that the Blood Cancer UK chief executive has called the booster programme a
“chaotic failure… poorly planned and badly implemented”,
and Kidney Care UK has said that there has been an “inexcusable exposure to risk”.
I hope the Minister will say more about what the Government are doing about that, and also offer some clarification, because there have been media reports that only two thirds of care home residents, who are the most vulnerable, have had their booster jab. I have been trying to discover the source of those reports to find out where the figures are from. Will the Minister say something about that? I am desperately concerned as a shadow social care Minister, so I hope she will let me know where the figures are from and where I might find them.
There is a similar situation with respect to vaccinating children, and the reason—
Order. Before the hon. Lady continues, I should say that I am giving her quite a bit of leeway because the Minister made some more general points towards the end of her remarks, but this is a narrow statutory instrument about restrictions and self-isolation. I am sure the hon. Lady will want to return to those subjects quite quickly.
I absolutely will. This statutory instrument on people having to self-isolate if they test positive would not be required if we were much more on top of the spread of infection, particularly among school-age children. The highest rates in our city are among that school-age group, and we have to get that vaccination programme going. Countries such as the United States finished their child immunisation programmes in July and European countries are motoring ahead.
Let me briefly make some practical suggestions on how we get those programmes back on track. First, there should be more flexibility in where vaccinations can be delivered. Pop-up centres, mosques, gurdwaras and community centres have made a big difference in places such as Leicester. There should be more support for local communication around the plan because we have to keep ramming home the message about how important vaccines are. Can we use venues other than schools for vaccinations for young people? That would really help in some areas. Will the Minister also consider the proposals made today by Opposition Members on exclusion zones around schools? We have discussed the matter before, and she knows there have been some horrible incidents of abuse and threats being made to teachers. Children should not have to go through that, so will she consider the proposals?
Let me turn to the issue of self-isolation, which is at the heart of the regulations. We know that self-isolation is essential to reducing the spread of this horrible virus, but we must do more to help people do the right thing. The Minister talked about the assistance being given to local authorities in supporting people who are self-isolating. My local authority has done incredible things in getting food boxes, food vouchers and social emotional support to people, but if they cannot afford to self-isolate because they are on a zero-hours contract, they do not qualify for sick pay, their boss does not pay enough or they are an unpaid carer—if an unpaid carer has to self-isolate, they cannot care for the person they love—the situation is impossible. Will she look at the evidence from the Office for National Statistics, which showed that care homes that gave full pay to people who had to self-isolate had lower infection rates? You do not have to be Einstein to realise that that is the key to making this work. It is not rocket science.
Let me conclude by thanking you, Mr Hosie, for allowing me some flexibility; I am very grateful. I want this to work. I want the vaccination—the booster programme—to work. I want self-isolation to work. The Government have to get to grips with this. We have infection rates rising and hospitals under pressure. Alongside mask wearing in enclosed spaces, including in this place, and working from home where possible, as well as other measures in the so-called plan B, which Opposition Members are calling for, the Government have to get to grips with plan A on vaccination, boosters, sick pay and ventilation. Plan B, plan A, whatever we call it, we have to get more on top of this, and I hope that the Minister understands why I wanted to make some practical proposals today.
(2 years, 10 months ago)
Commons ChamberI agree with my right hon. Friend. The forthcoming White Paper on adult social care reform, which we will publish before the end of the year, will set out our vision for the sector. It will cover issues that affect care users, including housing and innovation within our housing models, access to information and advice, and funding for the workforce. I am very happy to be meeting him on 4 November in his role as chair of the all-party parliamentary group on adult social care to ensure that his insight and all the work that he and the APPG have done in this area are carefully considered.
I welcome the hon. Lady to her post. I listened carefully to what she said about the Government’s recent announcement. However, is not the reality, as the Association of Directors of Adult Social Services says, that all the additional money announced is going to the NHS in the first three years and little, if any, will ever make it to social care; there is nothing to deal with the overwhelming workforce pressures and increased levels of need we are experiencing right here, right now; and we will not see a single extra minute of care and support or an improved quality of life for older and disabled people or family carers? On top of this, at £86,000 the cap on care costs will not even stop people having to sell their homes to pay for care, and the vast majority of people will be dead before they ever reach the cap because it does not cover the costs of accommodation or food. How is this a long-term solution to social care, and is the Chancellor finally going to fill these gaping omissions in his Budget and spending review next week?
I am sure the hon. Lady is in fact delighted that finally a Government have come forward with a plan for social care. In addition to that, this Government have spent an extra £34 billion this year in the NHS and we have raised the levy, which, as she says, will fund both the electives and the catch-up from the pandemic—we all know that many of our constituents need this—but there is also the £5.4 billion that is the biggest investment we have had in social care in this country. As things stand, one in seven adults over 65 face care costs of over £100,000 in their lifetime. Nobody will be forced to sell their home, as people will now have a very clear cap of £86,000 that will give families peace of mind that their assets will not be wiped out, and people can already take a deferred payment agreement so that their payments can be deducted from their estate after they die. Most people I have spoken to truly welcome this announcement and are absolutely convinced that this Government will introduce it.
(2 years, 11 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
It is a pleasure to serve under your chairmanship, Dame Angela. I welcome this timely and important debate, which has been secured by the hon. Member for Penistone and Stocksbridge (Miriam Cates).
My Labour and I colleagues strongly welcome the fact that children aged between 12 and 15 are now being offered their first dose of a covid vaccine, following advice from all four of the UK’s chief medical officers. That is something we have been calling for since June. It will have both direct and indirect health benefits for children, and it will help to keep them in school, which is vital after all the face-to-face learning they have missed out on and the impact that it could have on their long-term life chances. Vaccinating 12 to 15-year-olds will also help their families and the wider community by helping to keep infection rates down.
The latest figures show that there were 36,000 new infections in the last 24 hours. There are 7,847 people in hospital with covid-19. The average number of daily deaths over the last week has risen to a tragic 142. In my own city of Leicester, rates remain highest among 11 to 16-year-olds, with a considerable increase over the last month, so there is not a moment to waste.
We have been calling on the Government since the start of the summer to press ahead with a vaccination programme for children. Back in June, the shadow Minister for Schools, my hon. Friend the Member for Hove (Peter Kyle), argued that if covid vaccinations for children were found to be safe, as the Medicines and Healthcare Products Regulatory Agency clearly says they are, they should be rolled out over the summer holidays, before the beginning of the new academic year, to help to keep disruption in schools to a minimum.
In July, the shadow Health Secretary, my right hon. Friend the Member for Leicester South (Jonathan Ashworth), pressed the Health Secretary on why covid-19 vaccinations were being given to children in the United States, Canada, Israel, France, Austria, Spain and Hong Kong, but not here in the UK. I am sad to say that, at that stage, the Government failed to act. Although we are rightly proud of the amazing vaccination programme delivered by our NHS, the truth is that we are now being overtaken by other countries, and that is due in no small part to the vaccination of children.
France was one of the first to offer vaccines to children, back in June, and now 68% of children aged 12 to 18 have received a single dose. In Italy, the figure is 62% and in Spain 79%. Israel, the United States, Canada, Sweden, Poland and Switzerland have also raced ahead. While our Government spent months delaying on this vital issue, countries across the world acted, and they are now streets ahead of us in protecting children, their education and the wider community. It is vital that we catch up.
I thank the hon. Member for the important points that she is making. Does she believe that it is important to follow what other countries are doing, and to roll out the vaccine almost on the basis of an international competition, or is it more important to be safe? Does she not think that the fact that we were in advance of many other countries, and we broke the link between case rates and deaths early on, gives us more space to breathe and allows us to take longer to make finely balanced decisions about vaccinating children?
I am sure the hon. Lady is not suggesting that all those other countries have made decisions that are not based on the evidence, because to say so would be insulting to them. I believe that we should base our decisions on evidence and advice from the experts, and I will come on to say more about that. That is what has happened in other countries. I just wish we had done it earlier in this country.
The hon. Lady is absolutely right; I am not saying that other countries are not basing decisions on their own evidence. I am saying that the success of our programme was based on the JCVI’s advice and its particular method of offering vaccination based on individual medical benefit, which gave us an incredible advantage that could have allowed us to wait a further six or nine months to make this decision.
Prior to the hon. Lady responding, the hon. Member for Penistone and Stocksbridge must remember that she has to put questions.
Thank you, Dame Angela. I will come back to this point, because several hon. Members have talked about what the JCVI recommended, and I hope I will be able to set out a little more information about what it actually said later in the debate. Before I go on to talk about the evidence—
If the hon. Gentleman will forgive me, I want to make sure there is time for the Minister to respond and for the hon. Lady who secured this debate to speak again at the end. I want to make some important points about the evidence, but may I first say something about some deeply concerning and troubling incidents in my Leicester West constituency?
I am appalled that some of our headteachers have received threats via letter and on social media—including threats of legal action, and even death threats—accusing them of supposedly promoting illegal medical experimentation on children. That is disgraceful and completely unacceptable. As Jane Brown, the headteacher of New College in my constituency, says, we need to call this out. Schools are having a tough enough time as it is, without being bullied, too. I hope that when the Minister—I welcome her to her place—rises to speak, she will join me in condemning those threats and intimidation, and in once again making it clear that vaccination will be voluntary and no child will have the vaccine forced upon them. It is also vital to stress that although schools are the venue for the vaccination, the delivery of the programme will be done by the NHS and arrangements for consent are exactly the same as for all other vaccinations and medical procedures. I hope that the Minister will say what the Government are going to do to try to deal with the threats and intimidation, which I fear are growing.
I turn to why my Labour colleagues and I so strongly welcome the CMOs’ decision. As always, we are guided by the evidence and the advice from experts, which show that covid vaccines for children are safe and effective to use, with the benefits exceeding the risks on an individual basis. That is the view of the MHRA and the equivalent regulators in Europe, the USA and Canada. The JCVI agrees that the benefits of vaccinating 12 to 15-year-olds exceed the risks—in other words, that for people in this age group, it is better to be vaccinated than not.
In their decision to recommend the universal vaccination of 12 to 15-year-olds, the four CMOs took as read the JCVI and MHRA view that the benefits exceed the risks, and they then looked at the wider benefits. It is not true that the JCVI advice has been undermined, as I have heard several times in this debate. The JCVI says that
“it is not within its remit to incorporate in-depth considerations on wider societal impacts, including educational benefits. The government may wish to seek further views on the wider societal and educational impacts from the chief medical officers of the 4 nations, with representation from JCVI in these subsequent discussions.”
The JCVI recommended that wider societal impacts were looked at. Doing so is not undermining the JCVI’s decision; it is putting it into practice. The CMOs consulted with a wide range of organisations, including the Royal College of General Practitioners, the Royal College of Psychiatrists, the Royal College of Paediatrics and Child Health, the Academy of Medical Royal Colleges, the Faculty of Public Health and many others.
In making their decision, the CMOs said that the most important issue for 12 to 15-year-olds was the impact on education, which is vital in itself and one of the most important drivers of public health and mental health. The CMOs note that the
“impact has been especially great in areas of relative deprivation which have been particularly badly affected by COVID-19”.
That is, in areas of the country precisely like those that I represent in Leicester West, which were in lockdown far longer than any other part of the country. Children have lost out on an average of 115 days of class learning. That could have a huge impact on their later life chances, not to mention the knock-on impact on their ability to fulfil their potential and earn, and all the impact that has on the wider economy.
The CMOs rightly say that missing out on schooling has health ramifications, as educational attainment is a key determinant of a person’s health throughout their life. It has an impact on their wider social mobility and their future likelihood of developing co-morbidities. It can affect the likelihood of obesity, smoking and alcoholism, and it can affect their life expectancy. That is not to mention the widely recognised mental health benefits of education in both the long and the short term.
Children cannot afford to miss out on any more face-to-face learning, given the effects on their educational opportunities and the wider impact. As the CMOs said,
“the additional likely benefits of reducing educational disruption, and the consequent reduction in public health harm from educational disruption, on balance provide sufficient extra advantage in addition to the marginal advantage at an individual level identified by the JCVI”.
Recommending vaccination for this age group is not undermining the JCVI’s advice; it is putting it into practice. The Royal College of Paediatrics and Child Health agrees. It says:
“We believe that vaccination could benefit healthy children, irrespective of any direct health benefit, in enabling them to have less interruption to school attendance, to allow them to mix more freely with their friends”
and
“to help reduce the anxiety some children feel about COVID-19.”
We need to move swiftly on this. We need to strain every sinew to get children vaccinated, to help them, their families and the wider community. I hope that when the Minister rises to speak, she will say what more the Government are doing to encourage this and, critically, to make sure that the appalling threats to our schools are effectively dealt with. I look forward to her response.
(3 years, 1 month ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
It is a pleasure to serve under your chairmanship, Mr Hollobone, and I congratulate the right hon. Member for Kingston and Surbiton (Ed Davey) on securing the debate. His speaking about his personal experiences over many years was powerful; the House is often at its best when people share such experiences. I am sure many carers across the country will have heard what he said and been grateful to him for raising those points.
My main argument is that transforming support for families who care for elderly and disabled relatives must be at the heart of any plan for social care reform. This will be a critical test of whether the Prime Minister finally delivers on his promise to
“fix the crisis in social care”,
which he made two years ago on the steps of No. 10 Downing Street. That is vital for the 11.5 million unpaid family carers in England, who provide the vast majority of care and support in this country, but who are all too often relegated to the bottom of the list when it comes to attention, investment or reform.
This is vital, too, for the taxpayer, because if unpaid carers’ own physical and mental health suffer, or they can no longer provide support for the people they love, which means more people end up using more expensive NHS services, the cost to the public purse will be far greater. It is vital for our wider economy. If millions of people struggle to balance their work and caring responsibilities and end up having to give work up or reduce their hours because they cannot get the support they need, they will lose their income, employers will lose those people’s skills and the Treasury will lose taxes. We have never been able to afford that, let alone now, as we begin to emerge from the horrors of covid-19.
In this century of ageing, we cannot build a better future for our country without transforming social care, and unpaid family carers must be at the heart of our plans. Even before covid-19 struck, millions of family carers were struggling to look after the people they love most following a decade of cuts to local authority budgets. I will talk briefly about what I think are the two most important issues that have been raised with me in talking to carers across the country. I also want to thank Carers UK for organising so many events both before and during the pandemic, as well as in my constituency of Leicester West.
The first thing that many families say is what a battle it is to try to find your way around the system of the NHS and social care. My constituent David Towers is a self-employed carpenter. When his parents fell ill, he rang me to say, “Am I going wrong here, Liz? I don’t understand. I have to organise everything and tell my story time and again. I don’t know what my rights are. I don’t know any information. Is this how it is supposed to be?” I answered, no, that is not how it is supposed to be, but we do not have the changes in the system to pull things together.
The second issue is that of breaks. Even before the pandemic struck, almost half of family carers had not had a proper break from their caring for five years. The stress and the strain that that puts on people are huge. I vividly remember speaking to an unpaid family carer called Della during an event organised by Carers UK. Della was looking after her husband who had been very poorly. She told me she used to go for a half-hour swim in the mornings. That was all she wanted. It was her dream to have just half an hour. She was not asking for much—just that space and time for herself. Surely, in the 21st century, in one of the richest countries in the world, that is something we can deliver.
We know that the situation has got worse since the pandemic struck. People who were already family carers are doing even more hours, and an extra 4.5 million people have taken on new caring responsibilities. At one of my recent surgeries, an unpaid family carer said, “Liz, I am done. You cannot pour from an empty cup. I have nothing left to give.” She was looking after her mum, so she had no choice. For new carers, the pandemic has been hugely stressful. People have been very frightened of infecting the person they care about, and they have not known what support is out there. They get even fewer breaks, money is running out and they were almost completely absent from all the focus during the pandemic.
In Leicester, we have been working hard to address the problem. Over the past nine months, I have brought together our local hospital, ambulance service, primary care, the city council, mental health community services, voluntary groups such as CLASP—the Carers Centre and Age UK, and unpaid family carers. We have talked about how to improve the system. We are working together better to identify family carers, because most people do not consider themselves carers. They are a son, a daughter, a husband or a wife trying to look after the person they love. We want to make simple information more widely available and to have much better co-ordination of services.
We have a long way to go to make the system work, but I am very pleased that services such as East Midlands Ambulance Service have agreed to involve families in training paramedics so that paramedics can better identify carers, and that the city council has completely changed its language so that it does not talk about “carers”, because most people do not think they are a carer. However, services, voluntary organisations and families need a Government who back their efforts.
This Saturday, it will be two years since the Prime Minister stood on the steps of No. 10 Downing Street promising to
“fix the crisis in social care once and for all with a clear plan we have prepared to give every older person the dignity and security they deserve.”
Yet the plan is still nowhere to be seen. The papers are full of briefings that an announcement is imminent, but in reality—and as with so much else with the Government—all we get is chaos, confusion and broken promises.
First, we see that there will be a levy to fix the crisis in social care, then the levy is for the NHS backlog and to fix the crisis in social care. Now it is for the NHS backlog, social care and the NHS pay rise, and we hear from the papers that it is to be funded through an increase in national insurance contributions, which the former Chancellor, who is now Secretary of State for Health and Social Care, explicitly promised not to raise under a majority Conservative Government. The people who use care, the staff who deliver it and the unpaid family carers who rely on it deserve better, especially following the horrors of covid-19.
Will the Minister say when we are finally to see the Government’s plan? Are the Government considering raising NICs, in direct contradiction of the explicit promise they made before the last general election? Is the rise in NICs how they plan to pay for the NHS backlog and the NHS pay rise, leaving virtually nothing for social care? Does the Minister understand that while a cap on care costs is vital, that alone will not fix the crisis in social care? That is because it will do nothing for the third of social care users and half the social care budget represented by working-age adults with disabilities. It will do nothing for the 1.5 million elderly people who need help with getting up, getting washed and getting fed who cannot get that help. It will do nothing for the paid care workforce, and it will do nothing for unpaid family carers, who are the subject of today’s debate.
After a decade failing to transform social care, nothing less than a full plan will do. That is the test the Government will face when they finally come up with their plan, and that is the test of whether the Prime Minister fulfils the promise he made on the steps of No. 10 Downing Street. I look forward to the Minister’s response.
(3 years, 1 month ago)
Commons ChamberMy hon. Friend will be interested to know that the Department commissioned the Care Quality Commission to review the DNACPR decisions that were being made during the first wave of the pandemic. That review was published in March, and the Department then established a new ministerial oversight group that will be responsible for delivery and the required changes that were recommended in the review. We want to ensure adherence to the guidance throughout the system whenever DNACPR orders are used. The first meeting of this new group will take place on 8 June.
I welcome the Secretary of State to his new position. I wondered whether he might be able to clarify something for me. Five days ago, he told the Local Government Association conference that for social care reform,
“we may not be able to announce the whole plan…with all the details there”,
but that he hoped to
“set out…the general sense of direction”.
The general sense of direction! It is two years since the Prime Minister made a clear promise to fix the crisis in social care “once and for all”. Since then, more than 40,000 care home residents have died from covid-19 and 2 million elderly and disabled people have applied for care but had their request turned down. Millions more families and staff have been pushed to breaking point, so may I ask the Secretary of State: what is the plan? When will we see the plan? Will it provide the full details that he and the Minister for Care, the hon. Member for Faversham and Mid Kent (Helen Whately) have promised, or does keeping your word mean nothing to anyone in government anymore?
I think the hon. Lady may well have misunderstood what I said at the conference; I am not sure she listened to the whole session. It is worth repeating that the Government are absolutely committed to coming forward with a sustainable plan for adult social care and to bringing forward that plan to make sure that every person when they reach old age in our country can have the dignity they deserve. We will bring forward full proposals—a full plan—this year.
(3 years, 1 month ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
It is pleasure to serve under your chairmanship, Ms Cummins. I thank the 110,000 people who signed the petition, including 49 from my own constituency. I also thank the Motor Neurone Disease Association, the My Name’5 Doddie Foundation and MND Scotland for their tireless campaigning on this really important issue.
All hon. Members have spoken very powerfully and personally about the scale and impact of motor neurone disease, including on their constituents, friends and colleagues. While those who suffer from this disorder face a very fearful future at the moment, there is a real opportunity here and, if we seize it, we can transform people’s lives for the better. However, we have to deal with the significant and fundamental challenges in the existing research funding model, and we have to move beyond single centres and small collaborations to a large-scale, international, collaborative and co-ordinated approach. We know from experience that that is how fundamental change is achieved, and that is what we are calling for today.
I do not simply want to make the case that this funding should be provided and this model adopted for a moral reason—to stop appalling human suffering—although that is clear and unequivocal. Supporting this proposal should be a major part of how, after covid-19, we build back a better country that draws on our amazing nation’s world-class strengths in science and research, and that uses the potential of the NHS for clinical trials. Not only will doing so lead to the development of new drugs and treatments that will transform the lives of people with MND and their families and, potentially, those with dementia and other conditions, but it will help to create the high-quality, high-skilled jobs we need, so that we have an economy that is fit for the future.
This case is based on three areas. First, the economic case for funding investment in this sort of research is that if patients get earlier diagnosis and better treatment, and their condition is kept stable earlier on, that delivers better value for money. Treatments in the late stage of MND are up to nine times more expensive, so such investment will ultimately help to deliver better value for money. Secondly, we have real opportunities here for the UK research and pharmaceutical sector, because MND, as many hon. Members have said, is one of the fastest growing sectors in UK health and biomedical research. If that is the case, we should be trying to turbocharge that research and development and give it backing from the broad range of public, private and charitable research funding. That mixed economy approach is a huge strength of this country, and in MND we need to build on that. Thirdly, although everybody has rightly said that the debate is about having very specific funding for research into MND, we know that there may be very valuable results out of it for advances in the treatment of other degenerative disorders, such as dementia, which is a huge issue facing this country.
What now needs to happen? I do not need to repeat what hon. Members have said, but we need to bring this together into an MND research institute to implement rigorous clinical research programmes and sustainable MND trials programmes, linking up with the NHS, to provide infrastructure to accelerate treatments and bring them to market in a partnership between our research and industry, and support world-leading drug discoveries and development. If the Minister has not already, will she meet those involved in this sector from the medical research charities, universities and industries, and bring them together, alongside her colleagues from the Department for Business, Energy and Industrial Strategy and the Treasury—we need a cross-Government approach on this—to go through the proposal in detail and look at the value for money, as well as the patient outcomes that it would develop?
On the point that my hon. Friend the Member for York Central (Rachael Maskell) rightly made, will the Minister also meet the Association of Medical Research Charities, if she has not already? During the pandemic, all medical research charities have seen their income slashed, and we really need a plan to get that research going again. As my hon. Friend said, the Association of Medical Research Charities has proposed a life sciences charity partnership fund, so that all the research done and the skills, knowledge, people and expertise do not go to waste because of the pandemic, and so that we get this back on track.
Let me end where I began. If we want to build back a better country after this pandemic, we need to think and work differently rather than in the same old ways. We are world leading in science, research and the pharmaceutical sector. Alongside our NHS, with the potential that leaves for clinical trials, it is a no-brainer that this is an area that we should focus on. I ask the Minister to raise her eyes, sights and mind to think about all the potential that this could bring for sufferers and their families, and for the life sciences, in which Britain leads and should continue to lead in future.
(3 years, 1 month ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
It is a pleasure to serve under your chairmanship, Mr Efford. I congratulate the hon. Member for Strangford (Jim Shannon) on securing the debate on this important subject, which has, so far, had too little attention during the pandemic. This is a prescient debate because retirement communities, which are sometimes called “housing with care” or “extra care housing”, should be an important part of the Government’s plans to reform social care—when they finally see the light of day.
Retirement communities enable older people to continue living independently in their own home with properly regulated home care services and other community facilities available on site. We have heard some wonderful examples from Members’ constituencies. Around 75,000 people live in such communities in the UK. Around 40% of residents are under 80 years old; almost half are between 80 and 90; and 15% are over 90.
As hon. Members have said, the pandemic has clearly posed real challenges to retirement communities, the people who provide them and the people who live in them. Residents faced increased loneliness and isolation due to the measures being put in place to control the virus’ spread, and communal areas and non-essential services have been closed and postponed. Many providers, although not all, struggled to get PPE at the beginning. They faced considerable staff shortages, and staff and residents reported real anxiety and stress. One of the issues raised with me was the lack of specific guidance for housing with care providers. I was told that they had to come up with a lot of that themselves. That is an important point, as we all know that we will have to live with this virus for some time.
Overall, as we have heard from the hon. Member for Strangford and the right hon. Member for Staffordshire Moorlands (Karen Bradley), research has shown that people living in retirement communities have been remarkably protected, compared with people of a similar age in the rest of the country. A smaller proportion died, and most housing with care providers reported no or very few covid cases in each of the months between March and December last year. Interestingly, some of that is due to the design and layout of retirement communities, and the self-contained nature of individual homes. One of the things we will have to look at in the future is whether capital investment is needed in residential homes to change their layout to make people less susceptible to the virus.
Although it is clear from evidence and research that many retirement communities did very well in protecting residents from the immediate impact of the virus, there are real concerns about the long-term implications of covid-19 on residents. Providers of housing with care fear that some residents may avoid seeking support from the NHS in the future because they are still worried about catching the virus if they go into hospital. The providers are also worried about the longer-term impact on the cognitive functions of older residents if they are cut off from family and friends, despite all the efforts to use Zoom and other technology.
Providers are also worried about older residents’ physical abilities, because they have been less mobile during the pandemic. That is part of a much wider issue. We have rightly heard about the huge backlog in operations and treatment in cancer care or acute-based care in the NHS, but we also have to think about the backlog and need in the community. As Age Concern and others have reported, we need to think about the support we provide for older people whose mobility has been reduced. Lots of older people report that they are not able to walk as far or feel less steady on their feet. That can have an impact on falls.
There are also mental health needs. It is not just about not seeing and hugging people—the friends and family they love—but living with the stress of fearing that they will catch this virus and die. As we think about the NHS recovery plan, I urge the Minister—I am sure she has already done this—to think about not just acute services but services in the community.
The benefits for the health of people living in retirement communities have been known about for quite a while. We know that older people in housing with care have higher exercise levels and fewer falls, and are less likely overall to suffer from anxiety and depression. That benefits not just them as individuals but the rest of the health and care system. Research has shown that those living in retirement communities are less likely to go into hospital and have fewer GP and nurse visits than comparable age groups. Indeed, some evidence suggests that the overall use of the NHS is about 30% to 40% less. That is really important not just because the people living there have better health but because there is a better use of taxpayer money. The health benefits of retirement communities are just one of many reasons why Labour is calling for an expansion of housing with care options in the future as part of our wider proposals to transform social care.
We live in the century of ageing. We have all heard about how the number of people aged over 65 will increase by more than 40% by 2040 to over 16 million. Most people want to stay in their lifelong family home for as long as possible, but having more options between care at home and a care home must be part of our vision for social care and housing in future, so that someone can be in their own home, living independently, but draw down those services and support as and when they need them. As the right hon. Member for Staffordshire Moorlands rightly said, other countries are way more advanced than us. Only about 0.5% of over-65s live in housing with care developments in this country, compared with 5% or 6% in New Zealand, Australia and America.
If we are to expand the options, three things need to happen. First, we need a clearly defined category of housing with care in the planning system, as the Housing, Communities and Local Government Committee, and the sector itself, have recommended. It is currently much harder to build housing with care properties than care homes due to a lack of definition in the planning system. It was a real missed opportunity when the Government did not include that specific definition in their “Planning for the Future” White Paper and the legislation. They need to think again.
Secondly, we need—the sector itself is calling for this—sector-specific legislation and regulation for housing with care, to give consumers greater confidence, spelling out residents’ rights and the nature of the relationship with care providers. It is also crucial to give investors long-term confidence. The legislation that has been introduced in Australia and New Zealand has really underpinned the development in those countries, which is why we need something similar here.
Thirdly, the Government need to seriously look at how we ensure that housing with care is an option for all older people, regardless of their means or housing wealth—in other words, not just available to those who have a lot of equity in their existing lifelong family home. Currently, around two thirds of housing with care properties are available for affordable and social rent. We are doing well at the moment, but cuts to local authority social care budgets over the past 10 years, including funding for complex services through such things as Supporting People, have meant that the creation of new affordable extra care housing has slowed, and in some cases services have been withdrawn. It is not good for older people, or the taxpayer, if people end up having to use more advanced and expensive care, or end up relying on the NHS.
I hope the Minister will set out what plans the Government have to support this important sector as we continue to live with the virus, and crucially what plans they have to support its expansion, so that all people have the choice, as the right hon. Member for Staffordshire Moorlands said, to live the life that they choose in the home that they call home, which will include these options in future.